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Chamber and committees

Meeting date: Thursday, October 26, 2017

Meeting of the Parliament 26 October 2017

Agenda: General Question Time, First Minister’s Question Time, Scottish Disability Sport, Science, Technology, Engineering and Mathematics Strategy, Diet and Obesity Strategy, Hydro Nation, Parliamentary Bureau Motions, Decision Time


First Minister’s Question Time

National Health Service

This morning’s Audit Scotland report says that reform of the national health service is progressing, but that major challenges still lie ahead. Nobody underestimates the work that is needed to see services improve year on year within our health service, but the bottom line is that seven out of eight key performance standards have been missed this year. Will the First Minister confirm how many of the performance standards have seen any improvement over the past five years?

Of course in England, under the Conservatives, the figure is eight out of eight. [Interruption.]

Let me address directly the Audit Scotland report. For completeness, I will point out some of the findings that I suspect we will not hear about from the Opposition today.

First, NHS staff are maintaining and improving the quality of care. Secondly, there is

“a strong culture of continuous improvement in the NHS”


“there is a continued focus on safety and improvement.”

Levels of patient satisfaction are at an “all-time high”, and there are signs that reforms are having a “positive impact”. The report also points out that, since 2008, there has been an 8.2 per cent above-inflation increase in spending in the national health service, and that health today accounts for a higher proportion of the Scottish Government budget than it did in 2008.

As we know, and as is the case in every health service across the developed world, changing population patterns mean that there are rising demands on our health service. However, in meeting those challenges—they are big challenges—we are seeing the NHS in Scotland perform better against many measures than the NHS in any other part of the United Kingdom performs. That is because of the actions that we are taking: increased investment in the NHS, reform including integration of health and social care, the focus on realistic medicine, and the work that we have done on accident and emergency services and are now doing in elective care more generally.

This is tough stuff—nobody denies that—but we will continue to focus on delivering the investment and reform that the NHS needs and that patients across the country deserve.

The answer to my question is—according to Audit Scotland—one: in only one of the eight key performance indicators has there been any improvement at all in the past five years. Audit Scotland says that the reason for that is that the Scottish Government is still struggling to do the basics.

One of the big issues is staffing. Audit Scotland warned two years ago that we needed a new national approach to workforce planning. The Scottish Government promised to deliver one by early 2017. That one then grew to three—two of which we are still waiting for. According to Audit Scotland, the only one that has been published is not a plan at all. What is more, the Auditor General makes it clear that there is no likelihood that the Government will be able to produce a proper plan because it still does not have the data with which to do so.

Audit Scotland has been warning about this for years, so why is there no proper plan in place and why is there not the data that would allow one to be written?

The Audit Scotland report points to the improving data that we now have—not just in the acute service, but across primary care—which allows us not just to monitor trends in the NHS, but to drive improvement. That is one of the specific things that the Audit Scotland report points to as being a sign of positive improvement.

I will make this point seriously. I accept the challenges in the health service and I absolutely accept the responsibility of the Government, which I lead, to face up to and address those challenges. However, Ruth Davidson seems to be saying that the challenges in Scotland’s NHS are unique to Scotland and that they are, somehow, uniquely down to this Government. If she is saying that, she has to explain why, under the Conservatives in England, no NHS targets are being met. That is a serious question for the Conservatives.

On staffing, a plan has, as Ruth Davidson is aware, been published that looks specifically at NHS staff. One of the pieces of legislation that we will take forward in this session of Parliament is a bill to enshrine safe staffing levels in law—something that no other part of the UK is doing.

However, it is increasingly the case—anybody who knows anything about how health services are delivered these days knows this—that we cannot look at the NHS in isolation. Therefore, the second and third parts of the workforce plan for the NHS and health services more generally will also look at social care and local authority staffing, so that we can bring together an integrated plan that will map out NHS staffing needs not just for now, but for the years to come. That is the right way to do this and it is what we will continue to do.

My final point on staffing is a point that I have made before and will continue to make. One of the biggest risks that we face in Scotland generally, and in the NHS in particular, is the growing inability to recruit people into our public services. Why is that? It is because the Conservatives want to stop or restrict our ability to recruit the best and brightest people from other countries. It is one of the biggest risks that we face in recruitment, and Ruth Davidson should be ashamed of herself for supporting it.

I will just quote a little bit of what the Auditor General says specifically on the issue that the First Minister has tried to sweep under the carpet. It

“is not a detailed plan to address immediate and future issues ... The Scottish Government is likely to find it challenging to provide any more detail in the next two plans. This is due to a lack of national data on the primary care and social care workforces”.

The data is not there and the plan is not there.

Let us talk about one area where that lack of workforce planning is having a real and immediate effect: primary care. Audit Scotland makes it clear that general practitioners are “central” to the changes that we all agree are needed to improve healthcare. However, that has been hindered by the continuing difficulties in recruiting and retaining family doctors.

The Royal College of General Practitioners has today made the situation clear: it has written that the Scottish National Party Government has over the past decade consistently cut the percentage share of health spending that goes directly to GPs, and it asks how hospital targets can possibly be met when people feel that they have to attend A and E because they cannot secure an appointment closer to home.

Does the First Minister have an answer for the Royal College of General Practitioners?

First, on staffing, it is precisely because we need to make sure that there is an integrated plan, not just across the acute health service, but in primary care and social care too, that we are developing the workforce plan as we are. We are doing it in the way that I think Audit Scotland would advise us to do it. That is why we will continue with that work.

Scotland is not the only country that is experiencing challenges in recruiting GPs. That is why we are taking a range of different actions, from increasing the number of medical training places in our universities to establishing a new graduate entry programme that will focus specifically on general practice and, of course, on rural and remote areas working.

This year, we have seen an increase on last year in the fill rate of year 1 trainees. For the same point in the year, last year the rate was 65 per cent: it is up to 74 per cent this year. We have, of course, made a commitment to increase the proportion of the total health budget that goes to primary care by £500 million over the current session of Parliament, which will take it to 11 per cent of the total NHS budget. I think that that, again, is a greater commitment than has been made by any Government anywhere else across these islands.

They are big challenges, and anybody can stand here—as Ruth Davidson has done—and point to them. I accept those challenges; this Government is putting in place the actions to address them, and that is what we will continue to do.

I am standing here calling on the First Minister to honour the promise that she made to GPs a year ago. I am standing up for GPs, who are saying that she has gone back on her word and that that promise is not being kept.

Today, we have a report from the nation’s auditor saying that health in Scotland is not improving, that huge inequalities remain and that there has in the past year alone been a 99 per cent rise in the number of outpatients waiting more than 12 weeks. The SNP set its own targets to make things better, but it has improved in only one, in the past five years. We know that there is no long-term plan, even although one was promised for the start of the year, that GPs are being underfunded and that we spent £171 million pounds hiring agency staff to plug the gaps.

Yesterday, I met a group of fantastic trainees at the University of Edinburgh medical school. What reassurances can the First Minister give them, that after 10 years of Audit Scotland reporting the same failings on health by her Government, she has taken some action to turn that around?

There were a number of points to take on in that question.

First, agency spend is down in the past year, which is recognised in the Audit Scotland report. We are taking a range of actions to ensure that we have the right people coming into medical training and that we can get them into the NHS to deliver the excellent care that the NHS delivers for patients across the country. Again, I remind Ruth Davidson that the Audit Scotland report points to the fact that NHS staff are not just maintaining, but are improving the quality of care across our NHS.

I do not know whether Ruth Davidson understands the detail of the commitment that we have made to primary care; she said that we have not kept to the commitment that we made last year. Let me tell her what that commitment is. Over the current session of Parliament, we will increase spending on primary care by £500 million, of which £250 million will be spent specifically on general practice. The reason why not all that money will be spent on general practice is that in order to take pressure off our GPs, we need to build wider primary care teams. That is the commitment, and it will take the proportion of NHS spend on primary care to 11 per cent. It is a commitment that we will deliver over this session of Parliament. As I have said, that commitment has not been repeated by any other Government across these islands.

We come to the central point that we so often come back to when we discuss public services in the Scottish Parliament. Since we came into office, the Government that I lead has increased the health service budget by £3 billion—that is recognised in the Audit Scotland report.

Week after week, Ruth Davidson stands up and calls for action on health and education, and across the range of our public services—the same Ruth Davidson who would reduce the amount of money that we have available for public services by giving tax cuts to the richest people in our society. It does not add up: Ruth Davidson cannot offer tax cuts to the richest while calling for more investment in our public services. The Tory policies and the Tory approach have no credibility at all. We will continue to deliver investment and reform.

The most important finding in today’s Audit Scotland report is the one that says that the reforms that the SNP Government is introducing are starting to show the positive effects that they were designed to deliver. We will continue with that focus on delivering for people across the country.

National Health Service

It is worth remembering that a few weeks ago, Professor Jim Gallagher published a report that showed that spending per head of population in Scotland compared to England has fallen as a direct result of decisions made by the Scottish Government.

Anyone reading the report from the Auditor General on our national health service in Scotland cannot be anything but concerned. They will be concerned about the budgets and the financial management of health and social care, about the shortages of staff at every level and about the impact of all that on patients. The report clearly states that the patient experience will get poorer unless the pace and scale of necessary change are actioned now. When will we see that level of change?

As any reading of the Audit Scotland report will tell us, we are seeing that change happen in the NHS. That is one of the key findings of the Audit Scotland report. One of the key points in the report, looking specifically at integration authorities, is that the reforms that we have introduced are now starting to deliver the change that we need to see.

Spending on the health service in Scotland per head of population is 6.5 per cent higher than that for the United Kingdom as a whole: £143 higher for every person in Scotland, compared with the rest of the UK. I frequently make this point, but all parties have to be accountable—certainly my party as the Government party has to be—for what they put forward. Labour went into the most recent Scottish election promising less money for the health service than any other party—even the Tories, for goodness’ sake—represented in the Parliament.

The fact of the matter is that record funding is going into our health service and record numbers of people are working in it. However, as Audit Scotland expressly says in its report, it is no longer enough just to put extra money into the health service because of the rising demand: we need to deliver reforms. Those are the reforms that we are delivering and which, according to Audit Scotland, are now starting to show real benefits to patients across the country.

However, if we stick to the facts, health boards across Scotland are not able to make the cuts to balance their budgets. Those same boards are then borrowing money from the Government to balance the books, storing up debt for the future. Prescribing costs are increasing at a level that is not sustainable. Indeed, we now have council tax funding being used to pay for prescriptions through the integration joint boards. The lack of workforce planning is driving up costs and we are having to use more and more agency staff and locums. The whole thing is spiralling out of control. The Royal College of Nursing is today calling for clarity on how more care will be delivered in the community, and it wants to know how staff and the public will be engaged in the development of community services. Can the First Minister answer that question?

I am not quite sure which one of those questions Alex Rowley wants me to answer first. He said that prescribing costs are rising, but they are rising in every health service across the developed world and probably across the entire world: it is a feature of the ageing population. That is exactly the challenge that health services here and elsewhere are dealing with. That is why we have to reform how care is delivered.

Alex Rowley asked about how we deliver more care in the community. As I am sure he knows, for the past two budgets—again, this is narrated in the Audit Scotland report—we have taken the very difficult step of transferring money from the NHS into integration authorities so that we bring together health and social care not just in theory but in practice. Again, the Audit Scotland report talks about the reduction in delayed discharges that the integration approach is now delivering. If we do that to build up social care, we take the pressure off the acute services.

I say to all the parties in the Parliament that this is not easy stuff; it is not easy in Scotland and it is not easy in England, Wales, Northern Ireland or in any part of the world. However, in Scotland, we are doing some of the necessary stuff that is still being dodged in most other parts of the UK. We are doing the reforms. We are integrating health and social care, transferring the budgets and taking the steps around the workforce that will ensure that our NHS can deliver in the face of the rising demand that it faces. That is why, although everything that the Audit Scotland report says is important and has to be addressed, the key finding of the report—in my view as First Minister with responsibility for the reforms—is that the reforms are starting to show positive signs. That says to me that we stick with what we are doing, because we are on the right track and that is why we keep that focus.

I accept totally that this is not easy. I think that the Audit Scotland report says today that we are not doing enough and we are not moving fast enough. However, it is important for us to remember that behind all these statistics are real people. Today, we should remember that it is about people who are trapped in hospital because they cannot get the care packages that they need in the community. It is also about those people and communities up and down Scotland who cannot get the support from health and social care that they need, and it is about all those people who are on waiting lists. It is about the dedicated staff in our hospitals, our health centres and our community care centres who are run off their feet. That is why we need action. Labour will use our debate in the Parliament next week to discuss the Audit Scotland report further, because I believe that we need a more detailed discussion on its findings.

After 10 years in government, the First Minister has a choice. Will she continue to do more of the same or will she publish a response to the report that tells the people of Scotland how her Government intends to tackle the big issues that are facing our health and social care services?

First, I warmly welcome the fact that we will debate the report. In that debate, if Labour’s position is that the Government is not doing enough, maybe Labour will bring forward some ideas as well, rather than simply talk about the problems.

Secondly, the whole point here—which, again, any reading of the Audit Scotland will tell us—is that we are not just doing more of the same. We are doing things differently, and it is those reforms that are starting to have the positive impact that the Audit Scotland report talks about.

Alex Rowley says that we should do it faster. Do you know what? I am absolutely open to doing this faster, but often, when we bring forward proposals for change, we find that the impediments to that change sit on the Opposition benches, because they never want to do the tough stuff. [Interruption.]


It is the easiest thing in the world to get up and diagnose the problems. Our job—and this is what we are doing—is to come up with the solutions.

I will tell Alex Rowley what we will not do. We will not do the daft and wrong-headed things that we are seeing south of the border. With the action that we are taking in Scotland, delayed discharges are coming down because of sensible change. In England, we see proposals to use Airbnb to rent accommodation from local residents to get old people out of hospitals.

We will continue to do the sensible, evidence-based things that deliver the improvements in our NHS that we are determined to continue to deliver.

We have a couple of constituency questions.

A75 and A77 (Dualling)

The A77 was closed for 24 hours over the weekend due to severe flooding. Paul Grant, Stena Line’s trade director, said:

“It’s quite clear from this and other incidents that the current A77 and A75 don’t reflect the requirements fitting of a major UK-Ireland travel and freight hub so I’m afraid that major disruptions and loss of trade could be a feature of life in the region until those responsible commit the necessary resources to alleviate these recurring problems.”

Will the Scottish Government make this long-overdue commitment to the people of the south-west of Scotland and dual the A75 and A77?

We have a range of improvement plans for our roads in the south of Scotland, as in all parts of Scotland. I am sure that all members will appreciate that there will be times when issues such as flooding will result in a road being closed. That is deeply regrettable, but it is sometimes unavoidable.

I will ask the Minister for Transport and the Islands to write to the member in more detail about the specific issue that he has raised, but I think that anybody who looks at the record of this Government—in fact, the Greens often criticise us for it—would say that the investment that we have made in improving our roads over the past 10 years is a good one, and we will continue to do more, including in the south-west and in particular the area that the member talks about.

Freight Ferry Fares

The First Minister may be aware that the conclusions of the Government’s review of freight ferry fares, which was due out by the end of the summer, has still not been published. Pending the outcome of that review, hauliers in the northern isles were told last month that freight fares would be frozen. A week later, they received notice that fares would rise by 2.9 per cent next year.

How does the First Minister justify that decision? How does it square with the Government objectives of bearing down on the cost of living for islanders and indeed support for Scotland’s food and drink sector? Does she believe that it is right that, as Audit Scotland has highlighted, freight fares paid by hauliers on west coast routes have remained largely unchanged since 2010 but fares have increased significantly for hauliers that serve businesses and residents in Orkney and Shetland?

Of course, we have invested over £1 billion in our ferry services since 2007. We have been talking about a particular Audit Scotland report. There was an Audit Scotland report out last week that said, I think, that the investment in ferry services had doubled over the past decade. We have introduced new routes as part of that investment, we have already cut fares for CalMac customers and we will shortly be doing the same for Orkney and Shetland, which I know that the member will welcome. We have tackled long-standing underinvestment and we will continue to do so. The ferry fares review will be published as soon as possible.

Health and Safety at Work

The First Minister will be aware of the recent gas explosion at a derelict building in Lanarkshire that resulted in the tragic death of worker Pawel Urbanski, who was from Coatbridge. Will the First Minister outline how she will support the investigation and what steps she is taking to enhance health and safety at work regulations in Scotland?

I take this opportunity to express my deepest sympathies to those who have been affected by what was a very tragic incident and particularly to the family of Pawel Urbanski. Under the direction of the health and safety division of the Crown Office and Procurator Fiscal Service, the investigation into the death is on-going, and the family will be kept updated on any developments. It would be inappropriate to comment further while the investigation is under way.

The regulation of workplace health and safety is reserved to the United Kingdom Government, and the Health and Safety Executive is responsible for drawing conclusions from health and safety incidents as to whether relevant regulations remain fit for purpose. I am sure that the HSE will do that once it has completed its investigation into the incident. In the meantime, I am sure that the thoughts of everyone in the chamber are with the family and friends of the individual who lost his life in the incident.

National Health Service (Pay Settlement)

Nobody who has looked at today’s report on the challenges that the national health service faces should pretend that there is a simple quick fix that would solve every problem at a stroke. However, is it not clear that challenges such as recruitment, retention and staff morale will be made worse, not better, if we fail to provide a fair pay settlement for the dedicated professionals who provide these essential services, who have seen a real-terms pay cut of 14 per cent over the past five years?

Yes. That is why the Government is committed to ensuring fair pay settlements for public sector workers not just in the NHS but across our public sector. Again, I say that I think that we are still the only Government in the United Kingdom that has given an unequivocal commitment to lift the 1 per cent public sector pay cap.

The commitment has been given to lift the 1 per cent pay cap, but no commitment has yet been given to an inflation-based increase—a real-terms increase to restore the lost value of pay that people have suffered over recent years. However, the Scottish National Party’s Kate Forbes, who works closely with the finance secretary as his parliamentary liaison officer, said on television this week that the pay settlement for the public sector should be

“at least inflation, if not above inflation”.

We have also heard a wider range of voices from multiple political parties accepting the basic Green proposition that fairer rates and bands of taxation can raise adequate revenue to fund our public services without resulting in cuts elsewhere and without cutting the pay of public sector workers. I do not expect the First Minister to publish her budget today, but does she agree with the basic point of principle that, through fairer taxation, we can provide an inflation-based or above-inflation increase without hitting low earners?

We have given the commitment to lift the public sector pay cap. We have not made that dependent on actions being taken by the UK Government in the budget, unlike the Welsh Government, which has done exactly that. We have said—and I have said personally—that we must seek pay settlements that are fair. Of course they must be affordable, but they must also reflect the real-life circumstances that public sector workers face, which include the rising cost of living.

In the normal course of events, we will confirm the detail of our public sector pay policy when we publish the budget, because we require to know the overall budget that we have available to us before we do that. That is the normal way in which we do things, and we will continue to set out policy in that way.

The other part of Patrick Harvie’s question focused on tax. I have said openly that, notwithstanding the parties’ different manifesto commitments, as a Parliament we require to come to a consensus position on tax in order to pass a budget. Given the continuation of austerity and given the implications of Brexit, which are becoming clearer by the day, we as a Parliament need to ask ourselves how we will use our still-limited tax powers to protect our public services and provide the infrastructure that businesses need to thrive.

Next week, we will publish a discussion paper that sets out some of the options and principles that should guide that decision. That paper will form the basis of the discussions that we will have across the Parliament in the lead-up to the budget.

I suppose that that is a long way of saying that I agree with much of the sentiment behind Patrick Harvie’s question, but the fact is that we have to take proper decisions in line with the proper process of budgeting. Unlike the Opposition parties, the governing party in any Parliament has the responsibility of making sure that we can pay for the commitments that we make.

Colleges (Part-time Courses)

The Government’s policy of prioritising full-time college courses has resulted in a cut of 150,000 part-time places and deprived thousands of people—particularly women and older people—of the education that they want and need. Last week, the Minister for Further Education, Higher Education and Science sent a guidance letter to colleges with an apparent change in policy that had never been announced publicly. Has the policy changed and, if so, when exactly did that happen? (S5F-01627)

I think that the most recent figures show that the majority of college courses are still part time. However, I should point out—we set out this commitment in a manifesto—that, given the rate of youth employment that we faced at the time, we made the deliberate, and right, decision to try to increase full-time places in colleges in order to increase the likelihood of people who were going through our colleges getting into work at the end of their courses. Do you know what? The proof of the pudding is in the eating, because youth unemployment in Scotland today is half the rate that it was 10 years ago, when we took office. In fact, we have one of the lowest rates of youth unemployment not just in the United Kingdom but anywhere across the European Union.

The policy that we ask our colleges to pursue depends on the needs of the economy at any given time, and that is the basis for the guidance that the minister put forward, which Willie Rennie referred to. We have taken the right decisions in our colleges, and we see the evidence of that in the economic data that I talked about.

So nothing has changed—but everything has changed. [Interruption.] That is a bizarre answer. Has the policy changed or not? If it was such a success story, why did the First Minister’s minister sneak it out in paragraph 7 of a letter on a wet Wednesday afternoon? Surely if it had been a success, she would have been parading it in the Parliament. Everyone knows that the birth rate at the turn of the century is more responsible for the drop in youth unemployment than any policy of the Government.

The truth is that it has taken six years for the Government to realise the economic value of part-time learners over the age of 24. This is a crashing U-turn, and the First Minister should be big enough to admit it. Six years of narrowing the focus has left us short; we have had six years of missed economic opportunity and six years of those in the chamber who dared to question the policy being abused. Will the First Minister apologise to the generation of women and older people who have lost out because of this Government? [Interruption.]

Willie Rennie—[Interruption.]

Hang on a second—order, please. [Interruption.] Order, please. I would appreciate it if members listened to the question and then the answer.

The fact that his pals on the Opposition benches felt the need to give Willie Rennie so much help there suggests that they know how fundamentally wrong he is. I will not apologise for the fact that youth unemployment is now at half the rate that it was when the Government took office, nor will I apologise for the fact that we fought an election on a manifesto commitment to maintaining full-time-equivalent numbers in our colleges—and that we did not just meet that commitment but exceed it. Those are solid achievements.

The flaw in Willie Rennie’s question is that, despite the commitment, which was delivered, to increase the number of full-time college students in order to get more young people into work, the majority of courses in our colleges continue to be part-time courses that are open to the very people Willie Rennie is talking about.

In colleges and in every other aspect of Government policy, we will continue to take forward the policies that are right for this country’s needs. That is what we have done and it is what we will continue to do.

Universal Credit

Today’s Daily Record has figures showing that a quarter of Scottish councils are already spending almost £9 million mitigating the impact of universal credit. Does the First Minister agree that the impact on people who are left in dire financial straits because of universal credit is morally unacceptable, and does she agree that the idea that local authorities or the Scottish Government should have to pay the price for failed Westminster austerity is a disgrace?

The fact that the United Kingdom Government is refusing to pause the implementation of universal credit, even though it knows that it is pushing already-vulnerable people into debt and rent arrears and is making it difficult for parents to put food on the table to feed their children is not only morally unacceptable, it is morally repugnant, and I think that every Conservative should be deeply ashamed of that.

The fact of the matter is that universal credit is not working. That is being demonstrated in the pilot areas. I have spoken before about the visit that I made to Inverness, where I talked directly to people who found themselves in these unacceptable situations. There needs to be a pause to universal credit now, before any other person has to suffer the indignities and anxieties that many have already suffered.

Again, we come back to the issue of mitigation. As people across the chamber know, we should mitigate where we can, but we should not have to spend money that should be getting spent on education, health or colleges mitigating welfare cuts that are implemented and imposed by a Conservative Government in Westminster. The sooner that we get all of the welfare powers into the hands of this Parliament, the better.

Scottish Fire and Rescue Service

Does the First Minister believe that cutting yet more firefighter posts and closing fire stations will a) make our communities safer or b) put more lives at risk? If she does not know the answer, she can have a guess.

Sometimes you only have to listen to Neil Findlay’s tone to understand why Labour is in the dire straits that it is in. It is shockingly bad.

First, I want to take this opportunity to thank our firemen and firewomen across the country for the essential and vital work that they do. It is in recognition of the importance of that work that the Scottish Government has this year increased the operational budget of the Scottish Fire and Rescue Service. Since reform, there have been no compulsory redundancies and no fire stations have closed. In fact, over the past year, 100 new firefighters have been recruited.

However, like any other service in the public sector, the fire service cannot stand still when circumstances change. There are changing risks, changing patterns of demand and changing technology, and it is right that the fire service looks closely at how it deals with those changes. However, as it does so, its priority and the priority of this Government is not only to protect the front line, but to enable our firefighters to deliver an even better service for the people of Scotland in the future.

Superfast Broadband

To ask the First Minister what progress is being made with the reaching 100 per cent programme to connect premises that have not received support from the previous programmes for access to superfast broadband. (S5F-01630)

The digital Scotland superfast broadband programme has been a huge success so far. It has already enabled fibre broadband to be delivered to more than 800,000 premises in Scotland, and we are on track to meet our target of 95 per cent of premises having broadband access by the end of this year. However, we recognise that many areas still do not have access. That is why the reaching 100 per cent programme will focus on extending superfast broadband access to those premises that will not be reached in the current programme. We have completed an open-market review and public consultation to formally agree an intervention area and will undertake an extensive supplier engagement in order to maximise competition. We will set out our delivery approach in greater detail shortly, ahead of the launch of a procurement exercise later in the year.

I congratulate the Scottish Government on its success in rolling out superfast broadband and accelerating the policy, given the slowness of previous UK Governments. Tens of thousands of my constituents have certainly benefited from the programme, but I wonder whether the First Minister recognises that the one side effect of that success is that the gap between the haves and the have nots has got bigger. Many rural communities have not benefited or received any form of public support.

While we await the next programme and the roll-out of R100, can ministers consider any further short-term measures, perhaps working with the private sector, to connect such communities, which, in this day and age, see connection as a utility, not a luxury?

Can the Scottish ministers press UK ministers to introduce appropriate regulation, perhaps introducing universal obligations and dealing with the likes of BT, which is charging customers similar amounts every month for widely varying levels of service?

I am acutely aware that some premises, particularly in rural parts of the country, do not yet have fibre broadband access. That is why the reaching 100 programme will seek to prioritise those communities through the initial procurement exercise.

In the meantime, the better broadband scheme already offers the residents of premises with broadband speeds of less than 2 megabits per second a voucher code that subsidises the costs associated with alternative broadband solutions. I am sure that all members will wish to make their constituents aware of that.

As Richard Lochhead knows, telecoms is a wholly reserved function. There are a range of issues that I think need to be addressed, and we are working closely with Ofcom to ensure that Scotland’s particular challenges are considered. Indeed, we are calling for a more regional approach.

Issues such as the universal service obligation are important, although the problem with a USO being pursued by the UK Government is that it is not delivering broadband at superfast speeds. However, we will continue to deliver on our own programme, and we will continue to press the UK Government to take the action that it needs to take to deliver the same.

National Health Service Boards (Waiting Time Targets)

To ask the First Minister what action the Scottish Government is taking to hold to account national health service boards that do not meet their waiting time targets. (S5F-01631)

We work with and support NHS boards to improve the delivery of waiting time targets. For example, in May, we announced that £50 million had been made available to improve waiting times between now and the end of March next year. In August, we announced the setting up of an expert group to improve how elective care services are managed across all boards. Derek Bell of the Academy of Medical Royal Colleges and Faculties in Scotland, who will lead that work, did similar work that led to the improvement of accident and emergency waiting times.

We are investing £200 million in a network of five new elective and diagnostic centres over the period of this parliamentary session.

I thank the First Minister for that answer. I would like to set out a few things to help the First Minister so that she does not have to address them in her next answer.

We accept that hard-pressed staff in NHS Scotland are committed, dedicated and hard working, and we appreciate what they do.

Saying that failing to reach seven out of 10 targets is okay because other places in the United Kingdom are worse does not help people who are waiting for treatment.

Making targets easier is not acceptable.

Just increasing spending on the NHS will not solve the problem.

I turn to Audit Scotland’s report, which says:

“Previous approaches such as providing more funding to increase activity or focusing on specific parts of the system are no longer sufficient.”

There is no doubt that the situation is getting worse, and the Cabinet Secretary for Health and Sport was unable to say this morning on Radio Scotland when it would get better. We need transformational—

Mr Mountain, please ask a question.

We need transformational and inspirational leadership. What is the First Minister going to do to ensure that our NHS has the leadership that it desperately needs but clearly lacks?

We certainly will not do what other Governments are doing, which is to privatise the NHS—something that the member will know lots about. There was so much in there—I was going to say “in that question”, but it was not really a question—that is just wrong. Making targets easier? One of the things that we have done over the past 10 years is to make many of the NHS targets tougher. That is part of the challenge that we face. For many of the targets—and I have never said it is okay that we are not meeting them—we are performing better against tougher targets than used to be the case against targets that were weaker. We are toughening up many of the targets. In other words, we are stretching our expectations of what the NHS delivers at the same time as demand on the NHS is increasing.

We will continue to take the action that I have already set out several times today. That is: investing record sums in our NHS, making sure that record numbers of people work in our NHS and taking forward the difficult but necessary reforms that will equip our NHS to deal with rising demand now and in the years to come.

Public Sector Pay

To ask the First Minister what the Scottish Government’s position is on whether public sector workers should be given a real-terms pay increase in 2018-19. (S5F-01636)

As I have already made clear today, the 1 per cent public sector pay cap will end in 2018-19. I fully understand the impact that increasing living costs and social security cuts are having on working households. We will set out our plans fully in the draft budget on 14 December. We will develop a pay policy that is affordable and recognises real-life circumstances, such as the cost of living, while continuing to support those on the lowest incomes.

Public sector workers in Scotland and across the United Kingdom deserve a fair deal. The UK Government should follow our lead in lifting the pay cap, ensuring that there will be proper investment in our vital public services.

In recent years, the public sector pay policy followed by the Scottish Government has resulted in 156,000 health service and police staff being worse off in real terms. That is unacceptable, and the budget is the opportunity to address the situation.

When Patrick Harvie raised this topic earlier, we got two minutes of waffle from the First Minister. I will give the First Minister another chance to answer the question. Does she accept Kate Forbes’s position on “Scotland Tonight” that the pay rise should be set at least at the rate of inflation? Will the Government bring forward the consequential tax changes that are required to give public sector workers the pay rise that they deserve?

We will bring forward the detail of our spending and tax plans in the budget that will be published on 14 December.

Labour’s hypocrisy on the issue is, quite frankly, staggering. We have said that the pay cap will be lifted. We have not made that dependent on actions taken elsewhere. That is completely different from the position taken by Labour in the Welsh—[Interruption.] I have got a letter here. [Interruption.] They will not want to hear this.

I have got a letter written by the Labour health secretary in Wales to Jeremy Hunt, the UK health secretary. It says that, without a commitment from the UK Government to give the Welsh Government more money, the public sector pay cap will remain. That is what Labour in Wales has said.

Here is what we have got: Labour calls for the cap to be lifted in Scotland and it calls for the cap to be lifted in Westminster, but in Wales—the only part of the UK where Labour has the power not just to call for things to be done, but to do those things—Labour refuses to give a commitment to lift the public sector pay cap. What does that tell us about Labour? It tells us that Labour is all mouth and no action.