Meeting of the Parliament

Meeting date: Wednesday, June 14, 2023

Official Report 1075KB pdf

---

NHS Waiting Times

The next item of business is a debate on motion S6M-09462, in the name of Jackie Baillie, on taking action on national health service waiting times. I ask members who wish to speak in the debate to please press their request-to-speak button.

14:51  

There are 779,533 patients on waiting lists in Scotland. That is one in seven Scots, and it is the highest number of people waiting since records began. At the same time, there has been a 73 per cent increase in the number of people going private because they cannot wait any longer. Despite that and the warm words and promises of action, the number of people waiting is increasing. When Humza Yousaf took over as health secretary, 603,000 people were waiting for diagnosis or treatment; now, the figure is 175,000 higher.

This touches every area, from failure to meet cancer waiting times targets, which we know has profound consequences on outcomes; to orthopaedics, where people are suffering in pain, waiting for literally years for treatment; to children waiting in distress for more than a year for an appointment with child and adolescent mental health services. In response, Humza Yousaf set targets for people with the longest waits to be treated. We welcomed the fact that out-patient waits of more than two years were to be eradicated—completely gone—by August 2022, but that has not happened. In-patient waits of more than two years were also to be eradicated by September 2022. That has not happened. Waits of more than 18 months were to be eradicated by December 2022 for out-patients. That also has not happened. One-year waits for out-patients were to be gone completely by March 2023, and—you guessed it, Presiding Officer—that has not happened either. In fact, there are 31,498 patients still waiting.

By every measure that the Scottish National Party Government has set itself, it has failed. In England, with a population 10 times greater than that in Scotland, there are only 599 people waiting more than two years, while here the figure is 7,849, which is 13 times higher. It is clear that the NHS recovery plan that was launched two years ago simply has not worked.

The consequences of that could not be more stark. Over 18,300 patients died while on waiting lists last year, which is a 39 per cent increase on the number of such deaths before the pandemic. Those are people for whom treatment could have saved or prolonged their lives. While SNP members are fighting like ferrets in a sack, mired by their internal party scandals, Scotland’s healthcare system plunges deeper into crisis.

Will Jackie Baillie give way?

No, I do not have time.

All those numbers are, of course, people whose lives are put on hold while they wait, often in pain, to get the medical care that they need. They are people like 82-year-old Robert Stone, who has been waiting more than three years for a knee replacement. His daughter Carol Murray told me:

“He’s now lost all his dignity because of waiting so long. He is sleeping in a bed in ... his living room because he can’t access his bedroom. ... He has become a prisoner in his own home. ... He is now being treated like a dog waiting for scraps.

Where is the fairness in this? Where is the humanity in this? ... I feel like I am slowly watching my father’s demise before my eyes.”

He is one of the shocking 2,207 people who have waited for more than two years for orthopaedic surgery. Humza Yousaf pledged to end such waits by September 2022.

The creation of national treatment centres to get through the backlog and streamline the approach to diagnostics and treatment was a welcome step. It is therefore hugely disappointing that many have been delayed and that there is a funding shortfall and a lack of staffing. It took a freedom of information request from the Scottish Labour Party to get the details out of the SNP Government. We now know that the Government is unlikely to meet its commitment for national treatment centres to deliver an additional 40,000 in-patient and day-case procedures in 2025-26. The response states that

“projections included in the NHS Recovery Plan have dropped significantly”.

Plans for 1,500 additional staff by 2026—a commitment in the NHS recovery plan—are unlikely to be met, with some boards already experiencing staff recruitment challenges. In March, a briefing to the cabinet secretary revealed that there was no revenue funding source for the national treatment centres that are not yet in construction. To top it all, the remaining programme is “not affordable” on the basis of the current capital spending review.

In August 2022, the update on national treatment centres showed that five centres were classed as red, meaning that they were in danger of not being delivered until 2027, such was the limited progress being made.

Will the cabinet secretary publish the revised schedule for national treatment centres? Will he confirm whether they will all proceed and the timescale for them? Given that the NHS budget is reportedly overspent and that capital projects are being cancelled, we need transparency and we need that information.

Not content with crashing the health service, the SNP is now failing to deliver the modest recovery plan that it promised to implement. Waiting times are increasing. National treatment centres were promised but have not been delivered. Staffing targets are not being met. Ultimately, patients are being let down.

We urgently need a new recovery plan, and we need clinicians to lead that process. Clinicians and Versus Arthritis have been arguing for a recovery plan for orthopaedics—the single largest component of waiting lists—for years, but Humza Yousaf did not listen to them. Will the cabinet secretary commit to such a plan now?

SNP incompetence is threatening the very existence of our NHS. Michael Matheson must act now to support our valiant NHS staff and to undo the deadly legacy of his predecessor—Scotland’s worst-ever health minister, Humza Yousaf.

I move,

That the Parliament is deeply concerned that NHS waiting lists continue to increase to record levels, with over 779,000 patients awaiting treatment; regrets that over 18,300 patients died on NHS waiting lists in 2022, whilst the number of people in Scotland paying for private treatment has increased by 73% since before the COVID-19 pandemic; notes that the Scottish Government has failed to meet its revised national targets for tackling long waits for planned care; is concerned about the delay in rolling out the network of National Treatment Centres; recognises that the NHS is facing a workforce crisis, with over 7,000 vacancies unfilled, and agency costs spiralling to £567 million in 2022-23, and calls on the Scottish Ministers to bring forward a revised NHS Recovery Plan, in consultation with key stakeholders, to reduce long waits as a matter of urgency.

14:58  

Let me start by acknowledging the importance of this topic. I welcome the opportunity to highlight the progress that has been made by our NHS and, equally, the challenges that we continue to face. It is important to state at the outset that we remain focused on ensuring that the health service recovers from the greatest challenge in its history, and I take this opportunity to thank our exceptional health and social care staff, who are at the heart of our services.

However, for many people accessing NHS or social care services, their experience is not what they or I would like it to be. There is work still to be done, and that is encapsulated in the published commitments that the First Minister and I have made to achieve a series of tangible improvements in the health and social care system by 2026. Those commitments include reducing NHS waiting times year on year and delivering new national treatment centres.

Inevitably, pausing planned treatment during the pandemic has led to a build-up in the number of people waiting. We must recognise that our health service has experienced unprecedented pressures, including pandemic backlogs, staff shortages and the most difficult winter in the NHS’s history. I recognise that challenges remain, but I am committed to delivering sustained improvements and year-on-year reductions in waiting times through service redesign and enhanced regional and national working.

Even in the face of those challenges, we continue to see progress in the reduction of long waits, following the introduction of the targets last year. We have seen a substantive reduction in new out-patient over-two-year waits since the targets were announced, with 80 per cent of specialties having fewer than 10 over-two-year waits while 20 per cent have none.

Will the cabinet secretary take an intervention?

Data on our 18-month out-patient target shows that the number of people waiting more than 78 weeks reduced by 48.5 per cent between June last year and March this year, and data on our 12-month out-patient target shows that 41 per cent of specialties had fewer than 10 patients waiting more than 52 weeks. Over-two-year waits for in-patient and day-case treatment have reduced, too, by 27 per cent since the targets were announced.

Will the member take an intervention?

I will give way to Jackie Baillie, because she was first.

The cabinet secretary will of course realise that the targets that his predecessor set were to completely eradicate those waiting lists—he did not say, “Reduce them”; he said, “Eradicate them”—and that those targets were set after the pandemic.

As I have outlined, we are making steady progress and seeing capacity increase in our NHS in order to continue to reduce those waiting lists.

All that work is further supported by our flagship national treatment centre programme. Four NTCs are opening this year, which will provide significant new and protected capacity for orthopaedics, ophthalmics and diagnostics. The new centres, which include ones in NHS Fife and NHS Highland that opened in March and April, will provide eight orthopaedic theatres, an in-patient and day-case ward, three endoscopy rooms and two general theatres.

I recognise that orthopaedics is one of our most challenged specialties, which is why last week I met orthopaedic leads and asked them to support the development of a clear and specific plan for orthopaedics, considering capacity and what further improvements can be achieved. I want to see direct action in addressing the issue of orthopaedics, which Jackie Baillie raised.

The work that we are taking forward also includes investing in the recruitment and retention of staff. NHS staff levels are historically high under this Government, with nearly 23 per cent more in post than when we came into government. Only last week, I announced that health boards have exceeded the target of recruiting an additional 750 registered nurses and allied health professionals from overseas, with 800 firm offers in place. We will continue to do what we can to make a long-term investment in healthcare education, too, which is demonstrated by our funding a record number of nursing and midwifery student places this year.

I reiterate my commitment to recovery and reform for a sustainable NHS, and my commitment to focus on what can be done now and in the short term to maximise all capacity and resources to ensure that we see further improvements this year and into next year. As we build on the progress that we have made in the face of our challenges, we will continue to maximise our capacity to achieve year-on-year reductions in the number of people who have waited too long for treatment in NHS Scotland.

I move amendment S6M-09462.2, to leave out from “is deeply” to end and insert,

“recognises the impact of the COVID-19 pandemic on both the people of Scotland directly, and on the operation of the health service; further recognises that too many people are waiting too long for treatment, and welcomes the reductions in the longest waits recently; notes that health services across the four nations are dealing with the effects of the pandemic on waiting times, and recognises that use of the independent sector by individuals is proportionately lower than that in England or Wales; supports the twin approach of investment and reform of the NHS so that delivery continues to be enhanced, backed by investment founded in progressive taxation; appreciates that the workforce is at the heart of all that the NHS does, and thanks everyone working in the NHS for their dedication, expertise and commitment; believes that the NHS must be kept true to its founding principles of being publicly owned, publicly operated, and free at the point of need, and further believes that the only way to protect the NHS from the threat posed by the UK Government is to realise independence for Scotland.”

I call Sandesh Gulhane to speak to and move amendment S6M-09462.1 for up to four minutes.

15:03  

I refer members to my entry in the register of members’ interests: I am a practising NHS general practitioner.

Our heroic NHS staff have been failed by the SNP’s management of Scotland’s NHS. The multitude of failures and the neglect have resulted in prolonged suffering and deteriorating health for countless patients. The consequences of dereliction of duty are far reaching and unacceptable. More than 800,000 Scots are on NHS waiting lists; more than 18,000 Scots died last year while waiting for treatment. Cancer waiting times in Scotland are the worst ever.

Let us be clear: that is not down to Covid—the SNP last met its target more than a decade ago. It is a betrayal of trust and a failure to deliver the quality healthcare that patients deserve. It is simply unacceptable.

Equally distressing are the record waiting times in accident and emergency departments. Urgent action is needed to rectify that dire situation, but does the SNP-Green Government act? No, it does not.

The failure to meet waiting times for child and adolescent mental health services has left so many of our young people in jeopardy. Again, that is not due to Covid. The SNP has never met its target for 90 per cent of children and young people to start treatment within 18 weeks of referral.

When Humza Yousaf was promoted to First Minister, 7,700 children were left waiting to start treatment. That is a disgrace. The Deputy First Minister also knows a thing or two about announcements and no delivery. When Shona Robison was health secretary, she promised to end delayed discharge from hospital by the end of 2015. Seven years on, more than 17,000 beds a day are occupied due to delayed discharge.

Moreover, SNP-Green Government cuts to general practitioner budgets, as well as to health and social care spending, demonstrate a shocking lack of foresight and a disregard for the wellbeing of the population—£65 million has been cut from the primary care budget, £38 million from mental health care and £17 million from social care.

Since the SNP promised, in 2017, to increase the number of GPs by 800, GP numbers have actually decreased by 26, yet that pledge was made time and again by Humza Yousaf, who said in the chamber and in the press that the Government was on target.

The SNP has undermined the very foundations of our healthcare system, leaving it teetering on the brink of collapse. We now have an alarming number of vacancies for clinical staff: more than 6,000 nurses are missing and the Scottish Government is spending an exorbitant amount on hiring agency staff.

Take note: over the past decade, the SNP has short-changed our NHS by more than £17 million and not fully passed on the Barnett consequentials to our health service. The SNP’s management of Scotland’s NHS is marred by record failure, and it is clear that the SNP has run out of ideas. We need a fresh approach that incorporates modern, efficient and local solutions in healthcare. In light of those pressing issues, we call on the cabinet secretary for health to present a revised NHS recovery plan—one that includes the fact that Humza Yousaf knew in February that the projections for his flimsy recovery plan had dropped significantly.

Scotland does not need a cabinet secretary who is just a continuity candidate. There is a palpable lack of accountability and a history of failure. We urge the cabinet secretary to deliver a credible plan—a fresh approach that prioritises the wellbeing of our people and ensures that our healthcare system is properly supported.

I move amendment S6M-09462.1, to insert after “2022-23”:

“; notes with concern that long waits are an issue throughout all aspects of the health service, with cancer waiting times at their worst ever level, A&E targets not being met in three years, and the Scottish Government failing to clear the Child and Adolescent Mental Health Services (CAMHS) backlog”.

15:07  

I am grateful to Jackie Baillie for securing time for this important debate. I would say that I am happy to speak in it, but that would be a lie. I mean, here we are again—it is like beating your head against a brick wall. The facts that are set out in the motion make for grim reading indeed. We keep having to have this debate in Opposition time, because the Government will not get to grips with the crisis that it is presiding over.

A staggering 779,000 people are waiting for treatment, and some 7,000 of them have been waiting for more than two years. There has been a 73 per cent increase in the number of Scots who are paying for private medical treatment. The very worst statistic of all is that more than 18,000 patients died while waiting for treatment last year alone—18,000. Think about that for a second, Presiding Officer, because we are in the foothills of a public inquiry that will ascertain the root causes and decisions that contributed to the deaths of 15,000 Scots during the entirety of the pandemic. How many of those 18,000 people might be alive today were it not for the crisis that is engulfing our national health service? The stakes simply could not be higher.

I have lost count of the number of times that we have had to debate this issue in Opposition time. Whether they are forced to wait for hours for an ambulance or to be seen at A and E, left abandoned on trolleys or languishing on wards, people are being let down. I fear that we have become accustomed and desensitised to crisis and, indeed, tragedy in our health service.

It is simply not good enough. We may have a new First Minister and a new health secretary, but it is the same old, same old when it comes to ministerial disinterest and mismanagement. Did someone mention continuity? It feels as though that is what we are getting.

I want to be crystal clear from the outset that none of that is the fault of NHS staff. They have worked their socks off. They have worked for long hours, often under the most stressful conditions imaginable, and they deserve our utmost thanks—but they are being let down as well. There are currently more than 7,000 NHS workforce vacancies left unfilled. The chair of the British Medical Association Scotland, Dr Iain Kennedy, has said that doctors and other healthcare workers are “exhausted” and “facing burn-out” under increasing workloads.

Now the Government’s failure to negotiate fair pay means that junior doctors are set to strike, making things even more difficult. When he was health secretary, Humza Yousaf repeatedly rejected my party’s calls for a staff burnout prevention strategy and a health and social care staff assembly. How helpful might those have proved to be in allowing junior doctors to feel better supported and ensuring a conduit for their views to be heard? Instead, they now feel that they have no recourse other than industrial action. Let us remember that Humza Yousaf, during his leadership campaign, set great store by pointing to Scotland as the only place where NHS strikes were not happening—well, they are happening now.

Under this Government’s watch, costs for temporary staff rose to £567 million last year. It would seem that, rather than making the meaningful investment that our health service needs, this Government is relying on short-term fixes to plug the gaps. They are sticking plasters.

The SNP enjoys comparing Scotland with the rest of the UK when it suits it, which is not so with NHS waiting times. Waits in Scotland are twice the length of those south of the border. In England, around 10,000 patients have been waiting longer than 18 months for treatment; in Scotland, 21,000 have. It is no wonder, then, that so many people are turning to private medical treatment. The Government should be utterly embarrassed by that. Competent management of our health service is, perhaps, the measure of a civilised society. It is what we elect our Government to do, first and foremost. What an indictment it is, then, that people are being forced to pay to get well.

Let me say to the Government and to the health secretary: stop blaming the pandemic. It insults the intelligence and seriously tests the patience of both staff and patients. Instead, the Government must now follow the advice of the Scottish Liberal Democrats and invest in our health service, give staff the fair pay that they deserve, adopt our burnout prevention strategy and set up that staff assembly, so that doctors, nurses and junior trainees can feel heard and understood, rather than ignored and unappreciated.

We move to the open debate and back-bench speeches of up to four minutes.

15:12  

I appreciate that the SNP has other things to be worried about this week, but Scottish Labour remains firmly focused on the priorities of Scottish people. That is why we are debating the issue of increasing waiting lists, which is impacting so many across the country. Labour was required to bring this important debate to the chamber, as the current Government tries to hide from the necessary business of the day. The Government needs to listen, and to act.

One in seven Scots find themselves on waiting lists today. Many of them have been waiting for months, if not years. Many, like the countless constituents who have been contacting me, are waiting with insufferable pain. Tragically, many have died while waiting.

The Scottish Government can point to the pandemic as a global factor that caused unavoidable challenges; predictably, the cabinet secretary did so. Indeed, we do not disagree—we know that the pandemic exacerbated issues with waiting lists. However, the reality is that it is disingenuous and plainly incorrect to suggest that it was not an issue before, and it is disingenuous and plainly wrong to say today that we are making good progress. I had been told to expect better from this cabinet secretary.

Long waiting lists predate the pandemic. They are a result of Governments avoiding difficult decisions; in Scotland, that is in plain sight. They are a result of a Government that is tired, after 16 years, and that has failed services, staff and patients. Why? To push its own agenda. Let me be clear that our NHS workforce is incredible. The service that they continue to strive to provide daily is of the highest standard, but they are being badly let down and they deserve a lot better.

In relation to debates such as this, we all look at the correspondence that we receive from constituents, who feel helpless. They are in pain, they are suffering and they cannot live the lives that they want to live with their children, friends and families. They feel guilty for being unable to do the things that they used to be able to do, because they are sitting on waiting lists and they have no indication of when their time will come. That is the unfortunate reality of SNP Scotland.

The SNP members at the back of the chamber will not like to hear this, but they know as well as we do that it is a reality; they receive correspondence from constituents, too. Do they scrutinise, or do they accept the excuses? Do they push those on the SNP front benches to do something, or do they clap to drown out the reality?

Will the member take an intervention?

I will not take an intervention, thank you. Members need to listen to this. They need to live with the decisions that they make in that regard.

Like others, I was shocked and saddened to hear that more than 18,000 people had died on NHS waiting lists last year. If the trend continues, the figure will be more than 20,000 this year. That is tragic.

If that does anything, it should tell the cabinet secretary and the Government that more of the same simply will not do. We need a plan for reducing waiting lists that supports NHS staff by improving recruitment and retention; by opening up national treatment centres urgently, supported by a highly skilled workforce; and by delivering for patients through action, rather than making promises and failing to follow through. It has become clearer to people every day that this Government, while it is no stranger to a strategy, has a poor relationship with delivery. That must change.

The challenges that we face with waiting lists are 16 years in the making, and they have undoubtedly been worsened in recent years by existing problems. Despite that, however, the NHS workforce is lacking a funded and targeted investment plan. This Government is falling short on reducing waiting lists; it is time that it stepped up and provided a service to our NHS staff and patients.

15:16  

I welcome the debate. It is right that we look at the NHS.

However, I sometimes think, when Labour brings these health issues to the chamber, that its members are living very much in a political bubble and not looking at what is happening on the ground. In my constituency of Coatbridge and Chryston, the Labour Party would have removed the accident and emergency department from our local hospital, Monklands, if it had had its way and if it had not been for this Government and the previous Cabinet Secretary for Health and Wellbeing and First Minister, Nicola Sturgeon, reversing the decision. That is never mentioned, but it would have been an absolutely catastrophic blow—

Sixteen years ago.

That was 16 years ago—what is happening now?

Members are saying “16 years”, but that is—

Will the member give way?

I will not be taking any interventions, because I have only four minutes—Labour should have picked a time when there was longer for debate.

The key issue in the debate is to address NHS waiting lists and the workforce crisis. That is an issue, and it is important that we are discussing such issues, but we have to do so—as the cabinet secretary has said—in the context of the past few years.

Yes, it is true that waiting lists for certain treatments are long; we will all have constituents and personal contacts who have experienced that. However, it is also true that the pandemic brought about the most challenging set of circumstances in the 75-year history of our NHS—

Will the member take a brief intervention on that point?

I cannot—I am sorry.

That applies to the health service not only in Scotland but in Northern Ireland, Wales and England. The Labour motion completely fails to acknowledge that, but it is the reality of the situation. We are not alone in that.

It is true that the Scottish Government decides policy and funding for the NHS, and it is also true that the Scottish Government funds the NHS to a higher level, proportionately, than other Governments across the UK—[Interruption.]

It is the Labour Party members, and their friends in the Tory party, who do not like those facts.

The SNP-led Government’s £100 billion NHS recovery plan has delivered a significant reduction in the number of two-year out-patient waits. The waiting time targets have already led to a substantial increase in the number of patients seen, with almost 56,000 in-patients or day cases, and more than 311,000 out-patients, seen in the quarter to the end of December 2022. Those are the highest numbers of patients seen since the onset of the Covid pandemic.

With regard to staffing, once again, we must consider the issue in the wider context of the rest of the UK. Since the SNP first entered government, NHS staffing has increased by 22.7 per cent. Recent research from the end of 2022 shows that NHS Scotland has higher staffing per head than NHS England. Scotland has also invested in the future sustainability of the NHS, with NHS agenda for change staff being paid better here than anywhere else in the UK.

There is an issue with bank staff—as MSPs, we all hear that. Perhaps the cabinet secretary can reflect on that in summing up, because a lot of staff are saying that they can get better pay as bank staff.

Finally, the motion touches on the rise in the number of patients having to pay for private care, and it is important to analyse that increase in a wider context. The rise in the number of people paying for private healthcare is, again, not unique to Scotland; it affects health services right across the UK. Wales has similar rates, and self-pay admissions have been at their highest or joint highest levels over the past four years in eight out of nine English regions.

The rise in the number of patients across the UK having to use private healthcare is very concerning to me, and it is probably concerning for others. However, unlike the Tories—and perhaps Labour as well—who might be happy for our NHS to be run by private providers like in England, and Labour, whose private finance initiative policies caused unprecedented damage to our NHS, the Scottish Government continues to support the principle of a public service that is free at the point of use and need.

Will the member give way?

No, I will not.

The member is about to conclude.

The Scottish Government supported buy-outs of hospital car parks in Glasgow and Dundee last year and supported the ending of private finance initiative contracts that outsourced a range of hospital support services. For example, Wishaw hospital in my colleague Clare Adamson’s constituency has brought those services back in-house.

The NHS in Scotland faces grave challenges, but the Scottish Government continues to fund and support our NHS with the limited powers that we have. I will leave it there.

15:21  

Fulton MacGregor is trying to defend the indefensible. What can be said in four minutes? Let me start by saying how let down patients, their families and NHS workers feel. We put a lot of trust in the NHS; we trust it with our lives and the lives of our loved ones, but dedicated doctors and nurses feel the frustrations of a system that too often fails patients, and they feel that acutely.

A health board in my constituency is in special measures because of a failure of leadership accountability and culture. The lack of accountability is startling. The board has launched a host of initiatives, but, as elected representatives, we are told that it is too soon to say whether they are working. The special measures will probably last for more than a year. My constituents are fully entitled to question how well the NHS works in their area, and they are entitled to explanations for huge waiting lists and missed targets.

The more waiting lists increase, the more people who have paid their taxes and put their trust in the system are being let down. We all know that it is heartbreaking to listen to their stories. It comes down to a lack of capacity in the system, which is a failure of leadership by the Government. Many people in my constituency struggle even to get an appointment at their local health centre, because general practice lists are full to bursting point.

I am not saying any of that to criticise the brilliant people who work tirelessly in our NHS. For most NHS staff, their work is a vocation. They consistently go above and beyond, because, if they did not, the whole system would collapse. However, they are being asked to do more and more, and, as a result, their mental health suffers.

We have record levels of spending in the NHS despite the fact that the Scottish Government did not pass on £16 billion of Barnett consequentials that should have gone into the health service. We also have record levels of vacancies, and there is a crisis in recruitment and retention. There are astonishing levels of vacancies in key roles.

What has gone wrong? In short, there has been a catastrophic failure of workforce planning, and that failure is the failure of SNP Scottish ministers and their lack of strategic planning. They are in their 17th year in government. There can be no passing of the buck.

We have a problem of toxic workplace cultures in many places, including in NHS Forth Valley, meaning that critically important staff are leaving. Time and again, whistleblowers speak of bullying and intimidation. All that is not happening just because of the pandemic. Nothing makes NHS workers more frustrated or angry than to hear ministers trot out those tired old lines, because this goes a long way back before the pandemic; it goes back to when Andrew Neil said to Nicola Sturgeon in an interview that the NHS in Scotland needed legislation to protect it from the SNP. What we are talking about in this debate is a colossal failure of Government.

The NHS is a complex organisation and bringing about change is akin to turning around a fleet of tankers, but management tick boxing has been prioritised by management over providing the service that patients expect and need. To change the culture, we need leadership, and that starts at the top. Courage is needed to break the failed groupthink that currently exists in too many parts of Scotland’s NHS. We need a culture that focuses on delivering the core purpose of the NHS: patient-centred care that is free at the point of need. For that to happen, I fear that we need a new set of Scottish ministers who are open to the change that is needed badly.

15:25  

Across the country, patients and staff are crying out for help to get the treatment that they need or support to do their job; that is what overwhelms my email inbox and office phone line. I get email after email and call after call from people who are in pain, unable to work or unable to go about their daily life because they are on a waiting list with no end in sight. If that is what I get and what Carol Mochan gets, it is what every single MSP will be getting, yet the Government comes to the chamber and dismisses those concerns. Instead, it continues to blame the pandemic for record waiting times, delays to national treatment centres and an NHS workforce crisis.

It is more than two years on from the 2021 election, which is when the people of Cumbernauld and Kilsyth were promised a new treatment centre that we were told would help to clear the waiting lists, but the Government has not even mentioned the treatment centre in its amendment to the motion. In Cumbernauld, it will be June 2028 before the first patients are seen, and even that date is doubtful. The centre will not open in 2026, as was promised on those glossy election leaflets. The treatment centre was meant to help people who were on gynaecology, urology and ophthalmology waiting lists—waiting lists that the health board said had increased by 83 per cent before Covid. At the end of March this year, of those people who were on waiting lists for those specialisms, more than half of ophthalmology patients had been waiting more than 12 weeks, half of all gynaecology patients had waiting times of six months and a quarter of urology patients will wait more than a year.

Under Humza Yousaf, nothing was done to recover from the pandemic, and now we are left with waiting lists that are the First Minister’s legacy; this is his mess, and those are his waiting lists. Freedom of information requests that I have seen show two years that have simply been wasted. Damning internal documents put into doubt the new centre that is meant for Cumbernauld. Report after report has warned that NHS Lanarkshire is concerned about its

“inability to fund and recruit additional workforce”.

The health board is concerned about how it will attract staff to the town, and, worse still,

“due to workforce restrictions, the board may have to increase days of working per week.”

That means asking burnt-out NHS staff, who are already struggling, to increase their working week to cover for SNP Government failures. That is entirely unacceptable, but the First Minister knows that—he knows that he wasted two years while those waiting lists spiralled.

When the First Minister gave an update on his NHS recovery plan in October 2022, it scrubbed out the timescales for Cumbernauld’s new local centre, and, when the health board did the right thing and said that the opening date should be pushed back to 2028, his Government published its updates with no dates at all. That was a cover-up operation consisting of spin to deceive the people of Cumbernauld. That centre was meant to be worth £40 million in investment and more than £12 million annually, but now it goes without a mention in any Government documents. The First Minister did that knowing full well that, only two months earlier, officials had told him that those election commitments were at risk. They said that

“successful delivery appears to be unachievable”

and that

“the major issues do not appear to be manageable or resolvable”.

That advice was given to the First Minister.

The Government has let down the community of Cumbernauld, and, in today’s amendment, it washes its hands of the issue. Instead of talking about investment in the town, the amendment droned on about England and Wales. The SNP wants to be in power, but it never takes responsibility. Patients and staff are fed up with endless excuses and the Government’s constant blaming of someone else for its ineptitude. Only the Labour Party will properly fund our NHS, ensure that it is fighting fit and deliver the treatment centre for Cumbernauld that is so desperately needed.

15:30  

I am so disappointed this afternoon. I am disappointed because our health service has challenges—there is no doubt about that—but the Labour Party has brought to the chamber a debate that completely ignores the impact of the coronavirus on our NHS and it is attacking this Government while completely failing to point out the inadequacies of the Westminster Government, including the Trussonomics budget that led to what Mark Drakeford described as a sledgehammer being taken to the economy and public service. Both of those things have had an impact on the NHS in Scotland, too.

We have big challenges to face. However, given some of the things that have been said about workforce planning and about people working, I say to Conservative colleagues, including Dr Gulhane, that the pension rules that have made it financially unattractive for retired health service professionals to come back and support the health service are not in the control of this Government. They are in the control of—

Will the member take an intervention?

No. I will not take any interventions.

Those rules are in the control of Westminster—[Interruption.]

Members!

Westminster could have changed those pension rules. It is quite ready to come forward with section 35 orders on things that we want to do here. How about fixing the pensions situation so that retired doctors and doctors who would be willing to come back to the NHS can do so at financial benefit—[Interruption.]

Dr Gulhane, please. We need to listen to the member who has the floor. [Interruption.] Excuse me, Dr Gulhane. I said that we need to listen to the member who has the floor. Thank you very much indeed. Ms Adamson, please continue.

What about the immigration system? What about the hostile environment that makes it less attractive for people to come here? Brexit has in itself made people think twice about coming to the United Kingdom. However, I have spoken already in the chamber and I will speak again about the plight of Sudanese health workers who have gone home or who were in Sudan at the time of the conflict and have been unable to bring their families here, or have been unable to come back into the country with an elderly relative and are stuck in Egypt or in Dubai. These are people who work for our health service, who are being denied the opportunity to help their families at a terrible, terrible time of need.

Where are the Tories when it comes to fixing that situation to make it more attractive for people to stay and to be able to come and work here? That is a shocking indictment of what the UK Government is doing in terms of immigration, and we wonder why we cannot recruit people.

Will the member give way?

I am not going to take any interventions—sorry. [Interruption.]

Craig Hoy rose—

I have just a very short time for my speech this afternoon. [Interruption.]

Members! I have already said that we need to listen to the member who has the floor. Thank you.

I understand Labour’s concerns. I think that we all understand the concerns for our NHS. However, it is simply not possible to ignore what Labour’s own ministers have said or the concerns that they have raised, including the Minister for Health and Social Services in the Welsh Government, Eluned Morgan, who recently blamed chronic underfunding by the UK Government for making the management of the Welsh NHS extremely difficult and who called last winter the most difficult time in the history of the NHS. Those concerns are also felt in Scotland. Those have also been the conditions that our health workers have been working in.

I agree that we need to work harder, and Michael Matheson has pointed out how hard he is working to ensure that we still have the best-paid health workers in this country and that we can protect things such as free prescriptions and free eye tests—things that people in Scotland value. However, it would be really nice if the Labour Party, for once, could put a bit of criticism on to the UK Government about its failure to support the NHS here and in Wales.

On a point of order, Presiding Officer. Can you tell us whether there is a means by which it is possible to amend or correct the official record of this Parliament when a member has knowingly or unknowingly presented things in a speech that are factually incorrect—for example, in relation to pensions and doctors or perhaps in relation to record levels of immigration to this country over the past two years?

I thank Mr Kerr for his contribution. We are straying into debating points. On the issue of correcting the record, I think that Mr Kerr is well aware of the mechanism that exists to that end.

15:34  

I begin by expressing my heartfelt thanks to everyone who works in our NHS. They have had a mountain to climb since the outbreak of the pandemic. The fact that so many staff members have worked so hard to keep us safe while facing that enormous challenge is incredible. There have also been huge impacts on patients, with too many people waiting too long for treatment due to the backlog in care that has been exacerbated by Covid. It is undeniable that we have to get those waits down. However, it is also essential that people are supported while they wait.

In the Health, Social Care and Sport Committee, we have been hearing about waiting well initiatives that are being implemented by health boards, whereby patients are sent letters when there are long waits. In NHS Fife, for example, staff engage in person-centred conversations with patients in all specialties to give them information about the expected waiting time and the reasons behind that and to signpost them to other opportunities. That keeps the lines of communication open and allows patients to keep in touch with the relevant consultants.

In my region, NHS Forth Valley has implemented assessment appointments in order to reduce waiting times. Between July and September 2022, all patients who were on the adult psychological therapies waiting list were offered an assessment appointment with a clinician, which allowed them to be matched to an appropriate intervention without unnecessary waits. That has reduced waits, but it has also allowed the board to undertake more effective service planning to better match the types of demand to capacity. We would all recognise that that has relevance beyond the current time period.

Keeping in contact with patients who are on waiting lists and keeping them informed about how long they can reasonably expect to wait will help to reduce patient anxiety. It is worth noting that boards are implementing new and innovative ways to do that. However, there is still much work to do.

I am very concerned about staff wellbeing, as I know other members will be, given the amount of pressure that people are under. Staff had to shift from fighting Covid-19 during the worst periods of the pandemic to tackling the huge backlog that built up during the lockdowns. Members have heard many times about the impact that that has had on people. Staff are also being affected by workforce pressures, as vacancies are a key barrier to reducing workloads and waiting times. Recruitment efforts must be prioritised, as must retention. We need to ensure that the NHS has sufficient staff to tackle the backlog, and the promotion of staff wellbeing must play a key part in improving retention.

In the health committee, we have also heard from health boards about how maintaining a focus on wellbeing has aided them in those efforts. During an evidence session, Robin McNaught, who is the director of finance and e-health at the State Hospitals Board for Scotland, spoke about the positive impact of peer support and induction on the recruitment and retention of new staff. He described the focus on the development of a peer support network, both clinical and non-clinical, throughout the board. The board has also delivered training sessions on peer support this year. A number of staff are now trained as peer support workers and they can provide dedicated support to new staff.

At a later committee evidence session, I asked representatives of NHS Fife, NHS Grampian and NHS Lothian whether they had considered setting up similar networks. They confirmed that they have rolled out peer support models across their organisations, as well as wellbeing initiatives such as psychological first aid and speak up ambassadors.

I would be interested to hear from the cabinet secretary in his closing speech how the Government can support all health boards to roll out such peer support schemes where they are not already in place. I would also be grateful for an update on the implementation of safe staffing legislation, as that will also help to reduce the pressure on staff.

We must not underestimate the challenges of working through the backlogs in care. While that work is on-going, we must be keenly aware of the extra pressure and stress that it causes for staff, patients and their loved ones, and we must do everything in our power to alleviate that.

15:39  

I appreciate the opportunity to speak in the debate because it is only the third time that I have been able to contribute to a debate on a health motion. It is, however, disappointing to be repeating myself about the pitiful record of the SNP-Green Government when it comes to Scotland’s failing health service, especially with regard to mental health provision for our children and young people.

Many care-experienced children are likely to suffer from mental health issues, including attention deficit hyperactivity disorder, anxiety, depression and eating disorders, and it is to that part of the Conservative amendment that I want to draw the attention of Parliament, because it is imperative that we stop looking at those situations in isolation.

Both my daughters have experience of the aforementioned mental health issues. For most of their adolescence, they had to contend with extreme anxiety, which manifested itself in paralysing fear and insomnia, difficulty in maintaining focus, control practices in relation to food, and periods of debilitating depression. They are not alone in their experience.

Time and again, we stand in the chamber and voice our collective backing for the Promise, and we regularly renew our commitment to changing the lives of care-experienced children, but that is impossible if we do not recognise the connection between that and the mental health of our young people.

I want to draw members’ attention to the statistics for NHS Forth Valley, which is in my region, especially those for child and adolescent mental health services waiting times. Nearly two thirds of young people in the NHS Forth Valley area who are struggling with their mental health are not being seen within the target time. Figures show that NHS Forth Valley has missed a key child mental health waiting time target. Between January and March 2023, only 42 per cent of patients began treatment within 18 weeks, which is absolutely disgusting when we consider that the target is 90 per cent. Fewer than half of our local young people are being seen within the allocated time frame. Most shocking of all is that half of the referrals for CAMHS in the area were rejected altogether: 110 young people in a single month found themselves without support.

No one but SNP ministers is creating those targets for the Scottish Government. It makes me wonder whether the targets are based on any tangible analyses or are simply plucked out of thin air for a hashtag and a headline. Time and again, we are told of the work that is being done by the SNP-Green Scottish Government to reduce waiting times, but nothing is happening. We hear chants ad nauseam about increased spending per head of population, but what are we actually seeing for that additional spending? Surely 10 per cent extra spending should at least result in a 10 per cent increase in service provision. Of course, while all that goes on, our young people with mental health issues have nothing to show for that headline-grabbing funding and are left living through mental and emotional hell.

The final area that I wish to highlight concerns the pandemic and the consequences of locking down our young people. Our response to the pandemic has had a massive detrimental effect on our young people and we have barely begun to scratch the surface of the on-going problems that it will cause their generation. Furthermore, we are missing targets now, but the situation is surely going to get worse.

However, the pandemic was a massive magnifying glass for scrutinising every one of our processes: businesses and all levels of government alike were put under a microscope and analysed. The pandemic highlighted where society was working just as much as it highlighted where it was not.

If we only, and blindly, use our current situation as an excuse for recovery delay, we are missing the opportunity to fix what was wrong in the first place and we do a disservice to the people whom we serve—especially in terms of the on-going mental health of Scotland’s children.

15:43  

The Scottish Government is determined to reduce waiting times across all health specialties. Within the past seven days alone, the health secretary has announced funding for a new national digital dermatology programme, which could reduce demand for out-patient appointments in dermatology—one of the biggest out-patient specialties in Scotland—by up to 50 per cent.

In addition to that, on Monday in Inverness the First Minister opened Scotland’s third national treatment centre. The extra capacity that it has created will help to reduce NHS waiting lists that have built up during the pandemic, and the two further NTCs that are set to open this year will help to further that aim.

Although there is still more to do, since targets were announced last July such actions have resulted in a continued reduction in long waits of over 18 months, as well as a significant reduction in long waits of over two years.

The Labour motion shows us that that party has its head in the sand and demonstrates how little it understands the challenges that are faced by our NHS—not only in Scotland but across all the UK nations. There is no recognition or acknowledgement in it of the biggest challenge that the NHS has faced in its almost 75 years of existence: that is, the Covid-19 pandemic. Scottish Labour might not wish to accept that fact coming from SNP members, but it should listen to Welsh Labour’s First Minister, who recently said:

“The health services are trying to cope with the impact of the coronavirus, and they are also trying to re-establish everything else that is important in those services.”

Quite evidently, health services across the four nations and, indeed, internationally, are dealing with the effects of the pandemic on waiting times.

I also find it telling that, in its motion, Labour refers to use of private healthcare, which—although Labour would have us believe otherwise—is not unique to Scotland but affects health services across the UK. The rate of people who are self-funding for private in-patient day-case care in England is 19.9 per cent higher than it is in Scotland. In Wales, where Labour has been in charge of the health service for about 25 years, the rate is an eye-watering 120 percent higher than it is in Scotland. Labour’s UK shadow health secretary, Wes Streeting, recently said that

“Labour would use the spare capacity in the private sector to get patients seen faster”.

Another area in which some self-reflection from Labour would not go amiss is Brexit, which it now fully supports despite the impact that it is having on recruiting and retaining NHS staff. Although NHS staffing is up to historically high levels under this Scottish Government, we know that workers from overseas have long been an important part of our health and care workforce, and that international recruitment is vital to addressing staffing shortages in the NHS. Since Brexit, the number of new international nurse registrants from inside the European Union has fallen dramatically. Friends and colleagues have returned to their EU home countries, and other people who might have considered a new life here have decided not to come to the UK. That is evidenced in Nursing and Midwifery Council registration data from the past few years, so it is fact, rather than opinion.

As a country, we need to find a way of ensuring that we have an immigration system that is not just humane but meets our social and economic needs.

Will the member take an intervention?

The member is about to conclude.

It is clear that Scotland will not find either of those things as part of the Westminster system of Government. The route to both is Scotland becoming an independent country.

Challenges remain, and there are still unacceptable waits in some specialties, but the Scottish Government remains committed to delivering sustained improvement and year-on-year reductions in waiting times, through maximising capacity across Scotland, enhancing regional and national working, and redesigning care services.

We move to closing speeches. I call Craig Hoy to wind up the debate on behalf of the Scottish Conservatives.

15:47  

I would like to say that what the SNP has lacked in its number of contributions today, it made up for in quality, but those were some of the worst and most delusional speeches that I have heard since coming into this Parliament. It is no surprise that only four back-bench SNP members were in the chamber when the cabinet secretary started her speech. I do not know where the others were—perhaps they were down at the florists—but they were clearly not here.

The debate has exposed a shameful record of this Government on the NHS. There are 7,000 unfilled vacancies in our health service. Since the beginning of this parliamentary session, more than 800,000 people have waited more than four hours at our overstretched accident and emergency departments. In my region, more and more patients are not being seen within the four-hour target at A and E rooms in the Borders and Lothian—more than ever before. At the start of this year, as many as three in seven patients waited in accident and emergency rooms in the Borders and Lothian for longer than four hours. That number is, frankly, unacceptable.

In East Lothian, pressure on the NHS has been mounting due to underfunding of community treatment and care services by the Scottish Government, which has led to closure or suspension of some vital services. At the Edington cottage hospital in North Berwick, the minor injuries clinic has closed and in-patient beds have been removed. That is a monument to ministerial inaction.

The arteries of our social care system are clogged to a critical point, which is having an impact across our NHS and in primary care. Daily, those capacity issues are leading to delays in discharging patients from hospital, as Carol Mochan said. In February alone, 51,732 bed days were lost because of patients waiting to be discharged. That is a shocking increase of 4,019 lost bed days on the figure for February last year.

Therefore, post-pandemic the position is getting worse. Delayed discharges have cost our NHS more than £1.2 billion in the past decade of SNP rule, which is contributing to longer waiting times throughout our NHS. As Jackie Baillie said, that is simply not good enough. We are witnessing severe waiting times across Scotland’s health service.

Perhaps in closing the cabinet secretary might answer the question that I would have asked, had he taken my intervention, which was whether he will say sorry to our constituents, some of whom are elderly, frail and living in pain and are having to borrow money from their children or grandchildren for treatment that they deem to be essential but that would not come quickly enough.

We see some of the longest waiting times in the diagnostic arena, where there is an average wait of 63 days for out-patient neurosurgery, 70 days for respiratory medicine and oral surgery, and 98 days for neurology patients.

Targets were set, targets have been missed and all Government credibility is lost. What do we get from the SNP Government? We get a flimsy recovery plan from a flimsy First Minister—a First Minister who is so flimsy that he is not willing to stand up to his predecessor.

We should all be worried about the state that the NHS is in today under the SNP. In concluding today’s debate, I echo the calls of my colleagues for better funding and support and for urgent action. We have a Government that has lost control of our NHS and social care system right across Scotland. It is an incompetent SNP Government that is more worried now about search warrants than about waiting times, and it is a Government that has mismanaged the NHS workforce.

This SNP Government is forcing patients, young and old, to live in pain. It is a Government that, ultimately, is now more focused on dividing our country than it is on healing its people.

15:51  

My apologies that, in the short time that is available to me, I will not be able to respond to many of the points that members have raised.

I am sure that everyone in the chamber would recognise that our NHS has gone through a major challenge over the past few years, and it would be disingenuous to pretend otherwise. For those who do not want to believe me, they have only to look at the published report from Audit Scotland, which recognises the significant challenge that NHS Scotland is facing as a result of the challenges during the pandemic and Brexit. They have only to look at the National Audit Office’s report on NHS England, which states that

“activity ... has continued to lag behind the pre-pandemic level and is well below planned trajectory”,

and that there are

“significant threats to the recovery”.

In Wales, Audit Wales has said the same thing. It has said that

“Whole system change is overdue”,

and it has talked about the challenges in the system.

Therefore, all parts of the NHS are facing significant challenges, and it will take time to make sure that we are able to address that recovery, which is exactly what our NHS recovery plan is doing. We can see the progress that it is making on waiting lists.

The recovery plan that your Government produced was after the pandemic and after Brexit. Did you not take account of those things? Frankly, the recovery plan is failing.

You need to speak through the chair.

The plan took those factors into account, but they are all still impacting our NHS, which is an important point to be recognised. Ms Baillie said that the targets that we set were to “eradicate” the long waits. Actually, the targets were to do that across the majority of specialties, and we are seeing good progress on that.

Then we had the brass neck of Tory members on several occasions talking about standing up for the founding principles of our NHS, when they are rapidly going through the process of privatising the NHS in England as quickly as they can to keep the fat cats and their back benchers happy while they take money from private healthcare companies. Therefore, it is a bit rich listening to anybody from the Conservative Party talk about the founding principles of the NHS, given that it abandoned them many years ago and is rapidly selling it off to its pals in the private sector as quickly as it can. [Interruption.]

A number of important points were raised—

Excuse me, cabinet secretary—please resume your seat for a second.

I am being talked at by members who are remaining in a sedentary position. That is not acceptable. If members have something to say, they need to intervene and say it. If not, please let the member who has the floor continue to speak.

I want to pick up on a couple of issues that have been raised. Jackie Baillie spoke about orthopaedics. I hope that I will not disappoint her when I tell her that I am ahead of the game on that issue—I have already started work to consider how we can take further action on orthopaedics.

Jackie Baillie also mentioned Ms Murray's father, who is waiting for treatment presently. I do not know the details of that case, but if the member passes those on, I would be more than happy to have that matter looked into as well.

Gillian Mackay raised an important point about the safe staffing legislation. We are making steady progress with that. I had a good meeting with the Royal College of Nursing earlier this week, when we discussed the progress that we are making in the working groups that are taking forward some of the work on the associated guidance for that legislation for next year. I hope that we will continue to make progress with that.

Presiding Officer, I am very conscious of time. In drawing my remarks to a close, I apologise for being unable to respond to many of the points that members have raised in the time that is available to me. I must say to Mr Hoy that some of those are worth more than others.

I will do everything that I can, as the health secretary, to continue to support our NHS staff in the NHS’s recovery, and to protect it from those who would seek to undermine it—and particularly from those on the Conservative benches, who have a track record of trying to undermine our NHS through privatisation and choking off its funding where they can.

One thing that the people of Scotland can be sure of is that this SNP Government is completely committed to an NHS in the public sector’s hands, delivering for the people of Scotland.

15:56  

It is a pleasure to close this debate on the Labour motion on NHS waiting times.

The Government seems oblivious to the fact that we are holding it to account for tests that it set itself after Brexit and after the Covid-19 pandemic. We do not dispute that those are hugely challenging events and that they continue to exert an impact, but any credible plan would have accounted for that variability and stress, and it would have taken countermeasures and actions accordingly. We just have not seen a dynamic or invigorating approach from the Government to try to get on top of the issue; nor have we seen the degree of honesty that we should have from any responsible Government.

This is not simply an abstract, technocratic exercise; we all have skin in the game. One in seven Scots—these are our neighbours, our family members and our friends; it could be one of us—are at the mercy of a system that is in serious distress. Therefore, it was essential that the motion was brought to the chamber for debate today.

I had hoped that members on the Government benches would have treated the motion with that degree of seriousness. However, I have been very disappointed at the tone that has been adopted. We brought the motion in the spirit of collegiality and in the spirit of trying to come together to resolve a common challenge that our country faces and that one of the most precious institutions that our country has ever built faces.

Public Health Scotland data has shown that 31,498 patients are still waiting more than one year for an out-patient appointment. That is completely unacceptable. As we have heard already from colleagues, 18,000 of our fellow citizens have perished waiting on treatment. That is a scandal, and that cannot be treated with the glibness that it has been in the chamber today.

Many members have referred to the structural and systemic issues that our NHS faces. I think that Dr Gulhane mentioned that there is an issue with delayed discharge and that patient flow is critical to achieving efficient systems. That is a fair observation, and it is something that the Government needs to better understand.

Simply maintaining the status quo is not a neutral option, because people are paying the price for that. We have seen the data that shows that 6,895 people face a wait of more than two years for routine surgery. That is two years in agony, two years being disabled and two years being unable to contribute or care for their relatives. That is just not acceptable, and it casts a very dark shadow over our country. It impacts on all sorts of things, including our economic capacity. It introduces lifelong costs and so ends up being a false economy, as people face lifelong disabilities.

The member for Coatbridge and Chryston referred to A and E departments, but that was a red herring. This is stuff that took place when I was still at school. The reality is that this Government has been in power for my entire adult life, and it is about time that it took responsibility for its own actions in government. This continuing nonsense about things that took place a generation ago is simply not acceptable. The reality is that these decisions were taken on this Government’s watch, and it should have the intellectual and moral honesty to take responsibility for them.

What I had wanted to say in my intervention on Mr MacGregor, if he had taken it, was that this is not about the political bubble. This week, I have been speaking to young people in Lanarkshire who have come here from Ukraine seeking sanctuary. They said to me that it is easier and quicker for them to get healthcare by travelling back to Ukraine than it is to get it in Lanarkshire or elsewhere in central Scotland. That is the reality that we are facing.

What does my colleague say to that? I think that people in Scotland expect us to have very strong responses—

Paul Sweeney, please.

It is absolutely critical. Every member will have received correspondence of that kind, whether it is from new Scots or people who have lived here their entire lives.

One constituent of mine was unable to work until he received a series of tests on his heart. He was out of work for almost a year while he waited on an appointment. When it was chased up for him, it transpired that his referral had never been made. That is shocking.

Ms Mackay, the Green member for Central Scotland, mentioned that waiting well initiatives are taking place. We commend and encourage those, and I thought that the Health, Social Care and Sport Committee heard great evidence on them, but the reality is that they are clearly not working. In every instance that they fail, the cabinet secretary must have a report on his desk so that he can understand the root cause of what went wrong and ensure that resilient measures are put in place to correct it.

We have had many other cases. Another constituent of mine was told in 2020 that she needed knee surgery—

Mr Sweeney, you will need to bring your remarks to a close, please.

—and then was told in 2022 that she might need to wait for another two years for treatment. The orthopaedic recovery plan is to be commended, but that case clearly points to a wider policy failure.

In reality, although we recognise that the Government is facing challenges, we are holding it to account on its own tests, which are set according to the constraints that it has already identified. There is not an excuse. The Government needs to get to grips with the crisis that is engulfing our national health service, or we risk losing it for ever.

That concludes the debate. There will be a short pause before we move on to the next item of business.