Scottish Parliament, 6 March 2013

204 contributions from 55 members. The official report.

Business Motion

Tricia Marwick (None, Mid Fife and Glenrothes)

Good afternoon. The first item of business is consideration of business motion S4M-05839, in the name of Joe FitzPatrick, on behalf of the Parliamentary Bureau, setting out a revision to the business programme for today.

Motion moved,

That the Parliament agrees to the following revision to the programme of business for Wednesday 6 March 2013—

delete

followed by Scottish Labour Party Debate: NHS Waiting Times

followed by Business Motions

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

and insert

followed by Ministerial Statement: Basing Review

followed by Scottish Labour Party Debate: NHS Waiting Times

followed by Business Motions

followed by Parliamentary Bureau Motions

5.30 pm Decision Time—[Joe FitzPatrick.]

Motion agreed to.

Companies (Growth and New Markets)

Bob Doris (Scottish National Party, Glasgow)

1. To ask the Scottish Government what assistance is available to help companies grow and identify new markets. (S4O-01862)

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Sustainable economic growth is the Scottish Government’s key objective and is delivered through a strategy of promoting and supporting growth companies in growth sectors and growth markets.

Bob Doris (Scottish National Party, Glasgow)

The firm Elmwood employs 102 workers in my region in the design, manufacture and fitting of various products, and includes a museum fit-out division. It informs me that despite a strong performance throughout the United Kingdom, further expansion depends on being able to promote its high-end products on the world stage, which means attending global conferences and expos.

Will the minister consider what incentives might be available from Government or Scottish Development International to support Elmwood in such ventures throughout the world? Will he consider visiting Elmwood with me to see the fine work that it does?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Yes, I would be happy to take up the member on his invitation and praise the company for its success thus far.

In relation to Elmwood’s ambitions for exporting, we will ensure that it receives the excellent support of the enterprise network, which helps companies precisely in the way that Bob Doris has identified, for example by assisting trade missions. Thereanent, I am looking forward to leading a trade mission of 29 oil and gas companies to Brazil, which departs Scotland on Sunday.

Mike MacKenzie (Scottish National Party, Highlands and Islands)

Does the minister agree that the findings of the latest global connections survey, which showed that Scottish exports increased by £1.6 billion to £23.9 billion in 2010-11, is evidence that the efforts of the Scottish Government, SDI, Scottish Enterprise and Highlands and Islands Enterprise to promote Scottish goods and services are paying off?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Yes, I agree. I have seen at first hand the commitment and abilities of the staff of our enterprise network, who are working to make a terrific success of our aspirations for companies to grow.

We have set an ambitious target of achieving a 50 per cent increase in exports by 2017. I hope that that will be achieved. If it is, it will be by sectors in oil and gas, renewables, chemical science, and food and drink. It seems that even in a recession—or perhaps because of it—the world cannot drink enough whisky.

Aberdeen Western Peripheral Route (Funding)

Richard Baker (Labour, North East Scotland)

2. To ask the Scottish Government what recent discussions the Cabinet Secretary for Finance, Employment and Sustainable Growth has had with the Cabinet Secretary for Infrastructure, Investment and Cities on the funding arrangements for the Aberdeen western peripheral route. (S4O-01863)

John Swinney (Scottish National Party, Perthshire North)

The Aberdeen western peripheral route Balmedie to Tipperty scheme is now in procurement and the funding arrangements are a matter of on-going consideration among ministers and officials throughout the Scottish Government.

Richard Baker (Labour, North East Scotland)

In those discussions with the Cabinet Secretary for Infrastructure, Investment and Cities, I am sure that the importance of speedy progress on this much delayed scheme was high on the agenda. To aid progress, local authorities have indicated that they are prepared to pay up front their share of the costs of the AWPR. Given that the Government’s funding is to be through non-profit distribution, will the cabinet secretary reassure us that the Scottish Government is on track to secure the private sector funding that it is to lever in? Can he confirm that the Haudagain roundabout is also still part of the procurement exercise?

John Swinney (Scottish National Party, Perthshire North)

It has been made clear that the work on the Haudagain roundabout will be undertaken once the work on the Aberdeen western peripheral route is completed. That represents no change to the current arrangements.

On the pursuit of NPD funding, as I said in my original answer, the scheme is now in procurement and the funding arrangements are being pursued. We will take the project forward because we are as dissatisfied as anybody else with the length of time that it has taken to get the project out of the authorisation mechanisms and into procurement.

United Kingdom Credit Rating

Chic Brodie (Scottish National Party, South Scotland)

3. To ask the Scottish Government what discussions it has had with the UK Government since its credit rating was downgraded from AAA to AA1 regarding any impact on the Scottish economy. (S4O-01864)

John Swinney (Scottish National Party, Perthshire North)

The decision to downgrade the United Kingdom’s credit rating confirms the failure of the UK Government’s economic strategy. We have on many occasions warned that the UK Government’s approach and the pace of implementation of austerity are undermining the recovery, and evidence has become ever clearer to support that view.

Shortly, I will write to the Chancellor of the Exchequer ahead of his budget statement later this month and will urge him to deliver a budget that boosts real investment in our economy.

Chic Brodie (Scottish National Party, South Scotland)

Last week, the Tory finance spokesperson told us that the downgrade would not affect the markets and had not affected the markets. We ken better noo. Sterling has fallen by 7 per cent against both the dollar and the euro in the past week and is now the weakest major currency. That means more expensive imports—

Tricia Marwick (None, Mid Fife and Glenrothes)

Yes, but can we have a question, Mr Brodie?

Chic Brodie (Scottish National Party, South Scotland)

Does the cabinet secretary agree that the UK Government’s austerity policies have lost all credibility and that the sooner we have our hands on the levers of economic power, the better?

John Swinney (Scottish National Party, Perthshire North)

As I said in my original answer to Mr Brodie, the downgrading of the UK’s credit rating is indicative of the failure of the UK Government’s economic strategy. We predicted the sequence of events if the UK Government placed too much emphasis on the pursuit of austerity and not enough on supporting growth—that is perhaps best illustrated by the reduction in our capital budget by 26 per cent—and Moody’s has clearly highlighted the lack of growth that has become apparent. I urge the United Kingdom Government to pay heed to that judgment and to take a different course in the budget on 20 March.

Scotland Excel (Meetings)

Tavish Scott (Liberal Democrat, Shetland Islands)

4. To ask the Scottish Government when it last met Scotland Excel and what matters were discussed. (S4O-01865)

Derek Mackay (Scottish National Party, Renfrewshire North and West)

Scottish Government officials regularly meet Scotland Excel to discuss a range of matters in relation to public procurement. Earlier today, I attended a meeting of ministers, officials and local government representatives including Scotland Excel to discuss the standards and processes that are in place for school meals and local authority procurement of food and drink. In fact, I left the meeting to attend portfolio questions.

Tavish Scott (Liberal Democrat, Shetland Islands)

I do apologise to the minister for dragging him away to answer questions in Parliament.

Was the principle of the traceability of livestock, which consumers now expect, recognised at that meeting? Parents, pupils and teachers now expect the contents of school dinners to be traceable. If the minister and the Government accept that principle, does that mean that procurement policy through Scotland Excel will change and move forward to achieve that?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I am sure that the whole Parliament will benefit from the joint statement that will be released at the conclusion of today’s joint meeting with local government, at which two cabinet secretaries are present. I assure the Parliament that a great deal of intensive work is being done on the subject in partnership with Scotland Excel.

The member will know that a number of tests are being done at present, and work is being done in partnership with agencies to ensure that quality is in place and that we can have confidence in the food supply. Scotland Excel has encouraged local authorities to adopt a precautionary approach at this time while it looks at both procurement practices and standards in school meals.

I refer all members to the statement that will be released at the conclusion of the meeting on the next steps in relation to this serious issue.

Linda Fabiani (Scottish National Party, East Kilbride)

How will the procurement reform bill increase the Scottish Government’s efforts to support both sustainable procurement and fair trading in the public sector?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I do not wish to pre-empt the bill, but it will present an opportunity to Parliament and those who are engaged in public sector procurement to consider social, environmental and economic benefits in future procurement—some £9 billion-worth of procurement.

At the moment, the partnership that exists for procurement in the public sector, particularly in local authorities—whether councils are part of Scotland Excel and whether they adopt contracts—is voluntary. Of course, councils have the latitude to buy local within the parameters that are outlined in Excel, so some of the good work that exists in current procurement can be emulated. However, the bill could present further opportunities to include greater consideration of ethical and other benefits as part of the formal procurement process.

Claudia Beamish (Labour, South Scotland)

What provisions are there at present within the Scotland Excel guidelines to encourage local, fresh and fairtrade food procurement? The Scotland Excel website highlights that it shares best procurement practice.

Derek Mackay (Scottish National Party, Renfrewshire North and West)

I reassure the member that a range of working guidance encourages local procurement. There is a myth that Excel deals only with national procurement, but there is provision to purchase and supply food and drink locally and for that to be included in contracts and specifications. Indeed, suppliers can provide on an authority to authority basis, rather than on a national basis.

In terms of specific guidelines, there is strong quality assurance through nutritional requirements, the work of inspectors and a food for life catering mark initiative. A lot of progress has been made on the hungry for success initiative as well as on our work in partnership with the Soil Association.

Across that range of activities, the emphasis is on trying to buy local as much as possible and on buying the best-quality produce. Those are factors within the current procurement process and we will continue to encourage them through the guidance that we produce.

National Performance Framework

Jean Urquhart (Independent, Highlands and Islands)

5. To ask the Scottish Government what progress the national performance framework has made in reducing inequality. (S4O-01866)

John Swinney (Scottish National Party, Perthshire North)

The national performance framework describes the kind of Scotland that we want to see and how our actions will improve the quality of life for the people of Scotland. That commitment is reinforced by a specific national outcome defining success as reaching a point at which

“We have tackled the significant inequalities in Scottish society.”

Progress towards the achievement of the outcomes and of the Government’s purpose is assessed through a set of diverse indicators. We publish that material in an impartial and transparent way on the Scotland Performs website.

Jean Urquhart (Independent, Highlands and Islands)

I thank the cabinet secretary for his answer. Does he agree that the ambition for a fairer, more equal society is a priority for an independent Scotland and that evidence of how we can achieve that is crucial?

John Swinney (Scottish National Party, Perthshire North)

Yes. The steps that we have taken through the national performance framework have been designed to establish an approach across Government—across all areas of the public sector—whereby we draw together under some common themes the steps that we can take to improve the quality of life for people in Scotland.

I was heartened by Professor Joseph Stiglitz’s assessment of the national performance framework in his contribution to the Economy, Energy and Tourism Committee meeting last week—especially given Professor Stiglitz’s strong presence and profile on the question of tackling inequality within the global community. I assure Jean Urquhart that such thinking will be at the heart of the Scottish Government’s approach and it is certainly at the heart of the opportunities that are presented by Scottish independence.

Dennis Robertson (Scottish National Party, Aberdeenshire West)

The cabinet secretary has pre-empted my question. In light of Professor Stiglitz’s evidence to the Economy, Energy and Tourism Committee and his positive comments about the national performance framework, what action has the cabinet secretary taken—or does he envisage taking?

John Swinney (Scottish National Party, Perthshire North)

First, I record my appreciation to Professor Stiglitz for his assessment of the national performance framework. Over some months, we have been involved in a discussion about how we can develop and enhance awareness of the national performance framework and the effect that it has on policy making.

Kenneth Macintosh led a debate in Parliament on related themes. I made a contribution to that debate that highlighted the Government’s interest in pursuing the issue. Subsequently, I met Claudia Beamish on related areas. I have agreed to convene an all-party discussion on how to take forward the national performance framework with external stakeholders, recognising that that has a constructive contribution to make to development of the Government’s policy agenda and, crucially, to the interaction that Parliament might wish to have with the Government on achievement of the Government’s policies and assessment of those within the national performance framework. I am grateful to colleagues from across the parliamentary spectrum who have indicated their willingness to participate in that discussion.

Offshore Wind

Lewis Macdonald (Labour, North East Scotland)

6. To ask the Scottish Government what contribution Scotland’s offshore wind resources will make to meeting European Union renewable energy targets. (S4O-01867)

Fergus Ewing (Scottish National Party, Inverness and Nairn)

With over one quarter of the European offshore wind resource, Scotland is ideally placed to make a significant contribution to the European Union target of generating 20 per cent of its energy from renewable sources by 2020.

Lewis Macdonald (Labour, North East Scotland)

Does Fergus Ewing acknowledge that it is because Aberdeen has the highest concentration of offshore energy expertise anywhere in Europe that the EU wants to invest in a wind energy deployment centre in Aberdeen bay? Does he agree that it is important to send out the right signals about the priority that Scotland gives to further development of offshore wind technologies?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

As Lewis Macdonald will be aware, Scottish ministers must refrain from commenting on live applications: it would not be appropriate for me to make specific comment on any application that is before us.

However, to answer the question in a general sense, it is absolutely correct that Aberdeen possesses expertise in oil and gas, some of which can be transferred to assist in developments in the offshore wind sector. That knowledge, together with knowledge from the fishing industry about how to operate in the cruel seas around Scotland’s waters, is an essential ingredient for the success of the offshore industry. Lewis Macdonald’s point is well made.

Stewart Stevenson (Scottish National Party, Banffshire and Buchan Coast)

Are the uncertainties and delays in the UK Government’s energy market reform impeding progress in our meeting the renewable energy targets?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

We are extremely concerned about what is, in effect, an investment hiatus, because there are simply no rules for the post-2017 future incentivisation of renewable energy, and of offshore wind in particular. We therefore urge the UK Government to end the uncertainty and to provide answers on EMR as quickly as possible, otherwise—the industry has warned—we risk leaking investment to Germany and France, and we risk jeopardising an industry that could contribute a great deal to Scotland and the rest of the UK.

A report by Cambridge Econometrics says that the success of offshore wind by 2030 could add nearly 1 per cent to United Kingdom gross domestic product. That is what is at stake. Therefore, we are working with the UK Government to end the uncertainty as quickly as possible.

Severance Payments (Public Sector)

Mary Fee (Labour, West Scotland)

7. To ask the Scottish Government how much it has spent on public sector severance payments in the last five years. (S4O-01868)

John Swinney (Scottish National Party, Perthshire North)

In a period of unprecedented financial restraint, the Scottish Government is taking action to reduce costs and improve efficiency. As part of the efficiency drive, we are committed to reducing our headcount through an on-going programme of voluntary early exit.

In the five years to the end of March 2012, the core Scottish Government has spent £58.7 million on voluntary early-exit payments, which are estimated to deliver savings of around £99 million a year. Throughout that period, the Scottish Government’s no compulsory redundancy policy has provided certainty to public sector workers. We remain committed to protecting public sector employment as far as we can within the resources that are available to us.

Mary Fee (Labour, West Scotland)

A freedom of information response from Renfrewshire Council shows that, as a result of budget cuts of around £30 million between 2008 and 2012, Derek Mackay, who was then leader of the council and is now local government minister, spent more than £39 million on exit packages—

Tricia Marwick (None, Mid Fife and Glenrothes)

That is a matter for Renfrewshire Council, not for the cabinet secretary. Can you come to a focused point, please?

Mary Fee (Labour, West Scotland)

One hundred and twenty-eight staff members received half of that £38 million. At a time of swingeing cuts, transport charges being brought in for adults with disabilities, teachers losing their jobs and directors’ pay increasing, is this—

Oil and Gas Reserves

Kenneth Gibson (Scottish National Party, Cunninghame North)

8. To ask the Scottish Government what recent assessment it has made of the reserves of oil and gas remaining in Scottish waters. (S4O-01869)

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Oil and Gas UK estimates that up to 24,000 million barrels of oil equivalent have still to be recovered. Those reserves have a potential wholesale value of up to £1.5 trillion—£1.5 million million. That implies that, by value, more than half the reserves in the United Kingdom continental shelf have still to be extracted.

Furthermore, the latest Oil and Gas UK activity survey reports record levels of North Sea investment. In 2012, investment was worth £11.4 billion, which was the highest level for 30 years. Total investment in companies’ plans is now estimated to be worth almost £100 billion—that is £100,000 million. Oil and gas will therefore remain an enormous economic resource for several decades to come.

Kenneth Gibson (Scottish National Party, Cunninghame North)

Fergus Ewing will be well aware of the McCrone report, which showed that the Labour Government in the 1970s deliberately lied to the Scottish people about the extent of our oil and gas wealth. How confident is he, as we approach next year’s independence referendum, that the better together campaign will refrain from talking down the extent of our oil and gas resources and how those resources could help to transform an independent Scotland into a more prosperous and equal society?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

I would not be overwhelmed with confidence in that respect. However, as energy minister, my part is to work productively to assist businesses and individuals in Scotland—especially in Aberdeen—to achieve enormous success. They are truly world leading and world beating in many areas, such as subsea work, reservoir management and project management. They are running projects throughout the world, thanks to their expertise.

What we need is for the UK Government to address the very serious problems—for example, the ageing infrastructure—that could, according to the analysis that has been submitted to PILOT by Jonathan Roger of Centrica Energy, if they are not addressed cost £85,000 million of lost tax revenue. Those are the serious issues that we need to address and the Scottish Government is, for its part, determined to give those matters the consideration that they deserve.

Kenneth Macintosh (Labour, Eastwood)

Was the cabinet secretary present at the recent meeting of the Scottish Cabinet at which John Swinney presented a paper on the finances of independence, which has miraculously found its way into the hands of the better together campaign? On the subject of oil and gas revenues, does he agree with the following statement from Mr Swinney:

“This high level of volatility creates considerable uncertainty in projecting forward Scotland’s fiscal position”?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

I suppose that I should be complimented that I have been promoted to the post of cabinet secretary. However, that is a post that I do not hold, so I do not attend Cabinet meetings. Therefore, the question, albeit that it is somewhat contrived, is hypothetical. Be that as it may.

Every minister in the Scottish Government recognises the terrific success of the oil and gas industry. That is the serious point that is before us. Moreover, we need to spell out the facts to the public—they do not want the political spin, if I may gently say that to Mr Macintosh.

Kenneth Macintosh (Labour, Eastwood)

I quoted John Swinney’s paper. [Interruption.]

Fergus Ewing (Scottish National Party, Inverness and Nairn)

The public want the facts, even if the Labour Party is not particularly interested in them—as we have seen to be the case on previous occasions.

To conclude the point, the facts are that around one half of all the earnings that are made in the oil and gas sector in Scotland are made through exports. That is because we are not simply extracting oil from the waters off our own shores but are exporting our expertise throughout the world. Wherever oil is discovered, Scottish men and women will be found at the forefront of that industry. That fact must be better appreciated in Scotland in order to build up the confidence in our nation.

Alex Johnstone (Conservative, North East Scotland)

What estimate can the minister make of the production and economic potential of Scotland’s unconventional gas industry, which is based onshore? What actions can his Government take to ensure that the tremendous wealth and expertise that is based in the north-east of Scotland can spread across Scotland to the advantage of our whole economy?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

I am not sure how relevant that is to the primary question, but I am happy to answer.

As I think Alex Johnstone is aware, we pursue an evidence-based approach in relation to unconventionals. Before we proceed, we want to see the evidence on potential environmental impacts and other matters, and we want to work with local authorities, the Scottish Environment Protection Agency and the United Kingdom Government. That is exactly what we are doing, and that is the right approach.

I say with respect to Alex Johnstone that it might, because there is no unconventional gas mining in Scotland at present, be a little more productive to focus on the real live issues that face us now. For example, if over the lifetime of projects we extract 1 per cent more oil and gas from the fields off our shores, the gain to the taxpayer will be £22,000 million. The oil and gas industry is achieving great success and is maximising recovery, which is the centre of our oil and gas strategy. We are delighted that the UK Government is finally, after we produced our oil and gas strategy last May, getting round to producing its own strategy. What a shame that it is nearly four decades too late.

Angus MacDonald (Scottish National Party, Falkirk East)

I recall Donald Dewar at The Scotsman’s great debate in 1992 saying that there was no guarantee that oil would stay above $12 per barrel. Given Scotland’s considerable reserves of oil and gas in the North Sea and the Atlantic and our significant renewable energy potential, does the minister agree that, provided that we can properly harness those resources, Scotland is set for a prosperous future?

Fergus Ewing (Scottish National Party, Inverness and Nairn)

Yes, I do. Perhaps if the UK had pursued the approach that Norway has pursued, which was to set up an oil fund—I believe that Norway’s fund is of the order of £300 billion—the resource would not have been squandered in the 1980s, the 1990s and the noughties. If Tory and Labour Governments at Westminster had taken that sensible and prudent fiscal approach, perhaps things would be in a better state now.

However, next year, we will have the opportunity, in the hands of our own nation, to determine to make the decisions for ourselves and to run our own affairs. We have the opportunity to determine whether our children and grandchildren receive the benefits of the enormous assets off the shores of this country and to make an investment for the future, rather than squander those assets, as has happened over the past four decades.

Strategic Forum (Savings)

Gavin Brown (Conservative, Lothian)

9. To ask the Scottish Government what savings the strategic forum will achieve in 2012-13. (S4O-01870)

John Swinney (Scottish National Party, Perthshire North)

In the spending review, we challenged the strategic forum partners to achieve savings of £20 million in 2012-13. In the spring budget revisions, adjustments totalling £15 million were made to the partners’ budgets to reflect the savings that are required. The balance is currently being treated as a pressure on the overall budget. The partners have been pursuing a number of initiatives that are designed to achieve the savings in their budgets in a way that minimises the impact on front-line expenditure. The savings will count towards the efficiency savings of at least 3 per cent per annum that we have made clear we expect all public bodies to deliver during the spending review period.

Gavin Brown (Conservative, Lothian)

What does that do to the three-year figure for the strategic forum over the spending review period? I understand that the figure was meant to be £85 million over three years, but what will the saving now be?

John Swinney (Scottish National Party, Perthshire North)

The only change to the position is the one that I referred to in my initial answer: we are treating £5 million of the projected savings from the strategic forum partners as a corporate pressure on the Government’s budget. The figures for the remainder of the spending review remain as set out when I announced the spending review.

Rolls-Royce (East Kilbride)

Linda Fabiani (Scottish National Party, East Kilbride)

10. To ask the Scottish Government what assistance it is giving to the task force set up by South Lanarkshire Council in relation to the proposed closure of the Rolls-Royce plant in East Kilbride. (S4O-01871)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government is represented on the task force by officials from Scottish Enterprise and Skills Development Scotland, who are contributing to the development of an East Kilbride action plan, which is aimed at encouraging future business opportunities. The Scottish Government is, through Scottish Enterprise and with partners, supporting the action plan by funding resources for its development. A member of staff from Scottish Enterprise has now been assigned to project manage development of the plan, which will sit in the council’s economic development strategy for the wider South Lanarkshire economy.

Linda Fabiani (Scottish National Party, East Kilbride)

I ask that the cabinet secretary recognise the importance of East Kilbride within South Lanarkshire and the west of Scotland as Scotland’s largest town and a prime business location. Will he ensure that appropriate assistance is given at all times to the town to promote innovative responses to major employment losses?

John Swinney (Scottish National Party, Perthshire North)

I am happy to give Linda Fabiani that assurance. The Government acknowledges the significant role that East Kilbride has played in the development of innovative technologies and of a strong and continuing manufacturing base. I assure Linda Fabiani that services such as the Scottish manufacturing advisory service would be available to relevant companies in the locality to assist in developing their capability to ensure that East Kilbride continues its reputation as a significant economic player and centre of manufacturing activity.

Currency Union

Maureen Watt (Scottish National Party, Aberdeen South and North Kincardine)

11. To ask the Scottish Government what discussions it has had with the United Kingdom Government regarding a currency union between an independent Scotland and the rest of the UK. (S4O-01872)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government has proposed discussions with the UK Government to explore a joint approach to issues to be resolved after the referendum in line with the Electoral Commission’s clear recommendation and within the spirit of the Edinburgh agreement.

The fiscal commission has published a set of proposals to deliver a stable and robust macroeconomic framework post independence, including a formal monetary union. We look forward to the UK Government agreeing to discuss the proposed set-up of a formal monetary union and other matters of importance for the people of Scotland as they prepare for their decision in the referendum.

Maureen Watt (Scottish National Party, Aberdeen South and North Kincardine)

Investment in the oil and gas sector is at its highest for 30 years and the sector contributes upwards of £40 billion to the strength of the pound, with more than £1 trillion-worth of oil and gas still to be extracted. Does the cabinet secretary therefore agree that the UK Government should acknowledge that a currency union with Scotland is beneficial to the UK as well as to Scotland and that it is time that Scotland saw more of that benefit? Bizarrely, the no campaign argues that having access to billions of pounds of oil tax revenue is somehow a bad thing for Scotland but a good thing for Westminster.

John Swinney (Scottish National Party, Perthshire North)

I assure Maureen Watt that the Government is giving clear consideration to the output of the fiscal commission, which made it clear in its report that there are advantages for the rest of the United Kingdom not only from the contribution of oil and gas to the strength of sterling but from the continuation of Scotland as a key trading partner, which strengthens the arguments for the attractiveness of a currency union.

An independent Scotland would be uniquely placed to benefit fully from the strengths of its own economy and to invest to secure its continued success for future generations. Maureen Watt makes a point about the use of oil and gas resources. Those who are opposed to Scottish independence seem to have some difficulty in believing that that resource, which is clearly attributed to Scotland, should be used in the interests of, and to the benefit of, the people of this country.

Lewis Macdonald (Labour, North East Scotland)

Does the cabinet secretary not acknowledge that we already have a currency union, that we have had one for 300 years and that the only threat to that currency union is from his party?

John Swinney (Scottish National Party, Perthshire North)

The problem for Mr Macdonald is that all the decisions about the use of any fiscal flexibility are taken by the United Kingdom Government. If he is prepared to leave all that decision making to a Government that the people of Scotland did not choose and which imposes its agenda on Scotland—whether the squandering of our oil and gas resources or the disgraceful benefit reform agenda that the UK Government is implementing—that is up to him, but we have a different agenda for where we want to take our country in the years to come.

Willie Rennie (Liberal Democrat, Mid Scotland and Fife)

For a moment, I thought that Maureen Watt had been converted to the case for the United Kingdom. Should Mr Swinney not just recognise that, under his proposals for the currency, Scotland would have less influence, not more?

John Swinney (Scottish National Party, Perthshire North)

I suspect that that question is why Mr Rennie is sitting over there as a lonely wee soul this afternoon.

Public Art (Investment)

Joan McAlpine (Scottish National Party, South Scotland)

12. To ask the Scottish Government whether the Cabinet Secretary for Finance, Employment and Sustainable Growth supports investment in large-scale public art projects as a means of generating jobs and boosting economic growth. (S4O-01873)

John Swinney (Scottish National Party, Perthshire North)

The Scottish Government supports investment in large-scale public art projects through grant funding to Creative Scotland, which is Scotland’s national agency for the arts, screen and creative industries. Creative Scotland aims to encourage high-quality public art projects that contribute to successful places, build new audiences and extend the diversity of public art practice.

Joan McAlpine (Scottish National Party, South Scotland)

The cabinet secretary will be aware of the star of Caledonia, a world-class landmark that has been designed by Cecil Balmand and Charles Jencks to mark the border between England and Scotland. Does he agree that the star could stimulate sustainable economic growth throughout the nation as an iconic gateway to Scotland, and that it could stimulate the economic growth of Dumfriesshire?

John Swinney (Scottish National Party, Perthshire North)

Joan McAlpine makes a strong and valid point. The developments are exciting and imaginative. As we have seen from our own investment in the cultural facilities of Scotland, once they are supported financially and programmes such as the refurbishment of the national museum of Scotland take their course, they attract significant numbers of visitors and have a beneficial economic impact. I am quite sure that the star of Caledonia venture in Dumfries and Galloway has all that potential into the bargain.

Local Government (Constitutional Protection)

Mark McDonald (Scottish National Party, North East Scotland)

13. To ask the Scottish Government what engagement it has had with the Convention of Scottish Local Authorities in relation to constitutional protection for local government in an independent Scotland. (S4O-01874)

Derek Mackay (Scottish National Party, Renfrewshire North and West)

The Scottish Government engages regularly with COSLA and other key partners and stakeholders ahead of a constitutional platform being developed.

Mark McDonald (Scottish National Party, North East Scotland)

The minister will be aware of the recent comments of COSLA president David O’Neill about constitutional protection for local government. Does the minister agree that that appears to indicate that some in the Labour movement are opening their eyes to the opportunities that independence will bring? Would it not be better if the Labour Party helped to inform the debate by setting out its stall to show what it would do with the powers of an independent Scotland?

Derek Mackay (Scottish National Party, Renfrewshire North and West)

It looks as though I am not the only minister who has had a promotion this afternoon.

In line with the Electoral Commission’s call for both sides of the independence campaign to set out the process following the referendum, the Scottish Government has published a number of papers, including the paper outlining the transition to independence, the fiscal commission working group’s considerations, and a discussion paper about streamlining and strengthening economic and competition regulation. Those papers are helpful to the debate. I am glad that some people in the Labour Party are now recognising the opportunities that will be provided by a yes vote, and I look forward to their being joined by other members of the Labour Party in the forthcoming debate.

Employment Opportunities (Older People)

Roderick Campbell (Scottish National Party, North East Fife)

14. To ask the Scottish Government what it is doing to improve employment opportunities for older people. (S4O-01875)

John Swinney (Scottish National Party, Perthshire North)

From April, we will introduce a new employability fund that is aimed at further supporting local areas to provide targeted interventions for those who are out of work. Through Skills Development Scotland, the fund will deliver 17,100 individual training opportunities in 2013-14. As with the current training for work programme, the fund will be open to people who are aged 18 and over. To date, £64.6 million of European social fund grant has been allocated in priority 5 towards projects that are worth £168 million, of which £32.3 million has been allocated to six community planning partnerships in some of the most deprived areas of Scotland, and almost £3 million has gone to projects being delivered in Fife.

ESF projects address the challenge to improve the skills of the unemployed, the lowest paid and the socially deprived, while contributing to Scotland’s future economic growth. Since the start of 2007, more than half of those who accessed ESF employability support across Scotland have been over the age of 25.

Roderick Campbell (Scottish National Party, North East Fife)

I acknowledge the Government’s efforts to help younger people into work. What opportunities are there for the exchange of knowledge and skills between older workers and young people?

John Swinney (Scottish National Party, Perthshire North)

Many such opportunities will be contained in the training for work interventions that I have set out. As we discussed in yesterday’s debate on the changing demographic pattern in Scotland, older people can play a strong and vibrant role in Scotland’s labour market, and the Government will do all in its power to encourage the fulfilment of that potential.

Basing Review

Tricia Marwick (None, Mid Fife and Glenrothes)

The next item of business is a statement by Keith Brown on the basing review. The minister will take questions at the end of his statement, so there should be no interventions or interruptions.

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

In the House of Commons yesterday, the Secretary of State for Defence, Philip Hammond, made a statement on the basing of military forces, including in Scotland. The implications of that statement are serious and are of direct relevance to the current responsibilities of the Scottish Parliament. The military’s presence in our nation has highly significant social and economic impacts.

That statement was, as the Deputy First Minister said yesterday, a betrayal of Scotland and her communities. I will set out why that is the case and what the Scottish Government intends to do to continue to hold the UK Government to account for its decisions.

The Scottish Government fully recognises and values the vital part that the armed forces and those who serve in them play in the life of our nation. That contribution cannot be sustained in isolation—it must be supported by wider society. The Scottish Government’s successful approach to ensuring that that happens was set out in the paper, “Our Commitments: Scottish Government Support for the Armed Forces Community in Scotland”, which I launched at Edinburgh castle last September.

Yesterday’s announcement came a long time—more than 18 months—after the then Secretary of State for Defence, Liam Fox, made his initial announcement about military basing. The Scottish Government had worked hard to support the UK Government in the process that led up to that announcement. That included forging a cross-party consensus and submissions from all the main parties in the Scottish Parliament.

When it came, Liam Fox’s announcement included some severe disappointments, including—importantly—that Royal Air Force operations would cease at Leuchars. Given that it came on top of the previous announcement that the RAF would be leaving Kinloss, it was a particularly heavy blow. At a stroke, the number of air bases in Scotland was cut from three to one.

That disappointment was somewhat mitigated by Liam Fox’s commitment that, as part of the rebasing of Army personnel from Germany, up to 7,000 additional troops would be coming here to Scotland. That commitment was made in the full knowledge that the United Kingdom’s regular Army would be reduced to 82,000 by 2020. Suggestions otherwise are a reinvention of history. Philip Hammond’s betrayal of that promise is a disgrace.

Following Liam Fox’s announcement, we committed to working positively with the Ministry of Defence, local authorities and other partners to make the changes work as best they could for service personnel, their families and communities around Scotland. Officials from the Scottish Government have engaged fully with the MOD and its Defence Infrastructure Organisation at every available opportunity.

At ministerial level, since July 2011 various ministers—including the First Minister, the Deputy First Minister and me—have underscored that commitment by raising issues connected with the basing review, both in writing and through meetings, a total of 18 times with UK ministers. We have also been supportive of the local communities involved by meeting those affected in the aftermath of the announcement and, through officials, keeping closely in touch with local authorities.

The time that it has taken to work through that process has led to a great deal of uncertainty and anxiety in the communities that are affected around Scotland, but now, at last, the announcement has come. Again, it is deeply disappointing, given the work that we have put in to trying to make the process work for Scotland.

In place of the commitment that Army numbers would rise significantly as troops were rebased from Germany—Liam Fox talked of a figure of up to 7,000—we now have a commitment that the total number of armed forces personnel will rise by only around 600 from the baseline at July 2011. That suggests that numbers—if the time commitments are delivered—will be just over 12,500 by 2020.

That ignores the fact that Scotland has already seen disproportionate cuts in our defence footprint, which has shrunk by more than a third since 2000. By comparison, across the UK as a whole, it has reduced by about a fifth. The increase that Philip Hammond announced yesterday will serve to reverse only a small part of the reduction in the military footprint that we have seen in Scotland under successive UK Governments.

Liam Fox’s announcement included the news that Scotland would become home to one of five multirole brigades, but Philip Hammond has downgraded the military commitment to Scotland. Now Scotland will be home not to one of five multirole brigades but to one of seven army hubs. We need clarity from him and from the MOD on what the roles and functions will be of the elements that will be located here.

Philip Hammond also made no mention of his predecessor’s commitment to exploring the possibility of an additional training estate in Scotland, a proposal that we actively worked to support and which he has ditched.

I have mentioned the overall military footprint and the impact of the announcement nationally in Scotland. However, where these changes will really impact is at the local level. Although I welcome the UK Government’s complete about-turn on the basing of the Royal Marines at RM Condor in Arbroath, around much of the country there is little else to be genuinely pleased about.

Although it has finally been confirmed that Army units will be based at Leuchars to replace the RAF, the numbers, though not yet confirmed, will not reach the 1,300 that Liam Fox promised. Moreover, Liam Fox talked about an Army headquarters at Leuchars, but that was absent from Philip Hammond’s statement and questions remain about what, if anything, that will amount to. There will also be disappointment in Fife at the confirmation that no Army units will be based at the current Royal Navy facility at Caledonia in Rosyth.

As for Edinburgh, we have confirmation that Dreghorn will remain but Craigiehall and at least part of Redford barracks will close; we also know that the Kirknewton site on the outskirts of Edinburgh will not be developed. The MOD must work immediately and closely with us and the City of Edinburgh Council to ensure that the situation is handled properly, including setting out again the numbers associated with the units that it has said will be based in the different locations.

Similar questions arise in other areas. Clarity is needed on the partial disposal of the Army site at Forthside in Stirling with the relocation of the headquarters of 51st brigade. We have also been led to believe that there will be a further small increase in the numbers at Kinloss—although it will still not bring the Army presence there, welcome though that is, to anywhere near the previous levels of RAF personnel.

I have already set out some of the unanswered questions that remain around this announcement. That so many remain is partly because of the remarkable—indeed, someone described it today as “bizarre”—fact that UK ministers have made no contact with the Scottish ministers in connection with the announcement, even though an MOD minister, Mark Francois, found time yesterday to stroll on Edinburgh castle esplanade while briefing the media.

We also understand that, although local authorities have received some written communication, it does not set out the numbers associated with the Army units that have been allocated to different locations. That is a shocking omission at this stage. We also have no detail on timing and numbers in relation to changes for the other services beyond the Army. That detail is required not just by us but by local authorities, and the situation is quite frankly unacceptable.

Of course, it does not need to be this way. I believe that this Parliament is more than capable of taking decisions about defence in the best interests of our people and our communities. Given the many years of draconian cuts to Scotland’s defence footprint by both Labour and Tory Governments, how can anyone disagree with that simple, democratic proposition?

Scotland already contributes a great deal to defence spending and, like other nations of similar size, could afford conventional forces of its own. The Scottish National Party has made it clear that, with independence, Scottish defence forces would have 15,000 regular personnel and be supported by a £2.5 billion defence and security budget. Such a defence settlement is designed to meet Scotland’s needs and priorities.

By way of comparison, I note that, in 2010, Finland spent £2.3 billion on defence and Denmark £2.8 billion. No one would seriously suggest for a minute that those countries do not take their defence seriously. In stark contrast to the UK’s approach, we would not spend money on Trident—those weapons of mass destruction on our shores, which cost Scotland £163 million each and every year.

In conclusion, we will continue to support local authorities, communities and other partners, and I am writing to them to offer our on-going support. Indeed, I have just spoken to senior Army personnel to convince them that we will continue to provide that support in future. However, the UK Government must now confirm the numbers associated with each of the units that it has said will be located in different parts of the country.

Alongside that, we have since September been pressing the UK Government for baseline information to enable us and local partners to understand the economic impact of the changes. We will continue to demand the immediate release of that information to allow us to work with local authorities, communities and other partners on an impact study that will help us to plan fully for, as well as to mitigate, the economic consequences of these UK Government decisions.

Once again, Scotland has been let down by a UK Government and its ill thought through and poorly handled decisions. At least some members will remember debates when it was a Labour UK Government whose proposals—at that time on regimental amalgamation—were doing damage to Scotland’s military heritage. Labour Governments, as well as the current Westminster Government, have presided over a long-term decline in Scotland’s military footprint.

Democracy is about having the ability to choose. I believe that the people of Scotland will choose to reverse that decline and vote yes in next year’s referendum.

Mark Griffin (Labour, Central Scotland)

I thank the minister for the advance notice of his statement.

We have seen a disappointing reduction in the number of armed forces personnel who are coming to Scotland compared with the number promised, and the Scottish Government is asking for clarity. What clarity can the Scottish Government give on the future of the armed forces in an independent Scotland and the civilian jobs that are associated with them? Figures today show that, as part of the UK, overall spending per head in Scotland is £1,197 higher than in the rest of the UK.

In John Swinney’s leaked Scottish Government document on the future finances of an independent Scotland—

Mark Griffin (Labour, Central Scotland)

The statement says—and I quote:

“I have made clear to the Defence Workstream that a much lower budget must be assumed”.

Despite the public rhetoric, can the minister give a categorical assurance that the budget for a Scottish defence force will not be subjected to the savage cuts that John Swinney has suggested in the leaked document? Why is the SNP saying one thing in public and another in private? [Interruption.]

Mark Griffin (Labour, Central Scotland)

Does the Scottish Government expect special forces personnel to automatically transfer to Scottish armed forces? Some have expressed reservations about the deployment, specialist training and promotion opportunities that will be available to them. If there is no significant transfer of special forces personnel to a Scottish defence force, how long does the minister expect that it would take to recruit and train a special forces unit, and how long would key assets, such as North Sea oil rigs, be left vulnerable as a result?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

For clarity, my statement was about the UK Government’s statement. I tried to deal with some of the complications and implications of that. [Interruption.]

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Mark Griffin’s first point was about clarity. Things are starting to become quite clear. He asked questions to try to provide a human shield for the Conservative cuts that are taking place, as Jim Murphy did on the radio on this morning. As I said, things are becoming clear. The Labour Party will commit billions of pounds towards nuclear weapons rather than towards the equipment and troop numbers that our defence forces need. That is providing clarity.

The member may not remember this, but in the 1980s Paul Weller said that it is the kidney machines that pay for rockets and guns. In 2013, Labour’s and the Tories’ bedroom tax will pay for nuclear bombs. That is the clarity that we are now seeing from the Labour Party. [Interruption.]

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

As I said in my statement, we are committed to providing £2.5 billion-worth of expenditure towards Scottish defence forces. That amount is commensurate with amounts in other countries of our size. What is the Labour Party’s commitment? Will it continue with the Conservative cuts or reverse any of them?

Alex Johnstone (Conservative, North East Scotland)

I thank the minister for the advance sight of his statement. I also take the opportunity to welcome the significant increase in the number of troops who will be stationed north of the border that was announced yesterday. [Interruption.]

Alex Johnstone (Conservative, North East Scotland)

Having a well-equipped, highly trained and motivated army presence makes Scotland a safer place. The minister cannot bemoan the number of troops who are coming to Scotland when the effect of a vote for separation in 2014 would be the British Army withdrawing altogether.

Of course, Angus Robertson tells us that Scotland’s share of defence spending would be kept in defence. That is diametrically opposed to the views of Annabelle Ewing, for example, and others on the SNP back benches who have already committed it to welfare or any one of a dozen other fleeting priorities. The truth is that the Government does not understand defence.

Alex Johnstone (Conservative, North East Scotland)

Why on earth does this anti-combat Government want more troops but does not want them ever to be deployed anywhere? [Interruption.]

Alex Johnstone (Conservative, North East Scotland)

Above all, will the minister commit to setting out clearly in detail the facts and costs associated with his Government’s defence policy?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

On Alex Johnstone’s final point, I have already set out the level of finance that the SNP would contribute towards defence, which is commensurate with that of other countries of our size. I have therefore answered that point.

Alex Johnstone started off by saying that he welcomed the UK Government’s announcement. It would be interesting to listen to what squaddies are saying in barrack rooms around the country about yesterday’s announcement, as they get shuffled around Scotland from barracks to barracks.

It is not just us who criticise the announcement. Newspapers that are not noted for their support for this Government almost universally talk about a betrayal of troops in Scotland. One particular leader is headed “Armed Farces”, which might give members a clue as to what that newspaper thinks about the announcement. It goes on to state about Philip Hammond’s announcement:

“an extra few hundred who will play musical chairs around our barracks ... It’s hard to escape the conclusion he was simply plucking numbers out of the air to stave off the flak.”

It ends by saying:

“But a lie is a lie is a lie and there is no defence.”

That is what other people think about the Conservative Party’s statement yesterday, so there is obviously not the same welcome for it elsewhere that Alex Johnstone would like me to have for it. I do not welcome it, because it is a betrayal of many promises that were made by his own former defence minister, Liam Fox.

What we have to do now is to see how we can mitigate the impact of what has been announced on various communities across the country. The SNP Government will do that.

Roderick Campbell (Scottish National Party, North East Fife)

It is disappointing that the UK Government has failed to provide the Scottish Government or, indeed, Fife Council with details of the numbers of troops coming to Leuchars. However, it seems likely that the number of personnel at Leuchars will be about 450 fewer than promised by Liam Fox in July 2011 and approximately 350 fewer than the Royal Air Force numbers at that time. That will have an economic and social impact in my constituency, and my constituents are disappointed. Does the minister agree that, rather than that being a union dividend for Leuchars, it is more of a union IOU?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Rod Campbell is right to point out that the reaction to the announcement that is of most importance is that from those in our local communities who are affected by it.

Nobody in Leuchars is going to be duped by what has been announced by the UK Government. I visited RAF Leuchars recently to find out about some of the issues that its personnel face and some of the transitional issues that they will face in moving from an RAF base to a largely army base. There is a lot that the Scottish Government can do to try to help that process take place, but there is no question but that there is a feeling of betrayal.

I have been involved in these things for many years now, with accusations from parties on both sides of this chamber, indistinguishable as they are, that Scotland under the SNP would have a reduced number of air bases. The number of air bases has now been reduced from three to one in the space of a year, and we have a challenge to mitigate the impact of that.

I am sure that we can work with the community in Rod Campbell’s constituency to ensure that we mitigate the impact as best we can. However, it would have been much better had the UK Government decision not been made.

Graeme Pearson (Labour, South Scotland)

SNP proposals seem to focus on leaving us with one of the smallest defence budgets in Europe, at £2.5 billion, which is even smaller than Denmark’s and proportionately less than is currently spent across the UK. Does the minister seriously suggest that filling all an independent Scotland’s defence capability gaps can be furnished on the cheap? Or does he intend introducing conscription to Scotland, just as his examples of Finland and Denmark already have?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

I am sure that the public will note that in the question just asked there was not one word of condemnation of the Conservative-Liberal Government’s announcement.

Far from getting it on the cheap, I think that Scotland is currently being taken very cheaply by the UK Government. We commit around £3.3 billion just now to the UK’s defence expenditure and we get in return about £2.5 billion. What could we do with that extra £800 million a year, which amounts to around £7 billion over the past 10 years? What could we do with that to mitigate things such as the bedroom tax or to improve our forces’ equipment?

Alex Johnstone said earlier that the SNP does not want to commit troops to combat. We do not want to commit troops to illegal wars like Iraq, as Graeme Pearson’s party did; we want to have a Scottish defence force that is properly funded and equipped.

Colin Keir (Scottish National Party, Edinburgh Western)

Does the minister agree that the closure of military bases in Scotland such as Craigiehall, in my constituency, will have a devastating effect on the economy of local communities and shows that the biggest danger to the defence of Scotland is Westminster politicians who choose to lavish billions on new nuclear weapons while disproportionately cutting defence personnel in Scotland?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

That is a good point. A number of military sources—think tanks and so on—say that it is unsustainable for the UK to have the number of troops that it currently has, as well as the 1 per cent increase in the equipment budget to which the Government was committed and nuclear weapons. That is just not sustainable. There is fantasy in defence policy in the UK today.

In relation to Colin Keir’s area, it is bizarre that the Royal Scots are to be moved to Belfast. As it says in today’s Evening News:

“Part of the strength and uniqueness of these proud and famous fighting Scots regiments came from their link with the local community.”

The Royal Scots is the oldest regiment in the British Army and its traditional geographical recruiting base is Edinburgh and the Lothians.

Such is the nature of the thinking behind the announcement, if there is thinking. I am sure that we could organise things far better to maintain the link between our communities and our armed forces, which is vital in a modern democracy.

Willie Rennie (Liberal Democrat, Mid Scotland and Fife)

I thank the minister for the advance copy of his statement. He said that he is more than capable of making decisions on defence for Scotland, but he omitted to make substantial reference to the Royal Navy and its new submarines on the Clyde. The new HMS Ambush officially joined the fleet on Monday. Does the minister or does he not welcome the decision to base all the UK’s conventionally-armed submarines on the Clyde?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

It is true that I did not mention that, because it was not mentioned in the statement by the UK Government to which I was responding in my statement. If we are talking about the Royal Navy, it is worth noting that there are no combat-ready units of the Royal Navy in Scotland and that two carriers are going to be constructed with no provision for aeroplanes to go on them.

There is something seriously wrong at the heart of UK defence policy. I do believe that we could cope much better with such questions in Scotland, democratically.

Graeme Dey (Scottish National Party, Angus South)

One of the very few positive aspects of yesterday’s announcement was that 45 Commando Royal Marines will stay at RM Condor for the foreseeable future, which is welcome news for the marines who have put down roots in the area, not to mention the local economy.

My constituency is also home to Barry Buddon. Does the minister agree that, given the training facility’s close proximity to Condor and Leuchars, it is logical and appropriate that full use be made of it?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Yes, indeed. Much more could be made of Barry Buddon. Barry Buddon relies very much on the local marines and others undertaking training in relation to live firing and certain vehicles.

It is a matter of some satisfaction that the previous proposal, which was to take the sole remaining units of Royal Marines out of Scotland, has been reversed in another about-turn. That is emblematic of the decision that has been made. There has been discussion about the UK Government making a right turn; it strikes me that this was not a right turn but an about-turn—and one that was so badly executed that had Philip Hammond done it on a parade ground he would have been marched off and given extra duties.

Duncan McNeil (Labour, Greenock and Inverclyde)

I thank the minister for his statement. We should not forget that yesterday was a sad and disappointing day, which will not be forgiven lightly, as Jim Murphy said.

In his statement, the minister moved on quickly to describe the benefits of independence. There was a wee debate about different budgets. Will he say what the start-up costs would be for the Scottish armed forces? How much does a single jet fighter cost, or a single conventional submarine? We need to worry about not just the budgets but the start-up costs. Has the Scottish Government done any work on that?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

It might be that Duncan McNeil has been reading and believing too closely the document that Jim Wallace recently produced, which suggested that we would start with nothing on independence.

That is not the case. We have a share in the UK forces, to which we have contributed over many years. Before Duncan McNeil writes that off, it is worth bearing in mind that Scotland has traditionally contributed between 10 and 14 per cent of the personnel of the UK armed forces, which is a substantial contribution. We are not starting from year zero; we start with a huge amount of experience and our share of the resources of the UK military defence establishment.

What we can do is improve on that. Currently we are paying a surcharge. We pay around £700 million a year more than we get back. We could do far more if we were independent.

Bruce Crawford (Scottish National Party, Stirling)

It is interesting—and quite remarkable—that not one Labour member has criticised yesterday’s Conservative announcement. [Interruption.]

Bruce Crawford (Scottish National Party, Stirling)

Let me bore down into some criticism of the position. The 51st brigade at Forthside in Stirling will move to Edinburgh. The important site at Forthside, which is shared by the defence support group in the Stirling area and which employs many people, is being disposed of. Is the minister concerned that that is the first step towards potentially removing the DSG from the Stirling area? Is he concerned about the potential loss of many jobs and the impact that that will have on the local economy?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

I share those and a number of other concerns that arise from the fact that there is so little detail on what has been proposed. It should have been the case that yesterday’s announcement was also accompanied by an announcement on reserved forces across Scotland so that we could have some idea about what impact there would be in relation to them, too. I do not understand why that did not happen.

Bruce Crawford is absolutely right—there are uncertainties because we do not have the detail. We were not approached and we did not receive any correspondence from the UK Government or the responsible minister before the announcement was made. Instead, it flew in a senior member of the military today to provide some background. That, of course, is a case of Government sending in the military to do things that it finds uncomfortable. That is the wrong way to go about it, and that is why there is uncertainty in Bruce Crawford’s area, as there will be in many other parts of Scotland.

Richard Simpson (Labour, Mid Scotland and Fife)

I begin by correcting Bruce Crawford. Duncan McNeil said that Jim Murphy regrets the UK Government’s statement and the Labour Party does, too.

The minister said that an independent Scotland would end up seeing none of the next generation of Royal Navy frigates being built in this country, which would inevitably have a huge impact on current and future jobs. [Interruption.]

Richard Simpson (Labour, Mid Scotland and Fife)

How many naval bases is the Scottish Government planning to maintain in the event of a yes vote for an independent Scotland within a £2.5 billion budget that would cover not only defence but security?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Dr Simpson’s question is based on the fallacy that Scotland will have no need for vessels, whether for its navy, coastguard or other coastal services.

Of course it is the case that we will have to procure vessels—we understand that point perfectly well—but it is also the case that what is available to the UK Government is partly Scotland’s. We have a share in that; that is necessarily the case. That means that we must have a discussion with the UK Government.

The discussion that we will have once Scotland is independent will be a far more rational, considered and measured that what we have seen in relation to yesterday’s announcement. As I have mentioned, carriers are being built with no provision for aircraft and billions are being spent on airplanes that are dismantled before they are completed. I am pretty sure that Scotland could do better than that.

Stewart Stevenson (Scottish National Party, Banffshire and Buchan Coast)

Is the minister aware of the bitterness that burns bright in Moray at the closure of RAF Kinloss? The minister has indicated that there will be a small increase in personnel numbers at Kinloss. In theory, that is welcome. However, is he aware that that takes no account of the P45s that are being dished out by the UK Administration with gay abandon and which will negate the effect of that increase? The bitterness remains.

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

That is the background against which the decision was taken and the statement made by the UK Government. We have seen a vast number of redundancies. We are told by the MOD that there will be 5,000 more redundancies across the UK—1,000 may perhaps come from Scotland. Of course, P45s are being delivered to troops on the front line in Afghanistan. Who would have thought that a Conservative Government would have reduced itself to that?

It is absolutely the case that Scotland will lose out badly, not least because, as Stewart Stevenson has mentioned, the cuts take money out of local communities. If you reduce a base that was supposed to have 1,500 personnel to 900, you are removing a huge chunk of finance from that local community. As I said at the start of my statement, the decision will have an impact on Scotland socially and economically.

Murdo Fraser (Conservative, Mid Scotland and Fife)

Philip Hammond’s announcement yesterday on moving troops to Leuchars was warmly welcomed by Fife Council and Fife Chamber of Commerce. Why are we hearing negative carping tones from the Scottish Government today when local representatives are so positive? [Interruption.]

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

Perhaps Murdo Fraser has seen the comments of the community councils of Garbridge and nearby, which have been very concerned by the UK Government’s statement. Perhaps, like me, he has talked to the families and people in the communities. They do not welcome the statement—they think that it is a major change to Leuchars, a diminution compared with what there was before and a change from an RAF base that has served the UK very well over many years and settled effectively in Scotland.

There is no broad welcome. Are all the newspapers wrong? Are all the personnel that we have talked to wrong? People realise that the UK Government’s decision is a complete betrayal of what was first announced by Liam Fox. Murdo Fraser’s attempt to hide that does him no credit at all.

Drew Smith (Labour, Glasgow)

The biggest challenge faced by my constituents and thousands of defence workers in Glasgow is the future of the Clyde yards, 90 per cent of whose work comes from the MOD. Will the minister explain what information the UK Government has provided to the Scottish Government about the likelihood of the MOD placing contracts for defence ships with what would become, in an independent Scotland, foreign yards on the Clyde? Is it the same information that trade unions have, which is that the likelihood of the rest of the UK placing such orders is basically nil?

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

There is very little information. The member may be aware—indeed, he may support the idea—that the UK Government does not engage with the Scottish Government on those issues and it does not provide the information that he is talking about.

Interestingly, the process that was followed—in which the UK Government did not allow its ministers even to speak to the Scottish Government, the Welsh Government or local authorities, which means that we do not have that kind of information—is the same process that was followed for the west coast main line. There has been no contact whatsoever. The news came like a bolt out of the blue, and there is no way that we can respond to it as quickly as we would like to—nor can we do all the things that we would like to do to mitigate the effects.

A statement was made, as we just heard, that the MOD would buy no vessels that were built in foreign yards. That is simply not true, and the member should check his facts before asking a question like that.

National Health Service Waiting Times

Tricia Marwick (None, Mid Fife and Glenrothes)

The next item of business is a debate on motion S4M-05813, in the name of Jackie Baillie, on national health service waiting times.

I remind members to speak through the chair and to refer to other members by their full name and not as “you”. I invite members who wish to take part in the debate to press their request-to-speak button now.

Jackie Baillie (Labour, Dumbarton)

I welcome the opportunity to debate waiting times, which is a subject of considerable importance to patients and staff in the NHS. People value the NHS, which is a much-loved institution. People do not need their confidence in the NHS to be undermined by the Scottish National Party’s approach to healthcare.

People want the best possible care, as quickly as possible. The time from general practitioner referral to diagnosis and treatment can be anxious for patients and their families. Anything that prolongs that wait clearly adds to the worry and uncertainty. We know that, for many conditions, early diagnosis and early treatment can lead to much better health outcomes, so all of us across the chamber know the importance of reducing waiting times.

However, the achievement and meeting of waiting time targets must be real. Targets must not be the only thing that matters to the Government, because if that is the signal, we will see distortion of behaviour. If targets are all that matters, that ends up having a negative impact on patient care. The Scottish Government’s self-congratulatory amendment is totally out of place in light of Audit Scotland’s report and the reality on the ground.

Audit Scotland’s report demonstrated that the focus was on targets rather than patient care. It set out a picture of sharp rises in social unavailability at the same time as target times were reducing. A staggering one in three people were recorded as socially unavailable in June 2011. Then the NHS Lothian scandal broke. Boards were told to stop misusing codes and—miracle of miracles—the number of socially unavailable patients dropped dramatically. Of course, at the same time waiting times started to rise and targets were breached. Warning bells were absolutely ringing.

Audit Scotland also pointed out that one in four patients had an actual wait that was well in excess of what was reported—the figures are only 3 per cent reported, against 23 per cent of cases with much longer waits, which remained unreported. The evidence clearly shows that social unavailability was growing and that the reported number of breaches was far fewer than the actual number.

I was disappointed to have confirmed that the former cabinet secretary, Nicola Sturgeon, knew about that but chose to ignore the warning signs. In March 2010, Audit Scotland published its report into the management of waiting times. It made a number of observations, such as:

“NHS boards vary in how they deal with patients who do not or cannot attend appointments and this may not always be appropriate”,

and:

“The report also finds that the NHS is not accurately recording all relevant information about patient waits which makes it difficult to demonstrate that it is managing all patients correctly in line with the new guidance.”

It also noted:

“There is wide variation in levels of social unavailability across”

12

“boards. This implies that boards are applying the code differently, which has implications for patients.”

Audit Scotland told the Scottish Government in March 2010 but nothing was done.

In evidence to the Public Audit Committee, members were told that, in March 2011, Audit Scotland contacted the Scottish Government about the report’s recommendations on monitoring progress. Audit Scotland was told by the Scottish Government that new guidance was imminent. In my understanding, “imminent” meant that the guidance was just around the corner or looming, not that it would take some 18 months before the guidance was issued—long after NHS Lothian’s deliberate and retrospective manipulation of waiting times came to light. By that time, the horse had well and truly bolted.

What was going on? Is it legitimate to expect the health department to know what its own statistics division knew? Should we have expected the cabinet secretary to have seen the data? The NHS statistics division says in The Sunday Times that it reported the figures for social unavailability on a quarterly basis to the health department. Was that to the director of health workforce and performance, whose responsibility includes waiting times? Did he report it to the director general for health or the cabinet secretary? Surely a policy area of such importance deserves closer scrutiny than it appears to have received. It beggars belief that nobody was monitoring that.

Audit Scotland is clear. It says that during 2011, the focus

“was on meeting waiting time targets”

and that

“There was not enough scrutiny of the increasing number of patients recorded as unavailable.”

Audit Scotland’s contention is that better use of the available information could have helped to identify concerns about the use of unavailability codes. Audit Scotland told the Scottish Government in March 2010 and reminded it in March 2011. Despite the evidence before its very eyes, the Scottish Government did absolutely nothing. Not one single iota of action was taken—not by the officials, not by the senior management team at St Andrew’s house and not by the cabinet secretary herself. The consequence? Thousands of patients have been let down by the SNP and parked on hidden waiting lists, in some cases with no end date, as a way of managing the waiting time targets. The whole system was focused on avoiding a breach instead of on the patient.

Contrary to what the cabinet secretary said, I do not blame the hard-working nurses and doctors who are trying their best with fewer and fewer resources—2,000 nurses cannot be removed from the NHS without consequences. Nor do I blame the waiting list managers, who are under enormous pressure to deliver—some of them are off sick with stress. It is the SNP that has put an obsession with targets ahead of patient care.

Jamie Hepburn (Cumbernauld and Kilsyth) (SNP) rose—

Mark McDonald (North East Scotland) (SNP) rose—

I think that it was James Callaghan who once said:

“The sky has darkened with the wings of chickens coming home to roost.”

The sky is very dark indeed, when we consider Nicola Sturgeon’s handling of waiting times. But we should not worry—Alex Neil is there to clean up her mess. However, even he is encountering some difficulty.

When the situation at NHS Lothian first came to light, Nicola Sturgeon said that it was an isolated case. After all, she had received assurances from all chief executives of all health boards that they were acting in line with the waiting time guidance. Well, they would say that, wouldn’t they?

The British Medical Association tells us that

“feedback from our members would suggest that this aggressive management style is not isolated to Lothian.”

Let me allow that statement to sink in. Our doctors are telling us that pressure on and bullying of waiting list staff are more widespread. With growing allegations about a bullying culture in the NHS, what action has the cabinet secretary taken? Indeed, what action did his predecessor take?

Then we had Alex Neil telling the chamber in December that waiting time data was “reliable and accurate”. Just a few weeks ago, we were treated to the cabinet secretary’s “Little Britain” defence of “Computer says no”: it was all just an information technology problem. The cabinet secretary cannot have it both ways. He cannot say that the data is reliable and accurate and at the same time tell us that there was a problem with the IT system and that it did not record the information properly. He might wish to pause and reflect on developing a consistent line.

Let us look a bit closer at the SNP’s claim that it is all just one big IT problem and that that is why the social unavailability figures dropped. I asked Audit Scotland whether that was a reasonable assumption to make. The Auditor General’s response was:

“There has not been a significant change in IT systems over that period.”—[Official Report, Public Audit Committee, 23 February 2013; c 1243.]

The drop is therefore not due to any change in IT.

The cabinet secretary has said that everything has been sorted and that the unavailability codes have been abolished. There is also a new waiting time guarantee of 12 weeks from decision to treatment. Plans have been approved by health boards, based on the new guidance and, in turn, agreed by the health department.

Can the cabinet secretary explain why we are already seeing a postcode lottery and considerable variation in treatment? Some patients receive seven days’ notice of appointments, but others receive 21 days’ notice. Some patients get two chances for appointments, but others get only one before they are consigned to the back of the queue. Some patients are offered treatment in just their health board area, but others are offered treatment in different areas and sectors.

In a letter to The Herald yesterday, the cabinet secretary said that the new waiting time guarantee has already been achieved and that 99.9 per cent of all cases are meeting the new target. I have to say that the 0.1 per cent of people for whom it is not being achieved must all live in my constituency.

We can have little confidence in the accuracy of waiting time information. The systems that are used to capture the information have been discredited and they could not be properly interrogated by Audit Scotland. If it could not extract the data, how on earth can we be sure about what the cabinet secretary is saying? He should tell my constituents about his 99.9 per cent achievement. He should tell Miss M, who is 21 years old and an athlete. She has a hip injury and has waited 12 months for a magnetic resonance imaging scan. She has been told that she will need to wait five months for an operation. That young woman’s life is on hold. Was her case reported as a breach or is she being parked on a hidden waiting list somewhere?

What about Mrs D? She has a problem with her gall bladder and was referred by her GP on 21 August. On 3 October, her consultant took the decision to treat, but—guess what?—she is still waiting. Has that been reported as a breach or is she, too, parked on a hidden waiting list somewhere?

What about Margaret Gray, who came to my surgery two weeks ago? She attended her general practitioner in July 2012 with severe pain in her right knee. As it was not improving, she was sent for an x-ray and was then referred to a consultant on 12 October. She had a scan on 11 January and she was told that she would need to wait two weeks for the results. Guess what? She is still waiting for the results and for treatment. Her waiting time guarantee has been breached. Margaret is off work on sick leave and may lose her job due to the delays in treatment.

That is the reality for Scots. Are SNP members seriously saying that constituents have not brought to them similar examples of concerns about how long they have to wait? This is about people’s lives. What does the cabinet secretary say to my constituents? What does he say to all our constituents whose treatment is not meeting his target?

I turn to accident and emergency waiting times. There is no doubt that we have the worst set of waiting times for accident and emergency since the SNP came to power. The target has not been met across Scotland as a whole since 2009. The number of patients who are seen within the four-hour waiting time target has fallen to the lowest level recorded since it was introduced, and the number of patients who spend more than 12 hours waiting rose to 323, which is the highest number on record.

In NHS Lothian, 75 people spent more than 12 hours in A and E in January alone. The cabinet secretary said at the time that the experience of John McGarrity, an 84-year-old man who was left to wait on a trolley for eight hours in a freezing cold corridor, was

“not a true reflection of the National Health Service”.

He should tell that to the family of Mary Scott. Mary, who was a feisty and sprightly 93-year-old, had a stroke and, aside from waiting six hours for an ambulance to arrive, had to wait on a trolley for six hours for a bed. We can imagine the stress of that wait on her and her family. The cabinet secretary should tell the 323 patients who waited even longer than Mr McGarrity and Mrs Scott that that is not a reflection of the NHS under the SNP.

Nurses, too, tell us a different story. One nurse said:

“It is ... a common occurrence to have old and very ill people lined up in corridors on trolleys because there are not enough beds. In some cases, they are the lucky ones. Others don’t make it out of the waiting room because there are no trolleys or staff to put people on them.”

The Royal College of Nursing tells us that the current reality is that, while nurses and other healthcare staff are trying to do their best, there are not enough staff, beds or resources in the system.

The SNP can ignore me if it wants to, and it can even ignore the journalists with whom it disagrees, but it ill behoves the cabinet secretary to ignore what doctors and nurses are telling him. He should not ignore what he has been told. The system is on the point of breaking.

The cabinet secretary announced £50 million. That will make it all right. Although I welcomed that initially, as more detail emerged, the announcement appeared to be an exercise in smoke and mirrors. It does not deal with providing extra beds, and nurses tell us that that is the problem. When we look closer, it is not new money. It is funding that will be taken from health boards, repackaged, tied with a fancy ribbon and handed right back to them. That is nothing less than the cabinet secretary reacting to events and headlines. It is not strategic, it is not planned, and it is not sensible.

The cabinet secretary did not want people to know that hidden away in that announcement was a cut in the waiting time target. Now, instead of 98 per cent, he has cut the target to 95 per cent. Was that announced to Parliament or to doctors and nurses, or even to the people of Scotland? No. That admission of failure was sneaked out. Some might accuse the cabinet secretary of moving the goalposts; others would call it cheating.

The SNP is responsible for this mess. It is responsible for thousands of people being parked on hidden waiting lists. What is worse is that the warning signs were there and the SNP did nothing. Now, instead of coming clean about the challenges that the NHS faces because of the choices that the SNP has made to cut the number of nurses and beds, the SNP has moved the goalposts—it has changed waiting times for A and E—with spectacular sleight of hand. It is a sneaky and dishonest approach that is more about spin than it is about patient care. Frankly, the people of Scotland deserve much better.

I move,

That the Parliament believes that the recent hidden waiting times scandal raises significant questions regarding the integrity of the Scottish Government’s claims on waiting times; believes that clear warning signs were overlooked; recognises that both the hidden waiting times scandal and the Scottish Government’s failure to meet its four-hour A&E waiting time target for Scotland as a whole since 2009 are signs of an NHS under significant strain, and asks the Scottish Government to put patients and hard-working NHS staff first and to ensure that the health service properly meets its waiting times obligations while providing the best possible patient care.

Alex Neil (Scottish National Party, Airdrie and Shotts)

As you know, Presiding Officer, I used to go to Ayr academy and the school motto is “Respice prospice”—look backwards, look forward. All I can say about Jackie Baillie is that she is all respice and no prospice.

I welcome the opportunity to yet again put on record my gratitude for the dedication and commitment of our hard-working NHS staff across Scotland. This Government, unlike the Labour Party, has the highest respect for the staff of the NHS—unlike the Labour Party, we do not seek to paint a picture of dishonesty and a lack of integrity.

Let us get things in perspective. As the First Minister said last week, of course there are problems in the national health service, but the national health service this year will spend £12 billion; 6 million times this year, someone will see a doctor in the national health service in Scotland; and more than 1.5 million people will be referred to A and E. One half of our entire population have something wrong with them at any one time, and one third of the population have more than one thing wrong with them at any one time. Clearly, those are major challenges for any health service.

One of the big policy differences between us and the Labour Party is that we made a commitment, which we have stuck to since 2007, that we would pass on every penny of the Barnett consequentials every year for the health service in Scotland. The Labour Party refused to make that commitment and if it had been in power over the past six years, the total amount of money spent on the national health service over those six years would have been £1.1 billion less than it has been under this Administration.

Jackie Baillie and her mob have a real cheek to complain about waiting times in accident and emergency. If we look at the figures per health board, two boards that have had more problems than most are Ayrshire and Arran and Lanarkshire. What did Labour try to do in Ayrshire and Arran and Lanarkshire health boards? It wanted to close the A and E units at Monklands and Ayr hospitals. If Labour had succeeded in doing so, the A and E waiting times today would have been much worse than the problems that we have had over the winter.

Let us consider the difference between the Labour Party’s performance and our performance. Prior to this Government coming to power, patients were waiting six months for an out-patient consultation, following a referral from a GP, a dentist or an optometrist; there was six months’ wait for in-patient and day-case treatment; there was no target for diagnostic tests; there was no delivery of the old 62-day cancer target—at the beginning of 2007, only 84.6 per cent of cancer patients started their treatment within 62 days; and there were tens of thousands of patients languishing on a hidden waiting list, waiting for treatment with their guarantee removed. The Labour Party does not have the moral right to criticise anyone, because its performance was dreadful.

Under this Government, waiting times are now significantly better and, on the basis of an Organisation for Economic Co-operation and Development comparison, are among the best in Europe. On cancer, we delivered the old 62-day target by December 2008. We have also extended the target to include thousands more patients a year, referred through the screening programme. We have added an additional target: 95 per cent of patients who are diagnosed with cancer should start their treatment within 31 days, and we continue to deliver on both those targets. We extended the out-patient waiting time standard to include all source referrals, such as consultant-to-consultant referrals, which Labour never did. That means that tens of thousands more patients are covered by our waiting time standard than were covered under the previous Administration.

On diagnostic tests, most patients are now receiving one of the eight key diagnostic tests within four weeks. We also continue to deliver the 18-week referral to treatment time standard. The latest figures show that 90.9 per cent of patients receive treatment within 18 weeks of initial referral. We have also enshrined in law a 12-week treatment time guarantee for in-patient and day-case treatment, and 99.9 per cent of that target was achieved in the first quarter—a percentage that no one ever gets anywhere near for anything.

Jackie Baillie (Labour, Dumbarton)

Will the member give way?

Alex Neil (Scottish National Party, Airdrie and Shotts)

No, Jackie Baillie would not give way to me, so I will not give way to her.

That all shows that this Government is committed to patients being treated more quickly, and that more patients are being covered by our waiting time standards.

Jackie Baillie tries to say that people cannot have any trust on the issue of recording. In 2010, the UK Statistics Authority published an assessment of compliance with the code of practice for official statistics on waiting times. The report found that the changes that were introduced through our new ways programme improved the quality of the statistics. It stated that the statistics that were covered by our report were

“readily accessible ... produced according to good methods, and ... managed impartially and objectively in the public interest.”

That is a claim that Labour could never make about any statistic on health or anything else.

Jackie Baillie’s allegations about widespread manipulation of waiting times are a real slur on hundreds of NHS staff throughout Scotland. Her view is totally unfounded. Indeed, at last week’s Public Audit Committee meeting, Caroline Gardner, the Auditor General, stated—read my lips:

“we have not found any evidence of manipulation at all”.

She went on to say, as I have said, that the

“IT systems need to improve”.—[Official Report, Public Audit Committee, 27 February 2013; c 1238 and 1240.]

Under this Administration, we have made significant improvements. We have replaced social unavailability and placed in legislation patient-advised unavailability. The directions for the legal treatment time guarantee place a clear duty on boards to record not only the period of unavailability but the reasons for it. The boards also have a duty to write to patients to confirm any periods in which unavailability applies.

Finally, let me make this point. For A and E, Labour ministers did not actually measure what happened against their target because they were too feart. They had only one survey in April 2006, according to which 87.6 per cent of patients waited less than four hours. That compares to December last year—at the maximum period of challenge—when we achieved an equivalent figure of more than 90 per cent.

Next year, we will vote on two futures, but let us compare the two records: their very poor record of not measuring, not performing and not delivering, and our record of measuring, targeting, performing and delivering for the people of Scotland.

I move amendment S4M-05813.2, to leave out from first “believes” to end and insert:

“welcomes the significant progress made on improving waiting times in recent years; recognises that the Labour administration’s hidden waiting lists meant that over a third of all patients in Scotland were on a hidden waiting list and had no treatment time guarantee; notes that this system has been scrapped and replaced with a system designed to be patient-led to ensure fairness; further notes that both the internal audits of NHS boards and the recent Audit Scotland investigation found no evidence of deliberate manipulation of waiting lists; further recognises that under the current administration the number of A&E consultants will have more than doubled by the end of 2013; further welcomes the £50 million unscheduled care action plan that has been developed by the Scottish Government, NHS Scotland and medical colleges, and supports an NHS that has care of patients at its centre and that values the work of its hard-working staff.”

Nanette Milne (Conservative, North East Scotland)

Throughout the lifetime of this Parliament, and certainly in the decade since I became a member of it, waiting times for treatment have been regarded as a key benchmark of success for the NHS in Scotland. There is no doubt that, during that time, waiting times have improved significantly so that now, following adoption of the 18-week referral to treatment standard at the end of 2011, patients rightly expect that they should have hospital treatment within 18 weeks of referral from their GP.

Waiting time reductions are of course welcome, because no one wants to wait any longer than is necessary for treatment. However, waiting times are not the only indicators of good healthcare. Patient outcomes, readmission rates and healthcare associated infection rates are equally, if not more, important in assessing NHS performance. In recent years, the key focus on waiting times has meant that increasingly demanding targets set by Government have been met only because of very hard work by a dedicated and conscientious NHS workforce, who are under constant pressure from management who in turn answer to their political masters.

There has undoubtedly been a loss of morale among hard-pressed hospital staff, and anecdotes abound—from staff and patients—about the manipulation of waiting lists. The BMA’s briefing for today’s debate quotes the general surgical staff who, when interviewed in November 2010 for the independent report on NHS Lothian, said:

“If we are about to breach we have to cancel in patient scans in favour of outpatients in patients are usually more urgent but the target gets priority every time”.

I have heard more than once of management dropping a major case from an operating list that has been drawn up by a surgeon and replacing it with several more minor procedures to assist in meeting a target.

Staff and patients have previously raised concerns about such behaviour, but until now health boards did not have effective whistleblowing policies that allowed people to raise their concerns safely and in the knowledge that they would be acted on. I know that I am not alone in welcoming this year’s pilot of a national confidential phoneline. It is a pity that that was not in place sooner.

What happened in Lothian is of course scandalous, and NHS Tayside’s inappropriate use of unavailability codes is unacceptable. Although it is reassuring that Audit Scotland’s recent report did not find any widespread manipulation of waiting times across Scotland, it is nonetheless concerning that social unavailability codes were used by many NHS boards with inadequate controls and audit trails and limited information in patient records. It is therefore impossible to determine whether the inappropriate use of the codes was due to human error, inconsistent interpretation of guidance or deliberate manipulation of waiting lists.

Due to inadequate scrutiny of the mounting number of patients recorded as unavailable for treatment because of that focus on meeting targets, the attempts to improve capacity in areas where parents were waiting longer resulted—to paraphrase Audit Scotland’s report—in a failure by both Government and health boards to see the broader picture of the pressures that were building up in the system around the capacity of NHS boards to meet the waiting times targets. I hope that lessons will be learned from recent sorry events. Audit Scotland’s recommendations to the Government, to NHS boards and their non-executive directors and to the Information Services Division must be carried out, in the interests of patients and NHS staff.

With regard to A and E services, since 2009 the number of patients assessed and admitted, transferred or discharged within four hours of arrival has dropped from the then target of 98 per cent to 90.3 per cent last December. That is not acceptable, but I am not convinced that the solution should be to lower that target to 95 per cent, as the Government has done without telling Parliament. However, I welcome the increase in the number of A and E consultants and the proposed £50 million unscheduled care action plan, which I hope will go some way towards giving A and E patients the prompt diagnosis and care that they deserve in a 21st century NHS.

Recent history has borne out what the BMA and the clinicians that it represents—and, to be fair, my party—have been saying for years to the previous coalition Governments and the current SNP Administration: that clinical priorities can be skewed by pressure to achieve centrally driven targets. Patients in the NHS should be treated according to their needs, with clinical decisions taking precedence and clinicians supported in carrying out the care that they know is right for their patients.

Alex Neil (Scottish National Party, Airdrie and Shotts)

I put it on the record that, where we get evidence that a target or standard is distorting clinical decisions, I would be happy to review that target or standard. The intention is to deliver, and we do not want artificial distortion of clinical decisions that is driven by targets or anything else. If I get evidence, I am prepared to look at it.

Nanette Milne (Conservative, North East Scotland)

I welcome the cabinet secretary’s comments. He can believe me when I say that I will be in touch if need be.

Unfortunately, when centrally imposed targets become the driving force, intense pressure is put on NHS services and clinical decision making can be distorted, against the best interests of patients. In time, that can impact negatively on a hard-working and committed workforce that is focused on doing the very best for the patients who are in its care. Of course, targets are needed in a health service that must be mindful of finite resources and which faces increasing and unrelenting demand from an ageing population living with many long-term health problems. However, as the BMA has said, it is important that the targets are based on clinical evidence and appropriate patient care.

It is disappointing that waiting time targets and waiting lists have become highly politicised, with both the main parties using them to score points against each other. As my colleague Jackson Carlaw said in a previous debate, we are not interested in disputing which Administration did better at getting people off waiting lists; we want to secure what is best for patients. I hope that the Cabinet Secretary for Health and Wellbeing, who has made it clear that he wants to listen to staff and learn how things really are at the coal face of the NHS, will pay careful heed to the Audit Scotland report and listen to the BMA and the clinicians in our hospitals so that, in future, treatment can be planned according to the needs of patients, rather than the need to satisfy waiting time targets that are set by Government.

I move amendment S4M-05813.1, to insert after “strain”:

“; considers that the setting of targets in the NHS should be a clinically led process that is appropriate for delivering meaningful improvements in patient care”.

Bob Doris (Scottish National Party, Glasgow)

The Labour Party motion adds to the growing evidence of that party’s decision to use the NHS overtly as a political football to seek party advantage, whereas a responsible Opposition would use the Parliament to improve the NHS for the people of Scotland. That is the Opposition’s duty. It is in sorrow rather than in anger that I call into question the motivation behind the Labour motion. I hope that we can unite across party boundaries where possible to support our NHS. However, I believe that the current Labour strategy deliberately seeks only to create conflict. That strategy can serve only to potentially demoralise many hard-working NHS employees and disengage the public, whom we all seek to serve.

The first sentence in the motion refers to a “hidden waiting times scandal”, which, as I shall go on to prove, is clearly a preposterous and demonstrably erroneous statement. When Nicola Sturgeon and the Scottish Government abolished the shameful hidden waiting lists that were inherited from the Labour and Liberal Democrat Executive, waiting lists received the full glare of public scrutiny for the first time since devolution. Let us not forget that up to one third of patients were removed from regular waiting lists altogether and were left languishing on hidden waiting lists, sometimes for many years, without treatment.

That was the unacceptable situation that the current Government inherited. That previous system treated patients as an irrelevance, and an accounting process was used so that patients on waiting lists simply disappeared, in a fashion of which even David Copperfield would have been rightly proud. Labour must apologise for that if it is ever to start to regain any credibility with the NHS.

What progress has been made since Labour was kicked out of power in 2007? Under the new ways system that the SNP Government introduced, for the first time all patients were accounted for on waiting lists in a system that was open to public scrutiny. There is now nothing hidden about waiting lists under the Scottish Government. Labour would do better to have a constructive discussion on how we improve matters further.

The Labour motion notes, wrongly, a supposed “waiting times scandal”. I will focus on the period during which Audit Scotland said that there were issues with the recording of data. There were shortcomings and many of the matters that needed to be addressed have either been attended to or are currently being attended to. However, let us consider the waiting time experiences of all patients during the period in question.

I refer to ISD data, which includes patients who were designated as socially or medically unavailable and who may have had delays as a result. Irrespective of social or medical unavailability, we find that 94.3 per cent of all patients—including those who had delays—were treated within 18 weeks. That is a figure to be proud of, but I stress that it is not one to be complacent about.

Record levels of achievement against waiting time targets is not my definition of a scandal. It is a scandal only in the parallel, alternative universe of the Labour Opposition in the Parliament.

Audit Scotland did not suggest that there was a lack of progress on waiting time targets. It rightly suggested that there was a need to improve recording of reasons for patient delays. That is what the NHS seeks to address. I am pleased to hear much of the Scottish Government response to date.

The Labour Party tends to ignore the vast majority of patient experiences. Every negative patient experience that has been put to the chamber today should be taken seriously, but the Labour Party completely ignores the vast majority of patient experiences. It completely ignores the 88 per cent satisfaction rating that the NHS in Scotland has. I stress again that I want to consider how we further engage with the 12 per cent and improve the quality of service to them, but Labour completely ignores the vast majority of people, who are happy with the NHS.

I will give members one example, because Jackie Baillie gave us many examples. How about the patient from the area that I represent, who said:

“Splendid! Many thanks to all at southern General and Glasgow Royal for looking after my 83 year old mother during her operation on Jan 10th. Splendid care from splendid staff in a splendid organisation. No wonder our NHS is the envy of the world.”

That is completely ignored by the Labour Party, which puts a cheap tabloid headline ahead of patient care. That is absolutely scandalous.

I will say something that the Labour Party could do to shine some scrutiny on the matter. At the Public Audit Committee, the Auditor General mentioned a particularly good use of waiting time targets: she said that, when they are not achieved, it identifies a financial or provision gap and Audit Scotland would expect the NHS to act on that. It is in that light that I look at NHS targets for waiting times of four hours in accident and emergency—I point out that they are considerably better than they were under the Labour Party, although, to be frank, they are still not good enough—and the £50 million of investment in the unscheduled care action plan to address that.

Where targets are met, we should be proud of our NHS; where we fall just short, we allocate and reallocate resources to address the fact. That is a quality NHS, well funded by the Government, which the Labour Party would not have supported financially had it got into power and been where we are standing in the chamber.

Neil Findlay (Labour, Lothian)

Again, we hear Government ministers repeating their well-worn mantras about the SNP’s alleged great successes in the NHS. They regurgitate the lines about record levels of patient satisfaction and the old chestnut that we hear time and time again: they patronise NHS staff for their hard work and commitment, implying that any criticism of Government policy is, somehow, an attack on nurses, doctors and the hospital staff who work under intense pressure. The reality is that the concerns that we raise more often than not come from those staff, who are being worked into the ground trying to cope with a system that is increasingly under strain.

As politicians, we should know what is happening in the NHS in our constituencies and regions. We have case loads that reflect the realities of the cuts to budgets, the reductions in staffing levels, the lack of resources and the falling morale. Is it just me who has that on my case load? I do not think so. I am sure that most members do.

In my region, the waiting time issue has been the bad penny that just keeps on returning. Last year, the manipulation of waiting times and the use of the social unavailability codes was exposed at NHS Lothian and it pains me that my region is seen as the benchmark for bad performance in that area. That scandal was compounded by a culture of bullying and harassment, in which senior management bellowed decrees down the chain of command, not in the interests of patients and their care, but to pauchle the waiting list system and make it look as if imposed targets were being met.

We know that ministers were alerted to that scandal, but they did nothing about it. No one has yet been held to account for their actions. Indeed, the chief executive—the head of the organisation—waltzed off into the sunset with a £375,000 retirement package. If a porter or canteen assistant was guilty of aggressive and long-term bullying, and they lied about a major element of their work when they reported to their superiors, they would be dismissed in an instant. It appears that there is one rule for the workers in the NHS and another for the bosses. Some things never change.

Last week, it was revealed that waiting times in accident and emergency units were the worst for five years. They were so bad that Margaret Watt, chair of the Scotland Patients Association, was moved to remark:

“The figures on waiting times in accident and emergency in Scotland are shocking.”

Margaret Watt’s remarks reflect the real world. Across Scotland, only four NHS boards have met the target to have admitted, transferred or discharged 98 per cent of their patients within four hours of their entering an accident and emergency department. The national average for December was 90.3 per cent; in Lothian, the average was 86.2 per cent, which is a fall from the 92.6 per cent we saw in September.

What do those figures mean for the people who lie behind them? For patients, the situation is intolerable. Sick children and elderly people have to wait anxiously in accident and emergency for hours on end as the staff are run ragged trying to cope. As Jackie Baillie said, Mr Neil tried to suggest that the long waiting times in accident and emergency that Mr McGarrity faced as he waited on a trolley in a corridor for more than eight hours were not a true reflection of the NHS. If the cabinet secretary would pay me the courtesy of listening, he would hear me say that that was Mr McGarrity’s experience of the NHS, as well as being the experience of 75 patients in Lothian who were stuck in accident and emergency departments for more than 12 hours in January. That is double the figure that we saw just one year ago.

Why are waiting times worsening, and why do NHS boards feel the need to distort the figures? Because the NHS is under intense pressure. We have seen cuts to beds, nurses, midwives and support staff, and those who have been left behind are expected to do more for less. They have seen their case loads increase to almost unmanageable levels, and all the while their wages are frozen. The upshot is that staff in the NHS are already under strain, and NHS Lothian now has to do even more to put right the cases that were affected by the waiting time scandal. That is the reality, and no amount of ministerial bluster can deny it. Of course, the minister knows that, because NHS Lothian has had to pour £27 million into sorting out the waiting list scandal, which has resulted in a feast for the private sector.

Two weeks ago, I attended a packed meeting of West Lothian community councils in Blackburn. The meeting was called to discuss their concerns about the NHS, and the message that came out of that meeting was absolutely clear: people are not prepared to accept what they see going on in the NHS day in and day out. The cabinet secretary should not take my word for it; he should speak to his colleagues Fiona Hyslop and Angela Constance, who will tell him about the angry comments to which they were subjected at that meeting. The people who were there had good reason to be angry. On top of the waiting lists fiasco, we have had the temporary closure of the children’s wards at St John’s hospital during the summer, and threats to services such as homoeopathy, community podiatry, and the hospital nursery, all of which are facing temporary or permanent closure.

I appeal to the Government to stop the spin and bluster, and face up to the reality of what is happening in our communities. These are very serious issues.

John Scott (Conservative, Ayr)

I call Drew Smith, who will be followed by Kevin Stewart. [Interruption.] I beg your pardon—I should have called Mark McDonald, who will be followed by Drew Smith.

Mark McDonald (Scottish National Party, North East Scotland)

I thank Mr Findlay for pointing out that the Presiding Officer had forgotten to call me.

Sometimes I wonder what life is like in the world that Jackie Baillie occupies. I envisage it as a dank, dark and depressing place that is forever to be viewed through the prism of a half-empty glass. Meanwhile, those of us who live in the real world wonder why the Labour Party appears to have such a low threshold for a scandal.

As the cabinet secretary pointed out at last week’s meeting of the Public Audit Committee, the Auditor General for Scotland stated quite clearly:

“As we have said in the reports and as I have said today, we have not found any evidence of manipulation at all.”—[Official Report, Public Audit Committee, 27 February 2013; c 1238.]

Indeed, in the key messages section of its report Audit Scotland states:

“Our sampling found a small number of instances in which unavailability codes were used inappropriately.”

However, what Jackie Baillie said would lead people to assume that the practice was widespread and that there were hundreds and thousands of examples beyond those that Audit Scotland identified. Jackie Baillie is simply going with supposition rather than evidence, which is what Audit Scotland presented at the Public Audit Committee.

The BMA states clearly that it is satisfied that

“The Audit Scotland report on waiting times in Scotland did not find any widespread manipulation of waiting times across the NHS Boards in Scotland.”

Jackie Baillie hung herself out to dry when she claimed that the situation in NHS Tayside was an example of widespread manipulation of the figures. She should at least have the humility to accept that the reality does not match up to her rhetoric.

Let us compare the situation with the one that existed under Labour. If the current situation qualifies as a scandal, one can only imagine how Jackie Baillie would have referred to the Labour Party’s record on the matter, when around 35,000 people were stuck on waiting lists with no waiting time guarantee and when no statistics were published on the length of their wait. That is a scandal—the situation that Ms Baillie reported as such is not.

The notion that the Labour Party is putting across that everyone on social unavailability codes has been parked or put there inappropriately, which Jackie Baillie directly implied in her speech, is frankly untrue. There are perfectly good reasons why people find themselves socially unavailable. I could have been socially unavailable last year had the surgery that I required been available only in the months during which Parliament was in session. Luckily, I was offered an appointment during a recess period, so I could take it up, but it is quite feasible that I could have found myself being socially unavailable at that time.

Dr Richard Simpson (Mid Scotland and Fife) (Lab) rose—

In its briefing, the BMA clearly states:

“It is important to recognise, however, that waiting times”—

Neil Findlay (Labour, Lothian)

On a point of order, Presiding Officer. I was always under the impression that this was a debating chamber. Can you advise me whether that is still the case? [Interruption.]

Mark McDonald (Scottish National Party, North East Scotland)

Thank you very much, Presiding Officer.

I thought that the understanding was that it was for the member who was speaking to determine whether to accept an intervention, rather than for Mr Findlay to use his tried and tested bully-boy tactics to muscle in on my speaking time. I hope that the Presiding Officer will give me a little bit of time back for that spurious point of order.

The BMA also states:

“It is important to recognise, however, that waiting times are not the only or the most important indicator of performance—patient outcomes, readmission rates, health care associated infections etc are also important indicators of the quality of care received. It is important not to lose sight of these in favour of throughput and patients being seen quickly.”

Let us look at some of those statistics. Since 2008, there has been a 12.4 per cent reduction in hospital mortality, which equates to the saving of 8,500 lives. There was a 24 per cent reduction in the number of C difficile cases and a 10 per cent reduction in MRSA/MSSA cases in 2011-12. Between 2007-08 and 2011-12, there was a cumulative fall of 78 per cent in C difficile cases and 35 per cent in MRSA/MSSA cases. That shows that real progress has been made on hospital-acquired infections, which belies the rhetoric of Jackie Baillie, who tried to paint Scotland as the hospital superbug capital of Europe but forgot that she was referring to figures for when her party was in power.

There have been 272,000 alcohol brief interventions to tackle harmful and hazardous drinking over the past four years. The emergency bed days rate for people aged 75 and over has reduced by 10.9 per cent since 2006-07, and 48,000 inequalities-targeted cardiovascular health checks were delivered in 2011-12. Scotland’s suicide rate reduced by 17 per cent between 2002 and 2011. Those are real results for real patients in Scotland. The BMA has been instructive in advising us to look at what lies behind the statistics. We should always remember that it is the outcomes for patients that matter.

That is why it is important to look at and compare patient satisfaction ratings. We can never be complacent about the NHS because, as has been made clear, it is a human organisation and errors will occur. Indeed, even in the Labour Party, errors, such as bringing this debate to the chamber, occasionally occur. The task that we must face is to learn the lessons from the errors made by human organisations and understand how to put them right.

The Labour Party’s real game was given away by its press release in advance of this debate. The aims are, first, to attack Nicola Sturgeon, because Labour recognises that she is quite rightly viewed as an asset not only to this Government but to the nation and, secondly, to save Jackie Baillie’s rapidly diminishing credibility after she overcooked the pudding on the NHS waiting time scandal. My advice to the Labour Party is that it should set itself more achievable targets.

Drew Smith (Labour, Glasgow)

Two groups should be at the heart of this debate: the patients to whom waiting time promises are made and the front-line staff who are left to deliver on those promises made by ministers. Like others on this side of the chamber, I have questioned ministers on waiting times on a number of occasions. Although my principal concern has been about what is happening in Glasgow, I have also been in the chamber when colleagues on this side have warned the Scottish Government that things were going wrong and have heard ministers’ denials at every stage of this scandal.

On the occasions when I have asked questions on this subject, I have sought a simple assurance that none of my constituents in Glasgow has waited longer than they should have because of inappropriate manipulation of waiting lists. However, despite all the heat and noise that have been generated, I have never received such a guarantee and, given that I suspect that I will not get it from the Scottish Government today, I will tell the chamber what Audit Scotland said on that specific question. In his splendid speech, Bob Doris should perhaps have taken note of that report when he claimed that the figures have always been open and transparent, because according to Audit Scotland:

“The actual time patients waited is longer than the waiting time reported in national performance reports”.

Page 29 of the report makes it clear that although 3 per cent of patients were officially recorded as waiting more than nine weeks, the actual figure was 23 per cent and that

“the biggest difference in the number of patients was in NHS Greater Glasgow and Clyde”

where the figure was 5,000.

Since the initial indications of this scandal, there have been assertions, excuses and carefully worded obfuscations. First, the allegations were simply malicious lies that had apparently been made up by the Labour Party, then they were a small and isolated example of malpractice. Then we had internal reports that, it was claimed, were exonerations of board managers when they contained no such thing. A national inquiry by Audit Scotland has revealed startling statistics including an example at the Western infirmary—a hospital that, along with the Victoria infirmary in Glasgow, is experiencing severe pressures—of 900 orthopaedic patients with painful conditions who were all apparently socially unavailable at the same time.

At every stage of this scandal, the Scottish Government and the SNP have denied everything and shouted loudly at anyone who dares to ask them questions. Labour called for a whistleblowers helpline because we did not believe that abuse could be happening without anyone knowing but our request was ignored, then rejected and then finally acceded to only when the denials and inaction became untenable.

If I have one quibble with the motion that is in front of us today, it is about its suggestion that “clear” warnings “were overlooked”. I do not think that the warnings “were overlooked”; instead, the warnings and those who made them were haughtily dismissed by the very person who made her own career blaming every dropped bedpan in the NHS on the previous Scottish Executive.

The reason that the Scottish National Party is in such a mess on this issue is simple. When faced with a scandal, the former cabinet secretary did nothing but belittle those who asked her for answers when she should have been asking the questions herself. Nicola Sturgeon is not in the chamber this afternoon but the back benchers who cheered and jeered with her then are now having to defend the latest defence. Indeed, it was good to see the Minister for Commonwealth Games and Sport back in the chamber to do just that. In the latest defence, the definitions of unavailability are being rewritten; patients themselves might have caused the problems; targets are being decried as the problem; and computers and IT systems are to blame.

As with college funding and blankets on wards, reality is denied until it confronts the SNP in the face. SNP MSPs who a few weeks ago were still arguing that there was no problem are now falling all over themselves to tell us that they actually understand the problem better than anyone else.

Neil Findlay was absolutely right. The reality is that there is now a lack of confidence in waiting time data that are provided by the Government. When it was trumpeted that waiting times were falling, social unavailability skyrocketed. When social unavailability was uncovered to be the SNP’s hidden waiting list and it began to fall, the officially approved waiting time figures somehow went back up again. What a surprise.

Even now, we are supposed to believe that the problem—which never actually existed, of course—has been resolved, but patients are still facing inequalities in how waiting lists are being managed across the country. The result of the legal right to treatment policy, which the Scottish Government signed off, is that my constituents in Glasgow will receive seven days’ notice of an appointment. In Lanarkshire, the notice is three weeks. I say to Mr Doris that patients in Glasgow will have their waiting time clock reset if they turn down one appointment. In Lanarkshire, two appointments will be offered.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member give way?

Drew Smith (Labour, Glasgow)

No, thank you.

The Scottish Government has approved a new postcode lottery, and my constituents in Glasgow will once again lose out, not least because equality impact assessments have not been carried out. Therefore, patients in Glasgow who do not have English as their first language, for example, will have to work out all of that from an automated letter that has been generated in board headquarters.

Finally, I turn to staffing. Under the SNP, there are 2,000 fewer nurses and midwives in the Scottish NHS, and there is severe pressure on hospitals such as the Western infirmary and the Victoria infirmary, where patients are waiting on trolleys in corridors for eight hours at a time. Across Scotland, A and E waiting time targets have not been met since 2009. The Auditor General for Scotland has told us that the NHS is on an amber warning, and the RCN has said that hidden waiting lists should be a wake-up call for the Scottish ministers. In its briefing for the debate, the BMA—doctors in our hospitals—highlights examples of managers who have shouted at clinical staff, and suggests that patients are being inappropriately admitted to hospitals because they would otherwise breach A and E targets.

I hope that the Scottish Government will reflect on this debate and the scandal, finally decide to take responsibility, and end the denials and the defence of its own in favour of working with national health service staff to deliver for patients on the promises that it has made to Glaswegians and people across Scotland.

Finally, as a trade unionist, I say to the Scottish National Party: stop using national health service staff as a human shield for the political failures of the Government.

Kevin Stewart (Scottish National Party, Aberdeen Central)

We have heard the Labour Party again and again calling what has happened a scandal, but we are also seeing it backtrack on what it has said in the chamber in the past few weeks. Although we know about the situation in Lothian, which the Government acted on very quickly, we have heard accusations and inferences in the chamber about the same things happening in NHS boards throughout the country.

NHS Grampian was mentioned in the Parliament only a few weeks ago. Since then, I have been in discussion and communication with it, as probably many members have been. NHS Grampian has said about certain things that have been thrown its way:

“Waiting times in Grampian are at their lowest level and most patients are being seen sooner than ever before.

We categorically deny any deliberate tampering with lists. There is no evidence of any kind that Grampian staff manipulated waiting list figures to achieve national targets, nor does”

the Audit Scotland

“report suggest that. We acknowledge that there have been administrative errors, which NHS Grampian had identified two years ago, and which resulted in staff training and the appointment of a new administration manager ... No patient was disadvantaged by these errors. Any patient who is unavailable remains on the list and is treated according to clinical priority.”

Those are the facts from NHS Grampian, but many members peddle rumours that there is a major problem in it. That is categorically not the truth. If anybody has any concerns, they should go and talk to the folks in NHS Grampian.

One of the things that has been highlighted is social unavailability codes. There were some cases in Grampian when folk were unavailable four times in the course of their wait. Some folk may question why that happened so many times, but I come from a part of Scotland where many people work offshore and their work sometimes does not let them go to get treatment at the times that are offered. I have an example in which that has happened and I am sure that, where there is one example, there are many more. Statements about the manipulation of social unavailability codes sometimes come from folks who may not understand why people would be unavailable at certain times.

There has been a lot of talk in the debate about NHS staff. I resent Drew Smith’s final comment about the SNP using NHS staff as a human shield. I have the highest regard for the staff who work in our NHS, particularly in recent times when quite a number of my family and friends have used the services of the NHS in the Grampian area. Saying that people are manipulating waiting times is actually to slag off those staff.

Neil Findlay (Labour, Lothian)

Will the member take an intervention?

Kevin Stewart (Scottish National Party, Aberdeen Central)

No, I will not take an intervention from Mr Findlay—sit down. I have got far too much to say on the matter.

During debates on this issue, some folk have lost sight of how important the NHS is for the people of Scotland. We should thank our lucky stars that we have an SNP Government here that deals with the NHS differently from what goes on south of the border in the NHS. We can consider what our NHS staff have achieved in improving our nation’s health in recent times: we have seen reductions in deaths from cancer, stroke and coronary heart disease since 2007 by 5, 24 and 20 per cent respectively; the standardised mortality rate for coronary heart disease has reduced by 43.2 per cent since 2002 and that for strokes has reduced by 41.8 per cent; the incidence rate for coronary heart disease has decreased by 28.9 per cent over the past decade and that for stroke by 21.7 per cent; and the overall death rate for cancer fell by 12 per cent between 2001 and 2011.

Those are things to celebrate. It may well be that not everything is perfect in our national health service, but the folks who work in it are doing the best that they possibly can to improve the health of the people of this nation.

Jim Hume (Liberal Democrat, South Scotland)

I, too, put on the record my admiration for the incredible job that our hard-working staff in the national health service do day in, day out. Their duties are often carried out in the most trying of circumstances, and that has never been truer than over the past few months.

Although the two issues at hand relate to NHS waiting times, they are not related to each other and should not be confused. One of them involves administrative malpractice on the part of some boards, while the other is about woefully inadequate winter contingency planning. However, the common denominator is that both have transpired under this Government’s stewardship of the national health service.

The BMA in Scotland produced a briefing ahead of this debate, with a line in it that reads:

“It is important to recognise however, that waiting times are not the only or the most important indicator of performance.”

I would have hoped that that truism was obvious to the Scottish Government, but recent revelations suggest that, somewhere along the way, it forgot that.

In its obsession for achieving targets, the Scottish Government lost sight of the most important thing, which is the patient. It is just as worrying that it did not appear to care how the targets were being met, so long as the numbers looked good at the end of each month.

Audit Scotland said, in relation to its report into the waiting times management scandal:

“The management and scrutiny of the waiting list systems have not been good enough.”

Surely the cabinet secretary cannot in good conscience try to blame everything on IT systems. We know that in Lothian and Tayside there was a culture of pressure and that there were instances of bullying, such was the fervour with which management sought to achieve the Government’s targets. We know that the use of social unavailability codes plummeted remarkably after Lothian was caught red-handed, and we know that, in those health board areas, the specialties that had the most critical capacity issues deployed such codes more frequently. None of that can be attributed to IT systems, and to suggest that it can be is to insult the intelligence of patients and staff.

One of the more frustrating and disappointing elements of the Government’s handling of the health service has been the spin—the smoke and mirrors that the Government deploys to deflect any negative attention. Patients deserve absolute honesty from the Scottish Government and they are simply not getting that. [Interruption.] I would appreciate it if the cabinet secretary would stay in the chamber and listen to my speech.

Two months ago, when I highlighted the incredible strain that accident and emergency units were experiencing, the cabinet secretary said:

“We should not paint the kind of picture that Mr Hume is trying to paint.”—[Official Report, 8 January 2013; c 15126.]

A few unpalatable headlines later, we had a £1 million emergency care action plan, which was short on details and resources and was, apparently, not a response to a crisis.

There were yet more headlines last month, with the bigger-budget sequel of a £50 million unscheduled care action plan, which is mentioned in the Scottish Government’s ludicrous amendment. On the surface of it, that sounded like a step in the right direction, until we discovered that the initiative involved no new money but the reallocation of funds that had been promised elsewhere. We are yet to hear from the cabinet secretary which departments will have to tighten their belts.

Today we learn—yet again from a newspaper and not an announcement in the Parliament—that the very health improvement, efficiency and governance, access and treatment target that we have been discussing has secretly been reduced from 98 to 95 per cent. The cabinet secretary has not only moved the goalposts but widened them, to make it easier—

Alex Neil (Scottish National Party, Airdrie and Shotts)

Will the member give way?

Jim Hume (Liberal Democrat, South Scotland)

The cabinet secretary has not been listening to my speech; he has been out getting a glass of water. He would not take an intervention from me, so I will finish, if he does not mind.

Alex Neil (Scottish National Party, Airdrie and Shotts)

On a point of order, Presiding Officer.

Just so that the Parliament is not misled, let me say that we did not abandon the target. There is still and always has been a standard of 98 per cent. We have added a new target of 95 per cent. The member should get his facts right.

Jim Hume (Liberal Democrat, South Scotland)

Thank you, Presiding Officer. Perhaps the cabinet secretary will take the issue up with the Evening News. He talks about hidden waiting lists. What phrase other than “hidden targets” can we use to describe today’s revelation? It is rank hypocrisy and another example of half-truths and smoke and mirrors.

Despite the cabinet secretary’s reluctance to come clean on the scale of the challenges that face the NHS, the First Minister appeared to signal admission of a considerable problem when he described the unscheduled care action plan as

“a serious response to a serious issue.”—[Official Report, 28 February 2013; c 17151.]

It is clear that the problem is serious. The Government has had to slash its waiting times target. I remind members that only three months ago the cabinet secretary was heralding the winter contingency fund, which would, as he put it,

“make sure the winter runs smoothly.”

There is no doubt that targets, when they are clinically appropriate, are a good thing. Targets were introduced more than 10 years ago by Lib Dems in coalition, to quicken and improve the patient journey. That happened, which is why we will support the Conservative amendment to the Labour Party’s motion, which we will also support.

Clare Adamson (Scottish National Party, Central Scotland)

I will start uncharacteristically, by quoting Jim Murphy, because I have no doubt that the Labour motion is simply a “flirtation with surrealism”. The motion bears no relation to the excellent work and achievements of the NHS throughout the country.

The SNP abolished Labour and the Lib Dems’ hidden waiting lists. It is meeting the cancer care target and, as Bob Doris said, it is achieving a target of more than 90 per cent for patient treatment, even if we include social unavailability figures.

Jim Hume mentioned—I was listening to his speech intently—how waiting time targets are not the only targets in the NHS. I agree that there are other statistics that we should take cognisance of. For example, 10 years ago in 2003, under the Labour and Liberal Administration, 1,670 patients were parked in delayed discharge positions for more than six weeks. In January 2003, under the SNP, the figure was 57 patients. That is because, under the SNP Administration, the NHS has transformed how we are delivering services, especially for elderly patients.

The demographic places huge challenges on the NHS. However, I want to highlight some of the good practice that is happening. When I was a councillor in North Lanarkshire, we had the living well project, which is a cross-partnership group that encourages the wellbeing of elderly patients. Its quality of life strategy is a commitment to improving their lives. It brought together the whole community in recognising the pressures that the demographic changes in our society bring on our services. North Lanarkshire Council, the Voice of Experience Forum, North Lanarkshire Carers Together, Cumbernauld Action on Care of the Elderly and Alzheimer Scotland—Action on Dementia were all involved in the project.

North Lanarkshire Council has also been recognised for its good work with NHS partners in the re-ablement project for older people. The project is designed to increase confidence, capacity, mobility, health and the long-term prospects for elderly patients through intensive work when they present to social services or the NHS. The project is changing how we deal with patients.

I am also glad to highlight the intermediate care beds system in North Lanarkshire, which is on the Scottish Government’s website as an example of best practice. North Lanarkshire Council and NHS Lanarkshire have piloted intermediate care beds in two care homes, Belhaven—I am glad that it has been saved and not cut, as North Lanarkshire Council proposed at one point—and Leslie house in Wishaw. The pilot has led to two adapted care homes being developed at Muirpark and Monklands house, to provide respite care and to ensure that elderly patients are not held in hospitals when they have presented in A and E, but get the appropriate care and re-ablement procedures.

When I was a councillor, I also did a lot of work with the Scottish Accident Prevention Council. The pressures in A and E very much come from the numbers of trips and falls that elderly people have. The Royal Society for the Prevention of Accidents highlights the problems for an ageing population:

“The risk of falling at home increases with age. A substantial number of falls are due to unspecified reasons ... The cause of a fall is ... multi-factorial, involving both environmental hazards and underlying medical conditions.”

Strength, balance and gait, decline in vision and mental health problems all contribute to problems that elderly patients present with at A and E.

RoSPA also tells us that children who live in highly deprived postcode areas are more likely to attend A and E than those who live in other parts of the country. Indeed, mortality rates for boys under 12 are much higher in that demographic. As someone who lives in and represents a region with pockets of high deprivation, I find it incredible that a Labour and Liberal Democrat Administration chose to close Monklands hospital A and E and, as a result, put pressure on Wishaw general hospital A and E. Both hospitals are in areas in which there is significant poverty.

Nicola Sturgeon, then Cabinet Secretary for Health and Wellbeing, reversed that decision. She said:

“Let me be clear from the outset. The Government’s view is that the decisions to close the A and E departments at Monklands hospital and Ayr hospital were wrong ... We must never forget that the NHS is a public service—a service that is used and paid for by the public. It is the duty of health boards and of responsible Government to take full account of particular local views and circumstances. It is my view and the Government’s view that, given the circumstances that are involved in these cases—the geography and demographics, the high levels of deprivation and ill health, and the concerns about access and public transport—A and E services at Ayr and Monklands should be maintained.—[Official Report, 6 June 2007; c 390-1.]

Our position has not changed.

I will quote some of the figures for presentation at A and E in Wishaw and Monklands. Since 2007, when the SNP reversed that decision, 54,918 patients have attended Monklands A and E and, in December last year, 5,551 patients attended. In the same period the figure at Wishaw was 5,207.

It beggars belief that there are complaints about A and E targets being missed when we consider how much worse it would have been had Labour been able to close the A and E departments in those areas.

Jenny Marra (Labour, North East Scotland)

I found the first half of this debate and the SNP’s response to Labour’s motion extremely limited at best. Labour is using its parliamentary time to shine a light on some of the realities in our NHS and the best that the SNP can do is accuse us of flirting with reality and rehearse arguments that were settled six years ago. The SNP has had six years; it is high time that it took some responsibility for the health service and for what is going on.

As the Royal College of Nurses said:

“It can become easy to forget that behind every statistic is a person who needs quality and timely care and a nurse or healthcare assistant who wants to care for him or her to the best of their ability.”

That should never be far from our minds. This debate is not just about the statistics; it is about how the Government is responding to the pressure that our NHS staff are under and the toll that that is taking on patient care the length and breadth of Scotland.

In Tayside, we have 14,000 dedicated NHS workers who are meeting the needs of more than 400,000 people. It is clear, from recent inspections and audits, that that challenging task is becoming harder. As a result, corners are cut and standards fall well below what is expected.

A December 2012 audit report into NHS Tayside waiting times revealed that over half of staff interviewed raised concerns about the environment in which they were expected to perform their duties—an environment, the report states, in which staff

“felt pressured into entering unavailability they considered to be inappropriate.”

The report went on to detail how that resulted in the routine allocation of up to three weeks’ unavailability in circumstances in which questionnaires were issued to patients. Unavailability had been added because equipment was unavailable in hospital, not because “unavailability” meant that the patient was unavailable.

However, just one week after that report was published, Alex Neil came to this chamber and said:

“waiting times ... published by boards are reliable and accurate.”

In justifying himself, he said that

“more ... needs to be done”

to address

“consistency of recording and the quality of waiting times information.”—[Official Report, 20 December 2012; c 15052-3.]

He went on to say in a radio interview that computers were to blame for the problem. We do not accept, in the face of overwhelming evidence and overwhelming reports from Audit Scotland, that the problem was the computer systems. That was proven by the Auditor General just the other week. Instead, what is becoming abundantly clear to everybody but the SNP is that our NHS workers are being forced to try to deliver under intense pressure by a Government that has ignored the warning signs and that continues, this afternoon, to ignore and turn a blind eye to them.

John Mason (Scottish National Party, Glasgow Shettleston)

Is Jenny Marra arguing that more resources should be put into health and taken away from some other sector of the Scottish budget?

Jenny Marra (Labour, North East Scotland)

I am arguing that the SNP needs to wake up and smell the coffee, and listen to what we are saying. There is overwhelming evidence from the Auditor General that the figures are not reliable and that waiting times have been hidden. I am arguing for clarity.

The warning signs include the August 2010 Audit Scotland report that warned the Government that availability codes were being applied differently in each health board, and the Auditor General recently putting the NHS on amber warning. Another sign is the fact that between April 2011 and March 2012 NHS Tayside lost nearly 250,000 hours, because staff were suffering from stress, anxiety or depression. With facts like that, it is little wonder that the pressure mounts.

The problem will not be resolved or avoided by a Government that seeks to deny that the problem exists or justifies it by telling the nation that it was worse under the previous Government. As I said in my opening remarks, the cabinet secretary’s Government has had six years. That attitude does nothing to relieve the burden on the staff in NHS Tayside, who feel like they do not have the equipment or resources that they need to do their jobs.

The attitude that “It’s all fine” did nothing to help the patients and staff in Ninewells who were inspected by Healthcare Improvement Scotland in September 2012. The inspection resulted in a report that was never released. It will do nothing for those who have been marked as socially unavailable for treatments that they desperately need.

We need a Government and a health secretary that are not only prepared to accept responsibility when things go wrong, but a Government and a health secretary responsible enough to reap the advice of experts and their own auditors on how to make things right. Until then, we will not see the real change in the NHS that we need to give NHS staff the support that they need to give patients the levels of care that they deserve.

Jamie Hepburn (Scottish National Party, Cumbernauld and Kilsyth)

I agree with Jim Hume that there is more to health care than waiting times. However, given that the subject of the debate is waiting times, he should not be too surprised that we are focusing on the issue.

I agreed with Jackie Baillie when she said that people do not want to have their faith in the NHS undermined. I think that I have got what she said right; if I have not, I apologise to her. I agree with that sentiment totally. However, one of the main reasons why faith in the NHS is being undermined might be that Jackie Baillie comes to the chamber week in, week out to decry what is happening in our national health service as if it were broken. Indeed, I think that I am correct in saying that she suggested that our NHS was at the point of breaking. That is hugely unhelpful and does not reflect the reality on the ground.

As Mark McDonald said, the NHS is a human institution. As a large institution, it will not always meet the standards that it should. How could that not be the case with an institution of that size? What do I do—what does any of us do—when a constituent comes to us with a problem about the NHS? I will tell Jackie Baillie what I do. I try to resolve that problem for that individual. I do not come to the chamber and use my constituent’s problem in a form of political knockabout to suggest that the NHS is at the point of breaking.

Jackie Baillie (Labour, Dumbarton)

Will the member take an intervention?

Jamie Hepburn (Scottish National Party, Cumbernauld and Kilsyth)

Jackie Baillie has the temerity to seek an intervention. When I tried to intervene on her, she would not accept it. However, lest I bear the brunt of Mr Findlay’s wrath, I will give way to Ms Baillie.

Jackie Baillie (Labour, Dumbarton)

I take all my constituents’ cases up with the health board and with the minister. My constituents, however, are so disappointed and upset at what is going on in the NHS that they, along with NHS staff, have come to me and agreed that their cases should be used in the chamber to try to bring about change and get the Government to wake up to the reality of what is going on in the NHS.

Jamie Hepburn (Scottish National Party, Cumbernauld and Kilsyth)

I am sure that Jackie Baillie’s constituents are delighted that she does what the rest of us do to try to get their problems resolved. What I do not do and what I do not see other members do is bring that problem to the chamber and say, as Ms Baillie did, that the NHS is at the point of breaking. That is unhelpful hyperbole and does not reflect the reality on the ground. I do not come to this chamber to seek to undermine people’s faith in the NHS, which is what Ms Baillie does.

Jamie Hepburn (Scottish National Party, Cumbernauld and Kilsyth)

Her card is not in.

Claudia Beamish (Labour, South Scotland)

Does the member agree that it is the role of the Parliament, and particularly the Opposition, to scrutinise what has happened in public bodies such as the NHS when an issue such as social unavailability has not been resolved and a previous cabinet secretary has hidden behind issues such as IT? That is our job, in part.

Jamie Hepburn (Scottish National Party, Cumbernauld and Kilsyth)

I appreciate that, Presiding Officer. I should have known better, because the last time that I gave way to the member, she made the same mistake and did not have her card in the console. I will need to learn my lesson.

I absolutely agree that it is the responsibility of members on the back benches—not just Opposition members, but all of us—to scrutinise what the Government is doing. However, we have to do that in a responsible fashion. We should not come to the chamber and suggest that the NHS is at breaking point. That does neither the NHS nor the people whom we represent a service.

Jenny Marra suggested that the debate was brought to the chamber to shine a light on what is happening on the ground. That would be all well and good if that was the case but, to be frank, the motion is a travesty. It is a travesty in several ways, not least because the waiting time circumstances are far improved from what they once were. Under the previous Administration, we had availability status codes that in essence allowed people to be put on hidden waiting lists for time immemorial. They would not get an appointment and they were stripped of any guarantee. Little wonder, then, that 10 years ago 6,494 patients were waiting longer than nine months for in-patient treatment, which represented a doubling since 1999. As of December 2012, there were 395 patients across Scotland waiting longer than 18 weeks. That is a dramatically improved set of circumstances.

We saw at least some recognition from the previous Administration that the availability status code system was not working. In 2004, Andy Kerr said:

“by the end of 2007 we will end the system of availability status codes”.—[Official Report, 15 December 2004; c 12892.]

It was all well and good for him to say that, but he did not deliver on it. It took the election of the SNP Government to deliver in that regard. We have instituted a system that is immeasurably better at ensuring that people can get seen by the NHS.

Audit Scotland has been cited several times during the debate. I point out that, in 2010, it released a report that stated:

“The NHS has done well to implement the new arrangements.”

It stated that the new system

“has stopped people remaining on waiting lists indefinitely.”

That was recognition by Audit Scotland that the new system was working far better than the old one.

Even those with unavailability are being referred for treatment much more quickly. Since 2008, the median wait for treatment in Scotland, including those who have been marked as medically or socially unavailable, has reduced from 40 days to 32 days.

The suggestion in the motion that there is some scandal is, in itself, a scandal. The NHS is in far better hands under the SNP Government.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I start with a confession. I am really rather fond of the Cabinet Secretary for Health and Wellbeing. I was fond of him when he was convener of the Enterprise and Culture Committee, I was fond of him when he was the housing minister, I was fond of him when he was the Cabinet Secretary for Infrastructure and Capital Investment, and I am still rather fond of him.

As well as that, I admire the cabinet secretary’s courage. I admired his courage on Friday when I heard that he had gone into the lion’s den of an operating theatre to witness an operation—I believe that it was a kidney transplant. Imagine my distress and concern when I heard that he had been taken unwell. What was my relief when I found out that he had recovered having been fed simply a glass of water and a chocolate biscuit? If only all those who are suffering in the NHS could be revived so easily, we would at a sweep do away with many of the problems that we face.

As well as being fond of the cabinet secretary, I have started to feel rather sorry for him, because he has been left to pick up the pieces that were left behind by his predecessor, Nicola Sturgeon, who has swanned off to her new position as cabinet secretary for breaking up Britain. He has been left to sort out the mess in the Scottish health service as, week after week, we get new revelations about all the terrible things that happened and were covered up by his predecessor. Now, all Nicola’s skeletons are coming dancing out of the closet and poor Mr Neil is putting on his bravest face as he tries to put them all back in and force the closet door shut.

Talking of Nicola Sturgeon—I am sorry that she is not here to defend herself—I gently remind Jamie Hepburn, in relation to his speech and his exchange with Jackie Baillie, that some of us have been in the Parliament for long enough to remember when Nicola Sturgeon was in opposition, sitting where Jackie Baillie is sitting now, and was never done raising the cases of individual constituents in the chamber with the then Scottish Executive. Perhaps Mr Hepburn should reflect on that.

I will touch on the situation that has been exposed by the recent Audit Scotland report as it affects my constituents—first, those in Forth Valley. The Audit Scotland report showed that, although NHS Forth Valley had shown good practice with its electronic waiting list system in relation to information recording, there were also notable instances of poor practice, such as people no longer employed by NHS Forth Valley having access to electronic waiting lists and the extended use of the incorrect local code “Aware of breach—willing to wait”, which was eventually dropped in 2012.

Forth Valley also had a Scotland-high discrepancy between reported and actual waiting times of 35 per cent, so there were quite serious issues at NHS Forth Valley. Those issues are not entirely its own fault—after all, it has seen a reduction by 97 in the head count of nurse and midwife staff since September 2010. As the RCN pointed out in its briefing for the debate, reduced resources will result in mistakes as staff toil under greater pressure and strain—that appears to be a national trend.

NHS Tayside was highlighted along with NHS Lothian in the Audit Scotland report as indicators of a failing system. Nearly 25 per cent of NHS Tayside unavailability levels were classed as inappropriate. Let us remember that behind those statistics are individual patients who are left without care.

On the new ways guidance failures at NHS Tayside, the report states:

“Whilst some of these appeared to be based on misunderstandings, for 17% of the 367 transactions tested, unavailability appeared to have been systematically applied to prevent patients being reported as not meeting their treatment guarantee date”.

An NHS Tayside internal investigation found that there was no evidence of an intentional manipulation of waiting time figures. Although the First Minister has emphasised the lack of deliberate wrongdoing, it is clear that the current system lends itself to bad practice and errors. Moreover, the complete failure to have an adequate whistleblowing system has been noted. Staff must be allowed to identify errors without fear of reprisal.

As Jackie Baillie said, the A and E waiting time figures make for the worst reading. When questioned on the issue, the First Minister blamed seasonal weather for lower than expected compliance figures. Whatever excuse comes to mind—bad weather, good weather, too much sun, too much rain—unfortunately, the buck has to stop with his Administration.

In NHS Forth Valley in December 2007, there was a 98.1 per cent compliance rate with the A and E target of being seen within four hours. Last year, in December 2012, that figure was only 85.6 per cent—a substantial reduction by anyone’s standards, bearing in mind the target of 98 per cent. At NHS Fife, the figure was also down in the same period by nearly 8 per cent. Of course, every statistic hides a person who is waiting too long to be seen in A and E, often in a very distressed state.

As Jackie Baillie pointed out earlier, the Scottish Government has secretly slashed the A and E target and not bothered to tell anyone about it—at least not publicly. That is not good enough.

Alex Neil (Scottish National Party, Airdrie and Shotts)

Just to clarify that point, the 98 per cent standard is still there; the 95 per cent is a new target that will be achieved from April—from next month. The distinction between the standard and the target is what the member does not understand, with all due respect. [Interruption.]

Elaine Smith (Labour, Coatbridge and Chryston)

Order. Murdo Fraser—I will give you 30 seconds.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I surely cannot be alone in the chamber in having difficulty in understanding the distinction between those targets. Perhaps, rather than sneaking the new target out in a newspaper report, the cabinet secretary would be better coming to Parliament with a ministerial statement on the issue, when he can explain in great detail to those of us who are slow learners exactly what the difference is between those two points and we can ask suitable questions.

I am still—just—an admirer of the health secretary, but he needs to get a grip on the health service in Scotland or it will take more than a chocolate biscuit to revive his career.

John Mason (Scottish National Party, Glasgow Shettleston)

I greatly admire the cabinet secretary for attending an operation. I would not have dared to go in—the first time I gave blood as a student, they had to take me home afterwards.

I am delighted to speak in today’s health debate. Members will not be surprised that I come at this from something of a finance angle. I do not often speak on health and I am therefore particularly glad to be talking about this today.

In most debates, it is good to be positive, if we can be, and I would like to start with some positive points. It is clear that the Scottish Government is continuing to emphasise expenditure on health, and that is evident in the coming year’s budget. The Finance Committee has heard from some people who think that it is too focused on health and that we could put more resources into other things. However, I congratulate the Government on putting that emphasis on health, and I support its decision to focus resources on it.

Waiting time figures are positive. We have heard a lot of figures this afternoon, but it is useful to compare the situation with the one that we were in 10 years ago, when 6,494 patients were waiting longer than nine months. In December 2012, only 395 patients were waiting longer than 18 weeks. That sounds like improvement to me.

Patient satisfaction is another key indicator, and 88 per cent of patients are satisfied or very satisfied.

However, there is always going to be room for improvement. Everybody accepts that. Nicola Sturgeon, Alex Neil and Alex Salmond have all accepted that.

I have to say that some of the wording in the Labour motion is quite poor and perhaps even contradictory. One phrase that it uses is:

“put patients and hard-working NHS staff first”.

Presumably that is what targets are intended to do: they are supposed to ensure that people get the very best treatment they can. I wonder what exactly Labour is suggesting should be done to put patients and NHS staff first. I have listened to a number of speeches today and have heard a lot of description of problems and of individual cases, but I have not heard much about what Labour would do to put the situation right or improve it—for example, by putting in more resources. If it intends to put patients and NHS staff first, does that mean that education and schools will be put down the list and given fewer resources? If that is the case, I would not be comfortable with that.

In one sense, targets put pressure on staff to deliver for patients. Is Labour suggesting that there should be less pressure on staff, even though the patients would suffer because of that? Again, I would have major problems with that approach.

A phrase at the end of the Labour motion is “best possible patient care”. What does that mean? The best care in the world for every problem, no matter what the cost is? That is surely impossible. All our services have to live within their budgets. I agree that we want to provide the best possible care we can, within the budget. However, if the request is for more funding for health, we have to be told where that funding is to come from. Jackie Baillie said that we need more nurses. Where would she take the required resources from? Teachers? Colleges? When I intervened on Jenny Marra, she refused to say whether she wanted more resources for health or not.

That happened again and again during the budget process. Many people came to the Finance Committee and the finance secretary saying, “We want more resources for our little part of the world”—each of which is important—“but we cannot tell you where that money should come from.”

Jackie Baillie (Labour, Dumbarton)

I think that I am on record as saying, on numerous occasions, that we would reorganise the 22 health boards that are currently part of the institutional clutter in Scotland, which would release tens of millions of pounds and could lead to more nurses being employed.

John Mason (Scottish National Party, Glasgow Shettleston)

That is interesting, as that would mean that there would be a centralised system, which is an issue that I wanted to deal with in my speech. That is something that I would also be wary of.

We should be wary of making all sorts of comparisons. I think that we make too many with our nearest neighbour, England, and with the United States and so on. However, comparisons between health boards are interesting. If we believe in pushing down decision making to the lowest level, there needs to be an acceptance that there will be differences in the local provision. The word “lottery” gets used in this regard, but that is a wrong use of the word, because it suggests chance, and what we are talking about is local decision making. For example, in Glasgow we do not have exactly the same problems as people face in Edinburgh or Aberdeen. Quite frankly, I do not want the health decisions for Glasgow made in Edinburgh or Aberdeen, if that is what Jackie Baillie is suggesting.

Although the NHS is there to serve patients, which is potentially all of us, we also need to be realistic about what we expect from staff. Of course figures should not be fiddled, no matter what, and staff should be able to challenge colleagues if fiddling is suggested—or happening, as I think Murdo Fraser suggested.

Finally, I just want to say how committed our party is to keeping health in the public sector. In yesterday’s debate on demographic change, one Labour member suggested that those who can afford to pay should do so. I do not find it acceptable that, when people turn up at A and E or go to their GP, they should be asked for their credit card or be means tested. As far as I am concerned, we are committed to the NHS being free at the point of delivery. This is a dividing line between our party and Labour members: they are willing to roll back the NHS, whereas we will fight for the national health service. We may not always be successful in that fight and we will not always be able to afford all that we want to do, but we will fight for the NHS.

Helen Eadie (Labour, Cowdenbeath)

At the outset of the debate, Alex Neil said that the Labour Party does not have respect for the honesty and integrity of doctors and nurses in the NHS. I have total disrespect for that comment, because it would be total anathema for the Labour Party not to have absolute respect for every worker in the NHS.

Through decades and generations, the Labour Party has fought tooth and nail to make improvements to the NHS, and I am sure and certain that the Labour Party will continue to do that. It is quite right that we scrutinise the work of the Scottish Government, and SNP back benchers such as Jamie Hepburn—who is not in the chamber just now—need to reflect on that. We are doing the job that we were sent here to do by the people of Scotland. Contrary to what Jamie Hepburn said—

Jackson Carlaw (Conservative, West Scotland)

On a point of order, Presiding Officer. I am having difficulty hearing Mrs Eadie. Could she turn her microphone round so that it is pointing towards her during her speech?

Helen Eadie (Labour, Cowdenbeath)

Sorry, it is not usual that people complain about not hearing me.

Jamie Hepburn criticised our front-bench team in the shape of Jackie Baillie. I know that I—and other members of the Labour group, members in our wider party and people right across Scotland—have every reason to be indebted to Jackie Baillie, Richard Simpson and Drew Smith for the forensic work that they are doing on behalf of the Labour Party in scrutinising the work of the Scottish Government. We have brought a really important topic to the Parliament for debate today.

I very much agreed with Nanette Milne when she said that neither she nor Jackson Carlaw is interested in who did something 10 years ago. Ten years on, everyone should have learned and made progress and that progress must be demonstrable. SNP members need to ask themselves whether they are happy with having no progress at all. They need to take responsibility for their choices: they chose not to be responsible for winter and they chose not to be responsible for cutting beds and nurses and making the NHS do more and more with less and less.

Since the SNP came to power, the proportion of patients seen within the four-hour waiting time target fell to 90.3 per cent in December 2012, which was the lowest level recorded since the target was introduced in December 2007. During December 2012, the number of people who spent more than 12 hours in A and E was the highest on record—323 people. Some 323 people had to wait, with their families caring for them. This week, the Scottish Government’s own statistics showed that the last time that compliance was met across Scotland was in September 2009.

Alex Neil said that Labour would have closed the A and E unit at Monklands. Cabinet secretary, I can tell you that the SNP closed the accident and emergency unit at the Queen Margaret hospital. If you ever have a by-election in the west of Fife, the first thing you had better reopen is the accident and emergency unit at the Queen Margaret hospital. That happened on your watch, when Nicola Sturgeon refused to unpick the decision taken by Fife NHS Board.

Helen Eadie (Labour, Cowdenbeath)

We are concerned about the real world. I say to Jamie Hepburn, who is not in the chamber, John Mason and others that patients action Scotland is running a crisis conference this weekend. The reality is that far too many constituents are not getting the support that the NHS should provide. That is the real world, and that is the world that patients action Scotland will articulate this weekend. The BMA, the Royal College of Nursing and all the other organisations that have written to us with briefings for the debate need to be listened to. We fail to listen to them at our peril.

The former health secretary, Nicola Sturgeon, must explain to Holyrood what she knew about the NHS waiting time scandal before it was exposed. The recent report from Audit Scotland scrutinised NHS boards’ management of waiting lists and made clear that Nicola Sturgeon should have known about the hidden waiting lists over which she presided. She should have asked questions about the misuse of social unavailability, but she failed to act when told what was happening. Nicola Sturgeon needs to explain to Parliament what she knew, when she knew it and why she failed to act on the warnings. She sat through the ministerial statement on the Audit Scotland report but did not speak at all. She now needs to answer for her inaction. If she cannot, Alex Neil owes it to patients across Scotland to speak for her and to give clear information.

In December, NHS Fife had the third highest number of patients in Scotland waiting for more than 12 hours in accident and emergency. In the final month of last year, 65 patients had to wait more than 12 hours in accident and emergency, which is an average of more than two per day. Only NHS Lothian, with 78 patients, and NHS Lanarkshire, with 117 patients, posted worse results. NHS Fife’s failure to meet its accident and emergency waiting time target follows on from its missing the cancer waiting time target, the fall in the number of available hospital beds in Fife and the rise in the number of hospital complaints there.

The Scottish Government’s failure to address the underlying problems in our NHS is resulting in the people of Fife and Scotland having to pay the price when it comes to accident and emergency waiting times.

Gil Paterson (Scottish National Party, Clydebank and Milngavie)

As a member of the Health and Sport Committee, I welcome the opportunity to speak in the debate. The issue of waiting times for treatment in the national health service affects many of my constituents and those of other members.

As Jamie Hepburn and John Mason highlighted, in 2003, 6,494 patients were waiting longer than nine months for in-patient treatment. Progress has certainly been made since then, and currently only 395 patients across Scotland have been on waiting lists for longer than 18 weeks. However, there is still a lot of work to be done, and I recognise the Scottish Government’s commitment to bringing down the figures even more.

It is worth repeating that, when the Labour Party was in power prior to the 2007 Scottish parliamentary elections, the threat of closure was hanging over a number of hospitals. The Labour Administration targeted accident and emergency departments at Monklands and Ayr hospitals. One must ponder what would have happened to waiting times and general patient care if the Labour Party had been elected to government. Fortunately for the local population, many of whom had campaigned to protect the services, the SNP was elected to government and kept its promise to prevent their closure and the potential catastrophic effect on local healthcare provision.

Added to that, the Vale of Leven hospital, on which some of my constituents rely, suffered salami slicing of its services under Labour in a bid to run down the facility and open the way to closure. The SNP Government again stepped up and reversed proposals to close the hospital, providing some comfort to local people. Since July 2007, a total of 82,386 patients have attended the Vale of Leven hospital, which should raise concerns about where they would have gone if the hospital had been closed under Labour.

Jackie Baillie (Labour, Dumbarton)

Would Gil Paterson care to comment on the fact that, on the SNP’s watch, maternity services at the Vale of Leven hospital have been slashed from a 24/7 service to a 8-to-8 service, lab services have been taken away and centralised at the Royal Alexandra hospital and, despite a commitment to keep services local, the SNP closed the Christie ward at the Vale of Leven?

Gil Paterson (Scottish National Party, Clydebank and Milngavie)

The Christie ward burned down—that is another story.

I notice that you did not come to the rescue of your Labour Government, Jackie. You know as well as I do that you put more paint on your nails than went on the wall of the Vale of Leven hospital in 10 years.

Gil Paterson (Scottish National Party, Clydebank and Milngavie)

Sorry, Presiding Officer.

Jackie Baillie (Labour, Dumbarton)

Members can see that I do not paint my nails.

Gil Paterson (Scottish National Party, Clydebank and Milngavie)

Okay. Nice nails.

The Labour Party would do well to remember its own actions on waiting lists before lecturing others. The shame of the hidden waiting lists that it operated through its availability status codes, which effectively stripped patients of their treatment guarantee, will long be remembered by those who were affected by the system.

The SNP Government again stepped up to the challenge and introduced a system that has the best interests of patients at its heart. The new ways system was designed to be more transparent than the failed Labour Party system. That is why the statistics are available to the Parliament and can be audited.

When we look across the border to our neighbours in England, we see how the United Kingdom Government is intent on dismantling the national health service. I am pleased that the Scottish Government has a different approach. I am pleased that it is committed to the founding principles of the NHS, which continues to be a universal public health service.

Care for patients is the highest priority for the Government. That can be seen in the decision not to cut the health budget despite the overall cut to the Scottish budget being made by Labour’s better together partners.

However, without the support and dedication of the hard-working NHS staff, patient care would suffer. For that, they should be commended. Our NHS staff deliver a top-class service to patients and families. I am concerned that their morale might be damaged by the constant negative scare stories that emanate from Labour.

Continued public confidence in our NHS must be of the highest priority. When the public begin to mistrust doctors and nurses, we are in a serious situation. That is why I welcome Audit Scotland’s findings that, after an extensive investigation, there was no evidence—I stress that—of deliberate manipulation of waiting times. Further to that, I am pleased that 91 per cent of the 105 internal audit recommendations have already been enacted.

The health service faces a large number of challenges over the next three years. The UK Government’s welfare reforms will have a negative impact on the health of the people in Scotland and many will require assistance. That is why the Scottish Government has protected the NHS budget and why there will be a real-terms increase in the front-line NHS budget over the next three years. The Labour Party’s refusal to ring fence the health budget is just one reason why it failed in 2011.

Gil Paterson (Scottish National Party, Clydebank and Milngavie)

I recommend that members support the amendment in the name of Alex Neil, the cabinet secretary.

Jackson Carlaw (Conservative, West Scotland)

This afternoon, it has been a great shame that there has been only water to drink.

Once upon a time, a Scottish coalition Government was elected in a devolved Scotland, and it was entrusted with the care of Scotland’s NHS. From out of the mists on the moor came a wicked woman who harangued it about waiting times. And it came to pass that said wicked woman was herself elected to take charge of the NHS, so her former coalition partners decided that revenge is a dish best served cold, so they would harangue her as she had harangued them.

That is a pantomime, but a pantomime is what we have witnessed in the chamber this afternoon. We are past the point at which we can pretend that nothing is wrong in Scotland’s NHS. The Audit Scotland report—I welcome the cabinet secretary’s saying that there will be an earlier review of waiting times—has highlighted problems. We know that some accident and emergency targets are being missed; we are in denial if we pretend that that is not the case.

We know that the accident and emergency performance in December was the worst for six years, that nursing vacancies are at a six-year high, that bed-blocking targets are due to be missed, and that the weather, holidays and IT systems do not explain all that. Some of the criticism in the Labour Party’s motion is due and it is partly fair.

I want to put at the heart of this afternoon’s debate the voice of a nurse whom I know personally, who as a teenager lost a relative in the most shocking circumstances and who pursued a career in nursing, as a result. She posted this, on an online forum, to the BBC:

“I don’t believe anyone has the right to pass comment on a nurses job without having done it! After years of constant stress from abominable staffing levels, constant verbal & physical abuse, lack of support from hospital management, lack of support from the public (not all thankfully), ridiculous expectations from many & countless hours of my own time spent caring for others with nothing but scorn from those who feel I have not done my job properly; I have now spoken with my feet & left the profession that I worked so hard to enter. People complain constantly about the terrible care they receive, but at the end of the day we are only human ... what you see is not the full story. Relatives & patients see only their own circumstance; a nurse juggles you & many others ALL wishing her attention right then & there! I believe I was very good at my job & cared for my patients to the highest standards that were possible; but at the end of the day I had to manage my time ... a wet bed, a turn due, a dressing needs changed, a patient needs the toilet, a patient needs fed, someone wants paracetamol, someone is about to pass away, someone has fallen & there’s a really sick patient needing transfer to HDU & a handover needs to be given (this patient needs constant monitoring, IVs, documentation & general care), a relative has been waiting to speak to me for 10 minutes & is now getting annoyed, there’s another relative on the phone & 4 more wanting my attention before the end of visiting (I’ve spoken to most of them on the phone already today while trying to look after others), an emergency buzzer, a lady wanting into bed, drugs needing made up & given, notes needing written up, bed managers wanting beds cleared and A&E wanting to give handovers of more patients needing into the ward, there’s a patient shouting & swearing at me because he wants out for a cigarette, it’s not safe for him to leave because of the treatment he has had, so someone needs to stay with him, someone else is unhappy because they haven’t had all their drugs, they do not understand this is for medical reasons, I need time to explain this to them ... but there’s hardly any staff so what comes first? What should be the priority?

Yes patients suffer & receive standards that are below those expected by the public but the care most nurses give is the highest standard they can physically manage!!! People have NO idea the stress our profession brings. I studied 4 years for a BSc (Hons) degree & continued to train & develop throughout my career, however this job is changing, not because nurses care less, but because the demands get greater every day while staff numbers decline. I have decided enough is enough, I no longer want to suffer the constant stress & abuse that nursing brings. I deeply respect all my friends & every other person still struggling on in nursing, the public should hope & pray that they can withstand the constant negativity & abuse, as without them many lives would be much much worse & many people would not live to see another day. Every profession has good & bad but no one comes into nursing for the pay or as an easy option ... if they did they wouldn’t last long! I believe many (although not all) of the ‘bad’ nurses are ground down by the job or are just the perception of a bystander who knows little of what they are dealing with!”

That is the testimony of a nurse. It is a not a criticism of any one Administration. We know that there are avoidable conditions that we are failing to tackle and that the preventative care agenda is not turning the tide as well as we need it to do.

At the time, I complained about the previous cabinet secretary’s abandonment of the health visiting strategy in Scotland. What should the NHS do? Perhaps we need a radical review of the procedures and processes in the NHS that would be every bit as severe and investigative as the Scottish Medicines Consortium review of new medicines.

We are six and a half years into the SNP’s time in government and at the mid-point of its current term. Although the Labour Party’s criticism might be fair, I look across at Labour members and I do not hear a convincing strategy that is deserving of government; the case has yet to be made. At one point during the debate—on the issue that, above all others, Labour thinks is the defining one by which we should judge the current Administration—Labour attendance dropped to nine members.

I do not hold a candle for the NHS in England; it is not my duty to do so. Our duty as politicians is to the NHS here in Scotland, to the patients here who need it, to the public here who cherish it and to the staff here who sustain it. What they are looking for is leadership from the cabinet secretary. That is an acknowledgement that some of what his predecessor did was not a success, however well intentioned it might have been.

Jackson Carlaw (Conservative, West Scotland)

Those people are looking for leadership and they are giving him an opportunity to provide it. If he will provide a solution for the NHS, we will work with him, but we cannot pretend that there is not a problem, and we cannot pretend that we can go on as we are.

Michael Matheson (Scottish National Party, Falkirk West)

As everyone in the chamber does, I recognise that we all have a shared interest in ensuring that our NHS is the best health service that can be provided to the public. I have no doubt that many members have made use of it themselves or have family members who have made use of it. We all want patients to receive the best possible service.

We have always recognised that the service does not always get it right. I have seen it not get it right for members of my family, and I speak to constituents for whom the NHS does not get it right. However, I also speak to constituents and members of my family for whom the NHS gets it right time and again because of the hard work and dedication of its staff.

I recognise that when there is clear evidence that the NHS is getting it wrong, we as a Government have a responsibility to take action to address those errors and to ensure that we rectify them when they occur. That has always been the case with this Government. We recognise that we need to continue to build on the improvements that have been made, and to improve the service overall.

There is one respect in which I disagree with what some members have said. On issues to do with our NHS, there are times when assertion is presented as fact, and time and again there is a lack of evidence for the criticisms that are made. People such as Jackie Baillie can make such assertions over and over on certain issues, but that does not mean that they automatically become fact. When it is a fact that errors are being made, we can take action.

Jackie Baillie asserted that there are fewer staff in the NHS now than there were in the NHS that we inherited. The fact is that that is not the case; there are more staff in our NHS now than there were when we inherited it. I will put the issue in context. There are more qualified nurses and midwives per 1,000 of the population in Scotland than there are in the rest of the UK; there are 7.9 nurses and midwives per 1,000 of the population in Scotland, and there are 5.8 in England, 7.1 in Wales and 7.8 in Northern Ireland. Therefore, we have a significant number of NHS staff in comparison with other parts of the UK.

Jackie Baillie said that we have an inadequate number of staff in our A and E departments. It is worth bearing it in mind that, under this Government, there has been a 92.7 per cent increase in the number of A and E consultants in Scotland. I recognise that, despite the improvements that we have made, we continue to face significant challenges. In our A and E departments, we face the challenge of ensuring that patients are treated as quickly as possible and moved on to the next place where their care can be provided. We need to take the concerted action that is necessary to address those challenges. That is why the Scottish Government has brought forward its programme for unscheduled care—it wants to ensure that we plan for such issues more effectively so that the move from the community to the front end of the hospital and on into the other departments in the hospital is handled much more effectively than is the case in some areas.

Mark McDonald made an important point in his speech; in the scramble to have a go at the Scottish Government and the NHS, the progress that has been made in a number of areas is very often forgotten. For example, significant progress has been made in our treatment of people with cardiovascular disease and of people who have suffered strokes, and there have been improvements in cancer treatment in Scotland. However, we can certainly do more to prevent avoidable ill health and, thereby, to reduce the pressure on our NHS.

Another very significant area of progress in recent years has been the reduction in HAIs. As of 9 January, the number of cases of Clostridium difficile in patients over 65 has decreased by 79.2 per cent—I said 79.2 per cent, not 7.9 per cent—compared with the figure for 2007. That massive improvement is a result of the dedication and work of our NHS staff.

Moreover, in the latest quarter from July to September 2012, there were 33 cases of MRSA, which represents a decrease of 86.7 per cent—I said 86.7 per cent, not 8.6 per cent—from the figure for the equivalent period in 2007. That is another reflection of the progress that our staff are making. We have also increased the budget for that from £15 million to £50 million in order to continue the improvements.

Our NHS has also made very significant improvements as a result of the five-year Scottish patient safety programme, which was launched in January 2008 and focuses on the acute sector with the key objectives of reducing HAI, adverse surgical incidents and adverse drug events, and of improving critical care outcomes and organisational and leadership safety culture. The programme, whose primary aim is to reduce mortality by 20 per cent by 2015, has reaped significant benefits for our NHS in Scotland. That is not just my view, but the international view. Don Berwick, the person who has been brought in by the Prime Minister to help to repair the damage that has been caused off the back of the Mid Staffordshire NHS Foundation Trust report, has stated:

“The Scottish Patient Safety Programme is without doubt one of the most ambitious patient safety initiatives in the world—national in scale, bold in aims, and disciplined in science ... aligned toward a common vision, making Scotland the safest nation on earth from the viewpoint of health care.”

Michael Matheson (Scottish National Party, Falkirk West)

That view has been internationally recognised; indeed, Sweden, Norway and Denmark are all looking at adapting our patient safety programme.

The programme applies not only in the acute setting. We have already moved it into mental health services, tomorrow I will launch it in our maternity care services, and next week the cabinet secretary will launch it in our primary care service. These significant improvements are a result of the changes that have been made over the past six years.

I recognise that there are still areas where we can make further improvements, but I point out that at last week’s meeting of the Public Audit Committee the Auditor General said on waiting times:

“we have not found ... evidence of manipulation at all”—[Official Report, Public Audit Committee, 27 February; c 1238.]

That does not mean that the Audit Scotland report did not highlight areas of inconsistency where further improvements can be made. Indeed, that is why we have accepted every single one of its recommendations and why three quarters of them have already been implemented. We want to ensure that we address the areas where further improvements can be made.

Michael Matheson (Scottish National Party, Falkirk West)

This Government is committed to building on the improvements that we have made in our NHS in Scotland over the past six years. Parliament can be confident that the cabinet secretary and I will continue to ensure that we build on that progress in the years to come.

Richard Simpson (Labour, Mid Scotland and Fife)

No matter how often the SNP repeats it, the statement that we were not committed to passing on health consequentials is just wrong. Labour committed, in its 2011 manifesto, to passing on all consequentials.

Let us begin by acknowledging that, with the doubling of funding for the NHS and the staff’s extremely hard work, significant progress has been made continuously over the past 15 years. We began with people waiting for two years, and we reduced the time to six months. We acknowledge that there has been further progress—there is no doubt about that.

However, that is not what today’s debate is about; it is about promises that were made to correct a system—the availability status code system—that members agreed was wrong in 2005-06, and to replace it with a better system that the public could trust. Let us look at the history. We will start with 2007. As the RCN said in its briefing, the waiting times management systems should have been about

“supporting timely, equitable and transparent access to our healthcare system.”

In a statement in September 2007, Nicola Sturgeon said:

“the new system will be subject to full scrutiny. First, hospitals will be obliged to advise patients when their waiting time clock has been stopped”.

She went on to say:

“I have asked that further measures be put in place to ensure that NHS boards operate the new arrangements fairly, consistently and in the interests of patients”

and she said that the NHS National Services Scotland‘s information services division

“will also undertake cross-checks on samples of patients’ details. The aim will be to ensure that details are accurate and that recorded periods of unavailability are supported by evidence.” [Official Report, 19 September 2007; c 1836-7.]

That was the promise that the Cabinet Secretary for Health and Wellbeing made to us in 2007, so where are all those checks and balances?

Let us roll forward to 2009, one year after the new system came into being. I asked a question then that I have asked repeatedly throughout my period as shadow minister. When something changes or there is variation, I believe that it is the responsibility of ministers and shadow ministers to ask questions and ask for explanations. I therefore asked the then cabinet secretary whether she was sure that the putting off the list of 100,000 patients annually was justified. In the first year of operation, the figure had been only 60,000. In 2013, the Audit Scotland report has the figure at 339,000 for nine months. That is an annual figure of 440,000. The figure has multiplied immensely.

That issue has not been raised today, but it is another issue that I suggest the cabinet secretary needs to look at, because real people and real patients are being put off the list. If that is not a hidden list, what is? If all are either classed “did not arrive” or cancelled their appointments, that is absolutely fine, but we cannot tell from the recording systems what is actually happening.

Let us roll forward again to March 2010. Audit Scotland produced a report that said, “Yes. We’re making quite good progress. The system seems to be quite good.” Indeed, the UK Statistics Authority said that it looked like a good system. I accept that, but Audit Scotland also said that there were warning signs that needed to be addressed. It made a series of specific requests of the Government, which Nicola Sturgeon—as the cabinet secretary—ignored. When the SNP was asked in April 2011 whether action was being taken, it said that a revision of the system would be in place imminently. That did not happen until the scandal of NHS Lothian was exposed and we got through the next Audit Scotland report. Then there was action. The SNP therefore gave a false reassurance to Audit Scotland.

What do we know now, in 2013? We know that we have a massively dysfunctional system. Manipulation was proved in NHS Lothian, but in many other health boards there was simply no way that the data could be tracked. However, it is telling that, as soon as the NHS Lothian scandal was revealed, the social unavailability levels, which had reached 30 per cent from 10 or 11 per cent in 2009, suddenly began to drop. Not one SNP member in the debate has explained to us why.

We have been offered explanations. The first was from Nicola Sturgeon to me when I asked about the matter, before the Audit Scotland report. The explanation was: “Well, the waiting times have become shorter, so people are getting less notice, and so they’re asking for social unavailability more.” Were there three times as many people? Have 900 patients—70 per cent—in an orthopaedic department asked for social unavailability? My God! The whole of Glasgow seemed to be on holiday.

It is not a consistent system or a transparent one that is open to full scrutiny; it is not the system to protect patients that Ms Sturgeon promised Parliament and the public. However, we have a cabinet secretary saying on 20 May that we have a transparent system, and then saying that the Government was not told and that it was the ISD’s fault. However, we have a statement from the ISD spokesman saying that, regarding the ISD’s reporting to the Scottish Government,

“social unavailability would have been one item in the extensive quarterly reporting of waiting times statistics”.

For one particular system, we were told that it was the IT system that was at fault. However, the Auditor General made it clear to Jackie Baillie at the Public Audit Committee that most systems that are currently in use have a facility to record the reason why a social unavailability code is applied to a patient to demonstrate that it is the result of a conversation with a patient or GP. However, in most places, that was not used.

Labour has therefore now been joined by Audit Scotland, the RCN, the BMA and—most important—patients and families in saying that there is a real problem with our waiting list system. Unless the cabinet secretary admits that, we cannot move forward. It is of particular concern to the BMA that the use of social unavailability codes was so widespread and that they were used so inappropriately.

Is all well now? We are told that it is, but the answer is “No, not quite”, because there are reports of bullying, and the BMA said that the pressures are not necessarily isolated to NHS Lothian.

Alex Neil (Scottish National Party, Airdrie and Shotts)

Will Dr Simpson take an intervention?

Richard Simpson (Labour, Mid Scotland and Fife)

I am sorry, but I really do not have time. I have a lot to get through.

A survey that accompanied the 2010 audit indicated that more than half of doctors and nurses believed that patients were sometimes inappropriately admitted to hospital in order to avoid breaches of the four-hour waiting times target.

Feedback from BMA members suggested that an aggressive management style is not isolated to NHS Lothian—a point that we have made but which has been rejected repeatedly. However, it is the BMA that says that—not us. It is more than two years since I called for the introduction of a whistleblowers’ line, but it will not come in until next month.

Are there any other problems? Audit Scotland also reported that more than 500,000 patients—in fact, the annualised figure is slightly more, at 520,000—were offered an appointment with three days’ notice. Is that a reasonable offer under the new system? Is the new system of seven days reasonable? It used to be 21 days. We also have inconsistency in that area, as many members have pointed out.

Accident and emergency is clearly a problem. In 2005, the drive to a four-hour target was announced and it was achieved in 2009, but has not been achieved since then. That is the reality, even if the figures are not being recorded quite correctly. However, more worryingly, 323 people were in A and E for more than 12 hours, as Helen Eadie said, which is the highest total since the target came in. Trolley waits are again becoming the norm, with graphic pictures such as that of 84-year-old John McGarrity. As Jenny Marra said about a hidden report from inspectors observing patients on trolleys in NHS Tayside, the inspectors were rubbished instead of there being an acknowledgement of the pressures and the effects on staff.

As Jim Hume reminded us, this is not a new situation and the money that is offered to solve the problem is also not new. We have had a lower target of 95 per cent sneaked out. Again, it was not announced to the Parliament, but we hear, “Oh! It’s a target, not a standard.” I say to Murdo Fraser that he was not alone in his absolute incomprehension of what the hell is the difference between those two. Forgive my words.

Tricia Marwick (None, Mid Fife and Glenrothes)

I do not think that that word was appropriate, Mr Simpson.

Richard Simpson (Labour, Mid Scotland and Fife)

I said that I apologise.

Richard Simpson (Labour, Mid Scotland and Fife)

An area that is of considerable concern to me is cancer. In December, I asked the First Minister about the 600 Scots—200 with colorectal cancer—for whom the target had been missed. I was offered an explanation from the cabinet secretary in due course, but I am still waiting. However, why am I concerned? It is because although we have a target and the health service is doing phenomenally well with that target, those who wait are waiting a median time of a further 61 days, which is double the target, so the matter is not being dealt with properly.

All that we ask the Government to do is look at those matters carefully, to come up with a system that works and be honest about it, and to take a deep dive on those patients who have been misled by waiting time figures that are inappropriate, as Audit Scotland has said. That is what should happen and, as Jackson Carlaw said, that is where the debate should now move to.

Business Motions

Tricia Marwick (None, Mid Fife and Glenrothes)

The next item of business is consideration of business motion S4M-05820, in the name of Joe FitzPatrick, on behalf of the Parliamentary Bureau, setting out a business programme.

Motion moved,

That the Parliament agrees the following programme of business—

Tuesday 12 March 2013

2.00 pm Time for Reflection

followed by Parliamentary Bureau Motions

followed by Topical Questions (if selected)

followed by Scottish Government Debate: Scottish Government Food Policy

followed by Business Motions

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

followed by Members’ Business

Wednesday 13 March 2013

2.00 pm Parliamentary Bureau Motions

2.00 pm Portfolio Questions

Justice and the Law Officers;

Rural Affairs and the Environment

followed by Scottish Liberal Democrats Business

followed by Business Motions

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

followed by Members’ Business

Thursday 14 March 2013

11.40 am Parliamentary Bureau Motions

11.40 am General Questions

12.00 pm First Minister’s Questions

12.30 pm Members’ Business

2.30 pm Parliamentary Bureau Motions

2.30 pm Scottish Government Debate: Scotland – the Best Place to Grow Up

followed by Scottish Government Debate: Local Government Finance (Scotland) Order 2013 [draft]

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

Tuesday 19 March 2013

2.00 pm Time for Reflection

followed by Parliamentary Bureau Motions

followed by Topical Questions (if selected)

followed by Scottish Government Business

followed by Business Motions

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

followed by Members’ Business

Wednesday 20 March 2013

2.00 pm Parliamentary Bureau Motions

2.00 pm Portfolio Questions

Health and Wellbeing

followed by Scottish Government Business

followed by Business Motions

followed by Parliamentary Bureau Motions

5.00 pm Decision Time

followed by Members’ Business

Thursday 21 March 2013

11.40 am Parliamentary Bureau Motions

11.40 am General Questions

12.00 pm First Minister’s Questions

12.30 pm Members’ Business

2.30 pm Parliamentary Bureau Motions

2.30 pm Scottish Government Business

followed by Parliamentary Bureau Motions

5.00 pm Decision Time—[Joe FitzPatrick.]

Motion agreed to.

Parliamentary Bureau Motion

Tricia Marwick (None, Mid Fife and Glenrothes)

The next item of business is consideration of Parliamentary Bureau motion S4M-05846, on referral of a Scottish statutory instrument to the Parliament.

Motion moved,

That the Parliament agrees that the Local Government Finance (Scotland) Amendment Order 2013 [draft] be considered by the Parliament.—[Joe FitzPatrick.]

Decision Time

Tricia Marwick (None, Mid Fife and Glenrothes)

There are four questions to be put as a result of today’s business. I remind members that in relation to the debate on national health service waiting times, if the amendment in the name of Alex Neil is agreed to, the amendment in the name of Nanette Milne will fall.

The first question is, that amendment S4M-05813.2, in the name of Alex Neil, which seeks to amend motion S4M-05813, in the name of Jackie Baillie, on NHS waiting times, be agreed to. Are we agreed?

Members: No.

Conservation (Endangered Species and Wild Land)

John Scott (Conservative, Ayr)

The final item of business today is a members’ business debate on motion S4M-05602, in the name of Murdo Fraser, on endangered species and wild land conservation. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes that 2013 is the Year of Natural Scotland; recognises the efforts of conservation charities and other organisations to save endangered species and wild land in Mid Scotland and Fife and across the country; understands that the indigenous red squirrel and the wildcat face a significant threat; believes that only 150 breeding pairs of wildcat are not in captivity; considers that habitat conservation coupled with breeding programmes could hold the key to saving endangered species; believes that there should be a network of grey squirrel trapping areas; notes the report, Public Perception Survey of Wildness in Scotland, which was published in July 2012 by Scottish Natural Heritage in association with Loch Lomond and the Trossachs National Park Authority; understands that the report claimed that 86% of people surveyed felt that further action was necessary to preserve wild land and that the most popular means by which this could be ensured was by introducing a specific wild land designation, and acknowledges calls for a concerted effort in 2013 to deliver a step change in conserving wild land and endangered species.

Murdo Fraser (Conservative, Mid Scotland and Fife)

At the outset, I thank all the members from different parties who have signed the motion, which allowed me to secure the debate.

The debate is on the broad topic of conservation, and the motion refers to the year of natural Scotland 2013. It is very much a composite motion that covers different topics. There is something in it for everyone, so I am sure that members who wish to contribute can find an issue that they want to address and others that they might wish to avoid.

There is no better time than the year of natural Scotland to evaluate our strategies to conserve wild land and endangered species. I will start by talking about two species in particular that are under threat.

The first of those species is the Scottish wildcat. For 9,000 years, the wildcat has lived and thrived in Scotland. However, despite the efforts of hard-working conservation charities such as the Scottish Wildcat Association, Cats Protection and the highland tiger group, the pure-bred cat faces imminent extinction. The SWA has released figures suggesting that only 35 pure-bred cats are left living in the wild. My motion refers to 150 breeding pairs but, in fact, the true situation could be much worse than that.

The Cairngorm wildcat project trialled measures aimed at encouraging the growth of wildcats in the Cairngorms. Its recommendations included raising greater awareness, encouraging responsible domestic cat ownership, fostering partnerships with estates and conducting thorough research and monitoring. An extensive captive breeding programme should be added to that list. However, in the immediate future, those actions may not be enough—and desperate times often call for desperate measures.

I recently asked whether the Scottish Government would consider cloning as a means to save the wildcat. Although that suggestion did not immediately get a positive response from the minister, the storage of frozen gametes should be taken as a necessary precaution—only a multifaceted approach will save the wildcat, and we do not want the species to die out without a means of recreating it.

The red squirrel is another native species that is under threat. It is the pin-up species of natural Scotland but, thanks to the spread of the grey squirrel, its numbers are under threat. I have raised the plight of the red squirrel in previous members’ business debates, and I have been pleased with the positive actions that the Scottish Government has taken on the issue.

There is more than sentimentality at stake when protecting this iconic species.

Claudia Beamish (Labour, South Scotland)

Murdo Fraser’s point about the need for a multifaceted approach to species protection is important. It is also essential that there be an adequately funded vaccination programme for red squirrels. Will he comment on that?

Murdo Fraser (Conservative, Mid Scotland and Fife)

Claudia Beamish makes a good point. A whole range of measures can be taken, and looking at vaccines is important. However, there is the difficult question of how they would be administered to squirrels. I dare say that we could find some volunteers if that was required.

The point that I was going to make about ancient woodlands is that grey squirrels cause irreparable damage to conifers and broad-leaved trees. They strip outer bark, with the result that vital nutrients are unable to travel up trees, which often consequently die.

Grey squirrels are also thought to be the carriers of diseases, including one that kills Japanese larches. They certainly carry the squirrel pox virus, which is not lethal to grey squirrels but is to red squirrels with which they come into contact. In many parts of Scotland, the red squirrel population is dying out as a result of its contact with grey squirrels that carry squirrel pox. We also know that grey squirrels kill woodland birds and damage arable crops, telephone wires and electricity cables.

Invasive non-native species cost the British economy £1.7 billion a year and it is estimated that the grey squirrel alone costs it £14 million per year. In Perthshire, in the part of Scotland that I represent, there is a front line between red and grey squirrels and strong measures are needed to stop grey squirrels encroaching on the reds’ territory. It is clear that, in the past 10 years, grey squirrels have moved further and further north and we are seeing battleground areas in places such as Perthshire. There are similar situations in Aberdeenshire and the Borders, where there are red and grey squirrels in the same areas. As a consequence over time, the reds are being driven out into more and more remote areas.

I pay tribute to the Perth and Kinross red squirrel group, which I met recently. It is working incredibly hard to raise awareness of the threat. Of course, the efforts of voluntary organisations, although important, can only go so far. I would like to hear from the minister about what more the Scottish Government can do to support the conservation efforts of foresters, landowners and conservation charities, including the European Squirrel Initiative. Habitat protection, trapping and the creation of grey squirrel exclusion zones should be set up.

It is not just that animal species are being threatened. Wild land is disappearing—and disappearing fast. According to Scottish Natural Heritage, between 2002 and 2009 the amount of land free from visual interference or built development declined from 41 per cent to 28 per cent. If we had up-to-date statistics, I am sure that we would see that the situation has deteriorated further. Those statistics are worrying, and action must be taken to reverse the trend.

In a recent BBC article based on forthcoming research from David McCrone, our landscape was chosen as the most important aspect of our culture, ahead of music and the arts. A 2008 SNH study found that 92 per cent of Scottish residents felt that wild places were important and a recent public perception survey of wilderness in Scotland found that 60 per cent of respondents believe that wild areas are under threat.

There is a substantial financial case for protecting wild land. Nature-based tourism contributes £1.4 billion to the economy and spending on nature-based activities is worth 40 per cent of all tourist spending. A simple click on the VisitScotland website shows headlines that highlight Scotland’s scenery.

What can be done to save wild places in Scotland? The John Muir Trust is calling for a specific wild land designation. That approach should certainly be looked at, but we would need to have some caution in implementing such a strategy. After all, what is wild land? Wild land is often a managed asset. The rolling, heather-clad hills that we have in Scotland are actually a carefully managed landscape, which supports jobs in the form of stalking and grouse shooting. Any designation must ensure the sustainability of that important rural industry.

One area in which the Scottish Government could practise greater responsibility is its approach to planning. Pylons, telephone masts, wind turbines and bulldozed hill tracks are all-too-common sights on what people would see as wild land.

In this debate, I do not want to go into the detail of concerns over the cost, viability and effectiveness of wind turbines, but if we are to have renewable energy projects, it is clear that we have to be very careful where we site them. Scotland is home to 10 per cent of the world’s blanket bog resource. Peat bogs are a natural carbon sink that helps to absorb harmful carbon gases. Due to their national and international significance, surely peat bogs should be exempt from turbine developments.

SNH has estimated that 39,000 jobs rely on nature-based tourism, which is an awful lot more than the 11,000 who are estimated to be employed in renewable energy. We should be concerned about further losses to wild land, because of the impact on those who live and work, particularly in tourism, in the Highlands.

In the year of natural Scotland 2013, saving endangered beautiful wild land and endangered species should be a priority. I urge the Scottish Government not only to get behind wildlife charities but to put in place measures to save wild land before it is too late.

Mike MacKenzie (Scottish National Party, Highlands and Islands)

I am particularly pleased to speak in the debate because I have spent all of my adult life and much of my childhood living and working close to some of Scotland’s wildest places. Although I use the word “wild” in the ordinary sense of the word, on reading some of briefings that have been sent to me I find that the word is inadequate. A stronger word is needed, at least for me. What I mean by wild is the wildness that we experience going through the Corryvreckan whirlpool in a small fishing boat in a gale or walking over the mountains of Mull in a snowstorm in winter, not for fun but out of necessity, and sometimes out of grim necessity.

I am led to believe that the definition of wild land is

“an area where an individual finds the experience of wildness is particularly strong.”

I find that that sometimes applies to Edinburgh. According to that definition, there is not much of Scotland that I, and the people who work on the land in our remote rural areas, would describe as wild.

I have a love of our natural environment and all its inhabitants. I am fortunate to be able to enjoy that right on my doorstep. Dolphins often play around the ferryboat that serves my island home. I can climb into my kayak and, in less than an hour, watch sea eagles on Mull or golden eagles on the Garvellachs. I have scratched the backs of basking sharks on lazy summer seas and rowed madly away from killer whales when their distinctive dorsal fins have appeared too close for comfort. I have come face to face with wild Mull goats, looked into their eyes and understood why the devil was sometimes personified as a big billy goat with horns and a beard. I am really not being funny here. I have watched otters play and nursed young seals back to health.

However, my chief concern is that it is our own species, Homo sapiens, that is the threatened species throughout much of the Highlands and Islands. Mankind has inhabited Scotland for around 10,000 years, perhaps more. In that time, we have disposed of the Caledonian forest that once covered our country. In Argyll, we did it to make cannonballs for Nelson’s navy. Almost all our land has been grazed or burned, and the landscape has no resemblance to what it was even a few hundred years ago. A handful of people make a meagre living from it. It supports fewer people every year. Traditional rural economies are declining. Many people cling to their livelihoods like limpets on wave-washed rocks.

Rural economies are changing, as they must do, to survive. New opportunities are opening up, which almost always involves some new development. Many of our most economically and socially fragile areas are already suffering death by designation. Living and life itself are sometimes banned in those areas, yet those people who live on our land, as opposed to those who go there only to play, have been the custodians of that land for generations. They have a deep-rooted understanding of the land and how to nurture it. That landscape quality takes work and active management. Under the care of people who understand that, our landscapes have been maintained in an almost pristine condition—a pristine condition that leads others to conclude that it is wild. Successful conservation is a bottom-up and not a top-down process, and cannot and should not be imposed by designation.

Claire Baker (Labour, Mid Scotland and Fife)

I congratulate Murdo Fraser on securing this evening’s debate. As the motion recognises, 2013 is the year of natural Scotland, which gives us an opportunity to focus on biodiversity and promote our heritage, wildlife and landscapes. I hope that it is about more than pinning a natural Scotland label on events that are already in the pipeline. We need much more debate and discussion about our environment, and a tangible legacy of the year would be a robust biodiversity plan with clear actions to deliver on our targets.

In focusing on endangered species, the motion highlights the red squirrel. Last summer, I went to a red squirrel fun day in Tentsmuir forest in north-east Fife to find out about the work of the Fife red squirrel group. Fife is not a target protection area, but the peninsula at Tentsmuir provides an opportunity for local activists to try to grow a population there. I commend the work of the Fife red squirrel group and groups like it across the country as they work tirelessly in raising awareness and introducing programmes to protect endangered species. However, as Murdo Fraser said, they need support to do that successfully.

Not for the first time in the chamber, I highlight the work of Scottish Environment LINK and its species champions programme, which is certainly capturing the imagination of MSPs. Although it is a bit of fun, it is proving to be an effective way in which to engage the Parliament in the challenges that many endangered species are facing. I am grateful to Dave Thompson, who is not here this evening, for adopting the sand eels. My puffins need them as they provide a valuable food source and help to grow their habitat.

Habitat protection is vital to securing the future of species. The minister will be aware that there are concerns that the marine protected areas do not protect seabirds. The motion also mentions habitat conservation. That is just as important offshore as it is onshore, and the minister knows that there is growing concern about the delayed marine plan.

Paul Wheelhouse (Scottish National Party, South Scotland)

I understand the concern about migratory species such as seabirds, but I put it on the record again that we are proposing to protect sand eel populations through the MPA network.

Claire Baker (Labour, Mid Scotland and Fife)

I am aware of other measures that the Government is taking, but the minister will know that there are still concerns about marine protected areas not protecting seabirds. Their inclusion would give an extra layer of protection.

To show that I am not someone who will back away from trickier issues, I note that the motion also mentions wild land designation, and I understand that the Public Petitions Committee will take evidence on the John Muir Trust petition in the near future. I recognise the concerns of the John Muir Trust and other organisations such as Ramblers Scotland about wild lands in Scotland. Effective protection of wilderness areas is important and, as Murdo Fraser highlighted, it is valued by the public. The Parliament has introduced protective measures over the years. The National Parks (Scotland) Act 2000 resulted in the establishment of the Loch Lomond and the Trossachs national park in 2002 and the Cairngorms national park in 2003.

In a response to the Public Petitions Committee, the minister outlined the existing means of protection, which include sites of special scientific interest, national parks, national nature reserves and national scenic areas. NSAs are defined as areas

“of outstanding scenic value in a national context.”

There are 40 such areas and they cover 13 per cent of the land area of Scotland. They ensure that areas such as Glencoe, Ben Nevis, the Hebrides and some landscapes in Perthshire and the Borders are protected from inappropriate development.

There is a system of protection and there is already a system of constraints that are placed on developers. It is not easy to achieve the right balance between competing demands, but it is essential to do so. The John Muir Trust has a clear position on the limiting of renewables development and it raises concerns about the impact that such development has on our landscapes and the environment. However, Murdo Fraser started to explore the fact that designating wild lands would present other challenges. Decisions would be fairly subjective and they would run the risk of creating an imbalance in another direction. The key debate needs to be about the value of what is being protected, rather than what is being prevented.

The Government has said that it is

“satisfied that existing legislation and administrative systems for land use planning and environmental management provide appropriate means for meeting the obligations and objectives set out in the”

European landscape convention. However, there are issues, such as hill tracks, on which we need progress to make the protections that we already have work better. I am sure that there will be an interesting debate on the matter in committee, and I look forward to hearing the minister’s response when he closes the debate.

Joan McAlpine (Scottish National Party, South Scotland)

I, too, congratulate Murdo Fraser on securing this important and timely debate in the year of natural Scotland. I thought that it would be useful to use the debate to talk about what is being done positively to help endangered species.

I know that many members have joined Scottish Environment LINK’s species champions scheme, which Claire Baker mentioned. That is a great way to highlight the plight of 93 species that are currently facing significant threats. Many members have now adopted a creature and the chamber is full of strange species. I have no doubt that many members hope that the qualities of their chosen animal might reflect on them. Perhaps that is why Rhoda Grant has chosen the golden eagle, Aileen McLeod is the industrious red squirrel and Mary Scanlon is the exquisite freshwater pearl mussel. However, I cannot understand why Murdo Fraser omitted to mention that he is the champion of the natterers bat as well as the wildcat.

Murdo Fraser (Conservative, Mid Scotland and Fife)

I am also the champion of the juniper—that might be something to do with the fact that it is a key ingredient in a popular drink.

Joan McAlpine (Scottish National Party, South Scotland)

That was also a good one to choose.

I have more of a challenge on my hands, as I am championing the adder. I was a little bit alarmed when Scottish Environment LINK told me that it thought that I would be the perfect champion of the only venomous snake in Britain—indeed, the only snake at all in Scotland. Apparently, the reptile was unloved among parliamentarians and could not find a champion because, for some reason, politicians did not want to be associated with a poisonous snake. I felt that I had a duty to take up the cudgels on the adder’s behalf and I have no regrets.

Like so much of our wildlife, the adder has a huge cultural significance. It features in our language, our literature and our art. It was originally known as the northern viper, which comes from the Latin words “vivus”, meaning alive, and “parere”, meaning giving birth, because of its live bearing habit. It is unusual in that it is a reptile that does not lay eggs.

Shakespeare made several references to the adder. In sonnet 112 he said:

“In so profound abysm I throw all care

Of others’ voices, that my adder’s sense

To critic and to flatterer stopped are.”

The adder’s sense that Shakespeare refers to means turning a deaf ear. There was a belief that adders could stop their ears to unpleasantness and screen out sounds that did not please them, which is quite a handy attribute for politicians as well. Unfortunately, it is a myth, as adders do not have ears.

A lot of our fear and suspicion of adders is based on our misunderstanding of them. No one has died from an adder bite in Britain for more than 20 years. With proper treatment, the worst effects of a bite are nausea and drowsiness, followed by some swelling and unpleasant bruising. The best advice is to leave adders alone. They only tend to attack in extremis, when they are frightened.

Adders are relatively common in areas of rough, open countryside and this is the best time of year to see them, when they get ready to mate. In the phenomenon called the dance of the adders, males rise up and writhe and compete against one another for female attention.

The south of Scotland—the area that I represent—is an important area for the adder. Currently, the population status of the adder in Scotland is unknown. However, anecdotal evidence suggests that it is in decline because of habitat loss, habitat fragmentation, unsympathetic land management and increased public access, which all put it under pressure.

One important way to manage land to favour adders in Scotland is to do with how we manage forestry—once we have a dense canopy of trees with close planting, the snake does not have the sunlight that it needs to thrive. It does much better on the edge of woodlands, where there are young trees, so new planting is important.

Adders favour areas with habitat diversity, so their presence usually indicates a healthy ecosystem. They provide food for predatory birds and mammals and they prey on mammals and reptiles. Scotland has no baseline data to indicate the size and distribution of the adder population. Perhaps that is because of the adder’s unpopularity. That lack of data represents a significant barrier to the conservation of the species, so a project to assess the number of adders, where they are and how populous they are, is important. I hope that we have plans to do some counting in the future, as has already taken place in England and Wales.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

Murdo Fraser said in his introduction that this is a wide subject, and so it has turned out to be. The debate has been all the better for that. It is an interesting topic with many different dimensions to it. I congratulate Murdo Fraser on bringing it to the chamber. It is an important debate, especially in the year of natural Scotland.

I declare an interest, in that I am a member of the John Muir Trust. As a national body, it is to be widely commended for all the work that it has been doing over many months to ensure that we are debating the facts rather than the myths.

I am often told by my climbing friends from south of the border that Scotland is the most privileged nation thanks to the extraordinary beauty of her landscapes, particularly those that are in the most remote areas of the country. Mike MacKenzie made an important point about what wildness actually means. For those people, the landscapes are a powerful magnet that attracts many people from all over the world, in all seasons, in all weathers and in all kinds of outdoor adventures. The argument for the protection of that wild land—or, at least, some of it—is compelling, just as it is in places such as Northumberland’s national park, north-east England’s heritage coast or the north Pennines. However, some caveats have to be put in place, which I will speak about in a minute.

As Tories, we are obviously not given to supporting additional legislation too easily, but we remain conscious of the tensions between the wilderness and economic development, specifically the creation of employment, which have been brought into the starkest focus by the march of wind farm development across our precious landscapes. Two summers ago, when, along with some others, Murdo Fraser and I were climbing in the Fisherfield area—accompanied by millions of midges—we had to accept that, even in one of our most treasured wilderness areas, large-scale wind farm developments could be seen on the skyline. That brought home to us just how significant that development is and why it is difficult for some people to accept it. Obviously, that is an issue that has been widely debated in many forums in this Parliament already.

Apart from the overwhelming need to protect the ever-more fragile environment, there are growing social and health reasons for taking action, as is evidenced by some of the studies from other countries that have been set out in the briefings that we have had.

On that point, I should say how important the role of groups such as the John Muir Trust has been in educating our young people about the responsibilities that they have when it comes to the protection of wild places. I remember vividly, when conducting my first school project with the John Muir Trust, the slightly indifferent reactions of pupils when they heard that we would be helping to do a major beach clear at Achmore on the south side of Loch Carron. I think that, perhaps not surprisingly, the pupils thought that they were there for a litter pick-up because their teachers fancied a bit of time off. Of course, nothing could have been further from the truth and, on that day, the John Muir Trust made a huge impact on the lives of 14 teenagers, none of whom had been in that kind of environment before and who knew nothing about the responsibilities that come with it.

In 2002, only 35 schools were involved in the John Muir Trust award. Now, 259 are involved. That means that the number of pupils who are in receipt of the award has risen tenfold in that period. The trust deserves congratulations for that. Of course, that is very much in line with the basic principles of the curriculum for excellence.

We have had a briefing from the Ramblers Association, too. It makes a good point that there has to be a much more coherent approach that includes other measures relating to the planning process and the design of the financial incentives. It is absolutely right to point out that there is a balance to be struck when it comes to the economy and the protection of wild land. I particularly note the association’s campaigning on the issue of what is happening just now in relation to the Cairngorm national park.

We must be careful to ensure that all voices are heard. My colleague Jamie McGrigor would have made that point had he not been unwell today. Protection should not be considered on a blanket basis, lest we do not pay due attention to the needs of the traditional land uses, such as farming, angling, crofting, game shooting, deer stalking and so on, all of which are hugely important.

We must hear the voices of those who speak for managed land, because they are just as important as those of us who like to enjoy the wilderness. Most land is managed, to a certain extent, but it is important that we take a structured view and try to consider all avenues because, at the end of the day, we have the most significant landscapes in the world.