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Chamber and committees

Meeting of the Parliament

Meeting date: Thursday, October 27, 2016


Contents


First Minister’s Question Time


Engagements

1. Ruth Davidson (Edinburgh Central) (Con)

I congratulate the Presiding Officer on his recent appointment to Her Majesty’s Privy Council.

To ask the First Minister what engagements she has planned for the rest of the day. (S5F-00361)

Engagements to take forward the Government’s programme for Scotland.

Ruth Davidson

It is clear that the Scottish national health service is in crisis. Audit Scotland said that there is “no evidence” of a clear long-term plan from the Government to put the NHS in order. The First Minister has been in charge of the Scottish NHS for nearly 10 years. Can she claim today to have such a plan?

The First Minister

Presiding Officer,

“Over the last decade, there have been improvements in the way health services are delivered and reductions in the time that patients need to wait for hospital ... treatment. There have also been improvements in overall health, life expectancy, patient safety and survival rates for a number of conditions, such as heart disease.”

Those are not my words; that is the first paragraph of the Audit Scotland report that was published today. Context is important.

Notwithstanding all that, the NHS faces challenges. It faces rising demand, principally from an ageing population. The challenges are in no way unique to Scotland. They are common to health systems around the world, which is a point that the Auditor General for Scotland made on the radio this morning. She also said that Scotland’s performance stands up well against that of the rest of the UK. In the light of those challenges—in the light of that rise in demand—we are ensuring record levels of funding and will increase funding by more than the rate of inflation over the course of this parliamentary session. Those challenges are why we have ensured that, as Audit Scotland said,

“staff levels are at the highest level ever”.

Those challenges are why we are not just investing in the health service but reforming it, through integration of health and social care, shifting resources into social care and primary care and expanding elective capacity for routine operations.

There is nothing unique about the challenges that are faced by the health service in Scotland, but the Government is focused on meeting them and we will continue to do that.

Ruth Davidson

The First Minister is the only person in Scotland reading today’s papers who thinks that her Government deserves a pat on the back for its performance on healthcare.

The reason why I asked my specific question, which the First Minister ducked, was that the Audit Scotland report that I quoted from was not from today. It was the one that came out in 2007, when the SNP first came to power. Nearly 10 years on, Audit Scotland reports with the exact same warning that it gave then about the lack of a clear plan and the failure of this Government to get a grip, which has inevitable costs: waiting time targets being missed, doctors and nurses under ever-greater pressure and health boards on the brink.

The Royal College of Nursing asks today:

“How many ... reports will be published by Audit Scotland before action is taken?”

That is a fair question, so what is the answer?

The First Minister

I am very happy to compare the situation in the health service today with the situation in the health service in 2007, when this Government took office. There is now more than £3 billion more investment in the health service than there was when we took office. There are 11,000 more medical professionals, nurses and other healthcare professionals working in our health service, which is why Audit Scotland today says that staffing levels are at an all-time high.

Of course there are challenges around waiting times in our health service, but let us look at the position when we took office. Back then, just 85 per cent of in-patients were seen within 18 weeks; today, more than 90 per cent of in-patients are seen within 12 weeks. The NHS is performing better against a tougher target.

Let us look at out-patients. When we took office, 70 per cent of out-patients were seen within 12 weeks; today, more than 85 per cent of out-patients are seen within 12 weeks.

The performance of our accident and emergency departments is 8 per cent higher than that of accident and emergency departments in England, where the Tories are in government.

Yes, there are challenges in our health service. That is why we have our vision 2020 strategy; why we have put in place our new clinical strategy; why we are planning increased investment in the health service; why we are determined to shift the balance of care into community, social and primary care; and why we will continue to focus on ensuring that we improve the health service so that it continues to have what it has today: high patient satisfaction levels.

Ruth Davidson

So, on my first question, there is no answer to the charges levelled by Audit Scotland and, on my second question, there is no answer to the charges levelled by the RCN and Scotland’s nurses.

We need to spell things out for what they are, and that is the failure of the Government to get to grips with our NHS. It is an outrage. Health boards are having to make huge savings in order to break even, to take out loans to keep going and to put off essential repairs to hospital buildings, yet we have also learned today that, because of the Government’s failure to manage staffing, there has been a 47 per cent increase in agency nursing and midwifery staff and—staggeringly—that individual agency doctors are being paid more than £400,000 each to provide cover for periods of less than a year. All that is happening while patient care suffers from cuts and hospital buildings are left to crumble. I call that a scandal. What does the First Minister call it?

The First Minister

Health service funding is higher than it was when we took office; the number of people working in our health service is higher than it was when we took office; and waiting times are lower than they were when we took office.

The hypocrisy of Ruth Davidson is staggering. She talks about the financial performance of health boards in Scotland; that is, of course, challenging, but health boards in Scotland met all their financial targets, as narrated by Audit Scotland today. In the same year that Audit Scotland looked at, the NHS in England had a deficit of £2.5 billion, which was three times its deficit in the previous year. Agency spend for nurses is 0.4 per cent of the total budget, and that spend per head of population is less than a third of what it is in England, where the Tories run the health service.

The point that I am making is this: our NHS faces challenges, but those challenges are not unique to Scotland. They are being faced by health systems across the world. As the Auditor General herself said this morning, when it comes to facing up to the challenges, Scotland is performing well compared with other parts of the UK, and we will continue to focus on making sure that we do that.

The point is this: although there have been some improvements in some areas over the past 10 years—

Members: Oh!

Ruth Davidson

—which are welcome as far as they go, there is a big question about reforms that would give our NHS a sustainable future and allow health boards to budget for the long term. Successive Scottish National Party ministers, including this First Minister when she was in the role, have ducked the big challenges. When the SNP came to power, we had the opportunity to avoid that, but now we have an unavoidable crisis on our hands because the Government has preferred sticking-plaster solutions and, as we have heard today, a strategy of no clear framework, no milestones and no costings.

Audit Scotland and the Royal College of Nursing are recommending today that health boards be given more flexibility to plan by having three-year rolling budgets instead of annual financial targets. We will back that. Will the First Minister?

The First Minister

That last question was a case of not waving, but drowning, with the grudging acceptance that there have been some improvements. There have been lots of improvements in the NHS in Scotland, unlike in England, where her party is in charge.

We will continue to focus on that. That is why we have integrated health and social care, why we have put in place a new national clinical strategy and why we have a range of work to improve population health. All that adds up to delivering our 2020 strategy and our broader strategy to 2030. Of course, Ruth Davidson should know that work is under way to combine all that work into a single delivery framework, which will be published before the end of this year.

I do not deny the challenges in our health service. There are challenges faced by health services right across the world, but the performance of our health service is good. Those who work in it deserve our thanks, and the Government will continue to work hard to support them.


ScotRail (Meetings)

To ask the First Minister when she last met ScotRail. (S5F-00392)

Scottish Government ministers meet ScotRail regularly. The Minister for Transport and the Islands did so most recently last week.

Kezia Dugdale

We discovered today that ScotRail is not the only thing that is going off the rails under the Government. The independent experts at Audit Scotland gave our national health service under the Scottish National Party a check-up, and the results of a decade of SNP control produced a grim diagnosis. Funding is not keeping pace with increasing demand and patient need. Only one of eight key targets has been met. A workforce crisis that has been brewing for years is getting worse.

Those problems did not appear overnight—they are the legacy of a decade of the SNP controlling our NHS. The First Minister was the health secretary for the best part of those 10 years. Does she accept full responsibility for the problems that it now faces?

The First Minister

Yes—as First Minister, I accept full responsibility for what happens in the health service. I also accept responsibility for the fact that the health service budget is £3 billion higher than it was when we took office, for the fact that there are 11,000 more staff working in our health service than there were when we took office and for the fact that, whether we look at in-patient waiting times or out-patient waiting times, those times are lower today than they were when the Government took office. I accept responsibility for all that and more.

I accept responsibility for the manifesto commitment that we made in the recent election, whereby we said that, over this parliamentary session, we would build on the increases that we had already made and increase the health budget by £500 million more than inflation. Kezia Dugdale has a cheek to talk about funding in our health service when she authored a manifesto that promised the lowest funding increase to the health service of any party that contested the election. Perhaps she should put her own house in order.

Kezia Dugdale

The First Minister can read out every statistic that she likes from her big book of excuses, but there is a human cost to a decade of SNP mismanagement. We can just ask the patients. One patient who is not satisfied is James Neilson from Fauldhouse. He was a miner who had worked down the pit his whole life. He has a blocked artery in his leg. He wanted to be in the public gallery today but, when I spoke to him this morning, he was in too much pain to leave the house. He has been told that he will have to wait seven months for an appointment. That is a seven-month wait not for treatment but for an appointment.

We have heard the First Minister reel off a lot of statistics. Will she explain to Mr Neilson why, under her Government, he has to wait seven months to see a consultant?

The First Minister

I absolutely agree with Kezia Dugdale that behind all the statistics that all of us cite on the health service lie human beings. I am happy to ask the Cabinet Secretary for Health and Sport to look into Mr Neilson’s case, but I will not comment on it today without having all the details; it would not be reasonable for me to do so.

I repeat the point that I made earlier. As long as one patient in our health service is waiting too long, that is one too many. I will be the first to say that and to say that we have more work to do. However, I look back at the situation that existed when we took office. I repeat that, at that time, 70 per cent of out-patients were seen within the target of 12 weeks. Today, the figure is 85 per cent. That is not good enough, but it means that we are performing well and that the health service is performing better than it was when we took office.

I say again that we have a great deal to be proud of in the way in which our health service operates and the services that it delivers. That is why there is record patient satisfaction in our health service. Of course, there is much work still to do, which is why the Government is focused on doing it.

Kezia Dugdale

Mr Neilson does not want to know what was happening 10 years ago; he wants to know when he will see a doctor.

The First Minister might not want to listen to me on the NHS and she might want to disregard Mr Neilson’s case, but she cannot ignore what NHS staff are saying. One in four general practitioner surgeries are short of staff and nine out of 10 nurses say that their workload is getting worse.

This summer, the First Minister set up a listening exercise, but she is not listening to patients, doctors and nurses. She should stop living in denial. When will she wake up to the NHS crisis that started on her watch?

The First Minister

The problem for Opposition leaders is that they forget that people are sitting at home and watching our exchanges, so those people will know that I did not disregard the case of Mr Neilson and that I said that I would be happy to look into it. If Kezia Dugdale wants to pass me his details, I will do so.

People also know the facts that underpin all this. I am not standing here and saying that everything is perfect in our health service, and I am not saying that there is not more work to be done. I am pointing to the progress that has been made and on which we are determined to build.

Kezia Dugdale talked about nurses. Our nurses do a fantastic job in the health service; they work incredibly hard and in difficult circumstances. However, there are 2,000 more nurses in our health service now than there were when the Government took office.

There are more staff, there is a larger budget and waiting times are lower. Progress has been made, but much work still has to be done. That is why the Government is not just investing in our health service but determined to undertake reforms in our health service, to make sure that it is fit for today and for the future.


Cabinet (Meetings)

To ask the First Minister when the Cabinet will next meet. (S5F-00381)

On Tuesday.

Patrick Harvie

The Scottish Government is due some credit for its work on climate justice, which, in its own words, aims to

“secure global justice for the many victims of climate change who are usually forgotten”.

The Government says that

“that does not exclude people in our own communities. This is not simply an international issue.”—[Official Report, 1 March 2012; c 6769.]

However, that principle does not seem to apply to the people who live under the flight paths at Heathrow. A third runway would create 250,000 extra flights a year, which would cause a massive increase in emissions and be the single biggest threat to the whole United Kingdom meeting its climate change targets. It would leave thousands of people’s homes too noisy and polluted to live in, and unknown tens of thousands more would be left to suffer the damaging health effects.

I can only imagine the outrage—I would join it—from the Scottish Government and its colleagues at Westminster if the UK Government inflicted that kind of damage on so many lives in Glasgow, Inverness or Dundee in exchange for alleged economic self-interest, but Scottish National Party members will now troop through the voting lobbies to bail out a Tory Prime Minister who stood for election saying, “No ifs, no buts—no third runway.” What is the point of a principle such as climate justice when it is surrendered so easily?

The First Minister

I will let the Prime Minister explain her position. The decision on another runway in London—whether it be at Heathrow or anywhere else—is for the UK Government, not the Scottish Government. In welcoming the announcement that was made this week, we recognise that there are many hurdles still to be overcome for the decision about Heathrow.

In reaching our judgment—the work was led by Keith Brown, who is our economy secretary—the Scottish Government looked carefully at which option would deliver the greatest benefits to Scotland’s economy and connectivity. If we look at connectivity, we see that 40 per cent of long-haul visitors to Scotland connect through Heathrow, compared with just 4 per cent who come through Gatwick. We are working hard with our airports to increase direct flights, but hub connectivity remains important to Scotland.

On the economy, there is the potential for significant construction spend in Scotland and thousands of jobs. In the shorter term, there is the potential for a supply-chain hub at Prestwick, which will have an extremely important impact on the economy and on jobs. There will be a £10 million route development fund. A reduction in passenger charges will start in January, which will make services between Scotland and Heathrow much more viable, and there is to be a new marketing campaign.

Those are the reasons on which our decision was based. Patrick Harvie rightly raises the issues of climate change and emissions. The UK Government will have to answer questions and satisfy people with its answers to those questions.

The Scottish Government has shown global leadership by including domestic and international aviation in our emissions reduction targets. Where Scottish Government policies or policies that we support would increase aviation emissions, we have to work harder to reduce emissions in other areas to meet our overall targets. The Government has a strong record on climate change and meeting our emissions reduction targets and we will continue to show leadership on that.

Patrick Harvie

The argument about connections to more destinations would make sense if those connections were going to be instead of more short-haul aviation, but the Scottish Government’s approach shows that it wants more of both. As for the job creation figures, they are entirely spurious. We begin with the airports commission’s figures of 59,000 by 2030 and then 75,000 by 2050, and then we move on to Heathrow’s pie-in-the-sky estimate of 180,000. That is about as believable as the job projection figures for Donald Trump’s golf course. Surely we are not going to fall for that, are we? What were the Heathrow bosses putting in the drinks at the Scottish National Party conference?

The Heathrow deal and the Scottish Government’s policy on cutting air passenger duty seek to reduce aviation fares, although aviation already enjoys a privileged position as the only transport mode that pays no tax on its fuel. Public transport remains overpriced, unreliable and run for private profit. Rail fares from Glasgow or Edinburgh are often three times the price of flying to London. Surely the First Minister must accept that it is time to focus on the affordable, sustainable and low-carbon transport that people actually need in their daily lives instead of boosting the most environmentally destructive, unhealthy and unsustainable transport mode.

The First Minister

I totally respect Patrick Harvie’s position but, when we come to take decisions—the Heathrow decision is not the Scottish Government’s decision, although we have made a judgment about which option best suits Scotland’s economic and connectivity interest—they are not always either/or decisions between all the things that he talks about. We have to strike the right balance. Of course it is extremely important that we have good-quality affordable and accessible public transport in Scotland and to connect Scotland to other parts of the United Kingdom and other parts of Europe, but so too is making sure that we have the air links that allow our economy to grow and boost the connectivity that our economy often depends on. We have to balance such decisions.

Around all that is our moral obligation to meet our climate change targets and to reduce emissions. I simply say that the Scottish Government’s record on that is very strong and good, although I am not complacent about that. Unlike many other Governments, we include emissions from aviation. We have met our target years ahead of schedule and we are already working on increasing the target and ensuring that we have the policies in place to meet it.

There will always be difficult decisions to make and difficult balances to strike, but the objectives of meeting our climate change targets and ensuring that we have the necessary infrastructure to enable our economy to grow and support jobs are not mutually exclusive; they are things that Governments have to consider in the round.


Cabinet (Meetings)

To ask the First Minister what issues will be discussed at the next meeting of the Cabinet. (S5F-00358)

Matters of importance to the people of Scotland.

Willie Rennie

The Audit Scotland report on our national health service is a horror show. The Government said that it would eradicate bed blocking by now, but thousands of people are still stuck in hospital; it said that it would meet all the targets, but it missed seven out of eight; and it said that it would recruit enough general practitioners, but the shortage has got worse. The Royal College of Nursing is right to ask:

“How many more reports will be published by Audit Scotland before action is taken?”

Does the condition of the NHS give the First Minister sleepless nights?

The First Minister

The NHS is always uppermost in my mind, day and night, because one of the most important responsibilities of any Government is to ensure that we have a health service delivering for patients who need it. As I have already said in response to earlier questions, we have a health service that is performing well in difficult circumstances. There have been significant improvements over the time that the Government has been in office, but the health service faces significant challenges, in common with health services across the world.

Willie Rennie mentioned delayed discharge in particular. The number of bed days lost to delays has actually reduced in the last year, so there is progress, although there is much more work to be done. Similarly, on primary care, we have recently made clear our commitment to shift resources from acute care into primary care so that, by the end of this session of Parliament, for the first time ever, half of the total health budget will be spent not in acute hospitals but in the community. That is a really important commitment and one that is right.

We have work to do—I am the first to admit that—but compared with health services in all other parts of the UK, our health service is performing well. It is facing up to those challenges and this Government’s job is to support it to do so.

I say one last thing to Willie Rennie. I mentioned earlier that our health budget has increased by £3 billion since we took office. In many of those years, that was against a backdrop of a Conservative-Liberal coalition at Westminster that was reducing Scotland’s overall budget by 5 per cent in real terms. Willie Rennie should reflect on that before he stands up and talks about funding for the health service.

Willie Rennie

The First Minister blames everyone else for the past 10 years. It is about time that she accepted responsibility for her own responsibilities.

Workforce planning is the way to get valued staff with the right skills in the right place, but the Auditor General is very critical of the Government’s workforce planning. The Royal College of General Practitioners says that there will now be more than 800 GPs short. The health service has only five-yearly workforce plans, but it takes seven years to train a doctor. Is it not a tragedy that it takes nine years to educate an SNP Government to take that seriously?

The First Minister

Of course, that completely ignores the fact that there are more doctors working in our health service today than there were nine years ago. There are more staff overall working in our health service than there were nine years ago when we took office. We will continue to make sure that our health service is adequately resourced.

On planning, as I said earlier, we are implementing our new national clinical strategy. Together with integrated health and social care and our work in population health, that is how we will deliver our 2020 vision; work is under way to bring together all those strands into an integrated delivery framework that will inform our workforce plan and our investment decisions to make sure that those strategies can be implemented.

I know that I repeat myself, but it is worth saying again: our health service is making progress and performing well but—in common with other health services—it faces real challenges. That is why the Government has promised and has already delivered record investment and a record number of staff. Waiting times are lower than when we took office. However, we take nothing for granted and we continue to work hard with the health service to make sure that we build on that progress.

There are a number of supplementary questions.

Kenneth Gibson (Cunninghame North) (SNP)

The First Minister will be aware that Associated British Ports is attempting to entice the lifeline Arran ferry service from Ardrossan to Troon with the loss of at least 165 Ardrossan jobs, despite the fact that the existing service is the most direct, shortest, fastest and cheapest route for passengers, cars, buses and hauliers. Will the First Minister confirm that Ardrossan harbour remains the Scottish Government’s first choice Ayrshire port to serve Arran? When can we expect a decision to ensure that the new £47 million ferry that is currently being built in Port Glasgow to serve Arran will sail from Ardrossan harbour?

The First Minister

The Government is committed to providing the best possible service for Arran, including works at Brodick harbour as well as the new ferry that Kenneth Gibson refers to. A task force led by the Minister for Transport and the Islands has been set up to look at Ardrossan in the first instance, although no options are off the table. Any consideration will take into account the local social and economic benefits, the impact on public spending and, principally, the needs of ferry users. I assure Kenneth Gibson that no decisions have been made and we will continue to engage closely with all stakeholders to analyse the options.

Jackie Baillie (Dumbarton) (Lab)

The Cabinet Secretary for Health and Sport stated on radio this morning that the Opposition is standing in the way of service change. The irony of that statement is not lost on members. On the assumption that the First Minister takes responsibility for service closures, will she name the health services that she believes should close? Do they include the children’s ward at the Royal Alexandra hospital? Has she already decided to close the Vale of Leven maternity unit? Do the promises that were made to my community by the First Minister and the health secretary before the election count for absolutely nothing after the election?

The First Minister

All the services that Jackie Baillie refers to are undergoing due process—that is the right and proper way to proceed and that due process will continue. I take no lessons from Labour when it comes to protecting local health services.

We have talked a lot today about the situation in the health service when this Government took office. When this Government took office, Monklands and Ayr hospitals’ accident and emergency services were on the brink of closure, and they were saved by this Government.

Generally speaking, a moment of truth is coming for Opposition members. They are all quite happy to talk the language of shifting the balance of care from acute health services into the community. We will soon see whether they are prepared to back that rhetoric with action when it comes to supporting the implementation of our clinical strategy. I think that we all have a suspicion about how they will behave in those circumstances.

Gillian Martin (Aberdeenshire East) (SNP)

Scottish National Party pressure at Westminster has prompted the United Kingdom Government to review its two-child limit and rape clause for benefit payments. Will the First Minister join me in urging people to respond to the consultation and leave the Tories in no doubt that their pernicious policy should be scrapped?

The First Minister

The rape clause policy is disgusting and immoral and should never have seen the light of day in the first place. I pay tribute to Alison Thewliss, who represents part of my constituency in the House of Commons. She has been steadfast in her determination to fight the clause.

This week’s announcement of a consultation is welcome, but it is too early to declare victory. I encourage people to respond to the consultation and I call on the UK Government without further delay to drop a policy that forces women, in certain circumstances when they want to access tax credits, to prove that they have been raped. I cannot think of anything more disgraceful than that.

Neil Findlay (Lothian) (Lab)

Over the past 30 years, the Blackburn local employment scheme in West Lothian has helped more than 3,000 young people, including many who have been in care, into employment. The scheme’s future is extremely uncertain, due to the inflexible way in which Skills Development Scotland grants are managed.

I have twice written to the Cabinet Secretary for Economy, Jobs and Fair Work to seek a meeting to try to find a solution, but both times my request was refused. Developing the young workforce is supposed to be a priority for the Government. Will the First Minister instruct the cabinet secretary to meet me and representatives from BLES, so that we can find a way forward for an essential service?

The First Minister

I am happy to ask the cabinet secretary to meet the member. I am not familiar with the service that he mentioned, but I know that services like it do a fantastic job in local communities. The member makes a reasonable point, and the cabinet secretary will arrange to meet him to discuss it in more detail.


European Union (Scotland’s Position)

To ask the First Minister whether she will provide an update on discussions with the United Kingdom Government on protecting Scotland’s position within the EU. (S5F-00374)

The First Minister (Nicola Sturgeon)

As Mike Russell said in his statement to the Parliament yesterday, he and I attended the joint ministerial committee at Downing Street on Monday. He also met David Davis and David Mundell last week.

On Monday, we again set out our determination to protect Scotland’s place in the single market. Despite a full and frank exchange of views around the table, we learned nothing more about the UK Government’s approach to the EU negotiations than we already knew when we went into the meeting, which was, to put it mildly, frustrating.

However, we now have an agreement that a detailed work programme will be developed for the JMC sub-committee, which will be integrated into the wider process, so that devolved Administrations can influence key Cabinet sub-committee decisions. The Scottish Government will continue to focus on protecting Scotland’s economic and social interests, which have been put at risk by the Brexit decision.

Joan McAlpine

Expert research shows that Brexit threatens up to 80,000 jobs in Scotland and could cost the economy more than £11 billion a year by 2030. Thanks to the Goldman Sachs tapes, we now know that Theresa May privately agrees with such forecasts. Publicly, she says that Brexit means Brexit; privately, she says that Brexit means disaster. In the discussion on Monday, did the Prime Minister offer the First Minister an explanation for why she is now happy to be led by the wishes of hard-right Brexiteers instead of economic and common sense?

The First Minister

No, she did not, but I suspect that the truth is that the Prime Minister does not have a plan for Brexit, so the hard-right Brexiteers are able to impose their own agenda.

When we met this week, the Prime Minister was unwilling—or, I suspect, unable—to answer even the most simple and obvious questions. Brexit might mean Brexit, but the Prime Minister could not tell us exactly what that platitude means in practice.

The only new information that we got on Monday was that the UK Government has set up what it calls a hotline to David Davis. I can share with the chamber today that Michael Russell’s office called that hotline this week just before midday on Tuesday. It took until after 6 pm yesterday to actually get David Davis on the hotline. That took 36 hours, so there is now a telephone line that we can call, but currently it is not very hot.

Adam Tomkins (Glasgow) (Con)

When is the First Minister going to understand that securing the best possible Brexit deal for Scotland requires ministerial collaboration and co-operation with the UK Government, not hostility and threats?

In his statement to Parliament yesterday, Mike Russell was unable to identify even a single positive contribution that the Scottish Government has made to the JMC Brexit process. All we heard was moaning about the United Kingdom. Can the First Minister do any better today?

The First Minister

Of course, what the Scottish Tories want the Scottish Government to do is, I suppose, what they have done—not collaborate, but capitulate. That is not what we are prepared to do. I think that collaboration is essential. I just wish that the UK Government would start collaborating with us; 36 hours to get through on a hotline does not strike me as very constructive collaboration.

I have been clear about my priorities. First, I want to work right across the UK and across the political spectrum to avert a hard Brexit for all of the UK because I think that it would be a disaster. If that is not possible, we will make proposals to avoid a hard Brexit for Scotland to keep us in the single market, even if the rest of the UK chooses to leave.

When we make those proposals, it will be interesting to see what the Conservatives’ response will be. Of course, in the referendum campaign, Ruth Davidson was very clear—and she was clear in the days after the referendum—that she thought that Scotland should stay in the single market and that the UK should stay in the single market. The proof of the pudding will be whether the Scottish Conservatives are prepared to back proposals that are in the Scottish interest or whether they continue to capitulate to their bosses at Westminster.


Teacher Workloads

6. Maurice Corry (West Scotland) (Con)

To ask the First Minister, further to the decision by the Scottish Secondary Teachers Association to take industrial action, what steps the Scottish Government has taken to resolve the issue of teacher workloads. (S5F-00397)

The First Minister (Nicola Sturgeon)

The Scottish Government’s education delivery plan, which was published in June, made clear our commitment to tackle bureaucracy and to address excessive teacher workload. We work with teachers, parents and other partners in education, both nationally and locally, to take concrete steps to address workload issues. Those include the recent announcement of the removal of unit assessments in the national qualifications. The removal of those assessments is part of a package of measures designed to address unnecessary bureaucracy and to liberate teachers to focus on what they do best—teaching young people.

Maurice Corry

I thank the First Minister for that answer.

Members on the Conservative benches share the view that strike action is not appropriate. Nonetheless, there remains a serious issue with teacher workloads. The Scottish Government’s own figures show that between 2008 and 2015, there was an 11 per cent decrease in the number of secondary school teachers in Scotland, representing a loss of some 3,008 staff. In particular, since 2007, more than 100 science, technology, engineering, and mathematics teachers a year have been cut, with 187 fewer computing teachers, 410 fewer mathematics teachers, and 105 fewer chemistry teachers. That is clearly having a strong impact on teacher workloads in key subjects. In light of those statistics, what action is the Scottish Government taking to stem and reverse that trend?

The First Minister

As the member will be aware, in the past couple of years, the Scottish Government has provided funding to local authorities to maintain teacher numbers. We encourage local authorities to continue to maintain those numbers to make sure that we have the right number of teachers in our schools to teach young people.

Workload is an important issue. It is why, since his appointment as education secretary, John Swinney has spent so much time and effort on working with teachers to try to address their legitimate concerns. The changes to the national 5, higher and advanced higher qualifications that were announced by the Deputy First Minister are part of a package of measures that are designed to address unnecessary bureaucracy and to take away from teachers workload that was felt not to be necessary and not to contribute to their job of teaching young people.

As a whole, the plans that we have in place—making sure that funding is getting to the areas of greatest need, bringing new transparency to school performance, our governance review, and making sure that power and responsibility lie where they should, which is as close to or in schools and as far as possible with headteachers—are all about a determination to ensure that teachers are able to do what they do best, and that the contribution of teachers and teaching helps us to raise the standards in education and close the attainment gap. We are absolutely focused on that and will continue to be so.


Children in Care (Support)

To ask the First Minister how the Scottish Government will seek to improve systems supporting children in care. (S5F-00396)

The First Minister (Nicola Sturgeon)

On 15 October, I announced an independent root-and-branch review of the care system. The review, which will be the first of its kind anywhere in the world, will be taken forward in partnership with young people who have experience of care. It will look at the legislation, the practice, the ethos and the culture of the system. It is vital that we listen to young people’s experience of being looked after. I am absolutely committed to using what they tell us to help to change the care system, to put love at its heart, and to make their lives better.

I am delighted by the First Minister’s commitment to a review. What other action is the Scottish Government taking to support care-experienced young people to have the best opportunities in life?

The First Minister

We have taken action to modernise our children’s hearing system, to review secure care, to establish our youth justice improvement boards, to support kinship carers, to review learning and development opportunities for foster carers and residential work, and to support families who are on the edge of care. Those are just some of the things that we have already done; the list could go on. Improvements are being made: school exclusions, for example, are down and more young people are in permanent, rather than in temporary, placements.

When we look at the statistics for young people who experience care, none of us can be satisfied that we are yet doing enough, because those statistics are absolutely horrifying. When I speak to young people who are in care or who have been in care, as I have been doing a lot recently, they give me the simple message that the system works well to stop things happening to them. It should do that to some extent—we must have in place safeguards. However, the system does not always operate to make things happen for them. We need a system that ensures that, where young people cannot live with their own families, for whatever reason, and the state becomes their corporate parent, we give them a sense of family, a sense of belonging and a sense of love, and that the whole system operates to make sure that they can reach their full potential. That is what I am determined to do, but the Government cannot do it alone and Parliament cannot do it alone. We will succeed only if the review is driven by the experiences of young people in care. That is what will make the review unique.

Liam McArthur (Orkney Islands) (LD)

I welcome very much what the First Minister had to say, but I urge her to look in particular at access to higher education, which is an area where those with care experience are glaringly underrepresented. Will she look specifically at the support that is available to those with care experience to ensure that the maximum opportunity is provided for them to gain the benefit of a university education?

The First Minister

Yes, I will give that commitment. Indeed, we have already announced certain changes to help to make sure that that commitment can be delivered.

I have mentioned statistics: a horrifying statistic is that only 6 per cent of care-experienced young people go to university. We have therefore accepted the commission on widening access’s recommendation to ensure not only guaranteed places at university for care-experienced young people who have the grades, but full grants for those care-experienced young people going to university. That is a concrete example of the progress that we are making. We have to do much more, and we have to do it in partnership with the people who are the experts—those who are in care or who have experienced care.

I have been moved beyond belief by some of the conversations that I have had with care-experienced young people in the past few months. I have no doubt that, if we come together—not just as a Parliament, but as a country—and put those young people at the heart of what we are trying to do, we can do something really special that in years to come we can all look back on with pride.


Nursing

To ask the First Minister what the Scottish Government’s position is on the statement from the Royal College of Nursing that nursing in Scotland is facing “a perfect storm”. (S5F-00367)

The First Minister (Nicola Sturgeon)

We appreciate the dedication of our nurses, midwives and, indeed, all our national health service staff, and we recognise the pressures that they face. Under this Government, there are now more than 2,100 extra qualified nurses and midwives, which is a rise of more than 5 per cent since we took office. We are, of course, not complacent, so this year we will again increase the number of trainee nurses and midwives—a fourth successive rise. We will also spend £450,000 to enable former nurses and midwives to retrain and return to the profession.

Miles Briggs used the phrase “perfect storm”, which I accept is that of the RCN. A situation in the future in which people from other countries who work in our health service are prevented from doing so will add to the challenges that our health service faces. We value our health service staff: we must ensure that we value all of them, regardless of where they were born.

Miles Briggs

With the First Minister today taking responsibility for the health service, does she believe that she made a mistake as the then Cabinet Secretary for Health and Wellbeing in cutting the number of student work placements in Scotland? Why has it taken her Government 10 years to introduce a national health service workforce plan?

The First Minister

Workforce plans are in place in health boards and, as I have just said, the number of qualified nurses and midwives in our health service is higher today than it was when we took office. That suggests that the policies of this Government have been right—but we have more work to do. That is why, as I said earlier, we are determined to do that work and to focus on the challenges. We will work with our NHS staff to ensure that we meet the challenges.

Anas Sarwar

On a point of order, Presiding Officer. This morning, Labour requested an emergency question on the publication by Audit Scotland of the worst report since devolution on the state of the NHS, with only one out of eight standards having been met. The reason for the refusal of an emergency question, as I understand it, is that on Thursdays we have an opportunity to hold the Government to account through First Minister’s question time. However, emergency questions are the opportunity for Parliament to hold the relevant minister to account and standing orders are clear that emergency questions can be asked on any sitting day, including Thursdays.

It cannot be right that the Cabinet Secretary for Health and Sport hides behind the First Minister. Is she simply out of her depth? The report is a damning indictment of the health secretary and she should come to Parliament to address—[Interruption.]

One second, Mr Sarwar. I ask members to let Mr Sarwar speak, please.

Anas Sarwar

The tone from Scottish National Party members tells us how much they respect the NHS and its hardworking workforce.

Presiding Officer, can you tell us whether you have been advised that the health secretary had given any indication—[Interruption.]

I am sorry, Mr Sarwar, but I cannot hear the point of order. Will members please let him speak?

Is it not amazing that we hear everybody’s voice on the issue apart from Shona Robison’s? When will Parliament hear a statement from the health secretary about how she has allowed our NHS to decline?

The Presiding Officer

The member has made a point, but it is not a point of order. The member is perfectly capable of speaking to his business manager and raising the issue through the business manager at the Parliamentary Bureau meeting on Tuesday morning.

That concludes First Minister’s question time.