Chamber and committees

I should say first of all that I was an HR professional for more than 30 years.

I just want to consider the optics of your remark about being deeply disappointed at not being able to hire a communications professional. I note that you do not see not hiring an HR professional, even part time, as a serious or major issue, but the fact is that most organisations that want to bring in serious organisational change put HR at the forefront. When I was preparing for the meeting, I was appalled at and saddened by some of the examples. Why are you making comms a higher priority than HR?

I would challenge that. I think that you should reconsider and put in place even part-time or specialist HR resource.

I have a question for Vicky Irons that builds on something that she said.

In 1999, there were 79 local health co-operatives, which were replaced by the community health partnerships in 2004. The CHPs were then abolished in 2014, which led to the creation of the 31 integration authorities. You talked about the will to make that work. Were any lessons learned from the previous failed attempts? If so, which lessons were learned and which issues are still proving to be problematic?

Thank you, convener. Allen Stevenson said that people are tired because we have been through a difficult period in the past two years. What work is going on at the moment to integrate service delivery? Has it stalled? Has the National Care Service (Scotland) Bill taken resources away from forward planning in this area? My question is about bandwidth.

I will go back to something before I ask my question. Earlier you said that you want to involve more women in administration. Could you clarify what that means, please?

The Convention of Scottish Local Authorities responded to the National Care Service (Scotland) Bill consultation. I will give a straight quotation, then I would like Allen Stevenson first, then Stephen Brown, to give quick responses, please. COSLA said:

“Structural change typically fails to address long-standing systemic barriers, with integration being challenged by a lack of resource, infrastructure, and staff. As things stand, we risk repeating the cycle of successive reorganisations that change how services are planned and coordinated—and come with a significant opportunity cost and disruption—but fail to address the fundamental and deep-rooted changes needed to integrate services at the front line.”

Are you concerned that all your hard work over the past few years could be undone?

All members in the chamber pay tribute to the outstanding work of health and social care workers across Scotland, but the reality is that they have been badly let down by the Scottish National Party-Green Government.

The NHS recovery plan was published more than a year ago, but things have gone from bad to worse. Only today, we heard that August’s A and E waiting times were the worst on record across every category. There are already reports of ambulances stacking up outside emergency departments, often for hours, including at Aberdeen royal infirmary in my region, and that is well before the winter months arrive.

The system is not just stretched, it is overstretched. Few people, apart from SNP members, will be reassured by the cabinet secretary’s statement, so I will put three questions to him. First, his statement mentions improved call waiting times for NHS 24. Given that, in June, one patient waited two hours, eight minutes and 15 seconds to be answered by an operator, can the cabinet secretary tell us how that will be achieved and what he considers to be an acceptable waiting time?

Secondly, there is no mention in the statement of NHS dentistry, which is at breaking point. Does the cabinet secretary realise the catastrophic impact that his funding cuts will have on the dentistry sector?

Finally, the statement mentions growing the NHS workforce through recruitment, but there is almost nothing about retention. Nursing vacancies are up by as much as 25 per cent compared with last year. Therefore, what is the Scottish Government doing to improve retention of NHS workers?

I know from conversations with police officers in the north-east that they are often the stand-in for other services when someone is in crisis out of hours. That is starkly reflected in the Mental Welfare Commission’s report, which quotes officers as saying that the police and ambulance services are the

“constant fall back for other services, when neither are the appropriate services to offer meaningful assistance beyond an assessment at A&E.”

What immediate steps is the Scottish Government taking to ensure that people in crisis can be swiftly and reliably referred to the right help and interventions out of hours?

For months, the Scottish Conservatives have said that people are paying the price of Humza Yousaf’s mismanagement of Scotland’s NHS. Earlier this month, A and E waiting times hit their worst level on record. The figures that were released yesterday are only fractionally better.

The sobering reality, which the vice-chair of the Royal College of Emergency Medicine emphasised last week, is that emergency department delays are associated not just with patient harm but with increased mortality.

I will put that into perspective. For the 3,400 patients across Scotland who spent more than eight hours in A and E a couple of weeks ago, 40 additional lives could be lost in a single month. That is why those statistics really matter.

Let me be clear: the buck stops at Bute house. NHS staff the length and breadth of Scotland have worked tirelessly to treat their patients in recent years, often at the expense of their own wellbeing.

In July 2022—almost a year after the NHS recovery plan was unveiled—one in every 25 patients waited more than 12 hours to be seen in A and E departments across Scotland. That was the worst month since records began.

What were Nicola Sturgeon and her SNP colleagues doing in July? They were refreshing the case for separation, with the launch of the SNP’s second independence paper. That is a massive distraction from our NHS’s recovery and hardly the “sharp focus” that the First Minister pointed to during First Minister’s question time last week.

In August, the Royal Infirmary of Edinburgh’s A and E department was over capacity every day—not just by a handful of patients but by dozens of them. That has implications for the safety of patients and staff. However, in August, Nicola Sturgeon appeared not once or twice but five times at Edinburgh’s fringe to hobnob with Hollywood actors and polish her public relations. That tells us exactly where the First Minister’s priorities lie.

Those appalling waits occurred during the summer months, well before the pressures of winter and colder weather pile on to our NHS. In my region, the medical director for acute services at Aberdeen royal infirmary said in August that

“the system is not working because it’s not fit for purpose.”

Ambulances are already stacking outside ARI because the hospital simply does not have the capacity. Paramedics and their patients are waiting hours outside A and E, meaning that ambulances cannot be deployed elsewhere. People in the north-east are being told to present to ARI only if their condition is life threatening.

Figures that were published yesterday show that, for the quarter ending in June 2022, NHS Grampian failed to meet the 62-day standard and the 31-day standard for cancer waiting times. In addition, there are long waits for magnetic resonance imaging scans, colonoscopies and access to psychological therapies.

Meanwhile, Montrose minor injury unit has closed in Angus; Aboyne community hospital has been shut because of staffing shortages; Friockheim health centre has closed its doors because of lack of doctors; and primary care across the north-east is under impossible pressure. Many NHS services are being centralised by stealth with NHS 24 acting as the gatekeeper, with lengthy waits to speak to an operator.

Quite simply, Presiding Officer—

I am nearly finished. I wish that Humza Yousaf would listen to what people are telling him. His NHS recovery plan has not worked. Things have gone from bad to worse. That is no wonder, given that Audit Scotland has said:

“There is not enough detail in the plan to determine whether ambitions can be achieved in the timescales set out.”

The health secretary will be appearing before MSPs in the chamber next week to address those issues. I know that he wants to mention them now, but I ask him to please listen—I am nearly finished. I sincerely hope that he will address the issues. After months of excuses, this is an opportunity to rethink his failing recovery plan and to tell front-line staff and the public what action he will take to reduce delayed discharge, increase the number of beds, improve workforce planning and focus on staff retention.

Everyone has had enough of SNP soundbites. Humza Yousaf and his colleagues need to step up—[Interruption.]—and get a grip. Too much is at stake.