Chamber and committees

That is helpful in terms of understanding the process towards integration. If we could park the pandemic—I am sorry for that unfortunate phrase, and I know it is not easy to do—I would like to get a sense of whether people feel that integration was well established. Is it absolutely there, or does it still feel very much like a work in progress? Stephen Brown or Allen Stevenson might want to give their observations on that.

I will start by asking for another reflection on integration. To what extent have the legislation and guidance allowed for effective collaboration with the third and private sectors?

Sure. Putting the pandemic to one side, do you get the sense that integration is well embedded, or is it still very much a work in progress in terms of the wider picture?

That was very helpful.

We have already touched on some of the points that I want to raise in talking about the governance and scrutiny in IJBs and having different partners round the table, particularly third sector and trade union colleagues and others. Sometimes, people are present and are asked to leave when a vote happens, or they are at the table and do not have a vote. To what extent does that fray or fracture relationships and affect people’s ability to make a meaningful contribution?

Last week, it was reported that several patients have suffered cardiac arrests in the past month while waiting to be seen in the A and E department at the Queen Elizabeth university hospital. Tragically, two of those cardiac arrests were fatal and followed significant delays in triage.

That followed reports last week that winter surge beds are already almost at capacity, with John-Paul Loughrey, the vice-chair of RCEM Scotland, stating that the NHS urgently needs extra resources to cope.

It is only October and our NHS is on life support. What is the cabinet secretary going to do? When will he bring forward a detailed plan that provides A and E departments with sufficient staffing, capacity and resources to deal with already overstretching demand in relation to not only delayed discharge but triage?

This week, it was revealed that hundreds of additional surge beds that were made available to health boards across Scotland last winter continue to be occupied, and the vice-president of the Royal College of Emergency Medicine, Dr John-Paul Loughrey, said:

“Every hospital in Scotland just now is under the cosh.”

The bed shortage is a direct consequence of the Scottish Government’s actions. Our hospitals have 4,000 fewer beds than they had in 2010—and we know who served as health secretary in that period. The situation is unacceptable. We cannot normalise our national health service being in a perpetual state of crisis. Therefore, what is the First Minister going to do to address that crisis as well as the crisis in capacity and staffing across the NHS? Will she take action? That is something that the current health secretary seems unwilling or unable to do.

In rising to close the debate for Scottish Labour, I want to genuinely recognise the outstanding work that is done by everyone working in our NHS: staff who go out every single day on to the front line to look after all of us—staff who we clapped for every week during the pandemic, who now feel dejected, burned out and undervalued by this SNP Government.

The NHS is this country’s greatest institution—realised by a Labour Government, which rebuilt this country from the ashes of war. Let me say to Gillian Martin and others that I share their anger over the Tories’ economic policies, which is why we need a Labour Government across the UK, with the plan outlined by Keir Starmer this week in Liverpool to reverse the economic disaster that has been created by the Tories.

When Carol Mochan answered the cabinet secretary, he said that it was embarrassing. I will tell him what is embarrassing. In my lifetime, I have never seen the NHS in Scotland so unwell. I have never seen the people who work in it so demoralised. I have never seen people languishing on waiting lists and in A and E departments in the current state that they are in. The cabinet secretary should be embarrassed by that.

Many of the people who work in our NHS are our friends, family and neighbours. They are people who love the bones of our NHS but are totally broken. That is what 15 years of SNP mismanagement and a record of failure has done, as outlined by my colleague Jackie Baillie in her opening remarks.

This is at the door of the cabinet secretary.

I would like to make some progress.

The cabinet secretary has been in post for almost 500 days. People say that he is missing in action, but he is not even missing in action—he is just missing. It is time for him to own his record. He must listen and engage with what staff are telling him. In his speech, the cabinet secretary said that we should be grateful that two-year waits have been eradicated. Is that the sum total of his ambition for the NHS? Is that what he stands behind?

This week, it was revealed that hundreds of surge beds that were made available last winter to cope with additional patient numbers are still occupied.

Let us reflect on the views of doctors working in our NHS, as highlighted by Alex Cole-Hamilton and others. John-Paul Loughrey, the vice-president of the Royal College of Emergency Medicine Scotland, said that the latest delays could lead to 40 deaths in the following 30 days. He said:

“Every hospital in Scotland just now is under the cosh.”

As we have heard, just last week, 1,200 people spent more than 12 hours waiting in emergency departments in hospitals across Scotland. It is worth hearing that again, because we need to let it sink in. That is the reality in our hospitals right now.

We know that part of the solution to getting people out of hospital requires well-supported and valued social care.

Emma Harper rose—

I will give way to Emma Harper.