Chamber and committees

I understand why the Conservatives are feeling uncomfortable, because the Conservative Government in England has not managed to avoid strikes in the NHS.

The Conservatives also get uncomfortable when they hear me point out again that, despite the significant challenges in our national health service, which I will come on to in a moment, Scotland’s accident and emergency departments remain the best performing anywhere in the UK. If I may say so to the health secretary, that is not down to him—it is down to the hard work of staff across our national health service each and every day.

Our health service faces significant issues, and we see that in the Audit Scotland report that was published today. In that report, however, we also see important context that Douglas Ross always seeks to deny. Let me quote from page 7:

“The Covid-19 pandemic continues to affect the delivery of NHS services.”

If someone was to listen to Douglas Ross and others, they would be forgiven for thinking that the pandemic had not even happened.

The report also states:

“Scotland’s NHS is not alone in facing these issues … Many of the factors contributing to the extremely difficult situation facing the NHS in Scotland are not specific to health services, and many are not within the control of the Scottish Government”.

Notwithstanding that, we continue to support our health service to ensure record funding, record staffing, a record pay deal for agenda for change staff in Scotland and progress in reducing the longest waits in our national health service.

I do not know about anybody else, but it sounds to me as though Douglas Ross is pretty scared of Humza Yousaf—[Interruption.]—as, I am sure, he will be scared of whoever is elected to succeed me as SNP leader. [Interruption.]

Scotland is taking action to secure a net zero and climate-resilient future, and we are doing so in a way that is fair and just for everyone. Our focus remains very firmly on delivering the updated climate change plan, delivering on our adaptation outcomes through the 2019 adaptation programme, and planning for a just transition across the economy. We are also carefully considering the Climate Change Committee’s latest advice, and we plan to respond in the spring.

It is the ambition of this Government that every child in Scotland grows up loved, safe and respected so that they have the opportunity to reach their full potential, regardless of the circumstances in which they are born. As well as being a commitment of the Scottish Government, that is a personal commitment of mine, which I will take with me as I leave the Government over the next few weeks.

The budget that was passed on Tuesday commits almost £80 million to the Promise and £50 million to the whole family wellbeing fund. Back in December, we introduced the Children (Care and Justice) (Scotland) Bill, which seeks to put an end to under-18s spending time in young offenders institutions and to ensure that children who come into contact with the care and justice system are treated with trauma-informed and age-appropriate support.

Last Friday, I was delighted to visit East Renfrewshire to celebrate care day. I always value the opportunity to hear what matters directly from children and young people across Scotland as we work together to keep the Promise, which, as I said, is a commitment that I hold personally, as well as—for the time being—as First Minister.

I well understand the difficulties that general practice is facing right now, particularly during what has been—and, in some respects, continues to be—a challenging winter period. I put on record my thanks to general practitioners and their teams across the country.

A record number of GPs are working in Scotland. We have also recruited more than 3,000 healthcare professionals since 2018 as part of wider primary care multidisciplinary teams.

I very much value the work of the Royal College of General Practitioners, which is a very important partner. The survey is important, albeit that I should point out that the survey sample size is relatively small, as there were just 181 Scottish respondents from the many thousands of general practice staff who work here. Nevertheless, we pay close attention to the findings of the survey. We must encourage more trainee doctors and healthcare professionals to work in general practice, and we will keep working with the RCGP and others to ensure that that is an attractive proposition.

The cancer strategy will be published in the spring and will set out our 10-year vision for cancer in Scotland, which will include building on Scotland’s significant strengths in research. We have recently published an independent report on improving equity of access to cancer clinical trials and will be working with the cancer research community to prioritise the recommendations in that report and to take forward as many as is feasible.

I take the opportunity to absolutely recognise the very high quality of research in the west of Scotland and the collaboration between the Beatson institute, the University of Glasgow and the national health service. To support that, we have recently increased our contribution to Glasgow’s Experimental Cancer Medicine Centre, which will receive more than £2.25 million this year. We are also committed to supporting the NHS Research Scotland cancer research network in running innovative, high-quality research studies across Scotland.

I gave that commitment during the most recent Scottish election campaign, I think, and I am happy to repeat it today. The commitment of this Government is not “shaky”; it is rock solid.

The construction costs and the business case will obviously be interrogated, as is normal for all business cases. There is inflation in the costs of construction right now, which is impacting on the cost of many capital projects. However, we have a strong capital programme in the NHS and more generally, and we are committed to delivering it.

First, I thank Anas Sarwar for his generous comments. I fear that it might be damning him with faint praise to say that he has more grace in his wee finger than all the Tories combined—[Interruption.]—although I am sure that he will balance it out over the course of these exchanges. I am definitely showing my age when I reflect on the fact that, in one of my earlier election contests, I stood against Anas Sarwar’s father. In my most recent electoral contest, of course, I stood against Anas Sarwar himself, and I will spare his blushes by not pointing out the result of that latter one, even though his father beat me fairly and squarely back in the day.

Let me turn to the important matter of the NHS. Our NHS faces the most significant challenges that it has faced at any point in its history. That is largely because of the pandemic, but, as I have reflected before, there were challenges in our health service before the pandemic. Changing demographics and ever-increasing expectations of what health services can deliver are, in themselves, positive trends but ones that nevertheless pose challenges for the health service.

What has changed over the years that we have been in Government? Funding for the national health service has doubled and is higher, proportionately, than in any other part of the United Kingdom. Staffing in our health service has increased significantly. As the Auditor General recognises in this morning’s report, we are also seeing the signs of reform and innovation so that we can equip our health service to cope with the challenges.

I do not deny the challenges. However, what the NHS needs and has is a Government that will continue to support it and focus on addressing those challenges. That is the responsibility of Government, and that is what I believe the people of Scotland deserve and want to see continue.

I do accept the conclusions in Audit Scotland’s report. The challenges for our national health service are significant. The recommendations in the report are important, and we will seriously consider each and every one of them.

Staff have been working incredibly hard, and I recognise the description of the burnout that many NHS staff will feel. That is why it has been so important to give them the fairest possible pay increase and to ensure that, unlike the situation in England, Wales and Northern Ireland, NHS staff in Scotland have not had to go on strike to get the decent, set pay offer that has now been made.

As an aside on that issue, to bring pay for NHS agenda for change nurses in England up to the level of pay for those in Scotland, the United Kingdom Government would have to offer them a 14 per cent pay increase. That is the gap that now exists.

In terms of our focus on the national health service, we have doubled funding for the NHS since coming to office; the budget that was passed this week in Parliament increases NHS funding by a further £1 billion; front-line spending in Scotland is 10 per cent higher than in England; and we have more staff, including more staff per head of population, than other parts of the UK.

On waiting times, yes, there is much to do, but we have seen a reduction in the longest waits; we have a number of national treatment centres opening this year, which will see an additional 12,000 procedures able to be undertaken in the NHS; and, although cancer waiting times are challenged, as all waiting times are, we are seeing more patients being treated on the key cancer pathways.

There is much work to do, but this Government has a real focus on supporting our national health service, because that is our responsibility.

That is a decision for members in my party.

Since Humza Yousaf became health secretary—this is what Anas Sarwar never wants to mention—there have been, I think, three further waves of a global pandemic that have affected health services all across the UK, Europe and the world. That is not something that can just be ignored. We, in common with other countries, have also just come through one of the most challenging winters that any of us can remember. That is the context for the challenges in our national health service—a context that is recognised and, indeed, pointed out by the Audit Scotland report today, which—I repeat—says:

“The ... pandemic continues to affect the delivery of NHS services. ... Scotland’s NHS is not alone in facing these issues.”

It also says:

“Many of the factors ... are not within the control of the Scottish Government”.

We continue to support the NHS in the ways that I have set out: record funding, record staffing, a record pay rise for agenda for change staff, reform and innovation to change how patients go through the national health service, and action to reduce waiting times. It is going to take time to properly recover the NHS from the pandemic. That is true in Scotland and in other countries, but the focus of this Government will not waver. It never will waver in supporting our national health service and all those who depend upon it.