Meeting of the Parliament

Meeting date: Thursday, October 31, 2019

Official Report 1035KB pdf

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First Minister’s Question Time

As this is our first First Minister’s question time since recess, I would like to announce to the chamber that David McGill has been appointed as the Parliament’s new clerk and chief executive. David’s appointment follows an open competition and selection process involving all the Scottish Parliamentary Corporate Body members, alongside a senior representative from the National Assembly for Wales. Many of you will already know David as one of our assistant chief executives and I am sure that you will share the selection panel’s view that he will be an outstanding successor to Sir Paul Grice, leading the Parliament through the next few years. [Applause.]

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Independence Referendum

Yesterday, Jeremy Corbyn again declared that he is prepared to grant an independence referendum if he becomes Prime Minister. Given that they are here and that they have given in, would the First Minister like to thank Labour Party members personally?

Actually, the pact that I am most interested in this morning is the one that I read about in The Times between Labour and the Tories to help the Liberal Democrats in Ian Blackford’s seat. I am confident that Ian Blackford will see that off without too much difficulty.

I have to say that I think that United Kingdom Labour’s position on an independence referendum is a lot more democratic than that of Scottish Labour, which opposes independence and does not want another referendum. UK Labour recognises that it is down to the people of Scotland to decide that question. That is a basic issue of democracy.

Conversely, the position of the Tories, Scottish Labour and the Liberal Democrats appears to be to say to the Scottish people at the very start of an election campaign: “We don’t care how you vote. We’re going to ignore you, however you vote.” Why would anybody vote for such a contemptuous attitude?

The choice for the people of Scotland at this election is clear: it is Brexit—and a bad Brexit at that—with the Tories, or it is stopping Brexit with the Scottish National Party and putting the right to choose Scotland’s future and the right to choose independence into the hands of the people of Scotland.

Both the First Minister and I can agree that there is nothing that anyone can do to help the Liberal Democrats and that it will take more than a spoonful of sugar to swallow anything that their leader is offering. However, just two weeks ago at her party conference, the First Minister said that Jeremy Corbyn should not even pick up the phone if he was not prepared to agree to a referendum. Now that Mr Corbyn has made plain that he is, indeed, happy to concede to having that referendum, is it not obvious to everyone that the First Minister would roll out the red carpet herself in Downing Street so that Corbyn could walk into number 10?

What has become obvious to Scotland over the past few years is that, whether it is the Tories or Labour, the Westminster system is broken. That is why the people of Scotland need the choice of independence, and only the Scottish National Party will give the people of Scotland the choice over our own future. I do not want Boris Johnson to be determining the future of Scotland. I want that choice to be the people’s choice, and that is what they will get if they vote SNP.

I am a little puzzled that the First Minister is being so coy because, like me, she does not rate Mr Corbyn. Only last month she said that she was “no fan”. Worse, she has described him as “pitifully ineffective”, “unreliable” and “unelectable.” Perhaps she can enlighten the chamber—what is it that first attracted her to the independence referendum-supporting Jeremy Corbyn?

I do not know whether this will come as a shock to anybody—I am not sure that I am giving the newspapers or broadcasters any great exclusive—but I announce that I think that the leaders of the main two United Kingdom parties are completely and utterly useless. I do not think that they have got Scotland’s interests at heart. That is one of the many reasons why I think that Scotland needs to be independent. That would allow us to be a country at the top table in Europe, to invest Scotland’s wealth in our public services and to lift children out of poverty.

I am determined to give the people of Scotland the choice to be independent. On 12 December, if voters want to stop Brexit and take charge of the future of Scotland, they should vote SNP. That is the clear and unequivocal message from my party at this election.

This Saturday, the First Minister will start her election campaign the only way she knows how: by ignoring the priorities of most people in Scotland, refusing to listen to the majority and instead addressing yet another SNP independence rally in Glasgow.

The choice is clear: either Scotland moves forward together and puts the constitutional division of the past few years behind us, or we choose more division, more uncertainty and the prospect of a Corbyn-Sturgeon alliance dividing us all over again. A vote for the Scottish Conservatives is a vote to end the division, get Brexit sorted and say no to another independence referendum. Is that not the choice for the people of Scotland?

I can understand why Jackson Carlaw is feeling a little bit irate. His party has so much—or, perhaps, so little—confidence in him that it has put the picture of a back bencher on its election letters instead of his picture. I understand why he is feeling a little bit sensitive this morning. [Interruption.] I think that I might have touched a raw nerve there.

I have got news for Jackson Carlaw. Yesterday, I started my election campaign in Stirling, because that is one of my constituencies where my party plans to oust a Tory MP. I am looking forward immensely to the election, because everybody across Scotland knows that the only way to end the Tory-created Brexit division is to stop Brexit in its tracks. On 12 December, people will have the choice to vote SNP, to stop Brexit and to give the people of Scotland the right to choose a better, brighter future as an independent country.

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National Health Service (Workforce)

In 2013, the Scottish Government published its 2020 workforce vision for the national health service. It undertook to make the health service

“a great place to work”.

Does the First Minister believe that her Government is keeping its commitment to all NHS staff?

The NHS is an incredibly difficult place for staff to work in. I think that that has always been the case, but, as we see demand in our NHS rising, it is even more the case now. I was struck by Audit Scotland’s report last week, which recognises that the NHS is seeing and treating more patients than ever before. I have nothing but respect and gratitude for everyone who works in our NHS. This Government stands by them and will continue to support them.

Under this Government, staffing levels in our NHS are up by more than 13,000 whole-time equivalent staff, which is a more than 10 per cent increase. We pay many of our NHS staff better than they are paid elsewhere in the United Kingdom. We will continue to support our NHS staff. Every one of them has the right to expect nothing less.

The First Minister mentioned last week’s Audit Scotland report. Last week, when publishing her report, the Auditor General said:

“The NHS in Scotland is running too hot, with intense pressure on staff”.

Over the past year, professional bodies and trade unions have raised concerns that the NHS workforce is under growing pressure and faces staff burn-out. In view of that, Scottish Labour made freedom of information requests, which revealed that last year in Scotland, 3.5 million working hours in the NHS were lost to sickness absence—caused by stress or anxiety or for mental health-related reasons. That is a quarter of all sickness hours lost and a rise of more than 50 per cent in four years. Those workers are being let down. What does the First Minister intend to do about it?

We will continue to support those who work in the NHS. Sickness absence levels in the NHS fluctuate, but they have remained relatively stable in recent years. Of course, as I said in my original answer, more people work in our NHS now than did when this Government took office. The Audit Scotland report also confirmed that, over the past 10 years, the health budget has increased in real terms by 6 per cent . Most of that increase has been in the past five years. In tough times for our NHS—in that regard, the Scottish NHS is not unique—we will continue to support our front-line staff in the essential work that they do.

I mentioned the increase in the NHS budget. Let us cast our minds back to the most recent Scottish election and Labour’s spending proposal for the NHS. If Labour had been elected and had implemented that proposal, our NHS, in this financial year, would be £758 million worse off than it is now. That is the equivalent of 19,000 nurses. This Government will stand by our NHS staff. I am not sure that Labour would have done the same.

The sickness absence figures that I mentioned do not look like the Government standing by NHS staff. NHS workers are the heart of our health service and they are being badly let down. In the end, patients suffer, too: the treatment time guarantee has been breached more than 230,000 times; last year, delayed discharges from hospital were up by 6 per cent; and 20,000 more people were left waiting in accident and emergency for more than four hours—that is up by 17 per cent.

The Scottish National Party has been running Scotland’s health service for more than 12 years. Today, the human cost for patients and NHS staff is plain to see.

That health crisis has blown up on the First Minister’s watch. It is her responsibility. What does Scotland’s national health service need: another decade of the cuts that were prescribed by her blueprint for independence or the £70 billion of investment in our public services that would result from the election of a Labour Government?

Under this Government, there have been real-terms increases in NHS spending. As I said a couple of answers ago, there has been a rise in the number of people who work in our national health service. As in many countries, demand on the Scottish health service is rising. However, as last week’s Audit Scotland report said, in 2018-19, the number of people who were seen on time increased for

“seven of the eight standards”.

That means that the waiting times targets were met for more people in 2018-19 than in 2017-18. Therefore, the work that we are doing is leading to the improvements that we need to see in our national health service.

I go back to the point that I made earlier. Richard Leonard talks about the election of a Labour Government. In a few weeks, people in Scotland will have the opportunity to choose how to vote, and I look forward to them making that choice. However, if Scotland had elected a Labour Government in 2016, the fact of the matter is—it is a fact, because Richard Leonard cannot deny it—that this year, the NHS would have been more than £750 million poorer and would not have been able to afford to employ thousands of nurses. That is what would have happened if a Labour Government had been elected. It is only because there is an SNP Government in Scotland today that the NHS in Scotland is the best performing anywhere in the UK.

We have a few constituency supplementaries, the first of which is from Liz Smith.

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NHS Tayside (Breast Cancer Treatment)

What action is the First Minister’s Government taking to address the concerns of NHS Tayside’s oncology team regarding the recent controversy over breast cancer treatments? Will assurances be provided to each patient involved that they will receive full and accurate information about their treatment?

Assurances have already been provided to patients. Any patient who remains concerned should, of course, contact their general practitioner or NHS Tayside directly. We want to make it absolutely clear that patients should be given the assurance and the confidence that they require.

As far as clinicians are concerned, it is important that guidance, guidelines and recommendations are followed when it comes to the prescribing of any drugs and medication. It is vital that that is the case. The national health service will continue to discuss the matter carefully with clinicians. In fact, I understand that the medical director of NHS Tayside is currently in discussion with the Royal College of Physicians on how best to proceed, and I am sure that the Cabinet Secretary for Health and Sport would be happy to provide any further information.

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NHS Greater Glasgow and Clyde (Winter Planning Funding)

The First Minister will be aware that NHS Greater Glasgow and Clyde has reported that the money that it is set to receive for winter pressures this year is £1 million, which is less than half of what it received for last year, and it is not the only health board in that position.

Given the expectation of a severe winter, the ever-increasing number of accident and emergency admissions and the fact that performance on the four-hour target for patients to be treated and discharged is getting worse, does the First Minister believe that £1 million will be enough to enable NHS Greater Glasgow and Clyde to cope with winter pressures?

I am genuinely not sure whether Jackie Baillie was in the chamber when, I think—if my memory serves me correctly—Murdo Fraser asked me that question the week before the recess. The money that was announced by the health secretary a couple of weeks ago was the first tranche of the money for winter planning. A subsequent tranche will be announced shortly, so that NHS Greater Glasgow and Clyde and other health boards across the country have the money that they need to undertake the winter planning that requires to be done.

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Vulnerable Patients (Engagement with General Practitioner Services)

A notice has been on display in a GP’s practice in Springburn in my constituency that informs potential new patients that certain drugs, including diazepam, temazepam and morphine, or any of its alternatives, are not normally prescribed. The notice states that new patients would be expected to engage in appropriate withdrawal programmes. I do not doubt the good intentions behind the notice, but concerns have been raised with me that it might deter vulnerable individuals from registering with a GP in the first place.

How will the Scottish Government seek to support GP practices to develop a consistent approach that encourages drug users to engage with services in the first place and to ensure that appropriate services to support recovery are widely available in our communities?

I thank Bob Doris for raising an important issue. I can certainly understand the concerns that he has raised, and I appreciate the constructive way in which he has done so.

I am very clear that integration authorities and alcohol and drug partnerships must provide services that meet the needs of their resident populations, and that they must do so in a way that does not stigmatise people who need support.

Prescribers should follow national and local prescribing guidance in prescribing methadone, benzodiazepines and other medicines that might be used to manage people with problematic drug use. All services that are delivered and all medicines that are prescribed must be based on clinical need and should be discussed with patients in the context of their long-term recovery.

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CS Wind (Workforce Reduction)

The First Minister will be aware of the announcement by CS Wind that it is to reduce its workforce in Campbeltown by three quarters. That is a devastating blow for the workforce—and for the whole country, given that CS Wind is the only manufacturer of wind turbines in Scotland. What steps has the First Minister taken to protect those jobs and to assist the workforce at this difficult time?

I thank Rhoda Grant for raising the issue. I know that this will be an exceptionally difficult time for the workers who have been served redundancy notices at the CS Wind turbine facility in Machrihanish. The Minister for Energy, Connectivity and the Islands spoke with CS Wind management just a couple of days ago to discuss the reasons behind the decision. We believe that it is about a gap in the order book, and is not about future prospects or long-term sustainability. The Scottish Government and Highlands and Islands Enterprise are committed to doing all that we can to mitigate the impact of the redundancy notices. Dialogue continues with the company and any steps that can be taken to support the company to ensure its long-term sustainability and success are steps that we are prepared to take.

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Aberdeen Art Gallery (Funding)

I remind colleagues that I am a councillor in the city of Aberdeen.

The First Minister has seen the transformative effect that the new V&A museum has had on the city of Dundee—a project that the Scottish Government rightly agreed to contribute to. However, when Aberdeen City Council applied for funding for the new Aberdeen art gallery, which opens tonight and has similar potential for the city of Aberdeen, that application was turned down. Will the First Minister look again at that decision, to ensure that Aberdeen gets its fair share and is able to benefit from a thriving artistic community?

I thank Tom Mason for raising the issue for two reasons. First, it gives me the opportunity to welcome the new Aberdeen art gallery, which is due to reopen on 2 November. I look forward to having the opportunity to visit it, and I am sure that it is an absolutely first-class attraction that will be a real credit to the city of Aberdeen.

However, it also gives me the opportunity to address a point that I understand was made at an event last night and has been repeated in the chamber by Tom Mason today. To set the record straight, during the planning or business case stage, Aberdeen City Council made no approach to the Scottish Government, Historic Environment Scotland or Creative Scotland. [Nicola Sturgeon has corrected this contribution. See end of report.] Aberdeen City Council discussed funding with Historic Environment Scotland in 2016 after project works had already begun, but the council chose not to pursue an application for funding. It is a bit rich to criticise the Scottish Government for not giving funding when the council in question never asked us for funding. [Interruption.]

Order.

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Dr Gray’s Hospital (Maternity Services)

In August 2018, maternity services at Dr Gray’s hospital in Elgin were downgraded. In November of that year, the chief medical officer’s advisory group reported that NHS Grampian must produce a comprehensive plan and a clear timetable for the restoration of those services. It is now certain that the issue will not be resolved by the end of this year, as was pledged, meaning another winter of expectant mothers and their families travelling from Moray to hospitals in Inverness and Aberdeen for vital care. Local campaigners are concerned that the revised timetable to restore services by spring 2020 also shows little sign of being met.

Can the First Minister tell us why those clear timetables are being missed and what she will do about it?

I thank the member for raising what I know is an important issue in that part of Scotland. We want mothers to deliver their babies as close to home as is safely possible. The issues around maternity services at Dr Gray’s are issues of patient safety. Patient safety has guided decisions up until now and patient safety will guide decisions from here on. The health secretary remains in close contact with the health board about the issues around the restoration of those services, but patient safety will continue to be the guiding principle. I think that everybody would understand and expect that to be the case.

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Housing Shortage (Short-term Lets)

We have grown used to waiting for the Scottish National Party Government to act on a whole range of issues. We are waiting for the health and social care workforce plan; we are waiting for our new state-of-the-art children’s hospital to open; we are waiting for a real ban on fox hunting and for an end to the indiscriminate slaughter of Scotland’s wildlife on our grouse moors; and we are waiting for the First Minister’s Government to start meeting its own climate change targets.

Over the past three years, the number of homes lost to short-terms lets has tripled, making a home an ever-more distant prospect for tens of thousands of people in Scotland. Can the First Minister tell me how long we have to wait until her Government introduces the controls that are urgently needed to protect our communities?

We will set out our proposals following our consultation later this year, and since this year is beginning to draw to a close, that will be pretty soon.

My colleague Andy Wightman first raised the issue with the minister almost two years ago, in November 2017. He also amended the Planning (Scotland) Bill—his amendment offered a way forward. Parliament appeared supportive, but at the last minute, the First Minister’s Government sided with the Conservatives to block the amendment and give us a “Tory-style” planning bill, as the Conservative spokesperson so gleefully described it. Yet again, an SNP Government is too timid to take action.

Here in Edinburgh, short-term lets are out of control, and on Skye, one fifth of all homes are short-term lets—in the midst of a housing crisis. The public is demanding action. Even SNP MSPs who voted against controls are now demanding action. Will the First Minister give us a date when short-term lets will finally be regulated?

I addressed the timescale in my earlier answer, but the rest of the member’s question is a complete mischaracterisation. Alison Johnstone is wrong in what she is saying.

In his amendments to the Planning (Scotland) Bill, Andy Wightman was trying to impose on all parts of the country a solution that may be right for Edinburgh, but the fact of the matter is that we do not see exactly the same pressures in all parts of the country. We therefore took the view that, instead of imposing an inappropriate one-size-fits-all policy, it would be better to allow local authorities to decide whether short-term let control areas were required in their part of the country. That is the kind of devolved decision making for local authorities that the Greens usually pop up in the chamber to demand that we do more of.

We have further supplementaries.

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Prisoners (Early Release)

The power to release prisoners two days early exists to avoid the situation in which released offenders are unable to access services during the weekend that are crucial to getting them on the road to a law-abiding life. Over the past three years, the power has been used just 15 times, despite more than 11,000 Friday releases.

In November 2016, the First Minister gave an undertaking to my former colleague Douglas Ross that she would look into the matter. Can she explain why there have been no improvements since that undertaking?

Decisions concerning the release of prisoners should be taken for the right reasons and with consideration of what is right for the reintegration of prisoners into the community.

Our programme of reform of sentencing is under way. We want to make sure that the people who should be and deserve to be in prison are in prison; where other sentences are appropriate, we want to make sure that they are available. On the release of prisoners, the first and most important thing that we take account of is the interests of victims, but we also recognise that, on occasion, the early release of prisoners is in the interests of wider communities, because it helps with the reintegration process.

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Attention Deficit Hyperactivity Disorder (Assessment)

I remind the chamber of my diagnosis of attention deficit hyperactivity disorder.

In June 2018, I sent ministers a copy of a letter that NHS Grampian sent to an adult denying them an assessment for ADHD, baldly stating that the board did not assess adults as a matter of policy. Despite assurances made to both Clare Haughey and me that the policy would change, on 23 October this year, the Scottish Public Services Ombudsman upheld a complaint against NHS Grampian for that continued practice. In its report, the ombudsman stated:

“We also found that their approach was not in keeping with the relevant clinical guidance or the Scottish Government’s mental health strategy”.

The ombudsman also required the immediate reinstatement of an interim regime for assessments.

I am concerned that that practice is confined neither to ADHD nor to NHS Grampian. I have received reports of the practice happening elsewhere in Scotland and for conditions such as autism.

Will the First Minister contact NHS Grampian as a matter of urgency, to ensure that the measures that I mentioned are put in place? Will she urgently probe whether other health boards are also carrying out the practice of denying adults assessments? For me, diagnosis was a vital first step in transforming my life and that of my family, so does she agree that nobody should be denied that opportunity through being denied an assessment for ADHD or autism as an adult?

The short answer is that I agree with all Daniel Johnson’s points. Today, I will make sure that NHS Grampian is contacted. I would expect the health board to take account of and implement the recommendations that the ombudsman has made. I will ask the health secretary to look into the wider issues in terms of the practices and approaches of other health boards. I also agree that diagnosis is vital to allowing people to take the steps that they need to take and have the support and treatment that they need to live full lives with a condition.

I know that the health secretary would be happy to meet with Daniel Johnson, if that would be of interest to him, to discuss how those issues can be taken forward. I thank him for raising what I know is an important issue not just to him personally, but to many people across the country.

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Trade Deal (Drug Prices)

The First Minister will be aware of reports by Channel 4’s “Dispatches” that the United Kingdom Government has had a series of meetings with US pharmaceutical firms to discuss raising drug prices as part of a post-Brexit trade deal. Donald Trump famously said that the NHS would be “on the table” in trade deal discussions. Will the First Minister do everything in her power to protect our national health service from a Tory sell-out?

Emma Harper is right to raise that issue—[Interruption.]

I know that the Tories are not particularly bothered about the real and present threat to our national health service, but there is one. I do not think that there is any doubt that, if they are left to their own devices and if they get their way, a Boris Johnson-led Government would open up our national health service to Donald Trump in the interests of trade deals. Yesterday we even heard Boris Johnson, in the House of Commons, almost threatening to take control of the NHS away from this Parliament and this Government, which should alarm people across Scotland.

The way to ensure that we protect our health service—not to magic away all its problems and challenges, because health services everywhere have challenges—and invest in it, keep it in public hands and ensure that it remains the best-performing NHS anywhere in the UK, is to continue with the investment and reform that this Government is taking forward.

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Drug Deaths

It has been four months since we heard that 1,187 people in Scotland died from drugs last year. I lost my neighbour; other people have lost friends, mothers and whole families. I cannot believe that I am saying this, but things are getting even worse. STV news revealed this week that the number of residential rehabilitation beds in Glasgow is down from 52 to just 14. When are we going to stop just talking about this and start acting?

That is a hugely important issue. I do not believe that it is the case that we are simply talking and not acting. The Government is taking a range of actions, not least increasing funding for alcohol and drug treatment services, which can be used as appropriate to build services in different areas. We have also established the drug death task force, which is tasked with coming up with further steps and solutions that we require to take.

The Minister for Public Health, Sport and Wellbeing is overseeing all that work and remains willing to discuss it and to meet members from across the chamber as, collectively, we address an issue that must be addressed for the reasons that all of us understand only too well.

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Cosmetic Surgery (Regulation)

To ask the First Minister what action the Scottish Government is taking to improve the regulation of the cosmetic surgery industry in Scotland. (S5F-03663)

Scotland was the first country in the UK, back in April 2016, to introduce any form of statutory regulation of cosmetic surgery. As a result, an independent clinic providing cosmetic procedures run by a doctor, dentist, nurse, midwife or dental technician is required to be registered and inspected by Healthcare Improvement Scotland.

In addition, we have been working with the General Medical Council to introduce a framework for the credentialing of medical skills, including a credential in cosmetic surgery, in collaboration with the Royal College of Surgeons. That would apply across the UK, and we expect it to be approved in the near future.

The First Minister might be aware that I previously raised the need for regulation of facial aesthetic procedures on behalf of a concerned constituent and a practitioner. I understand that work on phase 2 of the regulation of independent clinics is very much under way. Can the First Minister advise me when those forthcoming regulations will come forward for public consultation?

I recognise that Stuart McMillan has raised this issue before, and I thank him for doing so. Cosmetic procedures that are provided by non-healthcare professionals within non-regulated sites are currently not subject to the same level of scrutiny as those that are undertaken by medically qualified healthcare professionals. As Stuart McMillan observed, that is being addressed in phase 2 of our work on the regulation of independent clinics, which seeks to ensure a similar level of safety and assurance for those sites.

The Scottish cosmetic interventions expert group is developing a range of options to regulate the sector. I advise Stuart McMillan that the group will put forward proposals very soon, with a view to holding a public consultation process on the options by the end of this year.

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School Meals

To ask the First Minister what action the Scottish Government is taking to encourage the uptake of school meals, especially among children eligible for free school meals. (S5F-03668)

Access to healthy and nutritious school meals is essential, given the benefits that such meals provide to people’s learning as well as to their current and future health. The Government places such value on school meals that we introduced universal provision for every child from primaries 1 to 3, which was a plan that the Tories voted against.

When Tory changes to tax credits threatened to strip entitlement from 22,000 children in Scotland, we changed the rules to ensure that they would still be able to get a meal. The fundamental difference between the Scottish Government and the Tory Government is that we always look for ways to lift children out of poverty, while Tory welfare reforms are pushing more and more children into poverty.

People would not believe that there is an election coming up, would they? Food poverty is a topic that is raised many times in Parliament, with much finger pointing and blame, as we have seen. However, a recent study has shown that many Scottish children—up to 40 per cent in some areas—do not take up their free school meal entitlement. We talk about food poverty, yet so much food is thrown out from our schools and hospitals. In a country where farmers produce some of the highest quality food in the world, is it not about time for the Scottish Government to take a genuine system-wide approach that links food production, nutrition and food waste, and that encourages the uptake of school meals, particularly for those who are eligible for free school meals?

We want to encourage the uptake of free school meals. The latest statistics, which were published in September, show an increase in the number of pupils who are registered for free school meals, and I want that increase to continue.

I say to Brian Whittle that what I have said has nothing to do with there being an election; I am just pointing out some facts. One of the problems is that the Tories in this chamber say things about, and demand things of, this Government, while expecting us to ignore the actions that their colleagues in Westminster are taking. The actions of a Tory Government at Westminster are, right now, pushing more and more children into poverty, including food poverty. Food bank use is growing in this country because of Tory welfare cuts, which is the first reason why it is a bit rich for Brian Whittle to ask me the question that he asked.

The second reason is that we have recognised the importance of free school meals by introducing universal provision for children in primaries 1 to 3. Brian Whittle would have a lot more credibility in asking his question if the Tories had not voted against that policy. How about the Tories thinking about their actions and ensuring that they match their rhetoric in the future?

In Glasgow, 3,500 families are eligible for free school meals, but those families, who are among the poorest, are not claiming, so we have to get to the bottom of why they are not doing so.

The First Minister will be aware that the delivery plan for the Child Poverty (Scotland) Act 2017 includes a specific commitment to support local authorities in considering automatic payment of benefits. Ministers have supported that concept in the past, but what progress has the Scottish Government made in supporting local authorities to automate benefits? I realise that that is not easy, but does the First Minister agree that finding a way to automate more benefits such as free school meals would help the poorest children and help to tackle poverty in Glasgow and across Scotland?

I agree with that general point. The more automation there is, the more we can increase uptake and ensure that people get the benefits to which they are entitled. We will continue to work with the Department for Work and Pensions and with local authorities to try to make more progress.

Of course, one of the most important things that we can do, particularly in relation to free school meals, is to make provision universal so that there is no stigma and so that we make it easier for young people to uptake the entitlement.

I said in response to Brian Whittle that the latest statistics show an increase in the number of pupils registered. Pauline McNeill talked specifically about Glasgow, and I point out that that increase is partly due to the introduction of universal eligibility to all primary 4 pupils in Glasgow city as a result of action taken by this Administration.

We will continue to do what we can to lift children out of poverty. Free school meals are part of that, as is the new Scottish child payment, but as long as we have one hand tied behind our back because so many welfare decisions are taken by Westminster Governments we will not be able to make as much progress as we want. That is why the sooner that Labour joins us in arguing for all welfare policy to be devolved to this Parliament the better, and perhaps the more credibility it would have in raising such issues.

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National Health Service (Funding)

To ask the First Minister what the Scottish Government’s response is to the projected £1.8 billion shortfall in NHS funding outlined in the Audit Scotland report, “NHS in Scotland 2019”. (S5F-03662)

We did not just respond to that; we anticipated it. If Monica Lennon recalls, in the Scottish Government’s framework for health and social care, which was published last year, the Cabinet Secretary for Health and Sport made it clear that because, as we all recognise, demand for our services is rising, we require reform in our health service to the value of £1.8 billion by 2023-24. That is in addition to the significant investment that is planned over that period. Audit Scotland’s report simply agrees with that assessment.

The Scottish Government continues to follow a twin approach of both investment and reform, further increasing our health investment to a record £14 billion and delivering sustainable improvements to secure better outcomes for people who use health and social care services. Lastly, on investment, as I have already pointed out to Richard Leonard, Labour’s spending plans in the last Scottish election would have seen £758 million less funding for our NHS in this year alone, which is equivalent to 19,000 nurses.

I would like to share the First Minister’s optimism about her investment plans, but health boards are struggling to break even at the moment. Under her Scottish National Party Government, the two largest NHS boards, Lothian and Greater Glasgow and Clyde, are predicting deficits of more than £151 million. Does the First Minister accept that those deficits are an indictment of her Government’s mismanagement of the NHS?

No, I do not. It is because of the investment decisions that the Government has taken that we have record funding in our health service. That funding would be £758 million lower had Labour had its way. We work with health boards to help them to manage their financial position. The health secretary has introduced more flexibility in how health boards manage their budgets and we will continue to increase funding in our national health service.

Interestingly, I stand to be corrected if I am misremembering this or have got it wrong in any way, but my memory tells me that at no point over the past few years in the annual budget negotiations has Labour come to Derek Mackay and asked for more money for the national health service. Labour has to decide where its priorities lie. We know that, if Labour was in office, the health service would have less money to spend and that, when it has the chance to do so, Labour never argues for more money for the health service.

Record funding has come from the United Kingdom Conservative Government, which the First Minister has failed to mention. However, looking at the Audit Scotland report, we see that spending on nursing agency and bank staff has soared by more than one fifth under her Government. Does the First Minister think that that is anything to do with her decision to cut the number of student nurse places while she was health secretary, or is it someone else’s fault?

For the past number of years, we have increased the number of nurse students and we have record numbers of staff in our national health service. Miles Briggs should probably think about the fact that in an organisation the size of the national health service, things such as nurse banks are essential to ensure that services can be delivered. The biggest challenge for NHS recruitment right now is, of course, Brexit, and the Tories should be hanging their heads in shame that they are the ones who are trying to impose it on Scotland.

Given that I have pointed out the implications of Labour’s policy for health service budgets, it is only fair that I do the same for the Tories. If we had followed the plans that the Tories wanted us to when Derek Mackay was setting his budget—if we had handed those tax cuts to the richest earners in our society—there would be £650 million less in our national health service right now. That would be the cost of the Tory policy, which is why people in Scotland will never trust the Conservatives with the national health service.

NHS Lothian is £90 million in debt, and that impacts on patients. What does the First Minister have to say to a constituent of mine who needs an urgent brain operation for excruciating nerve pain but who cannot get it because of the shambles at the sick kids hospital, where the neurological centre is to be located? That woman cannot work or drive. She is reliant on benefits, and she lives taking more than 48 tablets a day. That is the human face of the scandal at the sick kids hospital. What is the First Minister going to do about that to help my constituent, who lives in agony?

The Cabinet Secretary for Health and Sport gave an update to Parliament yesterday on the sick kids hospital situation. It is an important point that services that are intended to be provided in the new building are being provided on current sites.

I do not know the circumstances of the case that Neil Findlay has raised, but I would be happy to have the health secretary look into it.

What we will continue to do for all patients in our national health service is not deny the challenges that it faces, but ensure that we invest the sums of money that are required, employ the numbers of staff that are required, and undertake the reforms that our health service needs so that it can continue to be the high-performing health service that it is, thanks to the tens of thousands of staff who work in it day and daily.

On a point of order, Presiding Officer. In her response to Emma Harper’s question, the First Minister failed to outline her links to the Institute for Healthcare Improvement. Nicola Sturgeon has hosted lavish dinners for that US-based private health giant at Edinburgh castle. Since then, private meetings have resulted in the First Minister and SNP ministers holding more private meetings and the company being awarded a £2 million hospital contract. Through your good office, Presiding Officer, how can Parliament hold SNP ministers and their dealings with private companies to account?

I thank Mr Briggs for raising that matter as a point of order. As he may know, it is up to each individual member to decide whether to make a declaration on any conflict of interest. I am sure that all members will be aware of that.

I suspend the meeting to allow new guests to arrive in the gallery.

12:47 Meeting suspended.  

12:48 On resuming—