Chamber and committees

I have considerable sympathy with the points that Mr Fraser has made. I am very concerned by the manner in which the proposals that have been set out by NHS Tayside have been communicated, because they are likely to have caused alarm. Indeed, as the member of the Scottish Parliament for Perthshire North, I have seen evidence of that in my inbox. I accept that the proposals have not been well communicated.

What NHS Tayside is trying to do is recognise that early intervention support can be available in the community to assist young people who present with mental wellbeing challenges. If we provide such early intervention, that will eventually reduce pressure on child and adolescent mental health services, so that they can focus support on those children who have a more acute clinical requirement for such support. That is what is proposed, but I do not think that that has been particularly well communicated to members of the public.

I give Mr Fraser an assurance that the Cabinet Secretary for Health and Social Care is working very closely with NHS Tayside and other boards to ensure that the model that I have just explained to Parliament is the one that people feel and experience, because that model has the potential to better meet the needs of young people in Scotland.

By way of reassurance, I say to Mr Fraser and to Parliament that, for the first time ever, national performance has met the 18-week CAMHS standard, with 90.6 per cent of children and young people starting treatment within 18 weeks of referral. That progress has been made because, in the past decade, we have increased CAMHS staffing levels by 63 per cent.

However, if we are truly to meet the challenges with mental wellbeing that young people are experiencing today, which I think have been exacerbated by the Covid pandemic and other factors in our society, we must put in place the early intervention services that were somewhat missing from the NHS Tayside announcement.

Patient safety is a fundamental prerequisite of our healthcare system. Healthcare Improvement Scotland’s report was designed to address the legitimate concerns that have been raised by representatives of staff in NHS Greater Glasgow and Clyde emergency departments. I expect the board to implement and address the findings of the report, and I am confident that it will do so. There has been an entire change of leadership in NHS Greater Glasgow and Clyde, with a new chair, a new chief executive and a new medical director in place. As the chief executive of the health board has made clear publicly, the board is taking forward the necessary reforms at pace and at scale.

On the wider question, I understand the concerns about access to accident and emergency services. I reassure members of the public that, for some weeks, the performance of A and E units against the four-hour standard has been improving as we recover from the significant disruption as a consequence of the flu outbreak that dominated over the Christmas and new year period and well into January. The position in A and E departments is strengthening.

On the substance of Russell Findlay’s question about Healthcare Improvement Scotland’s report, I expect the recommendations to be addressed by the board.

In the recent budget that Parliament passed, the Government did two things that potentially help to address the issues that Pam Duncan-Glancy puts to me. First, we increased the health and social care budget to more than £21 billion to ensure that there was an uplift that would enable investment in local services. We also delivered a real-terms increase in local authority funding for core services to enable local authorities, which are the other contributors to integration joint boards.

Clearly, I have had questions from Mr Doris and Mr Sweeney on the Notre Dame Centre, and a question from Pam Duncan-Glancy on the care-at-home service, all of which relate to the integration joint board in Glasgow. There will need to be a wider conversation between the Government and the integration joint board to address the concerns that have been properly put to me by members today.

First, I thank Anas Sarwar for his generous remarks. I appreciate his words about our dear colleague.

In relation to the Healthcare Improvement Scotland report on NHS Greater Glasgow and Clyde, I do not think that the practice that Mr Sarwar recounts is acceptable. That is why Healthcare Improvement Scotland has responded to the concerns that were expressed by the clinicians.

I acknowledge the sustained questioning that Mr Sarwar has led on the leadership of NHS Greater Glasgow and Clyde. As he will know, new leadership is in place that is committed to addressing all the questions that are raised in the report. Professor Jann Gardner, the new chief executive of NHS Greater Glasgow and Clyde, has publicly indicated her commitment to addressing the recommendations “at pace and scale” to ensure that the issues are properly addressed.

I am very grateful to Patrick Harvie for his kind words and all that he has said about Christina McKelvie, which I entirely endorse.

It is at moments such as this that some of the conflict that goes on in this Parliament, in politics in general and in the wider political debate is put into sharp relief by the points that Patrick Harvie has put to me. I am no shrinking violet when it comes to defending my position and promoting the position of the Government, so I am not going to say that I am perfect and that everybody else is at fault, because that would just not be the way that it is.

However, there are lessons to be learned from the magnificent generosity of spirit of Christina McKelvie, who, despite the fact that she might have defended the Government’s position vigorously here, from the Government benches, or defended my party’s position from the back benches when she was on the back benches, would also wander out of the chamber with warmth and affection. If anyone—anyone—was facing a moment of difficulty, the first person at their side would be Christina McKelvie. Perhaps we could all take this moment to rebalance and recalibrate how we act and react in our politics, reminded by the astonishing example of Christina McKelvie.

As I set out in my speech on the national health service in late January, the Government will make a number of different interventions to improve access to healthcare services. At the heart of that will be access to GP services, as I said in my first answer. The Government has set out our intention to explain the specific interventions that we will make in that respect. That information will be shared publicly very soon.

We start from a high platform, in the sense that Scotland has the highest number of GPs per head of population in the United Kingdom. We are determined to build on that.

We are also determined to expand the workforce in general practice. For example, we have employed more than 3,500 whole-time-equivalent staff in other primary care teams. That is designed to boost access to healthcare. We have also employed an additional 1,300 whole-time-equivalent staff to support general practice through health boards.

Issues about the manner in which members of the public are able to access general practice—which I accept are important—are being responded to by the investments that the Government is making.

Long waits for support are unacceptable, which is why we are working closely with health boards and local authorities to ensure that they are tackled. As part of that work, we have allocated £123 million to health boards this year to support improvements across a range of mental health services, including neurodevelopmental services.

I give the reassurance that the chief constable will address these issues. The chief constable is responsible for the operational deployment of police officers around the country. I believe that the financial settlement that we have put in place for policing is adequate for the challenges that we face in our country, given that we know that recorded crime is down by 40 per cent since 2006-07 and that there has been a 54 per cent fall in the rates of attempted murder and serious assault.

We have, comparatively speaking, lower levels of crime in our society, but we continue to invest in policing. I know that the chief constable will be very attentive to the need for effective deployment of resources around the country to meet the needs of communities that are facing challenges.

Those are urgent priorities for me, because they go to the heart of what I think is the key issue that is affecting the performance of our healthcare system in a number of respects, which is our ability to manage flow within healthcare settings. For example, if a hospital is at full occupancy and congested, it is difficult for staff in an emergency department to admit individuals into the hospital, and if we do not have enough social care provision in the community, we will have delayed discharges from our hospitals. There is an integrated link between emergency departments, hospital occupancy and delayed discharge. I assure Mr Findlay that all three of those elements relating to flow within the healthcare system are priorities for the Cabinet Secretary for Health and Social Care and me as we undertake weekly scrutiny of the health system’s performance and the work to reduce waiting times.

We also want to strengthen access to general practice, which was the point that Mr Findlay made in his first question, so that individuals with healthcare requirements can get appropriate treatment and support at the earliest possible opportunity. Of course, a wide variety of treatments and support are available through pharmacies, general practice and other allied health professionals to whom we wish to improve access.

Not for the first time in my life, I find myself in huge agreement with Mr Carlaw’s comments. I appreciate the way in which he has expressed that point. The contrast of the material that Mr Carlaw has put on the record could not make his point more strongly. The education provision by the school has been acknowledged by Education Scotland and His Majesty’s chief inspector of education to be outstanding, and the outside of the school has been targeted by utterly unacceptable behaviour, which never had any place in Scottish society and certainly does not have any place in Scottish society in 2025.

I endorse entirely Mr Carlaw’s comments. Perhaps the best way through this is if Mr Carlaw and I visit St Joseph’s school. We could have a question-and-answer session to see how we both get on at the school in front of the pupils. The visit would be an indication of my warm appreciation of the strength of the school and what it does for the children of that community. [Applause.]