 Good morning. The first item of business today is general questions, and we start with question number 1 from Michelle Ballantyne. To ask the Scottish Government under what circumstances an NHS board would limit the amount of necessary operations that a patient requires due to budgetary concerns. No clinically necessary operations should be curtailed because of budgetary concerns funding for NHS borders will increase to £207.7 million, a 44.8 per cent increase in real terms since 2006-07, and in addition, NHS borders will receive £987,000 to target specialities such as ophthalmology and radiology as part of the first tranche of funding to reduce waiting times. I was contacted by a constituent who had been referred and been through the whole process and put on the waiting list for a double-hip operation. He was contacted and asked if he would be willing to go to the Golden Jubilee hospital to have his treatment, which he agreed to. I have to say that it was very good, very successful and he is very happy, except that they could only do one hip at a time, which we know clinically is the approach. When he went to his 12-week assessment and asked when will it be, I admit it, for the next hip, he was told, there is no plans to do your other hip, but you have to go back to the beginning and start again. The question is not about him, but he is concerned. When he tried to find out why NHS Lothian, as it was, had not approved having both hips done, which is the treatment that he was referred for, why that was done, the only whisper that he could get back was the only budget that was allocated for one hip. That raises some concerns. I wonder if the cabinet secretary could give some assurance for people who are facing that that that is not what they are going to experience. I am grateful to Ms Ballantyne. If I could ask her to email me with some of that detail, then I can look specifically at that issue. I am pleased that your constituent did have his first operation and that went well. It does not make sense to me what you have told me. It does not make sense and does not sound correct either, but if you would care to send me the detail, then I will happily look at that and, as soon as I have an answer, make sure that you have that answer too. Christine Grahame Thank you, Presiding Officer. To return to the first question that Michelle Ballantyne asked about budgetary considerations, does the cabinet secretary not agree with me that it is a bit rich for the Tories to top budgets? When their proposal to keep tax for the richest cut would have taken £500 million of our budget, that pays for an awful lot of medical staff. The Cabinet Secretary for Health and Sport has said that the health budget has been reduced by that amount. Unfortunately, the Parliament took a different view, but if that had been the case, that is a significant number of additional nurses, doctors, allied health professionals and so on, all of whom are absolutely critical to delivering the quality of healthcare that we are committed to as a Government and the reduction in waiting times that I have made very clear. I intend to see you over the next period. Colin Beattie To ask the Scottish Government what its position is on non-merically qualified practitioners, providing botox and other similar treatments. Joe FitzPatrick For the record, Presiding Officer, I should say that I have a family member who is a qualified beautician. We are considering a range of options for phase 2 of the regulation of independent clinics, which focuses on cosmetic procedures, including botox and derma fillers, which are provided by non-healthcare professionals within non-regulated sites principally, although not exclusively, and ministers by beauty therapists and hairdressers. Colin Beattie Given that sometimes desperate circumstances force people to undergo such risky treatment, can he outline what steps the Scottish Government is taking to improve access to such services on the NHS and to better regulate the industry? Joe FitzPatrick Botox and injections and other similar procedures are not provided by the NHS for cosmetic rather than medical reasons. In April 2015, the Scottish cosmetic intervention expert group published a report on regulation of independent healthcare, and its recommendations were accepted by ministers. Phase 1 of the regulations on 1 April 2016 focused on independent clinics run by a doctor, dentist, nurse, midwife and dental technician who administered cosmetic procedures such as derma fillers and lip enhancements, drugs such as botox, which is a prescribed drug and are required to be registered with Healthcare Improvement Scotland. Dean Lockhart To ask the Scottish Government when the feasibility study on junction improvements on the A84 near Blair Drum in Safari Park will be completed. Paul Wheelhouse Transport Scotland commissions its operating company to undertake a feasibility study and outline design for potential improvements at this location. That has taken longer than anticipated as new information in relation to historical accidents came to light during the final evaluation stage. This information is currently being reviewed to consider how that relates to the completion of the study. The Cabinet Secretary for Transport, Infrastructure and Connectivity, Michael Matheson, has asked Transport Scotland officials to ensure that they conclude this report at the earliest opportunity. Dean Lockhart I thank the minister for that response and update. Community representatives first met in December 2017 to discuss options to improve safety in the junction. The feasibility study was meant to appear in summer 2018 but has since faced the delays mentioned by the minister. Does the minister share my frustration about the delays to this report and the concerns that local communities have in relation to safety at that junction? Michael Matheson The first thing that I should say is that I absolutely recognise the strong community interest in this issue. I know this issue. Mr Lockhart has raised and Mr Crawford has also raised in the course of his work. I understand the frustration with any delay when such a key study for local community. As I said, the cabinet secretary is keen for the final report to be presented to him as early as the opportunity. I am sure that he will be keen to communicate that to Mr Lockhart. Bruce Crawford I am well and grateful for the information that the minister has provided to Dean Lockhart. I hope that the minister will understand that I am disappointed that it has taken a parliamentary question for this delay to emerge from Transport Scotland. I was informed in October last year that the study would be available in a number of weeks. I informed the community of that response. I hope that the minister will also understand that there will be considerable frustration within the Blair Drummond community about this delay because it has been gallantly campaigning on this issue of important road safety matter for a number of years. I absolutely accept the concern that Mr Crawford has raised. For what it is worth, I apologise to Mr Crawford for the delay in the production of the report. It is for the reasons that I have explained my answer to Mr Lockhart and the initial answer that additional accident data has been presented. I would hope that Mr Crawford would understand the need to make sure that we take that on board and make sure that the final report reflects that, if necessary. I am sorry that that was not communicated to Mr Crawford and that he has had to wait for this news today. I am sure that Mr Matheson is keen to make sure that all members who have an interest in this are communicated as soon as possible that the final report is produced. Mark Griffin To ask the Scottish Government whether it will provide an update on the progress of the neonatal expenses fund. Cabinet Secretary, Jeane Freeman. A mid-year evaluation report will be published by the end of this month, with the evaluation of the full year following the end of March being published in autumn 2019. To date, for the first four months of the scheme, £60,000 has been spent helping 435 families during that first four months. Mark Griffin I thank the cabinet secretary for that answer. The cabinet secretary will know of my interest in the operation of the fund because of my experience and the time that I daughter spent in a neonatal ward. I wonder if the cabinet secretary is able to say how the applications to the fund compare with the number of admissions to neonatal or special care wards and whether there is any variation across health boards and that perhaps there are some health boards that need an extra push to make sure that parents know of this fund. Cabinet secretary? Jeane Freeman I cannot give Mr Griffin that information at the moment. That will be part of that first full year evaluation, which will happen at the end of March. Although the publication of that is autumn 2019, I will look specifically at some of that data in advance of publication in order to be able to address those questions. I think that there are other areas where we are conscious that improvement is needed. We are looking in particular at the availability and the appropriateness of accommodation for parents in those circumstances and at the quality and the reach of the information that is being given to parents who should qualify for that kind of support across our health boards and may not be aware of it. We will look at some of that information in advance of the full year evaluation and I will make sure that Mr Griffin understands what we are looking at, the basis of it and takes, obviously, given his keen interest and indeed his pivotal role in that in the first place, to see if there is more that he thinks that we might do. Bob Doris To ask the Scottish Government how much pupil equity funding has been given to schools in the Glasgow, Maryhill and Springburn constituency. John Swinney Scoles in the Maryhill and Springburn constituency have been given almost £2.9 million of pupil equity funding in both 2017-18 and 2018-19. In the forthcoming financial year, schools in the constituency will receive over £2.9 million as part of more than £22.3 million allocated to schools across Glasgow. That funding is to be spent at the discretion of head teachers, and we will continue to the end of this Parliament as part of our commitment to invest £750 million to tackle the poverty-related attainment gap. Bob Doris I commend the imaginative use of PEF funds by Churnside primary school in Milton, in my constituency, where social enterprise, high, bogs, low work with students to improve physical literacy and build student confidence in a fun way. More important than that, cabinet secretary, teachers see improvements in children's readiness to learn. Can I ask how the Scottish Government seeks to disseminate examples of such good practice right across Scotland? I very much hope that the Scottish Government will consider continuing to extend PEF funds not just through the lifetime of this Parliament but by giving the success of my constituency and the benefit to my constituency into the next Parliament also. John Swinney Obviously, I would love to be in the position to continue the PEF funding into the next Parliament under the leadership of an SNP Government, but the public will, of course, make their choices on that question in 2021. I commend Churnside primary school in Mr Doris's constituency in the Milton area. We have seen a tremendous imagination deployed in the utilisation of pupil equity funding. The example that Mr Doris cites is a very good one about the way in which schools acknowledge that there are barriers to learning that some young people will face and those barriers have to be overcome before they can participate in effective learning. We look for solid and sound and evidenced examples of good practice and then share them widely through, for example, the regional improvement collaborative events that are happening this spring. I was at the first one on Tuesday in Murrayfield for the south-east collaborative event, and we will ensure that, on networks such as Glow and the national improvement hub, there is a wider understanding of the effective ways in which young people's performance can be enhanced as a consequence of the utilisation of pupil equity funding. Elaine Smith To ask the Scottish Government, in light of the recent comments by the chief medical officer for Scotland, what action is it taking to tackle gender inequality in the practice of medicine? Jeane Freeman The First Minister's National Advisory Council on Women and Girls will this month spotlight on women and girls' health, inviting individuals and communities to provide feedback on women and girls' health-related questions. A summary of that feedback is, I am sure that the member knows, will be published on their website and responses inform future reports to the First Minister. In addition, with the chief medical officer, I will look at how we can strategically, but at pace, focus on necessary improvements in tackling women's health across the NHS. Elaine Smith It is a very welcome answer from the cabinet secretary. I would certainly want to highlight this month's activities. Is she aware that women's inequality in medicine also includes thyroid patients whose diagnosis and treatment is deeply concerning? In recognition of that, her colleague the minister wrote to health boards advising them that the Government expects T3 to be prescribed where anendocrinologist has initiated it. What can the cabinet secretary do about NHS Tayside, who has blatantly ignored the Government's letter and only yesterday refused T3 to a patient, have said that T3 is non-formulary, which is wrong, as it is on the formulary, as I am sure the cabinet secretary knows, and have allowed a panel to overview a specialist clinician who has recognised that this woman needs this life-saving medicine? Elaine Smith I am grateful to the member for raising this with me. From what she has said, that sounds like a completely unacceptable response from NHS Tayside. I will ask the minister to pursue this with them with some urgency in order to resolve the matter so that they follow the guidelines and the clear views that we have expressed to them as other health boards are doing. Donald Cameron Question 7 has been withdrawn. Question 8, Donald Cameron. To ask the Scottish Government what action it is taking to improve ferry capacity in the Highlands and Islands region. Minister Paul Wheelhouse The Scottish Government remains committed to improving ferry capacity in both the Clyde and Hebrides ferry services network and on the Northern Isles ferry services network to support economic, social and cultural development of our island and remote mainland communities. The Government works closely with ferry operators to try and ensure demands on a ferry services network are met and, in line with the vessel replacement and deployment plan, a number of initiatives are being taken forward to ensure that future capacity challenges are met and that ferry services are further developed. Donald Cameron The minister may be aware of recent reports that distilleries on either have recently raised concerns about ferries that serve that island regarding the available space on vessels, not just for commercial reasons but also because of the vital tourism that the whisky industry brings. What action is the Scottish Government taking to improve the situation on island and elsewhere? Donald Cameron The introduction of road equivalent tariff has brought significant and continuing benefits to island. The member has indicated that there is increasing demand on the capacity that serves island. We are very much aware of that and forecast growth in 35 per cent growth in demand from the distilling sector alone will put additional pressure on the capacity that we have serving island. We have discussed with island ferry committee and Mr Russell as a local member. I am happy to discuss with Mr Cameron similar issues on how we try to respond to that demand long-term. Island is, of course, the next location that we are looking to provide a new vessel to serve. We have had discussions also with other ferry operas, including Western ferries, who have raised interest in that area, too. We are trying to do everything that we can to get all options to improve ferry capacity to serve the very important community in island and make sure that their economic aspirations can be met. Alasdair Allan The minister will be aware of the importance of upgrading Calmax booking system to allow better management of capacity, not least during times of disruption. Is the minister able to provide an update on progress in this area? I can. First, I want to recognise that this was a very important issue that was raised by a summit that was chaired by Dr Allan in the US. I am grateful to him for hosting that event last November. I can confirm that this is an area that I have requested that Transport Scotland officials prioritise in their discussions with Calmax. Indeed, proposals for the introduction of smart ticketing, as outlined by Calmax in its tender bid for the Clyde and Hebrides service, are currently under discussion with Transport Scotland. I recognise that an updated system could provide significant benefits in terms of communication with customers and also to help with different packaging of tickets to try and incentivise use of the services. Bill Kidd To ask the Scottish Government whether the Fair Food Transformation Fund will continue to provide funding to community-based organisations beyond the 2019 tranche. We are currently undergoing a review of the way in which organisations apply for funding through the Fair Food Transformation Fund and several other communities-related funds. As set out in the draft budget statement, we aim to launch a new single, a harmonised communities fund this year that will replace several current funding mechanisms, including the Fair Food Transformation Fund. The streamlined application process seeks to make things easier for third sector and community organisations. Something we know that sector would value and has requested. My officials have been keeping in contact with organisations throughout the review and with those who are interested in applying to the fund and will update them as soon as plans are finalised. Bill Kidd I thank the minister for that reply. Can the cabinet secretary outline what support might be given from the Scottish Government to food banks applying for funding who are looking to develop a wraparound food justice system, such as from Chapel Food Bank in my constituency, who also provide referrals to the health and social care services, including mental health and suicide prevention, local money advice services and interaction with local education services where appropriate? Bill Kidd I thank Mr Kidd for raising awareness of the incredible work that is going on in his constituency. Those are the sort of activities that the current Fair Food Fund seeks to support, because those are activities that allow access to foods in a dignified manner and provide that holistic person-centred support that is clearly the hallmark of Drum Chapel's approach. I can confirm that the new unified fund will also endeavour to support that innovative work, but what an absolute pity to have to deal with increasing levels of food insecurity that only now the UK Government has finally conceded down into its appalling roll-out of universal credit. The First Minister Thank you very much, and that concludes general questions. Before we move on to First Minister's questions, I invite members to join me in welcoming to our gallery Dr Hasam Zomlott, Palestinian head of mission to the UK.