Chamber and committees

The member has made a powerful series of points. Does he agree that, with the change in early recruitment in the shipbuilding industry necessitated by recent difficulties that it has faced—I am thinking of the trade assistant role that it has introduced, which removes academic entry qualifications—a great pathway is being offered to those who do not have traditional skills to enter the industry and build their skills in a practical way, and that that has been compounded by the creation of the applied shipbuilding skills academy in Glasgow?

The recent change in permitted development rights has led to significant degradation in the country’s built environment, particularly in conservation areas, due to the loose nature of the regulation. It means that, for example, PVC windows can be installed, which have poor life-cycle performance compared with timber.

Will the minister therefore consider putting in place more codified guidance for conservation areas to ensure that people make the right decisions with best-informed practical information that is based on best practice across the country? That could bring down the unit costs of installations such as timber sash-and-case windows, as more people would be encouraged to buy them.

I rise to second and commend to Parliament the motion in the name of my friend the member for Dumbarton. It is a very important motion, because the national health service in Scotland accounts for a third of all public expenditure for which the Scottish Government is responsible, and for up to half of day-to-day public expenditure.

The current Government’s administration of our national health service has lasted nearly 18 years, which is approaching a quarter of the NHS’s entire existence, so the Government has had almost the largest span of control of our national healthcare system since it was set up 76 years ago. In that time, the spend in Scotland per head relative to the rest of the UK was 17 per cent more at the start of the Government’s tenure, and it is now just 3 per cent more, so a significant decline in public expenditure overall is clearly a priority for this Government. We have seen the consequences of that long decline in its relative importance to the Government as the overall pattern of expenditure has evolved.

That point has come from clinicians and from our constituents in correspondence. That is why we are here: to convey their arguments to the Government and represent their interests. As many members have said, ministers and back benchers alike are all here to back our NHS workforce and our constituents who are seeking to access healthcare that is free at the point of need, as the purpose of the NHS when it was founded was to remove

“money worries in times of illness.”

Unfortunately, as we have heard all too often today from members across the chamber, when people are in need, the NHS simply is not there for them. They are waiting so long that they are developing money worries, because they are facing the torment of pain or, in many cases, are having to pour out their life savings to fund their medical treatment. That point was put ably by my Glasgow colleague Pauline McNeill with regard to her constituents. They have been waiting for so long, often for elective treatments, that they have been forced to pay to go private—some remortgaging their homes or dipping into their pension savings in order to do so, when they should be gearing up for a settled retirement.

Our business as parliamentarians is to ensure that the system is always getting better. We are conveying ideas on behalf of our constituents in order to achieve that. Certainly, there have been many good observations. For example, my colleague Rhoda Grant, who represents the Highlands, highlighted the urban bias that is often seen in healthcare planning, which was reiterated by several members, most notably Mr Ross, who also represents a more rural part of Scotland. He highlighted some of the appalling waiting times that constituents there are having to face.

Look at the analysis by the Institute for Fiscal Studies on six key metrics of the healthcare system in Scotland. The waiting list for elective care is longer than it was last year, and worse than it was prior to the pandemic, and on elective care, the percentage of treatment carried out within 18 weeks from referral is worse than it was last year, while, in the rest of the UK, against those metrics, performance is getting better. On emergency care and four-hour waiting times at A and E, performance is worse than last year. For cancer care—

I might, in a moment.

I refer to the metric on people waiting more than 62 days between referral and treatment for cancer care. As we have heard from oncologists, waiting that length of time between diagnosis and treatment for cancer is the equivalent of a death sentence, in many cases. The Government cannot be satisfied with that. It is appalling that it can be so complacent when constituents are dying because of that lack of performance. Clinicians, colleagues and the NHS are at their wits’ end due to their frustrations and the fact that they have been unable to get the system to perform better.

I will now take Christine Grahame’s intervention.

I am not unsympathetic to the member’s point about getting rid of prescription charges, but prior to the SNP getting rid of 100 per cent of prescription charges, 90-odd-plus per cent of prescriptions were already free in Scotland. Moving from 95 per cent free to 100 per cent free is a very marginal change, but it got a good headline. There was a degree of sophistry on the part of the member when she suggested that everyone was paying for prescriptions before the SNP came into power.

I highlight that as an example of the lack of sincerity that we are dealing with when we are talking about the evidence-based approach that we need for our healthcare system. That is why so many members have come here with appalling stories showing what we need to do to improve the system and how we can deliver that improvement.

It is absolutely outrageous that we have 863,000 waiting list places in Scotland. We should be moving that forward at a far quicker pace. Until the minister can deliver that, we will have clinicians telling us that operating theatres are lying empty and not being fully utilised because anaesthetists and surgeons are not in the right place to perform operations.

We need to get those things correct. We need to listen to what the workforce is telling us. We need to plan the workforce properly. We need to reduce the appalling outflow of expenditure on temporary agency contracts and locums. It is an effective privatisation of the healthcare system when we force citizens to wait so long that they are tormented enough to have to pour out their life savings to access private healthcare. That is, by anyone’s measure, privatisation by the back door.

As long as that persists in Scotland, we cannot rest. We must come together as a Parliament and ensure that we work together collaboratively to find ways to improve the situation for the people of this country.

My colleague Ms Duncan-Glancy makes a key point. We have heard it all across Scotland. Surely every member here has received correspondence from constituents about such problems, whereby people cannot get access to the healthcare system through the front door. When they get into the system, they are not getting a speedy referral to where they need to be within it. They are not being treated quickly enough and, when they are treated—often in a state of infirmity—they cannot get out of the system to an appropriate destination fast enough.

Those inefficiencies are at the heart of what is going wrong. The flow through the system is not optimised, and none of us should be satisfied with that situation. Indeed, some of the propagandistic speeches that we heard from the Government back benches do an ill service to the constituents whom those members represent. Constituents who were listening to some of those bombastic claims will be bewildered by the arrogance. Even if the healthcare system in Scotland were the best in the world, we should not be satisfied with that, because in any human system there is always scope for improvement. That is what our constituents want to see.

Does the member agree that it is deeply frustrating that, in this country, it seems that we cannot deliver infrastructure in a value-for-money manner? We seem to have the highest costs per mile to deliver railway or road projects. There needs to be a deep, fundamental review of how we are doing that compared with other countries.

Yes, I am happy to give way.

Ah, sorry—I am running out of time. I am afraid that I have to conclude.