Chamber and committees

I declare that I am a fellow of the Chartered Institute of Personnel and Development. I am gobsmacked by what I have heard. The issue is crying out for a work study to be done, to look at efficiency. It makes you wonder why we are not all over this. A work study should have been done, and one needs to be done with urgency. As Professor Din said, the entire pathway needs to be examined, so I am delighted that, as a committee, we are addressing the matter and treating it as important.

I have two questions on the theme of the barriers to meeting cancer waiting times. In its “NHS in Scotland 2023” report, Audit Scotland said:

“Meeting waiting times standards for cancer remains a priority, but performance against the 62-day standard is poor”.

Peter Hastie, you said:

“something is going badly wrong”.

What do you think are the main barriers to putting the wheels back on the bus, or—given that this has been an issue for a while—to putting them on the bus? We have talked about the fact that the surgeons just want to get in there and do their surgery. What are the other main barriers to meeting the waiting time standards?

The SNP does not want to hear what I have to say, but I would like to finish. [Interruption.]

The NHS is an incredible national asset, but as we have heard repeatedly in the debate, it is on its knees.

For 17 years, the SNP Government has been the custodian of Scotland’s healthcare service, but it is out of ideas and out of time. Perhaps that explains SNP Westminster leader Stephen Flynn’s ludicrous intervention yesterday, which abdicated any responsibility for the state of Scotland’s fully devolved health service. It was shameful grievance-mongering but, sadly, that is something that we have come to expect from the SNP. Professor James Mitchell was spot-on when he said that the latest deflection from the SNP was “evasive” and “simplistic”, with “no serious engagement” with the “challenges” that the NHS faces.

In a new report this week, the Royal College of Nursing has laid bare some of the challenges. It found that more than a third of nurses have delivered care in settings such as hospital corridors, which has alarming implications for patient safety. The situation is so bad that the RCN has described it as a “national emergency”.

Dr Sandesh Gulhane said:

“the SNP has chosen to manipulate Scottish parliamentary time in order to serve its UK general electioneering purposes. That is an affront to every Scot who relies on the NHS and to every healthcare professional who dedicates their life to serving others.”

Wherever we look, whether in primary or secondary care, the situation is critical for Scotland’s NHS. Delayed discharges are up by 12 per cent on last year and there have been almost half a million fewer operations than there were in the pre-pandemic period. Consultant vacancies are up by more than 11 per cent in a year, and nursing vacancies remain stubbornly high.

Across every health board, the number of GP surgeries is down on the number a decade ago. Ambulances are stuck outside A and E departments—especially at Aberdeen royal infirmary in my region—for hours at a time. NHS services are increasingly being centralised to urban areas. Minor injuries units in rural communities are closing or restricting their hours, and some rural health boards cannot even recruit GPs.

What about the one in seven Scots who are languishing on NHS waiting lists for months, or even years, as their conditions deteriorate? What about the national treatment centres, including in NHS Grampian and NHS Tayside in my region, that were promised to relieve the pressures on the system, but have been put on ice? Worst of all, we know that people are dying unnecessarily: in A and E departments alone, there were as many as 2,000 excess deaths in 2023.

For too long, the SNP has presided over a process of managed decline in the NHS. Successive SNP health ministers have overpromised and underperformed. NHS staff and patients are paying the price, with intolerable workforce pressures, inadequate infrastructure and unbearably long waits for people who are in pain and discomfort. SNP members do not want to hear it, but it is they who are responsible for the NHS in Scotland and they who are making spending decisions and determining spending priorities.

The crisis will only get worse with an ageing population and growing demand on a healthcare system that simply does not have the capacity to respond. A national conversation on the future of the NHS is welcome but, ultimately, we need solutions. Today, the cabinet secretary talked about the transformation of services and having a national conversation. He used the word “reform” at least seven times—in fact, it was used so often that I stopped counting. Why have the previous health secretaries and the current cabinet secretary not been listening to key stakeholders such as the RCN, the Royal College of Midwives and the Royal College of Surgeons? The SNP Government has the feedback that it needs. It is action that is lacking.

Today, Humza Yousaf was here at the start of the debate, but I noticed that it did not take long for him to scarper out of the chamber—[Interruption.] Did SNP members hear that? He scarpered out of the chamber when he heard the current health secretary talk about reform being required.

Carol Mochan talked about the importance of honesty when having a conversation—but how can one have an honest conversation with the SNP Government when it deflects and denies? There was deflection when the cabinet secretary questioned the figure of 840,000 people on NHS waiting lists, which came out last Tuesday from Public Health Scotland.

I am sorry—I will not take an intervention. I have had enough banging on the drum, Presiding Officer.

This should be about fixing and future proofing—[Interruption.]

The Scottish Conservatives have already delivered in that regard. We were the first of Scotland’s parties to contribute detailed and credible proposals to the conversation. As Dr Gulhane said, for all our population—urban, rural and island—we would take a modern, efficient and local approach to healthcare reform that would increase capacity and address demand. We would introduce a 24/7 digital health service, through a “My NHS Scotland” app.

The cabinet secretary says that primary care is the bedrock of our NHS, but I say to him that primary healthcare is on its knees. We would deliver 1,000 additional GPs, investment of 12 per cent of the NHS budget in GP clinics and a new national standard that would guarantee patients an appointment within a week. We would establish maximum waiting times across all major NHS metrics.

Our NHS has reached a crisis point—

I will refer to SNP back bencher Christine Grahame in a minute.

There was denial when every SNP back bencher—I am coming to you, Christine Grahame—electioneered with anti-Westminster rhetoric. Even when one of our favourite SNP back benchers bangs on her grievance drum—

Thank you, Presiding Officer. That point has been made: it was not a point of order, as we hear constantly.

If Neil Gray is serious about reform, the SNP Government must step up, stop shirking responsibility and finally show some leadership.

I, too, thank Jamie Halcro Johnston for securing this evening’s debate on the banning of wood-burning stoves in new-build homes. It is an opportunity for MSPs to scrutinise the Scottish Government’s ill-conceived policy and, crucially, to raise constituents’ concerns about its impact.

Yesterday, as we heard, Gillian Martin announced a review of the guidance. A review is not the same as a reversal. It should not have taken a public outcry and pressure from the Scottish Conservatives—

Yes.

This cannot be deflected: people who have been referred to NHS Tayside’s neurology service face waits of up to 98 weeks on treatment for nerve damage, multiple sclerosis and a host of other serious conditions. The situation pre-dates the pandemic, when the board paid private clinics in order that it could just tread water. Now, NHS Tayside is being asked to shave an extra £16.5 million from its budget. Will the cabinet secretary outline how those unacceptable waiting times in NHS Tayside will improve?