Meeting of the Parliament

Meeting date: Thursday, December 8, 2022

Official Report 1061KB pdf

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First Minister’s Question Time

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Accident and Emergency Waiting Times

This week’s health statistics show that almost two in three patients who attended accident and emergency at Glasgow’s Queen Elizabeth university hospital were not seen within the target time. In just one week, more than 1,000 people at the Queen Elizabeth alone were not treated within four hours. Across Scotland, the number of people who waited beyond the target time was more than 9,500. That is the worst-ever performance in Scotland’s A and E departments.

What specific actions is the First Minister taking to prevent people from waiting for hours on end at A and E departments over Christmas?

First, I will talk specifically about the Queen Elizabeth university hospital in Glasgow. Obviously, it faces the same challenges that other hospital sites face. The performance there—as is the case in hospitals across Scotland—is not where we want it to be, and it is certainly not where patients have a right to expect it to be. That said, the most recent statistics show that performance at the Queen Elizabeth had improved. However, we know that performance will fluctuate, and for the national picture, as well as for individual sites, the monthly figures give a clearer depiction of performance.

Through the overall urgent and unscheduled care collaborative, the Queen Elizabeth has a range of actions under way, including opening additional wards on site and reconfiguring its surgical and medical capacity balance. It is also working to improve performance in the minor injuries flow for patients who need care but not necessarily admission to hospital, and it is optimising its discharge process by rolling out discharge without delay, which has the potential to result in an additional two to three discharges per ward per day. The intensive work that is under way at that hospital reflects some of the work that is under way across Scotland.

The situation is of concern to me and to the Government, and we are working hard to address it by supporting the health service. Of course, the situation is not unique to Scotland; the same pressures are being experienced by health services in all parts of the United Kingdom and, indeed, further afield. We will continue to take steps to support the NHS to address the issues here in Scotland.

The First Minister focused on the Queen Elizabeth hospital, which is what I asked about, but I also said that the statistics that I mentioned are the worst statistics on record for A and E departments across Scotland. I think that people who are watching would like to hear what the First Minister plans to do across Scotland in the lead-up to the critical Christmas holiday period.

Let us look at other hospital departments beyond A and E departments. The First Minister mentioned discharges. The number of beds that are occupied because of delayed discharge is also at its worst-ever level. The most recent month of data shows that, every day, 1,900 beds were taken up in Scotland’s hospitals by patients who had been medically cleared to leave. They could safely have gone home but, instead, they were occupying beds.

Is it not the case that, if the Scottish Government had kept its promise to end delayed discharge, we would have 1,900 extra beds to treat patients right now?

I will go through all those points as quickly as I can.

First, I concentrated on the Queen Elizabeth university hospital in my previous answer for the simple reason that Douglas Ross asked me about the Queen Elizabeth university hospital. However, I also referred to the urgent and unscheduled care collaborative, which is a national initiative that is backed by £50 million of investment. That is supporting the implementation across Scotland of a range of measures to drive down waits in our accident and emergency units. Those measures include offering, where appropriate, alternatives to hospital, such as hospital at home, directing people to more appropriate urgent care settings and scheduling urgent appointments to avoid long waits in accident and emergency. As I said, the examples that I gave in relation to the Queen Elizabeth reflect that wider national work.

I also made a point that I think is worth repeating: although there are very serious issues in Scotland, which this Government is extremely focused on addressing, they are not unique to Scotland. In England right now, more than 10 per cent of patients going to A and E are waiting for more than 12 hours. Health services across the UK and in much of the world are facing similar issues right now. We continue to focus on those issues.

I will turn briefly to delayed discharges. Again, that problem is replicated across all health services in the UK right now. Of course, not all delays are in the acute sector, and it is important to point out that, in the most recent year for which we have data, 97 per cent of all patients were discharged without delay. However, we are taking significant steps, working with health boards and integration joint boards to target investment this year. That includes investment to enhance care at home, to increase the hourly rate of pay for those who work in social care, to support interim care arrangements and to enhance multidisciplinary teams.

Please be brief, First Minister.

I will be as brief as possible. This is important stuff, Presiding Officer. Serious questions have been asked and I am seeking to give detailed answers.

The final point that I want to make is that a ministerial—[Interruption.] I would have thought that, having raised those really serious issues, the Conservatives would want to hear the information that answers the questions. Even if they do not, I suspect that people watching at home do.

Please be brief.

My final point is that, in response to winter pressures, we have established a ministerial assurance group to provide advice on the deployment of options that support the resilience of the health and social care system. That group currently meets weekly.

The concerns from Conservative members were to do with the First Minister apparently disrespecting the Presiding Officer, who was asking her to focus on the issues. Perhaps the First Minister would have more time to focus on issues in and questions about Scotland’s national health service if she did not try to place the blame elsewhere around the United Kingdom.

The unique issue here is that Nicola Sturgeon and her Government are in sole control of the NHS in Scotland. I have asked about the problems in our A and E departments and I have asked about the issue of delayed discharge. Let us look at another issue that is happening in a part of our NHS where patients are really struggling to get treatment: general practices.

This week, Dr Andrew Buist of the British Medical Association Scotland said:

“my real fear is we are at a tipping point and what we are going to see is areas of Scotland that are under-doctored”.

He continued:

“And that is more likely to happen in areas of higher deprivation and the care of these patients is going to suffer.”

First Minister, are doctors right that someone who is poorer will receive second-rate healthcare in Scotland’s NHS?

A great deal of what this Government does in the health service, and, of course, what it does more generally, is designed to tackle and address inequalities, not least of which are the steps that we are taking through our social security system to lift people out of poverty and to mitigate the actions of a Tory Government at Westminster that is pushing so many more people into poverty.

On the NHS, I was giving, as I think is right and proper, detailed information about the actions that this Government is taking to address the challenges that our NHS is facing. I was making the point—it is an important one—that the challenges are not unique to Scotland and that they are not even unique to the United Kingdom right now. If Douglas Ross wants to say that this is all specifically about this Scottish National Party Government, that is okay. Notwithstanding the challenges that our NHS is facing, A and E units in Scotland are the best performing anywhere in the UK. Delayed discharges, although they are far too high, are lower than they are in England and Wales.

Before I come on to the question about GPs, I will mention head count. There are more GPs per 100,000 of population in Scotland than in the rest of the UK, by some considerable distance.

If Douglas Ross is saying that the challenges in our health service are all about the SNP, he must recognise the relative performance of our NHS when compared with other parts of the UK.

On GPs, we are working to increase the numbers in our national health service. We have record numbers across many different clinical areas already in our health service. We are working to increase the number of GPs. We have already increased head count by 277, working with the GP profession, and that positive progress will continue. Of course, we are recruiting and supporting the recruitment of other professionals to support multidisciplinary teams in primary care.

My final point, Presiding Officer, is that it is easy, and it is entirely legitimate, in this or any session of First Minister’s questions, to state the problems in our national health service, but the responsibility of Government is to take actions to support the NHS to address those issues, and that is the job that the people of Scotland trust this Government to do.

It is shameful that the First Minister dedicates more of her time on attacking the NHS in other parts of the United Kingdom than she does on focusing on what she can do here in Scotland. It is absolutely clear that more has to be done to tackle the crisis in Scotland’s NHS. There is a crisis in our A and E departments, a crisis with delayed discharges and a crisis at GP practices, all of which adds up to healthcare that does not deliver for patients. For cancer patients, the situation can then be between life and death.

We have received a freedom of information response on the issue from a Scottish health board. It reveals that a patient has waited more than six months to start treatment for breast cancer; that another patient has waited 18 months to start treatment for prostate cancer; and that, worst of all, someone has waited two years to start their treatment for cancer. First Minister, that is not good enough. Lives are at risk. The longer that someone waits to start treatment for cancer, the less likely they are to beat cancer.

What action will the First Minister and her Government take to tackle those appalling waiting times?

First, there are few areas of the NHS that are more important than cancer care, for the reasons that Douglas Ross has set out. He has cited individual cases. As always, I am very willing to look at the particular circumstances of individual cases. However, it remains the case, even with all the challenges of the pandemic, that the median waiting time for a patient with cancer to start treatment once a decision to treat has been made is measured in days, not in weeks and certainly not in months—

It is 721 days in that case. [Interruption.]

I am trying to answer serious questions in a detailed fashion, Presiding Officer. I had started to say that there will be individual cases where, sometimes, clinical circumstances will mean that it takes longer, and where, sometimes, yes, failings in the NHS will mean that it takes longer. I am making the point that, for the vast majority of patients, that is not the case. The median waiting time to start cancer treatment is measured in days in this country. That is down to the hard work of those on the front line.

Douglas Ross started his previous question by saying that I spent more time attacking the health service elsewhere than I did talking about the Scottish health service. First, I have not attacked the health service anywhere. Secondly, I think that anybody who reviews the Official Report of this session will see that that is just factually inaccurate. In fact, the Conservatives were getting impatient because they seemed to think that I was taking too long going into detail about the urgent and unscheduled care collaborative earlier on.

However, when Douglas Ross puts it to me that the problems in our national health service are unique to Scotland and they are worse in Scotland because of this Government, it is reasonable for me to point out that that is not the case—

Deal with the issues in Scotland. [Interruption.]

Thank you, members.

Despite the challenges, which nobody here is shying away from, our NHS performs better than its counterparts in England and Wales. The only reason why I say that is because Douglas Ross is putting the counter to me.

Finally, it is really important that we continue to support record investment in our national health service. It is not that long ago—here, we are measuring in weeks—that Douglas Ross was demanding that I cut taxes for the richest people in our country. Had I followed his advice, we would have had to take investment out of our national health service, which is why few people will take Douglas Ross or the Conservatives seriously when it comes to trust on the national health service.

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Child and Adolescent Mental Health Services

Child and adolescent mental health services are in crisis, as they have been since long before the pandemic. Too many children and young people are having referrals rejected, and too many are waiting for too long for treatment. How many referrals to CAMHS have been rejected in the past year, and how many children have waited for more than a year for their first appointment?

I will be happy to give Anas Sarwar the precise figures on rejected referrals later on. However, although there are challenges in child and adolescent mental health services—as there are across the national health service, as I have just been reflecting—-in recent months, we have seen some very positive changes in waiting lists. Those changes are among the most positive in more than half a decade.

In the latest quarter, the overall CAMHS waiting list has decreased by 1,398 children since the previous quarter; the number of children waiting for more than 18 weeks has decreased by 658 since the previous quarter; and the number of children who have waited for more than 52 weeks has decreased by 281. That marks the first time since September 2016 that there has been a decrease in all three waiting lists.

Although there is significant work still to do—not least to continue our progress in community mental health services for children and young people—progress has been made, particularly in tackling the longest waits. That should be welcomed.

In the past year, 8,873 children and young people have had their referrals to CAMHS rejected. A total of 1,248 have been waiting for more than a year for their first appointment. The First Minister has quoted statistics on those who have had their first appointment; however, even those who have had a first appointment are still not getting the treatment that they need.

Here is just one example. Charlie is a primary 7 pupil. He was referred to CAMHS in January 2020. In April 2020, he had a video consultation with a doctor from CAMHS—so he would have dropped off the list that was referred to by the First Minister. However, that was the last time that he heard from CAMHS. He has had no diagnosis and, without treatment, Charlie has become withdrawn and does not like to spend time with other children.

His mother found a video that he had posted on TikTok, in which he asked whether anyone felt like they wanted to die because they were so different. Charlie’s mum told CAMHS, but they said that it would make no difference to his waiting time. They told her that it could be another two years before Charlie receives the support that he needs.

That is not good enough. Charlie is not alone—there are thousands of children like him. How has the First Minister let it get so bad?

Before I come on to the general issue, I will say that, obviously, Charlie’s experience is not acceptable. I do not know all the circumstances of his case. As always, I am willing to look into individual cases that are raised.

It is the case that there are waits for child and adolescent mental health services that are too long. However, it is also the case that significant action is being taken, which is already reducing those long waits.

Anas Sarwar did not respond to the information that I gave him in my previous answer, but it is really important. Nobody is denying that there is a significant issue, but we are now seeing decreases in the numbers of children who are waiting for more than 18 weeks and the numbers who are waiting for more than 52 weeks—and the overall waiting list is also decreasing.

Does that say that there is no longer a challenge? No, but it does say that the significant investment—the increase in the workforce—is now having an impact where that is needed. We need to continue that.

We have already accepted all the recommendations in the audit of rejected referrals that was published in 2018, and we continue to act on those. One in every two referrals to CAMHS is seen within 10 weeks, and health boards have a duty to prioritise those who need to be seen most quickly. If any experience does not match that, we have a duty to look into that and learn from it.

There has also been a significant increase in the number of people who access community mental health services, which is an important part of mental health support. Local authorities report that, in the first six months of this year, more than 38,000 children accessed enhanced community-based mental health support services. That is important in ensuring that those who need specialist services can get them more quickly.

The First Minister is just not listening. If someone gets a first appointment that is a telephone call, but their diagnosis does not happen and their treatment does not start, and they then fall off a list, that is not a measure of success but a measure of failure. It demonstrates that the system is being gamed.

That was a problem long before Covid. When Charlie’s mother phoned CAMHS, she was told that it was still working through cases from 2018. There will be cases where someone has had their first appointment, but there will also be cases where treatment has not started and a diagnosis has not happened.

This Government has never met its CAMHS waiting time targets. According to Public Health Scotland, a quarter of all deaths of five to 24-year-olds in our country are from suicide. In the words of Charlie’s mum,

“Our children are being failed and no one is doing anything about it.”

However, we can fix this, so I ask the First Minister do the following: first, reverse the cuts to mental health in primary care; second, guarantee funding for schools-based counselling; third, commit to increasing the proportion of the national health service budget that is spent on mental health so that it reaches 11 per cent—the same level as England and Wales; fourth, create a new referral and triage system for mental health so that no one is rejected; and finally, record and publish the true waiting time, from referral to diagnosis and the start of treatment, so that no child is abandoned, like Charlie has been.

I will say it again, because it is important, that experiences such as Charlie’s are not acceptable. I do not know all of the circumstances; I am willing to look into that.

I am not standing here and saying that Charlie will be the only young person in the country who has that kind of experience—far from it—but nor is it right to say that the progress that I have narrated today is somehow unimportant, because that is the progress that requires to be made to ensure that there are far fewer experiences like Charlie’s.

In terms of funding, mental health spending has almost doubled in cash terms since we took office. We will continue to support record expenditure across our national health service and ensure appropriate expenditure for mental health services. As I said earlier, we are also shifting more treatment into the community. One of the most important things that has been done, backed by investment, is the recruitment of counsellors across our secondary schools. Those are really important issues.

Although it is right and proper to come to the Parliament and state the challenges, our job, as I have demonstrated today, is to get on with the work of addressing those challenges. As I have set out, we have seen a fall in the waiting lists for access to CAMHS. That is down to investment and the actions that have been taken, which is why it is so important that we continue with that.

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Cabinet (Meetings)

To ask the First Minister when the Cabinet will next meet. (S6F-01613)

The Cabinet will next meet on Tuesday. I advise the chamber that one of the matters that the Cabinet will discuss on Tuesday is on-going monitoring of the Strep A situation. Sadly, as we know, a number of children in England and Wales have died from invasive group A Strep infections; our thoughts are with their families.

Although increased levels of infection have been seen in Scotland, current numbers are not exceeding previous spikes, and so far, we have had no deaths of children. However, a total of 13 invasive group A Strep cases in children under 10 were reported to Public Health Scotland between the start of October and 5 December. The majority of those cases are mild and can be treated with penicillin. However, there is no room for complacency, and we will continue to monitor the situation very closely.

I am grateful for that reply and gratified to hear that Cabinet will be discussing the Strep A outbreak. I ask that the First Minister comes back to Parliament before Christmas with a statement on the progress on that issue.

What we have just heard from Anas Sarwar is devastating. Charlie is by no means alone—not by a long shot—and the situation is desperate. When Humza Yousaf launched the national health service recovery plan last year, the mental health treatment target was missed for one in five children; it is now one in three. Young people are battling the long shadow of lockdown, anxiety and depression without support. Nicola Sturgeon is trying to persuade the chamber of progress, but £38 million has just been cut from this year’s mental health budget—money that could have been spent on cutting waiting times, training staff and putting more counsellors in our schools—and that cut will lead to more delays.

We get only one childhood, and waiting month after month for help can shatter those formative years. The NHS recovery plan promised the eradication of mental health waiting lists by March. That was always a bold target, but it is barely 100 days away, and things are moving backwards. If that target is missed, will the First Minister continue to stand by the beleaguered health secretary?

Mental health spending has doubled under this Government—that is a fact. The number of people who are working in child and adolescent mental health services has also doubled under this Government; to be precise, it is up by 110 per cent.

There are significant challenges in waiting times for CAMHS, and we take that extremely seriously. However, it is right to point to progress, which that investment and the increase in the workforce are designed to achieve.

There has been a 14.4 per cent decrease in the number of children and young people who are on the waiting list compared to the past quarter. There is a decrease in the numbers of children and young people who are waiting more than 18 weeks and more than 52 weeks. As I said earlier, that is the first time since 2016 that there has been a decrease in all three waiting-list measures.

Does that mean that we do not have more work to do? Of course it does not; there are significant challenges, but real progress is being made because of the actions, focus and determination of this Government to support the work of those who are on the front line, and that will continue.

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Child Disability Payment (Roll-out)

To ask the First Minister whether she will provide an update on the roll-out of the child disability payment. (S6F-01626)

We know that caring for a child who is disabled or has a long-term condition can result in extra costs, from buying specialist equipment to taking part in activities. That is why the child disability payment is a vital benefit that helps parents to support their children to live their lives as fully as possible.

I am very pleased that, in the child disability payment’s first year, almost £60 million has been paid to the families of nearly 44,000 children and young people. The child disability payment is the first disability benefit anywhere in the United Kingdom for which applicants are able to apply online, by phone, by post and face to face. That demonstrates our commitment to improving access to social security and ensuring that people receive the assistance to which they are entitled.

With increasing financial pressures on families in Scotland, it is more important than ever that people get all the benefits to which they are entitled. Can the First Minister outline how our constituents can apply for the child disability payment and check what extra financial support from the Scottish Government they might be entitled to?

It is important that we take steps to raise awareness of all of the help that is available and encourage as many eligible people as possible to apply for assistance. As I said in my original answer, people can apply for the child disability payment online, by phone, by post or face to face. I encourage anyone who thinks that they might be eligible for any of our benefits to get in touch with Social Security Scotland. Staff are available to answer queries about benefits and help people to complete application forms, and local delivery officers are available across the country, so that the application can be made face to face, where that is necessary.

As shown through our benefit take-up strategy, we are absolutely committed to making sure that everyone gets the financial support that they are entitled to.

When setting up Social Security Scotland, the Scottish Government said that one of the things that it would do would be to get decisions right the first time round, in recognition of the distress that redeterminations can cause. Figures show that, in 86 per cent of redeterminations that were requested for the child disability payment, the decision was not right the first time around.

We were promised a fairer system here, so what can the First Minister do to address that issue and bring certainty to people who need social security that they will not need to jump through hoops in order to get it?

Feedback from applications in which the first decision is not made correctly is part of the process of making sure that the system is improved on an on-going basis. I know that Social Security Scotland takes that work very seriously and focuses very hard on it.

For all the issues that she rightly brings to the chamber about the operation of the social security system, particularly as it affects people with disabilities, I am absolutely certain—and I hope that I am not wrong—that Pam Duncan-Glancy shares my view that we already have a fairer system around those things in Scotland than exists elsewhere in the UK.

However, through Social Security Scotland, we have an obligation to continue to improve that experience, so that, first, people are getting all the help to which they are entitled; secondly, they are getting it as easily and with as little bureaucracy as possible; and, thirdly, decisions are being taken correctly in the first instance.

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Emergency Response Single-crewed Ambulances

To ask the First Minister how many single-crewed ambulances, responding to an emergency, have been deployed in the last six months. (S6F-01608)

Between June and November this year, there were 1,429 instances of the Scottish Ambulance Service single crewing ambulance shifts across Scotland. To put that into context, I would point out that it represents 1.72 per cent of the total number of shifts in that period. In addition, there will be paramedic cars or motorbikes that are routinely single crewed and which are used to support the Ambulance Service’s multivehicle response to serious incidents as well as being used by advanced paramedics to support patients with less serious conditions in the community. Single-crewed ambulance shifts happen only in exceptional circumstances that cannot be avoided, such as short-notice staff absences or a significant unforeseen increase in demand.

That is really concerning, because in simple terms, single-crewed ambulances cannot transport patients to hospitals. In the Highlands, where journey times can be over two hours, it means that there is a significant danger to life.

In 2008, when the First Minister was the cabinet secretary for health, she said:

“The Scottish Government’s policy is clear: traditional accident and emergency ambulances should be double crewed, with at least one member being a paramedic, unless there are exceptional circumstances. In too many instances, particularly in the Highlands, practice is not living up to that policy.”—[Official Report, 4 June 2008; c 9260.]

It is clear that after 14 years of inactivity the First Minister has failed. Will she explain to my constituents why she has failed and when single-crewed ambulances will be consigned to history?

I am genuinely not sure that Edward Mountain listened to the answer to his first question. With regard to the commitment that was made in 2008—and which I remember very well, because I was health secretary at the time—the instance of single crewing at that time was significant, particularly in rural areas, and our commitment to support the Ambulance Service with funding to eliminate the requirement for rostered single crewing, particularly in remote and rural parts of the country, was achieved. Single crewing now takes place only in exceptional circumstances that cannot be avoided. In the six months that I have been asked about and have talked about, 1.72 per cent—less than 2 per cent—of shifts were single crewed.

Let me explain to Mr Mountain’s constituents why that is the case. If, for example, at the last minute a member of staff is ill and does not turn up to work, as happens in any walk of life, the only alternative to single crewing would be not to have a crew at all and not to have the ambulance on shift. It only happens in such exceptional circumstances—and I would also say that, in any national health service, a figure of less than 2 per cent effectively amounts to eliminating single crewing. The Scottish Ambulance Service continues to work to minimise that figure as much as possible.

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Cost of Living Crisis (Freezing of Water Rates)

To ask the First Minister whether the Scottish Government will provide an update on whether it will instruct Scottish Water to freeze water rates for 2023-24 to help with the cost of living crisis. (S6F-01607)

Decisions on the levels of water charges are matters for Scottish Water’s board, and its decision must be taken with due regard to the principles of charging for water services, which are set by Scottish ministers and include the key principle of affordability. Last year, the board took a responsible view and held charges to a real-terms freeze, and we expect it to take a proportionate position again, balancing affordability with critical investment needs to protect the quality of our drinking water and the environment.

Of course, the average water charge in Scotland remains lower than the average charge in England and Wales, but we are committed to supporting people facing any issues with paying their water bills. That is why, as part of our overall package of cost of living measures, we have increased the maximum level of the water charges reduction scheme discount from 25 per cent to 35 per cent.

Last year, inflation was running at about 4 per cent. Under the formula agreed by Scottish Water and this Government, water rates are charged at the consumer prices index plus 2 per cent. Last year, the Scottish Government intervened to hold water rates down, which was welcome, but this year inflation is at 11 per cent and water bills are set to increase by an eye-watering 13 per cent. With this acute cost of living crisis—the worst in many decades—will the Scottish Government freeze water bills for the next financial year? The First Minister has the power to do this—she intervened last year—but the question is: does she have the political will?

This is obviously a matter for Scottish Water’s board. As I said in my original answer, the board of Scottish Water took a responsible decision last year—we would expect it to do the same this year—to recognise the cost of living pressures, which remain intense and acute. However, we also expect and require Scottish Water to discharge other responsibilities to ensure that we have a well-maintained water system, so that the quality of our water services is high, and it is mindful of its wider obligations to the environment. If we did not have proper investment in our water infrastructure and, as a result, the quality of our drinking water declined, I am sure that Jackie Baillie would be one of the first to point a finger at this Government.

We will continue to take responsible decisions on this issue and across the range of other ways that we are supporting people through the cost of living crisis—decisions and actions that continue to result in the Scottish people expressing high levels of trust in this Government.

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United Kingdom Fiscal Policy

Richard Hughes, chair of the Office for Budget Responsibility, has said that the last three Westminster Tory Governments fiscal policy U-turns have cost taxpayers more than £40 billion of extra debt in just six months—that is £600 for every man, woman and child in the UK, and is 2,000 times the estimated cost of the independence referendum that the Tories keep moaning about. Does the First Minister believe that it is acceptable for the people of Scotland to keep paying the price of Westminster’s economic incompetence?

No, it is not acceptable. The cost of Tory fiscal and economic incompetence, which is epitomised by the disastrous decisions in the mini-budget—decisions that, members should remember, the Scottish Conservatives initially wanted the Scottish Government to replicate—coupled with the disaster of Brexit that unfolds on a daily basis, is being paid by individuals, businesses and households across Scotland right now.

There is an alternative to that, and it is to make this Parliament responsible for the decisions that are being so badly mishandled at Westminster. I think that there is a growing desire in the people of Scotland to become independent and build a much better alternative to what we have now.

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A83 (Rest and be Thankful)

At the weekend, the Sunday Post revealed that, in the past 15 years, almost £100 million has been spent on short-term repairs to the A83 at the Rest and Be Thankful. Meanwhile, communities across Argyll remain exasperated by the lack of action since Transport Scotland announced its preferred permanent route last year. Will the First Minister now instruct Transport Scotland to select that route and make it a top priority for delivery, thereby ending once and for all the misery that closures of that road cause?

I assume that the member is not suggesting that the investments in temporary repairs should not have been made—that is my first point. Secondly, as I am sure that the member knows, in relation to the Rest and Be Thankful, a preferred route corridor for a permanent solution was announced in 2021. Route option designs within the preferred corridor are being progressed and we are working towards announcing a preferred route for the long-term decision by next spring.

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Housing (Mould)

The First Minister will be aware of the tragic death of Awaab Ishak in Rochdale due to mouldy housing. Currently, I have constituents contacting me with concerns about issues with mould in substandard temporary housing that could cause a similar threat to human life, with small children being particularly at risk. The issue seems alarmingly common across local authority boundaries in a variety of housing stock. What is the Scottish Government doing to ensure that similar tragedies do not happen in Scotland?

The Scottish Government continues to invest significantly in housing, in terms of our targets for new affordable housing and, as the member alludes to, our existing housing stock. I will ask the Cabinet Secretary for Social Justice, Housing and Local Government to write to the member in more detail about the actions that we are taking and any lessons that require to be learned in Scotland from the tragic case that the member has highlighted.

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Abortion Services (Safe Access Zones)

Yesterday, we saw the very welcome ruling from the Supreme Court on the Abortion Services (Safe Access Zones) Bill in Northern Ireland. The judgment was unanimous and unequivocal, and I believe that it gives a clear way forward for safe access zones in Scotland. Will the First Minister join me in congratulating Clare Bailey and her team on that victory, and will she give her response to the ruling and say what she believes that it means for Scotland?

I congratulate Clare Bailey and thank her for the advice that she has offered to the Scottish Government. She attended the summit that we held earlier this year, which Gillian Mackay also attended.

I was very pleased to see yesterday that the Supreme Court has protected the rights of women to access abortion services in Northern Ireland without fear of harassment or intimidation. The Scottish Government is considering very carefully the detail of that judgment, and we look forward to working with Gillian Mackay on how we can progress quickly the next steps for taking forward her proposed bill. We are absolutely committed to supporting her with the development of a bill to safeguard access for women in Scotland to healthcare facilities that provide abortion services and to do so without fear, harassment or intimidation.

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Cost of Living Crisis (United Kingdom Government Response)

Recent analysis from Citizens Advice Scotland found that half of Scots are being forced to cut back on household spending. The main levers to address that crisis reside in Westminster, which is an institution that cannot be trusted to concern itself with the plight of ordinary people. What conversations has the First Minister had with the Prime Minister about the inadequacy of the United Kingdom Government’s response to the crisis that it created?

When I met the Prime Minister a couple of weeks ago, I urged him, as the Scottish Government does more generally on a regular basis, to take more action to help people who are struggling with the basic necessities of life because of the cost of living crisis, which continues to affect the livelihoods, lives and, increasingly, the health and wellbeing of people across the country. The key policy levers are held by the UK Government, and we will continue to press it to use all the levers at its disposal to tackle the emergency. That includes access to borrowing, providing benefits and support to households.

We will also continue to take action ourselves. We have allocated almost £3 billion in this financial year to help, and we have, of course, increased the Scottish child payment by 150 per cent in less than eight months to £25 per eligible child per week.

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Police Complaints System

Rhys Bonner has been described as a “gentle giant” by his mum Steph. He was found dead in marshland in Glasgow in 2019. Police Scotland said that his death was fully investigated, but his family disagrees. Last week, three and a half years since losing her son, some of Steph’s complaints were upheld, with the Police Investigations and Review Commissioner asking Police Scotland to conduct new inquiries and to provide more information. Steph has told me that she is tormented by a process that she describes as “cruel”.

It has been two years since the Angiolini report laid bare the Scottish National Party’s broken police complaints system. How many more families have to suffer before the First Minister or her justice secretary fixes it?

On the police complaints system, we are, of course, taking forward recommendations from the Angiolini report and, indeed, we will legislate in respect of those recommendations.

It would not be right or appropriate for me to comment in detail on that specific case. However, the police are, of course, expected to respond to any recommendations or actions that they are instructed to take by the PIRC, and I would expect that to be the case there.

The broader reform of the complaints system is under way and on-going, and the justice secretary will keep the Parliament updated as appropriate.

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Community Justice System

This week, the BBC reported that the community payback orders backlog has reached 700,000. That is on top of the quarter of a million that were written off during the pandemic. The Cabinet Secretary for Justice and Veterans told the BBC that that was

“pretty much business as usual”.

With respect, if someone is a victim of crime, that is anything but business as usual. That includes the domestic abuse victim who saw her offender walk free from court with unpaid hours as his sentence. She was punched in the face and chucked through a glass door, and she is scarred and traumatised for life.

The justice system is letting people down. It is letting women down, and community payback orders are not even being served. When will that end, and when will the community justice system actually serve justice for victims of crime?

Obviously, individual cases of the kind that Jamie Greene has narrated are always difficult and unacceptable for the individuals concerned. However, more generally, as I often say in the chamber because it is absolutely right that I do so, court decisions are for courts. It is not for ministers or any politicians to intervene in decisions of our justice system.

When a community payback order is issued, the offender has to serve that order. That remains the case. More generally, our community justice system performs well. That will be one of the reasons why levels of crime in this country continue to be historically low and reoffending rates are reducing.

We continue to support the justice system to recover from the pandemic and catch up on backlogs in all different aspects of the system.

That concludes First Minister’s questions.