The next item of business is a debate on motion S4M-10088, in the name of Neil Findlay, on a motion of no confidence.
15:32
As the Scottish Government’s mental health strategy states, mental illness is one of the greatest health challenges that we face. However, with appropriate and good-quality treatment and support, people can cope, learn to manage their condition and make a full recovery. Government policy is—rightly—geared towards shifting the balance of care from institutional settings to more community-based provision, where treatment is delivered at home or in the community. All the major stakeholders are signed up to that policy—or at least we thought that they were.
In the past week, following a freedom of information request that my colleague John Pentland submitted 18 months ago and a ruling by the Scottish Information Commissioner that ordered the release of the papers involved, we have established that one of the key players who is supposed to be driving the policy is not signed up to it at all—or at least he was not signed up to it when he thought that it would have an impact on his constituency. That player is the Cabinet Secretary for Health and Wellbeing—the man in charge of the policy.
As far back as 2006, NHS Lanarkshire identified a need to change how it delivers mental health services. Years of consultation, planning and work with clinicians, staff, patients and voluntary organisations followed, and a consensus emerged that a two-site plan—with acute beds located at Hairmyres hospital and a much-needed intensive psychiatric care unit at Wishaw general hospital, complemented by community-based provision—was the best way forward to deliver much-improved services.
That plan was to help waiting time targets to be achieved, reduce admissions of young people to non-age-specific in-patient beds, extend child and adolescent mental health services provision beyond the age of 16, address the Mental Welfare Commission for Scotland’s critique of NHS Lanarkshire being the only mainland board without a dedicated intensive psychiatric care unit and provide a safer and more sustainable medical rota to deliver care. That was approved by the then cabinet secretary, Nicola Sturgeon, and by Lanarkshire Links—the leading mental health organisation in the area—and its members.
Following the Cabinet reshuffle on 5 September 2012, Alex Neil replaced Nicola Sturgeon as the cabinet secretary. He acted immediately and, on 15 September, he advised civil servants that he was reviewing the NHS Lanarkshire proposals and that a final decision would be taken soon.
On 18 September, the then head of NHS Scotland, Derek Feeley, advised Catriona Borland, director for health and workforce planning, that Alex Neil was
“minded to review the decision on Lanarkshire’s mental health proposal.”
On 26 September at 9.43 am, Alex Neil’s private secretary advised civil servants:
“Mr Neil is clear in his view that acute mental health facilities should be retained in both Wishaw and Monklands. The Cabinet Secretary has asked that you seek agreement from NHS Lanarkshire to reconfigure their plans accordingly.”
In other words, he scrapped the proposals that had been endorsed by the stakeholders and his predecessor Nicola Sturgeon.
Later that day, in a reply to Richard Lyle MSP in the chamber, the cabinet secretary said:
“I believe that”
NHS Lanarkshire
“is revising its original proposal for the mental health unit at Monklands with a view to retaining an acute mental health facility at the hospital.”—[Official Report, 26 September 2012; c 11895.]
Of course he believed that the board was reviewing its proposal, because he had instructed it to do so.
However, the plot thickens. It has now been revealed that, at 9.44 that day, several hours before the cabinet secretary answered Richard Lyle’s question, Ian Ross, the chief executive of NHS Lanarkshire, advised him:
“there is no alternative option which can deliver the same benefits within the funding. Any changes to this plan would need to be explained to the key stakeholders including service users and carers who are fully supportive of the proposed developments.”
Only later that day, after all that involvement, did the cabinet secretary decide to take a step back because, as he said,
“there could be a perception of a conflict of interest.”
There was not a perception of a conflict of interest: there was a conflict of interest. Alex Neil had already made a decision that ran contrary to the policy that he was in charge of promoting.
Let us review the evidence and charges against the cabinet secretary. When Nicola Sturgeon was in post, he initially asked her to delay any decision until after the council elections and then until after his holiday, thus putting the needs of mental health patients behind his party and personal interests.
He reversed the decision that Nicola Sturgeon had endorsed to go with the consensus on how to improve services—a decision that NHS Lanarkshire’s chief executive said would result in a
“less than optimal service for patients who might be cared for there.”
He ordered the retention of facilities known to be riddled with asbestos. He worked against the interests of the people of Lanarkshire by pretending to be their saviour when, all along, the clinical evidence was clear that the proposed changes were in the best interest of patients.
He actively opposed his own Government’s policy of shifting the balance of care—the very policy that he was in charge of. He breached the ministerial code by failing to recognise the conflict of interest between his ministerial role of promoting Government policy and his constituency interest and stood back only after he had decided to reverse his predecessor’s decision.
Crucially for members, he misled Parliament by stating that he “believed” that NHS Lanarkshire was reviewing a decision when, as we now know, he had already taken the decision.
I take no pleasure in moving the motion. We have been forced into this position by the cabinet secretary and the First Minister who, in the last week, have singularly failed to come up with—or even try to come up with—a credible answer to the charges that are laid before them.
I say to the other parties that this Parliament has a duty to demand integrity in our political system. The dogs in the street know what Alex Neil has been up to. He has been caught holding the smoking gun, and the First Minister and his deputy know it. We believe that he has misled his constituents and we believe that he has misled this Parliament. For those reasons, we have proposed a vote of no confidence in Alex Neil.
I move,
That the Parliament has no confidence in the Cabinet Secretary for Health and Wellbeing as a result of his failure to disclose his involvement in the decision to reverse the planned closure of mental health services at Monklands Hospital.
15:40
Some facts would be helpful for this debate.
Upon his appointment as health secretary on 5 September 2012, Alex Neil examined a number of key areas in his portfolio—something that is entirely reasonable. On the morning of 26 September 2012, having reviewed proposals for NHS Lanarkshire’s mental health services, the cabinet secretary informed officials of his reservations about the health board’s plans. That afternoon, he answered a supplementary parliamentary question, in which the future of mental health services at Monklands hospital was raised. He made clear that the health board was reconsidering its plans.
On 5 November 2012, Alex Neil replied to a letter from Labour MP Pamela Nash about the future of mental health services. He informed her that he had shared his reservations with the health board.
On 14 November 2012, Siobhan McMahon asked Alex Neil an oral question about mental health services at Monklands. She stated in her question:
“the cabinet secretary has recently intervened in provision of mental health services by NHS Lanarkshire.”—[Official Report, 14 November 2012; c 13407.]
The Evening Times reported the facts on 24 January 2013, when it quoted in full a Scottish Government spokesperson, who laid out all the details. The spokesperson said:
“On September 26, Mr Neil asked officials to make his long-standing concerns about the proposed reconfiguration of mental health services across Lanarkshire known to the NHS board. His view was that acute mental health facilities would be best retained at Wishaw General and Monklands hospitals, and with a unit at Hairmyres. On September 26, after answering an oral question, Mr Neil was concerned that as Monklands was in his constituency, there could be a perception of a conflict of interest. To address this he agreed, that day that all matters related to Monklands should be dealt with by Public Health Minister Michael Matheson.”
The facts were laid out yet again on 17 February 2013, when the First Minister responded to a complaint under the ministerial code, and yet again on 5 March 2013, in an extensive release of FOI material to Labour MSP John Pentland.
Throughout this process, the facts have been clear for all to see and a matter of public record. Alex Neil intervened and made his views known. The health board then had to come forward with a revised plan not just for Monklands, but for the whole of NHS Lanarkshire. In an answer to a question on 14 November 2012, Alex Neil made it clear that the plan required ministerial approval and that decisions would be made by me, in order to avoid any perception of a conflict of interests.
Mr Matheson was the deputy when Ms Sturgeon made her decision, then the deputy when Mr Neil made his decision. What was his view on each of those occasions?
If we deal with the facts Mr Findlay, we might make some progress on this matter—[Interruption.]
Order.
—rather than just inventing things for the purpose of getting a few headlines. Those are the facts, and they are a matter of public record.
The reality is that in other cases Alex Neil, as health secretary, will take decisions that are about health services that affect NHS Lanarkshire and its provision. On 17 December last year, Alex Neil established the expert governance and improvement support team to help the health board to make improvements in patient safety and quality of care. That decision included Monklands hospital, in his constituency. If we follow Labour’s bizarre logic, there should have been calls for a vote of no confidence when he made that decision. These decisions are about the whole of NHS Lanarkshire, and they affect half a million people—almost one in 10 of the entire Scottish population.
As you know, Presiding Officer, it is important that ministers avoid not only actual conflicts of interest but the perception of any such conflict. That is why, after Alex Neil was asked a supplementary question in the chamber on 26 September 2012 that was specifically about mental health services at Monklands general hospital, he chose to take advice from his officials. He then followed that advice and removed himself from the process to ensure that there was no suggestion of a conflict of interest. That was entirely appropriate, and he reported it to Parliament on both 14 November 2012 and 19 December 2012.
That does not change the fact at the very heart of the issue. There was no conflict of interest because the issue was about more than just Alex Neil’s constituency. It was about what was best for the people and for the patients of NHS Lanarkshire.
If the minister wants to move on to that issue, can he tell us on what basis, when Nicola Sturgeon signed off the option appraisal that showed option 1 as the best option, he and Alex Neil chose option 4—the worst option—as the best option for the people of Lanarkshire?
Michael McMahon might be interested to know the view of NHS Lanarkshire on the proposed option, which it stated would enable
“the most contemporary provision of acute inpatient care in a custom designed environment as well as freeing up resources”
to be put into the community. That is the option that the cabinet secretary chose.
As part of the mental health services plan, the ward in question—ward 24—has been undergoing a refurbishment to improve the facilities for patients. That includes the removal of asbestos from ward 24 earlier this year. I emphasise that the issue of asbestos is not unique to Monklands; it is a legacy from decades ago.
Very strict regulations are enforced by the Health and Safety Executive to control asbestos. The HSE makes clear that:
“asbestos is only dangerous when disturbed. If it is safely managed and contained, it doesn’t present a health hazard.”
That is exactly the approach that NHS Lanarkshire took.
The wellbeing of patients in Lanarkshire was at the heart of Alex Neil’s actions on the matter. It is instructive to look at what the patients themselves said about the proposed closure. A letter that was written to the Scottish Government in September 2012 when the closure proposals were being considered, from a patient who was treated for mental issues at Monklands, stated:
“We felt our voice should be recognised. The closure of these wards could cause many mentally ill patients to take our own lives”.
That heartfelt plea sat alongside the views of doctors, NHS management and others. It was by balancing all those opinions that Alex Neil made his intervention.
Will the minister give way?
I need to make progress.
Members can disagree with what I have said and argue that they would have come to a different conclusion, and it is their right to do so.
Indeed, we know that Labour came to a different conclusion on previous NHS Lanarkshire closure proposals. If Labour had won the 2007 election, it would have closed the accident and emergency department at Monklands. Labour told us that there was no alternative. Since July 2007, when this Government saved Monklands A and E, there have been 437,000 attendees, and 67,000 in 2013 alone. Attendance has reached almost 500,000, which proves that there was an alternative to Labour’s NHS closure plan.
The facts are straightforward. Alex Neil made his views known, and weighed up all the options and opinions—[Interruption.]
Order.
He did so without fear or favour. If Labour members wish to argue against that decision, that is their right, but that is not what they are doing. They are throwing everything they can at the man. Their objective is not about the quality of services that are being provided, but about getting at the health secretary.
This might be the third motion of no confidence in the Parliament’s short history, but it is the first time that I can think of when a health secretary has been attacked for not closing a hospital ward and for saving part of our NHS—but, then, no scare story is too silly and no smear is too low for the Labour Party, and no accusation is too base for it to use against the Scottish National Party Government. That is what we have seen today, so I urge members to reject the motion. [Applause.]
Order.
15:50
A motion of no confidence is a very serious matter and not one that the Scottish Conservatives take lightly. After careful consideration, we will be supporting calls for Alex Neil to resign, for the simple reason that we believe that it cannot be acceptable for a minister to come to the chamber and allow Parliament to be misled.
We have all seen the evidence, but it is worth going over once again. On 26 September 2012, Alex Neil told Parliament that he believed that NHS Lanarkshire was revising its plans on mental health services at Monklands. A few hours later, he announced that he would be removing himself from the formal decision-making process surrounding the plan, because of his constituency interests.
That was all accepted in good faith but, thanks to a freedom of information request, we now know that, five hours before addressing Parliament, Alex Neil’s private secretary had emailed a civil servant in the health department. That email could not have been clearer. Sent to health officials in the Scottish Government, it declared that Mr Neil was clear that the mental health facilities should be retained. It concluded:
“The Cabinet Secretary has asked that you seek agreement from NHS Lanarkshire to reconfigure their plans accordingly.”
Astonishingly, even Michael Matheson was copied into the email. So, in the morning, he was made aware that the decision to retain Monklands had already been made by his superior yet, that very afternoon, he was told that the decision over Monklands was being delegated to him.
It is of course the right of every member of the Parliament, be they a minister or not, to oppose decisions that affect their constituents, and we do not disagree that, as a newly appointed minister, Mr Neil was within his rights to reconsider decisions that his predecessor had taken. However, the issue here is not about the rights and wrongs of closing medical facilities at Monklands, and nor is it about Mr Neil’s competence in his job. The issue at hand is a cabinet secretary who ordered his officials to do one thing in the morning and then decided consciously not to reveal that fact to Parliament in the afternoon.
I suggest that this is a sad instance of a minister deliberately allowing an untruth to gain credence in order to avoid difficult questions about his position. Mr Neil should have told Parliament that afternoon that he had just told NHS Lanarkshire to “reconfigure their plans”. That he did not do so was not just a dereliction of duty; it now looks suspiciously like a tacit admission that he knew that he was doing something underhand and wrong—it is as simple as that.
The fact is that the investigation that the First Minister carried out into the case failed utterly to address that point. The First Minister said that the health secretary acted “perfectly properly”. His defence of Mr Neil goes on to note that Mr Neil was concerned over a conflict of interest, but nowhere in the First Minister’s letter exonerating Mr Neil is the key point raised—that, by the time that Mr Neil raised his concerns about a conflict of interest, his wishes had already been made clear to NHS Lanarkshire. Nowhere is there acknowledgement of the fact that Mr Neil made the decision and then tried to wash his hands of it. Now, by refusing to sack his health secretary, the First Minister is putting politics above the Parliament.
The whole episode is symptomatic of the SNP’s disregard for the Parliament, particularly in the run-up to the independence referendum. It gives us in the Conservatives no pleasure to conclude that, in this instance, the cabinet secretary deliberately ensured that Parliament was misled. As he clearly did so, we can no longer have confidence in him in carrying out his duties, so we support the motion of no confidence.
We move to a very short open debate. I call Bob Doris, to be followed by John Pentland. I can give both of you no more than four minutes.
15:54
Integrity applies to every member in this chamber, including our Opposition members. I feel that they have not passed that test this afternoon.
We are being asked to make a judgment on the appropriateness of Alex Neil staying as Cabinet Secretary for Health and Wellbeing. Let me tell the chamber about the Alex Neil I know as Cabinet Secretary for Health and Wellbeing—[Interruption.]
Order!
He is the man who has worked in partnership with the Parliament’s Health and Sport Committee to develop a vastly improved system of access to new medicines in Scotland for end-of-life and orphan and ultra-orphan conditions. He values people and has meaningfully changed the lives of constituents right across Scotland.
Let me tell the chamber more about the Alex Neil I know. He has introduced a workforce planning tool that is leading to an increase in nursing numbers right across Scotland and which ensures that they are in the right place and the right job—[Interruption.] I hear heckling, but I have to say that the constituents whom I represent prefer a quality NHS to the bluff and bluster of the Labour benches.
Let me tell the chamber why I think that this is just bluff, bluster and political opportunism. On 24 January 2013, an article in the Evening Times reported:
“On September 26, Mr Neil asked officials to make his long-standing concerns about the proposed reconfiguration of mental health services across Lanarkshire known to the NHS board. His view was that acute mental health facilities would be best retained at Wishaw General and Monklands hospitals, and with a unit at Hairmyres.”
The exact same content that was in the email is now apparently a smoking gun. There is nothing new in any of this.
With this information available, I have to say that Alex Neil was perfectly fit for purpose 15 months ago. He was fit for purpose as a health secretary 10 months ago, and he was fit for purpose as a good-quality health secretary five months ago. The only thing that has happened in the past week is the Labour Party grandstanding for cheap party-political points.
Will the member give way?
No, thanks. Let me tell the chamber something I know about health boards—[Interruption.]
The member is not taking the intervention. Order!
Just the other day, as deputy convener of the Health and Sport Committee, I took part in a robust evidence session with health boards about their budgets. Health boards are not shrinking violets; they say what they think, and they make what they think clear. No decision was taken by Mr Neil. His position was well known; it was publicly known 15 months ago that he sought agreement with NHS Lanarkshire. However, if there was no agreement to be sought, the decision would have been taken by Michael Matheson, our Minister for Public Health. There was no conflict of interest.
I want to tell the chamber one final thing. Labour members might have a view of Government that it simply goes into robotic mode and rubberstamps things; they do not take the view that they can think for themselves. I expect—[Interruption.]
Order!
Someone must have held up a sign saying, “Clap!” there. Labour members were certainly not thinking for themselves.
I expect a cabinet secretary for health to take a strategic view of mental health services across Lanarkshire, for the 500,000 patients in Lanarkshire. Alex Neil did so, and he made his views known. [Interruption.]
Will members please stop barracking the member and let us hear what he has to say?
As I said to Lewis Macdonald in a previous debate, the louder the Labour Party speaks, the more it realises that it is on shaky ground and that there is nothing true in what it says.
Because time is short, I will simply say that the people of Scotland value Alex Neil as health secretary. Week in, week out, he is improving Scotland’s national health service. However, the party opposite, in conjunction with its better together friends in the Conservative Party, would rather make patients across Scotland suffer for a cheap party-political stunt. Make no mistake—that is precisely what this motion of no confidence is.
15:59
Lanarkshire’s mental health plan was about far more than the two wards at Monklands, but they were Alex Neil’s main focus, even as cabinet secretary. The plan was years in the making and was for the whole of Lanarkshire. It was backed by service users, carers, clinicians, NHS managers, council partners, voluntary organisations and on several occasions by the health secretary at the time, Nicola Sturgeon, who saw the improvements that that robust plan would bring across the board, including to Monklands. They saw the bigger picture.
The plan would have funded a new intensive psychiatric care unit for NHS Lanarkshire, which was the only mainland board without one. It would also have supported the development of intensive home treatment and young people’s services, greatly expanded community mental health, and provided a safer and more sustainable medical rota. There was
“no alternative option”
that could
“deliver the same benefits”.
Those are not my words—that is what the chief executive of NHS Lanarkshire, Ian Ross, wrote in an email at 9.45 on 26 September 2012.
Alex Neil chose to ignore that advice and vetoed the plan, with no reason given. When he was asked a question that afternoon on mental health services at Monklands, he did not even tell Parliament that he had rejected it. He said that NHS Lanarkshire was reconsidering. It was not; it was reconfiguring its plans on Alex Neil’s instruction. We know that because, in an email that morning, Alex Neil told it to pick the worst of four options. It took us 18 months to extract that email from the Scottish Government. Now we know why it fought so hard to keep it a secret.
However, there is much more. The pretence and manipulation was not an isolated incident. We have an email that says that Alex Neil was signing off lines in October, and we have a letter that he wrote in November. More important, his diktat of 26 September was not rescinded. One email even stated that the strategy was ready to go
“but due to concerns raised by Alex Neil ... Derek Feeley asked Tim to defer taking it to the Board till after the local authority elections at which point it would be approved.”
We could have had the best plan before May 2012, but over a year later we got a poor substitute.
Since the original plan was kicked into touch by the cabinet secretary, I have heard that problems include a patchwork community service, staffing problems, difficulties with junior doctors’ training and unused capacity at Wishaw. What about the recurrent costs instead of money being freed up to address those issues? Most important, that worst option does not provide the service that the people of Lanarkshire have a right to expect.
We have strong evidence and we believe that Alex Neil has misled Parliament. He has also betrayed the public and health professionals with a scandalous political fix. He should resign, or else the First Minister, rather than trying to defend him, should sack him.
16:03
I want to take us into three areas of the debate.
The first is the question of transparency, on which I will spend some time, because I want to be able to establish to the chamber that what Richard Simpson disagreed with me about at First Minister question time was, in fact, erroneous on his part.
We can remove the question of transparency and then get to the issue of principle as to when a Government minister is able and is not able to intervene and take action on a matter that affects their constituency.
Thirdly, let us look at the rights and wrongs of the issue. Let us look at the patients in Lanarkshire.
Finally, let us also look at the competence of the health secretary.
The reason why I disagreed with Richard Simpson was because I can establish beyond any doubt that the whole detail of this area of decision making was in the public domain. I have here the press lines issued to the Sunday Herald on the weekend of 1 December 2012, which were reported in the Evening Times of 24 January 2013. I will have them put into the record so that every member in this chamber can see them. They go into great detail about what happened on the day of 26 September 2012:
“The Cabinet Secretary for Health and Wellbeing, Alex Neil, is not currently looking at proposals from NHS Lanarkshire on the provision of Mental Health Services.
Previously, on 26 September, Alex Neil, as Cabinet Secretary for Health, had made his concerns about the proposed reconfiguration of mental health services across Lanarkshire known to the NHS board through Scottish Government officials.
With over 500,000”—
Will the First Minister take an intervention?
I will read the quotation, and then of course I will give way to Johann Lamont.
“With over 500,000 people resident in NHS Lanarkshire’s area, Mr Neil addressed his concerns on the service change to the region as a whole. He was clear in his view that acute mental health facilities would be best retained at Wishaw General Hospital, Monklands Hospital, and with a unit at Hairmyres Hospital.
On the 26 September Mr Neil also answered an oral question ... where in the supplementary he was asked specifically about mental health services in Monklands Hospital. After answering the question Mr Neil was concerned that despite Monklands Hospital serving people across Lanarkshire, as it was located in his constituency, there could be a perception of a conflict of interest. To address this he arranged, that day, with the Director General of the Health portfolio, Derek Feeley, that all matters related to Monklands Hospital should be dealt with by the Minister for Public Health Michael Matheson.”
Before Johann Lamont intervenes, let me say that that totally disproves the Labour Party assertion that all of those details were not in the public domain. Just in case Johann Lamont did not happen to buy a copy of the Evening Times on 24 January, all of what I quoted is contained in the FOI response to John Pentland of 5 March 2013—all of it. Therefore, all of that information was available in the public domain, which puts a very severe question mark over Labour allegations of a lack of transparency and the fact that, in this week in particular, this issue is suddenly presented as if it was a contemporary issue.
Of course, we have been waiting for 18 months to get the freedom of information response that the First Minister’s Government has resisted giving. This is not about Alex Neil expressing a view. When the First Minister cleared his minister of any wrongdoing, was he aware of Alex Neil’s email of the morning of 26 September directing the Lanarkshire health board to reconfigure its plans?
Of course I was, and Johann Lamont—[Interruption.]
Order.
Johann Lamont has just told us that the Labour Party waited for this information, but I repeat that the information was in the public domain and in the FOI response not of the past couple of weeks but of 5 March 2013—all of the information was contained in that. If John Pentland did not reveal to Johann Lamont the detail of that, perhaps she should address communications within the Labour Party as opposed to making spurious attacks on the health secretary.
I point out that the Scottish Information Commissioner himself conceded that the Scottish Government information and documents go
“a substantial way towards fulfilling the public interest in understanding issues relating to”
the ministerial code;
“it goes a long way in detailing the chain of events following Mr Neil’s appointment”.
The information commissioner obviously looked at the documents that were revealed, even if the Labour Party did not manage to do so.
Is the First Minister aware that, after the information that was given in February and March 2013, further information came from the commissioner identifying quite clearly that Mr Neil had instructed Lanarkshire health board to reconfigure the plans for mental health services in Lanarkshire?
I will give the member the benefit of the doubt because his colleagues prevented him from hearing what I said. What I have just read out contains the paragraph:
“With over 500,000 people resident in NHS Lanarkshire’s area, Mr Neil addressed his concerns on the service change to the region as a whole. He was clear in his view that acute mental health facilities would be best retained at Wishaw General Hospital, Monklands Hospital, and with a unit at Hairmyres Hospital.”
You had the information; you just did not have the confidence to bring it to the chamber.
Given that John Lamont actually tried to address those questions of process, I hope that hearing that information now will have satisfied at least some of his reservations. I could also go through the other instances that make it quite clear that the information has been in the public domain for some time.
I will now address the issue of principle in terms of the ministerial code, because that is what I have to look at—not the issues of policy, which are hugely important to the people, but the issue in the ministerial code of when a constituency interest is valid.
It is not the case that a minister cannot take decisions that affect his constituents. I raise the point because I have here a transcript of words spoken by Neil Findlay on the radio this morning. He said:
“Any minister who is in the position where they have a constituency interest and are acting as a minister has to make that position known as early as possible and withdraw from it.”
That is not the case, Mr Findlay. I am First Minister of Scotland. If I withdrew from every decision that affected my constituents, I would not be making many decisions as First Minister of Scotland. For example, the Aberdeen western peripheral route is an issue that has a massive effect on my constituency. As an MSP and as a First Minister, I have campaigned in favour of that route. It is a huge public investment, and I rejoice in the fact that it is going forward. I cannot withdraw or resile from making a decision about it because it happens to go across my constituency. It affects people throughout the whole of the north-east of Scotland, just as the mental health facilities in Lanarkshire affect the people throughout the whole of Lanarkshire.
First Minister, you need to start drawing your remarks to a close.
I will gladly do so. I have been perhaps too generous with the Labour Party. That is one of my weaknesses, Presiding Officer.
The information was transparent and was in the public domain. Unfortunately, through a communications failure, Labour Party members did not manage to tell each other that they had the information. That is the best possible reflection that we can put on the situation.
It is not the case that ministers cannot make decisions that affect their constituents. Mr Neil went through the correct processes. When a specific question was raised about Monklands hospital, he asked the advice of his officials.
Finally, I repeat the point that was made by Michael Matheson. When was the last time that a minister was attacked and had a motion of no confidence moved against him because he had saved a hospital facility that is vital to the people of Lanarkshire? The provision of mental health services in Lanarkshire is excellent. We know the views of the patients, and we also know the views of the Labour Party, because the last thing that was in the mind of the Labour Party when bringing this issue to the chamber was the welfare of the people of Lanarkshire. Uppermost in the minds of Labour members was the proximity of the elections. It is not the confidence in Mr Neil but the confidence in the Scottish people that this Administration will invest in.
16:12
I rise to sum up this debate on the motion of no confidence in Alex Neil, the Cabinet Secretary for Health and Wellbeing, with a measure of sadness, but also a measure of anger. Sadness, because I believe that, if the cabinet secretary had admitted his error in wrongly using his new position as cabinet secretary to instruct a health board, against its wishes, the wishes of its stakeholders, the wishes of the previous cabinet secretary and the wishes of the Minister for Public Health, but in the interests of his own opinion as a constituency MSP, and if he had apologised and withdrawn his instructions—I stress the word instructions—to NHS Lanarkshire, this motion would probably not be necessary.
Will the member give way?
I was refused by every speaker I asked to give way. No one took an intervention from me, but I will take one from the First Minister.
I want to make this intervention because of the spirit in which Dr Simpson has started his remarks. He disagreed with me when I said at First Minister’s questions that this information was in the public domain. I have now read out that information, including the sentence in which the cabinet secretary said that he was clear in his view that it would be best if the service could be retained in the three hospitals. Now that Dr Simpson knows that that was in the public domain—he must know, and I have put it on record—will he withdraw that accusation and, therefore, go ahead on a reasonable basis?
I will compensate you at the end of your speech for the length of that intervention, Dr Simpson.
Thank you, Presiding Officer. If that is the sort of intervention I am going to get, I do not think that I will take any more.
The First Minister and Bob Doris asked why the motion of no confidence has been lodged now, rather than at the time of the offence or when the initial emails were available. The reason is that it took us 15 months and a Scottish Information Commissioner decision against the Government to get information released. It was the additional information that led us to take this action.
What were the actions that the Government fought so long and so hard to conceal? First, Lanarkshire NHS Board undertook a robust, inclusive, exhaustive consultation. If the Government was not satisfied with the consultation, why did it approve the results? The decision was about modernising mental health services. The board scored four options for change, and the best-scoring and highest-ranked option, which was supported by the patient groups, the clinicians and management, was approved by Nicola Sturgeon, when she was cabinet secretary.
The announcement from the board should have occurred at the August board meeting, but it was delayed until September, to enable Alex Neil, the local MSP, to return from holiday and comment on it, and so that a number of additional new services that would come to Monklands could be announced at the same time as the closure of the substandard, asbestos-ridden wards was announced.
That was not to be, because on 5 September Mr Neil was appointed cabinet secretary. He did not immediately recuse himself from the issue, which necessarily involved his constituency directly. That in itself is not an offence. Alex Neil was perfectly entitled, as the new cabinet secretary, to call anything in for review. However, at 9.43 am on 26 September, an email was sent to Lanarkshire NHS Board, which was keen to confirm the previously agreed decision on the mental health service. The email said:
“Mr Neil has seen and noted both and is clear in his view that the acute mental health facilities should be retained in both Wishaw and Monklands (with a unit also at Hairmyres to serve south Lanarkshire). The cabinet secretary has asked that you seek agreement from NHS Lanarkshire to reconfigure their plans accordingly”.
That was not a request for a review or a consultation. It was not a calling-in. It was an instruction from the cabinet secretary to keep the units open. Moreover, that instruction raised the fourth and worst option. That was a disservice to the people of Lanarkshire as a whole.
We believe that the cabinet secretary misled Parliament in his response to a parliamentary question from Richard Lyle, given on the same afternoon, because having issued that instruction in the morning, he said:
“I believe that”
the board
“is revising its original proposal”.—[Official Report, 26 September 2012; c 11895.]
What did he mean by saying, “I believe”? He knew, because he had instructed the board to do so that morning.
The cabinet secretary then recused himself, appropriately—but not when he should have done. However, he had already copied Michael Matheson into his instructions. A deputy minister tends to follow his boss’s suggestions; when there is an instruction, the deputy minister certainly follows it.
If Alex Neil had apologised for issuing the instruction privately in the morning and for saying something that we believe misled Parliament in the afternoon, and if he had withdrawn his instruction, I am fairly certain that the Parliament would have been generous. However, even after recusing himself, the cabinet secretary continued to be copied into emails on the issue and to write to the local member of Parliament, Pamela Nash, on the issue. Indeed, in an email from a civil servant, he was referred to as having to sign off on the issue. Therefore, there was continued involvement of the cabinet secretary, even after he had recused himself.
I said that I was both sad and angry, and I have explained why I am sad. I share the anger of the stakeholders, who were appalled at the outcome of the cavalier decision that the cabinet secretary dictated. I quote from comments that Lanarkshire Links received from some of the 800 members of the organisation who were involved in the consultation.
“That we are not important and it doesn’t matter what we say we are not listened to”.
“Very Angry”.
“I feel my time and effort is as valuable as Mr. Neil’s. We have put a lot of input into this consultation only to be let down again.”
“Angry and hurt”.
“After 2 years of consultation and hard work, it has all been turned around and back to square one, so it has been all this work for nothing. Why should you change things that people have already decided on”?
This is not about the cabinet secretary’s performance, as Bob Doris would have people believe that we are suggesting. We have actually worked well with the cabinet secretary since his appointment. This is about a bad decision that was badly made in what was a clear failure to separate personal interest as a constituency MSP from his role as a minister. It was, I regret to say, an abuse of power that was compounded by his misinforming the Parliament, his continued involvement and his then preventing the release of the emails—it required the information commissioner to release them. The cabinet secretary must, therefore, see that his position is untenable. He should do the decent thing now and resign.
MSPs, irrespective of their party, have a duty and responsibility to uphold the integrity of the Parliament. I hope that, when it comes to the vote at 5.45 tonight, members will reflect on that.