I thank the cabinet secretary for her answer and note her previous answer to Donald Cameron. The Scottish Crofting Federation has expressed bitter disappointment that the crofting reform bill has not been included in the programme for government. Donald MacKinnon, the chair of the federation, described it as “galling” that neither the bill nor any actions specific to crofting were included in the programme. The working group on the bill, which is the voice of crofters and communities, was disbanded when the Government abandoned the process. Will the minister clarify the Government’s position on the progress of the bill and will she reconvene the group as soon as possible in order to explain her decisions to stakeholders and to re-engage on these important issues?

Will the member take an intervention?

The member acknowledges, I think, the scale of the crisis and the issues that existed before the pandemic. He made a point about ice, but would he accept that cutting local government funding and budgets contributes to our wider problems in the health service, and that it has a knock-on effect? We have to fund local government properly if it is to deliver services.

Certainly. As Gillian Mackay said, we need to ensure that we have better support for staff who are working on the front line. The reality is that we must put staff and patients first. They deserve better. I support the motion in Jackie Baillie’s name.

There can be no doubt that the Ambulance Service in Scotland—and, more widely, our NHS—is in crisis. Each member in the chamber today will have had correspondence from constituents about having to wait hours for help to come, and a number of members have spoken very powerfully of those cases today. We have seen ambulances queueing at our hospitals and we know that waiting times at A and E are at their worst levels since records began. Tragically, people have died. We heard today from Jackie Baillie about Susan Donald and her father from Aberdeenshire, and we have all heard about Gerard Brown from Glasgow, who passed away after waiting 40 hours for an ambulance.

Families are broken-hearted and they are asking why, because it did not have to happen. We have heard the calls from paramedics, doctors, nurses and other healthcare staff for immediate help to support a workforce that is “exhausted, undervalued and overwhelmed”. Those are the words of a whistleblowing paramedic, who does not want to be identified, because she fears for her job. She goes on to say:

“In all the years I have been a paramedic I have never seen the job as bad as I do now.”

Nobody denies that we are living through unprecedented times, but we know that things had been worsening for years before the pandemic. Services were struggling to keep up with demand and there was a growing backlog of care. The pandemic has exacerbated a bad situation.

Although we have heard it before, it is important to hear it again. Another paramedic whistleblower, who is based in Glasgow, said:

“I am fed up reading and hearing in the news that the pandemic is causing the problems with delays. It’s true that it’s a contributing factor but this has been a disaster in the making for years.”

That is not me, Jackie Baillie or any other politician saying that; it is a paramedic who is working on the front line, and the cabinet secretary and the Government cannot ignore those words. As much as James Dornan might want to make it about the hard-working staff versus Opposition politicians, those words cannot be ignored. [Interruption.] The cabinet secretary must listen to my point and explain to hard-working staff and bereaved families why he was missing in action—as my colleagues Jackie Baillie and Carol Mochan pointed out—until he went to the Daily Record to give that interview.

The reality is that the crisis did not start 18 months ago with a global pandemic. It has been consistently building, and the warning signs have been there year after year. In 2019, compared with 2014, there was a shocking increase of 634.4 per cent in long turnarounds, which impact on the availability of ambulances to respond to emergency calls. Those trends continued into 2021. Last week, Unite the union claimed that lives

“are being put at risk”,

as the average 999 ambulance waiting time across Scotland has increased to six hours.

In the debate today, other members have spoken about the problems with acute bed capacity, staffing and retention, as well as delayed discharge. The Scottish Government has been forced to take remedial action to alleviate the pressures that our Ambulance Service is facing, as has been evidenced in the debate, and the Government finds itself playing catch-up.

Scottish Labour’s priority is to give our Ambulance Service the urgent support that it needs in order to save lives. As such, we welcome the Government’s decision to request help from the Army, but the Government must go further and explore the potential of calling on recently retired ambulance staff to help during the crisis. We must acknowledge what the trade unions are saying to us about how much help the Army will be in practical, front-line roles.

Scottish Labour also supports the call from Unite for the introduction of a 30-minute maximum turnaround time for ambulances from arrival at hospital, which will release paramedics to answer other calls. As Jackie Baillie outlined, that is not a random request and we did not make it up; we spoke to Unite, which represents the staff on the ground, and they say that that would make a real difference.

In addition, temporary wards and field hospitals must be looked at. I appreciate what the cabinet secretary has said, but I ask him to work closely with the Royal College of Emergency Medicine and others to look at those options thoroughly.

We also recognise issues that Dr Sandesh Gulhane raised around reporting. We are in agreement that more regular reporting on response times has to happen, and I note what the cabinet secretary has said about improving the data that is available. We will therefore support Dr Gulhane’s amendment.

We have heard a lot of chat this afternoon about warm words and I want to point out some of the words that have been used by the Government in the past about the NHS. It has said that the NHS is

“Our most cherished public service”,

that it will “protect” and “nurture” it, and that

“shorter waiting times and treatment that continues to improve”

are the Government’s core priorities for it. Those are all quotes from SNP manifestos over the years. The reality is that patients and the hard-working staff of the Ambulance Service and the wider NHS are facing the consequences of 14 years of Government inaction on those issues.

Staff are upset, distressed and angry, and they fear for the winter ahead. That is why I want to speak about staff wellbeing, which is fundamentally important to supporting the workforce on the front line. I acknowledge what the cabinet secretary said about the wellbeing fund, but it needs to go further and deeper to make a difference. That is what the unions and the Royal College of Emergency Medicine are telling us, and the BMA told us that yesterday in committee.

I would not disagree with much of what has been said about the real pressure on staff.

I am interested in our immediate crises, and particularly in the onset of winter and winter pressures across the piece. Obviously, there is long-term workforce planning, but there is clearly an immediate need, particularly in acute settings, when it comes to how we physically keep the show on the road. We are seeing a lot of pressures at the moment, and we are not even at peak winter yet when it comes to admissions and use of service.

I am therefore keen to understand what is needed and what can be done to increase resources and staffing right now, and what would make most difference. I appreciate that that is not easy to answer, but I am keen to get a sense of that, possibly again from Dr Sue Robertson or the RCN, although I can ask everyone, I suppose.

My questions are on Covid-19 and its wide-ranging impacts. Every day, we see the direct impacts of the disease in terms of the number of hospitalisations and deaths, but I am interested in the longer-term indirect effects on health and in the impact that long Covid might have, particularly on people who already suffer from poor health or live in areas of deprivation.

If we take long Covid first, I am keen to understand its impact. We obviously do not have a lot of data and information on it yet. That is emerging, and there is still a long way to go in terms of interventions, but I am looking to get a sense from the panel of the impact that long Covid will have and what interventions it might require.

I thank the panel for their helpful introductory remarks, which touched on a number of key themes including in particular the pressures that are being experienced in our NHS, the pressure on staff and the staffing challenges that we face.

I am keen to get a sense of what you think about the Government’s recovery plan. There have been a variety of responses to its publication. For example, Dr Lewis Morrison of the BMA has said that it is at best “only a start”, and I have heard the RCN highlight the point that has just been made about the pressure on staff and whether the plan does enough to address staff burn-out and stress. Dr Robertson, will you tell us what confidence you have that the recovery plan will deliver the required transformation?

That is key. Retention has been identified across the board as being important, and successfully encouraging people to stay in the professions is about culture. Does the Royal College of Nursing want to add anything, particularly on the comments about burn-out in the nursing profession? [Interruption.]