Chamber and committees

Tuesday.

I will consider any proposals made in the chamber, but we are getting on now with the job of supporting the NHS and social care workforce. Obviously, Alex Cole-Hamilton will have heard my responses to Anas Sarwar about not only our long-term reform plans but the action that we are taking now to invest in adult social care, to increase the pay of those who work in it and to support them in a wider sense.

I turn to the Royal College of Nursing’s report. Of course, this has been a torrid time for nurses and others working at the front line of our national health service, but, right now, nursing and midwifery staffing is at a record high in NHS Scotland. It is up by almost 7,500 since this Government took office. That is staff in post—none of that number is vacant. We have also announced staff expansion in the last year alone to create nearly 5,000 extra nursing and midwifery posts, more than half of which are already filled. We are taking action now to increase the number of those working in the national health service and to support those who are already working in it, backed, of course, by record funding.

I will, of course, consider a proposition for further discussion about how we do that in the longer term, but what is more important is the action that we are taking now, and that is what we will continue to focus on.

As I listened to Willie Rennie, I could only conclude that, if the Parliament had existed and he had been in it back in the days of the establishment of the national health service, he would have opposed that, because he would no doubt have used the same arguments then.

The opportunity to create a national care service to mirror the national health service is one that we should seize and grasp with both hands. It is vital that we get it right, and all members of the Scottish Parliament will have the opportunity to contribute to that.

Willie Rennie should listen to more people around the country about the care service that they want to see in the future—he should reflect on that. In the meantime, we will get on with increasing investment in social care and increasing the pay of those who do such a fantastic job working in it.

Before I come to that extremely important question, I acknowledge that today is Holocaust memorial day, which is an opportunity to remember all those who were murdered in genocides in the Holocaust, of course, and more recently in Rwanda, Darfur and Bosnia. It is an opportunity for us to rededicate ourselves to resisting the hatred and prejudice that drives such atrocities. Whatever opinions or points of view might divide us, we should never forget that our bonds of common humanity are stronger and must always unite us.

I turn to the important question. On all those questions—I hope that this is a point that Douglas Ross will accept—the safety of pregnant women, mothers and babies is the paramount imperative of the Government and of clinicians who work on the front line.

Obviously, a review was commissioned on the issues of consultant-led maternity services at Dr Gray’s hospital and the implications for Raigmore. The report is thorough and substantial. Before Christmas, the cabinet secretary met staff, the health boards and local people, and the Scottish Government is considering very carefully all the recommendations. It is absolutely important that we get it right and that we recognise the understandable and important desire of women to give birth as close to home as possible. It is also really important that we do not lose sight of the issues of patient safety. I give an assurance to members and, more importantly, to local people that all the issues will be subject to the most serious and careful consideration.

First, I acknowledge and understand the personal experience. Many of us, myself included, have personal experience of baby loss at different stages, so I absolutely understand the emotion, sensitivity and seriousness of these issues.

The Scottish Government commissioned a report, conducted by Ralph Roberts, as part of our commitment to reintroducing consultant-led maternity services at Dr Gray’s in a safe and sustainable way. That is really important. The report that has been published is substantial and thorough, and it is important that all its recommendations are considered extremely carefully. The Government will again meet representatives from NHS Grampian and NHS Highland to look at practical next steps. Core to that, of course, will be listening to clinicians at Raigmore in any further discussions. I think that the health secretary has already indicated this, but, if not, I will indicate now that he is prepared to meet clinicians—it is important that he meets clinicians at Raigmore.

The Keep MUM campaigning group also has views on the recent review and report, and they also have to be listened to.

I do not underplay at all the seriousness of this issue, nor do I deny or challenge in any way how important it is to all women to give birth as close to home as possible. That is not just desirable; there are many good clinical reasons, and reasons of support, for it.

The most important thing, which is acknowledged and which underpins the questions that are being asked here—there have been experiences, which drive some of this—is that maternity services are safe for women and their babies. That principle will drive all the decisions that are arrived at. Those decisions will, of course, be informed by all those who have opinions or clinical expertise to bring to bear.

We are taking action now, as we progress the plans for the national care service. We have a commitment to increase public investment in social care by 25 per cent over this session of Parliament and we have started on that journey.

We have also taken steps to increase the pay of people in the adult social care workforce. In referring to 48p, Anas Sarwar misrepresents the scale of the amount. That is an increase of 48p per hour. That represents an increase of 12.9 per cent from March 2021 and is the first step towards substantially increasing pay in the adult social care workforce. We have already delivered an increase of 12.9 per cent. Does that go far enough? No. We have said that we want to go further. It is interesting that that is more than the increase in the part of the United Kingdom where Labour is currently in office and where just the real living wage is paid.

We recognise the need for immediate action, and we are taking action immediately. We are also working with partners to attract more people into the sector. In November last year, we launched a national marketing campaign to attract and recruit more people into the sector. I hope that Anas Sarwar will acknowledge that there are real pressures on recruitment across health and social care—and across the wider economy—because of the impact of Brexit and the ending of free movement. That is a significant challenge. We will continue to make the investment that attracts people into the sector and will invest more in that sector as we take forward the longer-term reform of creating a national care service.

We have continued to invest in Scotland’s railway and to support operators throughout the pandemic. We have allocated a record £4.85 billion to maintain and enhance the railway in the current control period, and we have supported our rail franchises with about £1 billion, including more than £450 million of additional funding via the emergency measures agreement. We are committed to ensuring that rail fares are affordable. ScotRail fares are still, on average, 20 per cent cheaper than fares in the rest of the United Kingdom.

I know that Stephen Kerr will particularly welcome the fact that work is well under way to provide passenger services in the public sector, under Scottish Government control, from April. Like me, he will be very much looking forward to that transition.

We have seen in recent weeks that the Tories at UK level do not pay that much attention to what their Scottish Tory colleagues say.

We have long called for those powers to be devolved. There is a serious reason for that. If the whole rail system in Scotland, including Network Rail, is fully accountable to the Scottish Government and the Parliament, we will be better able to provide the railway services that people in Scotland want and expect. Anyone with a genuine interest in those matters and in ensuring the future prosperity of our railway should get behind us and demand the full devolution of those powers to the Scottish Parliament.

I am not sure that Stephen Kerr’s fondness for the RMT will be reciprocated, but that is a matter entirely for the union. [Laughter.]

It is a serious issue. We will continue to make investments in our railway to improve passenger services, because it is really important for the country’s connectivity that we have good-quality railway services. Bringing the railway into public ownership will help with that. ScotRail will be under Scottish Government control from later this year. I had not noticed that, before now, the Scottish Government had escaped responsibility or accountability for those matters, but perhaps we will have more ability to shape things in the future.

Affordable fares are part of a high-quality railway. We need the investment in our railway. Less of the investment in the railways in Scotland comes from passengers through fares than is the case in other parts of the UK—more of it comes from Government subsidy. Of course, we want fares to be as affordable as possible. However, I return to the point that I made earlier: rail fares in Scotland are, on average, 20 per cent cheaper than they are in the rest of the UK, where—if memory serves me correctly—Stephen Kerr’s party is in Government.

The manifesto commitment stands, but it is important in relation to all services that we deliver such commitments in a way that is safe and sustainable. That could scarcely be more important than it is in the context of the issue that we are talking about here.

I appreciate that, while I have talked about—indeed, Douglas Ross has done so, too—a number of different maternity units, the issues of distance are much more acute in the area that he represents than they will be in other parts of Scotland. I absolutely do not deny the experiences, the views or the wishes of the mothers quoted in the chamber today. I absolutely understand those.

However, likewise, I know that there are some women, some of whom I have spoken to, who choose to go to bigger centres. Jackie Baillie is in the chamber; in the past, I have had such discussions with her about the Vale of Leven and Inverclyde.

We are talking about difficult issues. We have to strike the right balance between local access and safety and specialism, particularly for cases that involve more complex care. We need to do that carefully, taking account of the views of clinicians.

I repeat the point that I made about investment in Raigmore, if that is necessary. That is an important part of our commitment.

We will continue to take forward these issues carefully and listen to mothers who have given birth, mothers who will give birth in the future and clinicians who deliver the services, so that we get to the best balance that ensures not only that there is local access and that the need for travelling long distances is avoided but that our maternity services are rooted in safety as the absolute guiding principle for pregnant women and their children.