Meeting of the Parliament

Meeting date: Wednesday, October 26, 2022

Official Report 1158KB pdf

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National Health Service (Winter Support)

The next item of business is a debate on motion S6M-06437, in the name of Jackie Baillie, on supporting the national health service in winter. I invite members who wish to participate in the debate to press their request-to-speak buttons now or as soon as possible.

I call Jackie Baillie to speak to and move the motion for around six minutes.

14:51  

I received an email at 8 pm last night. It was from a man who had taken his mother to the Queen Elizabeth university hospital with chest pains. He told me that a member of staff had just come into the packed waiting room to announce the following:

“There is an 8-hour wait to be initially reviewed. There are 14 ambulances waiting to be processed. If your issue is not life threatening, go home and call your GP tomorrow.”

He went on to say:

“The SNP and the current, not-fit-for-purpose health minister, are running this country into the ground.”

Those were his words, not mine, but there is no mistaking the anger—and that is not an isolated incident. Thousands of people are waiting more than eight hours every week across Scotland.

Will the member take an intervention?

No.

Those delays have the most serious of consequences. The Royal College of Emergency Medicine tells us that delays in accident and emergency lead to worse outcomes and, ultimately, cost lives.

The NHS stands on the brink of a humanitarian crisis. The hard-working staff are doing their very best, but they are exhausted. They get angry when the Cabinet Secretary for Health and Social Care does not hear what they are saying, and they are in despair at the lack of support for them and for their patients.

Maybe the health secretary will listen to the British Medical Association, which has said that the system

“just doesn’t work properly anymore—staffed by people on their knees and genuinely at the brink of what they can cope with”

and that

“some honesty from our politicians on the scale of the challenge will help with this—and then finally we may start to address the need to make sure our NHS is sustainable for the future.”

However, the complacency in the Scottish National Party amendment suggests that the health secretary’s fingers are well and truly in his ears.

What about the Royal College of Emergency Medicine? It has said that many of the components of the SNP’s winter resilience plan

“will not be in place to prevent further harm to patients and staff this winter.”

How about the view from the Royal College of Physicians of Edinburgh? It tells us that the solution lies in properly funding social care in order to tackle delayed discharge and therefore free up hospital beds. Again, the health secretary is deaf to the solutions, because he knows better than the health experts.

His winter resilience plan has no new resources. That is right—not a single penny extra. All of the money has been pre-announced, some of it more than 11 months ago. We know that social care has been underfunded for more than a decade, and the health secretary’s repackaged, reheated and recycled funding announcement is a pathetic excuse for urgent action. In fact, he is currently raiding the budgets of general practitioners and health and social care partnerships at a time when they need the money the most.

But it gets worse. The Convention of Scottish Local Authorities tells me that, despite its asking, the health secretary has provided no detailed plan about what needs to be done in social care to help with the impending winter crisis. There has been not one single iota of detail—and winter is here.

I have been in Parliament for 23 years and I can say, without fear of contradiction, that Humza Yousaf is absolutely the worst health secretary since devolution.

Let us prove that—let us look at his predecessors. Under Nicola Sturgeon, in October 2011, 95.9 per cent of people were seen within four hours at accident and emergency. Under Alex Neil, the figure in October 2013 was 93.9 per cent. [Interruption.]

No, no—I am praising SNP ministers, so SNP members may want to listen. Under Shona Robison, the figure in October 2015 was 91 per cent. Under Jeane Freeman, the figure in October 2020 was 89.6 per cent—let me remind members that that was eight months into the same pandemic on which the current health secretary blames all his failings. Our missing-in-action health secretary presides over the record low of 64 per cent.

Waits of more than eight hours and 12 hours at A and E are at record highs. Literally thousands of patients—more than 3,000—have waited more than eight hours and 1,300 have waited more than 12 hours in the past week alone. That means that as many as 37 people could have lost their lives this week because of delays.

Patients wait on trolleys, get intravenous drugs administered in corridors, which is not safe, and sleep in chairs overnight. That is the new normal in accident and emergency. When Jeane Freeman was in charge back in October 2020, no more than 350 people—a fraction of the current figure—in any week during the month waited more than eight hours to be seen. That is the difference.

Finally, I turn to doctors, nurses and other NHS workers who are the backbone of our NHS. The health secretary is fond of telling us that the NHS has record levels of staff, but he fails to tell us that they are coping with record levels of demand and are doing so with record levels of vacancies—there are almost 7,000 nursing vacancies alone. There is a critical shortage of GPs and other allied professionals. Patient safety is being compromised on a regular basis, and there have been successive years of failure to workforce plan.

The latest pay offer helps the lowest paid the most, but for many skilled and experienced nurses the pay offer is less than the 5 per cent that was previously promised. Nurses’ pay has declined by 17 per cent in real terms, and inflation is now at 10 per cent. That is not a fair pay deal, and nurses in Scotland are now being balloted on strike action.

Our NHS is on its knees. The health secretary has a choice, but doing nothing is not a choice. He needs to stop people needlessly dying this winter. His choice is to set out a clear plan to end waiting times of more than eight hours, because this is about saving lives, and if he cannot do that, frankly, he must resign.

I move,

That the Parliament is deeply concerned that record numbers of patients are waiting over eight and 12 hours in A&E on a weekly basis; acknowledges that hospital capacity continues to be constrained by thousands of bed days lost due to delayed discharge; recognises the tireless work of the NHS staff who care for patients in increasingly difficult and safety critical situations; notes that the Scottish Ministers have not yet resolved the nurses’ and NHS staff pay claim risking industrial action during the winter period; considers the Scottish Government’s NHS Recovery Plan and Winter Plan to be inadequate with the new interim targets to reduce waiting times being missed and no additional funding for the impending winter crisis, and calls for the Cabinet Secretary for Health and Social Care to either set out a clear plan to end waiting times of more than eight hours ahead of winter, or to resign.

14:58  

I am eager to respond in the debate, and to outline the NHS’s continuing recovery from the Covid-19 pandemic.

No one in the Government—not I, nor my colleagues in the seats behind me—denies that the NHS is under significant pressure: of course it is. However, for Labour to lodge a motion about NHS pressures, and not to include one single solitary word about Covid and the pandemic demonstrates that it is Jackie Baillie and her party who have their fingers in their ears, and not the Government.

The pandemic is the biggest shock that our NHS has ever faced in its 74-year existence.

Will the member take an intervention?

I will not; I am sure that the member will have his moment.

I have no doubt that the NHS had challenges pre-pandemic, but for Labour not to recognise that Covid has been the biggest shock that the NHS has faced is frankly burying its head in the sand.

Let us remember: as we speak, more than 800 people in our hospitals are suffering from the effects of the virus. People are still dying and families are grieving due to loss caused by Covid. Any realistic and pragmatic discussion of the NHS in Scotland cannot simply cast aside the impact of the pandemic, because it is central to the challenges that we face. That is why a successful Covid and flu vaccination programme is central to our recovery, and I thank our staff who are in involved in that.

The NHS will not recover in weeks—as Jackie Baillie demanded that it should—or even months; it will take years.? That is why our £1 billion recovery plan is predicated on five years of substantial investment and dedicated reform. I am committed to that recovery, and taking care of our workforce is central to it.

As Jackie Baillie referred to, during the past week, we offered our NHS staff a record pay rise of £2,205 this year—which is an average uplift of 7 per cent—to help tackle the cost of living crisis and retain staff during the tough winter months.?The offer means that the lowest paid would see a rise of more than 11 per cent and qualified nursing staff would receive up to 8.45 per cent. If agreed, the pay uplift will amount to almost half a billion pounds, which is the largest single-year pay offer ever given to agenda for change staff, and if it is accepted, it will mean that NHS staff in Scotland will be better paid than those in England, Wales and Northern Ireland. Once again, I give my thanks to those staff.

Will the member take an intervention?

Of course.

Can the cabinet secretary explain why NHS nurses are balloting for strike action, if he is being so generous?

Unions are still meeting to discuss the latest pay deal. I will let them have those discussions and my door will be open to try to prevent industrial action from taking place. I hope that when NHS members see the detail of the deal they will accept it.

It is untrue to say that there has been no progress on waiting times in the NHS during its recovery, even while we are in the midst of the pandemic. I announced the planned care waiting times targets in the summer, and the latest figures from Public Health Scotland show that 76 per cent—31 of 41—out-patient specialties had no or fewer than 10 patients waiting more than two years, and that 60 per cent of in-patient and day case specialties had fewer than 10 patients waiting more than two years. That is demonstrable progress, and it is all thanks to our brilliant NHS staff.

There is no doubt that delayed discharge rates are too high. They create real challenges in the social care sector, and that is why one of the first things that I did when I came into this role was ensure not just one but two pay uplifts for adult social care staff. We know that there are challenges in the social care sector. Our care homes have been hit by a triple whammy of Brexit, the pandemic and high inflation and energy costs. Two out of three of those factors are, of course, a result of the Conservatives putting ideology above the interests of the country, and it is clear that our social care sector is paying the price.

On Tuesday, I met chief executives of local authorities and health boards and chief officers of health and social care partnerships from across Scotland, and we will do everything that we can to support them.

The pressures on accident and emergency departments are being driven by the pressures that I have already mentioned and by delayed discharges elsewhere in our hospitals, but we have put £50 million towards our urgent and unscheduled care collaborative programme. Although the current level of performance is not where I want it to be—and I agree entirely with the Royal College of Nursing and Jackie Baillie’s assessments that long waits harm patients—we will do everything that we can to take a whole-systems approach to reduce the pressures on A and E.

We must be frank that we face a very difficult winter ahead due to the cumulative pressure from the pandemic, flu and slips, trips and falls. Therefore, my focus, and that of the Government, will be to spend every single waking moment supporting our NHS and the staff who work in it.

In Scotland, we have the best paid NHS staff in the UK and more GPs per head, more dentists per head and more NHS front-line staff per head under this Government. Yes, challenges persist, but there are shoots of recovery.

Let me finish by acknowledging that although this winter will be one of the most difficult ones that our NHS has ever dealt with, I praise our NHS and social care staff for the incredible, compassionate care that they provide to the people of Scotland, day in and day out. I give them a promise that we will not just honour them with words, but through our deeds.

I move amendment S6M-06437.1, to leave out from “that record” to end and insert:

“about the impact of the ongoing COVID-19 pandemic on the health of the people of Scotland and on the operation of the National Health Service; acknowledges that, as a result, Scotland’s NHS and care services face deep pressures, with 884 patients with COVID-19 currently in hospital; recognises that, as a result of increases in inflation, the health budget is worth around £650 million less than in December 2021; notes that the £600 million Health and Social Care winter plan supports recruitment of 1,000 additional staff, and includes over £120 million to help health and social care partnerships expand care at home capacity; welcomes that, in the face of these challenges, the NHS has been steadily increasing activity levels; recognises the exceptional work of NHS staff through the pandemic and beyond, and that the NHS Agenda for Change pay offer would see the lowest paid staff in NHS Scotland getting an increase of over 11% and qualified nursing staff seeing an increase of up to 8.45%; further recognises that if the offer is accepted, an experienced porter will be paid up to £2,502 more than their counterparts in England and Wales; recognises that, similarly, an experienced paramedic and staff nurse will be paid up to £2,186 more than their counterparts in England and Wales, and understands that the £50 million investment in improving unscheduled care has addressing long waits as a key area of focus.”

15:04  

People are dying; they are dying avoidable deaths, and it will get worse during winter. Across the country, the Scottish Government continues to fail our Scottish national health service and our patients.

To be clear, that is not the fault of our hard-working clinical and support staff, who have gone beyond the call of duty and always will. However, those heroes really are at breaking point. The cabinet secretary should know that, and he would know it if he bothered to face the front line when he is on one of his well-documented PR drop-ins to one of our hospitals. The cabinet secretary just thanked and praised our staff, but he avoided Dr Moy in A and E when he went.

This debate is about responsibility and accountability, so let us consider the facts. Under the SNP, waiting times for A and E and cancer treatment are at their worst ever levels. In the second quarter of this year, more than one in 10 patients waited longer than 84 days to begin treatment, with one in 20 waiting 116 days. We even have one patient who was left 322 days before treatment began—and we are talking about cancer. As for routine treatments, over 7,000 people are languishing on in-patient waiting lists for more than two years, with the SNP breaking its promise to eradicate waits longer than 24 months by September.

While we are on the subject of broken promises, a near record number of patients are having their discharge from hospital delayed because there is no follow-on social care package in place and no space in residential care, yet the SNP promised to solve the problem of delayed discharge by the end of 2015.

The cabinet secretary is also failing our most vulnerable children. Over a quarter of young people referred to mental health services are not being seen within 18 weeks, yet the Government’s own target is to have 90 per cent of children seen by then.

I could go on, but I would run out of time. It is fair to say that there has been a catalogue of failures on the SNP’s watch. As I underscored in the Scottish Conservatives’ NHS debate last month, we have a record-breaking cabinet secretary; the trouble is that he is breaking the wrong kind of records. The First Minister and the cabinet secretary come to the chamber and make announcements, usually in the form of new spending plans. They are good—no; they are great—at spending taxpayers’ money, but they cannot deliver results or even get a squeaky-clean bill of health from the auditors.

For example, what happened following the September 2021 announcement of £10 million for long Covid support? Come May of this year, we found that the money would be spread over three years, with only £3 million being spent to start with, and we still do not know where that money is being spent. Let us not forget that, during that time, the number of Scots with long Covid rose from around 90,000 to 200,000, which is more than the population of Aberdeen.

It is just about headlines for the cabinet secretary. Winter is now fast approaching and it is plain to see that the SNP-Green Government is ill prepared. Its NHS recovery plan and winter plan are inadequate, and A and E waiting times alone are spiralling out of control.

We call on the cabinet secretary to go back to the drawing board and set out a clear plan to get our health services and patients through the next six months. We want to see more spending announcements with a clear target that can be audited. Patients—taxpayers—have a right to know how the Government is spending their money.

I should declare an interest—I am a practising NHS doctor.

I move amendment S6M-06437.2, to insert after “weekly basis,”:

“is equally concerned that cancer waiting times are at their worst level on record; expresses its disappointment at the Scottish Government’s failure to meet its target to end inpatient two-year treatment waits in most specialties; reminds the Scottish Government that it has never met its target to treat 90% of children with mental health issues within 18 weeks of referral; notes with concern the long ambulance waits being experienced across Scotland;”

15:08  

I am grateful to my friend Jackie Baillie for securing time for this important debate in the chamber. It is a timely debate. I cannot remember a time when our NHS was in such a state or when our valiant doctors, nurses and healthcare professionals were under so much strain. Had the cabinet secretary taken my earlier intervention, I would have reminded him that this is not solely about the impact of the pandemic that we have just been through. In fact, former chief executive of NHS Scotland Paul Gray reminds us that this is a crisis that was years in the making; Covid just hastened its arrival. It is wrong for the cabinet secretary to say otherwise and it is offensive to the people who are bearing the cost of this Government’s negligence day in, day out.

As grateful as I am that we are having the debate, I cannot help but feel a depressing sense of déjà vu. It feels like groundhog day. Each time we have such debates, Opposition parties come to the chamber armed with the latest round of disastrous health and social care statistics and, each time, the Government responds with reference to the pandemic and vague promises to make things better; often, it just tries to blame things on everyone else. It is small wonder that the SNP and Green Government does not make time for such debates in its own parliamentary time.

It is impossible to overstate the crisis that is engulfing our health service. Everybody knows somebody who is on a waiting list or who is suffering, whether it is a partner who arrives home late after another brutal ward shift or an elderly parent who is forced to wait for hours on a hospital gurney or for weeks just to speak to their GP on the phone. The cabinet secretary’s NHS recovery plan and winter plan fall woefully short. The Government is already missing its interim waiting time targets. The plans contain nothing that will make a material difference ahead of the inevitable strain of winter—and the first frosts have not yet arrived.

The stakes are literally life and death. For more than a year, A and E waiting times have steadily risen, tragically resulting in hundreds of avoidable deaths this year alone, yet, last month, the SNP-Green Government voted down my party’s proposal to hold an inquiry into those avoidable emergency care deaths. That is reprehensible. The more apparent the cost of this Government’s incompetence becomes, the more it will try to detract attention from its failures and instead turn attention towards the mythical vagaries of Scottish independence, which I think is the root cause of ministerial disinterest here.

I remind the chamber that, during her keynote speech at the recent SNP conference, the First Minister mentioned the NHS just 11 times, in comparison with the 58 mentions she gave to breaking up the United Kingdom. She had nothing to say on social care, and do not get me started on long Covid. I associate myself with Dr Gulhane’s remarks. There are now more than 200,000 sufferers of that debilitating condition. It is perhaps the biggest mass disabling event since the first world war, and we are nowhere in dealing with it. We are spending twice as much on an independence referendum as we are on assisting those people. It is the same old story, and it does nothing to help beleaguered nurses and doctors, or the patients who are left abandoned in our A and E departments.

The impact of Government failure is felt right across health and social care. The devastating story that we heard from Jackie Baillie at the top of her remarks is a story told the country over: ambulances cannot get to people in time because they cannot discharge patients into emergency wards when they arrive because A and E is full to the rafters with patients who cannot be admitted into the wider hospital due to the lack of beds. On any given night, more than 1,000 people who are well enough to go home but too frail to do so without a social care package are languishing in Scottish hospitals. Even when the care packages are arranged, too often those in need are still being let down.

The blame does not lie with staff. For years, they have worked tirelessly and diligently under enormous physical and emotional strain, and their reward is unfair pay and unimaginable working conditions. Were the Liberal Democrats in government, we would support staff immediately with a burn-out prevention strategy and an NHS staff assembly to set national standards in order to get rid of the postcode lottery in social care.

This Government loves to talk about a far-off land where everything will be better, but it has neither the desire—

You need to conclude, Mr Cole-Hamilton.

—nor the competence to make things better today. I say to the Government and to the cabinet secretary: either get it sorted or step out of the way to make room for someone who can.

We now move to the open debate. I call Carol Mochan for up to four minutes.

15:13  

It has been a busy week for bad news across the UK, so, understandably, the Scottish Government was hoping that its own failings would drift under the radar. However, with winter approaching, we need to get serious, and quickly, about the significant problems with the Government’s management of our NHS. It is putting lives at risk. There is a crisis in A and E across Scotland and, quite frankly, the cabinet secretary has been missing in action for a great deal of it. He and a number of his predecessors have overseen years of poor workforce planning, cuts to hospital bed numbers in many areas and a consistent failure to recognise the approaching dangers of the underfunding and underresourcing of social care.

The situation beyond A and E is also desperately concerning. I have been helping one constituent who has been waiting for more than 80 weeks for arthroscopy surgery—80 weeks, cabinet secretary, in serious pain. I am advised that things are deteriorating by the day and that she is dependent on medication to get through the day. I have written to the cabinet secretary about that case, and he is unable to give that woman—and that family—any idea of when it might be possible for that vital operation to take place. I will say it again: that constituent has been waiting for 80 weeks.

It is whole families who suffer. While living with considerable pain, that woman struggles to support her child, often relying on her husband to do things that she would love to be involved with. The situation is worse than just the constant pain. Imagine how that family feels, when, for 80 weeks, they cannot do the things that they would wish to do with their daughter. We should all think about the physical pain and the mental distress. The chances of her situation improving seem to be dwindling with every passing day, as she waits for an appointment that seems as though it will never come. As I have said, the cabinet secretary is unable to offer anything to that woman.

These are the human stories behind the statistics—stories that do not even warrant a headline anymore, as they are so common. If the health secretary thinks that that is acceptable and, on top of that, cannot seem to do anything about A and E waiting times of more than eight hours going into winter—with some as high as 12 hours—it is reasonable to ask why he is still in his job.

This week, we have seen lots of politicians in London miraculously regain the jobs that they had lost, but the bar here seems to be so high that, no matter how often a minister fails, they will be kept in post. I dread to think what would happen to ordinary workers in this country if they made as many mistakes as this Administration has.

Waiting times are a massive concern for many of my constituents. Month after month, year after year, people are living with anxiety and concern about how they will get the treatment that they need. We must remember those personal stories.

We must also remember that hard-working hospital staff are under huge pressure every day, which causes them stress and anxiety as well. However, that seems to be one of those things that people in this Government just appear to accept as a force of nature. Nothing serious is ever done to address the problem; no actions are taken, and it just comes back around the next year. People—

Actions are—

The minister can shout all she likes, but what I am saying is true. These are true stories that members bring to the chamber to enable us to have a serious discussion with the cabinet secretary about how we move things forward.

You need to conclude, Ms Mochan.

People truly value our NHS, but what is going on is just not good enough. One in seven Scots are now stuck on NHS waiting lists. The cabinet secretary should sort it out or pass the responsibility to someone who can.

15:17  

Despite being the best-performing A and E departments in the UK, Scottish A and E departments are facing capacity issues, and not just in winter. I would like to put forward suggestions and thoughts based on conversations that I have had with clinicians.

Staff vacancies are the north-east’s biggest issue, and we have a worrying situation in GP services, with a number of surgeries in my constituency struggling to treat patients because they have so many unfilled posts. One of the impacts of that is that patients who would otherwise receive GP care resort to turning up at A and E, which puts even more pressure on the service. That is one of the reasons why I would like to see the ScotGEM programme being extended to include Grampian.

I note that the cabinet secretary has made a pay offer to nurses, and I hope that it is accepted, but there are pressures on other groups of our staff, too. A wide range of people in the NHS have advised me that they have concerns that too many GPs and consultants are retiring far too early. Just today I spoke to a consultant in NHS Grampian who is concerned that, because of tax and pensions implications, consultants as young as 40 are reducing their hours. A reduction in consultant capacity obviously impacts on A and E departments; I am concerned that that might also impact on measures that the Government puts in place to offer scheduled urgent appointments in hot clinics that are designed to relieve pressure on A and E departments.

If pensions arrangements are making staying on less attractive to people, that will impact on capacity. Our budgets are stretched and are finite, but we need to address any seemingly illogical contractual disincentives to working full time until retirement age. After all, we have invested in training those consultants.

On training, I recently hosted an event with the Royal College of Emergency Medicine at which I heard from an advanced clinical practitioner who pointed to the roll-out of more ACPs being vital to supporting emergency rooms. I ask the cabinet secretary what we can do, within the work of the urgent and unscheduled care collaborative, to facilitate that. I welcome the £50 million funding that has been used to put in place ways to reduce A and E waiting times, including offering alternatives to hospital-based treatment. However, we need to accept that there will always be a need for hospital-based treatment and that, in addition to getting more ACPs, we need to look at increasing postgraduate training places and targeting them at areas where we have the biggest recruitment challenges. I have been told that those areas are respiratory medicine, acute medicine and geriatrics.

I realise that, so far, my contribution to Labour’s debate about winter planning has pointed to long-term strategies. However, the measures that I have outlined would get us through not just this winter but all subsequent winters, and would also aid recovery from the toughest period that our NHS has ever known—not just because of Covid, but because of the tough recruitment environment that has been caused by Brexit, which is the elephant in the room that cannot be ignored. My Grampian NHS Board colleagues have consistently pointed to the damage that loss of freedom of movement has done to our NHS and social care systems. The Labour motion does not mention that, because it is to the party’s endless embarrassment that its leader does not care about taking us back into the EU common travel arrangements. Until that changes, Labour has zero credibility on workforce issues that affect our NHS. [Interruption.]

I have spoken before about how Labour always comes to the chamber with a list of demands, but no costed solutions. To date, Labour has made nearly £2.68 billion of social care demands, which I have here, but it does not have the first clue about how to fund them. However, today, Jackie Baillie has not even come forward with ideas for the A and E departments. Uncosted or not, there has not been a single idea from Jackie Baillie or Carol Mochan. [Interruption.]

I will make one final point. Frankly, the last two words of the Labour motion and Jackie Baillie’s speech are a disgrace. Every health secretary and every Government is dealing with the same issues, so grubby personal attacks like that are the worst thing about this place—

Ms Martin, you need to conclude.

They undermine the very idea of politics as a public service.

Before we proceed, I remind members again that time is tight and that you need to stick to your allocated speaking times. Members—particularly those on the front benches, but also those on the back benches—should not shout across the chamber from sedentary positions.

15:21  

It feels like groundhog day. In September, Nicola Sturgeon told Parliament that she wanted to see immediate improvement in A and E waiting times, but for the third week in a row more than 3,000 patients waited for longer than eight hours to be seen in A and E, and 1,350 patients waited in pain and distress for more than 12 hours—not in hospital beds, but in waiting rooms and corridors. Those are shocking figures, not least because the Royal College of Emergency Medicine has repeatedly warned that such waits can lead to hundreds of avoidable deaths—each one of which is a tragedy.

The current chaos is just the tip of the iceberg, because the situation will only get worse as winter arrives. In September, well before the winter months, NHS Grampian in my region asked people to attend emergency departments only in life-threatening situations. Ambulances have been stacked outside Aberdeen royal infirmary and, because paramedics are treating patients in ambulances that are parked outside A and E doors for hours, the ambulances cannot be dispatched elsewhere.

However, the reality is that A and E waiting times are the symptom of a wider malaise that the SNP has presided over for years. Poor workforce planning and a failure to get a grip on delayed discharge mean that there are simply not enough staff and beds to care for patients. An elastic band can be stretched only so far, and we have reached breaking point.

It is abundantly clear that in order to help to prevent bed blocking we need more social care staff now, but the SNP has instead diverted hundreds of millions of pounds—or even billions, because the Scottish Government is not quite sure whether it is millions or billions—into the creation of a national care service that will not be up and running for another four years.

Meanwhile, cancer treatment waiting times are at their worst level on record, and waiting times for routine treatment continue to mount.

More than a quarter of children and young people are still not being seen by mental health services within 18 weeks, and people are having to wait hours—not minutes—for ambulances to arrive. With Humza Yousaf at the helm, our NHS is on its knees. With the resources that they have, NHS staff are working heroically to provide safe patient care. However, staff on the front line are telling us over and over that the system is simply not sustainable.

Just last month, nurses tried to share their concerns with the health secretary about their increasing workloads, their pay situation and patient safety. Shamefully, Humza Yousaf told them not to patronise him. My blood boiled when I heard that. My sister is a nurse, another is a midwife, and I speak to front-line staff every day, and that was just disgraceful. However, for Humza Yousaf, it was just another photo opportunity before retreating to self-congratulation and the platitudes of the SNP conference.

As the crisis that our NHS faces has gone from bad to worse, the Scottish Conservatives have called many times on the health secretary to completely rethink his NHS recovery plan, and we have urged him to go back to the drawing board on his NHS winter resilience plan. Enough distraction and deflection: Humza Yousaf needs to step up, because people’s lives are at stake.

15:25  

I have a few points to make in the short time that I have.

First, I welcome the fact that discussions are on-going and that another pay offer is on the table. Whether through that offer or a future one, I hope that we can reach an agreement, because the last thing that we need in our health service is industrial action.

I make the point to the health secretary that I have met front-line workers in health and social care, as well as local and national trade unions, and they have all stressed to me that it is not all about money; it is also about the massive pressure under which all the staff are currently working and are expected to work. We must address that in order to move forward.

I acknowledge the impact of Covid. I acknowledge that for whoever is in power, these are difficult times. I also acknowledge the impact of the disastrous Brexit. There are major difficulties for the NHS that we all face, but it is key that we have confidence that the Government has a grip of the issues and has plans that will operate to tackle the problems. This is the problem that I have: I do not see any evidence that such plans are in place. Indeed, when it comes to social care, I am not convinced that the Government has a handle at all on what needs to happen. That is the problem; I will say more about it.

I say first to the Scottish Tories that the reality is that the crisis in this country has been created in Downing Street. It is an economic crisis that will play out very badly. Last week, the Daily Record reported that 216 official heat banks have been opened, in addition to the 244 food banks that we have. If we are to go through this winter with people cold and freezing and unable to feed themselves, that will put massive pressure on our health service. The really difficult thing for me is that the Tories have tanked the economy but they have the nerve—

I think you’re in the wrong debate.

Please dinnae stand there and shout. If you have something to say, say it.

Ms White! I have already told you.

The Tories have the nerve to stand up and look into cameras with straight faces and say, “We’re gonnae have to cut public services”. I hope that this Parliament can unite to say that there should be no austerity when it comes to public services and that we will all join together to fight austerity. [Applause.]

I return to the Scottish Government and where it is at. Care homes are in crisis; we saw Robert Kilgour on the news last night talking about the massive pressures that they are under. That issue needs to be addressed, but it cannot be addressed by simply fleecing self-funders—people with more than £18,500 a year who have to pay for their own care. Right now, they are the only income source for the care homes and, sadly, the charges are increasing, against which there is no protection. That must be addressed.

With regard to social care itself, the inequality between those who work in the private sector and those who work in the public sector must be addressed: we cannot continue to ignore it. The Government’s national care service proposal is basically a national procurement service. That will not tackle the issues that we face right now. This morning, I looked at the responses to the consultation—

You need to conclude, Mr Rowley.

Everyone in that sector—all the professional bodies and people who use the sector—are warning the Government, so it must listen. People do not believe that the Government has a handle on the situation, so it must get a grip of it.

Thank you, Mr Rowley. I call Gillian Mackay. You have up to four minutes, Ms Mackay.

15:30  

This will, once again, be one of the most difficult winters in the history of our NHS. We have a workforce that is already tired, rising Covid-related admissions and a backlog of delayed and more complex treatment. We also face a battle to reduce A and E waiting times.

As always, some health boards are doing better than others. In my region, NHS Forth Valley is continually at the top of the table for long waiting times. We must understand better why that is the case. We also need to support a sustained incremental improvement in waiting times rather than what we are seeing at the moment: bad statistics one week, a marked improvement the following week, and then the cycle repeating itself. That does not deliver for patients, and I am greatly concerned about the pressure that clinical teams are being put under to achieve lower waiting times when they are already stretched and tired.

Keeping people out of acute settings in the first place should always be the primary goal. At the start of this week, I attended a Marie Curie round-table discussion, in which I heard about the experiences of unpaid carers and the organisations that support them. We discussed the current issues that face those who care for loved ones at home.

An issue that was raised was access to NHS 24 for people with a terminal diagnosis. Carers and patients often look for guidance on whether the issue that they currently have needs acute care. However, because of the wait to be triaged, they often end up phoning for an ambulance or taking their loved one to A and E.

I believe that some health boards, as part of anticipatory care planning, provide specific pathways for those with a terminal diagnosis to get the information that they need. Given the number of people who want to die at home, I hope that the cabinet secretary will look into that issue as one way to prevent people from ending up at A and E unnecessarily.

I have previously raised the issue of the staffing of out-of-hours GP services. That hugely valuable service diverts people away from A and E and provides timely care. We must make that service an attractive option for GPs to work in.

In its briefing, the Royal College of General Practitioners highlighted its belief that people are unaware of how to effectively navigate health and social care services. Many things have changed over the pandemic. Some services are not delivered in the same way, and pathways might have changed. I hope that, especially over winter, effort can be put into ensuring that patients know where and when they can access the most appropriate care. For example, the pharmacy first model will be able to help with minor ailments over the winter, which will potentially reduce the impact on GPs.

We should acknowledge those in different parts of community care who are working extremely hard to ensure that their patients remain well. District nurses are doing home visits, changing bandages and monitoring people’s conditions; school nurses are dealing with a vast range of issues across multiple schools; and health visitors are providing advice and guidance for new parents. They are all contributing to the system, as are the brilliant allied health professionals and support staff, without whom the NHS simply would not work.

We need to ensure that staff can take their breaks, that they have time for peer support, and that they can access wellbeing measures that help to relieve the physical and mental toll that they experience.

Pay is a very important issue. However, having spoken to nurses from the RCN outside the Parliament building before the recess, I know that their working conditions and their terms and conditions are really important issues, too. I will continue to work with RCN members on that.

This winter, we must reduce waiting times as far as possible without putting more undue pressure on a tired workforce, and we must ensure that all avenues for access to care are well advertised and communicated.

15:34  

First, I pay tribute to our outstanding health and social care workers across Scotland. The past few years have put an immense strain on our healthcare system and its workers. Despite those stresses, and in the face of unprecedented and unimaginable challenges, those who work in the sector have continued to provide exceptional service.

As we look ahead, no one in the chamber is under any illusions about the challenges and the difficulties that this winter will bring. We all know that extremely tough times lie ahead. This winter, it will take the combined efforts of national and local government, working alongside all our healthcare partners, to tackle the challenges that lie ahead.

Make no mistake, however: while Labour members stand here and criticise, healthcare staff and services are under strain not just in Scotland, despite what they would like us to believe. In every part of the United Kingdom, the NHS faces significant pressures. To my mind, the similarities end there. Why? What separates us from other parts of the UK?

We have a Scottish Government that cares, that has a strong and steady leadership and that has plans. We have a health secretary who recognises the challenges that lie ahead and is totally committed to improving performance and delivering positive change. Contrast that with our English counterparts, and I know who I would trust to safeguard the health and wellbeing of my family, friends and loved ones.

Labour has highlighted its concerns about our A and E departments. What we will not hear from it is the knowledge that our accident and emergency departments are performing better than those in England, Wales and Northern Ireland.

In Scotland, the staffing levels of the NHS have grown for 10 consecutive years. Although the staffing and funding are already at historically high levels, the Scottish Government will continue to look to maximise and enhance wherever possible as we approach the winter period.

Will the member give way?

No, thank you. Do you know why I will not take an intervention? When you went into coalition with the Tories in the [Inaudible.]—

Speak through the chair, Mr Torrance.

It is recognised by the Government that the current level of performance is not acceptable. No one here will deny that. That is why, earlier this month, the health secretary outlined in his winter resilience overview several actions for the coming winter months, backed by more than £600 million of funding. By April this year, more than 1,000 additional healthcare support staff and almost 200 registered nurses had been recruited to help to address our services’ challenges.

In the past year, staffing levels have increased by more than 2,800 permanent full-time-equivalent roles. The Scottish Government is investing in further recruitment and taking action through the £50 million urgent and unscheduled care collaborative.

I have listened with interest and some disbelief as my Labour colleagues have spoken of thousands of beds being blocked due to delayed discharge. I get the sense that, in their desire to criticise and condemn the Scottish Government, they lack some self-awareness. There can be no doubt that Brexit and the introduction of new United Kingdom immigration procedures have had a profoundly damaging effect on social care. However, the Labour Party continues to eagerly embrace the Tories’ extreme Brexit and all of its overwhelmingly negative impacts.

EU workers have made a hugely positive contribution in the care sector for many years, and they represent a vital component of our country’s social care workforce. However, Brexit and the Tory party’s yearning to take back control of the UK have created a shortfall in care services, which, in turn, has had severe knock-on effects on emergency and urgent care. The whole system becomes blocked when there are not enough care workers to provide support services for people who are leaving hospital. That leads to gridlock and backlogs through the entire system. If people cannot leave hospital due to a lack of social care, patients are stuck in A and E while they wait for hospital beds. People who have needed an ambulance have been left waiting because the ambulances have been waiting for transfers of patients.

Only this week, we all heard Keir Starmer’s determined and short-sighted answer when he was asked about rejoining the EU: “It’s a straight no”. That shows that Labour and the Tories are increasingly two sides of the same coin. Both are completely unwilling to stand up and do what is best for the people of Scotland.

Just imagine what our NHS could do with the £770 million a year that is spent on mitigating Tory policies.

You need to conclude, Mr Torrance.

In conclusion, our NHS has suffered the biggest shock of its 74-year existence, and it will not recover overnight, as the Government has acknowledged.

15:38  

I pay tribute to all our front-line staff in the NHS. Whether the treatment is routine or emergency, they never falter.

Last year, my personal contact with the NHS allowed me to see how hard its staff work. However, it is clear to me that our front-line staff do not have the resources that they need. That means that there are too many patients who struggle to be seen, to get diagnosed and, worse still, to get prompt treatment.

Overworked GPs often cannot see patients in person. Carrying out a diagnosis on a computer is a risky business. GPs need to see patients and, although Near Me and other online portals might work, being told that you have cancer on a telephone in your parliamentary office sucks, as does waiting 10 days for a full-hour appointment.

As the NHS comes under increased pressure and faces crisis management, there is a real danger that human care will be the first thing that is sacrificed. It is the personal approach—the bedside manner—which patients need and staff want to deliver, that suffers.

Not providing the resources to allow staff to deliver that care is in itself a dereliction of duty—your duty, cabinet secretary.

We all recognise the pressures of Covid, but the health service was under extreme pressure before Covid. Every winter, we face the inevitable and predictable rise in the number of patients. Every year, the Government guddles around trying to find solutions, and every year it says that it is listening and learning. The trouble is that, although it might have been listening, it certainly has not heard and it certainly has never learned.

Cabinet secretary, you will say that your winter plan will result in the recruitment of 1,000 extra staff and will provide £120 million extra to provide help at home. Where exactly are you going to get the staff from and—

Speak through the chair, please, Mr Mountain.

Sorry.

Where exactly will the cabinet secretary get those staff from, and how will the additional funds provide the care at home that is so desperately needed?

Another perennial problem that the Government has failed to address is that of delayed discharges. The Government promised to eradicate delayed discharges in 2015, but successive health secretaries, including the current one, have failed miserably to address them. The numbers remain at almost a record high. In NHS Highland, there has been a 32 per cent increase in delayed discharges in this year alone.

One word covers that: failure—this Government’s failure. Every treated patient in hospital who is waiting for a social care package is preventing another patient on the waiting list from getting treatment. Longer waits and delayed treatment result, without doubt, in outcomes that are less than optimal. The Government’s failure on delayed discharges is now very much the cabinet secretary’s failure.

Across Scotland, waiting times in A and E are going up, cancer waiting times are going up and nurse vacancies are going up. They are all going in the wrong direction—up. The real question is: when will the health secretary stop dragging our NHS down, which seems to be the only thing that he is capable of doing?

15:42  

Here we are again, with another politically opportunistic motion from the Labour Party that is politicising our health service in Scotland. Contrary to the motion, the health secretary and the team are focused on ensuring that Scotland’s NHS is as well equipped as possible to tackle the huge challenges that we face.

I know that there are challenges in taking care of people, the processes and pathways, the prevention of acute admissions and the work in primary care. The work that my former colleagues undertake every day is complex, and the systems are challenging. For 30 years before becoming a member of Parliament, I was in the NHS in Scotland and England and a nurse in the USA, so I think that I know a wee bit about what is going on in our national health service. Sometimes, when I read such motions, I wonder if the Opposition ken diddly qua qua about what is actually going on.

I know that, over the past two years, the NHS has suffered the biggest shock in its 74 years of existence. I thank all the people who work in the NHS for their work, care, compassion and commitment, and for what they do every day. The Scottish Government’s recovery plan, which is backed by more than £1 billion of investment, sets out plans for health and care over the next five years, so it is not just for this winter. The plan will support in-patient, day case and out-patient activity, as well as implementation of sustainable improvements and new models of care through investing in a network of national treatment centres. That will increase capacity for additional specialties, including diagnostics, general surgery, orthopaedics and ophthalmology.

The plan also supports the mental health and wellbeing of the health and care workforce, which we have heard so much about in the past couple of years. We should get right behind looking at ways to support people using digital opportunities such as NHS Near Me.

It is crucial that we help to equip the NHS for the winter pressures, but we need to think beyond the winter as well.

On specific A and E challenges, I hear what is being said. In common with other health services across the UK and globally, Scottish A and E departments are working under significant pressure, and the pandemic continues to affect services. Mind that word “Covid”? We need to remember the impact that the Covid pandemic has had, and is still having, on our national health service.

The Scottish Government is taking action to improve A and E waiting times, and the £50 million urgent and unscheduled care collaborative will help to implement a range of measures to drive down those waiting times. The work includes offering alternatives to hospital, such as the hospital at home service; directing people to urgent care settings; and scheduling urgent appointments to avoid long waits in A and E departments. I know about the long waits in A and E. I hear about them directly from former colleagues and from folk working 12-hour shifts. It is hugely challenging.

In August, Scotland’s core A and E departments performed 8.1 percentage points better than England’s and 10.3 percentage points better than Wales’s. During that period, A and E waiting times in Labour-controlled Wales were worse than they were in Scotland, so I wonder whether Jackie Baillie or any other Labour member, when closing the debate, can clarify whether they are also calling on the Welsh Labour health secretary to resign. Labour’s performance in Wales does not inspire confidence that Labour would do any better here in Scotland.

I am conscious of the time, but I note what Gillian Martin said about potential solutions, and I welcome the steps that the Scottish Government is taking to support our NHS. I want the health secretary to listen to clinicians directly so that he can hear their ideas and suggestions for improving systems. We need to get right behind our NHS workforce and support staff in any way that we can in the future.

15:46  

Scotland’s NHS faces its worst winter on record, and it faces that because of the SNP Government. It faces that because of the wrong choices that have been made by the health secretary—choices that have led to the worst cancer waiting times ever, the worst ambulance waiting times ever, a demoralised and unappreciated workforce, and nurses threatening to strike for the first time in history. The Government has chosen the path of poor terms and low pay. Critically ill patients in the most severe category are being forced to wait hours for an ambulance.

Will the member take an intervention?

No, I will not.

Tens of thousands of people waited more than four hours to be seen at A and E units last month, and hundreds of cancer patients have waited more than two months to begin urgent treatment. According to the Royal College of Emergency Medicine, delays in Scotland’s A and E departments last month meant that 40 people died who need not have died. Cumulatively, our NHS is not just facing a crisis this winter; it faces a catastrophe.

Week after week, the SNP and the Greens continue to waste millions of pounds of public money.

Will the member take an intervention on that point?

No.

Millions of pounds have been put at risk on the wrong choice for social care, millions of pounds are being wasted on a campaign for Scottish independence, millions have been wasted on fake foreign embassies and overseas junkets, and millions have been wasted by the SNP on botched ferries that were wrongly contracted against the advice of civil servants.

This situation did not come about by chance; it came about by choice—the SNP’s choice. It has made the wrong choices locally and the wrong choices nationally.

Will Mr Hoy add to his list by looking at some of the things that have happened recently south of the border because of the incompetence of the Tory party? For example, £65 billion has had to be spent propping up pension funds because of Trussonomics.

Why not focus on the £41 billion that the Government has here in Scotland to make our public services better? Perhaps—

What about the £65 billion?

Mr Stewart! You have had an intervention. Be quiet!

The minister is not in an Aberdeen nightclub now, so he should behave.

The wrong choices are being made time and again—wrong choices such as the closure of beds in the minor injuries clinic at Edington cottage hospital in North Berwick. The SNP makes the wrong choices for residents time and again.

The calamity of all calamities is coming in the form of the national care service. The SNP is choosing a national care service over local care, all because it chooses centralisation at every turn. Do not take my word for it. Let us look at what COSLA and Unison say:

“For the sake of those individuals and families who need our support waiting four or five years for the establishment of the NCS is not an option. We cannot and should not break up the Local Government workforce, particularly at this critical time in our recovery from the pandemic.”

Independent researchers from the Scottish Parliament estimate that the SNP’s proposals to create a national care service will cost up to £1.3 billion over the next five years. Even the nodding dogs on the SNP’s back benches conceded that point yesterday in the Finance and Public Administration Committee—

Members: Oh!

The minister knows only too well that he is on the wrong path. Scotland needs a well-funded, high-quality health service—[Interruption.]

Sit down, Mr Hoy.

On a point of order, Presiding Officer. Is it not incumbent on MSPs to treat other MSPs with respect?

I am not sure that that is a point of order, Ms Martin, but it is absolutely the case that members should treat one another with respect. That goes for everyone.

Continue and conclude, Mr Hoy.

Thank you, Presiding Officer.

Scotland needs a well-funded, high-quality health service in which care is delivered closer to patients, staff feel rewarded and valued, and patients are treated quickly and safely. In short, we need an NHS in which big choices are driven by patient care and not by the independence obsession of this incompetent SNP Government and its incompetent health secretary.

15:50  

I will not respond to the personal attacks, because it is a shame that a debate of such importance and seriousness has seen such pathetic and grubby personal attacks—not just on me, but on members across the chamber. It is a shame, because it does no service whatsoever to our hard-working NHS staff, who are working under incredible pressure.

I will tackle some of the issues that have been raised, which are important to all across the chamber. On cancer, statistics continue to show that, notwithstanding the huge impacts of the pandemic, we continue to meet the 31-day target. We are not meeting the 62-day target, which remains challenging. That is why our focus has been on the detecting cancer early programme, and it is why we have invested—as I announced—£10 million to improve cancer waiting times, on top of the £114.5 million in the national cancer plan. It is also why I announced three rapid cancer diagnostic services and why two more have just been approved. We will continue to focus relentlessly on ensuring that cancer is detected early, because we know that, if it is, that will lead to better outcomes and survivability for people.

On winter funding, I was astonished by what Jackie Baillie had to say. She complained that there was no new money and that I had announced all the money last year. However, it was Jackie Baillie who demanded, last year, that the money be recurring. Winter pressure money for this winter was recurring, and now she complains about that same money being recurring. She cannot have it both ways.

Everybody—including the cabinet secretary himself—has said that this will be the worst winter ever. Surely, this is the point at which to put in additional resource to cope with that, so that patients do not suffer.

That is why we are spending a record £18 billion on the health service in this financial year. I say to Jackie Baillie that you do not just wake up one day and say, “Oh, it’s going to be a bad winter.” You plan for it the year before, which is why we ensured that we had recurring money.

A thousand additional staff will be recruited over the course of this winter. Edward Mountain is on his phone, but he might want to listen, because he asked where those staff will come from. Of those 1,000 staff, 750 will be recruited from overseas—because boards tell us that they have the capacity to bring people from overseas—and 250 will be recruited domestically.

I will touch on Alex Rowley’s contribution, which I thought was fair and showed a willingness from some members of the Labour Party to come forward with ideas and solutions for the social care sector and the national care service. I say to Alex Rowley that there is no silver bullet. I promise him that, if there were, we would have deployed it by now.

Our relentless focus is on workforce, because that is the challenge, and I cannot disassociate that workforce challenge from the folly of Brexit. Kevin Stewart reminded me of the fact that one care home provider told him that 40 per cent of his staff had had to leave—he lost them—largely due to Brexit.

Our focus will be on the social care sector, and pay will be a part of that.

Will the cabinet secretary give way?

I cannot give way—I have to finish in less than a minute.

We have a relentless focus on pay, terms and conditions, whether in the NHS or in social care.

I will conclude my remarks shortly, Presiding Officer, but I cannot let the Conservatives get away with talking about social care and our public finances. How dare they come to the chamber and utter one syllable about the challenges that our public finances face? Through their incompetence, their economic mismanagement and their economic vandalism, my health budget is worth £650 million less than it was when it was set in December last year, So, why do they not grow a backbone and, instead of waiting for the next number 10 incumbent to tickle their tummy, try standing up for Scotland and for our public services?

I end by thanking our NHS staff for the incredible work that they do.

I call Paul O’Kane to wind up the debate.

15:55  

Our NHS is facing a humanitarian crisis this winter, and—let us be frank—the responsibility lies at the door of this Government and this cabinet secretary.

Today, we have again heard about the scale of the crisis in our NHS. We have heard from Jackie Baillie about the personal cost behind each and every one of the numbers, each of which represents a person with a family and their own story who is cared for by our amazing NHS staff, who are at breaking point.

The debate has been characterised by the cabinet secretary’s thin skin. He complained about being personally attacked, but the reality is that all that Jackie Baillie and Labour members did was point out his failures in comparison with his predecessors in the job of health secretary, including Jeane Freeman, who led the country through the beginning of the pandemic. Alex Cole-Hamilton took a similar approach when he pointed out what Paul Gray has said about the head of steam that has built up, the perfect storm that has been created and the fact that it is not all about Covid.

Will the member give way?

I would like to make some progress.

SNP back benchers accused us of making political attacks, but what we have heard from them is desperate stuff. They accuse us of making political attacks, but all that we have had from them is howls of “red Tory” as Carol Mochan made her speech, nonsense comparisons with Wales and England, and attacks on Keir Starmer, so scared are they of a UK Labour Government. We will not take lectures from a party that has spent this debate indulging in whataboutery and refusing to acknowledge its responsibility for every single person who has to lie on a trolley in A and E this winter.

The cabinet secretary said that he prepares for winter in advance, so can he tell us why Dr John Thomson, the vice-chair of the Royal College of Emergency Medicine, has stated that the measures that are outlined in the cabinet secretary’s winter resilience plan will

“not be in place in time to prevent further harm to patients and staff this winter”?

Yes, the experts are clear.

Gillian Martin called for solutions that are backed by the experts. That is absolutely right. I went outside and met members of the RCN when they protested in front of the Parliament. They told me that they need more training places to be filled and a fair pay settlement across all bands. They also told me that they need proper breaks and proper rest when they are on shift, because they are not getting those at the moment and the workforce is on its knees.

Perhaps we should subscribe to Emma Harper’s attitude and not listen to the hard-working staff and their trade unions. I am quite sure that they will make diddly quack of whatever her contribution was supposed to be about.

Let us be honest. The issue across our NHS is being exacerbated by the Scottish Government’s refusal to engage on pay, whether of nurses or of social care workers, and its refusal to back Scottish Labour’s pledge to pay social care workers £15 an hour—a wage that they could live on, not just survive on.

The Scottish Government has also failed on social care more widely. It has failed to implement key recommendations of the Feeley report, and there are serious concerns about its approach to the national care service, which have been outlined by trade unions, the third sector and professional bodies. As Alex Rowley and others said, it is clear that the Scottish Government is not listening to what is being said about the serious challenges in social care. All of that begs the question, if the Government is not going to listen to the advice of independent experts in the field, who is it going to listen to?

It is fair to say that Humza Yousaf is a record breaker. Week after week, we learn about record-breaking accident and emergency waiting times. Every time that Scottish Labour is forced to bring debates such as today’s to the chamber, we find that another record has been broken by the cabinet secretary. It is quite clear that, in place of meaningful action to address the crises in A and E, in social care and across our NHS, all that the cabinet secretary has to offer is hollow words. It is increasingly obvious that Humza Yousaf is the man with no plan.

I am sure that most of the members in the chamber could have pre-empted the cabinet secretary’s response before he got to his feet. If you do not like one of his excuses, he has others. First, it was Covid. Then it was Brexit, the cost of living, winter weather and staffing. It is the same old script, which does a disservice to healthcare staff, patients and the families of patients, who have real concerns about the current crisis in our NHS.

It is not good enough. We need a health secretary who can offer leadership, not one who hides behind tired old scripted excuses. The First Minister is fond of saying that the buck stops with the Government, although she rarely does anything other than look at the buck and watch it float by. So, in the cabinet secretary’s own words to hard-working nurses, let us not patronise one another. The buck stops with him, and, if he is not willing to get on and fix the situation in the NHS, he should resign.

That concludes the debate on supporting the NHS in winter. It is now time to move on to the next item of business. There will be a brief pause while the front-bench teams change.