Chamber and committees

If the member had listened to what I said, he would have heard me quote a front-line clinician, who pointed out that Covid, Strep A and flu—all the issues that we have heard about—are exacerbating an issue that has been 15 years in the making. This crisis has been building year on year and this Government has not sought to address it appropriately, because its recovery plan does not even come close to addressing the scale of the problem that is facing our health service.

This is a twin crisis—it is a twin failure of Government in both healthcare and social care. That is why we need a joined-up approach to deal with the problem, because we will not be able to deal with the issues that are facing our health service if we do not address social care.

This morning, along with Jackie Baillie and Anas Sarwar, I met a range of stakeholders, including people on the front line of delivering social care. Their testimony on the scale of the challenge being faced in social care was powerful and they were clear in stating that the Scottish Government is not doing enough to address the key problems in social care.

As we meet to debate this issue in this place, outside our NHS continues to face a huge crisis. Yet again, it is Scottish Labour, during Opposition business time, that has had to bring the issues that Jackie Baillie outlined in her opening speech to the chamber to ensure that the Government can be held to account.

Our thoughts are with all our dedicated and hard-working staff who are on the front line of our NHS. Never before have our accident and emergency departments had so many patients waiting more than 12 hours to be assessed. Never before have we experienced such a level of delayed discharge, with record numbers of patients stuck in hospital because they cannot secure an appropriate care package.

Tragically, as we have seen many times before, there is also declining performance in cancer treatment. The Scottish Government has failed to meet its own 62-day cancer treatment standard since 2012. All the statistics that we see week in, week out are not just box-ticking exercises; they are more fundamental than that. This is about people’s lives and about improving outcomes by ensuring that people have a higher likelihood of being treated before their condition worsens. In many cases, treatment can be the difference between surviving and recovering, and dying.

Indeed, waits of more than eight hours in accident and emergency departments have already led to avoidable deaths in our hospitals.

“Patients who need to be in intensive care or high dependency units are sitting in A and E departments for hours waiting, it is just not safe ... Patient safety is at risk every day in our A and Es across Scotland. You just can’t give the care you want to give to patients.”

Those are not my words; they are the words of Dr Lailah Peel, the deputy chair of the BMA in Scotland, another of those front-line voices that we have heard throughout the debate and which, sadly, have been characterised as exaggerated by members on the SNP benches.

However, that is the reality. It is the reality that I have heard; it is the reality that we have heard from colleagues across the chamber. In response, the cabinet secretary has sought—as he always does—to absolve himself of responsibility by lining up excuse after excuse. I have to say to the cabinet secretary that I found his weaponising of Covid in his remarks most unedifying, because the reality is that clinicians and those on the front line are saying that the cause of the current crisis is not about Covid; it is not about Strep A, the flu or winter pressures. It is about years of mismanagement and decline.

I am very grateful, Presiding Officer.

Perhaps the cabinet secretary does not want to listen to what I heard from social care workers today, which is that they have grave concerns about the situation in social care, that the National Care Service (Scotland) Bill is ill thought out and should be stopped, and that we should come back around the table to get it right.

I heard Gillian Martin quote Unison saying that it is in support of the bill—that is certainly not the conversation that I had with the union this morning.

Thank you. I am very grateful to the cabinet secretary for his opening statement, which has helped to set the scene for our questions. I will begin with broad questions before we move to questions from colleagues.

The petitioners have outlined the various challenges with regard to geography, access to services and availability of staff, and you have touched on much of that, cabinet secretary. Given the wider structural challenges in relation to the way that the NHS is set up and operates in many of the relevant communities, has any thinking been done about structures and how the NHS operates at board level in those communities? Do we need to look at how boards operate? Do we need to consider devolving more power to local communities? Have there been conversations about that? A great deal of what the petitioners have asked for is about decision making being more localised. Do you want to comment on that?

I will move to a question on something that you have referenced—the work that is being done on a national centre for remote and rural healthcare. As a committee, we are keen to understand how success will be measured in that innovation. It would be useful to have an update on the progress on developing that centre. Sir Lewis Ritchie might want to comment, but I will come to the cabinet secretary first.

There are some supplementary questions.

Thank you. That is very helpful.

We move to questions from Carol Mochan on the wider involvement of service users.

I am conscious that five colleagues want to ask questions on broader workforce issues relating to recruitment, retention, accommodation and training. It would be helpful to get through those questions, so I ask for more succinct questions and answers.

I will bring in Tess White first.

I am thinking about the relevance of the question to rurality and the petitions. Do you mean in a rural context, Evelyn?

Thank you. I invite questions for the cabinet secretary.