Scottish Parliament, 23 November 2022

378 contributions from 68 members. The official report.

Presiding Officer’s Statement

Alison Johnstone (Presiding Officer, Lothian)

Good afternoon. Before we come to the first item of business, I note that members will be aware that the Government has answered a Government-inspired question this morning on the judgment of the Supreme Court on the reference that was made by the Lord Advocate. The long-established good-practice guidance on announcements to Parliament states:

“Ministerial statements are appropriate in … matters of significant and either immediate or ongoing public (and Parliamentary) importance.”

I have asked the Government to reflect on the appropriateness of using a GIQ on this occasion.

Independence Referendum (Supreme Court Ruling)

Alison Johnstone (Presiding Officer, Lothian)

The first item of business is an urgent question.

Douglas Ross (Conservative, Highlands and Islands)

I had hoped that this question might be answered by the First Minister, but she is absent from the chamber.

To ask the Scottish Government what its response is to the UK Supreme Court’s ruling on the legality of an independence referendum bill.

Angus Robertson (Scottish National Party, Edinburgh Central)

As the Cabinet Secretary for the Constitution, External Affairs and Culture, it is entirely appropriate for me to answer questions about the constitution today. First Minister’s question time is tomorrow; I will wait to see whether Douglas Ross has any better questions then.

To answer the substantive question that is before us, the Supreme Court has decided that, under the devolution settlement, a referendum on the question

“Should Scotland be an independent country?”

is a matter that is reserved to the Westminster Parliament. That means that, without an agreement between the Scottish and United Kingdom Governments and the Scottish and UK Parliaments, a section 30 order or a UK act to change the Scottish Parliament’s powers, the Scottish Parliament cannot pass the laws that are required to hold a referendum to give effect to the mandate that people in Scotland gave it and to give us a choice about our future.

The Scottish Government accepts and respects that judgment. The Supreme Court was not asked to decide, and cannot decide, whether the Scottish Parliament should have the power to hold an independence referendum. Its job is to set out what the law is—in this case, the devolution settlement in the Scotland Act 1998—and that is what it has done.

The judgment makes it clear how the UK constitution gives the UK Government a veto over the right of people in Scotland to choose. The Supreme Court said in paragraph 81 of its judgment:

“A clear outcome, whichever way the question was answered, would possess the authority, in a constitution and political culture founded upon democracy, of a democratic expression of the view of the Scottish electorate.”

This is what the constitutional arrangements deny us:

“a democratic expression of the view of the Scottish electorate.”

Why does that matter? The Supreme Court tells us that the question is

“whether Scotland should cease to be subject to the sovereignty of the Parliament of the United Kingdom”.

So, the reason why the Scottish electorate does not get its chance to offer “a democratic expression” is because it would impinge on Westminster sovereignty if its views were known. That tells us what is truly left of promises that were made that the UK would operate as “a partnership of equals” and that we lived in

“a voluntary union of nations”.

No matter how the people of Scotland vote or how often they elect Parliaments that support a referendum or support independence, they cannot be told “No” by the UK Prime Minister. That cannot be right, and there are few stronger or more powerful arguments for independence than that. In a voluntary union, one part does not have to rely on the agreement of another before it is allowed to even think about leaving.

The Presiding Officer

Cabinet secretary, I would be grateful if you could draw that particular response to a conclusion, because there is a great deal of interest in this item. I call Douglas Ross.

Douglas Ross (Conservative, Highlands and Islands)

I noted that the cabinet secretary quoted paragraph 81 of the ruling and not paragraph 82, in which the judges said that they were absolutely

“in no doubt as to the answer”

to the question that they were considering.

Given the cost of the case in taxpayers’ money and in time, it is regrettable that the First Minister herself was unable to come to the chamber to answer. She was more than happy this morning to comment from behind a Scottish National Party podium, as SNP leader, but she is now unwilling, as First Minister, to answer questions in this chamber from elected Scottish parliamentarians.

The Scottish people have made it clear in poll after poll—[

Interruption

.]—that they do not want another referendum next year, so—[

Interruption

.]

The Presiding Officer

Members!

Douglas Ross (Conservative, Highlands and Islands)

I welcome the Supreme Court’s clear and unanimous judgment. It is one that we must all respect. I hope that the SNP back benchers do, as well.

We now have an opportunity to focus on the big challenges that Scotland faces right now: strikes, the global cost of living crisis, and a winter storm in our national health service. I ask the cabinet secretary this: will the SNP Government ditch its referendum obsession and get back to tackling those crucial issues for individuals, families and communities right across Scotland?

Angus Robertson (Scottish National Party, Edinburgh Central)

The inconvenient truth for Douglas Ross is that last year’s Scottish Parliament election decided the principle and the electorate decided the mandate—[

Interruption

.]—which was for parties that are in favour of an independence referendum. The SNP and the Greens won the election; the Scottish Conservatives lost the election—[

Interruption

.]

The Presiding Officer

I think that this session will be a lot more productive if we can hear whoever is on their feet speak. I would be grateful if members could, please, resist any temptation to contribute while members are on their feet.

Angus Robertson (Scottish National Party, Edinburgh Central)

Thank you, Presiding Officer.

The position of the Scottish Government remains the same as what the First Minister announced to Parliament on 28 June. Nothing has changed in that respect. We would prefer the UK and Scottish Governments to agree to a section 30 order under the Scotland Act 1998 to allow a legal and constitutional referendum to go ahead. That is what the people have voted for. It is for the Scottish Conservatives to explain why they are blocking and denying democracy.

Douglas Ross (Conservative, Highlands and Islands)

It is for the cabinet secretary to explain his misleading claim, because actually a majority of votes in the Scottish Parliament election were for parties that support our remaining part of the United Kingdom—more than for parties that support separation.

Let us be clear. The SNP’s political obsession with separation dragged both of Scotland’s Governments into court, but there is now a chance for Scotland and our two Governments to come together and move on. There is a clear choice for this SNP Government: either it continues to divide our country and focus on its political priorities, or it gets on with the job of dealing with the real priorities for Scottish people.

What choice will this Government make? Will it keep pushing for another referendum or will it focus on getting back to work, to deliver for the people of Scotland? Which will it be?

Angus Robertson (Scottish National Party, Edinburgh Central)

What I can say with absolute certainty is that my memory is long enough for me to remember that it was the Conservative Party that blocked Scottish democracy and devolution after the yes vote of 1979. It is long enough for me to remember that it was the Conservative Party that opposed devolution in the 1997 referendum. Perhaps it is unsurprising that the Conservative Party is not keen on Scottish democracy now. Blocking and denying democracy is a serious charge, and it is unfortunate that Douglas Ross and the Tories are leading the charge on it.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

Douglas Ross spoke about opinion polls. Although opinion polls are interesting, election results are definite, as this chamber proves. This Parliament has the biggest majority for an independence revolution that there has ever been in the history of devolution. What does the UK Government’s refusal to respect that mandate say about its view of this Parliament and decisions that are made by the people of Scotland?

Angus Robertson (Scottish National Party, Edinburgh Central)

To be honest, it is difficult to understand why a UK Government, having established the principle of respecting that a referendum should take place when a majority in favour of it is elected to the Scottish Parliament—which is exactly what happened after the 2011 Scottish Parliament election—should now depart from that precedent. I can come to only one conclusion, which is that it is scared—scared of losing the referendum. All the excuses for why democracy should be blocked now are factually inaccurate. They are a fiction, and they are democracy denial. It is not a good look, in a democracy, for political parties to block democracy, but the Tories have had form on that for decades.

Sarah Boyack (Labour, Lothian)

It was right for the Lord Advocate to refer this question to the Supreme Court, and it is welcome that we have the legal clarity on the matter that the Scottish Government sought. I also put on record my thanks to the court for its speedy work in considering the case. It is crucial that we now focus on the problems that our country faces, from soaring bills to the crisis in our NHS. Indeed, Scottish Labour will debate those issues in the chamber this afternoon.

Cabinet secretary, there is not a majority for a referendum or for independence, but neither is there a majority for the status quo. People across Scotland and, indeed, the UK, want change. Does the cabinet secretary agree that we need to get rid of the economically incompetent and morally bankrupt Tory Government, and that the best way to do that would be to help to elect a Labour Government across the UK to bring economic growth, restore living standards, prioritise our public services and deliver a green new deal?

Angus Robertson (Scottish National Party, Edinburgh Central)

I would prefer to get rid of unelected Tory Governments in Scotland for ever—[

Interruption

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I have lost count of how many times the First Minister has launched a new independence campaign, each with less energy and momentum than the last. While Nicola Sturgeon goes through the motions, people wait days for an ambulance, months for NHS treatment and years for lifeline ferries. Breaking up the United Kingdom is simply not a priority for people who are opening their bills with dread or living in pain. My goodness, teachers are on strike tomorrow. Scotland needs new hope, not old divisions, so why will the SNP-Green Government not finally focus on what matters instead of this arrogant, tired and divisive charade?

Angus Robertson (Scottish National Party, Edinburgh Central)

I say gently that it is neither liberal nor democratic to stand in the way of democracy and people being able to make a yes-or-no choice. No doubt, we differ on whether we support independence. I know that Alex Cole-Hamilton does not want to hear that he represents a party with only four members and the worst election result in its history. That loss was secured on the back of opposition to an independence referendum. Maybe he should listen to the electorate, because the electorate—[

Interruption

.] Indeed, members may point at these benches. Parties that were elected with a manifesto commitment to deliver a referendum have the majority in the Parliament. I am sorry that the Scottish Liberal Democrats are being neither liberal nor democratic, nor standing up for democracy in Scotland.

Ross Greer (Green, West Scotland)

I will start off by correcting Douglas Ross. Not only did the SNP and the Greens win more seats than the Opposition at last year’s election, but we won 16,057 more votes than all the anti-independence parties combined—[

Interruption

.]—

and we did so on the basis of manifestos that committed to giving the people of Scotland a choice over their future. If this is a voluntary union, the onus is now on the UK Government to explain how a part of that union can decide whether to stay or go.

However, in the absence of any alternative being offered by Westminster, does the cabinet secretary agree that every vote cast for pro-independence candidates at the 2024 general election will count towards the mandate for Scotland’s independence?

Angus Robertson (Scottish National Party, Edinburgh Central)

Indeed, they will.

As democrats, it behoves all of us to embrace every democratic opportunity to secure democratic change. However, in a democracy it also behoves other political parties that have different views to uphold the basic tenets of democracy. Overlooking and disregarding election results where one can clearly see—because of the numbers on the Opposition benches being less than the majority of the Parliament—that it is the Opposition parties that are opposing the democratic mandate that sent us all here.

The question does not need to rest on the next UK general election, because the UK Government could meet with the Scottish Government and do what it did in the run-up to the 2014 referendum by saying, “We disagree on the principal question of independence—yes or no—but, as democrats, we agree that the people should have their say.”

It is time for the people of Scotland to have their say. They decided, they elected us to do this, and nobody—nobody—should stand in the way of the Scottish Parliament and the views of the Scottish people.

Emma Roddick (Scottish National Party, Highlands and Islands)

Today’s ruling from the Supreme Court confirms that this is not a voluntary union. I ask the cabinet secretary what the fact that the Scotland Act 1998 prevents Scotland from having a referendum to escape Westminster control says about the security of the devolution settlement and the state of democracy in the UK.

Angus Robertson (Scottish National Party, Edinburgh Central)

Perhaps surprisingly, I am going to quote Margaret Thatcher in answer to my colleague, because it was Margaret Thatcher who said:

“As a nation”

the Scots

“have an undoubted right to national self-determination.”

She also said:

“Should they determine on independence, no English party or politician”

should

“stand in their way”.

It was John Major who said of Scotland:

“No nation could be held irrevocably in a union against its will.”

As part of the cross-party Smith commission, after the 2014 independence referendum, all parties said:

“Nothing in this report”,

which we all agreed on,

“prevents Scotland becoming an independent country in the future should the people of Scotland so choose.”

They have chosen to have a choice, but the Conservative Party, the Labour Party and the Liberal Democrats are working hand in glove to deny the people their say. We need democracy in this country, and today we have seen the end of the voluntary union as we know it. We will not give up on democracy, and the people will have their say.

Covid-19 Recovery and Parliamentary Business

Annabelle Ewing (Scottish National Party, Cowdenbeath)

The next item of business is portfolio questions. If a member wishes to ask a supplementary question, they should press their request-to-speak button or enter “RTS” in the chat function during the relevant question.

Scottish Child Payment

Collette Stevenson (Scottish National Party, East Kilbride)

1. To ask the Scottish Government how the expansion of the Scottish child payment will impact on the delivery of its Covid recovery strategy. (S6O-01573)

John Swinney (Scottish National Party, Perthshire North)

The Covid recovery strategy is focused on reducing systemic inequalities, tackling poverty and supporting people most affected during the pandemic. Increasing financial security for low-income households and tackling child poverty are central to achieving our vision of a Covid recovery that is firmly based on a fairer future.

The extension of the Scottish child payment to children under 16 means that more than 400,000 children are now potentially eligible. We have demonstrated our ambition to achieve our challenging child poverty targets by further increasing the value of the payment to £25 per child per week.

Collette Stevenson (Scottish National Party, East Kilbride)

I welcome the actions in the Covid recovery strategy to address inequalities and the role that

the Scottish child payment will have in supporting families. However, recent analysis from the Institute for Public Policy Research shows that removing the two-child limit and the benefit cap could lift 300,000 children in the United Kingdom out of poverty. Does the Deputy First Minister agree that, in the middle of a crippling cost of living crisis, it is nothing short of a scandal for the UK Government to continue to prioritise bankers’ bonuses rather than use the powers that it has to support families to get out of poverty?

John Swinney (Scottish National Party, Perthshire North)

I understand and sympathise entirely with the point that Collette Stevenson has advanced. The analysis that the IPPR has provided has demonstrated quite clearly the negative impact of the benefit cap and the two-child limit as being both unjust and unfair.

All Governments must take action to address child poverty issues. As I said in my opening answer, the Scottish Government has introduced the Scottish child payment, which is available only in Scotland—it is not available in any other part of the UK. However, our efforts to lift substantial numbers of children out of poverty would be substantially assisted by the removal of the two-child limit and the benefit cap. That could be of enormous assistance in addressing the issue of child poverty.

Covid-19 Inquiry

Douglas Lumsden (Conservative, North East Scotland)

2. To ask the Scottish Government when it expects the Scottish Covid-19 inquiry to conclude. (S6O-01574)

John Swinney (Scottish National Party, Perthshire North)

Section 17 of the Inquiries Act 2005 gives an inquiry chair alone, rather than ministers, responsibility for deciding how an inquiry should operate. It will be for Lord Brailsford to determine how to strike the right balance between addressing the wide range of questions that people have and making sure that the inquiry can be delivered at speed, so that we can learn and benefit from lessons as early as possible. The inquiry will provide information and updates on its website at www.covid19inquiry.scot as it progresses and as the chair considers appropriate.

Douglas Lumsden (Conservative, North East Scotland)

From reading the terms of reference, it is not clear to me whether the Government’s response to long Covid and its failure to take that issue seriously are part of the inquiry. Can the Deputy First Minister say whether the Government’s response to long Covid will be part of the inquiry, or will we need to wait for another inquiry after we hear about the handling of this one?

John Swinney (Scottish National Party, Perthshire North)

I am sorry that Mr Lumsden takes that view, having read the terms of reference. I answered a parliamentary question on that from Jackie Baillie, if my memory serves me correctly, and I made clear two points in that answer: first, the inquiry remit is set out to not be prescriptive—in that only the words that are in the remit can be addressed by the inquiry—but rather to create the broadest scope to address the issues that are relevant in relation to Covid; and secondly, in my judgment, the issues relating to long Covid are certainly at the heart of the inquiry remit and should be considered by the inquiry.

It will be for Lord Brailsford to decide independently what evidence he hears and considers, but I would be very surprised if the issue of long Covid was not scrutinised by the inquiry. In my view, the remit is set with sufficient breadth and scope to enable that to be the case.

I hope that that reassures Mr Lumsden.

Jackie Baillie (Labour, Dumbarton)

When Lord Brailsford was appointed, the Deputy First Minister gave me a reassurance about the centrality of bereaved families to the work of the inquiry. Is he able to give members an update on what steps have been taken to engage families?

John Swinney (Scottish National Party, Perthshire North)

I cannot give a specific answer to that question because, clearly, that would require me to have knowledge of the transactions of the inquiry. However, in my conversation with Lord Brailsford in the aftermath of my statement to Parliament, in which I announced his appointment, he indicated to me that he was making early preparations to meet bereaved families, and I am certain that that will be the case.

Beatrice Wishart (Liberal Democrat, Shetland Islands)

We are waiting for the Scottish Covid-19 inquiry to conclude, but would it not be more sensible to have the details and recommendations of that inquiry before ploughing on with social care reform?

John Swinney (Scottish National Party, Perthshire North)

Obviously, there are lots of issues to consider in relation to social care reform. As a Government, we look at all the available evidence. A parliamentary process is under way for each committee’s scrutiny of the National Care Service (Scotland) Bill. The committees will have the ability to consider all manner of questions in relation to social care, and ministers will, of course, listen with care to the evidence that is put forward.

Freedom of Information Appeals

Donald Cameron (Conservative, Highlands and Islands)

3. To ask the Scottish Government what its response is to the Scottish Information Commissioner’s section 46 report for 2021-22, which reported a 29 per cent increase in freedom of information appeals. (S6O-01575)

George Adam (Scottish National Party, Paisley)

The Scottish Government notes with interest the commissioner’s 2021-22 performance report, which was recently presented to the Parliament. I recognise that this is a challenging time for the commissioner’s team, with a marked increase in the number of requesters seeking information from Scottish public authorities, who are exercising their right to appeal. I note that, in the report, the commissioner set out the steps that his office is taking to address the challenges that are associated with that. The Scottish Government acknowledges the vital role that the commissioner plays as an independent regulator of access to information laws in Scotland, appointed on the nomination of the Parliament.

Donald Cameron (Conservative, Highlands and Islands)

The Scottish Information Commissioner’s report makes it clear that the 626 appeals that were received in 2021-22 were the highest number received since 2005-06 and that 18 per cent of the valid appeals were about a public authority’s failure to respond. What action will the minister take now in order to ensure that there is greater public authority compliance with freedom of information requests?

George Adam (Scottish National Party, Paisley)

I will take the opportunity to add to what I have already said, which is that the Scottish Government is committed to learning from all appeal cases, no matter their outcome. We are working to deliver an FOI improvement plan, which was launched in July 2022, to help Scottish case handlers to recover from the disruption of the pandemic and to adjust to higher numbers of cases that are more complex.

Over the past year, our response rates for FOIs in general have been at an average of 86.5 per cent, despite cases increasing by 48 per cent over a three-year period. We will continue to work with the commissioner and others internally to ensure that we address our response rates so that we can hit the 95 per cent target.

Covid Recovery (Funding)

Paul O'Kane (Labour, West Scotland)

4. To ask the Scottish Government what the reduction in funding for Covid recovery will be as part of the emergency budget review. (S6O-01576)

John Swinney (Scottish National Party, Perthshire North)

The aim of the emergency budget review was to support those who need most help, while also managing the nation’s budget. That meant making hard choices to further prioritise spending and find savings. Many of the difficulties that are facing public finances are the result of the United Kingdom Government prematurely cutting the funding that was intended to support our recovery from the pandemic, despite the Scottish Government warning against that action.

The emergency budget review identified a further £615 million in savings. Those are not decisions that we would wish to make but, in the absence of additional funding from the UK Government, they are decisions that we were compelled to make in order to balance the books this financial year, while prioritising funding to help families, back business and protect the delivery of public services.

Paul O'Kane (Labour, West Scotland)

The First Minister committed to the build back better approach for Scotland as we recover from Covid, but what has happened to that ambition? We need investment and support for people whose lives have been fundamentally affected by the pandemic. The Office for National Statistics estimates that there are more than 170,000 people across Scotland who are living with long Covid, yet the support from the Scottish Government to date has been inadequate. The Scottish Government committed £3 million in funding when the number of Scots with long Covid was estimated to be 70,000 people. Even that has not yet been fully allocated. Funding has not increased—

The Deputy Presiding Officer

Could I have a question, please?

Paul O'Kane (Labour, West Scotland)

Will the Deputy First Minister commit to working across Government to protect funding for long Covid sufferers in Scotland to help their recovery with access to physiotherapy and multidisciplinary rehab?

John Swinney (Scottish National Party, Perthshire North)

I sympathise very much with the point that Mr O’Kane makes about the importance of ensuring that people with long Covid are able to access the support that they require to assist them in their recovery. In some cases, that will involve clinical support; in other cases, it might involve additional assistance that individuals might require to assist them on their journey into employability. I assure Mr O’Kane that the Government is working across portfolios to ensure that we put in place the support that is necessary to assist individuals in their recovery.

Murdo Fraser (Conservative, Mid Scotland and Fife)

The Scottish Government established a £25 million ventilation fund that businesses can apply to for support. I think that, the last time I checked, just £1 million had been paid out from that fund. Is that the case? Is that fund still available? If not, has that money been reallocated, and, if so, where to?

John Swinney (Scottish National Party, Perthshire North)

To my recollection, the figures that Mr Fraser quotes for the funding that was available are correct. If that funding has not been utilised, it will be made available to meet other budget pressures within the Government. Mr Fraser is familiar with the fact that I am wrestling with the challenge of balancing the budget, so any resources that are not needed for the purposes for which they are allocated are being drawn into the centre so that I can meet funding pressures across the Government.

It is impossible to give Mr Fraser a link between the individual money that was allocated for one fund and the other purposes for which it is being used in the Government—Mr Fraser knows the way in which Government funding works—but I remind Parliament that I am still working to balance the budget this year, because of the significant and corrosive effects of inflation, and because of the public sector pay deals. Parliament was well informed of the challenges that I face by the Auditor General’s statement that was issued last Thursday, which gave a fair and accurate account of the significant challenges that I face in this financial year.

The Deputy Presiding Officer

Question 5 was not lodged.

Institutionalising Participatory and Deliberative Democracy Working Group (Recommendations)

Alex Rowley (Labour, Mid Scotland and Fife)

6. To ask the Scottish Government what progress it has made on implementing the recommendations of the institutionalising participatory and deliberative democracy working group published in March. (S6O-01578)

George Adam (Scottish National Party, Paisley)

In the most recent programme for government, we committed to publishing a response to the report of our working group on institutionalising participatory and deliberative democracy. That will set out how we can involve people and communities, government and children and young people in democratic decision making. We are in the process of carefully considering that further, assessing the new activities and skills that would make it a success, and taking account of the resource demands that that would create.

Alex Rowley (Labour, Mid Scotland and Fife)

I read the report, and the question is, what happens next? People need to know that.

The minister mentioned the recent programme for government, but the 2021 programme for government stated:

“We are committed to reforming Council Tax to make it fairer, working with the Scottish Green Party and COSLA to oversee the development of effective deliberative engagement on sources of local government funding, including Council Tax, that will culminate in a Citizens’ Assembly.”

There are controversial issues around drugs policy, the raising of extra funds and a lot of other things that a citizens assembly would certainly be able to grapple with in a way that would bring forward the views of people and communities. When are we likely to see some announcements on the issue?

George Adam (Scottish National Party, Paisley)

I should cut to the chase and say to Mr Rowley that we are probably going to write a response to the IPPD working group’s report before the end of this year. For all of us, that will be the start of our opportunity to consider the issue and move things forward.

As always, I am happy to work with Mr Rowley and meet him to discuss many of the issues, but I can say that the Government is committed to finding a way to move forward with council tax. We have various other options and participatory groups that are available for people to engage with. It might be a good idea for Mr Rowley and me to have an offline meeting in which we can discuss these issues further.

Covid Recovery Strategy (Impact of Recession)

Gordon MacDonald (Scottish National Party, Edinburgh Pentlands)

7. To ask the Scottish Government, in light of recently reported warnings by the Bank of England that the United Kingdom is about to enter the longest recession since the 1930s, what assessment it has made of the impact that this could have on its Covid recovery strategy. (S6O-01579)

John Swinney (Scottish National Party, Perthshire North)

The current economic landscape presents us with significant challenges. The approach of the United Kingdom Government in cutting public spending risks prolonging that recession, hampering efforts to restore the public finances. There are alternatives to austerity that invest in public services and the economy, including inflationary increases to devolved Governments’ 2022-23 budgets.

It is, unfortunately, inevitable that some of the savings that we need to make will have negative impacts. There are no easy decisions, but we have prioritised help for those who need it most. The Scottish Government remains committed to delivering the actions that are set out in our Covid recovery strategy, and our internal monitoring indicates that the majority of the strategy actions remain complete or on track.

Gordon MacDonald (Scottish National Party, Edinburgh Pentlands)

There is no doubt that the war in Ukraine is having a significant impact on economies across the world. However, yesterday, we saw the renewed warnings from the Organisation for Economic Co-operation and Development that, next year, as a result of the Tory Government’s disastrous Brexit and shambolic economic policies, the United Kingdom will be the second worst performer of the world’s largest economies. [

Interruption

.] Does the Deputy First Minister share my concern that, while the economies of countries such as Ireland will grow next year, Scotland can only look on powerless as the UK continues its decline, which has been accelerated by Brexit, making it more difficult to recover from the pandemic?

John Swinney (Scottish National Party, Perthshire North)

I am not quite sure why Mr MacDonald’s question, which is based on the substantive analysis of the OECD, was met with groans from the Conservative benches, because now, in the United Kingdom, we are wrestling with the economic consequences of Brexit, which was inflicted on us against our will by the Conservative Government. In September, that was added to by the folly of the mini-budget, which was entirely of Conservative design and will cause significant negative impact for many years to come. In addition, the political inertia of the United Kingdom Government since the revelation of partygate in December last year has resulted in there being no effective functioning domestic government in the UK over that period, and the inflationary pressures that arose from energy cost rises were not interrupted over the course of this summer. Therefore, we are dealing with very acute economic difficulties as a consequence of decisions that have been voluntarily taken by the Conservative Government. The implications are significant.

I will do all that I can to protect people from the effects of the Conservatives’ folly, but I cannot protect people from every aspect of the damage that has been done by the United Kingdom Government.

Covid Recovery Strategy (Impact of Inflation)

Emma Roddick (Scottish National Party, Highlands and Islands)

8. To ask the Scottish Government what assessment it has made of the impact that the increase in inflation will have on Scotland’s public services, as many are still dealing with the impact of the pandemic. (S6O-01580)

John Swinney (Scottish National Party, Perthshire North)

The current financial year’s budget has been significantly diminished by the corrosive effects of inflation. At the same time, demand for Government support and intervention is, understandably, increasing, and we have not received additional funding to compensate for the reduced buying power of that funding. The emergency budget review aimed to support those who need most help, while also managing the nation’s budget, which meant taking difficult decisions to further prioritise spending and find savings.

The

Covid recovery strategy, which has been agreed with local government, focuses on reducing systemic inequalities, tackling poverty and supporting the people who have been most affected during the pandemic. Despite the challenges that I have outlined, we remain committed to the strategy and the achievement of its outcomes.

Emma Roddick (Scottish National Party, Highlands and Islands)

From our national health service and social care sector to our local authority colleagues, people who come to live in Scotland are a huge asset and should be welcomed with open arms. However, Labour and the Tories are in absolute lockstep with each other, as they continue to ignore Scotland’s needs on every serious challenge that faces us right now. What powers would the Scottish Government need in order to ensure an open, welcoming system of migration that supports our public sector to deliver on the Covid recovery strategy?

The Deputy Presiding Officer

Deputy First Minister, perhaps we could focus on the impact of the increase in inflation with regard to those matters.

John Swinney (Scottish National Party, Perthshire North)

I will certainly do that, Presiding Officer, because the effects of inflation are undermining the purchasing power of our economy. As a consequence of that, and as a consequence of the issues that Emma Roddick raised about the migration stance of the United Kingdom Government, there is acute pressure on the availability of individuals to enter the labour market. We have historically low unemployment and historically high employment in the Scottish labour market now. That is creating acute labour shortages and acute inflationary pressures as a consequence.

Douglas Lumsden (Conservative, North East Scotland)

Is that causing inflation?

John Swinney (Scottish National Party, Perthshire North)

For Mr Lumsden’s benefit, that is causing acute inflationary pressures and, if Mr Lumsden wants to ask me a supplementary question, I will go into a lot of detail about the inflationary pressures that arise from migration challenges, because all of the available evidence highlights that particular point.

The Scottish Government, through the work of our ministerial population task force, tries to develop concepts such as the rural visa pilot proposal, which is designed to address some of the questions that Emma Roddick has raised with me, but we need a fuller range of responsibilities to enable us to address the negative effects of the migration stance of the UK Government.

The Deputy Presiding Officer

That concludes portfolio questions on Covid-19 recovery and parliamentary business.

Finance and the Economy

The Deputy Presiding Officer

The next portfolio is finance and the economy. If any member wishes to ask a supplementary question, they should press their request-to-speak button or enter “RTS” in the chat function during the relevant question. Again, I make a plea for succinct questions and answers.

Orkney Islands Council (Scottish Budget)

Liam McArthur (Liberal Democrat, Orkney Islands)

1. To ask the Scottish Government what discussions it has had with Orkney Islands Council regarding the Scottish budget 2022-23. (S6O-01581)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government continues to meet the Convention of Scottish Local Authorities and individual local authorities on a regular basis to cover a range of topics, including current and future budget pressures.

I was pleased to meet Councillor Stockan on 31 August during my visit to South Uist, which observers will note is not in Orkney, but it was on the occasion of a meeting with three island authority leaders, which took place on South Uist. I responded to Councillor Stockan’s most recent letter on 21 November, confirming that we will make arrangements to meet again at the earliest opportunity.

Liam McArthur (Liberal Democrat, Orkney Islands)

I thank Mr Swinney, and I confirm that we islanders are known to travel to different islands from time to time.

This week, Orkney Islands Council warned that the precarious state of the internal ferry fleet is risking “life and limb”, with the vulnerability of vessels having been exacerbated by recent repairs to ancient hulls and the grounding of the MV Varagen earlier this month.

I understand that Mr Swinney will meet Councillor Stockan shortly to discuss those concerns in the context of OIC’s forthcoming budget settlement. Does he accept that ferry replacement is now a matter of public safety? If so, what assurances can he offer my constituents that the Scottish Government is taking the matter seriously and is committed to finding an urgent resolution to this long-running saga?

John Swinney (Scottish National Party, Perthshire North)

In relation to the recent grounding of the MV Varagen, I was pleased that everyone was safe after what was a worrying incident.

Councillor Stockan has raised the issue of the strength of the interisland ferry fleet, which I appreciate causes significant concern to Orkney Islands Council and to islanders. Islanders rely on regular services in that respect, and we must make sure that those are operational and safe. That will be one of the points that Councillor Stockan and I will discuss, and I am aware that Councillor Stockan has also discussed the issue with the transport minister, Jenny Gilruth. I assure Mr McArthur that the Government is engaging constructively on the importance of renewing the ferry fleet to serve all our island communities.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

Presiding Officer, I apologise that I will have to leave before the end of this session to meet another commitment, as advised.

The cabinet secretary will be aware that the road equivalent tariff was delivered on ferry routes in the northern isles by the middle of 2018; however, during the intervening four and a half years, while Shetland has benefited from those arrangements, Orkney has been left behind. That is a failure to deliver on its pledge that will have saved the Scottish Government considerable sums of money.

Will the cabinet secretary confirm how much money the Scottish Government is estimated to have saved by not delivering RET as promised, and how will he ensure that the money will be reallocated in the budget to allow it to be used for the economic benefit of Orkney?

John Swinney (Scottish National Party, Perthshire North)

What Mr Halcro Johnston misses out is the fact that the Government has substantially increased investment in ferry services in Scotland. When the ferries plan was developed in 2012, if my memory serve me right, the budget was a bit over £100 million, and it is now well over £300 million. Substantial investment has been made in ferry services and in road equivalent tariff. The Government works constructively with individual island authorities to maximise their economic potential, which will continue to be the case with Orkney Islands Council.

Construction Apprentices and Workers

Monica Lennon (Labour, Central Scotland)

2. To ask the Scottish Government what discussions finance ministers have had with the Minister for Higher Education and Further Education, Youth Employment and Training to assess the number of construction apprentices and construction workers needed to support the recovery of Scotland’s economy and meet its net zero targets. (S6O-01582)

Richard Lochhead (Scottish National Party, Moray)

The Minister for Higher Education, Further Education, Youth Employment and Training and I share the commitment to ensure that our current and future workforce has the skills needed to support the transition to net zero.

The construction sector will need more than 25,000 additional workers by 2026, including workers with skills to support heat decarbonisation and offshore energy projects. The Scottish Government recognises that apprenticeship pathways are key to that and we are working with the skills agencies to increase the number of apprentices back to pre-pandemic levels.

Monica Lennon (Labour, Central Scotland)

I welcome the minister’s commitment. I asked about discussions with other ministerial colleagues. The minister might be aware that, last week, in my capacity as the convener of the cross-party group on construction, along with a number of industry stakeholders, including Unite the union, I met Jamie Hepburn to discuss the serious issues that are affecting construction crafts apprenticeships. The meeting was fairly positive, and we hope that a solution is in sight. However, there is a serious backlog, which is affecting around 1,700 apprentices and impacting on employers and colleges. We need a resolution, and we need to learn lessons.

Will the minister assure me that discussions are going on behind the scenes in Government? Might we get a statement from Government to Parliament by the end of the year to make sure that everyone who is waiting for good news receives it?

Richard Lochhead (Scottish National Party, Moray)

I will certainly convey the member’s request for a ministerial statement to the skills minister. I know that productive discussions were had, as the member mentioned, in the past week or so.

To assure the member and, indeed, Parliament, I note that, as the member might be aware, the climate emergency skills action plan is being refreshed and will be published in 2023. In addition, discussions are taking place across portfolios with the green skills minister, Lorna Slater, Jamie Hepburn and me, in my role as just transition minister. Talks are planned for the coming weeks, to make sure that the required skills are available.

Yesterday, I was in Aberdeen, visiting North East Scotland College to discuss how it is using £4.5 million that it secured from the just transition fund for north-east Scotland to build a facility to ensure that apprentices are trained up as welders for offshore platforms, electricians for installing electric vehicle charging points and so on.

A lot of activities are taking place across the country and I assure the member that we are co-ordinating them as much as we can.

Willie Rennie (Liberal Democrat, North East Fife)

We have been waiting for five years for the skills landscape reform, and the minister acted only after Audit Scotland criticised his lack of leadership in that area. The coherence and stability review for the college sector has largely been delayed, which happened in the middle of a crisis in the college sector. What chance do we have of increasing the number of construction apprentices and workers if there is a delay to reforming the skills agenda?

Richard Lochhead (Scottish National Party, Moray)

As the economy will transform over the next 10 years to help us get towards our net zero targets, it is clear that we must keep our skills landscape under review, given the 21st-century challenges that we face. James Withers has been appointed to carry out the review.

This Government has an excellent track record of delivering apprenticeships over the past few years. Of course, there has been a bit of a blip, because of the impact of Covid. We are now making up for lost ground. Skills Development Scotland has been instructed to deliver 25,000 apprenticeships from the start of this financial year and then to build back up to 30,000 a year in due course.

Net Zero (Economic Benefit to Scotland)

Brian Whittle (Conservative, South Scotland)

3. To ask the Scottish Government what assessment it has made of the potential economic benefit to Scotland of moving to a low-carbon economy and achieving net zero. (S6O-01583)

Richard Lochhead (Scottish National Party, Moray)

There are benefits and many opportunities arising from our transition to net zero, not least in the key energy transition sectors such as renewables and green hydrogen, but also more broadly across the whole economy, as we reduce emissions from transport, industry and our homes and as we build our natural capital resources.

The opportunities are set out in our national strategy for economic transformation and our hydrogen action plan. Those will be further developed as we bring forward our energy strategy refresh, which includes a just transition plan for energy, in the coming weeks, as well as our new climate change plan and our other just transition plans in the coming years.

Brian Whittle (Conservative, South Scotland)

The minister might be aware that NatWest has estimated that moving to net zero could be worth £22 billion to the Scottish economy. However, it warns that Scotland must increase that support to develop services in the supply chain and small and medium-sized businesses by a factor greater than two, which is much more than that required by the rest of the United Kingdom.

According to the NatWest report, we are behind the rest of the UK. What is the Scottish Government doing to support the development of our SME sector to ensure that the opportunities for our supply chain and the support services that are needed to achieve net zero remain here, in Scotland?

Richard Lochhead (Scottish National Party, Moray)

I am sure that the member will want to welcome the report that came out last week presenting independent research by Skills Development Scotland, the University of Warwick and the University of Strathclyde, which said that there are now up to 100,000 green jobs in Scotland. Although that is an upper estimate and it is still being researched, it is a very good indication that the green jobs revolution has started in Scotland.

We are not behind the rest of the UK. Numerous reports from PricewaterhouseCoopers, and a Fraser of Allander Institute report called “International Scotland” that came out just last week, show that Scotland is making excellent progress on that agenda in comparison with the rest of the UK. I do not think that we should talk Scotland down in that regard.

I agree with the member, of course, that there is a lot more to be done. He will be aware of the supply chain work in relation to ScotWind and other projects that have the potential to deliver thousands more green jobs in Scotland.

Daniel Johnson (Labour, Edinburgh Southern)

The emergency budget review cut £38 million from energy efficiency and £45 million from heat in buildings. Can the minister outline what impact that will have on the delivery of our net zero targets?

Richard Lochhead (Scottish National Party, Moray)

The member will be aware, of course, that we face a very difficult budget environment because of inflation. Indeed, the acting finance secretary outlined some of the challenges in his answer to questions just a few moments ago.

However, we are making good progress. There is a lot of planning in the pipeline. The just transition plans for energy, in the first instance, will address some of those issues. Those plans will be published with consultations in the coming weeks, after which members of Parliament can submit their views over a 12-week period.

There are good, positive signs that we are making progress in terms of green jobs being created, with the potential for many more in the near future.

West Scotland and Greater Glasgow (Economic Investment)

Pam Gosal (Conservative, West Scotland)

4. To ask the Scottish Government whether it will provide an update on how it is investing to support the economy across the West Scotland and Greater Glasgow areas. (S6O-01584)

Richard Lochhead (Scottish National Party, Moray)

The Scottish Government is a full partner in the Glasgow city region city deal, contributing £500 million over 20 years to the infrastructure investment fund. The deal empowers Glasgow and its city region partners to identify, manage and deliver a programme of investment to stimulate economic growth and create jobs in their area.

Similarly, the Scottish Government is investing £103 million in the Ayrshire growth deal, which will see transformational investment in projects across Ayrshire over the next 10 years to support long-term inclusive growth there.

Pam Gosal (Conservative, West Scotland)

If Glasgow city region were to be awarded the Clyde green freeport, it would be a massive boost to the local economy in Glasgow and the wider region. It would provide high-quality jobs and investment opportunities, in addition to accelerating net zero ambitions.

Several Scottish Greens and a Scottish National Party member of the Scottish Parliament have supported motions urging the Parliament to oppose the Clyde green freeport bid and all other Scottish freeport bids. Will the minister state his support for the Clyde green freeport bid? Does he welcome that positive co-operation between the Scottish and United Kingdom Governments?

Richard Lochhead (Scottish National Party, Moray)

Understandably, the member makes the case for her own region in terms of the green freeport bids. She will be aware that they are under consideration by the Scottish and UK Governments, and announcements will, I hope, be made in due course. There are a number of bids from across the country. The member has made her point well, and she will have to wait until the final announcements are made.

Natalie Don (Scottish National Party, Renfrewshire North and West)

Will the Scottish Government provide an update on the advanced manufacturing innovation district Scotland site in my constituency, which will include two new world-class innovation centres—the national manufacturing institute Scotland and the medicines manufacturing innovation centre—and on the projected impact on the economy of the west of Scotland and the greater Glasgow area?

Richard Lochhead (Scottish National Party, Moray)

Natalie Don has outlined many of the benefits of that work, and the Scottish Government is fully supportive of it. The

advanced manufacturing innovation district Scotland site is part of the £39 million city deal that is funded by the Glasgow airport investment area project. Work is well under way to deliver on the ambitious innovation district project.

The impact of the Glasgow city region deal will be transformational for local communities in attracting investment. Building on that investment, as Natalie Don will be aware, the Glasgow city region deal has created a regional economic strategy to help shape the long-term, post-deal economic future of the region.

Rural Broadband (Investment)

Alexander Stewart (Conservative, Mid Scotland and Fife)

5. To ask the Scottish Government how it is investing in rural broadband. (S6O-01585)

The Deputy Presiding Officer

I call the minister, Tom Arthur.

Oh—I am wrong. I apologise. It is Richard Lochhead.

Richard Lochhead (Scottish National Party, Moray)

Yes—I am still Richard Lochhead.

Future-proofed digital connectivity is vital for our rural communities, and Scottish Government delivery programmes have already connected around 1 million properties across Scotland to faster broadband. We are investing more than £600 million through the R100—reaching 100 per cent—contracts, to extend full-fibre broadband access to some of the hardest-to-reach rural communities in Scotland. Our Scottish broadband voucher scheme also provides funding to connect those who are not part of our R100 contracts or of commercial build plans.

It is also imperative that we urge all the relevant United Kingdom Government departments to extend Gigabit Networks services to Scotland’s rural communities, given that—of course—telecommunications is an entirely reserved matter.

Alexander Stewart (Conservative, Mid Scotland and Fife)

The Scottish National Party pledged to have the R100 scheme completed by 2021, but now, after the failure to meet that target, the new estimated date is 2026. I have a response to a freedom of information request that shows that the R100 scheme has cost £21 million since it should have been completed last year. That is an enormous cost to the taxpayer and shows that the SNP pledge for 2021 has not taken place. Does the minister agree that that failure will ruin rural communities’ chances of ever getting the broadband connections that they deserve, just as the ferries fiasco did with transport connections?

Richard Lochhead (Scottish National Party, Moray)

Maybe I should have asked Tom Arthur to answer this question.

If the member’s Tory colleagues in the UK Government, who have exclusive competence for telecommunications, had acted a few years ago and got their act together, it would not have been down to the Scottish Government to step in with hundreds of millions of pounds of investment to make up for lost time.

The R100 project is game changing for many parts of rural Scotland. According to thinkbroadband, which the UK Government also uses to gauge the success of its programmes, 95.1 per cent of premises across Scotland are now able to access superfast broadband speeds of 30 megabits per second and above, which is up from just 59.3 per cent in 2014, when deployment began. That is superb progress. The investment by the Scottish Government is making a real difference to rural communities in the south of Scotland and throughout the country.

Alasdair Allan (Scottish National Party, Na h-Eileanan an Iar)

The disruption to EE’s 4G mobile service, which my constituents in Uig have now been enduring for six weeks, has effectively cut off a huge geographic area from all broadband access and severely impacted on medical and other essential services. Given that, does the minister agree that EE’s response has been truly woeful? Will he commit to facilitating a meeting in Uig between the R100 team and the community?

Richard Lochhead (Scottish National Party, Moray)

That is clearly a very serious issue in Alasdair Allan’s constituency. Although ensuring that 4G mobile connectivity is maintained is a reserved part of UK telecommunications legislation—which means that the Scottish Government does not have a mechanism to intervene directly in such matters—we will certainly consider the member’s request and I will ensure that he is written to shortly.

Responsibility falls on Ofcom, as the UK’s telecoms regulator. However, as with the recent telecoms outages that were suffered on Shetland and Coll, we urge operators to ensure that they rectify such issues as a matter of urgency.

For our part, we are investing £28.75 million in the Scottish 4G infill programme, which is delivering 4G mobile infrastructure and services throughout rural Scotland, including the Western Isles.

Land Value Tax (Discussions)

Katy (Labour, West Scotland)

6. To ask the Scottish Government what discussions the finance ministers have had with ministerial colleagues regarding any plans to investigate the feasibility of a land value tax. (S6O-01586)

Tom Arthur (Scottish National Party, Renfrewshire South)

Although there have been no recent discussions on the feasibility of introducing a land value tax in Scotland, we will continue to look closely at the Scottish Land Commission’s recommendations on land reform and taxation, review any evidence in detail and assess that as part of our wider approach to tax policy.

As ever,

we are open to exploring how the Scottish Government can support land reform objectives, using its limited powers over taxation to generate revenues to invest in our public services and support a sustainable and inclusive wellbeing economy.

Katy (Labour, West Scotland)

It is estimated that 432 people own 50 per cent of the privately held land in Scotland.

In 2021, a record £447 million was invested in the purchase of private Scottish estates, which was a 333 per cent increase from 2018. Given that financial backdrop, does the Government accept that it is now essential that we introduce a land value tax as a matter of urgency?

Tom Arthur (Scottish National Party, Renfrewshire South)

As I said in my original answer, we are considering recommendations carefully. Clearly, the introduction of a new tax is a substantial matter. Although the Parliament enjoys powers to introduce local taxes, new devolved national taxes require the agreement of the United Kingdom Government and the Westminster Parliament. We are considering the details carefully; if we take forward any measures, we will do so in a way that is consistent with our framework for tax.

Ariane Burgess (Green, Highlands and Islands)

It is clear from stakeholders and constituents that high land prices can impede regeneration efforts and hinder attempts to assemble land for community-led development. That is why the Bute house agreement commits to delivering an effective and fair mechanism for capturing for public benefit a share of the increase in land value when a development is supported through the planning system.

What benefits does the minister see coming from that commitment? Will he give an update on progress in that regard?

Tom Arthur (Scottish National Party, Renfrewshire South)

We have, of course, been focused on preparation and delivery of our revised national planning framework 4, and I very much look forward to appearing before the Local Government, Housing and Planning Committee next week to give evidence on it.

As we move into the new year and when, I hope, Parliament approves and adopts the new national planning framework, we will turn our attention in earnest to delivery of the framework. That work will encapsulate a range of actions, including continued roll-out and implementation of the provisions in the Planning (Scotland) Act 2019, our on-going review of planning obligations and taking forward the Scottish Government’s and the Scottish Green Party’s commitment on the matters that the member raised.

Autumn Budget Statement (Impact on Scotland’s Finances)

Jenni Minto (Scottish National Party, Argyll and Bute)

7. To ask the Scottish Government what assessment has been made of the impact that the United Kingdom Government’s autumn statement will have on Scotland’s public finances. (S6O-01587)

Tom Arthur (Scottish National Party, Renfrewshire South)

The autumn statement has shown that households across Scotland are paying a steep price for the economic mismanagement of the UK Government, with the Office for Budget Responsibility warning that average household disposable income will drop by 7.1 per cent next year.

Inflation is eating away at the Scottish budget, which has fallen by 10 per cent in real terms between last year and this year. Due to the lack of additional funding in 2022-23 and the fiscal constraints of devolution, we have had no choice but to have already made unplanned savings of more than £1 billion. The corrosive impact of inflation and the turmoil that has been caused by the UK Government’s economic choices mean that the Scottish Government is facing very difficult choices on public spending over the next few years.

Jenni Minto (Scottish National Party, Argyll and Bute)

Earlier this month, the Bank of England warned that the UK might be facing the longest recession in a century. Does the minister share my concern that the UK Government’s plans to cut public spending risk prolonging the recession? Will he advise what alternative priorities could be pursued if the Scottish Parliament had full financial powers?

Tom Arthur (Scottish National Party, Renfrewshire South)

I share Jenni Minto’s concern. The Office for Budget Responsibility has painted a grim picture, with the UK economy now forecast to be no bigger at the end of the current UK parliamentary term than it was at its start. That means that there will have been five years of economic stagnation. That, combined with yesterday’s forecast from the Organisation for Economic Co-operation and Development, which is predicting that the UK economy will be the worst hit of all G7 nations, is a devastating indictment of the UK Government’s management of the economy.

We have made no secret of our frustration about the limitations that are imposed on us by the current fiscal framework. Our reserve funding is capped, our tax powers are limited and we have no legal ability to borrow to fund day-to-day spending. Not one of the three main Westminster parties supports giving the Scottish Parliament the fiscal flexibilities that it requires. Consequently, the only means by which we can assume those financial powers, which are so necessary, is by the Scottish Parliament assuming the powers of an independent country.

Privatisation of Public Assets

Richard Leonard (Labour, Central Scotland)

8. To ask the Scottish Government what assets currently in public ownership it plans to privatise. (S6O-01588)

Tom Arthur (Scottish National Party, Renfrewshire South)

The Scottish Government works on a case-by-case basis to secure the best outcomes for assets in public ownership. The Parliament would be notified of any future agreement to return a commercial asset to the private sector.

Richard Leonard (Labour, Central Scotland)

Three weeks ago, the First Minister told the Public Audit Committee that

“the Government’s position is that, ultimately, we want all the commercial assets that we have taken ownership of to be back in the private sector”.—[

Official Report

,

Public Audit Committee,

4 November 2022; c 42.]

I ask again, in the interest of openness and democracy: will the minister tell Parliament this afternoon what assets the Scottish Government wants to privatise?

Tom Arthur (Scottish National Party, Renfrewshire South)

I can only refer the member to my previous answer, which was that we work case by case to secure the best outcomes for assets in public ownership, and that Parliament would be notified. It is thanks to the Government’s intervention that many jobs have been saved, and the contributions that the relevant industries are making to the economy are being made only because of the actions of the Government.

Siobhian Brown (Scottish National Party, Ayr)

Ferguson Marine (Port Glasgow) Limited is clearly not without its challenges, but, by stepping in the Scottish National Party Government saved Scottish shipbuilding on the Clyde and hundreds of jobs that went with it. We now also see that Glasgow Prestwick Airport Limited is turning a welcome profit. Does the minister agree that moving assets and businesses into public ownership when they are failing in the private sector can and does work?

Tom Arthur (Scottish National Party, Renfrewshire South)

I agree. We have shown how we can, through our strategic investments, realise benefits to communities and businesses. Taking businesses into public ownership is a complex issue and in each case we work to understand the legal, financial and policy implications. I am delighted that Prestwick airport continues to grow steadily and is making a positive contribution to the local and regional economies as it supports 300 direct jobs and many more indirect jobs.

Through our intervention at Ferguson Marine, we have shown that we are standing by our commitment to the shipbuilding communities in Inverclyde, where we have rescued more than 300 jobs and supported our island communities that rely on the vessels.

The Deputy Presiding Officer

That concludes portfolio questions on finance and the economy. Before we move to the next item of business, there will be a short pause to allow front-bench teams to change positions, should they wish to do so.

Primary Care

Liam McArthur (Liberal Democrat, Orkney Islands)

The next item of business is a debate on motion S6M-06899, in the name of Jackie Baillie, on protecting primary care. I invite members who wish to participate in the debate to press their request-to-speak buttons, or to place “RTS” in the chat function if they are joining us online, as soon as possible.

Jackie Baillie (Labour, Dumbarton)

For most people across Scotland, the first point of call when it comes to their health is their general practitioner. GPs are very much at the front line of our national health service. Without functioning GP services, our health system would collapse.

In some areas of Scotland, however, GPs are closing their doors and handing back their contracts, and thousands of patients are being left without a GP. In other areas, lists are closed to new patients, and practices are simply unable to cope with the volume of patients that they have and to fill vacancies as GPs retire. I have letters from GPs in Lothian and Aberdeenshire and from a medical practice in Falkirk that is struggling to survive.

The Scottish Government must act to address the looming crisis in primary care, or more patients will struggle to get the help that they need. I will illustrate that point with some of the facts. GPs are seeing 500,000 people a week, which is a lot more than they were seeing before the pandemic. Most of them are working additional hours to try to meet the demand, and many can provide emergency appointments only due to short staffing as a result of vacancies or illness.

In a recent British Medical Association survey, 81 per cent of GP practices said that demand exceeded capacity, 34 per cent reported GP vacancies, and practices estimated that they are about 1,000 GPs short at present. The Royal College of General Practitioners says that there will be a need for even more GPs by 2027. Despite that, there is a lack of clarity about GP numbers. The Government bases its numbers on head count, but the truth is that many GPs work part time, and the flagship target of 800 GPs is well short of what is actually required. I ask the cabinet secretary to outline the urgent action that he intends to take to improve practice staffing and to say whether he will be transparent about GP numbers.

The SNP makes claims about the increase in multidisciplinary teams, but they are contradicted by GPs. Despite the recruitment activity, the Royal College of Nursing reports that 12 per cent of district nurse posts are unfilled. When we consider the numbers of allied health professionals, we see that there are 346 physiotherapy vacancies.

Faced with those challenges, it is extraordinary that the SNP has cut the health and social care budget by £400 million. Some £65 million has been cut from the primary care development fund alone, and £5 million has been cut from the GP sustainability fund. Our tone deaf health minister, Humza Yousaf, announced that at the same time as he is telling people to stay away from accident and emergency departments and to go to their GP instead.

That is just about the most wrong-headed decision that I have seen: cutting resources for GPs when they most need them, during a winter crisis. It represents breathtaking incompetence on the part of this SNP health minister. GPs are on their knees, and if the Scottish Government fails to address their serious concerns, more people will end up in already overwhelmed acute services when they could have been dealt with locally in primary care.

I urge the cabinet secretary to reverse the cuts and listen to the British Medical Association and the Royal College of General Practitioners. They are telling him that there is a crisis, so I say to him, “For goodness’ sake, please act.” Perhaps he could use for that purpose the £20 million that has been earmarked for a referendum. It never fails to astonish me that, when the nation is focused on a crisis such as the one that our NHS faces this winter, the SNP is focused on the constitution.

At the start of the week, there were extraordinary revelations that senior NHS executives were discussing the privatisation of our NHS. The discussion was green lit by Caroline Lamb, the most senior civil servant in charge of health for the SNP Government. Either the cabinet secretary knew about that and is complicit or he did not know about it, in which case he really cannot be trusted to be in charge. Either way, we can usually judge how close to the mark we are by the volume of abuse and aggression from SNP members and supporters, not just on social media but in the chamber.

This is a damaging story for the SNP, because it tells us that the NHS in not safe in SNP hands. Inside or outside the United Kingdom, the SNP—

Gillian Martin (Scottish National Party, Aberdeenshire East)

Will the member take an intervention?

Jackie Baillie (Labour, Dumbarton)

I will not. The member should listen to this.

Inside or outside the UK, the SNP

would contemplate a two-tier NHS where those who can afford to pay would get faster and better treatment and those who are not wealthy would receive a poorer service from a residualised NHS. However, the SNP is already presiding over a two-tier system. More and more people are paying for private consultations, diagnostics and operations. Those are some of the 700,000 people on waiting lists—

the one

in seven Scots who are being failed by the SNP and by Humza Yousaf.

Gillian Martin (Scottish National Party, Aberdeenshire East)

Will the member take an intervention?

Jackie Baillie (Labour, Dumbarton)

The minutes of the discussion are also interesting as they confirm something that we already know—that the cabinet secretary does not listen. He does not listen to clinicians or to civil servants. He is paralysed and he does not make decisions. People across the NHS have lost confidence in him.

Audrey Nicoll (Scottish National Party, Aberdeen South and North Kincardine)

Will the member take an intervention?

Jackie Baillie (Labour, Dumbarton)

A

s for the £1 billion black hole in the NHS budget, we should look no further than Nicola Sturgeon. When she was the health minister, she failed to pass on funding from the Labour UK Government to the health budget.

I will finish with two quotations. The first is from the

Scotsman

leader yesterday, which said:

“Whether or not this was part of a brainstorming exercise, it is deeply concerning that it has come to this.”

That is right. Secondly, Neil Mackay wrote in

The Herald

“If the NHS is a benchmark, then the SNP is unfit for government.”

Those are damning words indeed. This cabinet secretary is unfit for office, the SNP is unfit for Government, and Humza Yousaf should do the right thing and resign.

I move,

That the Parliament notes the recent warnings by BMA Scotland about the pressures on general practice, with 81% of practices surveyed reporting that demand was exceeding capacity and it estimating that an extra 1,000 whole time equivalent (WTE) GPs are needed now; understands that not all practices have access to full multi-disciplinary teams, limiting GPs’ ability to focus on the patients that need them most, and therefore regrets the Scottish Government’s decision to cut £65 million from primary care services and £5 million from the Sustainability Payment to practices; considers that this diminishes the ability of GPs to respond to winter pressures and will exacerbate the crisis in primary care, with serious consequences for staff and patients and the wider NHS this winter; is alarmed by reports that NHS board chief executives are considering the implementation of a two-tier system of access within the NHS, and considers this to be privatisation through the back door; remains committed to the founding principle of the NHS of being freely available at the point of need; calls on the Scottish Government to reconsider the cuts to primary care and to give an urgent update on where the 800 additional GPs it pledged in 2017 will be located, and regrets that the Scottish National Party administration is considering the privatisation of the NHS in Scotland.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Does it not show insecurity in her own argument that Jackie Baillie was not able to take a single intervention? This is meant to be a debate, but Jackie Baillie—

Daniel Johnson (Labour, Edinburgh Southern)

Will the cabinet secretary give way?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

At 14 seconds into my speech, I am happy to give way to Daniel Johnson.

Daniel Johnson (Labour, Edinburgh Southern)

If the cabinet secretary is so keen on interventions, will he answer this question? Did he know about the meeting and agree to it or did it happen without his consent?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

It was a meeting of five people with one chief executive present. Believe it or not, with the more than 160,000 healthcare workers that we have, I do not know about every meeting that takes place. [

Interruption

.]

The Deputy Presiding Officer

Mr Johnson.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

When I have met chief executives and the chairs of health boards, not one of them has ever floated the idea of charging patients. If they did that, I would, to be frank, tell them that that is not up for discussion under this Government.

I say to Jackie Baillie and Scottish Labour, who have brought to the chamber this serious debate on a serious issue—which was not given any serious consideration by Jackie Baillie in a speech that was, to be frank, ludicrous—that we should start by thanking all our primary care teams: not just our general practitioners, those who work in reception and our multidisciplinary staff, but primary care staff across the piece. I thank every one of them.

On Jackie Baillie’s concerns about the founding principles of the NHS and thanking our healthcare workforce, I give a categorical assurance that our Scottish NHS will never be sold off into private hands under this Administration.

The Government holds true to the founding principles of the NHS and Nye Bevan’s vision of patient care that is free at the point of need. We should be judged on our track record on that, which is, of course, one of abolishing prescription charges, removing dental charges for young people and continuing to fund free eye tests. Let us have it recorded that this Government will keep the NHS in Scotland publicly owned, publicly operated and free at the point of use.

Jackie Baillie decries the Government having to reprofile health spending to combat sky-high inflation due to Conservative mismanagement of the economy or to afford record high pay deals. There is one place that I would love to be able to save money: in the £250 million that Scottish people are still paying for Labour’s disastrous private finance initiative and public-private partnership projects to build hospitals in Scotland. Jackie Baillie was only ever trusted in government for the briefest of periods, but she should take the opportunity to apologise to every person in Scotland that they are still paying the price for Labour’s privatisation of our NHS.

Our general practice and primary care services have been impacted by Brexit, the pandemic and the cost of living crisis, but we will continue to invest in our multidisciplinary teams. Jackie Baillie seemed to talk them down, but 3,220 multidisciplinary staff and professionals have been recruited since 2018. Therefore, when people walk into their general practice, not only are they likely to be able to see general practitioners who do a phenomenal job, but they may well be able to see physiotherapists, advanced nurse practitioners and a multitude of multidisciplinary staff across the piece. Those individuals are there not only to give the best possible service to the public that they see, but to ensure that the incredible workload in general practices is spread more evenly.

Mercedes Villalba (Labour, North East Scotland)

I have previously raised with the cabinet secretary my constituents’ concerns about the declining quality of patient care at some general practices in Aberdeen. He has given a commitment that his officials will determine improvement plans for practices to put in place, but I am yet to receive an update from him. I seek confirmation that that will be forthcoming.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I will give that update. Mercedes Villalba is absolutely right. She has raised the issue with me on several occasions. It is, of course, an issue for the local health and social care partnership, but I will endeavour to get her an update.

Several initiatives are under way to address GP recruitment challenges. We have recruited 277 GPs as part of the target of 800, and figures will be published soon that will provide an update to that. There is no single silver bullet when it comes to GP recruitment and retention, and a number of interventions are under way. I make no apology whatsoever for doing what I can to ensure that timely access to GP services for patients up and down the country is a top priority for this Government.

I move amendment S6M-06899.2, to leave out from “notes” to end and insert:

“recognises the pressures on primary care and right across the NHS and social care due to the effects of Brexit, the global pandemic and the cost of living crisis; notes that the overriding priority for the delivery of healthcare must be to deliver the best outcomes for patients; supports the actions of the Scottish Government to abolish prescription charges and recognises that, under the current administration, they will remain free for all; believes that prescription charges are a tax on illness and that healthcare must be based on the clinical needs of patients and not their ability to pay; recognises that primary care provision extends beyond the work of general practice and welcomes that free eye care tests continue to be protected, that dental charges have been abolished for young people, and that, through NHS Pharmacy First, more first-line care is being provided for free through community pharmacies; recognises, in general practice, that Scotland currently has a record high level of GPs and that Scotland has proportionately more GPs than any other nation in the UK; welcomes that efforts to recruit 800 additional GPs by 2027 are on track, with 277 already in post by 2021; understands that, to support GP practices, over 3,220 multidisciplinary healthcare professionals have been recruited since 2018; acknowledges that primary care funding has increased again in the current financial year and understands that integration joint board reserves provided for primary care are to be utilised for primary care; recalls that it was the current administration that took the legislative steps necessary to stop the privatisation and commercialisation of GP services that was permitted by the previous Labour-led administration; further recalls that it was the current administration that brought Stracathro back into the NHS after its work was put into private hands by the previous Labour-led administration, and shares the Scottish Government’s unswerving commitment to the founding principles of the NHS to be publicly owned, publicly operated and free at the point of need.”

The Deputy Presiding Officer

There is a little time in hand, so I can give members a bit of time back for taking interventions. I would far prefer that to people shouting from a sedentary position.

Sandesh Gulhane (Conservative, Glasgow)

Jackie Baillie’s debate today is timely, because this week we learned about damning minutes of meetings of senior management of Scotland’s health boards, which, ultimately, are under the control of the Scottish Government’s health secretary. The minutes tell us that the health secretary’s NHS bosses have been weighing up charging wealthier patients to access NHS services.

After 500 days of failure in charge of Scotland’s NHS, that is a new low. The cabinet secretary is on record as saying that he would never consider charging anyone to use the NHS and that he finds the idea “abhorrent”. I wonder whether he also finds his record in office abhorrent. Here is a snapshot: the worst cancer waiting times on record—

Humza Yousaf (Scottish National Party, Glasgow Pollok)

It is better than England.

Sandesh Gulhane (Conservative, Glasgow)

—

and the worst delayed discharge record, with an average of 1,832 beds occupied each day due to delayed discharge. I heard the cabinet secretary say “better than England” from a sedentary position—we live in Scotland.

We have the worst NHS backlogs. Almost 700,000 patients are waiting for NHS treatment, according to the latest figures. That is the highest number since those stats were recorded in their current form.

Gillian Martin (Scottish National Party, Aberdeenshire East)

Sandesh Gulhane said that “we live in Scotland.” Yes, we live in Scotland, but the Tories are presiding over the English NHS. Is it not right that we criticise your policies in England, where you are privatising by stealth, day in and day out? People will not want you in government in Scotland, because you will do the same here.

The Deputy Presiding Officer

Through the chair, please, Ms Martin.

Sandesh Gulhane (Conservative, Glasgow)

The first thing to say is that you should be representing your constituents—

The Deputy Presiding Officer

Through the chair, Dr Gulhane.

Sandesh Gulhane (Conservative, Glasgow)

The member should be representing her constituents here.

The second thing to say is that we cannot trust SNP statistics, as we have found when it comes to energy, because the SNP does not make a proper comparison with England. If we look at the stats, it is clear that the SNP stats are false.

Let us be clear. The situation is not in any way the fault of hard-working front-line NHS staff. Perhaps the cabinet secretary, instead of offering platitudes, should fund us properly.

Such is the seriousness of this week’s revelations that the First Minister weighed in to say emphatically that the founding principles of the NHS are not up for discussion. Well, they are being discussed on the SNP’s watch. What else could be being discussed?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Will Sandesh Gulhane take an intervention?

Sandesh Gulhane (Conservative, Glasgow)

Yes, if I can get the time back.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I wonder whether Sandesh Gulhane will recognise and apologise for his party’s economic mismanagement, which has meant that my health budget is worth £650 million less? If he thinks that there are other places where we should reprofile the health and social care budget, he should name them. At the very least, he should stand up and apologise for his party’s economic mismanagement.

The Deputy Presiding Officer

I can give you up to five minutes, Dr Gulhane.

Sandesh Gulhane (Conservative, Glasgow)

First, when errors were made by Liz Truss and Kwasi Kwarteng, they resigned, unlike SNP ministers, who never take responsibility for anything. Secondly, I am not sure whether the health secretary looks around the world and sees that inflation is a global issue. Finally on the question that the cabinet secretary asked—[

Interruption

.]

The Deputy Presiding Officer

Cabinet secretary!

Sandesh Gulhane (Conservative, Glasgow)

The cabinet secretary should listen to his own questions. He is spending £1.5 billion on setting up a bureaucratic national care service. There we go—I have found his money.

We hear that senior management are concerned about a disconnect between political decision makers and clinicians. They speak of siloed conversations behind the Government’s closed doors, without the chief medical officer and chief nursing officer. The language is stark: senior management appear to have little confidence and little trust in this health secretary and think that his input and suggestions are

“divorced from reality of life and purpose of service.”

Members should let that sink in.

Primary care is the backbone of our health service and the NHS is at breaking point. There are increasing, unsustainable demands, there is limited capacity, and GPs are experiencing burnout and demoralisation. More and more doctors are at the end of their tether and are choosing to leave the profession.

Last year, the Scottish Government pledged a £30 million sustainability support package, but we instead saw a cut of £5 million to this year’s budget. Instead of grandstanding and talking about money that it does not have, or using money on its pet projects, the Scottish Government should fund the NHS properly.

Let me reiterate: every additional day that the cabinet secretary remains in office makes him and the SNP-Green Government that he serves even further divorced from reality. The SNP cannot be trusted on health. NHS staff and patients do not trust this cabinet secretary, and it seems that neither do senior NHS managers—he should do the right thing and step down.

I refer members to my entry in the register of members’ interests, as I am a practising NHS doctor.

I move amendment S6M-06899.1, to insert at end:

“, and finds it extremely concerning that there are siloed conversations within the Scottish Government occurring without the Chief Medical Officer or Chief Nursing Officer, and that there is a lack of clinical input into political decision-making, leading to Scottish Government announcements being divorced from the reality of life and purpose of the service.”

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Presiding Officer, if you will permit me, I would like, as many of the contributions that we have heard so far have done, to focus my remarks on the crisis that general practitioners currently face. I was recently contacted by a group of GPs who work at a practice in my constituency, and I know that others have had similar approaches. One told me:

“Things in primary care are bleak. Everyone is simply exhausted, and working harder is not possible.”

Last month, that same practice received a letter from the SNP-Green Administration confirming a cut of £5 million in promised funding to Scottish GPs in this financial year. The Government has blamed that broken commitment on budget pressures that have been caused by inflation. That is also a slap in the face to our GP practices, as it completely ignores the fact that those practices are under the same inflationary pressures—they are getting it from both sides.

It is also another grim case of the Government playing games when it comes to announcing funding. The new figure was announced as part of the winter resilience package, giving the appearance that it was somehow new funding, when it is plainly a funding cut. This week, we saw the first frosts of winter, and cuts at this juncture will have a direct negative impact on practices’ ability to meet the inevitable increase in demand that the cold weather will present. Those cuts will make it even harder for heroic healthcare staff to provide the timely high-quality care that they desperately want to provide.

There has long been a workforce crisis in general practice, with a lack of GPs, practice nurses and other clinical staff, and, as we have already heard, 81 per cent of practices have reported that demand is exceeding capacity, with 1,000 GPs needed to plug the gap. In 2017, the SNP promised to increase the number of GPs in Scotland by at least 800 over the next decade, but five years on, the improvement in numbers has been glacial. GPs are forced to pay the price for yet more ministerial disinterest in that regard.

Levels of burnout are among the highest in the health service, and Lib Dem research has found that almost every GP who is leaving the profession is retiring before their planned retirement date. Many others are leaving for other reasons at a time that we need them most, and who can blame them?

Our health service is being overwhelmed. No matter how many times the cabinet secretary denies it, SNP mismanagement set us on this course long before anyone had heard the word “Covid”. I mention again that Paul Gray, the former head of NHS Scotland, said that this crisis was inevitable and that Covid only hastened its arrival. The SNP and the cabinet secretary need to cut out the excuses, stop abdicating responsibility and get on with the day job. It is a damning verdict on the SNP’s handling of the NHS that senior health bosses have been discussing extreme proposals such as charging for treatment. It is clear that they are alarmed at just how bad things have become.

However, I feel duty bound to highlight the intense hypocrisy of Conservative members raising the alarm on threats to the NHS when Rishi Sunak is registered with a private GP practice that guarantees same-day appointments. Let us not forget that a Tory Government failed to take the NHS off the table during Brexit negotiations. It seems that Scots currently have the worst of both worlds when it comes to protecting our most precious national treasure.

It goes without saying that my party is utterly committed to the core principles of our healthcare system—that it is available to everyone and free at the point of need. It was, after all, Liberal Democrats who brought free eye and dental checks and free personal care to Scotland. We are also committed to supporting—

Monica Lennon (Labour, Central Scotland)

Will the member give way?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Well, in coalition with the Labour Party we did.

Monica Lennon (Labour, Central Scotland)

It is on a different point.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am in my final minute. We are also committed to supporting all those on the front lines of our NHS; they have been asked to go beyond the call of duty for far too long. Their service warrants far better treatment than this.

The Deputy Presiding Officer

We move to the open debate.

Paul O'Kane (Labour, West Scotland)

Primary care is the front door of our national health service. It is the cornerstone that allows intervention as early as possible to ensure that people can be successfully treated in the community. It refers people to the support that they need in the right place, and it should be able to do that at the right time. It is that early intervention that keeps people out of hospital by diagnosing, referring or treating them before their condition deteriorates. It is a vital service that people have trusted over many years.

Our relationship with our GP is crucial in all of our lives, and supporting general practice is crucial to reducing pressure on acute and emergency services. However, a survey from the British Medical Association has revealed that four in every five—more than 80 per cent—of GP practices in Scotland have reported that demand for their service is exceeding their capacity and almost half have reported that the level of demand for their service is substantially exceeding capacity.

As colleagues have said, I am not alone in looking at my mailbox and seeing that it is full of people who are struggling to see their GP and full of GPs who feel at their wits’ end trying to do the job that they love fully. Indeed, Dr Andrew Buist, chair of the BMA Scottish GPs committee, issued a stark warning by saying that the situation in primary care is at a “tipping point” because of the Government’s decision to slash funding for GP practices by £65 million.

The target to recruit 800 GPs by 2027 is short of what is required, and it kicks the issue down the road. The SNP has had 15 years to get NHS workforce planning right, but it has failed miserably year after year.

Emma Harper (Scottish National Party, South Scotland)

Will the member accept that the ScotGEM—Scottish graduate entry medicine—programme, which is unique to Scotland and was introduced by the SNP, is welcome and is specifically looking to address GP vacancies in rural areas?

Paul O'Kane (Labour, West Scotland)

Of course, it is important that we look at the needs of every community in Scotland, but it is clear that the issues go far beyond that and that we need sustained investment.

For 15 years, there has been a lack of a strategic plan on NHS staffing not only for GPs but across acute settings and all other healthcare settings.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Will the member take an intervention?

Paul O'Kane (Labour, West Scotland)

I would like to make some progress, if the cabinet secretary does not mind, because I am conscious of time.

The NHS is the Labour Party’s proudest achievement. It has transformed the health of our nation and is envied across the world for its defining principle of providing healthcare that is free at the point of use. However, this week, it has been revealed that the possibility of creating a two-tier healthcare system through privatisation has been explored under the watch of the cabinet secretary. This week, the First Minister and the cabinet secretary scrambled to state that they do not support any shift toward privatising the NHS, and SNP back benchers and members were scrambling to add BBC journalists to the list of things that are to blame for the current state of the NHS in Scotland. However, perhaps we should not be surprised by what we heard this week, because the SNP has form on this. Indeed, in his book “

Grasping the Thistle

”, the current SNP president and former MSP, Mike Russell, who was appointed to the Cabinet by Alex Salmond and Nicola Sturgeon, said:

“We would encourage the private sector to compete with established NHS, hospitals, clinics and other services. We would encourage NHS management and staff to buy out existing NHS facilities and services under favourable financial terms and join the private sector.”

Humza Yousaf (Scottish National Party, Glasgow Pollok)

The member is normally good, but this is desperate stuff.

Paul O'Kane (Labour, West Scotland)

The cabinet secretary did not want to hear that from his colleague.

Our NHS is on its knees and its front-line staff are suffering. They have had enough of the failing health secretary not listening to what they need. That is why the RCN is striking for the first time in its history and why Scottish Ambulance Service staff, including paramedics, are striking for the first time in over 30 years. The cabinet secretary should deliver

“A decent and acceptable pay rise for NHS and social care staff”,

which

“is essential, not just to avoid strikes but to retain and recruit the staff we need to make essential improvements to our health service”

Those are not my words; they are the words of another former SNP cabinet secretary, Alex Neil. Perhaps the health secretary should heed the advice of his former colleague and get back round the table and listen to what staff are telling him, because it is clear that the health secretary had lost the confidence of front-line staff, patients and their families. His record speaks for itself in comparison to those of his predecessors, and he has no idea, plan or support to offer.

Patients and staff deserve so much better than this Government and this cabinet secretary.

Bob Doris (Scottish National Party, Glasgow Maryhill and Springburn)

I am not sure about grasping the thistle—I think that the Labour Party is clutching at straws, with this debate.

The challenges that face Scotland’s NHS are plain for us all to see, but so is the clear, focused and considered action of the Scottish Government in seeking to address those challenges—some of which I will return to later in this short debate. It is, of course, right that our Scottish Government’s NHS recovery plan be properly scrutinised. In that context, this debate could serve Parliament well.

However, what does not serve our Parliament well is the Labour Party presenting, in a motion on the Scottish NHS, false accusations as though they are factual, when they are patently and demonstrably untrue. It is an exercise of significant deceit and, indeed, hypocrisy to suggest that the Scottish Government is considering privatising the NHS. With regard to Scotland’s NHS being free at the point of use, it was our SNP Government that abolished prescription charges, which were in place when Labour was last in control of this Parliament. It is our SNP Scottish Government that has maintained free eye tests in this country; it costs over £20 for an eye test in Labour-controlled Wales.

It was, of course, the Labour Party that brought private finance initiatives to our NHS in Scotland, and PFI and public-private partnership contracts still cost the Scottish Government £250 million every single year—liabilities that were run up under the Labour Party. It was the Scottish Government, however, that sought to unpick Labour’s PFIs. Indeed, in my city of Glasgow, that was done at a cost of £26.3 million to abolish at Glasgow royal infirmary parking charges that were put in place by the Labour Party. Therefore, there will be no NHS privatisation on our watch. Thank heavens that the Labour Party is not in charge of the NHS, here, in Scotland.

I agree with Jackie Baillie in relation to the pressures on GP services. That is why I am pleased to see that efforts to recruit 800 additional GPs by 2027 are on track, with 277 already being in post by 2021. Of course we need to strive to go further; we must do more.

However, I will tell members what does not help. It does not help that, when we, in Scotland, look to attract additional GPs or to fill vacancies elsewhere in health and social care, we have a Labour Party and a Labour Party leader, in Keir Starmer, that are doubling down against freedom of movement of people and are talking about there being too many immigrants in the NHS, then deploying cheap, gutter-level right-wing rhetoric about immigration dependency. That is just shameful, Presiding Officer. It is shameful.

On the contributions that overseas workers make to our healthcare system, we need to ensure that overseas-trained GPs in Scotland do not leave because of UK visa problems. I mention that because I noted, in my preparation for today’s debate, that the chair of the BMA Scottish GP committee, Dr Andrew Buist, said:

“We are desperately short of GPs as it is, so the last thing we need is to be in a position where fully qualified clinicians are being left with no choice but to leave Scotland because of an issue with the terms and conditions of their visa.”

When the minister is summing up, I would like to hear more about our negotiations with the UK Government to resolve some of those issues.

Labour also made another important point in relation to multidisciplinary teams. Yes—we want more workers and so on, but denying the fact that since 2018, there are 3,120 more of them in our NHS just does not cut it. Yes—we need more people, but look at the progress that we have made. The year 2018 is very important because it predates the pandemic. What has happened shows that the Scottish Government was well aware of the demographic challenges in Scotland’s healthcare and social care system and was taking steps pre-Covid-19 to address them. It is a work in progress.

This year, the budget for primary care in Scotland is actually on the increase; and I note that, according to the cabinet secretary’s amendment, integration joint boards are also going to use their reserves to invest in primary care. It would be helpful to get more information from the cabinet secretary on that proposed change.

Let us try to work collegiately to improve Scotland’s NHS, but let us base the demands of the challenges that the doughty NHS faces here, in Scotland, on the facts and not on Labour fantasy.

Graham Simpson (Conservative, Central Scotland)

I thank Labour for bringing the debate to the chamber. The only time that we get to hold the Government to account on health is during Opposition time. Even then, we know that we and Labour will lose the vote, because the SNP and the Greens will band together to defiantly say that we have somehow got this all wrong

.

Humza Yousaf often talks about challenges and recovery from the pandemic while forgetting that, under the SNP, the NHS was creaking before the pandemic.

Of course, as we have already heard, the background to the debate is the leaked discussion among health chiefs at which various ideas were floated, including charging people who can afford to pay. We already have a two-tier health service under the SNP. Constituents who cannot even get to speak to a GP have contacted me to say that they have gone private. One case, in particular, stands out: it is of a person who ended up paying thousands to see a GP privately, then paid for a minor procedure. That is just not acceptable. Quite apart from the “Thinking the unthinkable” leaked discussion, we already have a health service in which people who can pay get health treatment and those who cannot, or will not, do not.

We are all proud of our national health service, but, under the SNP, it is becoming the national have-not service. That is the reality on the ground. What happens in general practice affects what happens elsewhere in the health service. If people cannot see a doctor, they might well end up at an A and E department instead, or get sicker and go to hospital when that could have been avoided.

We need to know what is happening on the ground. However, we currently have no idea which GP practices are offering phone calls, no calls or face-to-face appointments. That would not be acceptable at the best of times, because data is needed in order to plan, and it is certainly not acceptable now.

In my area of Lanarkshire, things are particularly bad.

Monica Lennon (Labour, Central Scotland)

I tried to intervene on the cabinet secretary, but perhaps he did not hear me. In NHS Lanarkshire the situation is especially bad. Since October last year, it has spent 315 days at code black, and we are facing a second Christmas at that status. Graham Simpson knows that that is frightening stuff for patients and staff in our area. Does he agree that we need an urgent plan from ministers to get NHS Lanarkshire out of code black? The cabinet secretary is right to say that we should thank the staff—

The Deputy Presiding Officer

Be brief, please.

Monica Lennon (Labour, Central Scotland)

—

but we cannot thank them if they are working in unsafe conditions.

Graham Simpson (Conservative, Central Scotland)

I thank Monica Lennon for her intervention. She is absolutely right that NHS Lanarkshire is in a state of crisis, as it has been for too long. We need to see an action plan to get our area out of that completely unacceptable situation.

We have all been inundated with constituents who are desperate for help. I have a couple of personal testimonies. One is from an East Kilbride resident who said that they found themselves requiring support from a GP. They went to their medical practice and requested an appointment for a painful foot. They were told that there were no appointments available that day and that there were no pre-booked appointments available. That kind of thing is commonplace.

I have other examples, but I will not go through them because I am aware of the time. The situation that we face is not good enough—not just in Lanarkshire, but across Scotland. Frankly, the buck stops with the cabinet secretary and no one else. He should do something about it, or fall on his sword.

The Deputy Presiding Officer

I call John Mason, to be followed by Gillian Mackay. There is no time in hand, Mr Mason.

John Mason (Scottish National Party, Glasgow Shettleston)

I told Mr Kidd that that would be the case before I got up to speak.

Members might not be surprised if I start from a financial angle. Whether we are independent or not, and whether we have borrowing powers or not, we still need to set budgets and live within our means, and we will never have as much money as we would like.

Labour and others have complained in recent years that local government has not had the funding that it deserves. One of the reasons for that is that we have prioritised health and the NHS. If the Labour Party was in power, it could do things differently. However, it could not give more to local government and also give more to health services and the NHS.

First, we could agree that the NHS will always have a budget and that that budget will never be able to meet all the demands that every person in Scotland wants it to meet.

Secondly, once we have decided on a figure for the NHS and health, we need to decide how to split it up. How much should go to GPs and other primary care, and how much should go to hospitals, A and E and so on?

I think that most of us here would agree that we should focus more on preventative care and less on reactive care. However, what we have not agreed on so far is how to make that switch. If we cut funding to hospitals, including A and E, in order to invest more in primary care, including GPs, waiting times for hospitals will probably increase more. I wonder whether the Opposition parties would be willing to support that, or would still turn up at First Minister’s question time every Thursday to complain about hospital waiting times. Let us be honest: every time there are demands to reduce hospital waiting times, it discourages investment in preventative services, including GPs.

Even within GP funding, there are choices to be made. The 100 or so deep-end practices, which work in our most deprived 15 per cent of areas, would argue that funding should be more skewed to the poorer areas. I wonder whether Jackie Baillie would support a reduction in GP services in a better-off area such as Helensburgh in order to increase funding for GPs in a needier area such as Dumbarton. Like it or not, those are the kinds of choices that we have to make.

Mercedes Villalba (Labour, North East Scotland)

Why are the member’s expectations of and ambitions for our health service so low?

John Mason (Scottish National Party, Glasgow Shettleston)

We can all talk about ambition, and I am happy to do so, but the angle that I am taking today is that we have a fixed budget that has to be split up one way or another.

Although parts of the NHS are under severe pressure, much of it is providing excellent services. I certainly hear good reports directly from constituents and in Care Opinion emails. I will quote a recent example. It says:

“At my 34-week midwife appointment my midwife noticed a stop in”

the baby’s

“growth … so sent me to the Princess Royal for a … scan. The growth scan showed the baby was smaller than she should have been. From this minute the care I received from the PRM was amazing.

I was sent to either maternity assessment or day care every day for monitoring and every single member of staff was amazing. I was admitted one night into Ward 72 and again the staff were amazing. It was decided I would be induced at 37 weeks, throughout this long and scary process again the staff on Ward 72 plus the doctors were so reassuring and kind.

I was took to the Labour Ward after 2 days in Ward 72 and had Hannah as my midwife, a real asset. I had a problem at the end of my labour and had to have doctor intervention, again the doctor was amazing.

After birth I was took to Ward 63 where again the staff were all so nice and caring. After getting home my community midwife noticed my little one had some jaundice so back up we went, we were readmitted for 2 days back into Ward 63. This was very upsetting for me at the time and the compassion I received from all the staff was just amazing.

Throughout our whole journey every single person we met—healthcare workers, cleaning staff, midwives, doctors—were all second to none. I know the NHS is having a hard time and you can tell these people are overworked and understaffed, but that doesn’t take away anything from the care they give. I would like to thank every one of them.”

The Deputy Presiding Officer

Mr Mason, you need to close.

John Mason (Scottish National Party, Glasgow Shettleston)

We have an NHS to be proud of.

The Deputy Presiding Officer

I see my earlier plea fell on deaf ears, and we now have no time in hand, so I will hold everyone strictly to their time limits.

Gillian Mackay (Green, Central Scotland)

There is no doubt that primary care is under immense strain. Survey results from the BMA warn that 81 per cent of practices said that demand for their services was exceeding capacity. We know that, as a result of the pandemic, people are presenting later, often with more complex conditions and sometimes with more than one complex condition. Receptionists, who are often simply trying to get patients the treatment that they need in the quickest way possible, bear the brunt of the responsibility for telling patients about alternative pathways.

The Health and Social Care Committee’s report on alternative pathways highlighted that those need to be better communicated and that we need to move away from the expectation that every primary care appointment needs to be with a GP.

We need to diversify appointment types and ways of booking to make it easier for people to access an appointment at a convenient time. Many practices do late nights in order to facilitate appointments for people who are working, but, by facilitating phone or video appointments, we might be able to make better use of appointments and reduce the constant pressure to work longer hours.

The Royal College of General Practitioners has said:

“We urgently need a national conversation to manage public expectations of what people can reasonably expect from the health service in these conditions. Better public understanding of how to use our public services is needed, including the new ways of working in general practice.”

We need to make sure that GPs have the technology to be able to facilitate those appointments. We also need electronic prescribing, because GPs’ valuable time being taken up with signing individual prescriptions should be a thing of the past. Information technology systems can take time to roll out, but, if the cabinet secretary could look at a solution to reduce the number of repeat prescriptions that need to be physically signed, that would go some way to reducing the workload. Many people will be on medication for the rest of their lives and, aside from medication reviews, many of those prescriptions are just signed monthly with no contact with the patient. We seriously need to consider whether that is a good use of GP time and how we can make the process less cumbersome.

In its briefing, the Royal College of Nursing highlighted the vital work that district nurses and other nursing staff, as part of multidisciplinary teams, do to keep patients as well as possible, often visiting them in their homes and in community settings. The contribution that they make to the primary care teams should never be underestimated.

The RCGP highlighted that, as well as talking about resilience, we need to have a conversation about why GPs and other primary care staff become overwhelmed in the first place, and we must fix or mitigate those issues. The college also said that

“Short-term fixes to the health system must be paired with long-term strategic planning”

to address workforce and workload issues. We must aim towards a point where GPs do not feel overwhelmed through working for their patients.

I have previously mentioned in the chamber the need to support out-of-hours services, which are a key part of primary care. They also help to relieve pressure on A and E by providing an alternative route, but we are relying on dedicated staff to provide those services in addition to other roles, and we need to make that more sustainable.

We need to tackle the acute problems this winter and make sure that the situation does not worsen for staff and patients. At the same time, we need to work to make general practice more sustainable and put it on a good footing to be able to promote and support good health rather than the current cycle of constantly being a national sick service.

I thank all the organisations that sent briefings and every one of the people who work in health and social care. They are doing their utmost to support those who need it through the winter and the rest of the year.

Sarah Boyack (Labour, Lothian)

We rightly take pride in our NHS and its founding principles of universality of care, respect and dignity. The last thing that we need is a two-tier service, but that is already happening in Scotland.

Today’s amendment from the SNP Government is appalling. It does not acknowledge the massive pressures that our NHS is facing, which are increasingly impacting on people’s health. Our hard-working NHS staff are under huge pressures, not just because of Covid, but because of long-term systemic understaffing and a lack of action to recruit, support and retain staff.

I will bring to the chamber’s attention the experience of my constituents in the Lothians. We see pressures right across our NHS, including in A and E, among GPs, and in dentistry and care services. Waiting times for accident and emergency services in NHS Lothian are damning. Since May this year and up until November, there was only one week during which the percentage of people who were seen within the Government’s four-hour target was more than 70 per cent. Last week, more than 1,700 people were stuck in A and E for more than four hours. Only 63 per cent of those attending NHS Lothian’s emergency departments were seen within four hours. In the same week, more than 200 people were stuck in A and E for more than 12 hours. Members should imagine for a moment what it is like for someone to wait for 12 hours when they have gone to accident and emergency.

Jackie Baillie’s focus on GPs was absolutely right—people are going to A and E because they cannot access their GPs. For the first time, GP surgeries have started contacting my office to talk about the real pressures that they are experiencing, which are exacerbated by the reduction in funding. I am told that, in NHS Lothian, we lost £9 million because GP services in Lothian were unable to recruit the GPs that we had lost. That money is not coming back.

Constituents have reached out: one had to wait a month to see his GP; another one said that he finds it extremely difficult to register with a GP, because there is a queue outside the practice every week; and, in Musselburgh, people have been experiencing issues with access to a GP for years, to such an extent that an independent review had to be set up.

Our front-line services are under massive pressures, with our GPs being

“depleted and demoralised”.

Those are not my words but those of the Royal College of General Practitioners.

It is not only GPs—the pressures on our NHS dentists in Lothian are shocking. A Labour freedom of information request revealed that, between 2021 and 2022, 92 dentists withdrew from NHS Lothian’s dental list. At the beginning of this year, out of 163 general dental practices in Lothian, only 51 confirmed that they are accepting new patients, with some only accepting children. That creates the two-tier system that I talked about at the start of my speech. Those who can afford it go private while the rest are forced to wait months, borrow money from friends or family to get private treatment, be in pain or lose teeth. That is not acceptable.

The First Minister has said that the founding principles of our NHS are “not up for discussion,” but we are already losing our NHS dentistry. That is not acceptable.

It was the Scottish Labour Party that launched the call for a national care service, so we welcome the proposals from the SNP to deliver it. However, the reality is that, rather than focusing on the experiences of our carers and providing decent terms and conditions across the country and career development opportunities, we are seeing SNP centralisation—

The Deputy Presiding Officer

You need to conclude, Ms Boyack.

Sarah Boyack (Labour, Lothian)

That is adding to delayed discharges. In September this year, more than 6,500 beds in NHS Lothian were occupied by patients who could have been sent home. That is not good enough. We need an NHS that is invested in and that the patients deserve.

The Deputy Presiding Officer

Thank you, Ms Boyack. I now call Jeremy Balfour.

Sarah Boyack (Labour, Lothian)

The staff do everything that they can—they need our support now.

Jeremy Balfour (Conservative, Lothian)

The national health service is an institution of which the United Kingdom can be immensely proud. The provision of medical care that is free at the point of need fundamentally demonstrates our commitment to the idea that means should not determine access to healthcare.

On numerous occasions, I have spoken about my personal experience of that life-saving service.

Throughout all of our debates on the issue, we should remember that that is our goal, and it is our hard-working healthcare professionals on the front lines who should be supported in any way possible.

It is evident that the NHS in Scotland is going through a difficult time. My older brother has just retired as a GP, and his generation is walking away due to practices that are going on now. The number of GPs in Lothian is falling. I know of numerous practices here, in Edinburgh, where, if a patient does not phone between 8 and 5 past 8, they will not get an appointment on that day or in the week ahead.

As Sarah Boyack pointed out, dental treatment in the Lothians for NHS patients is collapsing. My dentist has decided to go private, and my family and I are still waiting to find a dental practice that we can register with, because no dentists are taking on that work.

We already have a two-tier system in Lothian. I ask the health secretary to visit places in my region rather than sit in his office, thinking that everything is fine.

The situation is bleak—that is the only word for it. We are proceeding through this most difficult of winters without a properly functioning primary care service. It is true that we are recovering from the pandemic, but to claim that all the problems in our health services began in March 2020 is fanciful. For too long, the SNP Government has hidden behind the pandemic as an excuse for its failings when, in reality, the situation in which we find ourselves has been years in the making. We need action.

The cabinet secretary will say that he has not got the money to do that. I will suggest a way that at least three or four committees in this Parliament that took evidence last week can also suggest: the Government can save £1.3 billion by getting rid of its fanciful plan for a national care service. That plan simply will not work. The trade unions are telling us that the Government plan will not work, the professionals on the front line are telling us that it will not work and the third sector is telling us that it will not work. The Government should put that idea to one side and put the money into primary care and hospital care. That would do so much more for the patients of Scotland.

Front-line services such as A and E and GP practices rely on other services to run smoothly. The deep-running problems in our health and care services date back long before the pandemic and are deeply rooted in the mismanagement by this SNP Government.

Stephanie Callaghan (Scottish National Party, Uddingston and Bellshill)

Will the member take an intervention?

Jeremy Balfour (Conservative, Lothian)

I do not have time.

That is not an abstract problem; it is not just numbers on a page or debating points for this chamber. The health secretary is putting at risk people’s lives and their wellbeing. The Government must act now to stop the stress on the system. Perhaps a good place to start would be for the health secretary to take some responsibility and for the First Minister to replace the man at the top.

The Deputy Presiding Officer

Stuart McMillan is the final speaker in the open debate. You have up to four minutes, Mr McMillan.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

First of all, it says something about Labour that it has lodged a motion that is factually inaccurate and is based on a

Daily Mail

headline. It appears to me that Labour’s journey to becoming red Tories is well under way.

I know that it has been a while since Labour was last in power here and in London, but it is certainly worth reminding it of its record on privatisation in the NHS. In 1999, it transitioned the NHS from a public sector provider to one that included the private sector under the disguise of choice and competition. We also have Labour’s costly PFI contracts, which my colleague Bob Doris mentioned earlier. Those have taken hundreds of millions of pounds out of the health budget in profit payments every single year. That money could and should be going to patients. When Labour comes to the chamber making a claim that it knows is false, it needs to be reminded of its distant but not yet forgotten past.

As for the blue Tories, their amendment states that

“Scottish Government announcements”

are

“divorced from the reality of life and purpose of the service.”

It takes a huge amount of brass neck to come to this chamber to make such a claim.

Gillian Martin mentioned the issue of privatisation in her intervention. The public know that the Tories want to privatise the NHS.

Jeremy Balfour (Conservative, Lothian)

Will the member give way?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I have only four

minutes, Mr Balfour.

Thankfully, this SNP-led Government does not agree with either of those parties. I am pleased that the health secretary announced—although he did not need to—that the founding principles of the NHS are not up for discussion and that the service will remain free at the point of need.

I welcome the Scottish Government’s investment in recruiting more than 3,220 healthcare professionals since 2018. The Government is committed to investing at least £179 million a year on growing primary care multidisciplinary teams.

However, we have heard from the Opposition today about costs, finances and cuts. I am not sure whether they understand a few simple economic facts. Brexit has been a disaster. As I stated in Christine Grahame’s members’ business debate last night—I mention this for the interest of Sandesh Gulhane—Adam Posen, who is a former member of the Bank of England monetary policy committee, suggested earlier this year that Brexit was responsible for up to 80 per cent of the increase in prices in the UK.

Currently, inflation is running at 11.1 per cent. That has largely been caused by Brexit. [

Interruption

.] Added to that are the European Union nationals who have left their employment in Scotland, some of whom would have been working in Scotland’s NHS. Those are undeniable facts that the Opposition must listen to and accept.

On top of that is the current race to the bottom on immigration in which the Tories and Labour are competing. Do those two parties not realise that that might make it harder to encourage people to come to live and work in Scotland, whether in the NHS or for any other employer?

If those parties want more money to go into the NHS—we all do—they must indicate from which budgets that money would come, because of the limited financial situation that this Parliament, sadly, faces.

We have heard some members make comparisons with the NHS elsewhere. I mention, once again for the benefit of Sandesh Gulhane, that prescriptions are free in Scotland but they are £9.15 each in England.

Dental care is free in Scotland for under-26s, without an opt-in. NHS eye tests remain free in Scotland, in comparison with England and Wales, where they cost £21.31 a time. Also, Scotland has 95 GPs for every 100,000 people, compared with 70 in England, 80 in Wales and 75 in Northern Ireland.

In contrast to that positive progress, in June 2022 the Health Foundation criticised the UK Government’s lack of action and said that it was unlikely to meet the target of adding 6,000 GPs for 2023-24. I know that the NHS has its challenges—it always has and it always will—but I also know that this SNP-led Government is focused on making, and is determined to make, our NHS stronger for generations to come.

The Deputy Presiding Officer

We move to closing speeches. I would be grateful if we could have less shouting across the chamber while people are speaking.

Tess White (Conservative, North East Scotland)

How many warnings from the front line of our NHS will it take for this health secretary not just to listen but to act? Primary care is at breaking point. Members have laid bare the fact that there simply is not the capacity to meet demand.

Sadly, Graham Simpson highlighted the fact that, under the SNP, we now have a national have-not service. Jeremy Balfour outlined the alarming stats and bleak picture. Dr Sandesh Gulhane highlighted the lack of trust in Humza Yousaf and shed light on conversations that are taking place behind closed Government doors. Jackie Baillie stated that GPs are on their knees while Humza Yousaf says, “Go to the GP rather than A and E”. What does Humza Yousaf do? He deflects and he blames Labour. He makes personal attacks on Jackie Baillie. He sneers at Dr Sandesh Gulhane. Alex Cole-Hamilton talked about a “slap in the face” to GP practices and the heroic healthcare staff. Paul O’Kane talked about GPs being at their wits’ end.

Research by the British Medical Association clearly shows that it is not just some practices that are struggling but the vast majority and that, if primary care buckles, it will be catastrophic not just for general practice and patients, but for the whole healthcare system.

There are two overriding issues affecting primary care: a lack of GPs and a lack of resources. Bob Doris referred to Humza Yousaf’s plan to recruit 800 additional GPs by 2027. However, the BMA says that we do not need 800 additional GPs—we need 1,000 and we do not need them by 2027; we need them now.

Bob Doris (Scottish National Party, Glasgow Maryhill and Springburn)

Will the member give way on that point?

Tess White (Conservative, North East Scotland)

We also need to stop the haemorrhaging

of existing GPs—

Bob Doris (Scottish National Party, Glasgow Maryhill and Springburn)

Will the member give way on that point, as she mentioned me by name? Will she give way on that point?

The Deputy Presiding Officer

Bob Doris, would you resume your seat! The member is obviously not taking the intervention.

Tess White (Conservative, North East Scotland)

We need to stop the haemorrhaging of existing GPs in search of better conditions abroad or early retirement, and to stop those who are considering cutting the sessions that they currently work.

Mr Doris talks about blame, and he is blaming Brexit for these dire situations. We cannot plug the gaps when the system is a sieve. More than a third of practices report having at least one vacancy, which is a higher figure than at this time last year. It takes years to train a doctor.

The SNP Government must focus on retaining the talent that we have.

Humza Yousaf says, “Judge me by my record”. On resources, the cuts of £65 million from the primary care budget and £5 million in support payments mean that GP practices will have to try to meet patient demand with even fewer resources than before, and the kicker? The slashing of £65 million from primary care was announced on the same day that the Crown Office confirmed that almost £51 million of taxpayers’ money has been spent on a range of malicious prosecutions.

If the health secretary left his bunker and his spin doctors and listened to our doctors and nurses on the NHS front line, he would understand that establishing multidisciplinary teams in primary care is vital if we are to scale up our patient care. We know that there are problems with putting in place multidisciplinary teams that can help to spread the GP workload.

We have an NHS recovery plan that has seen things getting worse, not better. We have a winter resilience plan that tells the public to access urgent care only if the situation is life threatening, which piles even more pressure on primary care. Things are so dire that NHS leaders have considered introducing a two-tier system for treatment, which would charge the wealthy.

The Deputy Presiding Officer

You need to conclude, Ms White.

Tess White (Conservative, North East Scotland)

Humza Yousaf must step aside and let someone else step up who has the confidence of the medical profession.

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I am grateful to members for the many considered contributions on this absolutely vital subject. I believe that there is support across the chamber for the Government’s steadfast position on maintaining Scotland’s NHS as publicly owned, publicly operated and free at the point of need.

Far from denying the challenges that primary care faces, the first thing that our amendment does is recognise those pressures. Earlier this month, in the debate on alternative pathways to primary care, I was very open about the challenges that the NHS is facing. It will take time to recover from the Covid pandemic, and we have yet to see the worst of the cost of living crisis. However, I also believe that primary care is in a better place to respond to those challenges as a result of our investment and reforms.

Evaluation from local areas shows that our reforms are working. The expanded multidisciplinary team—the 3,220 whole-time equivalent healthcare professionals whom Tess White appears not to know about—support the effective use of time and expertise by reducing multiple appointments for the same issue and freeing up time for longer appointments where required, and are associated with high staff and patient satisfaction.

The reforms are also helping to cut GP workload and make general practice a more attractive career by allowing GPs to focus on complex rather than routine care and leadership, which in turn is improving patient outcomes, community health and practice sustainability.

Monica Lennon (Labour, Central Scotland)

The minister heard me say to Graham Simpson that NHS Lanarkshire has been in code black for 315 days, since October of last year. The minister’s plan is not working. When will we see a plan that will work and when will we get out of code black in Lanarkshire?

Maree Todd (Scottish National Party, Caithness, Sutherland and Ross)

I absolutely understand and acknowledge the pressures that are being faced in NHS Lanarkshire. We are in regular contact with NHS Lanarkshire, and we have increased the level of staffing right across the board there.

GPs are rightly passionate about their vocations, and they want to encourage new medical graduates into the profession. So do we all, and what we say to the world matters. In the public discourse, our support for the sterling work of general practice teams must be crystal clear and unequivocal if we are to attract new undergraduates to choose general practice as the worthwhile and rewarding career that we know it to be.

I will tell members a little more about some of the initiatives that we have under way. We are listening to what GPs tell us, and the Government is responding. In June, we launched a new recruitment drive to attract qualified GPs to move to Scotland. Initiatives such as rediscover the joy of general practice assist some of our most remote areas to bolster GP coverage. We are increasing medical school places by 100 each year during this session of Parliament. Recruitment into GP specialty training in 2022 has so far been better than in any other year on record, with a 98 per cent fill rate. In October, we announced 35 additional places for GP specialty training and, as of November 2021, there were 1,184 established GP training places in Scotland. As Emma Harper mentioned, ScotGEM, which is our four-year graduate entry medical degree with a focus on general practice, is proving successful, with the first cohort of 52 students graduating earlier this year.

It is perfectly valid to compare the SNP-run NHS in Scotland to the Tory-run NHS in England and the Labour-run NHS in Wales. It is perfectly valid to look beyond the Opposition rhetoric to see what those parties actually do when they are in power. I reiterate my immense gratitude to our dedicated workforce, who work day in, day out to deliver the care that our citizens need in general practice and elsewhere in our NHS.

Carol Mochan (Labour, South Scotland)

In closing for Scottish Labour, I want to be clear that our motion has been brought to the chamber to ensure that the voices of patients, carers, GPs and all primary care staff are heard loud and clear—oh boy, has that been necessary.

It is obvious that the SNP Government and SNP back benchers are ignoring the pleas for help from all corners of our healthcare system.

It is unfortunate that, in his amendment to our motion, the cabinet secretary suggests that the pressures on primary care are due only

“to the effects of Brexit, the global pandemic and the cost of living crisis”.

Granted, those issues contribute to the pressures that exist—of course they do—but there is a glaring omission, because those pressures are also due to his, the First Minister’s and the entire Government’s shocking mismanagement of the health service in Scotland, their lack of openness to scrutiny and their constant harking back to what happened many years ago. My colleague Paul O’Kane pointed out that the SNP has been in government for 15 years. Given the cabinet secretary’s closed approach, it is disappointing—although not surprising—that allies of the SNP are considering options such as privatisation of the NHS in Scotland.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I will mention something more recent, not something that happened 15 years ago. Does Carol Mochan want to apologise for Keir Starmer talking down overseas workers in our national health service? Anti-immigration rhetoric will certainly not help our NHS in this time of need.