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.

I will not repeat all the details that I gave in my earlier answer to Mr Fraser, but I acknowledge the seriousness of the point that Mr McMillan has put to me on behalf of his constituent.

The Government’s budget includes substantial new investment in health boards. In my earlier answer, I indicated that we are making progress on the achievement of the CAMHS performance standard. The combination of early intervention and enabling the service to focus on those children with the most acute needs will help us to address the substance of the point that Mr McMillan has put to me. I would be happy for the health secretary to address the specific points that he has raised on behalf of his constituent.

I am grateful to Mr Sweeney for his kind remarks about Christina McKelvie. He is absolutely right to say that she went out of her way to help members on all questions.

I am concerned to hear the news about the Notre Dame Centre. I have asked Government officials to liaise with NHS Greater Glasgow and Clyde and Glasgow City Council, which are the partners in the IJB, to address the concerns and to provide the reassurance that we all need to hear, that the demand on the services that would have been provided by Notre Dame is able to be met in the future, because it is vital that individuals who require those services are able to access them.

I very much support the principle of water being owned in the public sector and managed in the interests of the public sector. That is exactly what Scottish Water does, and that is certainly different from water management systems in England, which are privatised and are of poorer quality, less resilient and more expensive and do not operate as firmly in the public interest as Scottish Water does. The model that Mercedes Villalba talks about is the model that I believe is in place in Scotland.

Obviously, Scottish Water will procure external construction support to enhance water infrastructure, and I think that we would all accept that that is necessary to ensure value for money for the public purse. Scottish Water invested more than £1 billion in 2023-24 and plans to invest a total of £6 billion across the current regulatory period of 2021 to 2027.

I cannot overstate the importance of that, given the fact that we are experiencing—as was made clear by a question last week—wildfires in Scotland in March. I leave that sentence for Parliament to think about. We are having wildfires in Scotland in March when the weather should be significantly wetter, so we now have to cope with such circumstances. That is an illustration of the challenges that we are facing, and I very much endorse the approach that Mercedes Villalba set out.

Those concerns have been raised with NHS Greater Glasgow and Clyde and Glasgow City Council, but I would be happy to meet Mr Doris to discuss those questions. I understand his long-standing connection with the Notre Dame Centre and his appreciation of its work, and I would be happy to meet him and the centre to hear the concerns that he has raised in Parliament today.

I stress the importance of there being effective dialogue between Police Scotland and local communities. That dialogue is one channel through which we will establish an understanding and awareness of some of the challenges that exist in local areas. I hope that Mr Mundell and I can agree that such understanding and awareness does not necessarily always have to be through attendance at community council meetings, because there are a lot of community councils across Scotland.

However, there has to be good, engaged local dialogue, which I know will take place with the local authority in Dumfries and Galloway. Such dialogue must be satisfactory in ensuring that Police Scotland is aware of the issues in and aspirations of local areas. I will seek the view of the chief constable on that point and will write to Mr Mundell with further details.