Chamber and committees

It is clear who understands and who does not understand the decision to downgrade University hospital Wishaw’s neonatal unit. We can clearly see who has their hands over their ears and who is not interested. The people who are watching in the gallery will see that.

The staff at Wishaw’s neonatal unit have supported families across Lanarkshire at times when emotions are at their most raw, and stress runs especially high. Neonatal units care for the most vulnerable babies, but they see parents being at their most vulnerable, too. It is no wonder that 12,337 people have signed Lynne McRitchie’s petition. The community feels blindsided by another top-down decision from this tin-eared SNP Government.

In the north of Scotland, we are all too familiar with centralisation of NHS services under successive SNP health secretaries. As Dr Gulhane said, Scotland is so much more than three cities. The downgrading of Dr Gray’s maternity unit in NHS Grampian as a result of staff shortages has been disastrous for pregnant women. They have been forced to travel miles to Aberdeen or Inverness to deliver their babies, away from their homes and their support systems. There have been harrowing stories of women having to deliver their babies on the side of the A96. It is shocking.

The Scottish Conservatives have campaigned for those services to be reinstated. I am thankful that they will be, but by the time the consultant-led maternity unit at Dr Gray’s is restored, services will have been downgraded for at least eight years. Members should think of the impact on women and their families in that time.

Under the new model of neonatal services, newborn babies who need the intervention of a specialist NICU will be transferred miles away from the Wishaw hospital. For parents, the process of caring for a premature or seriously ill baby in hospital takes place around the clock, and it can involve weeks and even months of highly specialised care. Being close to home is not a silver lining; it is a lifeline. It means being able to care for the baby’s siblings and still do the school run. It means being close to friends and family who can lend a helping hand.

Dr Sandesh Gulhane highlighted the alarming shortage of neonatal nursing staff, which means that neonatal intensive care agency nurses are being brought up from London to Scotland to cover shifts. Once again, NHS services are suffering because the SNP has botched workforce planning.

Monica Lennon talked about the ridiculous situation that we are in, with the SNP praising a service in one breath but downgrading it in another. She said that the Government’s decision was

“absurd, out of touch and dangerous.”

She requested

“a pause and a rethink”,

and she asked the SNP-Green Government

“to listen properly to families.”

Jackie Baillie talked about the fact that there has been no consultation of stakeholders. As she is, we are baffled; we are baffled that the SNP-Green Government has not listened to the community.

Meghan Gallacher said that it was an “outrage” that the community has not been listened to. She said that it was a “kick in the teeth” that Wishaw’s neonatal unit, which is the UK neonatal unit of the year, is being downgraded, and an example of the fact that the SNP-Green Government is tone deaf. She said that midwives cannot make any sense of the Government’s decision. The same will be happening elsewhere across Scotland—for example, at Ninewells hospital and medical school, in my region.

The only empathy that has been shown today by members of the SNP-Green Government was shown by Gillian Mackay. Will she, please, on behalf of the Government, listen to the women and families and ask the Government to pause its decision, which is a terrible decision that will have disastrous implications?

This SNP-Green Government is clearly intent on progressing its plans for neonatal care, despite the strength of feeling that has been shown locally. We are all concerned about the impact of the Government’s decision on women who need to be at the centre of decision making on the future of maternity and neonatal care. The SNP has got it so wrong before. For the sake of patients and staff, it cannot afford to do so again.

The Scottish Government has announced that the annual report on the contribution of Scotland’s international offices will be published in December 2023. Given the enormous pressures on the public purse, and given that ministerial portfolios are crying out for more funding, can the cabinet secretary explain what metrics will be used to justify the activities and output of those offices?

It does, thank you. That 4 per cent seems to be an important figure. The SFC’s “Fiscal Sustainability Report: March 2023” helped to inform the Scottish Government’s decision to apply a higher growth rate of 4 per cent to health and social care expenditure. In your view, given the wide-ranging pressures on the national health service, is that 4 per cent high enough?

My question is for Professor Ulph. The SFC has projected that health spending will increase from 35 per cent of devolved spending in 2027-28 to 50 per cent in 2072-73. What actions can the Scottish Government take now to prevent that from happening?

That is fine.

My final question is for Philip Whyte. Audit Scotland has highlighted many times that the NHS is not being run in a financially or operationally sustainable way. That was the case even before the Covid-19 pandemic. Do existing resources need to be deployed differently or more effectively?

The Lowit unit in the Royal Aberdeen children’s hospital provided day care and out-patient support to children and young people with autism spectrum disorders, but it closed almost a decade ago. Families in the north-east are crying out for dedicated post-diagnostic support such as that given by the Lowit unit. What action is Scottish Government taking with health boards and local authorities to ensure that such support is in place?

But, cabinet secretary, do you think that it is acceptable that a local community has to take recruitment into its own hands to find a GP?

There is a big difference between 800 and 2,000. The BMA says that we need to recruit 2,000 GPs in Scotland. Do you dispute that figure?

Cancer waiting times are at their worst level, with 8,000 people waiting for treatment. CAMHS and accident and emergency waiting times are way off your target. One-year waits for outpatients are on-going. Agency staff costs have quadrupled due to the high NHS turnover. There is a new variant of Covid; and you have brought forward the flu vaccination programme. Can we expect the worst winter for the NHS this year?

In relation to workforce planning, this is not rocket science. You do not have to wait to find out whether someone is retiring; if there were Scotland-wide workforce planning, you would be able to understand the flows, see when people would be retiring and therefore know at the front end how many people you had to recruit.

The launch of the national centre for rural and remote health and social care is now months overdue, and the workforce recruitment strategy has been kicked down the road until 2024. It is good that you actually recognise that workforce planning is required, but the fact is that we are kicking the recruitment strategy into next year.