Chamber and committees

We touched on this earlier, but my final question is on what happens next. You said that you had started discussions with the UK Government. How concerned are you about funding for future growth deals, bearing in mind that, in September 2024, the UK Government paused the funding for the Argyll and Bute deal? The funding has since been reinstated, but it was paused. Moreover, when Ian Murray was in front of the committee, he would not guarantee multiyear funding. How concerned are you about any new deals, given those two indicators, which suggest that they might not be possible?

I remind members that my wife is an NHS nurse.

Our NHS staff are fed up with the health service being used as a political football, and with the constant negativity from the opposition parties and their friends in the mainstream media, who continue to undermine patient and staff confidence in our NHS. It may be that that is what this debate is all about: that will come as no comfort to staff or patients.

There are challenges in our NHS, but let us put them into context, because all NHS trusts and health boards across the UK face challenges. NHS England has 7.5 million people on waiting lists and, in October, NHS Wales hit a record number of 800,000 people on waiting lists. So much for Labour having all of the answers—it cannae implement them in Wales.

In May 2007, the SNP came to power and was immediately met with the global financial crisis, as global banks collapsed and UK Government debt soared under Labour, which ushered in 14 years of Tory austerity. Cuts to public spending and welfare exacerbated inequality and increased levels of poverty and ill health which, in turn, put more pressure on NHS finances and waiting times.

In 2016, Tory Brexit happened, which brought uncertainty in our relationship with the European Union. Changes to immigration patterns created labour shortages, especially in our health and care sectors: Home Office stats highlight that there has been an 83 per cent drop in health and social care visa applications.

If that was not enough, we then had the Covid-19 pandemic in 2020 and 2021, which led to lockdowns, NHS staff falling ill and wards closing in order to stop infection spreading. The result was more delays and increased waiting times.

The inflation and cost of living crisis, which started in 2021 and continues to the present day, and which was caused chiefly by substantial energy price increases, has impacted the NHS budget. There is also the Labour job tax of around £140 million for the NHS, which is still to come, from April.

Those difficulties continue to this day, but it is more important to ask what the SNP has achieved against the backdrop of economic crisis that has been caused by Westminster mismanagement. First, it has doubled the NHS budget, from £9 billion in 2006-07 to £19 billion this year, with an additional £2 billion in the provisional budget for next year. We should compare that to Rachel Reeves’s decision last August to inform the Department of Health and Social Care in England that it had to find around £1.3 billion of savings in advance of the budget.

NHS Scotland’s staffing levels have benefited from a long-term trend of workforce investment and growth. Since the SNP took office, there are 31,300 more doctors, nurses and other staff working in Scotland’s NHS, which is an increase of nearly 25 per cent since 2006.

Qualified nurses on band 5 have a higher salary than those south of the border do, and nurses do not incur tuition fees when they are training and do not pay hospital parking fees. That is why the Scottish Government has been able to increase student nursing numbers every year for the past decade.

There has been capital investment in new hospitals, including the Royal hospital for children and young people in Edinburgh and the Queen Elizabeth university hospital in Glasgow, which is the biggest hospital in the UK, with 1,667 hospital beds.

Let us take stock of where we are in Scotland’s NHS. We have record health spending, the best-paid NHS staff in the UK, the highest number of qualified nurses and midwives in the UK, the highest number of GPs in the UK and the best A and E services.

Ninety-five per cent of people are registered for NHS dental care, which is the highest percentage in the UK. We have free prescriptions, 96 per cent of all hospital discharges happen without delay and hospital at home services have been expanded, thereby ensuring that older Scots get the care that they need at home.

Yes, there are challenges, but there has been progress. Under the SNP, there is a healthcare system that is more resilient, more compassionate and more determined than ever to serve the people of Scotland.

No.

In my Edinburgh Pentlands constituency we have seen, since 2011, investment in primary care, with new doctor surgeries in Colinton Mains, Ratho and Wester Hailes. People in Edinburgh also welcome the fact that the proposed budget includes funding to progress the replacement for the Edinburgh eye pavilion.

On NHS waiting times, an Office for National Statistics survey that covered the UK asked:

“Are you currently waiting for a hospital appointment, test, or to start receiving medical treatment through the NHS?”

In Wales, 29 per cent of people were on a waiting list. In England the percentage was 25 per cent, but in Scotland it was 22 per cent—the lowest in the UK.

Compared with 2019, more people are being seen within the CAMHS waiting time target, in psychological therapies more are being helped with drug and alcohol dependencies, and more people are being seen within the cancer diagnosis and starting treatment targets.

In accident and emergency departments, no healthcare service anywhere in the UK has hit the four-hour waiting time target; however, the ONS analysis confirmed that NHS Scotland has had the best performing A and E services in Britain for well over a decade. That is backed up by NHS Scotland, which highlighted that in the year to September 2024 more than 1 million patients were seen within the four-hour target.

Another aspect of the situation is the ability to attract the right mix of skills and labour to fulfil a contract. Unemployment in Scotland is lower than in the rest of the UK, so are businesses able to attract the right quality of staff to fulfil a contract?

Can you say which deal that 75 per cent figure that you have given relates to? Do you have numbers for all 10 deals that are currently up and running?

I will not mention national insurance increases—[Laughter.] Does Duncan or Carolyn want to add anything?

Can you expand on that? I am looking at the evidence that we received from the supplier development programme, which 23,000 people have registered with. The Edinburgh and south-east Scotland regional deal had 1,400 people attending a meet the buyer event. In your submission, Vikki, you say:

“We recently obtained data which shows incredibly encouraging procurement figures for one of the CRDs. The deal in question shows that local spend averaged at 75.2%.”

I know that you said that there is a mixed picture, but where is the good practice? Is it specific to certain areas?

You have talked about the massive opportunities that are available to your members in the 10 existing city deals and the two new ones that are on the table. Once your members win a contract, how do they go about fulfilling it? These days there is an awful lot of discussion about value engineering, which is about trying to produce a project that was envisaged 10 years ago under today’s cost pressures. For example, there is the pressure on the tender price as general inflation pushes up the cost of labour and materials. If we look at the Glasgow deal, we can see that £100 of purchasing power now needs to be £135. I am keen to understand how your members cope with general inflation and construction inflation when they are trying to fulfil what they signed up to a few years ago.

Duncan Thorp talked about massive opportunities, so I will go to him first.

Tory Brexit has had a detrimental effect on people and businesses throughout rural Scotland. Unfortunately, the Labour United Kingdom Government is continuing the economic vandalism of Brexit. Does the Scottish Government possess data on the cumulative impact of Brexit on rural Scotland across the five years since it occurred?