Alex Neil MSP

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Alex Neil MSP

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  • Member for: Airdrie and Shotts
  • Region: Central Scotland
  • Party: Scottish National Party

Alex is a member of the following Committees:

Alex is a member of the following Cross-Party Groups:

Parliamentary Activities

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Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
The Cabinet Secretary for Health and Wellbeing (Alex Neil)

The Scottish Government takes seriously the publication of section 22 reports by the Auditor General for Scotland and continues to work directly with NHS Highland and NHS Orkney on the progress that both boards are making towards addressing the issues raised. At no point has patient safety been compromised. All NHS health boards, including NHS Highland and NHS Orkney, met all their 2013-14 financial targets, including breaking even on their revenue and capital budgets for the sixth consecutive year. In addition, the Auditor General has issued an unqualified audit opinion on all health board accounts.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

Although I agree that the number of vacancies has increased, a large part of that is because of the increase in the establishment figures for doctors and nurses.

I have on many occasions in the chamber mentioned recruitment challenges, particularly in remote, rural and island communities. I have implemented a series of initiatives, including recruiting overseas junior doctors and giving NHS Highland board £1.5 million to lead for Scotland on various rural medicine initiatives, particularly aimed at recruiting new people.

As the member will also know, in areas such as Ardnamurchan, which is part of the Highland board area, there is a particular problem in recruiting general practitioners. The issue is not money, because the money is available; rather, the issue in recruiting GPs and consultants in the rural hospitals is the effect on work-life balance of out-of-hours working, which is often a problem.

We are well aware of the challenges and we are rising to them in every possible way. However, the issue is not unique to Scotland; the problem is being faced by rural and island communities throughout the United Kingdom. Of course, the background to that is an overall shortage in many of the areas of expertise that the boards require.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

I have never heard as much rubbish in all my life—or not since I last listened to a Liberal Democrat speech.

As I said, the reality in rural and island communities is that there are major recruitment challenges. To ensure that the services that should be delivered are delivered safely, from time to time we recruit locum doctors. That is costly; in fact, the cost of the locum doctor is up to 180 per cent more than the cost of a full-time doctor.

We cannot get full-time doctors, because it is difficult to persuade enough of them to live in rural areas and for them to get the right work-life balance. Another problem is finding an occupation for their spouse. Indeed, it is very often the case that, when we think we have filled a position, it remains unfilled because the spouse cannot find a place to work. Therefore, to try to reduce such a complex challenge to silly point scoring does not do the member or the debate any good. Everyone knows the challenges that the health service north and south of the border faces in recruiting GPs, consultants and specialists. We must take an innovative approach and, in the longer term, we must increase substantially the number of doctors we train in the first place.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

There are two separate issues in that regard. There is the issue of brokerage, when a health board will not have enough money to meet the cost of the services that it needs to deliver during a year and, in line with the precedent set by previous Administrations, we make money available to the health board, with an agreed repayment plan. That is brokerage, which is completely separate from the NRAC arrangement.

We are bringing all boards up to their NRAC allocation, and by 2016-17 every health board, including NHS Highland, will be within 1 per cent of its NRAC allocation. This year, NHS Highland’s baseline funding is £525.2 million, which is an uplift of 3 per cent on the previous year. The funding includes a £2.5 million NRAC parity uplift. NHS Highland is getting its annual NRAC uplift, and by financial year 2016-17 it will be within 1 per cent of its NRAC allocation.

We have followed the precedent of the previous Administration in relation to the Scottish health allocation revenue equalisation—SHARE—and Arbuthnott formulas, in that, rather than cut some boards’ allocations and take other boards straight to their NRAC allocation, we are giving everyone an uplift, with a disproportionate uplift for boards that are below their NRAC allocation.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

Let me say to the member, first, that we are talking not about cuts but about efficiency savings. Efficiency savings north of the border are reinvested in their respective boards, unlike the situation south of the border. If NHS Highland makes efficiency savings, NHS Highland will be the beneficiary.

I accept that there are particular challenges in the NHS Highland area. Not just in Highland but throughout the north of Scotland there is a shortage of particular types of oncology consultant. There is a dire shortage of colorectal cancer consultants in the north of Scotland—indeed there is a shortage of such consultants across the United Kingdom. That is why some targets were not met when they should have been met. As the member knows, we are advertising vigorously to recruit people to positions, so that the board can manage its budget and, more important, achieve its outcomes and targets for the benefit of patients.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

As usual, Mr Findlay is misinformed. On bank staff, the national health service, like many other public services and private industry, operates on the basis of bringing in additional staff as and when required—it is very similar to the use of supply teachers in education—



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

No, not zero-hours contracts.

On average, across Scotland the proportion of nurse hours that are filled by bank nurses is of the order of 5 to 6 per cent. That is a reasonable figure in an organisation that performs more than a million operations and when more than 1.7 million people attend accident and emergency every year. The organisation employs a total of 157,000 people and it looks after its staff so that, when staff are off sick, there are still people on the wards doing the jobs that need to be done. That is what bank staff do.

Let me be frank. The agency budget has gone down dramatically since Mr Findlay’s party was in power. When Labour was in power, the agency budget was far higher than it is today. We have deliberately—under my predecessor and under me—had a policy of instructing NHS boards to substantially reduce the use of agency staff. The use of agency staff is a different issue from the use of bank staff. Very often, bank staff are nurses who are employed by the national health service.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
The Cabinet Secretary for Health and Wellbeing (Alex Neil)

I am grateful for the opportunity to update Parliament today on the important issue of Ebola.

Members will be aware that we responded to questions on the subject in the chamber earlier this year. Last week, I provided an update in writing to the Opposition health spokespeople and the Health and Sport Committee. However, the outbreak of Ebola in west Africa is an issue of such international importance that it is right and proper that I make a statement to provide reassurance on where Scotland stands.

The situation in west Africa is grave. What we are seeing is nothing short of a public health disaster in the affected countries. The World Health Organization publishes weekly updates on cases and deaths, and the latest information, from 25 October, is that there have been a total of 10,141 cases of Ebola with 4,922 deaths.

Historically, the disease has been confined to rural and more dispersed communities in central Africa, where it cannot easily take hold. However, the outbreak in west Africa is affecting urban communities with large, densely-packed populations—areas where people move about regularly—and countries that, to varying degrees, face challenges in health infrastructure and leadership. Once Ebola had a finger hold in that part of the continent earlier this year, it began to spread very rapidly, and there is no sign yet that the epidemic is under control.

We in Scotland will play our full part in contributing to the international effort, along with our friends in the rest of the United Kingdom and elsewhere, to bring Ebola under control in west Africa.

More than 50 professionals from the national health service in Scotland have offered to help, and some are already in situ in west Africa. Nevertheless, it is likely that more support will be needed. I wrote to NHS chief executives on 16 October to reiterate our support for volunteers and particularly to identify the need for more nurses and laboratory staff.

I extend my sincere thanks to the Scottish aid workers who are operating in the region and the many healthcare workers and other staff who have expressed a willingness to volunteer in west Africa. We need to know that all our volunteers who travel to west Africa will be safe, and I am reassured that robust arrangements are in place to ensure that in partnership with Health Protection Scotland. We know who is going to west Africa; we know that they will be trained well both before they go and when they arrive; we are confident that they will be looked after when they are there; and we know that they will be monitored and supported when they return.

In Scotland, we are lucky enough to have the resources and infrastructure, and the public health expertise and experience, to be in a good position to deal with any serious infectious diseases, but we are not complacent. There has been an increase in concern about Ebola in the past few weeks, prompted by the reports of transmissions of the disease to healthcare staff in Spain and the United States. However, it is important that we understand the reality of the risk—the fear of Ebola can be more infectious than the virus itself.

The risk of a case arriving in Scotland is very low. There are no direct flights to Scotland from the affected countries, and robust exit screening is now in place in the three affected countries. Entrance screening is in place at Heathrow and Gatwick as well as in key European hubs such as Paris and Brussels.

Even if a case does appear in Scotland or the UK, it is very unlikely that we will see any transmission of the virus. The disease can be caught only through blood and other body fluids, and affected individuals will be unwell and will have a fever and other symptoms that are not infectious but will lead them to healthcare well before they are likely to pass the virus to other people. Indeed, the greatest risk of Ebola is to healthcare workers, because they are more likely to come into contact with body fluids when treating a patient.

We must keep the risks in perspective, but we must also be ready to respond. That is why we have been working with the NHS to ensure that it is prepared and ready. My colleague Michael Matheson, the Minister for Public Health, has led that work since early summer, when he met experts from Health Protection Scotland. Following that, we established a viral haemorrhagic fevers national group, chaired by Health Protection Scotland, to ensure that all the necessary arrangements and contingency plans are in place. That group met for the first time in August, and last week it started to meet on a weekly basis.

Given the importance of ensuring that we can quickly identify and diagnose possible cases of Ebola, we have provided funding to NHS Lothian to introduce a national testing service for viral haemorrhagic fevers in Scotland. That service, which will be in place from 1 December, means that blood samples will no longer need to be sent to the south of England for testing and we will get the results more quickly.

We are also working closely with the infectious disease clinical community to ensure that the facilities and resources are in place to rapidly respond to any potential case. Our main infectious disease units in Glasgow and Lanarkshire in the west, Edinburgh in the east and Aberdeen in the north are ready to operate as regional centres of expertise, providing advice to other local hospitals or clinicians as needed and managing possible cases.

Our many other infectious disease specialists and wards around Scotland are also ready to respond if needed. I am confident that we are ready to safely manage any possible case, should one emerge. Indeed, we have already shown that our health boards, working with the Scottish Ambulance Service and others, can safely manage such types of infection. We safely managed a case of Crimean-Congo haemorrhagic fever in Glasgow in 2012. We have 14 isolation rooms available to manage patients with Ebola in the three regional infectious disease units in Scotland, and we have access to many more specialist facilities across the UK.

An important strand of our work is ensuring that everybody across the NHS in Scotland and any other relevant professionals have all the information that they need, and I am grateful to Health Protection Scotland and the other professionals involved for all the work that they have done in the past few months to update the many different pieces of guidance and technical advice in relation to Ebola. That information is all available on the Health Protection Scotland website, and I encourage all health professionals to ensure that they are familiar with the content, as it is very likely that any questions that they have will already have been answered.

I have already mentioned the entry screening that is in place in the UK and European hubs. I am in regular contact with my ministerial contacts in the rest of the UK in the Scotland Office and the Department of Health, and we will keep under review the need for any additional entry screening, including in Scotland. I am not yet convinced that that is proportionate or necessary, but I am ready to implement screening if our assessment changes.

We have to make sure that our international partners across Europe are keeping under review the question of screening and other public health measures. Discussions are already taking place at a European level on all those matters. In addition, we are working with the oil and gas industry to ensure that any of our oil and gas workers who come from or go to affected countries will have access to the same type and quality of monitoring arrangements that are in place for medical volunteers.

That international, joined-up approach is vital if we are to successfully tackle the outbreak. Across the world, countries need to pull together, and we in Scotland are keen to play our part.

Earlier this year, the Scottish Government donated £0.5 million to the World Health Organization’s Ebola response. That was not a one-off gesture. Last week, I announced an additional donation of £300,000-worth of medical equipment and supplies to west Africa from Scotland. That includes more than 100,000 respirators and 1 million disposable aprons, which will be distributed to charities that run clinics in Sierra Leone. I will continue to ensure that we offer every assistance that we can to the international effort. The best way for us to protect public health in Scotland is to support the efforts that are under way in west Africa.

I hope that I have provided sufficient reassurance that we are monitoring the situation closely and that we take the public health of Scotland very seriously. The Government’s resilience committee, SGoRR, which is chaired by the First Minister, has already met three times on this matter. That has provided an opportunity for us to engage with the Scottish experts and to ensure direct Government oversight of our preparedness.

We will continue to be vigilant and alert, and we will maintain our links with other parts of the UK to ensure a joined-up approach. The public should be reassured that the risk of Ebola coming to Scotland is still very low but, if it arrives here, the NHS is ready to respond and public health will be protected.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

My colleagues Michael Matheson and Humza Yousaf and I are planning to meet the NGOs involved and, indeed, other organisations whose support we require—although some of the organisations may not be NGOs working in Africa, they may nevertheless be able to help with the supply of material.

We have now received a request from Oxfam for additional support as well as the Department for International Development list, which we are working our way through. Therefore, we would be more than happy to meet and are planning to meet the NGOs and, indeed, others as well. This has to be a joint effort: it is not just about the Scottish Government but about all the people who can make a contribution.

In terms of the staff who have gone, the latest number that I have is that 59 staff have volunteered from Scotland. Of them, 31 are doctors, 17 are nurses, seven are paramedics, three are lab technicians and one person is of unknown skill but has nevertheless volunteered. Prior to assignment in west Africa, those healthcare workers participate in a three-stage training programme that includes five days of training in a facility in the UK and three days of training in the relevant facility on arrival in west Africa. In our case, that will be in Sierra Leone because part of the international agreement is that the UK Government will lead the effort internationally in Sierra Leone while, for example, the United States Government leads the international effort of other Governments in Liberia. We have obviously agreed with the UK Government that we will focus our efforts in support of it in Sierra Leone, which we are doing.

The arrangements for monitoring the staff’s healthcare in situ are under the auspices of Public Health England. It has been agreed by the four Administrations in the UK that Public Health England will be the lead agency for co-ordinating the arrangements and acting as a conduit for them. It has offered to register any aid worker from the UK, wherever they are based, as they are doing with NHS volunteers from across the UK. Public Health England registers the aid worker before they leave, tracks them when they are there, performs a risk assessment on their return as regards exposure to Ebola and sets up a monitoring system as well. I believe that a total of 12 beds have been allocated in Sierra Leone, which are ring fenced for any health worker working in the area—not just UK health workers—who happens to contract Ebola.

I am happy to send any member more details, because I have volumes of details on the arrangements. However, I can assure the chamber that, in terms of the training and looking after the health and wellbeing of the volunteers when they are in the countries concerned, we now have a very comprehensive package that is similar to that for the rest of the UK.



Meeting of the Parliament 28 October 2014 : Tuesday, October 28, 2014
Alex Neil

I am happy to reassure the member on a whole host of points. On her last question, we have agreed with the oil and gas sector that no worker who returns from one of these countries will go back on to an oil rig in less than 21 days of arriving in the country. The reason for the 21-day period is that that is, of course, the incubation period for Ebola.

Perhaps I can take the chamber very quickly through the processes that each oil worker coming from west Africa to the UK will go through. After all, that is where the main risk will be, and Aberdeen with its oil workers is the area within Scotland that is most likely to be affected.

First of all, there is a full exit screening process that people must go through before they leave any of the countries involved, and if they show any signs whatsoever of the disease, certain clinical judgments will be made. To date, all those suspected of having Ebola, with one exception, have not travelled and have been treated in the country. Again, that situation is very much under the control of the UK Government in agreement with the affected countries and as part of the practice that is being adopted internationally. It is therefore likely that for any oil worker suspected of having Ebola the clinical decision will be to deal with them in country and ensure that they get the same treatment there that they would get back at home in the UK. To date, only one case—who, as you will know, was not an oil worker, but a nurse—has come to London, and that chap successfully recovered from Ebola.

Once the oil worker goes through exit screening—and assuming that they have not been identified as having Ebola—they will get on their flight. The three main routes from west Africa into the UK are via Casablanca, Brussels and Paris, and the flights primarily go into Heathrow, with a small number going to Gatwick. A small number of individuals will also go through St Pancras station, where there is also a screening process. Anyone arriving at Heathrow, Gatwick or St Pancras who has been to one of those countries will go through an entry screening process and for those with a temperature—or, indeed, for those about whom there is any worry at all, even if they have recently arrived in the country—there is a tracking process in which they are followed up and monitored for up to 21 days.

On the subject of oil workers, we are working very closely with Oil & Gas UK and the industry, because two companies that operate in the North Sea also operate in the affected region. I should point out, however, that most of the oil in that region comes from Nigeria, which is now Ebola free, so the risks should be absolutely minimal. Just in case, however, we are working very closely with the oil companies, particularly the two that have installations in the North Sea and west Africa, and with NHS Grampian to ensure that all the facilities are in place in Aberdeen to absolutely minimise any chance of an oil worker or indeed anyone else contracting Ebola.

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S4M-11304.3 Michael Russell: Addressing the Attainment Gap in Scottish Schools—As an amendment to mo
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YesCarried

S4M-11304 Liz Smith: Addressing the Attainment Gap in Scottish Schools—That the Parliament believes
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YesCarried

S4M-11123 Joe FitzPatrick on behalf of the Parliamentary Bureau: Business Motion—That the Parliament
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YesCarried

S4M-11114.2 Kenny MacAskill: Policing—As an amendment to motion S4M-11114 in the name of Graeme Pear
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YesCarried

S4M-11114 Graeme Pearson: Policing—That the Parliament acknowledges that policing in Scotland contin
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YesCarried

S4M-11116.1.1 Patrick Harvie: Scotland’s Future—As an amendment to amendment S4M-11116.1 in the name
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YesCarried

S4M-11116.1 Nicola Sturgeon: Scotland’s Future—As an amendment to motion S4M-11116 in the name of Jo
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YesCarried

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Motion S4M-10156: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 28/05/2014 Show Full Motion >>
Motion S4M-09336: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 13/03/2014 Show Full Motion >>
Motion S4M-09334: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 13/03/2014 Show Full Motion >>
Motion S4M-09222: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 03/03/2014 Show Full Motion >>
Motion S4M-09115: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 21/02/2014 Show Full Motion >>
Motion S4M-08915: Alex Neil, Airdrie and Shotts, Scottish National Party, On Behalf of Parliamentary Bureau, Date Lodged: 31/01/2014 Show Full Motion >>
Motion S4M-08752.3: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 14/01/2014 Show Full Motion >>
Motion S4M-08674: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 19/12/2013 Show Full Motion >>
Motion S4M-08580: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 11/12/2013 Show Full Motion >>
Motion S4M-08389: Alex Neil, Airdrie and Shotts, Scottish National Party, Date Lodged: 22/11/2013 Show Full Motion >>
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Question S3W-20481: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 03/02/2009 Show Full Question >>
Question S3W-20180: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 26/01/2009 Show Full Question >>
Question S3W-20020: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 21/01/2009 Show Full Question >>
Question S3W-19295: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19297: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19296: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19293: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19294: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19298: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>
Question S3W-19299: Alex Neil, Central Scotland, Scottish National Party, Date Lodged: 22/12/2008 Show Full Question >>

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