Chamber and committees

Islay, what would you like to see on board the trains that you use every day?

I will move on to my next question, because I see that the convener is looking at me. The committee has heard quite a bit about antisocial behaviour on rail and bus networks. How significant an issue is that? I ask Greig MacKay to comment first in relation to buses.

The alcohol ban on ScotRail services was mentioned earlier. Has the ban made any difference on the railway? Is it sustainable? Is it enforceable? Obviously, your members are stuck in the middle at times.

No, it has been asked already, convener.

Will the cabinet secretary take an intervention?

I completely agree with Beatrice Wishart—the problem that she describes is the one that most people face. They are on a waiting list but they have no visibility as to how long the wait is going to be. A lot of people will therefore go private if they can afford it. There needs to be a change.

During the recess, I spoke with residents in Turriff, where constituents have repeatedly raised the continuing lack of services in the local hospital. Those services were reduced during the pandemic and have never returned to full strength. This is not the first time that I have raised the situation in Turriff in the chamber. In January, I highlighted how many rural communities across North East Scotland were being let down by the huge reduction in local services, forcing them to travel to hospitals such as Aberdeen royal infirmary, which simply cannot cope. It is a hospital that is severely under pressure—so much so that staff were forced to declare a major incident and turn patients away, with a winter plan that had unravelled by November.

This all matters because, at the end of the day, it affects people—the people whom we were all elected to this place to serve.

I will conclude, therefore, with a story of someone who contacted me last week. My constituent has been diagnosed with basal cell carcinomas on a number of occasions. Normally, those were dealt with by the general practitioner performing minor surgery at a nearby minor surgery centre, but that does not seem to be an option now.

My constituent was instead referred to the dermatology department at the ARI. It took nearly two years for the carcinoma to be removed, and he was warned that there was a strong likelihood of the cancer returning. It has returned, and he has been referred to the dermatology department again; however, he has been warned that it may be over two years before he gets an appointment. He is rightly worried. We often hear about early intervention. In that case, I am sure that early intervention would have led to a better patient outcome and would most probably have been more cost-effective for our NHS.

I am normally a strong believer in local devolution, and I admit that I would be the first to complain if the Scottish Government were undermining local decision making. However, I feel that, with NHS Grampian, we have reached a point at which the Scottish Government needs to be bold. It needs to step in, steady the ship and provide a service that the people of the north-east deserve.

Let us make no mistake about it: these failings are not down to the thousands of dedicated doctors, nurses and surgeons, nor to the many other front-line staff; they are a direct result of mismanagement.

I therefore ask the cabinet secretary, considering the growing waiting lists, the financial interventions and the failure of enhanced monitoring, to turn the ship around. Does he have confidence that he will find the right candidate for the role of chief executive, considering that the interim chief executive has had enough and is going before a replacement has been found? Does he have confidence in the board of NHS Grampian to do its job, to deliver the leadership that staff need and to ensure that patient care is put back on track? If not, what plans does he have to step in and assist the people of the north-east, who are being so badly let down?

In the interest of transparency, I declare that I was a board member of NHS Grampian between 2017 and 2021.

I thank members from other parties who signed my motion, which has allowed the debate to take place. By bringing this debate, in no way am I criticising staff in our national health service, who work tirelessly to care for our constituents. However, given the level of correspondence that I receive from constituents, I felt that I had to try to do something to highlight the issues that are faced at present.

You will be surprised, Presiding Officer, that I do not want tonight’s debate to be a political knockabout with the Scottish Government. I have genuine concerns and would like to hear what the Government can and cannot do to improve the situation that patients in the north-east currently face.

Data so far this year shows that NHS Grampian is failing to keep pace with other health boards across Scotland. The majority of patients within the board’s area of responsibility are waiting longer than the 12-week target, with thousands facing waits of more than a year and some of even two years. Accident and emergency performance is among the worst in Scotland.

I have seen the consequences of that at first hand—not just through the many constituents whom I have met and who have explained how they have been let down, but within my own family. They have faced long, agonising waits in the back of ambulances outside an A and E department that is bursting at the seams, and they now face more long waits for much-needed surgery with no news or updates and no end in sight.

The board has explained that, due to what it calls its “extremely challenging” financial position, it must reduce spending. That is despite £92 million in Scottish Government bailouts and the Scottish National Party claiming to have increased funding for NHS boards. That will not give my constituents confidence in the healthcare system or that they will get the treatment that they need, when they need it, nor will it give them confidence in the leadership of NHS Grampian. How on earth will it get waiting times down when it is forced to make cuts to critical services? That will surely mean more waiting, more delays and more uncertainty.

Compared to other Scottish health boards, NHS Grampian stands out for all the wrong reasons. It has the worst performance against the 12-week treatment target and the greatest number of extremely long waits for treatment, and is near worst in relation to unscheduled care.

I am concerned that it is our elderly constituents who are being disproportionately affected by those waiting times, who are suffering the most and who are having their quality of life impacted. In audiology, there is more than a two-year wait for a hearing aid. In relation to cataracts, there is a 60-week wait for the first appointment and who knows how long for the operation. In orthopaedics, Scotland Versus Arthritis has analysed the waiting times in NHS Grampian and the waiting lists for trauma and orthopaedic treatment have increased by 25 per cent in the past two years, with orthopaedics currently making up 38 per cent of NHS Grampian’s total waiting list.

The financial situation, bed capacity issues, limited staffing and growing demand are all contributing to NHS Grampian’s floundering position. The new Baird family hospital is already five years late, with no opening date set. The board’s reliance on Government bailouts underscores the seriousness of the situation, which simply cannot continue.

The time has come for a robust and meaningful response. The Scottish Government must take steps to put patients and staff first and place NHS Grampian in special measures. Putting NHS Grampian into further enhanced measures would be the first step, but not the last. We need a clear recovery plan, leadership changes where necessary, independent oversight and emergency investment in the services that are under the most pressure. The Scottish Government must make this a priority, not just for the sake of the north-east but as a signal to every patient in Scotland that they matter.

The cabinet secretary mentioned the escalation procedure. Has he considered moving NHS Grampian to a higher level of escalation? There are a lot of problems that are not unique to NHS Grampian, but they seem to be worse there.

Will compliance with the convention mean that groups across Scotland that are campaigning against pylons will have greater support through legal aid, for example, to oppose some of the power generation companies that are forcing things through?

The Aarhus convention is an important document that gives power to local communities to have a say on what happens in their locality. It has been ignored for too long, and more should and must be done to ensure that its central tenets are incorporated into law in Scotland.

The issue has been raised time and again in Parliament. Indeed, back in 2022, my committee colleague Monica Lennon questioned the then Cabinet Secretary for Justice and Veterans, Keith Brown, on the matter. In 2023, there was a consultation and a report from the Scottish Government. In 2024, there was committee work on the topic, yet we still have little or no action—a phrase that cuts right to the heart of this devolved Scottish National Party Government. Quite frankly, it is a disgrace and a shambles, and it is letting down rural Scotland, our communities and all the groups that work so hard to ensure that our countryside is protected.

Campaigners in Dumfries and Galloway spent almost £26,000 unsuccessfully opposing pylons in their areas. Those costs are terrifying to groups such as Save Our Mearns, which face similar disruption and destruction of the countryside in their areas, with hundreds of kilometres of pylons being planned across Scotland. SSEN plans to build 500km of pylons across the north of Scotland. Local groups are left wondering how on earth they can oppose the plans of those large companies.

At the Citizen Participation and Petitions Committee last year, I spoke about the David versus Goliath battle that many communities face. Many communities feel that they are being priced out of trying to protect the countryside, while energy companies have deep pockets to spend on getting what they want.

Crowdfunders can get campaigners only so far. Many are being priced out of defending their local countryside from overindustrialisation up and down the country, and that cannot be right. I fear that it will get harder, not easier, for community groups to defend the countryside. The changes to the planning system, which are supported by both Labour and the Scottish National Party, look to take away local councils’ right to a public inquiry and erode local democracy in order to railroad pylons, batteries and substations across our countryside.

Communities feel ignored. They feel that their human rights are under attack, and they feel that they are being priced out of defending their homes. There needs to be a better way of allowing those groups to defend themselves. The changes that are required to bring us into line with the convention would mean that those groups could either access legal aid to combat the plans or, as the ERCS supports, the loser pays rule would be replaced with qualified one-way cost shifting. That would allow community groups much greater access to justice, and would be a relatively easy way to bring us into line with the Aarhus principles, which we are a long way from meeting.

In fact, of the six recommendations made by the United Nations Economic Commission for Europe, the Scottish Government has failed to act on four. Progress has been made on the other two, but they have not yet been met. For the past two years, promises have been made on our obligations by the Scottish Government, whether through the human rights bill or legal aid reform, but neither has been followed through. This left-wing, central-belt-focused SNP Government is once again talking the talk but failing to act on behalf of our rural communities.

I thank the organisations that gave evidence to the committee for their work on the issue. They are clearly exasperated by the lack of action on the matter, and many have expressed their dismay at the slow pace of progress. I hope that we will today hear from the cabinet secretary that progress will be made, along with timescales and targets, so that we can all have the transparency that is required in this area.

One call that came through strongly in many of the representations that we received was on the need for an environmental court to be established in Scotland, which would be in line with many other countries. That was ruled out by the Scottish Government without the due consideration that should have been given to it. An environmental court could increase access to justice, reduce the many fragmented paths to justice that currently exist, and allow Scotland’s legal industry to develop expertise in the area. It could also cut costs for those who are pursuing or defending cases. The cabinet secretary should listen to the groups that are calling for such a court to be established and not dismiss their suggestions out of hand. We should carefully consider the proposal for an environmental court and decide whether it is best for Scotland.

The issue is complex and important. It is about access to justice for our community groups who are seeking to protect our countryside, heritage and environment. Their concerns cannot, and must not, fall on deaf ears. I welcome the fact that two parliamentary committees have now looked at the issue, and I urge the Scottish Government to listen to the concerns that members express in the debate. To ignore those concerns is to ignore the fundamental right of community groups to access justice in Scotland. It ignores the voices of our rural communities and the Government’s legal obligations under the convention. It is vital that the Government acts and stops faffing about. This has gone on for far too long. Action must be taken to ensure that justice can be served.