 Welcome microphone friends! The first item of business this afternoon? is portfolio questions, the first portfolio rule affairs, land, reform and islands. I would invite members wishing to ask a supplementary question on when to press the request and speak button. I can advise the chamber that question 1 has been with drawen. Question 2 will be offey. To ask the Scottish Government how it will take account of the views of other farmers as part of its proposed agriculture possible? In the autumn of last year, in preparation for the agriculture bill, we ran a wide-ranging series of consultation events across Scotland to listen to the views of stakeholders, as well as members of the public too. This included a very well-attended event in air where Ayrshire farmers and producers shared their views on what needs to feature in the draft bill to ensure that the future adaptive framework can respond to any social, economic and environmental changes, challenges and opportunities. Willie Coffin, I thank the cabinet secretary for that answer. I recently met the Ayrshire farmers in Kilmarnock and heard from them some of their issues and hopes too for the new agriculture bill. One of the recurring concerns is that they feel powerless to influence the behaviour of the supermarkets when it comes to getting fair prices for their quality products. Does the cabinet secretary recognise this, and whilst we have no powers in this regard, would she be willing to meet the farmers at some point over the summer perhaps to listen to their concerns directly and hear their suggestions to take many of those matters forward? I am more than happy to do that and to engage with the member and to meet with him and any farmers in his constituency as well. I absolutely recognise the importance of the issues that he has raised, and those are issues that are repeatedly raised with me in this role and with different producers as I travel across Scotland. I will also be looking forward to that engagement that, of course, I will be having over the course of the next couple of days through the Royal Highland show, but I have also been in touch with supermarkets directly to have those conversations with them. The member will no doubt also be aware that this was an issue that was raised through the Food, Security and Supply task force that we had last year, and one of the recommendations that came out of the report from the work of that task force was about engaging with the competition markets authority and the groceries adjudicator to raise those exact issues. It is better for the climate to use homegrown produce than to fly in costly imports. It is better for the climate to use homegrown produce than to fly in costly imports with associated food miles emissions. Local food is high quality and produced to high environmental standards. Buying local also helps Ayrshire farmers to keep producing the first class food that they are renowned for. The Scottish Conservatives have a plan for this with our sustainable food future policy, so can I ask the cabinet secretary whether the agriculture bill will learn from our policy and help to encourage more people and organisations in Ayrshire to buy good local food? We are going to need briefer supplementaries and briefer answers, cabinet secretary. I will try to be as brief as possible, but I absolutely agree with the points that have been made by the member about the importance of supporting local producers having those short and resilient supply chains. That is why it is unfortunate that unfortunately her party in the UK Government has signed us up to trade deals that will see those imports, which are undercutting our industry in Scotland. A recent visit to Mineside Farm near Lockerby, the message from farmers was once again that the uncertainty over future mechanisms for funding was causing real concern. So can the cabinet secretary tell us when will the agriculture bill be published and will it provide the details of what is expected of farmers to secure that funding growing forward, because that uncertainty is a major concern? One point that I want to make first of all and that I have made previously in the chamber is that there absolutely will be no cliff edges when it comes to support for our farmers going forward. In terms of the agriculture bill and when that is introduced, in line with the commitments and what I have outlined already, we are aiming to introduce the bill this year. In terms of the clarity and future direction of support, I think that it is important to highlight to the member and to others across the chamber as well about our agriculture route map and the route map to reform that we have set out. It outlines within that when the key changes will be coming forward, when we will be providing more of that information and more of that detail there. I would encourage the member to take a look at that and we will be of course updating that as we go forward. To ask the Scottish Government whether it believes that Muirburn is a crucial tool for preventing and controlling wildfires. I am aware of the recent devastation caused by wildfires. The Rural Affairs Secretary recently admitted to the site at Daviet to thank forestry staff, firefighters and the local community for their work tackling wildfires. Sadly, the risk of wildfires in Scotland is likely to increase with climate change. We must continue to tackle that issue and encourage people to behave responsibly when outdoors. Muirburn can make a significant contribution to the prevention and control of wildfires. Our wildlife management and Muirburn Bill includes provisions that permit Muirburn to prevent and reduce the risk of wildfires. Professor Heinmeyer at University of York has been studying peatlands for two decades and has said that regarding the ways to prevent wildfires, you come across a lot of rewetting that will solve all the issues, but it is not guaranteed that you cannot get a wet bog everywhere because of different rainfall amounts. That is wishful thinking. If we want a down-to-earth thinking that will prevent wildfires, protect the peatland and the species that live in the area, Muirburn must be an important tool in our land management's inventory. I recognise that the minister said that there would be some. Can the minister confirm again that Muirburn Bill will not regulate this practice to a last resort, risking the damage of unnecessary wildfires? I agree with a lot of what Ross McCall has said, and I can confirm again if she would like me to, is that we recognise that licencing Muirburn will allow Muirburn to take place, particularly in areas where it is mitigating any risk in wildfire. I would also say that in terms of peatland, rewetting peatland is also a tool that we have in our box in controlling wildfires, not just from the point of view of sequestering the carbon that is out there as a result of climate change, but also providing areas in which the burning will be controlled because of wet peatland and re-established peatland. A number of supplementaries will need to be brief, as will the responses of 1st Karen Adam. Given the seriousness of recent wildfires and the impact that it has had on forestry staff and fire officers, shame on the Tories for turning that into a political football. The Scottish Government has already stated that there are situations where Muirburn is the best option. Minister, can you confirm that the Government is seeking only to ensure that Muirburn is used where appropriate and that the best practice is followed? I appreciate that there are a range of views on Muirburn. As I have said in my response to Ros McHall, I am completely aware that Muirburn can be a very positive tool when used appropriately, creating beneficial habitats for certain species and helping to reduce fuel loads and lower the risk of wildfires and control the risk of wildfires. The introduction of the Muirburn licensing through the Wildlife Management and Muirburn Bill will ensure that Muirburn is undertaken in a safe and environmentally sustainable manner with best practice in line with best practice. The licensing scheme will allow Muirburn for a number of purposes, including preventing or reducing the risk of wildfires. Upland management is so important, particularly for public health, but also for biodiversity. Can I ask the minister whether Asiolox will be approved in Scotland, which is an urgent matter? I do not think that that is relevant to Muirburn. I am going to move on to Murdo Fraser. I was going to ask a similar question, because dry bracken is clearly a major risk of wildfire, which is what the topic of the question is. When will the use of Asiolox to control bracken be granted in Scotland, given permission that was given in England last week? Is there anything that you can add to what you have already said? No, I have made my point on the licensing of Muirburn, so I think that I am going to stick with that. Like to ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the reported concerns of farmers about the potential impact on their productivity of beaver relocation. The reintroduction of beavers brings clear benefits for our biodiversity and ecosystems. I understand how the beavers can have adverse impacts on some types of agriculture. I have not met ministerial colleagues, including the cabinet secretary for rural affairs, to discuss the issue in particular. NatureScot has a range of mitigation measures to help to protect farms, and there are arrangements that allow lethal control of animals as a last resort. Additionally, all translocation projects must follow the process in the Scottish code for conservation translocations, including appropriate engagement with those most likely to be affected. Beaver numbers are expected to rise to 10,000 before the end of the decade, and that is clearly a concern for farmers who are justifiably worried of the threat of beavers post to their land, given the proven evidence that they will cause significant and costly agricultural damage should they appear in the wrong areas. Back in 2019, the then environment secretary, Roseanna Cunningham, gave an assurance that Scottish farming would not be compromised by beavers. What mitigation does the Government intend for those already affected by beaver damage, and how will relocated beavers be managed to avoid unnecessary damage to farmland in the areas that they are relocated to? Our Scottish beaver community was developed in partnership with stakeholders, including NFUS and the Scottish land and estates, and provided the direction of travel for beavers in Scotland. The Scottish code for conservation translocations sets out the consultation process for proposed projects and ensures those likely to be affected by proposals can have their views heard. NatureScot's beaver management scheme is integral to our work in managing beaver impacts. That scheme provides farmers and other land managers with mitigation advice, including proactive measures, to prevent beaver impacts. That includes tree protection, the installation of flow devices, and beaver exclusion ffensing, for example. While we consider lethal control to be a last resort, licensing approaches are available to prevent serious damage where mitigation cannot resolve the conflict. Thank you very much, Presiding Officer. I remind the Parliament of my interests in farming and fishing on spacefies. Beavers do not just damage crops, they damage trees, too. Given that the Government has missed its tree planting targets again last year, how does the Minister propose to protect the important young riparian trees that are being planted to mitigate the damages by beaver reintroductions, and please do not suggest wrapping them in plastic? As I have said in my previous answer, the beaver strategy that outlines the direction of travel for beavers in Scotland has been developed with more than 50 stakeholders working towards that, including the Scottish Wildlife Trust, as I have said, the NFUS and Scottish land and estates. They have collaborated on the strategy aims, and those are in line with our aims as a Government. The strategy also sets out the importance of community engagement in achieving those aims. Again, as I have previously set out, installation of protection for valuable trees is part of our beaver mitigation measures, and we will continue to support that going forward. Do you ask the Scottish Government what measures it has put in place to support new entrants into agriculture? The Scottish Government continued to invest in new entrants and the rural workforce. Since 2015, we have granted an excess of £28 million through a combination of national reserve, start-up and capital grant schemes. Additionally, we have provided 122 land opportunities through the farming opportunities for new entrants group, supported over 82 joint ventures through the Scottish land matching service, and continue to offer a range of general and bespoke consultancy advice to new entrants through the farm advisory service. We are also pleased to be supporting the machinery around pre-apprenticeship programme to really try to create opportunities for young people in rural areas. That is helpful, but the cabinet secretary is also aware of several corporate entities that are buying up large tracts of property for forestry in order to meet climate change targets. That means that substantial areas of land are being taken out of agricultural use at a time when we desperately need food security. That is something that is concerning constituents in Persia who have raised the matter with me on grounds that it also deters new entrants into agriculture. I ask the Scottish Government what it will do to address those concerns. I am aware of the concerns about that. Liz Smith raises a really important point, but one thing that I would say that we see coming through the forestry grant scheme is that about 80 per cent of applications through that are actually for smaller pieces of land and for small farms as well. I think that we do want to ensure that we are putting the right tree in the right place. I think that there is a strong role for forestry and agriculture. With agroforestry we have an integrating trees network as well, which I think shows how we can combine that because the member also raises a really critical point about our food security. As with a lot of the issues that we discussed here, it is about us ensuring that we get that balance right, but we want to continue to see that integrated land use because that does have benefits not just for our environment but for the farm businesses as well. A couple of brief supplementaries for St Emma Harper. It is regarding a new entrance. Can the cabinet secretary confirm how much funding the Scottish Government provided for new entrants and young farmers since 2015 and how that compares with other nations of the UK? Yes, the Scottish Government has invested considerable sums for new entrants over the course of a number of years. Since 2015, we have provided around just over £7 million worth of support via direct payments. We have provided around £12 million through the young farmers start-up grant as well as £600,000 for the new entrance start-up grant too. It is important to highlight that the forms of support for new entrants in England were discontinued. Given the contributions that new people in the sector can make to both food security and biodiversity loss, what additional measures can the Scottish Government take in terms of retention of new crofting and agriculture entrants? That is a really important point that the member has raised. We have committed in our manifesto to providing new entrance support. I think that it is important that we learn from the schemes that we have had in the past. I was also delighted to attend one of the farming opportunities for new entrants groups in Butte last week. It was really interesting there to hear from the farmers directly and the young farmers there about some of the challenges that they faced in terms of getting those opportunities. We want to make sure that we are breaking down those barriers and providing those opportunities. I am keen that we learn from schemes that we have had in the past as we look to develop new support. To ask the Scottish Government when the report by the task force to consider whether to extend wildlife crime investigation powers to the Scottish SPCA will be published. The report provided by the Scottish SPCA task force has been published in the Scottish Government website this morning. I want to thank the SPCA task force for conducting the review and producing that final report. I will provide a response to the recommendations in the report in due course. I thank the minister for her answer. On Monday I had the pleasure of joining the Scottish raptor study group to visit red kite nests. The conversation centred around the importance of red kite conservation. However, the team also highlighted incidents of raptor persecution, a practice that I am sure we will all condemn. The SSPCA is facing financial difficulties at present. I am concerned that, should the Scottish Government not fund this organisation correctly, officers will be stretched when trying to fulfil their duties. That would include investigation powers, should that be approved by Parliament. Therefore, can I ask the minister what reassurances she can provide to ensure that the SSPCA is fully supported? I thank Megan Gallacher for that question. I appreciate everything that she said about raptor persecution and agree with a novel lot of our concerns. The Scottish SPCA is not Government funded, but Scottish Government officials meet regularly with the SPCA to discuss current issues and provide support with appropriate. Like many charities, its income comes from other means, including membership fundraising and legacy donations among others. However, we will do everything in consultation with the SSPCA to make sure that it is supported to carry out any duties that we decide to give on to them. Barriers under existing powers mean that SSPCA inspectors who are already on the ground investigating animal abuse are prevented from seizing and securing evidence of wildlife-related crimes. Inspectors are further limited to enforcing powers only on living animals, where the hand is tied if a wild animal is found dead. Does the minister agree that that is inexcusable? Will she close the loopholes in future stages of the wildlife management bill? He will know that, when I was in the same committee as him in the last term, we heard exactly that kind of concern that has been raised about SSPCA officers not being able to act in certain situations that they found that there had been animal cruelty particularly in wildlife. The report that has been published today is to outline what the SSPCA says that it can do in this space. I am absolutely open to what we can do to support them to do that and to close those loopholes. To ask the Scottish Government whether it will introduce compulsory sales orders through its proposed land reform bill in the light of its plans to address the need for effective, efficient and fair land assembly powers for public bodies, as referred to in the Bute House agreement. We recognise the importance of effective, efficient and fair land assembly powers for public bodies and that is why we are committed to reviewing compulsory purchase order powers to ensure that they remain fit for purpose. We will be appointing an expert advisory panel over the course of this year and the start of next year to help inform the development of those options for reform. Work on the introduction of compulsory sales orders was undertaken in the last parliamentary term and it will be considered more fully in this one too. I thank the cabinet secretary for that answer. It is encouraging that the Scottish Government is investing £10 million in projects this year to tackle the waste of derelict lands such as decontamination and redevelopment of former military land at Cromarty Firth, so affordable homes can be built. Given the exceptional demand and skyrocketing prices for land right now, we must make better use of the 9,500 hectares of land that is currently benefiting neither people nor nature. Does the cabinet secretary agree that compulsory sales orders for councils to auction long-neglected land are a necessary tool to ensure that the people of Scotland are getting the most out of their land? In my initial response, I mentioned about the work that will be undertaken in compulsory purchase orders. Councils already have tools such as that that they are using to repurpose land for the benefit of local communities and for their local areas too. However, as I have highlighted, we are considering how the introduction of compulsory sales orders might enhance those tools that are already available to local authorities. Of course, we will continue to engage with our stakeholders in relation to that to really try and understand the need for those and to discuss the issues that I know were previously identified when that issue was initially raised during the parliamentary term. Ultimately, that has got to include how any introduction of compulsory sales orders might comply with the European Convention on Human Rights too. The Bute House agreement also refers to applying a public interest test to transfers of large-scale land holdings, but very few large land holdings are transferred in Scotland each year. Does the minister agree that waiting for all large land holdings to be transferred will take decades and that we need a public interest test that applies to existing holdings? The member will no doubt be aware that we had a consultation on our proposals for legislation coming forward, which we published the results of a couple of weeks ago. Of course, we are going to be considering the views that have been expressed through that legislation as we develop our proposals for a land reform bill, which we will be looking to introduce soon. Of course, I look forward to working with the member to discuss the issues that have arisen from that and, as we take forward the work on the bill, which we will look to address those issues. If the Scottish Government does take that forward, can the minister confirm whether, in the event of a compulsory sale, the new land owner will then be required to put it to the use that is designed for it, and if so, explain how that would be enforced? It is not possible for me to set that out at the moment, because, as I have said, while the issue was considered in the last parliamentary term, there is still a lot of work that would need to be undertaken in relation to that. Of course, we would look to bottom out some of the issues that the member has raised. To ask the Scottish Government whether it will provide an update on its plans to reform crofting law. Stated in the Scottish policy prospectus, I am committed to reform crofting law by 2026, subject to agreement by Parliament to support the future of crofting. The crofting bill group has made good progress since it was reinstated in May 2022 and has reached a consensus on many topics. The group is considering those issues raised by the bill group in the period of 2016 to 2018 and the issues that the Lost Society of Scotland singled out for a crofting law reform project in 2020 and issues identified by the crofting commission to make crofting regulations less onerous for crofters and the commission. I thank the minister for her answer. A range of issues daily highlight the need for crofting law reform, not least on the issue of common grazings. Given that crofting law expert Sir Crispin Agnew has noted that the current law is inadequate to manage subsidy regimes, environmental obligations and renewables opportunities, can the minister say whether legislation will deal with those issues in particular around common grazings? I thank Alice Allen for that question. As stated in the 2021 manifesto, work on crofting law reform will be undertaken during this parliamentary term and the decision on the timing of the bill is going to be taken by the cabinet in the context of setting the context of future legislative programmes in the normal way. Mr Allen will know that the crofting bill group is looking at that wide range of issues to inform that draft bill and we have asked him to look at how we can make crofting legislation more relevant to modern crofting and some of the things that he has mentioned are under consideration. One of the issues being considered by the crofting bill group is its work on crofting law reform, its common grazings. The minister concludes portfolio questions on rural affairs, land reform and islands. I will be brief paused before we move on to the next portfolio to allow the front benches to change. The next portfolio is NHS recovery, health and social care. I invite members wishing to ask a supplementary to press the request to speak buttons during the relevant question. We have a lot of interest in supplementaries. We are due to be sitting late this evening, there is no time in hand and therefore questions will need to be brief, as will responses. Question number one, Michael Marra. To ask the Scottish Government how many women are currently waiting for surgical treatment for pelvic organ prolapse. Thank you. Information on the number of patients waiting for pelvic organ prolapse surgery is not held centrally by the Scottish Government. However, we are keen to ensure that those patients are seen as soon as possible. We are currently working with the Centre for Sustainable Delivery to adopt a national approach to expediting weights for a range of urogynecology treatments. Work has started on this with the boards in question. Michael Marra. For that answer, she will perhaps recognise the cases that I have raised in the chamber, one most recently of an eight and a half year weight for one woman in my region. Since being contacted by another two women, one who has been waiting for 14 years for this surgery, so I am very keen to understand from the minister if she can commit to doing this, to understand whether this is a national situation or something that pertains just to Tayside. I think that if the minister could commit to looking into that, it would be appreciated. Thank the member for his question and would first of all like to apologise for women who have experienced this. I need to check with my officials to get back to you to see what information we hold, so I would absolutely commit to doing that with the member. To ask the Scottish Government what impact it anticipates that its recent 1.8 million investment will have on dermatology services. This new programme, which enables primary care teams to send digital images of a patient's skin conditioned to specialists, could potentially reduce demand for outpatient dermatology appointments by up to 50 per cent, with the potential for up to 90 per cent of referrals to include a digital image. This will lead to a better and quicker service for patients, allowing clinicians to see patients in the right place sooner. Modernising our services with innovations like this is absolutely vital for the future of our healthcare service, supporting patient care and reducing pressure on our workforce. I want to ask specifically about topical corticosteroid treatments for inflammatory skin conditions. Although those are generally safe and effective short-term, several of my constituents have experienced withdrawal reactions after using those creams over longer periods. They describe a range of symptoms, including burning or stinging, intense itching, peeling skin and skin redness that extends beyond the area that was originally treated, and the physical and emotional impact is devastating. Is the minister able to confirm whether reducing the number of patients using topical corticosteroids for prolonged periods will be a key area of focus while work to improve treatment pathways continues? I thank Stephanie Callaghan for that question and recognise the conditions and the impacts that the topical steroid creams can have, having spoken with people affected. That is why we are bringing in this new way of working. By capturing images in primary care and enabling triage in secondary care, the programme will support timely access for patients who need secondary care treatment, while providing quicker and more specific advice back to primary care to support patients who do not. Management within primary care may include reassurance for patients with lesions, guidance to monitor the condition or medical treatment, but I should note that prescribing decisions are ultimately matters for each clinician taking into account the individual circumstances and treatment needs of each patient. Question 3, Graham Simpson. To ask the Scottish Government what steps it is taking to support grass-roots sport in Scotland. Earlier this month, Sport Scotland announced record annual investment figures to support the delivery of sport and physical activity across 2023-24. Sport Scotland will invest up to 36.7 million of Scottish Government and national lottery funding into Scottish governing bodies of sports, local authorities and wider national partners. That includes significant investment in support for grass-roots sport in Scotland, supporting local authority partners in the delivery of community and school sport through community sport hubs and the act of schools network. Since April 2007, Sport Scotland has invested over £204 million to help sports clubs, community groups, local authorities, sports governing bodies and other organisations to deliver new and upgraded sporting facilities. I thank the minister for that answer. She will be aware that councils have been forced to close facilities due to SNP cuts. I am sure that she is also aware that the UK Government has invested in facilities across Scotland, including £0.5 million in Lanarkshire, through its multi-sport grass-roots facilities programme. Does the Scottish Government have a similar specific fund for grass-roots sport? We have discussed the issue a number of times in the chamber around investment in grass-roots sport. As I have set out, Sport Scotland is the body that we use to make those investments, and there has been a substantial increase this year in the investments that we are making. In terms of local government finance, we absolutely recognise the crucial role that councils and their employees play in communities across Scotland and the challenging financial circumstances that they face. Under the UK Government, we have suffered a decade of austerity, with average real terms cuts of more than 5 per cent equating to a loss of £18 billion. Despite that, local authority revenue funding is £2.2 billion, or 22.9 per cent higher in cash terms in the current financial year than it was in 2013-14. We have managed to protect local authority budgets. Local authorities are, of course, democratically elected bodies and make decisions for themselves on how they spend their money and where they focus their attention. As you would expect, central government cannot interfere in those decisions. I have a couple of supplementaries. They will need to be brief as will the responses. The minister mentioned active schools. Can the minister provide an update on the work being done with Sport Scotland to ensure that active schools programmes are free for all children and young people by the end of this Parliament? Thank you very much. We are working with Sport Scotland and local authorities to phase out any charging for active schools. That is a really important commitment of this Parliament. Sport Scotland continues to work with partners to address the very small number of cases where charging remains, taking a managed approach to avoid any unintended negative impact on the level of sport and physical activity provision in those communities. Sport Scotland's record annual investment into local authorities last year, which is £16.2 million, will support them with rising staff costs and allow them to drive and strengthen active schools' focus on inclusion. That focus is on supporting children who are living in poverty, those with additional support needs and care experience young people to participate. The school was an introduction to so many of us into sport. The minister can tell us around investment into school sport and maintaining the school estate open after four o'clock because sport is now becoming the bastion of the middle classes. Brian Whittle and I have engaged in this issue many times. I recognise that we share a passion for sport. I would argue that sport is not becoming a bastion of the middle classes. It has long been a bastion of the middle classes. In fact, our data illustrates that other than participation in football, which has equitable participation across the socioeconomic groups, almost all other sports favour the rich and the wealthy. That has long been a bastion. That is why the Government is so focused on tackling that inequality. That is why the Government is so focused on the active schools programme and taking any charges away from that to ensure that every child living in Scotland can have the opportunity to participate in sport and gain the benefits that that brings them, not just from the physical activity but from the involvement in sport. As Brian Whittle can testify, it brings you lifelong benefits. To ask the Scottish Government what plans it has for the future of community link practitioners working with GP practices, in particular in more deprived areas. We remain committed to community link workers in general practice, their role aligns strongly with the missions on equality and community in our policy perspectives, in which we also committed to increasing investment in general practice, serving disadvantaged areas. Funding for primary care improvement plans has been maintained at £170 million in this financial year, and each HSCP determines how to deliver link worker services within its own improvement plan. The Scottish Government recognises that there are service variations across Scotland, and we are currently reviewing local community link worker delivery to understand the benefits and challenges of those different approaches. I thank the cabinet secretary for that answer, and I take his point that the HSCPs are very much central to how that goes forward. I just wonder if he would agree with me that those link workers are very much valued by GP practices, especially in deprived areas in constituencies like mine. Would he agree that if the GP practices and everybody else had a bit more certainty over funding for the future, that would help the patients, the GP practices and the staff themselves? I agree with the points that have been raised by Mr Mason and the very specific issues that he has raised regarding his constituency. I appreciate that there has been a level of uncertainty for both staff and for patients who have benefited from the community link worker programme. I am pleased that we have been able to address that uncertainty, as the member made reference to. I recognise that the health and social care partnerships are working to try to address some of the contractual issues that are going forward. I also want to reassure the member that there is part of the review programme that we are taking forward. I want to look at how we can give that greater level of certainty going forward and a greater level of consistency in how committee link workers are going to be provided in general practices, particularly in our more deprived areas, in order to ensure that we are dealing with those issues in a consistent way, in a way that people have got assurance around their long-term vision in taking that forward. For a number of supplementaries, they will need to be brief as well as the responses for Sander Scolhoney. I agree that we need more community link workers and absolutely value them when I get to work with them in practice, but the SNP have broken their promise to GPs with a new contract. The £65 million cuts have broken the SNP promise to all primary care and the GP contract is and was detrimental in rural areas. I ask the cabinet secretary why primary care and GP should believe him now. We have a very strong commitment to primary care. One of the examples of our commitment to improving and investing in primary care has been the rapid expansion of the multi-discipline plenary team across primary care. Over 3,000 additional staff brought into that group, including the SNP, in order to expand capacity within our primary care setting, supporting GPs in their work, alongside the very important work that our community link workers carry out, which shows a very clear example of the Government's determination to expand and develop our primary care setting. Community link workers play a crucial role, particularly in community mental health support. The SNP's last programme for government committed to establishing 1,000 additional mental health roles to support wellbeing hubs for every GP practice and improve community mental health resilience. Summer recess begins next week. Will the Scottish Government have created those roles before the next programme for government, or is this yet another failed commitment by this Government? We are determined to do everything that we can to help to support the issues around mental health and the services that can help to support individuals who are experiencing mental health challenges. We have also had to look at prioritisation within our budget, given the budget cuts that we are experiencing as a result of the decisions that are being made by the UK Government, which have a direct impact on the Scottish Government's budget. However, I can assure the member that we will continue to look at what further support we can provide in the way of community mental health support to GP practices in order to make sure that we provide the support that the assistance is required. The cabinet secretary's presentation is not what people are facing in our communities. They have been waiting a long time to get through to a GP because the recruitment has failed completely. If you look at their number of whole-time equivalents, it has dropped for GPs. 23 practices have closed in the past three years. The multidisciplinary recruitment that he talks about has fallen well short of the targets, so I support like workers, but why does he not get real and understand that people are really suffering in accessing GPs? Community link workers are an important part of the primary care team, but I suspect that the member has chosen to ignore the over 3,000 additional staff that were recruited into primary care over the course of the last couple of years in order to expand and help to support capacity in that sector. I am notwithstanding that. I recognise that there are challenges within it. I am very aware of the challenges that some of our constituents have, which is why we are also looking to increase recruitment in general practice. However, there is a need for us to look at how we configure primary care to make sure that we refer people into the right services in the right way. That is about looking at the whole multidisciplinary team, GPs and the wider AHP team that can help to support patients with long-term conditions and to meet even short-term conditions as well. That is exactly what the Government has determined to do and that is the approach that we are taking forward. To ask the Scottish Government what discussions it has had with NHS boards in the Highlands and Islands region regarding whether there has been any impact in delivering their services as a result of recent ferry cancellations. The Scottish Government officials regularly meet all NHS boards, including Highlands and Islands, to discuss any challenges that impact their activity and to provide any necessary support. We have not been made aware of any specific impact on the nornails. However, I understand that some outpatient activity was postponed in the western islands where travel was resrupted for visiting consultants. Patients affected were reappointed at the next available opportunity. However, contingencies are in place for patients. For example, CalMac has a medical protocol that guarantees that islanders are booking on the ferry and a taxi should they have an urgent medical appointment to attend on the mainland. Northlink will provide assistance to any nornail residents with the issues that are travelling to the mainland for medical appointments. In addition to the problems that the cabinet secretary has mentioned, the Open Times recently reported that the hospital on Islay was unable to book patients on to ferries this month due to reduced deck space. In addition, the Scottish Ambulance Service has confirmed to me that the recent coron ferry breakdown resulted in longer travel times for patients and delays getting covered back to the area. What additional help can be provided to health boards to ensure patients can access vital health services in the event of problems with the ferry network? I recognise some of the challenges that have been experienced by patients who require to make use of ferries for the purposes of accessing services or coming on to the mainland for services. We would expect boards to look at alternative arrangements between put in place where that is feasible to do so. However, the critical aspect here is to get greater consistency and reliability within our ferry network in order to address those issues. Of course, a member will be well aware of the actions that have been taken forward in order to address those issues. However, we expect boards to make sure that, when it is necessary, alternative arrangements are put in place and if appointments have to be rearranged, that they are rearranged at as early a point as possible for patients. To ask the Scottish Government how many nursing and midwifery staff have left NHS in the last 12 months. 8,831 nursing and midwifery staff have left NHS in the last 12 months. That information can be found at Taurus, which is in the Scottish Government workforce planning programme. I thank the cabinet secretary for that answer. New statistics have revealed that the use of staff from agency in that period has increased dramatically, rising to the equivalent of 1,741 whole-time equivalent nursing and midwifery staff in 2022-23, which is up from 1,018 in 2021-22, a rise of more than 70 per cent. We know that nurses and midwives continue to leave the profession in their droves due to stress and burnout, and we know that, even though there is an astronomical use of agency, people cannot even access agency staff and wards are being left in very perilous positions. I know that the cabinet secretary has not been in post for that long, but he must accept that those are clear failures in workforce planning and he must take responsibility to address the issue. Therefore, I would ask when is he going to prioritise the work of the new nursing and midwifery task force to ensure that it delivers a plan for providing the nursing workforce that Scotland needs? Let me deal with the issue of the use of agency. His call for us to take action to address these issues. I am not sure whether the member is aware, but action has already been taken. New protocols were introduced at the beginning of this month, which plays restrictions on health boards in order to reduce the amount of agency that they are using and to switch more towards using bank staff. Action has been taken on that and applying restrictions to health boards on that. I hope that the member will find that new information helpful to him. On prioritising the task force—I am a little surprised at the tone of his question this matter—the task force has already met. I chair the task force, but due to her second meeting, the work of the task force is already progressing. What I will do is work with all those partners within the task force to make sure that we address the issues that it set up to address, and that includes looking at further pathways into profession. No doubt the member will welcome the work that has been taken forward today by the task force. Alice is by the Nothield Foundation, among others, makes clear that Brexit is a key factor in the NHS staffing crisis. This week marks seven years since Scotland voted overwhelmingly to remain in the EU, and yet we continue to feel the full force of the Tory's hard Brexit deal which Labour fully supports. Can the cabinet secretary provide an update on efforts to ensure the further recruitment of midwifes and allied health professionals from overseas in the face of those pressures? There is absolutely no doubt that Brexit has a significant impact on recruitment within a whole range of sectors, not just here in Scotland but across the UK and including within the health and social care setting. That is the reality, that is the facts on the ground, which is a challenge that we now have to address, despite the fact that the people of Scotland by a significant majority voted against leaving the EU. We have been taking action to try to help to increase our recruitment from overseas. Recently, we are able to exceed a target of recruiting an extra 750 nurses and HPs from overseas, exceeding that by some 800 offers being made to staff. We will continue to take further work forward by our health boards to look at how we can increase recruitment further in the years ahead. Cabinet secretary, some new fearsome facts from on the ground, because they have in fact shown that, for the first time, the number of staff leaving the health service has outstripped the number joining with 75,000 NHS staff being absent due to mental illness over the last five years. It is of little surprise that record numbers of NHS staff are leaving the health service. Recruiting more NHS staff will have little effect if existing staff are leaving at a higher rate. What steps is the cabinet secretary taking to ensure that our NHS staff are valued, respected and protected? Does he accept that this predecessor, Humza Yousaf, bears some responsibility for this accident? We have taken forward a range of work in order to continue to recruit into our NHS. As I mentioned, I am sure that the member will recognise the very significant challenges Brexit is now posing for the recruitment of staff, including the work that we are doing now. I do not know if the member wants to hear what I have to say, or if she is just going to sit from a certain position and shouting at me. For example, the point that was raised by Paul O'Kane on the nursing midwifery task force is very specific about how we can look at new routes into the healthcare professions, particularly into nursing through apprenticeships and in-as-you-learn programmes, all of which can open up the opportunity to do that. I would gently point out to the member that we have more NHS staff in our NHS since this Government has a committee office. Alongside that, we have more NHS staff per head of population in Scotland than we do have when we have what the Tories have in England, which demonstrates our commitment to invest in our staff and will continue to take that forward despite the very poor record that our own party has in England. To ask the Scottish Government what action it and NHS Scotland are taking to implement the recommendations of the CAS review into gender identity services for children and young people as they apply to Scotland. The NHS England commissioned CAS review only extends to clinical services as offered by NHS England. It is not considering or reviewing services as provided within NHS Scotland. How the NHS is structured, as the member will know, and how services are commissioned is different in England and Scotland. However, as we continue to state, the on-going findings of that review are being closely considered in the context of how such healthcare is best delivered here. That is alongside other national and international evidence in this field, as we collectively work to improve service delivery to children, young people and their families. Various work streams are under way to deliver that. Officials and senior clinicians from both Scottish Government and NHS Scotland have met with Dr Cas twice to date to share information on improvement work in Scotland. Expected outputs of that review are associated with timelines and opportunities for shared learnings. I thank the minister for her response. As she will know, the CAS review highlighted the significant uncertainty surrounding the use of hormone treatments for children and adolescents with gender dysphoria, reflecting the views and concerns of many in the medical profession. On 9 June, NHS England announced that puberty blockers would not be commissioned for children and young people in those categories except as part of clinical research. Will the NHS in Scotland, in light of the very serious concerns that have been highlighted, also now be taking this step? If so, when? If not, why not? I thank the member for his questions. Decisions on the type of treatment to prescribe are for clinicians to make in consultation with their patient following individualised assessment, which could be subject to regular monitoring. The Scottish Government remains proactive in our commitment to help to deliver high-quality healthcare to children and young people in the sensitive field of medicine. Consistent with that, preliminary discussions between Scottish Government and NHS England officials are on-going as to what form of engagement may be possible and appropriate with NHS England's recent announcement and not yet in place clinical research study on puberty blockers. However, the current situation in Scotland remains unchanged. To ask the Scottish Government what analysis it has undertaken of the results of the NHS Scotland's significant adverse event reviews. The national adverse events notification scheme has been in place since 1 January 2020, following the then Cabinet Secretary for Health and Sports instruction to Healthcare Improvement Scotland to collect significant adverse event review data for category 1 adverse events from health boards. Health boards are responsible for delivering safe, effective and person-centred care at a local level, and that includes inputting into the national notification system. The Scottish Government does not routinely request this data from Healthcare Improvement Scotland, however we are working closely with Healthcare Improvement Scotland to ensure that those processes are implemented and improved in line with national policies and the framework. I thank the cabinet secretary for that answer. According to NHS Greater Glasgow and Clyde's own publication of 2020-21, the most common serr contributory factor was guidance not being followed. Last year, my constituent, McIvan, who is in the chamber today, sadly lost her grandfather, John, while he was receiving NHS care. The serr carried out confirmed that guidance had not been followed, which may have caused or contributed to his death. How can the Government and NHS Scotland effectively learn from adverse events to improve the guidance provided and allow best practice to be actively promoted across Scotland? I am sorry to hear the loss of Ms McIvan's grandfather, John, and I believe that she may have written to me separately on this particular matter. Safety is at the heart of everything that we do. The national adverse events framework has been developed by Healthcare Improvement Scotland in collaboration with NHS boards. Its purpose is to provide an overarching framework and is developed from using best practice to support care providers to effectively manage what are adverse events when they occur. I can assure the member that this framework is currently being reviewed by Healthcare Improvement Scotland and we are looking at what further work can be taken forward to ensure that we continue to learn from significant adverse events. We are taking forward a piece of work on what is called the community of practice, which has been trialled with NHS boards as part of the adverse events framework to ensure that we are maximising the learning that can come from these instances.