Meeting of the Parliament (Hybrid)

Meeting date: Thursday, September 22, 2022

Official Report 1052KB pdf

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First Minister’s Question Time

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Emergency Treatment (Waiting Times)

This week’s health figures revealed that more people are waiting longer than ever for emergency treatment. In the past week, almost 10,000 people across Scotland waited for more than the target four hours at accident and emergency departments. Those are the worst waiting time figures on record and it is only September.

Our doctors, nurses and staff are doing outstanding work, but we know that the pressures on our national health service will only get worse over the winter. What action is the First Minister’s Government taking now to reduce the time that people are waiting for emergency treatment here in Scotland?

As the Cabinet Secretary for Health and Social Care said earlier this week, the most recent performance in accident and emergency is not good enough. I am very clear about the need for improvement. Of course, the most recent performance reflects the very significant pressure across health and social care arising from the two-year pandemic and from some pre-existing factors, such as our country’s changing demographics.

There is a sharp focus on doing what is required to improve that performance, which takes me to the specific question. In addition to what has been a 263 per cent increase in the number of accident and emergency consultants since this Government took office, we are investing more to support further recruitment, including overseas recruitment, and are taking action through the £50 million urgent and unscheduled care collaborative. That work includes a range of strands offering alternatives to hospital where those are appropriate, such as hospital at home; directing people, where appropriate, to better urgent care settings; and scheduling some urgent appointments to avoid long waits in accident and emergency. This week, the chief operating officer of the NHS wrote to health boards with five additional specific actions that we expect boards to take. We expect to see improvement and we want it to start to become visible immediately.

I will make one final point to put the issue into context, for the sake of those who are working so hard in our national health service. Our NHS is facing significant pressures, but the NHS in every part of the United Kingdom is doing so, too. Although performance needs to improve here in Scotland, our accident and emergency departments are performing better than those in England, Wales and Northern Ireland. For context—it is important to put it in context—in the last complete month for which we have figures, performance against the four-hour target in Scotland was 66.5 per cent, which is not good enough and needs to improve, but it compares with 57 per cent in England, 55.2 per cent in Wales and 45.7 per cent in Northern Ireland. The pressures exist everywhere and this Government is focused on ensuring that we support those in our health service to tackle them.

Context may be important for the First Minister and her members behind her but, for people who are waiting hours and days for A and E treatment, those are hollow words. We are now more than a year into the health secretary’s recovery plan, but the situation is getting worse, not better. The First Minister spoke about A and E consultants, but I will tell her what doctors on the front line are saying.

This week, Dr Peel, the deputy chair of the British Medical Association Scotland said:

“As an A&E doctor I often tell people that A&E is a safe space, you can come here if you’re in pain, if you’re sore, if you don’t know where to go.”

However, Dr Peel continued:

“Our A&E departments are no longer safe and what’s really concerning is our government just aren’t acting ... and they are turning a blind eye.”

New information that we have uncovered shows just how horrendous waiting times in Scottish hospitals are just now. A response to a freedom of information request has revealed that one patient at a hospital in Ayrshire had to wait 84 hours for treatment. That is three and a half days; the equivalent of turning up for emergency treatment right now and not being seen until next week, in the early hours of Monday morning. Is that really what anyone in Scotland should go through in 2022?

No—that is clearly an unacceptable situation, but it is also an exceptional situation. I am more than willing to look into the particular circumstances around that.

I have been very clear that the current performance is not acceptable. I would not, and do not, shy away from saying that. I have also been very clear about the action that the Government is taking to support those on the front line, to ensure that there is much speedier access to accident and emergency and to healthcare services more generally.

I have also made the important contextual points, because that is part of giving people confidence that we are taking action to address the issue. The performance against the four-hour waiting time target is not good enough, but it is better than it is in counterpart parts of the United Kingdom. With regard to long waits, there are 50 times more 12-hour waits in England than there are in Scotland, and they are four times higher in Wales than they are in Scotland.

That does not mean that performance in Scotland is good enough, but Douglas Ross and others often come to the chamber and pretend or suggest that those issues are unique to Scotland. They are not unique to Scotland; they are pressures that all health services are facing. I am rightly setting out the action that we are taking to support the health service in tackling the pressures with regard to recruitment, investment and changing the pathways of care to ensure that people not only get speedier access but access to the right part of the health service at the right time. We are taking action across all those strands and will continue to do so.

Unbelievably, the First Minister just said that 84 hours is not good enough but is better than the situation in other parts of the United Kingdom. How does the person—[Interruption.] How does the person who was waiting for 84 hours, and their friends and family, feel when they hear that?

Although that was the most extreme example that we found, it is not the only time that someone has waited for days at A and E. Our FOI responses revealed that another patient waited 79 hours earlier this year, another waited 66 hours, and another waited 53 hours. There are thousands of people waiting each week for longer than the Government’s target time.

A constituent wrote to us about their grandmother. They said:

“My nana took a turn for the worse last week and could not stop vomiting. Due to her type 2 diabetes and blood pressure this is very serious indeed. She was admitted to hospital after a lengthy wait then sent home. This happened several times over a number of days.”

Finally, she had to be rushed to A and E, and her grandson told us:

“What I was faced with was utter chaos. I felt so sorry for the doctors and nurses and helpers. They are literally at breaking point, there were beds and people everywhere. I wish I had taken a picture but the image is etched in my memory forever. The beds were wall to wall and my nana had to stay in her mobility chair as there was nowhere for her to go.”

First Minister, this cannot go on any longer, and it certainly cannot go on through the winter. When will people in Scotland get access to the emergency treatment that they deserve when they need it?

As I said, we expect to see, and we are supporting what it will take to deliver, immediate improvements in accident and emergency waiting times. These are really serious issues, as the case that Douglas Ross has narrated illustrates—I would not say otherwise—but it does not do anybody any service at all to deliberately twist, and indeed misrepresent, what I said in my previous answer. It is really important to be clear here: I did not say that 84 hours was not good enough but better than anywhere else in the UK; I said that our four-hour performance was not good enough but was better than in other parts of the UK, and I said that about our longer-wait performance, too. I said that 84 hours is clearly unacceptable, but cases like that are exceptional, and it is important that, where such cases occur, they are properly looked into.

I turn to our performance against the 12-hour target. In the most recent week, which was very challenging, there was the lowest four-hour performance on record, and it is important to be clear about that. However, more than nine out of 10 patients—95.4 per cent of patients—were seen within the 12-hour target time. Clearly, exceptional cases should not happen. When they do, lessons should be learned. It is important, however, not to misrepresent the situation or to misrepresent what I have said.

On the action that we are taking, which is obviously what matters, I have referred to support for recruitment, and it is important to point out the 263 per cent increase in the number of A and E consultants. We are also investing £11 million to support further domestic and international recruitment. Of course, international recruitment has been made significantly harder because of Brexit—I just put that on record. A thousand healthcare support workers were brought in last winter. I have already referred to the £50 million of investment to examine alternatives to accident and emergency where they are more appropriate for patients.

We will continue to focus on improving performance. To end my answer where I started, we expect to see performance improve immediately.

We have been told before that there will be immediate improvements, but people are waiting for 84, 79, 66 or 59 hours. The First Minister says that those are exceptional cases, but let me give her another one, as there are so many.

We spoke to another patient, who attended Monklands hospital. She was stuck at A and E again, again and again, waiting for emergency treatment. She went to A and E with severe abdominal pains. She was left waiting, vomiting and in extreme pain for nine hours. She was told to come back the next day at 9 am. This time, she waited a further six hours.

Two days later, her condition had worsened to the point that her general practitioner told her to go back to A and E for urgent treatment. On this occasion, she again waited nine hours. That is a total of 24 hours’ waiting for emergency treatment in just four days, all of it in extreme pain. That patient wants to ask one simple question to the First Minister: “How can you allow this to continue?”

We are not allowing this to continue. We are recognising the significant pressures on our national health service. An experience such as that is completely unacceptable, but there are significant pressures on our national health service, and significant action is being taken to address those pressures. We will continue to take steps around recruitment, investment and redesigning pathways of care. I do not know whether it is the case in the particular instance that Douglas Ross has just narrated, but there will be many people who end up in accident and emergency departments who would be better seen and treated in other parts of our national health service.

Her GP said that she should go there.

That is why I said that I did not know whether that was the case in that particular instance. However, many people would be better treated in other ways, and that is why we are investing in hospital at home, in different urgent care settings and in scheduling urgent appointments in A and E, so that people do not have to have long waits. That work takes time, and it requires the investment in recruitment that I have spoken about, but the health secretary and the Government are focused on ensuring that we do that and on supporting those working at the front line of the health service, as they support patients who need treatment on the national health service.

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National Health Service Waiting Lists

On 25 August 2021, the First Minister announced her NHS catch-up plan. Can she tell the Parliament how many people were on NHS waiting lists then and, 13 months on, how many are on NHS waiting lists now? (S6F-01349)

Waiting lists and waiting times have increased since then. The figures are published, so they are there for people to see; I am sure that Anas Sarwar will quote the published figures at me.

Since then, we have also had further waves of Covid, and the pressure on our national health service here and in other parts of the country continues. However, we are focused, through the recovery plan, on treating the most urgent patients and the longest waits. Just this morning, information has been published about performance against the target to eradicate, in most specialties, the numbers of those waiting two years or more.

We are seeing progress, but this is an extremely challenging time for the national health service, which is why it is so important that we continue to focus on investment and the action that we are taking.

Catch-up surely means that waiting lists come down rather than go up. In August 2021, 603,000 were on a waiting list; now—14 months on from the First Minister’s so-called catch-up plan—the figure is nearly 750,000 people.

The First Minister should stop pretending that that is all down to Covid. When the Scottish National Party came to power, there were 260,000 people on NHS waiting lists. Immediately before Covid, the figure was 420,000 people. Now, it is 750,000. That is one in seven Scots on an NHS waiting list, and that has consequences.

Listen to the staff. Dr Lailah Peel from the British Medical Association said this week that

“patients are now presenting at A&E because of complications developed while waiting for treatment and scans.”

Week after week, this Government has been breaking records for the worst A and E waiting times ever. Can you tell us how many people have waited more than 12 hours for A and E treatment since you launched your so-called NHS recovery plan?

I have just covered the situation in accident and emergency. The number of people waiting more than 12 hours has increased, but more than 95 per cent of patients are seen in accident and emergency within 12 hours. Of course, the target that we want to meet in accident and emergency is the four-hour waiting time target.

More generally, waiting times have been increasing. There has been a two-year pandemic, which has had a significant impact on waiting times in our national health service. However, as I think I said in response to an earlier question, there are other, pre-existing factors, the changing demographics of the country being one of those.

Over the past two months, there has been a focus on treating the longest waits in our national health service. The figures published today show the progress in that.

We are also seeing an increase in the number of in-patient and day-case patients who have been seen. In the most recent quarter, there was a 7.6 per cent increase in those seen, which demonstrates the recovery of the NHS from Covid.

These are difficult challenges—there is absolutely no getting away from that. Almost every country—certainly every country in the United Kingdom and most countries across the world—are grappling with these challenges, but the investment that we see in our national health service and the steps that we are taking to redesign care are what need to continue.

Lastly, we do listen to staff. The Cabinet Secretary for Health and Social Care meets staff, unions and professional organisations regularly. There are many more staff working in our national health service today than was the case when this Government took office. More than 20,000 additional staff have been recruited in that period.

The health secretary might listen to staff, but he is not hearing what staff are telling him and taking the necessary action to help people across the country.

On my question to the First Minister, the answer that she was looking for is that 38,255 people have waited more than 12 hours in A and E since the recovery plan was published. Frankly, people are sick of the same old excuses and of the SNP Government always looking for someone or something else to blame. Across Scotland, people are getting the same inadequate answer from this Government: wait—wait in fear for a cancer diagnosis; wait in pain for a hip replacement; wait for hours in an ambulance outside A and E; wait anxiously for their child to get mental health treatment. Today, we discover that life expectancy has dropped again for a second year running—all on Nicola Sturgeon’s watch.

After 15 years in power and 15 years of running our NHS, how long will the people of Scotland have to wait for you and your health secretary to do your job?

Speak through the chair, please, Mr Sarwar.

We will continue to do our jobs. Ultimately, as it always has been, it is for the people of Scotland to decide whether they want us to continue to do our jobs.

A two-year pandemic has presented real and very significant challenges for Scotland, as it has for every country, and every day we seek to address those challenges and support those who are on the front line. We will continue to do that in our NHS. We will continue to take action—albeit in this regard with one hand tied behind our back—to tackle poverty in Scotland, to have a positive impact on things such as life expectancy—[Interruption.]

Members—thank you.

Unfortunately, Labour still wants us to have one hand tied behind our back on these issues.

Although I take full responsibility for performance across all of these things in Scotland, the reality in terms of the national health service in Scotland is that, whatever the challenges we face, thanks to the dedication of those who are working in our national health service, it is performing better than its counterpart in England, where the Conservatives are in power, and better than its counterpart in Wales, where Labour is in government.

We will continue to address these challenges, we will continue to take the steps that are necessary to do so, and we will continue to ask the Scottish people to put their trust in us to do exactly that.

We move to constituency and general supplementary questions.

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Stem Cell Register

September is blood cancer awareness month, which provides an opportunity to increase awareness of the importance of new people joining the Anthony Nolan stem cell register. The simple act of a taking a swab test could lead to the selfless act of saving a life. Will the First Minister join me in encouraging young people aged 16 to 30, especially men from ethnic minority backgrounds, to consider joining the stem cell register, and in thanking Anthony Nolan and the Scottish Fire and Rescue Service for their continued efforts in raising this issue in schools up and down the country?

Yes, I am very happy to do so. I am grateful to Bill Kidd for raising this important issue. I join him in encouraging all those who are eligible to consider joining the stem cell register. Anthony Nolan’s research has shown that the younger the donor, the better the patient’s chance of survival. It has been pointed out that people between ages 16 and 30 can join the stem cell register.

In addition, I acknowledge the Scottish Fire and Rescue Service’s 13-year partnership with Anthony Nolan and I thank the service for its continued hard work in raising awareness of the issue.

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Suicide (Young People)

A recent report by Public Health Scotland has found suicide to be the leading cause of death among young Scots. Ministers have described every suicide as being “a tragedy” and have said that suicide prevention is the key priority for the Scottish Government.

Given that priority, what action is being taken to ensure that youngsters who are affected by suicide get access to the services that they require to reduce this appalling situation?

Every suicide is a tragedy. Obviously, we want to take and support steps to reduce the number of suicides in Scotland.

I am not trying to take anything away from the very important issue that has been raised, but thankfully the number of deaths by suicide among young people has decreased over the past two years. The Public Health Scotland report that came out earlier this month tells us that the average rate from 2011 to 2020 among under-24s was lower than the rates among those aged 25 and over, but it is still way too high.

Our new suicide prevention youth advisory group will help shape the approach to suicide prevention for children and young people. Here, of course, the wider work around mental health support for young people is also important, and so is encouraging young people to access support earlier rather than later and ensuring that the services are there for them when they do.

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Nursing and Midwifery Student Numbers

Recent shocking figures from the Universities and Colleges Admissions Service highlight a shortfall of almost 1,000 in the number of students who are currently accepted in nursing and midwifery courses in Scotland, compared with the Government’s own recommended intake for 2022-23.

In my South Scotland region last week, I saw at first hand the impact that shortages are having on Ayrshire’s hospitals and the wellbeing of their staff. We need a clear plan for making nursing and midwifery an appealing career for young people to address those figures, which are being described as “extremely worrying” for nursing.

I ask the First Minister: when will her Government stop patting itself on the back, realise the scale of this recruitment problem and outline in detail the actions that it will take to address it?

Again, in addressing an important issue, it is important to ensure that it is not misrepresented, and I know that the member would not want to do that. I will, therefore, address in some detail the issue of nurse and midwifery student numbers.

The target intake for this year is 4,837. So far—I stress that this is so far, and I will come back to that point—3,850 students have been accepted on to nursing courses and 280 on to midwifery courses, which comes to 4,120. I do not think that that is a shortfall at all, for reasons that I will come to, but there are around 700 places yet to be filled, not 1,000.

The reason why I say “so far” is that this is a clearing process that has not yet completed. It is still under way and final numbers will not be known until the end of the cycle in December. However, even so, compared with 2019, the figures so far are 5 per cent up in terms of acceptance for nursing places and 7 per cent up in terms of acceptance for midwifery places. Again, for context—because I think that context is important—the number of nursing acceptances in Wales over the same period is down by 17 per cent. [Interruption.]

Thank you, members.

The cycle is not yet complete, but I think that there is much to be encouraged about.

Perhaps one of the reasons for that difference is that we have increased the nursing and midwifery student bursary to £10,000—that is higher than it is anywhere else in the United Kingdom, and we also have more qualified nurses and midwives per head of population than any other part of the UK.

Yes, there are challenges but, clearly—as has just been evidenced—action is being taken to address those challenges.

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Food and Drink Sector (Brexit)

The Tories seem to have concluded that a trade deal with the USA was yet another effort to deceive themselves and others on the merits of Brexit. Meanwhile, former Scotland Food & Drink chief executive James Withers recently stated:

“The UK is suffering ongoing malaise ... This is Long Brexit & we’re all living with it.”

Does the First Minister support that view and agree that the renormalisation of relations with our European friends is the only way to ensure that Scotland’s world-class food and drink industry does not continue to be hamstrung by United Kingdom mismanagement?

There is no doubt at all that the food and drink sector in Scotland and across the UK has borne the brunt of the hard Brexit that has been pursued by the UK Tory Government, particularly through the loss of free trade and free movement of people. We know that Scotland’s food exports to the European Union in 2021 were down by £70 million compared with 2019, and that is clearly down to the reckless Brexit that the UK Government has pursued.

Given that it has had to admit this week that there is no trade deal with the United States on the horizon, the least that the UK Government can do now is to stop threatening a trade war with the European Union in the middle of the cost of living crisis. Brexit was not in the interests of Scotland and further exacerbating trade tensions with the EU would certainly not be in the interests of Scotland or anybody in any other part of the United Kingdom.

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Forced Adoption (Apology)

Campaigners were heartened when the First Minister signalled that the Scottish Government will take forward a formal apology to those affected by forced adoption. Monica Lennon and I have met ministers to try to progress the issue, but progress has been limited. For many campaigners, time is simply running out. Therefore, I ask the First Minister this straightforward question: will she today commit to take forward that national apology before the end of this year?

The commitments that I have made in this chamber still stand. I understand the importance of the issue and the great sensitivity around it. However, it is important that we properly think through and work through all the various legal issues that are inevitably involved and give careful thought to the framing and the wording of an apology.

This is an important issue so, rather than give an update right now, I will ask officials or the relevant minister to write to the member with a more detailed update on the work that has been done and the progress that is being made, and to place that in the Scottish Parliament information centre.

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Alpha Solway

Just last year, Scottish Government funding of £4.8 million was awarded to Dumfriesshire-based company Alpha Solway to build a manufacturing plant in Dumfries for personal protective equipment, with a promise from ministers of 300 jobs. That firm now employs less than half that number of people and it has just begun a consultation on further job losses because, in the firm’s words,

“NHS orders have been stopped”.

Of course, the overall amount of PPE that we need may well have reduced, but, surely, one of the lessons from the pandemic is that we should never again rely on importing PPE; it should be manufactured in Scotland. I presume that that was the Government’s view when it awarded funding to the company. Will the First Minister urgently investigate the Government’s approach to the purchase of PPE and the stopping of NHS orders so that we can avoid any further job losses at Alpha Solway and ensure that we have the vital future PPE resilience that we need?

During the pandemic, we built a resilient PPE manufacturing sector in Scotland, which is important. It is also important that we maintain it to reduce any dependence on imported PPE in the future. However, it is the case—and the member has referenced this point in his question—that demand for PPE has, understandably, slowed considerably between the peak of the pandemic and the current time, which means that procurement requirements have reduced. Work to implement a new approach to pandemic PPE and to learn fully the lessons from Covid is continuing.

Alpha Solway is one of our partners, and we appreciate the important contribution that it made during the pandemic. I know that this is a concerning time for the company’s staff. The Minister for Business, Trade, Tourism and Enterprise has spoken with the company and has offered the full support of the Scottish Government and South of Scotland Enterprise. South of Scotland Enterprise is engaging with the company to explore all options and it will offer any assistance that may be required. I will ask the business minister to keep the member updated fully on progress.

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Ukrainian Refugees

I refer the chamber to my entry in the register of members’ interests. I am a member of the homes for Ukraine scheme.

To ask the First Minister when the Scottish Government will announce the outcome of its review into the pausing of the supersponsor scheme for Ukrainian refugees coming to Scotland. (S6F-01353)

First, I report to the Parliament that more than 18,000 displaced Ukrainians are currently being accommodated in Scotland, which is almost 20 per cent of the total number in the United Kingdom. That includes almost 15,000 Ukrainians under the Scottish Government’s supersponsor scheme, which compares to our initial commitment of 3,000. That is something for everyone across Scotland to be very proud of, and it is an important part of our overall contribution to supporting and helping Ukraine in its hour of need.

We are currently reviewing the operation of the sponsor programme and the warm Scots welcome to ensure that we can provide appropriate and sustainable longer-term support to those who are here, as well as to those who are still arriving and are due to travel. I can also confirm that we are providing a dedicated capital fund of up to £50 million, which will be available for registered social landlords to help them to bring sustainable accommodation into use and boost the housing supply for those who are fleeing conflict in Ukraine.

The First Minister’s boasting about numbers will be of cold comfort to those who have been living out of suitcases since February or who are coming to the end of their placements with no idea what happens next. That is not a new life; it is a new limbo. Furthermore, the mobilisations in Russia and the pretend referendums mean that there is no chance of early return for our Ukrainian guests.

A memo that was leaked to The Herald from the Government’s rapid rehousing group has described confusion and increasing desperation. The Government has written good-will cheques that refugees cannot cash. Although the Government closed the scheme in July, it still has not acted on my call to re-issue the appeal for homes. In addition, we know that, if it is easier to travel, it is easier to find homes and jobs. Alongside the renewed call for homes, will the First Minister now extend free bus travel to all refugees?

If those who are being temporarily accommodated in Scotland were not in temporary accommodation here, they would not have refuge, so it is important that we recognise that Scotland is more than playing our part. Almost 20 per cent of all displaced Ukrainians in the UK are being accommodated in Scotland, which is a good thing. It is good for Ukrainians and it is good for Scotland to be playing a positive part.

We continue to take steps to ensure that not just temporary accommodation is available but longer-term, more sustainable accommodation. In relation to temporary accommodation, we continue to support those who have offered private homes for use, and we continue to work to speed up the matching process. However, it is important that we make longer-term accommodation available, which is why the fund that I referenced earlier is an important part of that work.

We will continue to take all of those steps to make sure that we are playing our part in continuing to support Ukraine at what is a pivotal moment in the war—we are all happy to see Ukraine in the ascendancy, but we continue to be concerned about Putin and his intentions. Scotland will continue to play its part, and I hope that members across the chamber will give the Scottish Government and our local authority and third sector partners every support in doing so.

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Flooding (Pakistan)

To ask the First Minister whether she will provide an update on the Scottish Government’s support for the people of Pakistan as they face on-going devastation following severe monsoon flash flooding. (S6F-01351)

We have all been shocked and concerned by the devastating impacts of monsoon flooding in Pakistan, which includes the destruction of or damage to 1.7 million homes. That is a clear example of the loss and damage caused by climate change and underlines the need for all countries to act on it.

As an immediate response, we have made available £500,000 in humanitarian relief funding. The Minister for Culture, Europe and International Development has also met the consul general of Pakistan to hear about the situation on the ground at first hand and to offer Scotland’s on-going support.

Pakistanis across Scotland, including from the First Minister’s constituency in Glasgow Southside and mine in Glasgow Kelvin, will appreciate that update.

On behalf of the Education, Children and Young People Committee, I have previously welcomed to Parliament a delegation from the regional government of Balochistan, which is one of the regions that has been worst affected by the flooding. This week, the UNICEF Pakistan chief field officer in Balochistan reported:

“We don’t have enough food, we don’t have shelter,”

and there is not enough healthcare, adding that

“Roads and bridges have been washed away ... the flood is not going anywhere.”

Will the First Minister commit to considering further support for Pakistan in the coming weeks, given the scale of the catastrophe and the on-going havoc and misery that people are living through?

Yes, we will absolutely do that. Kaukab Stewart is right to point to her constituency interest in this as well as my own—a significant proportion of my constituents in Glasgow Southside are of Pakistani origin and will have relatives affected by the flooding. My constituency is also home to the Pakistan consulate.

These are issues that concern all of us, and the scale of the devastation is truly overwhelming. It is estimated that 22,000 schools have been damaged, disrupting the education of an estimated 3.5 million children. It is estimated that the material damage will be up to $30 billion and that 45 per cent of the country’s agricultural land has been destroyed. The World Bank estimates that the floods could push 15 million people into poverty.

As the Prime Minister of Pakistan has highlighted, this is a clear case of climate injustice. Today, on the international day of recognition for loss and damage, we support his plea for additional finance to address loss and damage, and we will always do whatever we can to play our part in supporting countries affected by disasters such as this one.

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Net Zero Heating (Rural Homes)

To ask the First Minister what action the Scottish Government is taking to support the transition to net zero heating in rural homes. (S6F-01360)

Poorer energy efficiency and higher fuel poverty are long-standing issues in rural areas. That is why we provide more whole-house retrofits and a wider range of support for the installation of zero-emissions heating in rural areas. Overall, we have committed £1.8 billion for heat and energy efficiency over this session of Parliament. That includes £42 million for the Home Energy Scotland loans with cashback scheme, £55 million for the warmer homes Scotland scheme and £64 million for area-based schemes. We are committed to spending more per head on energy efficiency in remote rural areas, where we know that installation and labour costs are higher.

In addition, the Home Energy Scotland service provides free impartial advice on zero-emissions heating and energy efficiency. Its five regional centres provide location-specific energy advice that takes account of rural circumstances and the varying energy demands of properties across the country.

Earlier this year, a cross-party group of MSPs wrote to the Scottish Government to highlight the serious financial challenges that are facing off-gas-grid home owners who are seeking to replace their oil heating systems, which are increasingly expensive to run and are carbon intensive. Despite the Scottish Government’s much-vaunted target of a million zero-carbon heated homes by 2030, there is still no detailed plan on how that will be delivered, nor are the existing funding packages sufficient to meet the costs that those home owners will face to install net zero heat.

Does the First Minister recognise that any credible strategy should prioritise support for homes that are facing the costliest transition away from the most carbon-intensive heating systems?

Yes, I do. I have already set out some of the schemes that are in place, and the funding that is attached to those schemes, to help us to meet the targets to which Brian Whittle referred.

I have already made it clear that we recognise, and are responding to, the reality that there are deeper issues with poor energy efficiency and higher levels of fuel poverty in rural areas. We are addressing those issues, but there is a big responsibility on us, as there is on all Governments, to continue to do so.

I was struck by the British Energy Efficiency Federation’s recent comments relating specifically to Scottish Government policies on energy efficiency. I will quote those comments to give some background. The federation said:

“The Scottish government has deliberately concentrated such improvements in rural and remote communities not served by the gas grid.”

It went on to say:

“no such set of activist programmes to stimulate energy efficiency yet exists from the UK Government. My advice to Whitehall is simple ... you had best be copying Scotland’s initiatives.”

Communities across the Highlands and Islands are experiencing extreme fuel poverty. Many of those places also generate more than 400 per cent of their energy use through renewables. Will the Scottish Government consider extra support for homes in those areas that do not yet have, or cannot be fitted with, green heating systems and are still using systems such as liquefied petroleum gas and oil boilers, until they are able to be fitted with lower-carbon alternatives, given that those areas can already be considered net zero?

Regulation lies with the UK Government, and we have asked it to use its regulatory levers. Within the powers and resources that we have, which I have already given an indication of, we will seek to do exactly that. We recognise the particular issues that exist in rural areas and, as part of our overall approach, it is vital that we address those appropriately.

The First Minister will be aware that her Government fits only heat pumps under its central heating assistance scheme. Those pumps are absolutely useless in draughty houses, and people who need help to replace and install central heating cannot afford to clad their homes with insulation. Will she therefore urgently amend the scheme to ensure that insulation is fitted in tandem with heat pumps in central heating schemes to ensure that nobody is freezing this winter?

We will certainly look on an on-going basis at any adaptation or amendment that might be required to the rules for our existing schemes. I will ask the relevant minister to look at that particular point and to write to the member as soon as possible.

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Cost of Living (Single Parenting)

To ask the First Minister what the Scottish Government’s response is to the One Parent Families Scotland report “Living without a lifeline: single parenting and the cost of living”. (S6F-01364)

I welcome the report, although I wish that it was not necessary. We are all aware of the hardship that is felt by many families right now, and in particular by single parents. The Scottish Government’s very significant actions to tackle child poverty, alongside our interventions to mitigate the cost of living crisis, are providing direct support. For example, our five family benefits, which will shortly be worth more than £10,000 in the early years of a child’s life, include the Scottish child payment, which will increase to £25 in November, representing a 150 per cent increase within eight months.

All of that is in contrast to the approach of the United Kingdom Government, which continues to hold most of the key levers here. If it reversed the welfare reforms that it has imposed since 2015, such as the two-child limit, the £20 cut to universal credit, the benefit freeze and the benefit cap, that would put £780 million into household budgets and would lift 70,000 people, including 30,000 children, out of poverty.

Unfortunately, right now, we have to rely on the UK Government to exercise the levers. I look forward to the day when such decisions lie in this Parliament’s powers.

I thank One Parent Families Scotland for its report and I thank the parents who contributed. The report is indeed a grim read, and one parent’s response shows how bad things are. She said:

“Depression, anxiety, stress ... I am responsible for the most amazing children but I am falling apart and terrified of losing my job.”

The report suggests many ways to tackle child poverty including, crucially, employability support to help people to stay out of poverty.

Will the First Minister explore the recommendations that the report sets out? Will she give an assurance that the cuts to employability support that the Deputy First Minister announced will not impact efforts to help single parents and other priority groups, including disabled people, larger families, families with children who are under one, mums who are under 25 and people of colour?

I am happy to give that assurance and to engage in more detail on all of that. On the specific questions, yes, we will consider all the recommendations that are in the report. Support for employability is important. The Deputy First Minister set out the rationale for the savings that were announced two weeks ago. At a time of high employment and low unemployment rates, our judgment when our budget is under so much pressure is that we need to focus as much as possible on increasing people’s incomes through wage increases, as far as we can support them, and through increases to the Scottish child payment, for example.

Nevertheless, supporting employability for lone parents and others who tend to be furthest from the labour market remains extremely important. We will continue to use all levers and maximise the resources that we can bring to bear to tackle poverty generally and child poverty and the issues that lone parents experience in particular. The Government has a good record, but the more powers we hold in our own hands, the more we will be able to do.

Does the First Minister share my frustration that, while the Scottish Government has introduced significant poverty interventions such as the Scottish child payment, which she mentioned, our ambition to tackle poverty is not only unmatched but absolutely undermined by Tory policies and, as long as the UK Government holds the key tax, borrowing and welfare powers, we will always be constrained in our ability to protect the most vulnerable in our society?

I share that frustration. While we use our powers and deploy our resources to try to lift people out of poverty, the UK Government takes actions that push people into poverty. That is not a sustainable, sensible or morally defensible position. The UK Government now seems to want to increase the bonuses that are paid to bankers, while further eroding the incomes of those who are on universal credit. That is utterly indefensible.

We are showing what we can do with the limited welfare powers that we have—the Scottish child payment is the leading example of that. As long as so many such powers and levers lie with a UK Government that is acting in the way that this one is, our efforts will continue to be undermined. That is why it is so important that we get all such powers into this Parliament’s hands as soon as possible.

That concludes First Minister’s question time. The next item of business is a members’ business debate on a motion in Ruth Maguire’s name. There will be a short suspension to allow people to leave the chamber and the public gallery.

12:48 Meeting suspended.  

12:51 On resuming—