Chamber and committees

Unnecessary visits to accident and emergency units and unnecessary attendances and admissions to hospital are not in the interests of patients. That is why we are working hard to make sure that, where patients can and should be treated elsewhere, that happens.

Let me take Douglas Ross’s points in turn, and let us look in detail at demand, and why the figures that he has quoted are the case. There is absolutely no doubt that demand on our health service right now is higher than it has been for some time. If we look at calls to NHS 24 over the festive period, those showed the highest demand in a decade. If we look at emergency calls to the Scottish Ambulance Service, those were higher in the most recent week than the average of the four weeks before that. The reason that they are not all translating into attendances at accident and emergency units or admissions to hospital is the work that NHS 24 and the Scottish Ambulance Service are doing to avoid that.

NHS 24 now provides advice and, where necessary, treatment to the vast majority of patients during the initial call that they make. Most of the calls to the Ambulance Service are treated through see and treat, so that patients are not taken to hospital. However, because of that, those who do go to hospital tend to be sicker and their length of stay is longer. That is part of the reason why we have pressure on our hospitals.

The waiting times in A and E are a reflection of the fact that occupancy in our hospitals is so high, which is why we have focused on speeding up discharge from hospital, where appropriate.

Finally, we listen very carefully to, engage with and work with health professionals each and every day, and it would be hard for me to find the appropriate words to describe my respect for our health professionals. Elsewhere in the UK this week, we have seen healthcare professionals on strike. They have not been on strike in Scotland, because of the work that this health secretary has done and because of the respect that we have for our healthcare professionals.

What I will absolutely confirm is that, when people wait too long for treatment, it has severe consequences, potentially, for patients. That is why we work so hard, and will continue to work so hard, with the health service to reduce long waits for treatment, whether that is at accident and emergency units or for elective care in our national health service.

I was not—to use Douglas Ross’s phrase—“doubling down” on anything. For the avoidance of any doubt, I am certainly not blaming patients for anything. It is in the interest of patients that, where appropriate, they can be treated outside hospital, because it is not in the interest of any patient to end up in an accident and emergency unit or hospital ward just because treatment is not available in the community.

I was trying to explain—because it is obvious from Douglas Ross’s questions that he does not understand this—the flow of patients through our national health service and that the reason why we see longer waits at accident and emergency is overoccupancy in our hospital wards.

Finally, on the exit block, the significant chunk of what I and the health secretary set out on Monday was about tackling delayed discharges. [Interruption.] We understand, from our daily engagement with health boards—

On Jenni Minto’s last point, she is absolutely right. More importantly, people the length and breadth of Scotland, including our island communities, will draw their own conclusions from the approach that the Conservatives take on such issues.

Jenni Minto, who, in the Parliament, represents a number of islands, is right: the award of the contracts is good news for islanders and island communities, which is why it is important that they are progressing well. I understand that there will be an update on steel cutting and keel laying, which we expect in the coming days. We will continue to take decisions that are in the interests of people who live in our island communities, and that includes the decision that we are talking about.

—record investment or record staffing numbers, we will continue to support the NHS in these difficult times, as we always have done.

On the latter point, it is, of course, up to the people of Scotland to decide who they trust to be in government to lead the country through challenges.

Of course, there were challenges in the NHS before Covid—I have never sought to suggest otherwise—and the actions that we are taking around investment, staffing and reforms to patient pathways are designed to address that. There are record numbers of staff in our health service right now—almost 30,000 more than when this Government took office—and, of course, more staff per head of population than anywhere else in the UK. That is the reality.

People watching at home—including the one in 25 people in the Scottish population who have Covid and the many people suffering from flu and other respiratory illnesses—who hear Anas Sarwar say that the fact that we have 1,200 Covid patients in our hospitals and the fact that, in recent times, 1,000 patients with flu have been admitted to our hospitals every week have nothing to do with the pressures in our NHS will wonder what on earth he is talking about.

We will continue to work with and listen to those on the front line of our national health service as we continue to strive to give them fair pay increases and as we continue to support them to deliver excellent care, which, even during these tough times, they continue to do for the vast majority of patients across our country.

Forgive me if this is not parliamentary language, but, for reasons that I will come to, I am actually quite gobsmacked that that question has been put in that way by a Labour member of Parliament.

Let me first give these facts: a record number of young people secured places at university in this latest Universities and Colleges Admissions Service cycle, and a record number of 18-year-old Scots have secured a university place. That number has gone up by 20 per cent since 2019, the most recent year when there were exams.

The data provides a really positive story for those who are applying from deprived areas. The number of 18-year-olds from the most deprived areas who secure places has increased by 31 per cent since the 2019 cycle, and acceptances for people of all ages from the most deprived areas are up by 4 per cent.

This is where I take issue with Michael Marra. In my earlier days as First Minister, I used to be regularly criticised for the fact that too few young people from deprived communities were going to university. Now, I appear to be being criticised for the fact that too many of them are going to university.

I do not come from a deprived background. I come from a working-class background and went to a state school, and, when I studied law at Glasgow university, I was very much in the minority. Within a context of a record number of young Scots at university, I think that it is really good news that we are seeing more people from the most deprived areas actually going to our universities.

Uptake levels for the Covid and flu vaccines are high, which is welcome. We will continue to promote vaccine uptake for those who are eligible but have not yet been vaccinated.

We will, of course, think most carefully about those who are in the most vulnerable groups. Figures for, I think, the first week of January show that almost 90 per cent of older care home residents in Scotland are vaccinated, which is higher than the figures for England and Wales, and that 77 per cent of over-50s in Scotland are vaccinated, which is again higher than figures for other parts of the United Kingdom. We will continue to work hard to encourage everybody who is eligible for a vaccine to take that up.

I said on Monday, and the health secretary confirmed in writing to health boards this week, that although health boards can seek advice and guidance from the Government when they think that that is appropriate, it is up to them to take whatever decisions they think might be appropriate to prioritise critical and life-saving care. Douglas Ross started his questioning to me today by criticising the fact that NHS Greater Glasgow and Clyde has, in effect, done that by pausing non-urgent care in Glasgow—[Interruption.]

In relation to the FAI report that was published yesterday, I, too, thank the Scottish Courts and Tribunals Service for its work on this extremely important FAI and for publishing the report. I thank again the emergency services for their response on the night of the fire, and I give my condolences again to those who were bereaved in the incident.

Of course, we will thoroughly consider all the sheriff’s recommendations and I expect that, yes, we will accept all the recommendations. However, we must go through a process of considering them properly. We require to respond in due course, and we will do that.

In the light of the Cameron House fire and the more recent incident in Perth—my condolences go to the bereaved in that incident, too—it is right to look at enforcement provisions. Under the Fire (Scotland) Act 2005, the Scottish Fire and Rescue Service is appointed as the enforcing authority for fire and, as part of that, it produces all the relevant enforcement procedures, while applying the principles that are contained in the Scottish regulators’ strategic code of practice. As the enforcing authority, the Scottish Fire and Rescue Service works with duty holders in relevant premises to achieve compliance in fire safety, through providing advice and support and taking enforcement action when necessary.

Those systems are set out very clearly, but, of course, as part of our consideration of the recommendations of the sheriff, we will ensure that all appropriate aspects of that are looked at in an appropriate way.

That is a really important issue. It is important to make the point that the UK Government already has the most anti-trade union laws in western Europe, and the proposed bill threatens to undermine and weaken the rights of workers even further. We strongly oppose any bill that undermines legitimate trade union activity and does not respect fair work principles.

As Governments, we should be working with the public sector and trade unions to reach fair and reasonable settlements that respect the legitimate interests of workers, rather than pouring fuel on fires or taking away workers’ democratic rights. I will make those points very strongly when I see the Prime Minister this evening.