Chamber and committees

Prior to the summer recess, we had quite a consensual debate on many of these issues, certainly on medication-assisted treatment standards and the need for strong and timely implementation of them—April 2022 has been set as the target. I am keen to hear a progress update from the minister. Also, how will that progress be reported? I think that the minister made a commitment to report to the Parliament six-monthly on MAT standards. Could you address those points, please?

Alcohol and drug partnerships play a very localised role with regard to their relationship with their integration joint boards and delivery. I note that, in the consultation on the national care service, there has been discussion about whether ADPs should form part of a more national service delivery approach or whether they should remain more local. I am therefore keen to hear your views on that issue and the question of where they can be used most effectively.

Certainly, Presiding Officer.

The Government is letting down health and social care staff. If it is serious about the challenges that Scotland faces, it must show that it values every single member of staff in the NHS and create a plan to match.

In their manifesto, the Scottish Greens committed to £15 an hour for care workers. Are they still committed to that position, given that they are now in government, and will they support Labour’s amendment today?

A common thread has run through our debate. As colleagues have already done, I thank all our hard-working NHS and social care staff for all that they have done and will continue doing. They have worked hard on the front line, caring for us all and for the sickest people in Scotland and keeping services going in unimaginable circumstances. We owe them our deep gratitude.

As we have heard, warm words of thanks are not enough. Words will not solve the crisis in A and E, whereby people are waiting an average of six hours for an ambulance. Praise from ministers will not address the more than 600,000 people waiting for treatment or diagnosis. Applause does not make a £15 per hour wage for key workers a reality.

A Government motion and a thin recovery plan that fails to recognise the scale of the crisis are cold comfort to those who know what is happening on the ground: the doctors, nurses, healthcare assistants and support staff who, as we have heard today, use words such as “exhausted”, “undervalued” and “burnt out” to describe their day-to-day experience.

I know that ministers and SNP members are quick to retort that these are unprecedented times. Of course they are. The cabinet secretary continually cites the pandemic as he seeks to justify the serious and imminent challenges that have been referred to today. However, he refuses to acknowledge not only what we in Parliament are saying but what professionals, patients and carers are telling him: that the crisis has been growing since before the pandemic and has been exacerbated by it.

My colleague Jackie Baillie spoke about the stress that is experienced by people on waiting lists. There were 400,000 people languishing on waiting lists before Covid-19. As Craig Hoy said, BMA Scotland has been warning about workforce pressures in the healthcare sector since before the pandemic. Ambulance turnarounds were taking longer before the pandemic, with 17,926 turnarounds taking more than an hour, which is a shocking increase of 634.4 per cent since 2014. How can the Government be taken seriously when it talks about the planned recovery but refuses to admit that the crisis has been unfolding on its watch for 14 years?

The cabinet secretary has recently been fond of saying in his answers to members’ questions on these issues that he does not have a magic wand, but he clings to his plan as if that might be a magic wand. That plan has been described as “only a best start” by Dr Lewis Morrison, the chair of BMA Scotland, and further described as “unrealistic” and having a number of “worrying gaps”. The RCN has said that there is little detail in the plan on how issues such as staff burnout can be addressed and has warned that nurses have felt undervalued and underresourced for far too long. Sue Webber and others have said that it is time for the Government to show how it will support and retain exhausted staff in the system.

I turn to social care. Scottish Labour first advocated a national care service in 2011. As my colleague Jackie Baillie likes to remind the Government, we welcome all converts, however late. We have always been clear, as we heard from Willie Rennie and others today, that any such service must be about culture and not solely focused on structure. A national care service must be about those who live in our communities and who need access to the right care in the right place at the right time. Clare Adamson was right to speak about rebuilding our communities better.

The service must ensure that older people are supported holistically as they live for longer in our communities and must ensure that care homes adhere to rigorous standards and are held to account for those in order to drive up quality and improve the training and retention of staff. It must ensure that people who have learning disabilities can live their lives with choice and control and do not simply face false choices from ever diminishing budgets.

People want to have a seat at the table where decisions are made. Carers want to have a voice at the table and those who use social care want a meaningful say in the decisions that impact them. If the Government insists on driving an agenda that is about drawing power towards the centre and does not recognise the importance of local decision making, in which people who use services have a say, this will simply be upheaval and structural change with little real change on the ground.

The people of Scotland cannot wait five years for the Scottish Government to work out its big vision for a national care service. Action can be taken now, and action is needed now. There are practical steps, which Jackie Baillie alluded to, that will make an immediate difference to the lives of people who are in receipt of social care and those who support them. Those steps include restarting respite services and creating a plan around that; ending non-residential care charges; pausing commissioning; and addressing the poverty pay in the sector, which we have heard about, by supporting a pay rise to at least £15 an hour for social care staff. I welcome Gillian Mackay’s support for that and the fact that she has held true to the Green manifesto. I hope that she will influence her colleagues in ministerial office.

Our social care workers deserve more than warm words. As my colleague Carol Mochan pointed out, they must be valued. In its motion, the Government speaks of fair work, but it has failed to deliver. One in five workers are on insecure or temporary contracts and 15 per cent of staff work unpaid overtime. Once again, we on the Labour benches call on the Government to give care workers the pay rise that they deserve and show that they are valued.

It is clear that, after 14 years in power, the SNP Government has mismanaged the NHS, and we are facing a serious crisis before we even get to the crisis that winter will bring.

With dental practices across Scotland currently operating at restricted capacity in line with Covid restrictions, there have been worrying reports that although NHS patients are having to wait months to see a dentist, those who can afford to go private are being seen within days. Is the minister not concerned about risking the development of a two-tier dental system in Scotland? What steps will be taken to ensure that NHS patients who cannot afford private dental care still receive the timely treatment that they need and to which they are entitled?

The First Minister says that the work of test and protect is vital and hugely appreciated, but, two months since I first raised with her concerns about test and protect staff feeling stressed and overwhelmed, whistleblowers now describe staff as being burnt out. Test and protect is stretched to breaking point, with reports of contract tracers being told to make only two calls before closing a case, in order to get through the volume of calls. Staff have also reported not feeling listened to when scripts change.

In previous answers, the First Minister also referred to the overall number of cases being closed. However, the figures for the week ending 29 August show that only 60.5 per cent of contact tracing was completed within 72 hours. That is 13,330 contacts taking more than 72 hours to be traced from the time cases were recorded on the system. Will the First Minister clarify the position on that point and say what she is doing to fix test and protect and to support our hard-working staff?

I draw members’ attention to my entry in the members’ register of interests, as I am a councillor on East Renfrewshire Council.

As we meet this morning, we know that Covid cases have been increasing throughout the summer, and that there have been a number of very seriously concerning situations across our hospitals, with code black status being, or almost being, reached.

I would like to hear the cabinet secretary’s view on the capacity that we have to deal with the current surge, and any future surge, in cases. We know that there are concerns, for example, around staffing levels and staff fatigue. I know that we will come to those issues later in the meeting, but first I want to get a sense of where we are in the pandemic now, in terms of capacity and our preparedness for the future.

I thank the cabinet secretary for that answer. On what he said about recovery of services, a number of health board areas and hospitals have made the decision to cancel operations and surgeries, and there is concern about how long it will take to recover the previous position. Professor Caroline Hiscox, in NHS Grampian, has said that it will take “years” to recover the position in which people are able to get diagnosed and treated and get the operations that they require.

As I indicated in my earlier comments, I want to move on to talk about workforce pressures. Given what we know about those pressures and the number of people who, whether they are doctors or nurses, are considering leaving the medical profession, what is the cabinet secretary’s view on what could, essentially, become a perfect storm? Staffing levels are reducing, and a long period of time is required to recover to a position in which we are able to treat people in as normal a way as we would expect and that everyone in Scotland would want.

The pandemic has undoubtedly exacerbated health inequalities. We have all seen quantitative and qualitative data that shows that. I also think that public health has never been so in focus for people in Scotland and so sharply understood in our homes on a daily basis.

Cabinet secretary, with regard to the learning from the pandemic, what key interventions do you envisage as we look ahead and move beyond Covid into recovery? For example, do you support the suggestion in the paper on non-communicable diseases that was published yesterday by the British Heart Foundation and nine other charities that there should be quick interventions on issues such as the advertising of e-cigarettes, the monitoring of sugar content in foods and better planning of smoking cessation and obesity services?