Chamber and committees

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.

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.

On a point of order, Presiding Officer. My app would not connect. I would have voted no.

I wonder whether Sir Harry wants to come in, particularly in relation to testing change. Obviously, he has experience of testing change and seeing what works.

Pardon that expression.

I want to ask about social work. I imagine that it is challenging to make a comparison, because the scope of the bill goes beyond the practical delivery of social care. Northern Ireland is perhaps a good example to look at, because social work there is delivered slightly differently via more of a health board model. Have you found any international examples of elements of social work, as a profession, being put into a national social care structure?

Do those arrangements involve criminal justice, children and young people’s services or learning disability services, for example, as well as just older people’s services?

We have begun to touch on the issue of what the bill will actually achieve. I would like to reflect on some of the commentary that there has been since the bill’s publication. The Centre for Care said that there must be greater clarity on how the reforms will achieve the intended goals. It asked how we will test the bill against the theory of change and how we will establish whether it has done what we want it to do. There has been commentary on whether the bill will fully deliver the recommendations of the Feeley review, and there has been commentary from trade unions on whether it will do anything to tackle the issues around pay and terms and conditions. Unison has gone as far as to say that the bill should be paused.

In that context, I am keen to get a sense of how the bill can achieve the aims that have been set out. Perhaps we could start with Nick Kempe.

That leads me neatly on to my next question. The sense that I am getting from those contributions is that this has to be about cultures, not structures, and that we have to avoid that top-down approach. Indeed, Reform Scotland said in response to the call for views that there has not been an

“adequate explanation about why simply removing local government”,

for example, from social care would lead to implementation or to innovation in delivery. Do the panellists agree that we need to look at that in a more rounded fashion?

Forgive me—we have not done this before as a committee. As there is obviously an issue relating to local government and the structure of local government, is that an issue for the Local Government, Housing and Planning Committee? With the best will in the world, we are not going to be able to make a recommendation on the restructuring of local government in Scotland.

That is just a thought, and I am not sure how the ping-pong between committees works.