Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, September 7, 2021

Official Report 932KB pdf

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Urgent Question

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Accident and Emergency Departments (Waiting Times)

To ask the Scottish Government what immediate action it will take in light of the record high waiting times in accident and emergency departments during the last four weeks.

The pandemic has brought unprecedented pressure to bear on our national health service, our hospitals and our accident and emergency departments. That is why we invested an additional £12 million earlier in the summer to support non-Covid emergency care, and why we have set out our ambitious NHS recovery plan to increase capacity; that plan is backed by £1 billion of investment.

In addition, to help to address the challenge, we have established a systems response group, which is chaired by NHS Scotland’s chief operating officer, John Burns. That group of health and care professionals is working on the ground to help to improve systems and performance. Its work will include re-establishing previous good practice, such as on hospital discharge, and optimising flow through hospitals, which creates additional bed capacity.

We have provided an additional £20 million to the Scottish Ambulance Service, which is accelerating work with health boards and integration joint boards to enable more people to be helped by non-emergency department options, in cases for which that is safe and appropriate.

Over the next few weeks, boards are also further boosting staffing levels, which are at a record high, to help put measures in place to reduce waiting times for urgent or emergency treatment and are increasing available bed capacity.

I am grateful for that reply. The cabinet secretary may reference the pandemic, but this is a problem to which the SNP Government was unequal long before anybody had heard of Covid-19. More than a quarter of people attending A and E experience painful waits of more than four hours when they need help the most. In a country that prides itself on its health service, that is utterly depressing.

The percentage of people not being seen in time has reached record levels in each of the past four weeks. Health boards are actively warning people to stay away. The cabinet secretary referred in his response to funding that was made available three months ago. What will the Scottish Government do to make changes this week to ensure that those people do not have to wait?

I will go into some detail in response to Alex Cole-Hamilton’s question. However, listening to him, you would have no idea that there was ever a pandemic. You would have no idea that the NHS has just suffered, and is suffering, the biggest shock in its 73-year history.

A range of factors impact A and E performance. To think that we can look at A and E in isolation is incorrect. We have to look at the whole system of the NHS in order to help alleviate some of the significant pressures. A and E performance is not where I would like it to be—understandably so, given what I have just said about the pressures of the pandemic. However, despite those pressures, it is still the best performing A and E department in the entire UK.

On what we are doing, that £12 million investment is helping our boards to increase staffing at a local level, increasing bed capacity and providing additional transport options to improve flow in and out of hospital. We expect to see the impact of that in the coming weeks. However, I cannot wave a magic wand. I will not treat the public like fools and pretend that somehow we can simply wave a magic wand and the effects of the pandemic will suddenly disappear.

It is incumbent on us all, particularly the leader of an Opposition party, to recognise the seriousness of the challenge and come together. Where there are good suggestions from the Opposition, I will of course look to implement them.

The cabinet secretary is treating the Scottish public like fools. He expects them to believe that the waits in A and E are caused solely by the pandemic. We know that they are caused by an interruption in flow throughout the health service caused by a paucity of social care to receive people from hospital in-patient beds.

The ripple effects are catastrophic. Ambulance waiting times are off the charts. Waits are excruciatingly long. Two weeks ago, a pensioner in Edinburgh reportedly waited 16 hours for help to arrive. Staff are working tirelessly, but they need more. In addition to dealing with the waits at A and E, what immediate action will the cabinet secretary take to address the pressure on ambulance crews?

Alex Cole-Hamilton really needs to make sure that he is grounded in reality. He is not acknowledging that the pressures of the pandemic affect not only A and E. He referenced social care—is he seriously suggesting that social care has not been impacted by the pandemic? Of course it has, which is why we are investing in every single part of the NHS. We are investing £80 million this year in order to address some of the effects of the pandemic.

We are investing an additional £20 million in the Scottish Ambulance Service, because we recognise the pressures that the pandemic has put on that part of the system. Last week, in the last recruitment tranche, it recruited 60-odd additional ambulance staff to help in the north and north-east of the country.

We will continue to invest right across the NHS, but if there are real tangible suggestions from the Opposition, Alex Cole-Hamilton will find that I have an open door to listening and working collaboratively with him or other members of the Opposition. However, let us not make false promises to the public who are listening. We will invest and put in the effort to tackle backlogs, but we also have to be realistic as much as we are ambitious.

There are record A and E waiting times, record ambulance waiting times and record waiting lists. There is also a serious NHS staffing crisis in Glasgow, leading to all non-essential surgery being cancelled across Glasgow today—all non-essential surgery has been cancelled—increasing waiting lists. Will the cabinet secretary explain what he will do to address this crisis?

Not only do we have record levels of staffing in Scotland, we have the best-paid NHS staff of anywhere in the United Kingdom.

Difficult decisions are being made by NHS boards up and down the country. Those decisions are not being made easily or lightly; they are having to be made, to make sure that we can provide the urgent care that is absolutely necessary.

We still have a large number of people with Covid-19 in our hospitals—more than 800 people are currently in our hospitals with Covid-19—at a time when our NHS is remobilising.

What will we do? We have launched our NHS recovery plan, which looks to increase capacity by 10 per cent—[Interruption.] I heard a Conservative member shout, “Flimsy”; it is not so flimsy, given that the member’s party has copied that 10 per cent target. The plan is backed by £1 billion of investment, which is £400 million more than the Conservatives have committed.

We will make that investment, but I say again: let us not take the public for fools; it will take time to recover and remobilise our NHS, particularly as we are still in the midst of a global pandemic.

Dr John Thomson, vice-president for Scotland of the Royal College of Emergency Medicine, said in July:

“the Emergency Medicine workforce in Scotland is not adequately staffed to deliver the highest quality patient care. This has led to an increase in intense pressures on the existing workforce and is very likely to be a contributing factor to the continued deterioration in performance.”

He went on to say that

“before the pandemic, the increase in demand put ... pressure on staff”,

and it was a

“struggle to meet the four-hour”

target.

Given that A and E pressures in summer are resembling those in mid-winter, given that the NHS recovery plan has been met with scepticism by the British Medical Association and the Royal College of Nursing, and given that we have the worst waiting times since records began when this Government took office, is it time that the cabinet secretary stopped denying that there is a crisis, acknowledged that the crisis is on his Government’s watch and started listening to the serious and real concerns of the people who know best, that is, the doctors, nurses and workers on the front line?

What is disappointing from Paul O’Kane is, again, that he made no acknowledgment at all that there has been the biggest shock in the NHS’s entire 73-year history. In its entire 73-year history there has been no shock to the system like this one.

We are proud of our record of making sure that we have the best-paid NHS staff here in Scotland, compared with any other UK nation, the best terms and conditions and record staffing levels under this SNP Government—[Interruption.]

Can we hear the cabinet secretary, please? I would like to hear him.

We will continue to invest. We will continue to make sure that staffing levels are high and that staff are paid better here than they are anywhere else in the entire UK.