First Minister’s Question Time
Engagements
1. To ask the First Minister what engagements he has planned for the rest of the day. (S4F-01192)
I have engagements to take forward the Government’s programme for Scotland.
Ruth Davidson—I mean Johann Lamont.
In June 2011, the Scottish Government told us that only 3 per cent of patients had to wait more than nine weeks for an in-patient appointment. The truth was not 3 per cent, but 23 per cent—that is not three out of 100, but one out of four patients waiting. Why did the Scottish Government so mislead patients in need of hospital treatment in that way?
The waiting lists have always had areas of social and medical unavailability. That is part and parcel—[Interruption.]
I hear some disgruntlement from the Labour benches. As members will remember, one of this Government’s first acts was to abolish the availability status code that was established under Labour. That represented 33 per cent of the in-patient waiting list. Presumably, at that time, the Labour Party thought that there were reasons for that figure being 33 per cent. Therefore, Johann Lamont must accept that the 23 per cent figure—which I am quite happy to go into detail about—is, by definition, 10 per cent less than the figure that was inherited from the Labour Party.
The people of Scotland might expect the First Minister to take what I said a little more seriously. It is not good enough for him to come here week after week and to say—this is his new defence—“It wasnae just me who did it.” The fact is that the figures represent real people waiting for real help from the national health service. However, the First Minister’s response is about something entirely different—his is a political game, which is not the key issue.
If the First Minister took his job seriously, he would know that in March 2010 the then health secretary, Nicola Sturgeon, said:
“no one—no one—is on a hidden waiting list.”
Even after we found out that NHS Lothian was fiddling the figures, her replacement, Alex Neil, told the Parliament last December that
“the waiting times that are published by boards are reliable and accurate.”—[Official Report, 20 December 2012; c 15052]
The systems that Nicola Sturgeon and Alex Neil used to make those claims are described by the Royal College of Nursing as
“inadequate for the job and ... letting patients down, time and again”
Is not the truth that, far from abolishing hidden waiting lists, Nicola Sturgeon—for her own political convenience—reinvented and reinforced them?
The social unavailability figures are published so, by definition, they cannot be hidden. [Interruption.] Published figures cannot be hidden.
Johann Lamont says that I am talking about two different things. I am not: I am talking about exactly the same thing. The availability status code was a hidden waiting list because people were placed on that code—33 per cent of people on in-patient waiting lists—and then had no patient guarantee for their pathway through the health service.
There are a variety of reasons why people will not have operations at a particular time. They might have a medical condition that prevents them from having an operation, such as high blood pressure or a heart condition, or they could be pregnant, which would make a medical procedure inadvisable. Those reasons are in the report, if indeed Labour members have read it.
The report points to the fact that the information technology systems in the health service are not robust enough to give the proper examination across the health boards. That is exactly why the IT systems are being enhanced and improved. Therefore, it is not just a tale of two Governments. It is a tale of changing a system that was clearly a hidden waiting list, which affected 33 per cent of patients; of constant improvement to get the IT systems into a position that enables us to have robust figures; and of making the changes that are required so that patients round Scotland can have confidence in the figures. That shows that the Government is facing the issues, as opposed to the position that we inherited, in which people were dumped on the availability status code and left there ad infinitum.
The First Minister’s first defence is that there is nothing wrong; his second defence is, “A big bad computer did it and ran away”; and then he says, “However, we are changing things.” If he does not understand what the problem is, I am bemused about how he can work out what the changes should be.
Let me make it simple for the First Minister. In June 2011, Nicola Sturgeon was given a set of figures that said that only 3 per cent of patients waited for more than nine weeks for hospital treatment when the truth was that it was 23 per cent. At the same time, she was given figures that said that the number of people who were too busy to go to get the treatment that they needed had tripled. She was told that one Scot in three on waiting lists had said that they were too busy to be cured.
Nicola Sturgeon knew what was happening. Did she not have the wit to notice that waiting lists were being falsified or did it simply suit her purpose?
Let us have a look at why patients might not be able to have their operation in the timescale of a waiting list. [Laughter.] Okay, let us point to page 30 of the report. Audit Scotland recognised that medical unavailability
“has remained fairly constant … at around six to eight per cent over recent years”.
There is an element, which has been consistent over recent years, of people who, for medical reasons, are not in a position to have their procedure within the waiting time. That is medical unavailability. There is also a range of reasons why people might not want to have an operation at a specific time, such as work reasons or because they are on holiday. That is also perfectly legitimate.
The report points to the IT systems not being robust enough to provide that examination. That is the point of the report. If we have a problem with our information technology systems, is it not a good idea to introduce the TrakCare system to sort it out? Would it be preferable to leave it alone, as the Labour Party did, and not improve these things in the health service?
We can point to areas that are not about social or medical unavailability. We know that 88 per cent of patients are satisfied with the waiting times in the national health service. Although 88 per cent is not 100 per cent and means that the national health service is not perfect, it is a very high figure indeed. That means that, although the national health service is not perfect, it is an outstanding health service and every member in the chamber should be proud of the work that it does.
It is precisely because of the importance of the national health service that we deserve better than a Government that looks at health figures in order to gain political advantage rather than to serve the interests of patients. In December, Alex Neil said that there was nothing wrong. Today, the First Minister again says that there is nothing wrong. The rest of the world knows that the figures were manipulated to avoid the Government having to confront the failures in its own policy.
Of course, one policy, one code and one belief runs through everything at the heart of the Government: the nationalists think that, whatever the truth, if they say something often enough, they can fool the people of Scotland into believing it. [Interruption.]
Order.
Alex Salmond believed that, if he compared his protégé Nicola Sturgeon to Nye Bevan often enough, we would see her in the same light. I have to tell members that Nye Bevan never put press releases above patients. [Interruption.]
Order.
We have found out from Audit Scotland that patients come second to propaganda with this Government. Someone should tell Nicola Sturgeon that false statistics and public perceptions do not cure patients, and they do not win referendums either.
It has been said that, in politics—[Interruption.] It has been said that, in politics, there are two types of health ministers: failures and those who get out in time. Today, is not the truth laid bare that, despite the spin, Nicola Sturgeon did not get out in time?
I was going to say that there are three types of health minister. There was Andy Kerr, who tried to close accident and emergency wards before we sorted that out.
Let us address the issue. First, the Audit Scotland report examined 273,000 transactions and the internal health board audits examined a further 200,000 transactions. The conclusion was:
“Our sampling found a small number of instances in which unavailability codes were used inappropriately.”
Only a small number of such instances were found out of the vast number of transactions that were investigated.
I have already pointed out the level of patient satisfaction with the health service and waiting times—
That does not make a waiting time guarantee.
Jackie Baillie says that that disnae matter; that is what matters. That is the point.
We can also measure how the health service is doing above and beyond the issue of social unavailability. Since 2008, the median time wait for treatment in Scotland—that is the mid-point in waiting times, which includes those who have been marked as medically or socially unavailable—reduced from 40 days to 32 days. That tells us that there has been an improvement in the national health service over that period.
In reading out her prepared question, Johann Lamont gave the game away. We were told that this Government is obsessed by the politics. This issue is not about the health service; it is all about the Labour Party trying to get Nicola Sturgeon. Did the statement that it released say, “We want improvement in the health service; we want the computer system to be fast-tracked”? No. It said, “Sturgeon knew of hidden waiting lists.” That is the point. Nicola Sturgeon knew of Labour’s hidden waiting lists, which is why she changed things as health secretary.
Jackie Baillie said that when it came to hospital-acquired infection, Scotland was the “superbug capital of Europe”, until she found out that the relevant figures were from 2006, when the Labour Party was in office. The relevance of that is that it typifies Labour’s attitude to the NHS, which is not about improving the service or being jointly proud of the greatest public service in our country, but is about making demeaning political attacks on health secretaries. Instead of coming to the chamber to ask about the improvements that must take place, Labour accuses the Government. My goodness me. Is the Labour leader not aware of the unintentional comedy in her question over the most serious issue of all—the NHS? The NHS is not without failings or faults, but it is an outstanding health service, of which every one of us should be proud.
Question 2, Ruth Davidson.
Secretary of State for Scotland (Meetings)
2. This time—thank you, Presiding Officer.
To ask the First Minister when he will next meet the Secretary of State for Scotland. (S4F-01184)
No plans in the near future.
On Tuesday, the Cabinet Secretary for Rural Affairs and the Environment, Richard Lochhead, gave a statement to the chamber on the still unfolding horsemeat scandal. Can the First Minister tell us why Mr Lochhead failed to mention that the operating budget of the Food Standards Agency in Scotland has been secretly slashed by 10 per cent in the past year?
The general opinion, not of this Government but of every commentator, is that our decision to leave key responsibilities with the Food Standards Agency—as opposed to taking them directly into Government, which is what was done south of the border—has resulted in us being in a better position. We will be in an even better position as we publish our proposals to have a Scottish food standards agency.
A minute ago, it was a computer’s fault and now it is Westminster’s.
The First Minister has made quite a big play of the fact that, in Scotland, none of the FSA’s functions was moved to a Government department and none of its operations was moved elsewhere. Let us look at the timeline, because that makes things worse, not better. The Government learned that there was horsemeat in the food chain on 14 January. On 7 February, it published its spring budget revision, which showed a £1.1 million smash and grab on the FSA three weeks into a food scandal. That was not because any functions had been taken away from the FSA; it is a direct assault on the work that the agency does in Scotland.
Did nobody notice or think that it might be a risky idea to take money out of the FSA’s budget in the middle of a growing crisis? Surely—at this time more than at any other—it needs the full resources and tools to maintain public confidence in our food. Can the First Minister explain the logic behind ripping £1 million from the FSA’s budget?
There is an unconscious irony in a Tory spokesperson talking about “smash and grab” raids or “ripping” apart public spending. Every part of the public sector is under the most extreme pressure, bar the health service, which has been guaranteed a real-terms revenue increase, although it is still under pressure. Given the cuts from the Tory Government at Westminster, every part of the public sector is under pressure. Of course, the decision to leave key functions with the Food Standards Agency, separated from Government, is part of the better—although not perfect—position in Scotland in facing up to the crisis.
Incidentally, I do not accept that confidence in Scottish food has been lowered by the events of the past few weeks. As the Cabinet Secretary for Rural Affairs and the Environment has rightly said, there is a sea change in attitude and in people’s rightful demands about the sourcing and integrity of products. I think that that will be good for the Scottish industry, which can match those high standards. I hope that Ruth Davidson will join with the Government as we prepare a Scottish food standards agency, learning the lessons from the deficiencies that have been clearly shown over the past few weeks and the lessons about the dangers of taking functions out of an independent agency and into Government. I hope that she will work constructively with us to ensure that the new Scottish food standards agency is the best that it possibly can be.
I say gently to Ruth Davidson—
Och!
Well, I will say it very, very gently. I do not know that it is the greatest position for a Conservative leader to come to the Parliament and talk about additional public spending in a week where she has proposed a £500 million reduction through a penny cut in income tax. The Conservative Party should try to equate the calculation: it is difficult for that party to ask for more public spending when its new core policy is really to smash and grab and slash public spending much further.
I have a number of constituency questions and I want to get them in. I ask the three members whom I hope to get in to keep their questions as brief as possible—and if we could get brief answers, that would help.
The First Minister will be aware of the report that was published yesterday confirming that the Forth road bridge is not about to fall into the sea and, indeed, has a long-term future. Does he now regret committing to a massively expensive additional bridge, sucking money away from other projects, before knowing the results of the repair work? What will prevent this Government or a future one from bringing ever more traffic and congestion to the Lothians by going back on the commitment to dedicate the existing bridge to public transport and to avoid an eight-lane motorway across the Forth?
We will maintain the commitment that Alison Johnstone mentions. I do not share her analysis of the situation. Just maintaining the current bridge—not its falling down—would have imposed huge costs on the Scottish economy. That analysis was done. One reason why the Parliament decided to go ahead with the new bridge—by a massive majority, as I remember—is that it looked at that analysis.
It should be quite good news that some of the remedial measures that have been taken over the past few years are having some effect. However, as the report yesterday indicated, there is no guarantee that that position can be consistently maintained in future. That is why we will be in a hugely better position if we can do more rigorous or full-scale maintenance of the current bridge in a situation in which we have an alternative bridge across the Forth so that we do not impose costs on the Scottish economy. Therefore, I do not share Alison Johnstone’s analysis. However, the commitment on the use of the bridge will be maintained by this Government.
The First Minister will be aware that the Scottish Government has taken away the fishing and shooting rights in Raasay from local crofters and sold them to a shooting company in Ayrshire. The crofters have built the value of those rights over the years and invested the profits in their community, thereby boosting the local economy. Does the First Minister agree that the move flies in the face of the ethos of land reform? Will he take steps to overturn the decision immediately and return the rights to the local community, where they rightly belong?
There are difficulties, as the member should know, relating to upholding the Scottish public finance principles and best value. It is not necessarily within ministers’ discretion to overturn those principles, by which we are bound.
However, I heard the minister on the radio this morning addressing the subject and referring to an initiative that would allay some of the fears that had been expressed. I am sure that we all support the Scottish minister in doing that.
To ask the First Minister whether, in light of the fatal accident in Fairlie on 14 February, he believes that a fatal accident inquiry should take place. Also, will he ask Transport Scotland to bring forward a permanent traffic regulation order to restrict the movement of 44-tonne coal lorries through Fairlie and neighbouring communities?
That was a terrible incident and our sympathies are with the family and friends of Miss Catherine Bonner, who sadly lost her life in that tragic incident. The member will understand that police investigations into the accident are on-going and, in light of that, it would be inappropriate to comment on the particular circumstances that will follow from that. However, officials from Transport Scotland will be meeting with the police, and our operating company for the south-west will obtain more detailed information on the general public transport aspects of the incident. Once the investigations are concluded, I will be happy to report back to the constituency member.
Cabinet (Meetings)
3. To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S4F-01187)
Matters of importance to the people of Scotland.
I am astonished that the First Minister seems satisfied with the waiting times figure of 23 per cent. Has he any regrets about what he told us when he put out a press release on 27 May 2008 bragging that the Scottish Government had got rid of “the smoke and mirrors”? Has he got any regrets?
Although there are individual instances of patients who have not been properly treated within the national health service, the NHS and ministers have apologised for those specific circumstances. I was making the point that, if we look at the integrity of the NHS, we have an excellent, first-class health service that, by any measurement, has been improving its efficiency and standards over recent years. In the anxiety for political to-ing and fro-ing, we should not—as a Parliament and as a people—lose sight of how valuable, important and wonderful that institution is. Of course it is not perfect; of course there are demands—rightly—for proper improvement in systems. However, let us remember that the integrity of the system is an outstanding public health service.
The First Minister talks about political to-ing and fro-ing. His Government issued 50 press releases bragging about his waiting times initiative. Fifty press releases! He told us how good the system was at the same time as thousands of people were being sent to the waiting times equivalent of Siberia. Has he got anything humble at all to say to those people?
The availability status code that was used under a Government, of course, that the Liberal party was part of, was abolished. That code could have been described as the health service equivalent of Siberia, because people lost all rights and waiting times within the system.
The whole purpose of the new system that was introduced—the new ways system—was to ensure that people did not lose those rights. The clock was reset and they still retained their rights within the health service. Perhaps that was a helpful question from Willie Rennie, as it allowed me to explain that point. It is a bit much to talk about the health service equivalent of Siberia, which is what the availability status code was when the Liberal party was in power, and then to criticise a system the point of which is to ensure that patients keep their rights within the health service.
I am sure that when Willie Rennie thinks about the matter, he will recognise that there are proper reasons why people might not undergo a procedure in a set timescale. That is why the Audit Scotland key conclusion, out of the sampling of a vast number of patients, found a small number of instances in which unavailability codes were used inappropriately. That finding by Audit Scotland tends to back up the fact that, when improvements are necessary in style and in the computer systems that back up the process to give security, this health service is performing substantially better than it was when the Liberal party was part of the Labour coalition—which did, I am afraid, leave some patients in the health service equivalent of Siberia.
BBC Scotland (Redundancies)
4. To ask the First Minister what recent discussions the Scottish Government has had with the BBC in relation to redundancies at BBC Scotland. (S4F-01190)
In discussions with the chair of the BBC trust, the BBC trustee for Scotland, the director of BBC Scotland and all four director generals of the BBC over the past few months, the Scottish Government has consistently argued for BBC jobs in Scotland and for high-quality news and current affairs coverage.
BBC Scotland’s decision to front load cuts for a licence fee settlement is particularly disappointing. When Scotland is debating a hugely important public decision, the BBC should be prioritising its capacity to cover Scottish current affairs, rather than attacking it or at least reducing it, as is being done presently.
Does the First Minister agree that the BBC’s status as an institution that not only explains Scotland to itself but explains Scotland to the world depends not only on the correspondents that it employs but on every member of staff who supports those people in producing high-quality news and analysis? This week, those staff have felt compelled to take industrial action. Is it now time to heed the call of the National Union of Journalists for a six-month moratorium on the redundancies?
That proposal is positive. I see with dismay that no fewer than nine of a total of 30 compulsory redundancies across the BBC are to be in Scotland. That should tell us that there is huge disquiet among staff about not just their individual futures but the BBC’s collective ability to serve Scotland.
I will give a small example. I am not saying that this will be the most dramatic loss to the Scottish population, but I understand that “Sunday Politics Scotland” will not be broadcast next Sunday, because the Westminster Parliament is in recess. I accept that that might not be devastating news for the vast majority of the Scottish population, but it should raise an issue for reflection.
Surely our public service broadcaster should have the capability to cover politics and current affairs in Scotland and surely it should not be not broadcasting a programme because the Westminster Parliament is in recess. That points to a lack of ability in BBC Scotland to produce a programme with its current resources, which will surely be made much more significantly challenging if the cuts go ahead.
Child Poverty
5. To ask the First Minister whether the Scottish Government plans to implement new measures to tackle child poverty. (S4F-01196)
We should reflect the point that, according to the latest statistics that are available, child poverty is at its lowest level since devolution—the rate is 17 per cent, which is down from 28 per cent in 1999. However, I am sure that there is general agreement that the figure is still far too high. We remain committed to tackling child poverty through early intervention and prevention. That was set out in the child poverty strategy, which focused on maximising household incomes and improving children’s life chances.
Earlier this week, Professor Kate Pickett told Health and Sport Committee members that inequality is a human rights injustice and that it behoves all of us to shout about it all the time, so that solutions can be found. She argues that many different solutions exist at every level—in our communities, in local authority areas, nationally and internationally.
Today’s Evening Times quotes Dr John McKendrick of Glasgow Caledonian University as saying:
“The evidence is damning. Not only has progress in tackling child poverty ground to a halt, but current levels in Scotland are higher than they were in 2004/5 ... the projections are our poverty shame will worsen as we approach 2020.”
Can we get a question, Mr Smith?
Since we know that some of the First Minister’s flagship policies redistribute in the wrong way, which extends inequality—
Can we get the question, Mr Smith?
—will the First Minister acknowledge the need to re-evaluate his approach?
Drew Smith should acknowledge two points. The Government has many policies that support family budgets and enhance the protection against child poverty. I think of the policy on the living wage, for example. In comparison with the minimum wage, the living wage has resulted in a 30 per cent increase in people in that stratum of wage while the Government has been in office. That is an example of the progressive policies that the Government has pursued.
I must make the rather obvious and overwhelming point to Drew Smith, which is made by every organisation and in every report on the matter at present. When we are on the brink of a smash-and-grab raid—a huge withdrawal from some of the poorest sections of our community—that will involve massive amounts of money and billions of pounds over the next few years, by virtue of the Westminster Government controlling this country’s welfare system, is it not time that people such as Drew Smith recognised that people in this country will get an infinitely better deal from a progressive Parliament in Edinburgh than they would from a Tory coalition in London?
Obesity
6. To ask the First Minister what strategies the Scottish Government has to combat obesity. (S4F-01186)
The issue is serious and a serious report on it was issued this week. The strategy has been laid out in the Government’s route map towards healthy weight. This week’s report contains many proposals that require substantial examination.
Will the First Minister assure me that any Scottish Government approach to tackle rising levels of obesity will be based on the principle of personal responsibility, that he will not implement barmy proposals such as a punitive tax on fizzy drinks or chocolate bars, however eminent their advocates might be, and that he will help protect those of us who enjoy the odd can of juice or Mars bar from meddling, nanny-state policies?
The member does the report a disservice. There were 10 recommendations and he has picked on one of them—as, indeed, did most of the tabloid press—which I suppose is fair enough, in terms of politics and politicking. However, he should not ignore it that in many of the other recommendations there was serious—how shall I put it?—food for thought for the Scottish Government and other authorities.