Chamber and committees

I declare an interest as an employee of NHS Lothian.

I thank the cabinet secretary for the advance sight of her statement. In the light of the decision to pause the replacement of University hospital Monklands and implement sub-acute community health hubs in supplementation, can the cabinet secretary provide more detail of the funding timeline for the hubs? Given that a replacement for the hospital is needed, what contingency plans have been put in place for the current hospital to maintain current standards of care and ensure that acute cases and emergency pressures are not simply displaced to the nearest hospitals?

Britain is a multiracial country, and people of all backgrounds call this their home. When we have uncontrolled, unmanaged migration, the additional numbers create pressures on our hospitals, in our schools and elsewhere that are felt by people of all backgrounds. Those are the people we are standing up for, and the only people talking about race are other parties, not Reform.

[Made a request to intervene.]

On a point of order, Presiding Officer. During today’s First Minister’s question time, I did not note my interest as an employee of NHS Lothian. Mea culpa.

In April 2026, one third of patients attending accident and emergency were not seen within four hours. In the scrutiny of that, the people of Scotland are tired of the same rehearsed, scripted and dismissive answers that are given week after week in the chamber. The First Minister likes to project the image of a safe, steady manager; the truth is that he is simply managing decline. Will the First Minister put aside rigid dogma, stop dismissing patient suffering and deliver the reforms that Scotland desperately needs to meet the statutory four-hour A and E waiting-time target?

I declare an interest as an employee of NHS Lothian.

The truest measure of a society is how it supports its citizens to fulfil their potential. By that metric, Scotland’s approach to neurodiversity is costing us our future. We are looking not at a simple administrative backlog in NHS diagnostic clinics but at a catastrophic drain on Scottish potential, public finances and human life chances. The price of undiagnosed and unmanaged ADHD and autism is paid daily in ruined school careers, broken employment, relationship breakdowns and tragic mental health crises. When we leave people in limbo, the cost does not vanish; it merely shifts to more expensive parts of our state. We see it in schools, where bright children are excluded because their dysregulated behaviour is mislabelled as defiance, and in our economy, where capable adults cycle through unemployment because they lack workplace accommodations.

However, there is an equally damaging factor that we rarely talk about: the agony of the unknown. Our waiting lists are swollen with thousands of people who are left to languish for years. Let us be entirely honest: not everyone on those waiting lists has ADHD or autism—some are experiencing modern burnout, trauma or other misaligned mental health conditions—but the prolonged uncertainty is just as damaging to our economy and lived experience as being undiagnosed. People put their lives on hold; they delay career moves, pause education and suffer psychological paralysis while waiting for a clinical rubber stamp that might never come or might eventually tell them that they do not qualify.

Absolutely. I thank the minister for her intervention. I will answer her question more fully in the rest of my speech.

We cannot move through this crisis by funnelling every potential patient through a highly specialised illness pathway. We must stop treating neurodevelopmental differences like acute medical emergencies and start treating them through a modern public health framework. Let us look at how Scotland tackles obesity: we do not send every person who gains weight straight to a bariatric surgeon or we would have a massive waiting list, as we do for neurodevelopmental conditions. Neither do we place them on a five-year waiting list for clinical consultation before they are allowed to change their diets. Instead, we use a public health structure that prioritises preventative action, public education and community initiatives.

We must try to apply that framework to neurodiversity and mental health. The core of our strategy must move out of our hospitals and into our neighbourhoods for that first tier of treatment, because a significant proportion of cases on our current waiting lists are subclinical. Those individuals face genuine executive dysfunction, sensory overload and emotional regulation challenges, but they do not require highly specialised medical intervention or prescription medication.

We need to give people the tools to help themselves immediately. That means funding open-access community-led support groups. It also means rolling out digital coaching platforms supported by the Royal College of Psychiatrists, that are co-ordinated so that we have a single, solid standard on which we can rely and that teach time management, emotional regulation and organisational strategies.

If we shift our focus to immediate community-level empowerment, a person who is struggling with focus will be able to access help that day and will not need to wait three years for a consultant appointment at which they are told how to structure their day. That immediate support would resolve the damaging uncertainty and give subclinical individuals the belief that they need without ever touching an NHS waiting list.

Where such community-led strategies are not enough, our existing local infrastructure—GPs, school counsellors and workplace occupational therapists—must be empowered to step in. Instead of waiting for a formal diagnostic passport, local professionals should implement targeted adjustments. A school can adapt a child’s environment or an employer can adjust an adult’s working hours based on the traits that they present with, rather than a clinical label.

By filtering out and managing subclinical and mild cases in the community, we will clear the runway for our specialists. In that way, it will finally be possible for highly specialised psychiatric care, multidisciplinary diagnostic teams and complex medication management to be reserved strictly for the most complex acute cases and for those who genuinely require specialist medical care to be seen in weeks rather than years.

The current strategy of building ever longer waiting lists and relying on a consultant-led appointment as some sort of silver bullet while human potential rots is a failure of statecraft and imagination. The economic cost of doing nothing is a luxury that Scotland cannot afford. Let us democratise support and eliminate the toxic damage of clinical uncertainty by giving people answers and tools on day 1. We need to fund the community, restructure our pathways and treat the crisis like a public health challenge.

18:36

Does the cabinet secretary recall that Max Bannerman’s point on community wind farms was that they do not rely on subsidies? Therefore, it forms no contradiction in Reform policy on our opposition to net zero.

I congratulate the Cabinet Secretary for Health and Care on her appointment, and I thank members who have spoken for the first time today for their valuable contributions across a range of areas.

I declare an interest as an employee of NHS Lothian. My own path into healthcare was seeded at a very young age. I remember that, for a period, when I was a child, my grandmother was regularly visited in her home in the Grassmarket in Edinburgh by a really charming doctor from India with a cut-glass English accent. During those visits, the patience and compassion that he showed my grandmother was unlike anything that I had seen before. Medical treatments were all well and good, but the effect of those visits, in terms of caring human interaction, on my grandmother was obvious for days afterwards. That was a real inspiration to a four-year-old child.

Alas, I took a somewhat scenic route into healthcare but, thanks to the progress made in recruitment and the widening of access to the sector, I was able to enter medical training, albeit at a slightly riper age than most of my professional colleagues. Healthcare is an interesting sector to work in, because no one who needs it really wants to have to be there. However, where it is necessary to make use of our healthcare systems, patients rightfully expect to be listened to, to receive a diagnosis and to receive efficacious treatment, with a clear rationale. They also expect compassion—but that compassion is becoming harder and harder to deliver.

The motion congratulates our workforce. For the resident doctors, nurses, advanced nurse practitioners, porters, lab technicians and scientists who will work overnight tonight, those congratulations will be welcome, but congratulations are not enough. My colleague Helen McDade referred to the lack of investment and cross-speciality interaction when dealing with complex chronic conditions, and the lack of prioritisation and urgency in the training of nurse specialists—all of which is underpinned by management and approval mechanisms that hamper the recruitment and retention of expertise and the delivery of care.

Compassion cannot be delivered where there is inconsistency and a lack of resources. Congratulations are not enough. My colleague David Smith highlighted the variation in patient contact times depending on authority boundary. Not only is that cruel to those in need of help; one simply cannot, in seven short minutes, deliver the practical care required, as well as giving patients the patience, listening time and understanding to truly deliver compassionate care.

I do my NHS colleagues a slight disservice. In those extraordinary circumstances, they deliver all that is required, as well as offering warmth, kindness and close attention. However, if staff give all they have got for long periods, that eventually leads to burnout. That is reflected in staff employment surveys, which show that 37 per cent of nurses in Scotland are actively planning to leave, or are thinking of leaving, the profession. Congratulations are simply not enough.

The motion celebrates a decrease in waiting lists in the past 11 months. How did those waiting lists decrease? Were there more operations? Yes, but—to supplement Jackie Baillie’s point—last year, approximately 54,000 Scots resorted to private providers for their treatment. That is a 6 per cent increase on the previous year and the fifth consecutive year in which private healthcare admissions have hit a record high.

Members in this chamber have inferred that my party wishes to privatise our healthcare system. Those statistics show that, in our universal healthcare system, the Scottish Government is now effectively doing that itself. Private medical treatment was once the preserve of the very wealthy, but an increasing number of ordinary Scots are now using their life savings for cataract operations, hip replacements and knee arthroscopies, among other treatments. They do that having already fairly paid their taxes for the NHS during their working lives.

Let Reform state this clearly: we believe that the founding principles of our NHS—that it remains free at the point of need and is available to all—are non-negotiable. Anything else is misinformation. However, to protect those very principles, we must be honest that the current centralised structures of the NHS in Scotland are no longer fit for purpose. For decades, our health service has been weighed down by excessive, overlapping layers of bureaucracy, pulling vital decision making away from communities. We see the consequences of that every day: workers stretched to their limits while front-line services struggle with persistent implementation gaps that frustrate patients and staff.

However, despite my tone so far, I remain optimistic. The brilliance, compassion and dedication of our NHS workforce and the care sector that supports it remain unparalleled. The system is failing them, not the other way around. Imagine what we could achieve if we finally uncapped their potential by enacting real structural reform. Reform’s vision is rooted in a fundamental redesign that empowers practitioners at the local level. We must strip away inefficient administrative layers, stop pouring resources into duplicate management structures, redirect that to the front line and trust our GPs, district nurses and allied health professionals to design and manage patient pathways in their own communities. We also need an integrated health and social care system that truly prioritises prevention, expanding hospital at home initiatives and empowering community pharmacies so that families receive care where they need it most—close to home. I was pleased to hear that be discussed.

Let us be guided by this truth: the NHS do does not belong to the politicians; it belongs to the people of Scotland and to those who work tirelessly to keep it running. The Royal College of Physicians of Edinburgh and the BMA have called for cross-party consensus on that very issue and for radical reform. They know that change is not only possible but essential.

Hope cannot be only a passive feeling. It must be a deliberate choice. It must be the decision to look at the challenges that our health service faces, accept the need for honest change and build a system that finally unleashes the brilliance of our healthcare workers. Our amendment aims to do just that: it acts as an honest statement of intent, with the first necessary steps to make that happen through the setting up of an independent Scottish health and social care commission.

Let us work collaboratively across the chamber. Let us be bold, let us reform and let us build an NHS in Scotland that is a beacon of hope, innovation and compassion for generations to come.

Thank you for calling me, Deputy Presiding Officer. I welcome you to your new place, and I congratulate the minister on her reappointment.

It is a privilege to make my maiden speech in the chamber; I am deeply honoured to stand before members today as a newly elected Reform member for the Highlands and Islands electoral region. I offer my thanks to all those who made our successful electoral campaign possible, including our party director, our leader and the regional chair; all the candidates, activists and volunteers; and, of course, the voters who have put their faith in my party.

I also offer my thanks to all the staff and volunteers across Scotland who took on the role of tellers, for their admirable display of concentration and stamina for hours and hours as they counted votes one by one. They are an often-overlooked group at elections, but their contribution makes our precious democracy possible.

Like other members, I take this opportunity to congratulate our national football team on their qualification for the world cup—we offer them our best wishes for the campaign. I notice that the First Minister is not in the chamber. I wonder if he is sitting by the phone, hoping for a call-up from Steve Clarke for a place in the squad, perhaps in the position of striker—after all, his independence strategy has given him plenty of practice at kicking the can down the road.

In keeping with parliamentary tradition, I pay tribute to all my regional predecessors, regardless of their parties, who have served the region diligently. Although members here will inevitably hold different political views, we can all respect the hard work, dedication and long service that those former members have given to the people of the Highlands and Islands. I step into my role with a commitment to build on their efforts and to advocate for the needs of those communities, and I look forward to spending the next years travelling to every corner of the area to do just that. One thing is for sure: my camper van will not be spending much time on the driveway.

The Highlands and Islands is a region of unmatched breathtaking beauty—from the bustling streets of Inverness and the shores of Argyll to the furthest reaches of our island communities, it is a vast and diverse region. It gives Scotland so much: Ben Nevis, the UK’s highest peak; Orkney’s rich Viking history and fertile farmlands; the wool industry of Shetland and the Harris tweed of the Western Isles; the best whisky in the world—it is home to four of the five Scottish whisky regions; an encyclopaedia of tartans; and Highland dress itself. The Highlands and Islands give us not only world-class industry and tourist destinations, contributing much to our economy, but much of what we regard as our Scottish culture.

I am delighted to be in the chamber for my first debate, which addresses the Government’s motion on sport. I submit that discussion of that area is often overlooked in the ebb and flow of political discourse. Human beings have evolved to be active creatures, and our modern sedentary lifestyles have pulled us away from our natural state. As we have heard, an active lifestyle is an important tool in both the prevention and the management of mental health conditions and long-term physical conditions such as diabetes, obesity and cardiac problems, with all the costs that they bring to the taxpayer, the national health service and patients with lived experience. In the promotion of an active and healthy lifestyle, sport has a huge advantage over other elements of health strategy such as diet changes and habit cessation.

It is really good fun so long as individuals have equal and regular access to a wide range of different sporting activities to try, so that they can find out what works for them and what they enjoy most. It does not work if we simply force everyone to do one sport, or offer only a few; people need accessible infrastructure and opportunities to figure out for themselves where their passion lies so that they can see the benefits, keep up consistency and improve health outcomes.

I welcome much of what the minister said today—certainly in terms of her intention—and I salute her aspiration and ambition. However, my party’s main criticisms of Scotland’s 2026 summer of sport revolve around the risk of missing the most vulnerable low-income families due to hidden costs, and the economic instability of creating a one-off funding spike following years of stagnation.

Although we have heard the £20 million of investment being championed as a major milestone, sporting bodies, local councils and anti-poverty campaigners have raised critical concerns about structure. The programme mandates that councils prioritise families who face socioeconomic disadvantage, but critics argue that offering free or low-cost sessions is not enough to guarantee equal access, because there is a worry about hidden cost barriers. Even if a sports session is entirely free, low-income families still face steep secondary barriers, including the high costs of specialised sportswear or equipment if they want to take it on in the long term, and having to use expensive, unreliable public transport to get children to venues. Rural isolation also presents a disadvantage, which means that rural and remote low-income families are systematically sidelined. Although all local authorities have received funding, as we have heard, where localised extended overnight camps take place in, for example, Inverness or Oban, they will be functionally inaccessible to island families or isolated communities if transport links such as ferries or roads are not properly funded and maintained.

There is also a worry about nutritional shortfall. Although some regional programmes, such as that in Dumfries and Galloway, have attempted to integrate free food provision, there is no standardised nationwide mandate to ensure that all children are fed.

There are also criticisms of the long-term funding aspect. National sporting bodies have welcomed the funding injection, but point out that it highlights severe systemic funding flaws. Reform agrees that the initiative merely papers over the cracks presented by years of standstill budgets. Prior to this sudden overall cash boost, sports organisations in Scotland endured five consecutive years of standstill funding. The running on empty campaign led by sports governing bodies highlighted that years of inflation and flatlining budgets have left grass-roots sports facilities critically weak. Reform argues that this package provides a temporary Band-Aid rather than a sustainable financial model.

We face a cliff edge. The funding for the summer of sport is explicitly structured as a fixed, finite pool that is scheduled to run out by spring 2027. Club operators argue that wilfully spiking public interest via major events such as the FIFA world cup and the Commonwealth games will create a massive wave of youth demand that local clubs will lack the long-term infrastructure, staff or funding to support once the campaign ends.

Then we have the issue of volunteer burnout. The rush to roll out a massive, short-term, regionally focused programme relies heavily on volunteer labour and youth leaders. Sports analysts warn that, without sustained long-term funding to recruit and retain paid qualified coaches, this sudden pressure on local volunteer systems will make them unsustainable and it will risk the rapid burnout of those volunteers.

For those reasons, Reform UK has well-founded reservations about this initiative. It involves money that should be used to fund and expand our existing infrastructure and to promote grass-roots engagement and mass participation in order to achieve a wealthier, healthier Scotland. That is the vision of Reform UK, and it is an ambition that should be shared by all members across the chamber. There is a real danger that, in the way that it is currently structured, the initiative will look a lot like fee-free university tuition, and like the help-to-buy scheme that has just been announced, in that it will disproportionately benefit middle-class families at the expense of working-class taxpayers.

I am looking at my remaining allotment of time. Unless the Deputy Presiding Officer is willing to award me a generous, Celtic football club level of added injury time, I should probably come to a close. I will finish by saying this: as a Reform member for the Highlands and Islands region, I will strive to be a robust champion for our communities, always advocating the union as the bedrock of our peace and prosperity, now and in the future.

Let me be clear: if anyone from the SNP—be they a member, a minister, a cabinet secretary or a First Minister—comes to this chamber with fanciful, poorly thought through bills or motions, Reform UK will be here to scrutinise them, challenge them and send them homeward to think again.