Meeting of the Parliament

Meeting date: Thursday, November 10, 2022

Official Report 1048KB pdf

---

First Minister’s Question Time

---

Nursing (Industrial Action)

Tomorrow, and on Sunday, we will pause to remember those who lost their lives fighting for our country. I know that the whole chamber will want to show our respect to those who made the ultimate sacrifice defending our freedoms, and those who continue to defend us and our allies around the world.

For the first time ever, nurses who work tirelessly in Scotland’s national health service have voted to go on strike. It is not only about pay; they are incredibly worried about the crisis in Scotland’s health service. This morning, Hilary Nelson from the Royal College of Nursing Scotland had this grave warning when she said:

“Things are not safe for patients.”

Deputy First Minister, what has the health secretary, Humza Yousaf, done to address the concerns from nurses about staff shortages and patient safety?

Before I address the question from Mr Ross, I should explain that the First Minister is meeting the Prime Minister today in advance of the British-Irish Council summit and she has asked me to answer questions on her behalf.

I associate myself entirely with Mr Ross’s remarks in relation to the moment of remembrance over the weekend. We will all fall silent on Sunday. Tomorrow, in my constituency in the city of Perth, I will attend a remembrance event at 11 o’clock to mark the sacrifice of individuals throughout all conflict. As we speak, my Cabinet colleague Keith Brown, who is himself a distinguished veteran, is in the Falklands on the 40th anniversary of his active service in the Falkland Islands conflict. We remember the suffering of individuals and the sacrifices of their families and their loved ones and we pay tribute to those who continue to endure that suffering today because of the injuries that they have suffered and the experiences that they have had.

There are many challenges in our health service and I recognise the concerns expressed by members of staff through the ballots that have taken place. There have been extensive negotiations, which the health secretary and I have also been involved in, to try to resolve the pay issues. We have put forward a record pay deal which, on average, will offer members of staff a 7 per cent increase and, for those on the lowest of incomes, an 11 per cent increase, recognising the enormous contribution that health service staff make to our society and the enormous cost of living pressures that they are wrestling with.

In addition to that contribution to resolving the issues, the health secretary has been actively involved in discussions to address some of the challenges in our health service, principally around the issue of delayed discharge, which we recognise to be one of the most significant factors impeding the flow of patients through accident and emergency to other aspects of the health service, which, ideally, then ensure that those individuals are supported appropriately within the community.

There are of course challenges around the availability of members of staff to do that; we have record employment in the health service just now, but we also have vacancies, and we have vacancies in social care—a situation that has of course not been helped by the fact that we have lost free movement of citizens, which was helping us to deal with the issues that Mr Ross raises.

I assure Mr Ross that the Government is entirely focused on all the issues, with very clear direction from the health secretary and the active support of the First Minister and myself, to make sure that we address the challenges that we face.

That is the Scottish National Party’s defence for what it is doing. Let us hear from nurses. Dawn Marr from RCN Scotland said this:

“We have been in talks ... for months and months and months, and it has got to the point now where nursing staff are having to stand up not only for ourselves but for our patients as well, because this Government is not listening”.

It is now beyond doubt that the health secretary has failed.

Dr Peel, who is chair of the British Medical Association Scotland’s junior doctors committee said this week:

“Right now, it’s been so awful for so long we’re simply broken. Overwhelmed, exhausted, with nothing left to give. As far as I can see the NHS is collapsing around us. Staff are leaving in their droves to protect themselves.”

The facts confirm that our NHS is on its knees. This week’s statistics revealed that the situation at accident and emergency departments is at its worst ever level. More patients are waiting longer than ever before. That is a new low, but it is the 14th time since Humza Yousaf became health secretary that waiting times have hit their worst ever levels. Every time we think it cannot get any worse in the NHS under his leadership, it does. Deputy First Minister, surely you agree that that is a damning indictment of the health secretary’s time in charge of Scotland’s NHS?

Members should always speak through the chair, please.

I accept that there are significant challenges in the national health service right across the United Kingdom. Mr Ross’s point about accident and emergency is important, but it has to be considered in its proper context: although there are challenges in A and E departments in Scotland, we have the best performing A and E system in the United Kingdom.

On his question whether Governments listen, yes, this Government listens, which is why we have offered NHS staff in Scotland the best pay deal of any system in the United Kingdom. On his question of the future of the national health service, resources are absolutely fundamental. That is why it is laughable for Douglas Ross to come here and raise those issues with me when, only seven weeks ago, he wanted me to cut tax during the folly that was taken forward by Liz Truss, which would have damaged public investment in our health service.

John Swinney wants to consider the statistics and facts in the round, so let us make sure that he is speaking about the correct figures. We know that there have been reports from a whistleblower this week that as many as 2,000 patients per month are being missed off A and E waiting times in just one hospital in Scotland. If the Deputy First Minister is going to come to the chamber and quote figures, he needs to make sure that they are the correct ones, because this is the most serious of issues. Lives are on the line because the health secretary keeps failing to bring forward any solutions.

We spoke to one lady this week who called an ambulance when she had a suspected heart attack. She waited for an hour for the ambulance to arrive. When the ambulance got to the hospital, she waited outside for three hours. When she got inside, she waited for 36 hours to get a bed. The lady who was involved and her family are full of praise for the staff, but it is clear that she had a suspected heart attack—a tragedy was avoided in her case. I know that every MSP in the chamber, including those who applauded the Deputy First Minister’s response, has heard of cases like that in their areas. However, this morning, the health secretary, Humza Yousaf, said:

“Our recovery plan is a five-year recovery plan. We are already seeing elements of recovery.”

“Elements of recovery.” What planet is he on? Deputy First Minister, can you tell the chamber, patients and staff in our NHS, what are the elements of recovery within our NHS?

I remind members to speak through the chair, please.

In relation to the circumstances that Mr Ross has recounted, it is, of course, of the deepest concern that a member of the public has had to wait that long for access to an ambulance and to the accident and emergency department. I say to Mr Ross that the median time for the arrival of an ambulance is of the order of 45 minutes, so the circumstances that he has recounted are unacceptable.

There is congestion in A and E departments, which is caused by the volume of presentations and by the obstacle that is created by the number of patients who are in hospital but who should be discharged. That is a focal point of significant activity across Government: to ensure that we reduce delayed discharges. Indeed, the health secretary and I spent a significant amount of our time yesterday in discussion with partners about practical steps to address that.

In relation to the question of improvements in the national health service, the Government has invested £600 million in the winter resilience support package; we are helping to recruit 1,000 healthcare staff to support staff in their activities; and we are investing £50 million in urgent and unscheduled care, to help to improve A and E performance. When it comes to the progress that has been made, Mr Ross should be familiar with the fact that the longer waits for treatment are reducing significantly in relation to the two-year position, which was one of the priorities that was set by the health secretary.

I accept that there are challenges in the national health service, but I take the opportunity to pay tribute to the members of staff who are working phenomenally hard on the back of a pandemic that Mr Ross never acknowledged in its significance—[Interruption.]

I ask members to remember that our code of conduct requires that we treat one another with courtesy and respect. That means that we hear one another when we are speaking.

Thank you, Presiding Officer. I pay tribute to members of staff who are working phenomenally hard on the back of a pandemic that Mr Ross never mentioned and that has put a huge strain on our national health service. Staff in the national health service—the largest number of staff ever provided in the NHS, by this Government—are doing their level best to support the people of our country.

I will always praise our NHS staff. I highlighted in the case study that I used as an example that the family, rightly, praised our NHS staff. However, John Swinney, like his boss, is using Covid as a deflection from his Government’s failures.

Karren Morrison, the secretary of Unison for Forth Valley, described the situation at Forth Valley royal hospital as

“far worse than we had in the pandemic, a million times worse”.

Stop using the pandemic as an excuse for your failures, and start dealing with things, because—

Speak through the chair, please.

From day 1, we have said to John Swinney, the Scottish National Party and the Government that Humza Yousaf’s recovery plan was hopeless. It was flimsy: there was no detail and no substance. The SNP insisted that it would get Scotland’s NHS back on track. However, this is what its recovery plan has delivered: record vacancies; the longest-ever waiting times; patients struggling to see their general practitioner; nurses voting to strike for the first time ever; and the worst A and E waiting time statistics on record.

Scotland’s NHS is in crisis and, whoever the SNP tries to blame, it is obvious that the man responsible is sitting right next to the Deputy First Minister. Humza Yousaf has failed, and all he can do is spin that the NHS is in recovery, when, in reality, it is at breaking point. Just how much worse does it have to get for patients and staff in Scotland before he takes responsibility? I say to the Deputy First Minister: Scotland’s NHS deserves better than Humza Yousaf. When will this health secretary be sacked?

Given the absolutely totally chaotic turmoil of ministerial resignations and dismissals in the United Kingdom Government, what a laughable proposition to put to me this morning!

I have been active in politics for many years and a member of parliament for a quarter of a century. We know that someone has run out of road when they start playing the man and not the ball on an issue, which is what Douglas Ross is doing just now. [Interruption.]

Yes, there are challenges in the national health service, but there is a record pay deal on offer from the Scottish Government—[Interruption.]

Deputy First Minister, I am being gesticulated at from across the chamber, and members are shouting. I would be grateful if we could remember that, as parliamentarians, we have a duty to adhere to a code of conduct, which requires that we treat one another with courtesy and respect. I ask all members to remember that at all times.

I will tell Douglas Ross about the situation that we are facing and experiencing. We have the best pay deal for health and care staff on offer in the United Kingdom; we have the best record of A and E performance of any health system in the United Kingdom; and we have record numbers of staff in the national health service.

What is not helping is the folly of Brexit, which has reduced the number of staff available, because of the loss of free movement.

The other fact that is not helping is that the United Kingdom Government is not recognising the public spending pressures that exist because of the inflation that it has fuelled by its stupid economic decisions. As a consequence, public budgets are under enormous pressure. If Douglas Ross wants to make himself useful, he can ask the United Kingdom Government to increase the budget for the Scottish Government, so that we can support the health service to a greater extent and start addressing the issues facing members of the public.

---

Royal College of Nursing (Industrial Action)

Tomorrow is 11 November and, as we head towards remembrance Sunday, we remember all those who have made the ultimate sacrifice in defence of our country. We also thank all those who have served and continue to serve in our armed forces. We pledge to support them, their families and their communities. We must never forget.

For the first time in its history, the Royal College of Nursing has voted for strike action. The strike is not just about pay; nurses have been underpaid, undervalued and underresourced since long before the pandemic. These are the words of Julie Lamberth, the chair of RCN Scotland. She said:

“The Scottish Government needs to face up to the reality that their failure to focus on workforce planning and to properly value those ... in health and social care over the last decade is the root cause of the staffing crisis we face. The result of our strike ballot is a wake-up call that must not be ignored.”

Does the Deputy First Minister agree with Julie Lamberth and thousands of nurses across the country?

I associate myself with Mr Sarwar’s remarks in relation to remembrance day.

In relation to the situation in the national health service and the comments that he recounted from the Royal College of Nursing, I make it absolutely clear that the Government remains committed to, and willing to engage in, dialogue and negotiation with the Royal College of Nursing and the other affected and interested trade unions, as we have been doing for some considerable time. Notwithstanding the decisions that have been made by members of the RCN, we will continue that dialogue, and I commit the Government to that today.

In relation to workforce planning, we have record staffing levels in the national health service. Those staffing levels have been the product of sustained investment by the Government, despite the climate of austerity in which we have been operating for some considerable time. The Government will continue to sustain that investment to ensure that we have adequate staffing levels.

The Government is firmly restricted in what it can do by the financial context in which we are operating and by the pressures on the public finances. However, I assure Mr Sarwar and the Parliament that the Government will do everything in our power to properly support the health service workforce and ensure that we have adequate numbers of staff in our national health service.

Let me start on a point of agreement: I agree that we are in the midst of an economic and inflation crisis that has been created by a rotten Tory Government at Westminster. It should pay the price for that, and it will pay the price come the general election.

However, the Deputy First Minister missed the point of what Julie Lamberth was saying—there has been a decade of failure and a decade of not supporting, long before the past seven weeks of economic crisis, before the pandemic and even before Brexit. This Government gives the same old platitude about more numbers when we have record vacancies in the NHS under its watch.

The action is as much for patients as it is for nurses. For years, nurses have been warning that staff shortages risk patient safety. Let us look at just one health board—NHS Greater Glasgow and Clyde. In just one year, it reported 216 investigations into significant adverse events. Those are events that

“could have contributed or did result in, harm to people or groups of people.”

Among the top reasons for why they happened are workload, staffing levels and delays in referral and treatment. The same report reveals that six people died due to those unintended incidents.

Nurses are saying that a lack of resources is putting patients at risk. Lives are being lost and health boards are reporting the consequences, but the Government’s failure to workforce plan means that there are 6,000 nursing and midwifery vacancies. Why has the Government let it come to this?

Mr Sarwar’s comments are not borne out by the evidence that I have marshalled in my answers today.

Those are Glasgow’s comments.

I am addressing the question from Mr Sarwar, who has raised the issue of workforce planning. Today, we find ourselves with record levels of staffing in our national health service. That is a product of workforce planning, which has been designed to boost recruitment levels.

Over the past 10 years, we have seen an increase in nursing and midwifery admissions as a consequence of the investment that the Government has made. There has also been an increase in the number of consultants who are operating in the NHS, and we have 8.3 qualified nurses and midwives per 1,000 of population in Scotland compared with 6 per 1,000 of population in England. All of that comparative data shows Scotland to be in a better and stronger position.

What I do not think helps the situation are the comments that were made at the weekend by the leader of the United Kingdom Labour Party, who said:

“I think we are recruiting too many people from overseas in, for example, the health service”.

I listened to those comments with incredulity. What is hampering us in the national health service is the Brexit that was inflicted on us by the Conservatives, which ended the free movement of individuals and resulted in members of staff being lost from our national health service. We need to reverse that; we need an approach that is open to migration so that we can boost recruitment into our national health service. The comments from Keir Starmer are a disastrous signal to send to hard-working members of staff.

Let me address that final point. I have led a cross-party campaign in the Parliament against racial and religious prejudice, so no one should mischaracterise my position or the position of my party. [Interruption.] Members might want to heckle, but they should listen.

Thank you. We will hear Mr Sarwar.

Let me be clear: migrants are an invaluable part of our NHS—they always have been and they always would be. I also say that people who come to work in our NHS are not migrants; they are equal Scots, just like the rest of us. However, that should not prevent us from having a credible workforce plan that means that we train more doctors and nurses here.

In the past few days, the First Minister has rightly been calling for more action on loss and damage in relation to climate change, so we should not pretend that taking doctors and nurses from developing countries does not cause loss and damage to healthcare systems in those countries. Let us not create a climate of fear, let us not play on that rhetoric—which is beneath the Deputy First Minister—and let us talk about what is happening here right now on the Scottish National Party’s watch.

I listened to the answer that the Deputy First Minister gave. His head is in the sand. If it is so good and so rosy, why are nurses taking strike action for the first time in the RCN’s history? For years—since long before the pandemic—nurses have been crying out about the problems. Let us not forget that it was those staff who kept going even when their lives were at risk from a deadly virus. They are now being forced into action to try to save their patients’ lives. Week after week, tragic stories come to the Parliament and, week after week, we get the same old excuses. This health secretary and this Government are clearly out of their depth.

After 15 years in government, with 750,000 Scots on an NHS waiting list, the worst-ever waits at accident and emergency departments and now the Royal College of Nursing going on strike for the first time in its history, does the Deputy First Minister accept that our NHS has not faced a crisis like this in its history, that this is the worst that it has ever been and that it is all happening on the SNP’s watch?

First of all, I think that I touched a very raw nerve with my comments about Keir Starmer. Anyone who looks at my track record, throughout all my public service, will find that I have always—always—been on the side of openness and welcoming people from other countries into our society.

The point that I am making to Anas Sarwar is that our ability to recruit staff and provide the necessary means for people to work in our national health service has been totally undermined by Brexit and the Conservative Government. Keir Starmer, through his comments at the weekend and his hostility to addressing any migration issues, is simply taking the same line as the Tories, and that is an absolute disgrace.

Any international recruitment that is undertaken by the Scottish Government is done through an ethical route. We do not actively recruit staff from any of the World Health Organization’s red list countries.

I have acknowledged this afternoon, as my colleagues have done on other occasions, that there are huge pressures on the national health service, because we have had a pandemic. We are recovering from that pandemic and are experiencing enormous strain in the process of so doing. In that sense, I accept the points that Mr Sarwar raises about the seriousness of the situation that we face.

However, let me tell Mr Sarwar that the Scottish Government is absolutely focused on giving the necessary leadership and resources to address those circumstances, and we will continue to do so. The reactions and support that we have received from people in Scotland over successive elections show that they are supportive of the work that we undertake.

I am going to move to question 3 and take supplementaries at the end. In order to reach those supplementaries, I ask for short and concise questions—and responses to match.

---

Wildfires (Government Action)

To ask the Deputy First Minister what action the Scottish Government is taking to mitigate the impact and prevalence of fires in Scotland caused by accelerating climate change such as those seen during the high temperatures last summer. (S6F-01506)

Climate change is identified as a strategic priority in the Scottish Government’s 2022 fire framework. The framework requires the Scottish Fire and Rescue Service to invest in the provision of specialist resources and in technological advancements, and to undertake prevention and public awareness activity, to enhance its response to the increased flooding and wildfires that are associated with climate change.

The Government is responding to the full range of climate risks that have been identified for Scotland through its 2019 climate change adaptation programme, which sets out more than 170 policies and proposals to build resilience to the impact of global climate change as part of our just transition to net zero emissions by 2045. We are preparing our next programme in response to the most recent United Kingdom climate change risk assessment. That programme is to be published in 2024.

In spring and summer this year, we were repeatedly warned of extreme wildfires across Scotland, and we saw blazes spread rapidly through urban areas in England.

Research shows that firefighters come into regular contact with carcinogenic combustion products. They are at high risk of getting cancer, and they get those cancers earlier in life than the general population. In fact, the World Health Organization recently classified firefighting as a carcinogenic profession. Clearly, we have a responsibility to ensure that our firefighters, who tackle these blazes, are safe.

What is the Scottish Government doing to ensure that our firefighters have the equipment that they need to keep themselves safe? What plans are in place to ensure that fire stations have the necessary decontamination equipment? Will the Scottish Government consider routine health screening for firefighters, to catch any illnesses as early as possible?

There are a range of points in the questions that Maggie Chapman’s poses. They are properly operational matters for the chief fire officer and the SFRS board in allocating the £352.7 million of budget provision that we make available to them, which looks at the whole range of improvements and enhancements that have to be made in the Scottish Fire and Rescue Service.

I am aware that the Scottish Fire and Rescue Service contaminants group is taking action across all aspects of operations to reduce exposure to harmful contaminants. I also understand that that group met Professor Anna Stec of the University of Central Lancashire to hear directly of the important research work that she is undertaking on these questions and to offer SFRS co-operation on that work.

Before I take a supplementary, I remind members that supplementary questions should be brief and should not consist of multiple questions.

I call Siobhian Brown.

---

Cybersecurity

To ask the Deputy First Minister what measures are in place to protect Scotland from any potential risks to cybersecurity. (S6F-01502)

My apologies—that was question 4, not a supplementary.

Cyber resilience underpins everything that we deliver as a Government and is crucial to fully realising Scotland’s digital ambitions. Cybersecurity policy is reserved. However, in recent years, we have worked steadily with key partners to build Scotland’s cyber resilience. In 2021, we published “The Strategic Framework for a Cyber Resilient Scotland”, which sets out a vision for a digitally secure and resilient Scotland and builds on our initial strategy, which was published in 2015.

Cybersecurity is flourishing in Scotland, with the first cyber Scotland summit taking place only a few weeks ago and Edinburgh aiming to become the data capital of Europe. What will we do to continue that positive path through building cyber resilience in the public sector?

The Scottish Government has been working directly with public bodies to improve their cyber resilience. Through the roll-out of the public sector cyber resilience framework, more public bodies are regularly testing their incident management and business continuity plans. That can only help to improve their resistance to cyberattacks.

We are also progressing with the establishment of the Scottish cyber co-ordination centre, which draws together the work of Police Scotland, the National Cyber Security Centre and other organisations to enhance Scotland’s ability to prepare for and respond to cyber incidents.

I call Liz Smith.

Will the Scottish Government commission a full independent inquiry into the medical negligence of former Professor Sam Eljamel at NHS Tayside and the related governance issues, given that more and more patients are coming forward to tell their horrific stories?

That is not a supplementary to question 4. We might have time to come back to general constituency supplementaries at the end of First Minister’s questions.

---

Island Air Routes (Viability)

To ask the Deputy First Minister what the Scottish Government’s response is to the reported comments by Highlands and Islands Enterprise that cheaper air travel for business passengers could help to strengthen the viability of island routes. (S6F-01504)

We recognise that reliable and affordable transport to and from our islands helps to maintain thriving communities and local economies. That is why we provide significant funding to make air travel to our remote communities, including the islands, more affordable.

This year, we have allocated more than £77 million to support air services in the Highlands and Islands. That includes funding to Highlands and Islands Airports Ltd to maintain its airports and funding for the air discount scheme, which provides island residents with a 50 per cent discount on fares to and from the mainland. It also includes a subsidy for the air services from Glasgow to Campbeltown, Tiree and Barra.

We know that things are bad when a Scottish Government agency speaks of people moving away from the islands because the links are so poor. At least Highlands and Islands Enterprise understands the desperation of islanders—so much so, that it is giving £15,000 to some of them to look into how to run their own ferry services.

HIE says that many island businesses rely on planes to get them on and off the islands. That is largely because the ferries are so unreliable. Therefore, cheaper air fares for businesses would bolster vital air routes. HIE also says that better links for everyone will help to stop depopulation. It points to chronic issues on the west coast ferry fleet and the need to help island councils that run their own services to replace their fleets.

Will the Government do anything more on air fares, and will it help the councils to fund new ferries? When will the Government pull its finger out, tell us how it wants to run ferries in the future and set out a proper ferry replacement plan?

As I set out in my original answer, the Government is significantly funding air services in the Highlands and Islands, to the tune of £77 million. It is a bit rich for Mr Simpson to argue for more money to be spent on those services, since seven weeks ago the Conservatives were asking me to reduce taxes, which would have come at the expense of public expenditure—[Interruption.] No amount of agitated explaining from Rachael Hamilton will deter me from pointing out that the Conservatives come to the chamber with absolutely hypocritical propositions about lowering taxes and increasing spending at the same time.

On public expenditure on ferries, the Government was spending £139 million on ferry services about 10 years ago; we are now spending £315 million on those services and expanding the routes and services that people can rely on.

In 2011, Scottish National Party ministers removed island businesses from the air discount scheme with no prior consultation. Ministers desperately tried to blame the European Union—which was still used as an SNP bogeyman back in 2011—but they eventually admitted that it was a cost-cutting measure.

HIE’s assessment backs the Highlands and Islands Transport Partnership’s early analysis that the ADS cut negatively impacted staff productivity, turnover and operating costs. Given that assessment, will the Government now reverse the cut and allow businesses in the Highlands and Islands the chance to compete on a level playing field?

The Government makes substantial investments in the Highlands and Islands air network. As I have set out, £77 million is being spent to support that network. Obviously, the Government will engage constructively with local communities, as I and other ministers do constantly. However, we have to make choices about the availability of resources and concentrate those resources in the most effective way to ensure that we support island communities.

As I announced in the emergency budget review last week, we are putting additional financial support into island communities to support the recovery from Covid.

---

National Health Service (Staff Levels)

To ask the Deputy First Minister what urgent steps are being taken to ensure safe staffing across the national health service, in light of recent reports of staff shortages potentially contributing to patient deaths. (S6F-01498)

The Scottish Government is taking a number of measures to ensure safe staffing across the NHS, which include providing funding to health boards to support the recruitment of additional staff, measures to make it easier to retain and rehire experienced staff, and measures to improve health system flow, timely discharge from hospital and patient safety.

Today’s smokescreen excuses of Brexit and Covid do not wash. The Deputy First Minister would do well to listen to Professor Paul Gray, the former chief executive officer of NHS Scotland, who has stated that our NHS

“was going to be overwhelmed regardless of Covid”.

The Deputy First Minister’s excuses do not explain why the First Minister slashed training places for nurses and midwives in 2012 when she was health secretary. They do not explain why the Scottish Government missed its own target of recruiting 700 new student nurses this year or why, for the first time in history, nurses have voted overwhelmingly in favour of strike action—a dispute that is about not just pay but better working conditions and higher standards on wards. The responsibility for that situation lies at the door of the Government and its failing health secretary.

Two people died at the Queen Elizabeth university hospital in only one month this summer, with their deaths linked to short staffing. Our health service is on its knees due to the Government’s incompetence. When will the Deputy First Minister commit to an urgent investigation into those two deaths? When will he commit to getting a grip on safe staffing and ensure that all our hard-working staff are supported, with dignity and respect?

I regret any loss of life. Questions about the investigation of individual deaths are not a matter for me; they are a matter for the Crown to decide on, should it choose to do so.

Mr O’Kane does a disservice to the topic by brushing aside the implications of Brexit and Covid. We must live in the real world and consider the pressures that have arisen from the implications of the pandemic and from the significant loss of access to staff that has come about as a consequence of Brexit.

The Government is investing significantly to create a position in which we have record numbers of staff in the NHS, and we are working to reduce delayed discharge, because that is one of the identifiable ways of improving performance in the health service and ensuring patient safety. Those efforts will continue to be the focus of intervention by Scottish ministers.

---

Disability Benefits (Means Testing)

I have been contacted by constituents who are in receipt of disability benefits. They are worried and alarmed over the comments of the United Kingdom Secretary of State for Work and Pensions, Mel Stride, who has refused to rule out means testing of disability benefits for claimants elsewhere in the UK. I ask the Deputy First Minister to offer his reassurances to people who are in receipt of such benefits in Scotland that means testing will not be introduced here. Will he consider how either Social Security Scotland or the Scottish Government can reach out to Scottish claimants who are worried to get that message out loud and clear?

As Mr Doris will know, when the legislation was put through the Parliament to establish Social Security Scotland and handle the benefits that are now the responsibility of the Scottish Government, we legislated for dignity, compassion and respect to underpin the approach that we would take to the exercise of our responsibilities in relation to social security. I assure Mr Doris and the Parliament that those values will underpin all the actions of Social Security Scotland, and we will communicate them widely, because they are the foundation for any decent and respectful social security system.

---

Professor Eljamel

Will the Scottish Government now commission a full independent inquiry into the medical negligence of Professor Eljamel, the disgraced surgeon who formerly worked at NHS Tayside, and governance issues, given that more and more patients are coming forward with horrific stories about what happened to them?

I recognise the seriousness of the issue that Liz Smith has raised, and I express my regret to anybody who has suffered as a consequence of the practice of Professor Eljamel. The Cabinet Secretary for Health and Social Care has already met Liz Smith to discuss the issue, as she knows, and he has also met some of the people who have been affected by the actions of Professor Eljamel.

As Liz Smith will know, because the issues were professional ones that affected Professor Eljamel’s clinical practice, NHS Tayside commissioned a review from the Royal College of Surgeons into his practice and, as a consequence, restricted his clinical responsibilities.

The health secretary has made it clear to NHS Tayside that he expects it to meet the people who have been affected and, where possible, to answer any questions that remain unanswered, given the fact that the issues have already been thoroughly examined by the Royal College of Surgeons at the request of NHS Tayside.

---

Scottish Health Survey (Mental Wellbeing)

The results of the Scottish health survey for 2021 were published earlier this week. The summary report says:

“Average levels of mental wellbeing ... were lower in 2021 than in 2019”.

The survey highlights that the experience of

“Depression, anxiety ... attempted suicide and ... self-harm ... were ... more common in the most deprived areas.”

The figures highlight the Scottish Government’s failure to address the root causes of mental health difficulties, which has had a direct and detrimental impact on the mental health and wellbeing of the Scottish population. Importantly, the Government is failing to address the health inequalities that impact the most vulnerable people in our society. Will the Deputy First Minister clearly outline how the Scottish Government, across Government portfolios, plans to improve mental wellbeing in Scotland? Will he set out a timeline for ministers to report back on how the Scottish Government will eradicate the health inequalities that are deepening divisions in communities across my South Scotland region?

The Government has a range of measures to tackle health inequalities in all our communities, which include the work that we undertake in relation to the eradication of child poverty, as captured in the child poverty delivery plan that the Parliament considered earlier this year. At its heart, the plan addresses some of the fundamental issues that Carol Mochan puts to me.

That is supplemented by the work that is undertaken to tackle and address addiction in our communities, whether that is drug addiction or alcohol addiction, through the various measures that have been put in place in that respect.

In addition, the Government has achieved the objectives on the recruitment of staff in relation to the provision of counselling services in our schools and in the wider community as a consequence of the projects and priorities that we set out.

I acknowledge the importance of the issues that Carol Mochan raises, and I assure her of the Government’s commitment, across a range of portfolios, to addressing those issues, because the questions of health inequalities are directly connected to the questions of poverty and wider inequality in our society. Through its agenda, the Government is determined to address those questions.

---

Food Banks

As the Tory-made cost of living crisis soars, sadly, it will come as little surprise that the Trussell Trust has said today that it recorded its busiest-ever period between April and September 2022, when it distributed around 116,000 parcels in Scotland. Does the Deputy First Minister believe that the increasing reliance not only on food banks but, now, even on warm banks is illustrative of a Westminster system that is not working for people across Scotland?

I agree with the point that Natalie Don puts to me. [Interruption.]

Thank you, members. Let us hear one another.

I agree with Natalie Don, and my principal ally in providing me with material to support that position is none other than the chairman of the Scottish Conservative Party. Mr Craig Hoy said:

“Liz Truss made the wrong decision in going for growth in the way that she did and I think there is a price tag attached to that. I think we have to be realistic about the consequence of that, which may be tax cuts or public spending cuts.”

The only bit of that comment that I disagree with Mr Hoy about is that I do not think that the consequence of that will be either tax cuts or public spending cuts; I suspect that it will be both. That will be the unbridled responsibility of the Conservative Party, which, when that stupid budget came out, demanded that I follow that course of action. That would have inflicted misery on the public in Scotland. That budget, coupled with the Tories’ inaction on energy costs over the summer, means that the Tories are responsible for the cost of living crisis, and they should pay a price for it.

---

Endometriosis Treatment (Fife)

For more than two years, women in Fife with endometriosis have had no access to a dedicated specialist gynaecology department since the closure of the ward at the Victoria hospital. Constituents have informed me that, as a result, patients are being admitted to a section of the maternity ward, which is leading to the appalling situation in which women who have just suffered a miscarriage are separated from women nursing new-born children with nothing more than a curtain.

The Deputy First Minister will be aware that it takes, on average, eight years for endometriosis to be diagnosed, which means that women are living in severe pain, suffering with excess bleeding, being put on painkillers for excessive periods of time and needing surgery. When will the vital services at the Victoria hospital be reinstated so that those women can get access to the care that they so desperately need?

I understand the point that Roz McCall makes. The challenges that are faced on service provision around the country in areas of care in which a high degree of specialism is involved can be affected by movement of staff around the country and various other circumstances. Obviously, the health service works as hard as possible to minimise any disruption of such care. I recognise the seriousness of the point that Roz McCall puts to me.

One of the initial priorities of the women’s health plan is to improve access for women to appropriate support, diagnosis and the best treatment for endometriosis, and to improve the care pathways that are involved. The Government will focus on those particular issues, and I will look specifically at the issues relating to NHS Fife that Roz McCall has raised.

---

School Capacity (Renfrewshire)

A catastrophic blunder at Renfrewshire Council means that the newly built Dargavel primary school is half the size that it needs to be. It was built for a capacity of around 450 pupils, but the estimated roll is set to be 1,100. Children who were promised a new school now face learning in Portakabins; parents are appalled and have lost confidence in Renfrewshire Council. The mistake will cost millions of pounds from Renfrewshire’s already squeezed education budget. It is a colossal waste.

Will the Deputy First Minister meet me and parents to discuss what solutions can be provided for local children, to ensure that there is accountability for what has gone wrong and to ensure that no other child in Renfrewshire loses out because of any resulting shortfall in school budgets?

Such issues are a matter for concern. Mr Bibby’s points sit against a backdrop of widespread improvements in the school estate across the whole of Scotland. When this Government came into office, 63 per cent of children were being educated in buildings rated as good or satisfactory; that figure is now in excess of 90 per cent as a consequence of the investment that the Government has made. Mr Bibby raises an individual problem about one school, but the general nature of the school estate in Scotland is improving.

I will happily meet Mr Bibby and his constituents to consider the issues that he has raised, but I encourage him to recognise that, although issues can emerge in the planning of individual projects, that is against a backdrop of sustained investment by the Government and the quality of the school estate is improving across the country.

That concludes First Minister’s questions.