 The next item of business is topical questions, and I call a question number one, Monica Lennon. Thank you, Presiding Officer. To ask the Scottish Government what its response is to reports of NHS Lanarkshire moving to the highest risk level, black, and cancelling elective care, including some cancer procedures. Cabinet Secretary, Hamza Yousaf. Our health and care system is under extreme pressure due to the direct and indirect consequences of the pandemic. In NHS Lanarkshire, like all health boards, is experiencing significant pressures, including workforce challenges. We have deployed military assistants to support emergency care and to minimise delays for patients waiting for elective care and cancer treatment. The board is maximising theatre capacity and support from other boards to provide greater access for patients. We expect and are planning for this winter to be the most challenging in the history of the NHS to help to alleviate those pressures over and above the £300 million package of winter pressures. I also announced earlier today an additional £10 million to help patients to avoid a hospital stay wherever possible and to speed up the discharge for those in hospital, which of course will free up capacity for patient care. Monica Lennon. I thank the cabinet secretary for his response, and I thank the entire NHS Lanarkshire workforce for its exceptional efforts. Today, Cancer Research UK in Scotland has described a situation in NHS Lanarkshire as deeply concerning, warning us that for people with cancer, every day counts. Can the cabinet secretary confirm how many cancer procedures in Lanarkshire have been cancelled so far, and whether he expects more cancer procedures to be cancelled or delayed in the weeks ahead? Monica Lennon, I cannot confirm only because the number is so few that it would risk identifying the individuals, but I can say that those numbers that have been postponed are very, very small. I can also say that, having spoken to NHS Lanarkshire, it is working extremely, extremely hard in terms of the theatre allocation space to ensure that it can re-prioritise those procedures and treatments as quickly as possible. I know that Monica Lennon and I no doubt will have various exchanges on health over the course of this winter, but I am sure that she would agree and understand that decisions particularly around cancer—any patient care, particularly around cancer—are never taken lightly. I can also provide Monica Lennon written form if she wishes some of the updates on what we are doing to try to recover some of those cancer diagnostics that we know were affected because of the pause in screening that we took at the early days of the pandemic. Monica Lennon, I am pleased to hear that other theatres and boards have some capacity to assist NHS Lanarkshire. Is he aware of any other health board having to cancel cancer procedures and can he advise us whether any other health board in Scotland is warning that they too could declare a code black or to give it his correct term the highest risk level which is black? Decisions on what procedures and treatments can take place are taken by an individual health board level. I speak to health board chairs and chief execs on a very, very regular basis. They are all at a significant level of escalation. It is in my last conversation with chairs yesterday that there was no indication that anybody else—any other chair or chief exec or health board—was going to declare the highest level of escalation that Lanarkshire has done. However, that is of course a matter that is kept under review. In terms of Lanarkshire, I should say to Monica Lennon that the highest level of escalation—the black level of escalation—is kept under daily review and will not be in place for a moment longer than it has to be. I congratulate Monica Lennon for securing this question. There is no doubt that there are serious pressures across all aspects of our health and also our social care services, exacerbated by the pandemic. I thank NHS Lanarkshire staff for all they are doing in these difficult times to serve my constituents in airdrie and shot. Can the cabinet secretary outline again what additional support has been given to NHS Lanarkshire and, in particular, our GP services? As my constituents are reporting to me, some surgeries, most certainly not all, are referring patients directly to A&E, probably for understandable reasons, but that will be having an impact on the pressures being faced on the three accident emergency units and, by extension, the hospitals in Lanarkshire. Cabinet secretary, in the interests of brevity, it is probably easier for me to write to Neil Gray in relation to the additional funding that we have given NHS Lanarkshire that includes Covid and non-Covid funding, and the First Minister, in her statement, will outline some further funding that will go to health boards. In the interests of brevity, on that point, I will write to Neil Gray with the details. On the second point, which I think is incredibly important, we have given additional funding to GPEs and, indeed, in my winter package, I announced an additional £28 million for primary care services to which a portion of course will go to GPEs. I should say that I met the BMA earlier this week, and the BMA and I wrote jointly to every GP practice in the country. Of course, thanking them for their incredible service throughout the course of the pandemic, but saying in black and white that our expectation is with the change in guidance that we would expect to see an increase in face-to-face appointments, which will hopefully help in relation to the pressure that we are seeing at the front door of A&E departments. Since NHS Lanarkshire entered code black, I have received emails from constituents who have raised serious concerns over the advice that they receive from NHS 24. One constituent who emailed me was advised that no consultant was available, despite her family member having a repetitive cough, high temperature and sickness. The Scottish Government was aware of the critical level facing NHS Lanarkshire and other health boards, so why did it not address the staffing issues to ensure those who are phoning 111 do not have to present themselves at A&E? If there are any constituent cases that Ms Galco wishes to raise with me, she can do that, and I will contact the health board as well to see what more can be done for constituents in terms of her characterisation. I do not agree with it the fact that we requested military assistance as a demonstration of the fact of how seriously we took the situation in NHS Lanarkshire. I want to thank the armed forces for again responding in typically quick fashion to our request in NHS Lanarkshire's request. There are additional resources in the workforce that are going into NHS 24 with a new call centre opening up in Dundee, which will be helpful right across the entire country. Question 2, Evelyn Tweet. To ask the Scottish Government what work is being undertaken to address reports of recent increases in drink spiking and spiking by injection in our nightclubs and bals. Anyone who is found to spike a person will be arrested and may be prosecuted. Police Scotland are pursuing every single report of spiking and are in daily contact with my officials so that we can better understand the prevalence of this activity. A gold command has been established and led by an assistant chief constable and that command is reaching out to universities and to licensed premises. I would like to make it absolutely clear that no one case of this is one case or rather one case of this is one too many and the act of spiking is an absolutely despicable activity and these harmful behaviours cannot be tolerated in our society. So we are working with our partners to ensure the right balance of targeted and universal interventions and this is alongside our wider work to tackle misogynistic conduct and to ensure that men take responsibility for their behaviours. I thank the cabinet secretary for his answer. These reports are troubling and while I know that there is no simple solution to the abhorrent act of spiking I am determined to work with organisations such as Rape Crisis Scotland, Engender, the Scottish Licence Trade Association, Police Scotland and the cabinet secretary to see what more can be done. Will the cabinet secretary agree to meet with me to discuss this concerning issue? Cabinet secretary. Of course I'd be more than happy to meet with Evelyn Tweed and key partners to understand what more could be done to address this very concerning issue. The act of spiking, as I've said, is absolutely abhorrent and I'm absolutely committed to working with partners to tackle this unacceptable behaviour. Will the cabinet secretary join me in doing everything he can to encourage anyone who has been or has witnessed someone being spiked to contact the police as soon as possible so that they can investigate the instances as quickly as possible, especially since the evidence they need is time sensitive and also in highlighting that people can reach Rape Crisis Scotland for support via their helpline, which is 08088010302. Cabinet secretary. The member makes a very important point about the time sensitive nature of the evidence, which is crucial for the police. It is the case that Police Scotland is taking every report of spiking seriously. I would encourage anyone who has witnessed someone being spiked to report this to the police as soon as possible. As the member says, support is available from Rape Crisis Scotland for anyone who needs it and there will be no harm in repeating the number, which is 0808010302. The Scottish Government has a new policy of non-prosecution for drugs possession. Will the cabinet secretary back our calls for an exemption to this policy for those caught with drugs intended for the purpose of spiking? I think that the member misunderstands the fact that it's not a Scottish Government policy, it's a declared guidance from the Lord Advocate. That issue would be one for the Lord Advocate, although it takes on more the suggestion that it's made, and we'll give it further consideration. However, as to prosecutions, he should be aware that those decisions are for the Lord Advocate and the Lord Advocate alone. It is important that we all stand up against this spiking. On Wednesday, I'll be addressing a protest in St Andrew's University, and I want to report to them that this Parliament is taking action. There has been a successful testing strip promotion scheme already in place in Lincolnshire. It provides free test strips for all venues. Is that something that the Government would be prepared to roll out in Scotland as well as fund it? I think that it's a very constructive suggestion from Willie Rennie, and I would undertake to have a look at the particular initiative that he's mentioned, but I should say as well that both the police and other partners, so the nightclub industry and other partners, not least as he's mentioned in St Andrew's, are universities and colleges. A number of the incidents have been happening around students, bar, student pubs and universities, so I'm more than happy to look at both that suggestion and any others that have come forward. However, I would say that there's quite a number of actions being looked at just now by Police Scotland and within the Scottish Government. Like other members, I'm completely horrified by recent disclosures of spiking that have willfully and recklessly targeted young women. In my constituency, the Robert Gordon University has put the safety of students front and centre of its equally safe strategy. Can I ask the cabinet secretary what more can be done to support students within and beyond the campus to ensure that they are safe? I should say, as I've mentioned already, that the Gold Command group, which has been established and led by an assistant chief council in Police Scotland, is reaching out to universities and licensed premises. I hope that that would give some reassurance to the member. Members of the equally safe group in colleges and universities core leadership group, which includes University Scotland, NUS Scotland and the Scottish funding council, have been asked to share the important Police Scotland information on issues through their networks. One final point to make is that one thing that we cannot do is let this be the responsibility of those that are victims of the activity. That is largely, as we know, down to men. Four-fifths of the victims are women, and that is a bigger challenge for society and one where men have to take on responsibility for their actions. Although it might be well-intentioned to tell victims what they should do to avoid this, it really is our responsibility, along with the police, various institutions and the nightclub industry, to make sure that we can do what we can to make those premises safe for everyone concerned.