Scottish Parliament, 2 May 2018

298 contributions from 65 members. The official report.

Automated Teller Machines

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

Good afternoon. The first item of business is a members’ business debate on motion S5M-10648, in the name of Dean Lockhart, on the campaign to save automated teller machines. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes the campaign by

Which?

and the Federation of Small Businesses to call a halt to the potential closure of free-to-use ATMs across Scotland because of plans to reduce the interchange fee by the cashpoint network, LINK; recognises that ATMs are an important service in communities, particularly for people on low incomes, older people and in areas such as the Trossachs, Perthshire, Kinross and Fife; believes that this might exacerbate the problem of bank branch closures as some consumers might be left without access to even the most basic banking services; notes the calls for the Payment Systems Regulator to take action to prevent there being complete ATM absence in some areas, and acknowledges the view that assurances should be given that consumers and small businesses can maintain access to the network of free-to-use ATMs.

Dean Lockhart (Conservative, Mid Scotland and Fife)

I am pleased to bring to the chamber this members’ business debate on the potential closure of free-to-use ATMs across Scotland. I thank the members who supported the motion, thereby allowing us to debate an issue that has the potential to affect all our constituencies and regions. I also recognise the excellent joint campaign by Which? and the Federation of Small Businesses, which has attracted more than 75,000 signatures across the UK to highlight the concern.

As members will be aware, automated teller machines have a long history in Scotland, with the first ATM being introduced in the late 1960s. In fact, the concept of the ATM was pioneered by two Scotsmen—James Goodfellow from Paisley and John Shepherd-Barron from Inverness. The latter originally imagined that a cash machine could operate just like a chocolate dispenser. ATMs have clearly come a long way since then. There are now 5,200 free-to-use ATMs across Scotland, which offer a wide range of banking services and form an invaluable part of communities and local economies.

Despite the increasing use of digital transactions, cash is still the most common method of payment in the high street. More than a third of total high street spending is dependent on the ready availability of cash machines. FSB research highlights that local ATMs inject an average of £16 per withdrawal directly into nearby stores, and research by Which? has shown that 90 per cent of Scottish consumers consider the availability of free cash machines to be an important part of their everyday lives. The importance of local free-to-use ATMs has only increased following the recent closure of a number of bank branches, as ATMs are often now the only means for people across Scotland to access cash and banking services.

Given the importance of ATMs for local communities, serious concerns were raised when, in January this year, the UK’s largest cashpoint network, Link, announced plans to change the fee structure under which ATM operators are paid for the use of its ATMs. The proposed changes that Link has announced would reduce the fee paid to ATM operators by 20 per cent over the next four years.

The critical issue is that the fee reduction has the potential to close many hundreds of ATMs across Scotland, as they would become financially unviable. The Federation of Small Businesses has estimated that around one in 10 ATMs in Scotland—more than 500 ATMs—are at risk. If the proposals go ahead, the hardest hit will be those who are the most reliant on using cash, including those in rural communities, where branch closures have already limited access to cash and banking services. They face a double whammy if ATM services are also withdrawn. The FSB has estimated that rural areas will potentially be the hardest hit by the proposals, with one in five, or 20 per cent, of ATMs in rural areas being at risk.

The proposals would also have an adverse impact on vulnerable and deprived communities, where free-to-use ATM coverage is already limited. Age Scotland has expressed concern that poor mobility and the lack of public transport will make it difficult for older people to access more distant ATMs. For small retailers, the closure of local ATMs would damage their business. Small retailers are cash businesses. According to the Scottish Grocers Federation, 76 per cent of all its members’ transactions are cash based. Research shows that, without a nearby ATM, more than 20 per cent of consumers would be less likely to use local shops and one in seven consumers would find it more difficult to pay for goods in cash.

Evidence that was given last week as part of the Economy, Jobs and Fair Work Committee’s inquiry into bank branch closures highlighted that many small retailers rely on the cash deposit facilities of ATM machines and that many face insurance requirements to deposit cash at the end of every day or every second day. Without a local ATM facility, those retailers might have to travel for up to two to three hours to get to their nearest cash deposit facility. That has clear implications for managing cash flow, staffing and productivity.

The Link network has responded to the widespread concerns by giving assurances that vulnerable consumers and remote ATMs will be protected by various measures, such as its financial inclusion programme, which provides funding of up to £3 million for the retention of ATMs in areas that are underserved. However, it is uncertain how that will work in practice and how the £3 million of additional funding will offset the impact of the reduction in the interchange fee, which will result in £200 million being taken out of the system. The FSB has estimated that the financial inclusion programme would apply to only 220 ATMs in Scotland, which is less than 5 per cent of the network.

It is important that we acknowledge the changing nature of banking and the increasing use of online banking and cashless transactions. It is equally important that we acknowledge the pressures that banks face, with interest rates lower for longer, increasing regulatory compliance and increasing costs of doing business. However, cost-reduction exercises that would result in the closure of hundreds of ATMs around Scotland cannot and should not be the answer to those pressures. Therefore, I have written to the chairman of the Link Scheme Ltd to call for the proposed changes to be reconsidered, and for the Link network and member banks to take another look at the impact of the proposals on consumers, small businesses and communities. If the objective of the Link network is to achieve a better geographic and demographic balance of ATMs, there are better ways to achieve that.

I have also written to the Payment Systems Regulator, which is the relevant regulator in this area, to ask that it closely monitors all proposed changes to the Link, MasterCard and Visa payment systems to ensure that any future changes to those systems prioritise consumers’ access to free-to-use ATMs.

It is vital that the ATM network is not seen as just another banking service from which to make money but, instead, is viewed as a core service offered by the banking industry as part of its wider commitment to local stakeholders.

The Deputy Presiding Officer

As we must conclude by 2 pm to let the next business proceed, I must be very strict and members must keep exactly to their time. There will be no ifs, no buts and no extra seconds—I cannot make it clearer. Gail Ross will show the way.

Gail Ross (Scottish National Party, Caithness, Sutherland and Ross)

I thank Which? and the FSB for their campaign on the issue and Dean Lockhart for securing today’s debate. Which? and the FSB have worked tirelessly to bring to our attention the threat of ATM closures, and I am glad that we are debating the issue today.

As Dean Lockhart highlighted, Which? and the FSB have had to raise the issue because, in January 2018, the UK’s largest cashpoint network, Link, announced plans to reduce the amount paid by card issuers to ATM operators for every use by a customer of a free ATM. The plans will reduce the amount that is received by ATM operators by 20 per cent per transaction from July this year, which is a move that is likely to make thousands of ATMs around the UK financially unviable.

In rural constituencies such as mine, the removal of ATMs, as well as adding to the great difficulties that have already been created by bank closures, will have a considerable effect on tourism, making visitors less able to contribute to local economies. As a rural MSP and deputy convener of the Rural Economy and Connectivity Committee, I have fought against bank closures, and I am fighting for better provision of mobile banking. I will continue to challenge those decisions but, until the banks see sense, the role of ATMs is vital to the cash-based economy of rural Scotland.

Tourism is a key sector in my constituency, and the creation of the north coast 500 has helped to harness its potential. Having ATMs along the NC500 route is key to ensuring that tourists can access money when they wish and spend it freely in local businesses. Not all small rural businesses take cards, and many have card limits. Cashpoints ensure that tourists can spend despite that.

However, ATMs do not assist only where businesses do not take cards; they also increase the likelihood that customers will spend money. FSB research shows that, on average, local ATMs inject £16 per withdrawal directly into nearby shops. Keeping ATMs in towns and villages is an important way of continuing investment by tourists.

Rather than removing ATMs, companies should be increasing their numbers and ensuring that they are accessible. Of the 60 or so ATMs in my constituency, nearly half are inside shops and banks, which means that they do not have 24-hour access. The welcome increase in tourism that has been created by the NC500 makes it increasingly likely that existing ATMs will run out of cash. Just last month, the

North Star

newspaper reported:

“cash machines run dry in Tain”.

As the closure of banks leads to increased demand on ATMs, they will run out of cash more regularly unless their numbers are increased.

Link and its members should realise that the disappointing bank closures across rural areas mean that there is no better time to invest in ATMs. In my constituency, many local business owners would like to see an increase in the number of cash-and-deposit ATMs, which allow customers to deposit money as well as take it out. The provision of more such ATMs would allow rural businesses to bank quickly and easily and would prevent the safety and security issues that come with holding large sums of money on business premises or in homes.

ATMs will continue to have a role in rural areas, because of their importance to tourism and the cash-based economy. It is therefore vital that we ensure continued access to cash, and that we join Which? and the FSB in urging Link and its members to review the decision in light of its implications.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

I congratulate my colleague Dean Lockhart on securing today’s debate on an important issue. It comes at a time when the Economy, Jobs and Fair Work Committee, of which I am a member, is investigating bank branch closures—an issue that has current relevance across the UK. The House of Commons Scottish Affairs Committee is also taking evidence on access to ATMs specifically.

Therefore, I welcome this political attention on a matter that is clearly of considerable interest to people across the country, but which is more keenly felt in the rural and remote parts of my region of the Highlands and Islands, as Gail Ross said.

In recent decades, people have become increasingly used to readily accessible cash. As Dean Lockhart mentioned, Scotland can claim to be the home of the modern ATM. Its original inventor, John Shepherd-Barron, brought forward the concept that created the first Barclays machine. His invention was built upon by a Paisley man, James Goodfellow, who developed the machine-readable card accompanied by a personal identification number, thus reducing the need for slightly radioactive imprinting of the cheque-like documents that were paid in. The Enfield branch of Barclays, which still operates today, bears a blue plaque that notes its place in history. Captioned “lives made much easier”, it is a testament to the role that ATMs have played in our modern history.

The advances in contactless and chip-and-pin technology have doubtless had an effect on the use of ATMs. However, for many, cash remains the default method of purchase. The FSB has spoken about the higher level of cash transactions for small businesses. At a recent Economy, Jobs and Fair Work Committee meeting, small convenience store owners told us that when customers take money out of the ATM in their stores, some of that money is then spent in the store, and the storekeeper then puts much of the cash back into the ATM. That shows the importance of the ATM in supporting those businesses and the cyclical nature of the cash economy on which they rely. Cash withdrawals can also be used as a form of budgeting, with people taking out a weekly amount and being able to closely monitor their spending in certain areas.

Some of the proposals from the Payment Systems Regulator have been sensible attempts to agree to a reasonable way forward with Link, but this area will inevitably have to be monitored closely in the coming years. Therefore, although we may look to the future and the potential of an increasingly cashless society, cash is still an important part of many local economies. There remains a risk that some of the more vulnerable citizens and businesses will be left behind by a banking system that is increasingly difficult to access in the ways that they are used to.

Cashless transactions have grown at pace, without any great discussion of what the implications might be. People are often being forced to change business practices and their own banking practices with very little support or forewarning. The impact in specific areas and for specific groups of people should be considered.

Looking geographically, Which? has observed that Shetland has the highest level of charging cash machines in Scotland. Comfortably over half of its machines require a fee for withdrawals. However, that finding was based on a relatively small sample size, as Link has identified that there are a total of 31 ATMs in the northern isles taken together, of which 20 are free to use.

Those ATMs are important—they are crucial for the sustainability of rural shops, which rely so heavily on cash, and the shops themselves are important as part of their communities. They provide a hub and a place to meet, particularly for those who might otherwise face social isolation. Therefore, ATMs can be an integral part of the rural economy.

I do not think that anyone is seriously advocating getting rid of fee-paying ATMs in their entirety. Which? observed that they can offer additional convenience, but that should not be at the cost of losing out on existing provision. That is why ATMs and branches should be considered in the round. Access to money and banking services continues to be important, yet for many it can feel impossible to carry out relatively simple requirements. When online banking facilities fail—as they have done recently with the problems at TSB—customers can be left with few alternatives. There might be many elements at play—far too many to fit into a four-minute speech—but let us be very clear: if banks create barriers to customer service, customers will look for banking services elsewhere.

I will finish with a quote from James Goodfellow—

The Deputy Presiding Officer

You do not have time for Mr Goodfellow, I am afraid. I would love to hear from him, but no.

Joan McAlpine (Scottish National Party, South Scotland)

I am pleased to speak on a subject of great importance to my constituents, and I congratulate Dean Lockhart on securing the debate. I also congratulate Which?, the FSB and Age Scotland on their campaigning on this important matter.

The decision by Link to reduce the interchange fee is all the more concerning as it comes against the backdrop of local branch closures. In my area, three market towns—Langholm, Lockerbie and Annan—which are all close together, are all threatened by Royal Bank of Scotland closures. That problem was added to recently by the proposed closure of a Santander branch. While fighting such closures, my constituents were assured that, at the very least, they would still be able to access cash from cash machines. Now, we are told that Scotland will be among the hardest hit by a drop in the number of free-to-use ATMs. That is bad news, particularly for those from rural communities, where one in five people already say that their nearest cash machine is far too far away to reach on foot.

As is the case with anything to do with the financial sector, it is quite hard to get to the bottom of who is responsible. However, Link’s membership is comprised of 37 banks, so the scandal, again, looks like it comes from the banks. Despite the reduced interchange fees, banks could make the decision to maintain free-to-use ATMs where they are attached to local branches, or where they are pre-existing. However, if the past few months are anything to go by, relying on the social responsibility of RBS and Santander seems somewhat optimistic.

The loss of a local branch is difficult enough for a community to deal with, but losing a cash machine makes a bad situation worse. Once large machines are removed from towns, smaller ones cannot cope with demand. People are forced to travel ridiculous distances for want of a few pounds, and the amount of cash that circulates in towns plummets, which harms local businesses. I recently discovered that applications have been made to Dumfries and Galloway Council’s planning department for the removal of an ATM in Annan. My understanding is that that closure is directly linked to the reckless decisions on bank closures that were made by RBS.

On a positive note, campaigners in Maybole secured an impressive victory last week when RBS made a dramatic U-turn and reversed its decision to axe the town’s ATM. Sustained pressure from local campaigners, MPs and MSPs has resulted in RBS offering a reprieve to the closure-threatened Gretna branch in my area and nine more branches across the country. Of course, all branches and ATMs across the region—and across Scotland—should be kept open, and not just granted a temporary reprieve. However, such examples show that keeping up the pressure has an impact, which is why debates such as this are important.

People are rightly incensed by the idea that the banks, which caused such carnage in 2008, are imposing more damage on communities. I hope that the banking sector will learn from the events of the past few months and recognise that there is a continued need for face-to-face provision as well as cash withdrawal and deposit machines.

Link must acknowledge its responsibility as the network to which almost every cash machine in the UK is connected. In its submission to the Economy, Jobs and Fair Work Committee’s inquiry into bank closures, Link stressed its commitment to providing consumers with access to their cash for free through the strengthening of its financial inclusion programme. However, the issue is too important to leave to Link’s voluntary corporate social responsibility. It is the role of the UK-wide Payment Systems Regulator and the Bank of England, which also regulates Link, to ensure that consumers are able to access cash effectively and efficiently. Perhaps it is time for the Bank of England to step in and force Link to revise its plans.

Monica Lennon (Labour, Central Scotland)

I congratulate Dean Lockhart on securing the debate, and I thank Which? and the FSB for their campaigns.

I have been following this issue closely, as my MP, the member for Hamilton and Rutherglen West, Ged Killen, has also been leading a campaign on the issue. He plans to introduce a bill at Westminster this month to create a legal requirement for free ATMs in order to protect free access to people’s cash. I share Ged Killen’s concerns about Link’s decision to effectively cut funds for those who operate free ATMs.

As we have heard, before making its decision Link consulted only its own members, many of which are large banks that have a commercial interest, and did not consult the public more widely. However, the impact on the general public could be significant, because there could be whole high streets and communities in which no free-to-use ATMs will exist.

Less than six months ago, communities across Scotland were shaken when it was announced that more than 60 bank branches face closure, and several RBS branches in my region, Central Scotland, were affected, including the RBS branches in Larkhall and Hamilton’s Cadzow Street. Dean Lockhart referred to the research by Which?, which shows how heavily people rely on access to free ATMs.

We have no doubt that the most vulnerable people in our society will be hit the hardest—people without their own access to transport, including the elderly and people with disabilities. The cost of accessing cash from fee-charging ATMs will be felt most by those who can least afford it. Someone with £10 or £20 left in the bank will be placed in real danger of being overdrawn if they have to pay a couple of quid to withdraw their money, and they simply cannot afford that.

The Cadzow Street branch of RBS will close, as I said. In Hamilton, there is an ATM in Quarry Street, which currently charges £1.99. RBS will abandon Larkhall—I know that Dean Lockhart hails from there—where there is an ATM, in John Street, that charges £1.75. In Stonehouse’s Strathaven Road, the ATM charges £1.99. In East Kilbride, the ATM charges £1.85. We could all go on and on. However, we know that, in Lanarkshire, one in five children lives in poverty. It is therefore unacceptable for families who are already struggling to be charged to access their cash. We cannot allow these charges to become the norm.

Link tells us that it has strengthened its financial inclusion programme by subsidising ATM operators with cashline machines in low-income areas. However, the reality is that, in areas that are struggling to cope with poverty and deprivation, there is already an underprovision of ATMs. For example, Ged Killen counted more cashlines in one corridor of the House of Commons than there are in the whole of the main street in Cambuslang, in his constituency.

The banks and card issuers that make up much of Link’s membership might have commercial concerns about the projections of reduced cash usage, but Link is a not-for-profit company with a social remit. Those who value ATMs as a lifeline service must be properly considered.

On behalf of my constituents across Central Scotland, I add my voice to the calls of Ged Killen MP and organisations such as Which? and the FSB for the Payment Systems Regulator to engage in a full market review of the effects of the proposed changes. I welcome Ged Killen’s plans to launch a bill in Westminster to protect free access to cash, and I hope that the bill gets the cross-party support that it deserves.

Richard Lochhead (Scottish National Party, Moray)

I, too, congratulate Dean Lockhart on securing this debate so that we can all make a contribution highlighting the issue’s importance to local communities and to wider rural Scotland in particular. I also pay tribute to Which? for its campaign, and thank the FSB, Age Concern and others who have sent us valuable briefings.

There is a sense that there is a new emerging banking crisis in Scotland. This time, it is about not sub-prime mortgages but banking facilities being withdrawn from Scotland’s rural communities. Although many commentators have for a long time predicted the cashless society, that is still several decades away. However, due to a combination of the inaction of the UK authorities and the policies of the banking sector, we are in danger of creating cashless communities in rural Scotland, which will have all sorts of detrimental social and economic impacts.

In the past two years in particular, those of us who represent rural constituencies have seen the closure of many high street branches in those areas. In my constituency of Moray, the whole of Speyside is in the ludicrous position of having no high street bank branches. They have all closed in the past couple of years. That is the part of Scotland whose whisky industry is one of the biggest revenue generators for the UK Treasury, because 50 per cent of Scotch whisky is produced in Speyside. It is also the home of Walkers Shortbread Ltd, a major company that operates in 80 markets around the world. It is a centre of angling tourism and other economic sectors. However, there is not one bank branch in the whole of Speyside for those sectors.

To replace the bank branches that have closed, mobile banks were introduced. However, I have just had to see off a fight with the Royal Bank of Scotland, which wanted to reduce the twice-weekly visits of its mobile bank to Dufftown in Speyside. I am thankful that it has reversed that decision and that the service will continue for the foreseeable future.

All that we have left are the holes in the wall, which contain autobank machines at the moment. Those ATMs are vital for the communities where they are, so the idea that they could be removed because of the change in the pricing is ludicrous. That must absolutely be stopped.

In fact, when the high street branches in Aberlour in Speyside closed, the banks also took away the autobank machines, so people now have to travel to the ATM in Rothes down the road, which sometimes runs out of cash because so many people are dependent on getting cash from it. When Aberlour’s ATMs closed, there was no consultation with the local community of elected representatives, as far as I am aware.

The issue is important for the rural economy for a number of reasons. First, many shops in rural communities take cash only. That is the case in Wester Ross, where I was for my holidays over Easter—it is a spectacular area. The shops do that because they have fragile profit margins and therefore cannot afford the cost of card transactions. If tourists and local people cannot access cash, such businesses will lose out big time.

Secondly, in Aberlour, and elsewhere in Speyside and rural Scotland, summer shows, summer fetes and Highland games will be coming up. At those events, charities, good causes and other organisations raise money. They depend upon visitors and tourists going to the local ATM, taking out some cash and spending it at the show. If those people run out of cash, they can go back to the ATM and top up because they are having such a good time. If that service is not free, they will be put off doing that in many cases. Therefore, the good causes, charities and businesses will lose out for that reason as well.

In rural Moray and many parts of Scotland, people do not have a good broadband or mobile phone signal—if they have any at all. Therefore, not to have those ATM facilities to carry out their banking and access cash is detrimental to quality of life, particularly for elderly people.

I ask the minister to do what he can to address the issue with Link. The UK Government should set up a task force to look into the rural banking crisis.

Maurice Corry (Conservative, West Scotland)

I thank my colleague Dean Lockhart for bringing this important debate to the chamber.

Throughout my region, as is the case throughout Scotland, people face different challenges in different areas. For quite a few years, many services have been centralised. That has shown us the difficulties and challenges that people who do not live in central locations face.

People require certain facilities that can be accessed at any time. That is particularly pertinent in Arrochar and Tarbert in my region, which is a tourist area where there is no ATM. An emergency situation does not allow time for people to wait for the shop to open for them to withdraw cash and nor does the possibility of having to store more cash at home for such situations make us safer.

Numerous constituents have expressed to me their concern about the decline in banking services, for differing reasons. With technological advances, a growing number of people are now working from home and do not have to travel. People who work from home in more rural areas are faced with having to store cash reserves in their houses or make a timely journey to withdraw cash. For people who use public transport, that raises serious safety concerns.

Older people are much more likely to travel on public transport and are therefore being put at risk by the potential decline of ATMs. That situation is made more difficult by the recent closure of bank branches. If people do not have access to cash withdrawal facilities, there is a severe knock-on effect for the local economy. In some areas of my region, there has already been a spate of burglaries as a result of the potential increase in cash being stored under the bed. It would be logical to assume that the number of burglaries may increase further.

The risks and dangers that the situation could pose to the public outweigh the cost implications to the service providers. We must do everything within our power to ensure that ATM services remain in our communities.

The Deputy Presiding Officer

Thank you very much, Mr Corry. Your generosity has allowed the last two speakers to claw back to four minutes each.

Mark McDonald (Independent, Aberdeen Donside)

I congratulate Dean Lockhart on securing today’s debate and I thank Which? and FSB for their campaign. I realise that the debate has focused predominantly on rural issues and rural communities, as is quite proper, but I wonder whether I might take the opportunity to include a city-based perspective. Clydesdale Bank currently proposes to close two bank branches in Scotland, one of which is in Mastrick in my constituency. The branch is located just opposite my constituency office in the Mastrick shopping centre. That branch has two ATMs attached to it. There is one other ATM in the centre, which is a Link ATM.

My concern, which brings me to speak in the debate, is that my constituents in Mastrick face a potential double whammy as a result of Clydesdale Bank’s decision to close its branch and the potential implications of the decision by Link to reduce the transaction fee and therefore potentially make its Mastrick ATM unviable. I want to explain why that is important.

Dean Lockhart quite rightly mentioned the issue of vulnerable and deprived communities. Although Mastrick has a number of low-income households and a number of elderly individuals, it is not classified as a regeneration area or a community of deprivation in the city of Aberdeen, so some of the protections and considerations that might be applied to deprived communities might not be applied in the situation as it relates to Mastrick, even though there are a number of people in the community who would fit in the categories of low-income, elderly or vulnerable, as well as digitally disenfranchised.

There is a wider implication regarding ATM coverage and the difficulty that people would have in a city context. I appreciate that distances in cities are dwarfed somewhat by the distances that individuals have to travel in a rural context, but even in a city context topography and public transport links can make it difficult for individuals to access alternative ATM provision if they face the nuclear option of all the ATMs disappearing, or of the ATM running out of money—something Gail Ross highlighted—which has happened at a number of ATMs in the area over holiday weekends, when the ATMs are not regularly topped up.

That could be a double whammy that would force people to look elsewhere, and that would have a knock-on effect on businesses. Dean Lockhart highlighted the £16 spend that takes place in businesses surrounding ATMs. There are a number of small local businesses in the Mastrick shopping centre, which benefited from the town centre regeneration funding that was put in place after 2007 and has seen the centre lifted, although there are still some empty units there.

Following discussions, Clydesdale Bank may reconsider its decision on the ATMs. The branch is going to close in June, and it has suggested that it will revisit its survey on ATM coverage and look at whether there is a possibility of retaining the ATMs, either in their current location or within another provider in the centre. My concern is that, if that does not happen, and given the potential for the Link machine to be viewed as unviable by the operator on the basis of the decisions that have been taken by Link in relation to the fees that are paid, my constituents and the businesses located in the Mastrick shopping centre will face a double whammy that would be highly unacceptable. I hope that the minister would agree with that.

It is important that that issue is reflected in today’s debate. We understand that, although the rural context is important, there are also impacts on populated urban communities as a result of Link’s decision.

Mairi Gougeon (Scottish National Party, Angus North and Mearns)

I add my thanks to those offered by others around the chamber to Dean Lockhart for lodging the motion for today’s debate and for highlighting this important campaign. I also thank Which? and the FSB for their campaign, for keeping up the pressure on Link, and for the briefing material that they provided for the debate.

Although all the major banks are determined to make us think that no one needs or uses cash any more, so that they can get away with shutting all our branches, that simply is not the case. I read the statistics provided by Which? and the FSB with great interest. They found that the demand for banknotes had gone up by 10 per cent, with cash still the most widely used payment method right across the UK.

The threat from Link to reduce the interchange fee and the resulting impact that that could have on the network of ATMs across the country is bad enough in itself; that has been well articulated around the chamber today, particularly by Monica Lennon, who highlighted the point that those ATMs that charge people to access their own cash hit vulnerable people the hardest. However, the news about Link came straight on the back of the RBS announcement of bank branch closures and the obvious impact of that on the availability of ATMs, which came straight on the back of Clydesdale Bank closures and the removal of its ATMs. We have had the news recently about Santander, too. The cumulative effect of all those closures is huge, especially for the likes of Speyside; I was shocked to hear from Richard Lochhead that ATMs are all that it has left after all the high street bank branches have closed.

Such changes are made with no cognisance of those who use only cash, businesses that rely solely on cash transactions and the festivals and events that our rural communities hold, for which cash is so vitally important. My constituency of Angus North and Mearns has had six bank branch closures over the past two years; Clydesdale Bank closed three of four—in Brechin, Forfar and Stonehaven—and RBS soon followed with bank closures in Brechin, Laurencekirk and Stonehaven. There has also been the recent announcement of the closure of the Montrose branch.

Like many members, I was disgusted by last week’s news from the RBS chief executive, Ross McEwan, who told everyone that he was pleased that RBS had made a good start to the year—I am glad that it did, because nobody else did. In the first three months, RBS made a pre-tax profit of £1.2 billion, which was 70 per cent up on the same period last year. In the meantime, it is determined to pursue a programme of branch closures and has tried to appease us with woefully inadequate mobile branch visits—two hours a week is granted to Montrose, which serves not just the town but the wider north-east area that was forced to use that branch when the others closed—and mobile banks, which are inaccessible and do not give the full range of services. The closures force more pressure on the post office, which seems to pick up every major bank’s slack and, again, does not have the full range of services available.

I strongly urge Link to listen to this debate and to take heed of what all the members have said. I ask Link not to abandon the communities that it serves, as so many others have. The Tories have to act for the communities that they serve and do what they can to get the Government in Westminster to intervene and stop the RBS branch closures. It has the responsibility and the power to do something about that, and it beggars belief that it has done nothing so far.

Paul Wheelhouse (Scottish National Party, South Scotland)

I thank Dean Lockhart for today’s debate. It is a very important subject, as we have heard from all today’s speakers. I appreciate that Mr Lockhart and many members have genuine concerns about Link’s proposed changes to interchange rates, the implications for the ATM network and the impact of those changes on consumers and businesses across Scotland.

Members will know that the UK Government retains legislative and regulatory responsibility for banking and financial services. However, Mairi Gougeon has made the point that we hope that UK Government ministers can take action to intervene, and I call on them to do so. I put on record that the Scottish Government stands ready to work constructively with all concerned, including UK ministers, in the interests of consumers and businesses.

Link has proposed changes to the operation of the UK’s ATM network with the intention of shifting incentives for ATM installation and operation from well-served urban areas to rural and financially excluded communities. As Monica Lennon and Jamie Halcro Johnston said, those machines are vital in allowing financially excluded communities and families to budget—they withdraw the money that they know they can spend without risk to their bottom line. That important function has not received the attention that it deserves. I take on board Mark McDonald’s point that, although the implications for rural communities are serious, there are issues for urban communities as well.

Link is introducing the measures because it believes that current incentives cause ATM providers to focus on profitable city centre areas where 80 per cent of free-to-use ATMs are within 300m of another free-to-use machine. It has proposed changes to the interchange rate to take effect from 1 July this year and is adopting a phased approach to the reform; we understand that each further reduction will be subject to further review by Link before implementation to assess the impact on consumers.

Link has said that there will be no change in the interchange rate for free-to-use ATMs that are 1km or more from the next nearest free-to-use ATM and, as Dean Lockhart said, it has indicated that 221 Scottish ATMs will be protected in this way. We also understand that Link is tripling its financial inclusion subsidy from 10p to 30p for ATMs in areas with poor cash access. I do not yet know whether that will support the community of Mastrick, for example, given the point that has been made about urban communities. However, like Mairi Gougeon, I hope that Link will listen to the concerns that have been raised in the chamber today with regard to both the urban and rural contexts.

We understand that Link believes that the changes are required to strengthen and increase the geographical coverage of the ATM network in the UK. We have to take it at its word, but I echo the response of members throughout the chamber: we need Link to carefully review the impact of its proposed changes on communities across Scotland and in the UK more widely.

Although Link’s aim to support the ATM network in vulnerable communities is laudable, the practical implications of the changes for consumers, businesses and communities in Scotland are as yet unclear. I was interested to hear the points that were made about the 10 per cent increase in cash use, and Richard Lochhead’s point about rural shows and other businesses that require cash was well made. In addition, charities in both rural and urban areas often require cash for donations.

The industry body, the ATM Industry Association, has estimated that as many as 10,000 free-to-use ATMs could be at risk as a result of LINK’s planned changes. The uncertainty surrounding the potential implications of the changes, on top of the continued branch closure announcements including that by Santander in the past week—Joan McAlpine mentioned a potential closure in Lockerbie—is unacceptable. Our communities need to know that they will continue to have free, secure access to cash to allow them to go about their daily lives.

I am pleased to support the save our cashpoints campaign that has been launched by Which? and the Federation of Small Businesses, although I am saddened that such a campaign is necessary. I have written to both the Payment Systems Regulator and the Treasury in support of the campaign, and I am pleased that I have received constructive responses from the Economic Secretary to the Treasury, John Glen.

The joint campaign by Which?, representing consumers, and the FSB, representing our small businesses, highlights the important role that cash continues to play in sustaining functioning local economies. Cash use is declining, although I take on board Mairi Gougeon’s point that there is evidence of a 10 per cent increase in cash use in recent times. For many, however, cash remains the preferred and in some case the only form of payment, and it accounts for 40 per cent of transactions.

I also note Maurice Corry’s point that there is a potential increased risk of burglary if people stash cash on their premises because they cannot rely on being able to access ATMs or bank branches, particularly if those facilities are far away from them, or if they are elderly.

I have no doubt that society as a whole is moving towards a cashless future, and there are opportunities and benefits to be achieved in doing so. However, the important point is that we are not there yet, and I am sure that we will not be there for quite some time to come. There is therefore a continued need for cash to be readily available to all.

The Which? and FSB campaign calls for the Payment Systems Regulator to conduct a wider market review to ensure that consumers continue to have access to cash. The review would cover the provision of free-to-use cashpoints and the long and short-term implications of Link’s decision, the requirement for Link to ensure that its financial inclusion policy meets the needs of consumers, and the long-term alternatives that will be available to consumers if free cashpoints are removed. As I said, I have written to the Payment Systems Regulator indicating the Scottish Government’s support for such a review.

Given the continuing trend of bank branch closures, it seems likely that the communities that are most affected by such closures will also be those that are most threatened by changes to the ATM network and face added uncertainty about the future of ATM provision.

I welcome the Payment Systems Regulator’s commitment to actively monitor developments as Link’s proposals are implemented. Indeed, that is a point with reference to John Glen’s response. I understand that the PSR will require Link to report to it monthly on the impact of the decision and on action that Link has taken to address any unexpected negative impact on the free-to-use ATM network.

If any protected ATM is due to close, the PSR is keen to ensure that there is a quick transition to a new operator without any adverse effects on consumers, and we need to hold it to that. I hope that the PSR will go further, using its regulatory powers and committing resource to ensure that no ATM in a vulnerable community closes until a new operator is found, and that communities are not left without free access to cash as a result of Link’s changes.

As Gail Ross, Dean Lockhart, Joan McAlpine, Monica Lennon and many others highlighted, concerns have been raised about the impact of branch closures on our local communities. As Richard Lochhead and Mairi Gougeon highlighted, those are being exacerbated by reductions in the services that are offered by mobile banking units to communities that have already been affected by branch closures. That is a matter of great regret. I think that we all agree that such closures are a body blow to communities across Scotland. They have left many areas with significantly reduced branch coverage.

Unfortunately, closure announcements continue, with Santander’s announcement being the latest. Link and the PSR have indicated that they will take into account the needs of communities that are affected by branch closures as, often, when a branch closes, an ATM—a vital source of cash—is lost alongside the branch services.

The Deputy Presiding Officer

Please conclude for 2 o’clock, minister.

Paul Wheelhouse (Scottish National Party, South Scotland)

I support all the comments that have been made and I thank Dean Lockhart again for raising this important issue.

Secondary School Education Budget (Fife)

Alex Rowley (Labour, Mid Scotland and Fife)

1. To ask the Scottish Government what support it can provide to teachers in Fife regarding reports of over £2 million of reductions in the secondary school education budget. (S5O-02027)

John Swinney (Scottish National Party, Perthshire North)

Despite continued United Kingdom Government real-terms cuts to Scotland’s resource budget, we have treated local government fairly. This year, Fife Council’s increase in spending power to support local authority day-to-day services, including secondary school education, amounts to £18.8 million—or 3 per cent—on the figure in 2017-18.

Alex Rowley (Labour, Mid Scotland and Fife)

I am tempted to say, “Meanwhile, in the real world,”—and I do not mean that disrespectfully. The fact is that a presentation that is being given to teachers across Fife shows that Fife Council has approved savings of £4.095 million in secondary education. The presentation says:

“Of these £4.095m of savings, £2.338m is expected to come directly out of school budgets”.

The reality is that teachers in secondary schools in Fife, with all the other pressures that they have on them, are now being asked to work out how they are going to cut hundreds of thousands of pounds from their working budgets.

Does the Deputy First Minister and Cabinet Secretary for Education and Skills think that that is acceptable? I will not even start on the cuts in primary schools. How will we raise attainment when we are seeing such levels of cuts in front-line education in our classrooms?

John Swinney (Scottish National Party, Perthshire North)

I attach the greatest of importance to investment in education, which is the foundation of the Government’s education approach, particularly with the focus on the Scottish attainment challenge and pupil equity funding. I reiterate to Mr Rowley the point that I made in my earlier answer: Fife Council’s budget—its spending power—will increase by £18.8 million as a consequence of the decisions taken in the Government’s budget.

We are of course seeing funds being distributed directly to individual schools. Schools in Fife have been allocated more than £10 million in pupil equity funding, which I know from my various visits around Fife has been used very effectively by Fife schools to meet the needs of young people.

I have just come from a meeting of the Scottish education council, present at which was Fife Council’s executive director of education, who is leading the south-east of Scotland regional improvement collaborative. We heard at the education council this morning about the significant plans that the improvement collaborative is deploying to support the enhancement of education in the school sector in Scotland.

I understand the points that Mr Rowley is making. Those are decisions that Fife Council must make within the overall financial allocations that are made by the Scottish Government and other sources of money that are available to it. In that regard, the Scottish Government has investment significantly in local services in Fife Council.

Alexander Stewart (Conservative, Mid Scotland and Fife)

Several heads of schools in Fife have told me that they would like to spend pupil equity funding on employing more teachers with skills in additional support needs but that the spending of such money on additional teachers is not permitted. Will the cabinet secretary clarify whether that is correct?

John Swinney (Scottish National Party, Perthshire North)

Of course pupil equity funding can be used to employ members of staff. I can tell Mr Stewart that 506 additional teachers have been employed under the Scottish attainment challenge and pupil equity funding arrangements. That provision exists around the country, so there is no reason why it should not apply in Fife.

To be honest, I would be very surprised if schools in Fife were facing such a difficulty, because I can think of examples in Fife where additional teachers have been recruited and are able to contribute to the education of young people.

Education Maintenance Allowance

Ben Macpherson (Scottish National Party, Edinburgh Northern and Leith)

2. To ask the Scottish Government what role the education maintenance allowance plays in encouraging young people to stay on at school. (S5O-02028)

John Swinney (Scottish National Party, Perthshire North)

The education maintenance allowance programme provides a financial incentive for 16 to 19-year-olds from low-income households who are attending non-advanced learning in school or college, or who are on an activity agreement, to stay in learning. Home-educated pupils are also eligible.

The EMA programme is an entitlement in Scotland, unlike in the rest of the United Kingdom. The Scottish Government wants young people to be able to choose from the same learning opportunities, regardless of their background or circumstances.

Ben Macpherson (Scottish National Party, Edinburgh Northern and Leith)

I welcome that the Scottish National Party Government continues to recognise the importance of the EMA programme in allowing our young people to make learning decisions that are based on their abilities and aspirations rather than their financial circumstances.

What proportion of EMA recipients live in our most disadvantaged areas?

John Swinney (Scottish National Party, Perthshire North)

The most recent statistics on education maintenance allowance show that in 2016 the proportion of recipients who live in Scotland’s 20 per cent most deprived areas increased to 36.8 per cent from 34.9 per cent in the previous year. The figures tell us that education maintenance allowance arrangements continue to make a positive difference to young people from the most disadvantaged areas in Scotland. I welcome the increase that has taken place.

Mary Fee (Labour, West Scotland)

This morning, the Education and Skills Committee heard evidence that families lose access to clothing grants and tax credits when a pupil applies for education maintenance allowance. Families are falling into poverty and debt, due to the gap in processing applications. What action will the Scottish Government take to prevent families from falling further into debt as a result of applying for EMA?

John Swinney (Scottish National Party, Perthshire North)

I will look with care at the transcript of this morning’s committee meeting and follow the evidence. It is my understanding that the decision on whether other benefits are forfeited as a consequence of an application for EMA is enshrined in the rules and eligibility criteria of individual local authorities.

I will consider with care the point that Mary Fee raised, because I would be concerned if a family who applied for an education maintenance allowance forfeited access to other elements of provision, such as a school clothing grant—because an EMA will be available to an older pupil, who will be bound by the rules on uniform in relation to which school clothing grants are designed to try to assist.

If Mary Fee has particular information to draw to my attention, I will look at it carefully, because what she described is certainly not the policy intention or the situation that I want to emerge. I will examine the detail, to see what the Government can do to rectify the situation. It might be to do with individual decisions that are taken by local authorities, over which I have no control.

Science, Technology, Engineering and Mathematics Teaching Initiative

Rhoda Grant (Labour, Highlands and Islands)

3. To ask the Scottish Government what action it is taking to encourage female pupils to consider enrolling in the STEM teaching initiative run by the universities of Dundee and the Highlands and Islands. (S5O-02029)

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

The Scottish Government’s STEM strategy includes a range of actions that are aimed at encouraging women and girls to take up STEM-related careers. The partnership induction model that is

being developed by the University of Dundee, supported with £240,000 of Scottish Government funding, will contribute to that goal.

The University of Dundee has more females than males across its STEM teacher education programmes, and it has put in place an action plan to encourage the on-going recruitment of underrepresented groups, including females, into STEM teaching. The new programme is being marketed in conjunction with four partner local authorities, who will also actively encourage female applicants.

Rhoda Grant (Labour, Highlands and Islands)

There is a big skills shortage in engineering and very few women are taking up a career in the area. Indeed, women make up only 14.4 per cent of the workforce in all STEM careers. That will not change, because there appears still to be a shortage of girls taking up STEM subjects in school. Such subjects are crucial to a career in the sector. What is the Scottish Government doing to ensure that more girls choose maths and science at school?

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

A number of measures are detailed in the STEM strategy, which I had the pleasure of launching last year. At the recent second meeting of the implementation group for the strategy, we discussed issues on gender imbalance, including how we can tackle, in schools, the unconscious bias that goes on in society and build on the fine work of the Institute of Physics in that area.

We are also looking at what can be done to tackle apprenticeship challenges—that work is being led by my colleague Jamie Hepburn—and further and higher education challenges, through the Scottish Further and Higher Education Funding Council’s gender action plan.

A number of other methods are being dealt with through the STEM strategy. For example, some of the key performance indicators deal specifically with gender imbalance challenges in schools and encouraging take-up.

If Rhoda Grant has further questions in relation to particular aspects of the STEM strategy and how we can take it further, I will be happy to take them up with her in due course.

Clare Adamson (Scottish National Party, Motherwell and Wishaw)

Following the recent refresh of the Royal Society of Edinburgh’s publication “Tapping all our Talents”, what measures is the Government taking to ensure that women who are qualified but not currently working in STEM have an opportunity to take up the new initiatives?

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

Last night, I had the pleasure of receiving an update on that—albeit briefly and informally—when I attended a UK Research and Innovation reception, at which I spoke to Professor Lesley Yellowlees, who chairs the RSE working group. Government officials, the RSE and I are having very detailed discussions on how we can support the RSE as regards the data that it is looking at. We have committed to working with the RSE to look at the updated recommendations that it will give once it has refreshed the document. As I understand it, its consultation is on-going.

At the moment, we have a number of measures to tackle gender imbalance, including funding though the equalities budget to support Equate Scotland, which, as Rhoda Grant will know, is an organisation that works to tackle underrepresentation of women in the STEM sector—for example, through careerwise, which is a placement scheme that is exclusively for women studying STEM subjects at universities and colleges. Also through Equate Scotland, there is funding of up to £50,000 to deliver a women returners programme.

We are therefore taking action at the moment but are very aware of the issue. We will help the RSE in any way that we can and will listen very carefully to the recommendations that will come from its refresh of the document.

South Lanarkshire Council Education Resources (Meetings)

James Kelly (Labour, Glasgow)

4. To ask the Scottish Government when it last met officials from South Lanarkshire Council’s education resources. (S5O-02030)

John Swinney (Scottish National Party, Perthshire North)

My officials regularly meet officials from South Lanarkshire Council’s education resources to address a range of issues.

James Kelly (Labour, Glasgow)

Last month, the Child Poverty Action Group told the Education and Skills Committee that young people face a postcode lottery as far as their opportunities in education are concerned. That is emphasised in South Lanarkshire Council’s attainment figures, in which just more than a third of pupils are able to attain national 5 standard, which is below the national average. Does the cabinet secretary agree that the objective should be to give a fair opportunity to all young children in Scotland? That is constrained by the Government’s policy of penalising councils through cuts, as demonstrated by the cuts of £134 per head that South Lanarkshire Council’s citizens have faced since 2014.

John Swinney (Scottish National Party, Perthshire North)

I was on the verge of agreeing with quite a bit of Mr Kelly’s question until he got to the last bit. However, on the first bit of it I unreservedly agree that the whole focus of the Government’s education policy—with its emphasis on the achievement of excellence and equity for all—is on ensuring that, regardless of their background, young people are able to achieve their potential in the education system. The disparities that have existed in that system for all of my lifetime are what we are trying to tackle in focusing on the attainment agenda.

I will make three points in relation to South Lanarkshire. First, South Lanarkshire Council’s spending power has increased by £16.3 million, or 3 per cent, in this financial year compared with the previous year.

Secondly, in the current financial year, schools in South Lanarkshire will benefit to the tune of just short of £8 million in pupil equity funding. I have seen schools taking action to address the individual issues that confront them within their own localities as a consequence of having the pupil equity funding resource available to them. All the localities that Mr Kelly is concerned about have the means available to help them to address the attainment challenge.

Thirdly, in the context of having the resources available for schools, there has been an increase in the number of teachers who are available in South Lanarkshire schools. The latest census shows that there has been an increase from 3,202 to 3,282 teachers. That is a welcome indication of the priority that is allocated to education and to increasing the number of teaching professionals employed to educate our young people.

Knife Crime (Schools)

Jamie Greene (Conservative, West Scotland)

5. To ask the Scottish Government what action schools take to protect children from knife crime. (S5O-02031)

John Swinney (Scottish National Party, Perthshire North)

All staff in schools share a responsibility for identifying the care and wellbeing needs of children and young people. Schools should establish open, positive and supportive relationships across the whole school community.

Education authorities, in consultation with key partners, including staff unions, should develop their own policy on knives and offensive weapons within the wider context of positive relationships, learning and behaviour. The Scottish Government is investing significantly in various violence reduction preventative approaches with young people across Scotland as part of a wider strategy to promote positive relationships and behaviour.

Since 2007, we have invested more than £14 million in violence reduction programmes for young people, and we continue to expand the work undertaken with children and young people on those programmes.

Jamie Greene (Conservative, West Scotland)

Recent figures show that the number of pupils being excluded from school for incidents involving conventional and even improvised weapons is at a five-year high, with an average of two exclusions a day involving a violent incident with a weapon. Those are shocking statistics. If it is the cabinet secretary’s understanding that local authorities have standardised their processes on gathering knife crime data, why are incidents at a five-year high? What comfort can he offer to parents that they are sending their children to a school environment that is weapon free and safe?

John Swinney (Scottish National Party, Perthshire North)

I agree with the aspirations behind Mr Greene’s question: parents should expect to be able to send their children to weapon-free schools and a safe environment. Yesterday, I chaired a meeting of the Scottish advisory group on behaviour in schools, or SAGBIS. That wider stakeholder group focuses on putting in place the mechanisms to enable positive behaviour and a positive ethos to be created in schools, with an emphasis on removing the incidences of any weapon carrying, so that the policy environment that Mr Greene expects to see is present in every school.

The statistics to which Mr Greene refers are a concern to us because, for some time, we have seen reductions in the overall levels of exclusion. In Scottish education generally, the levels of exclusion are falling, but we have seen a rise in exclusions relating to weapons and weapon carrying. That tells us that we must be vigorous in ensuring that activities such as the no knives, better lives campaign, which is a youth engagement programme, and the mentors in violence prevention programme are felt within individual schools, and that the positive behaviours that we expect to see are prevalent in all our schools. I assure Mr Greene that those considerations are very much uppermost in the minds of ministers and our stakeholders in trying to ensure that we create the environment to which he referred in his question.

James Dornan (Scottish National Party, Glasgow Cathcart)

Obviously this is a serious issue. Although it is probably harder now for young people to access knives by buying them, what sort of discussions has the Government had with the United Kingdom Government on restricting the online sale of knives?

John Swinney (Scottish National Party, Perthshire North)

In the aftermath of the Bailey Gwynne tragedy, the Government considered the recommendations of the report that examined the circumstances of that tragedy, and the justice secretary then made representations to the UK Government about working together to raise concerns about the online sale of knives and the need for a cohesive approach by us and the UK Government in relation to what actions to take.

The UK Government agreed with that approach, and in October, it published a consultation on knives, corrosive substances and firearms. The consultation extended some proposals to Scotland and it ended just before Christmas. The UK Government is currently working with our officials on legislation to address concerns about online sales of knives. These are reserved responsibilities, but we are keen to co-operate with the UK Government on putting in place the most effective regime that we can to tackle the issue.

Kenneth Macintosh (Labour, West Scotland)

I appreciate the detail of the cabinet secretary’s answers, but I would encourage some succinctness so that we can get through some more questions.

Science, Technology, Engineering and Mathematics Teachers

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

6. To ask the Scottish Government how it encourages people to consider becoming teachers in STEM subjects. (S5O-02032)

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

We have taken a series of actions to encourage more people into teaching science, technology, engineering and mathematics subjects. Our teaching makes people recruitment campaign targets STEM undergraduates and career changers to consider teaching as a career. We have increased student intake targets for STEM subjects and we are offering bursaries of up to £20,000 for up to 100 career changers to train to teach in STEM subjects.

We are also supporting innovative new routes into teaching in STEM subjects. They include the University of Strathclyde’s masters course for STEM graduates to complete an initial teacher education course alongside a masters degree.

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

In my constituency of Strathkelvin and Bearsden, one school is only able to offer an elective computing class to third-year students due to a shortage of teachers. Does the minister agree that the subject is crucial to young people’s future careers and, wherever possible, should not be compromised?

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

I absolutely agree that digital skills are crucial both for everyday life and for Scotland’s future economic prosperity. Indeed, only yesterday, I was at Tulliallan primary school, where I heard first hand about the work that is being done in a number of primary and secondary schools to develop young people’s digital skills through the digital schools awards programme.

We recognise that some councils are facing challenges in STEM teacher recruitment. That is why the Government has taken a number of actions to support further improvement in teacher recruitment. I mentioned some of those actions in my original answer. There is also, for example, work on-going with the University of Aberdeen to allow former oil and gas workers to train as teachers. There are the bursaries that I mentioned earlier, and we are also working with the University of Dundee, where we are looking at highly qualified graduates and career changers who specialise in science and technology and related subjects. This is an issue that the Government is determined to take more concerted action on.

Oliver Mundell (Conservative, Dumfriesshire)

There are some encouraging signs that uptake in highers and advanced highers is increasing in some science subjects, but in others, uptake is falling. What is the Scottish Government doing to improve uptake across the board?

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

We are doing a number of strands of work, as I mentioned earlier, on encouraging more young people—especially young women—to take up STEM subjects in school and then within apprenticeships, further education or higher education.

Most of the strands of work are detailed in the STEM strategy.

We are looking to inspire, and we are looking to connect the work that we are doing on inspiring young people all the way through early years, primary and secondary school subject choices with ensuring that those young people know about the exciting opportunities for them to access STEM careers at the end of that process.

Uptake of STEM subjects is something that the Government is taking action on with the Scottish Further and Higher Education Funding Council. In the STEM implementation group, we have representation from the Convention of Scottish Local Authorities and from the Association of Directors of Education in Scotland.

We are taking a whole-system approach in looking carefully at the challenges that we have in attracting more young people into STEM subjects. We want them to be able to see the opportunities that are undoubtedly out there for them.

Iain Gray (Labour, East Lothian)

How many people have signed up to the career changers and bursary programmes?

Shirley-Anne Somerville (Scottish National Party, Dunfermline)

There are a number of schemes that individuals can go on in universities that are about encouraging STEM teaching careers. Many of the schemes have started, and others are due to start in 2018. If Iain Gray would like detailed figures on the numbers of people who have started specific courses, I would be happy to extend that information to him. We can see the progress that we are making to date and who has signed up, but we want to encourage more people to take advantage of the courses that are due to start.

Education Governance (Island Proofing)

Tavish Scott (Liberal Democrat, Shetland Islands)

7. To ask the Scottish Government whether any changes that will be introduced to the governance of education will be island proofed. (S5O-02033)

John Swinney (Scottish National Party, Perthshire North)

Any changes that are proposed will be island proofed.

Tavish Scott (Liberal Democrat, Shetland Islands)

The cabinet secretary will be aware that Cunningsburgh primary school in Shetland has a headteacher who teaches. Shetland Islands Council advises me that

it is becoming increasingly difficult to recruit headteachers who also have to teach as part of their day-to-day responsibilities. Given that reality not just in Shetland but in other parts of the country, how will that work, in the context of island proofing, if the cabinet secretary plans to increase headteachers’ responsibilities?

John Swinney (Scottish National Party, Perthshire North)

This consideration applies in any circumstances, island or mainland, around the country: I want to ensure that young people can access the strongest quality leadership and learning and teaching in individual schools, because those two elements are the foundation of a successful education at local level. All reforms that we bring forward will be about strengthening leadership capability and ensuring that leadership has more support available to it, and about support also being available to enhance the quality of learning and teaching.

I understand the different circumstances of many schools in the constituency that Mr Scott represents. We will ensure that the steps that we take take due account of those considerations in the final design of our legislative proposals.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

Yesterday, a number of people protested outside Orkney Islands Council against proposed cuts to support for learning budgets, and the council has now decided not to proceed with those proposals. The cabinet secretary will be aware that because of their geography and demographics, island communities are often less able to collaborate and share among schools the costs of services such as support for learning. What provision is there to ensure that budgets that are assigned for support for learning are sufficient to meet local needs? Have ministers had any contact with Orkney Islands Council about its particular proposals?

John Swinney (Scottish National Party, Perthshire North)

To my knowledge, there has been no dialogue with the council about its proposals, but they are ordinarily and properly a matter for Orkney Islands Council to consider.

Mr Halcro Johnston asked about the challenges of collaboration in island communities. In my view, the best example of interauthority co-operation on education policy is the northern alliance, which includes Orkney Islands Council. What I have detected from talking to practitioners around the north of Scotland is that they are feeling the benefit of that, particularly on strengthening learning and teaching, which is facilitated by that co-operation among a number of authorities. The smaller and more remote local authorities are benefiting enormously from co-operation with other authorities. There is, therefore, good work going on in that respect, and it is work that pays proper respect to the democratic interests and perspective of Orkney Islands Council, and enables the council to co-operate with others to enhance education provision for the young people of Orkney.

Teachers (Pay Campaign)

Anas Sarwar (Labour, Glasgow)

8. To ask the Scottish Government what its response is to the Educational Institute of Scotland’s campaign value education, value teachers, which is calling for a restorative pay rise for teachers. (S5O-02034)

John Swinney (Scottish National Party, Perthshire North)

We value Scotland’s teachers highly. We are committed to taking an active role in the current discussions through the Scottish negotiating committee for teachers and I urge everyone round the table to take a constructive approach. This Government is the first anywhere in the United Kingdom to commit to lifting the 1 per cent public sector pay cap, and the teachers’ pay deal for 2017-18 is an example of that.

Anas Sarwar (Labour, Glasgow)

The truth is that, under Scottish National Party management, our teachers have seen their pay go from among the highest in the Organisation for Economic Co-operation and Development countries to well below the average. As well as that, they are now teaching some of the biggest classes in Europe. The Government has cut 4,000 of their colleagues and has managed to create a teacher recruitment crisis

. When will the cabinet secretary accept that it is not divisive reforms that our teachers need, but the pay that they deserve, and support and resources to do the job that they do so well in difficult circumstances?

John Swinney (Scottish National Party, Perthshire North)

I remind Mr Sarwar that we have been living in a period of fiscal austerity that has been applied by United Kingdom Governments going back to when his party was in power before the 2010 election. It is all very well for Mr Sarwar to come here and talk about pay constraint, but pay constraint was applied by the Labour Government when it was in office because of the financial crisis that it presided over in the aftermath of 2008. It is not easy to hear Mr Sarwar come here with his simple solutions to the problem.

I am committed to substantive negotiation with the teaching profession. As I said in my original answer, our work in 2017 has seen us deliver a pay deal for teachers that has moved outwith the pay caps that have been in place, and I welcome that. We are committed to putting in place support and assistance to enhance the teaching profession, because I want teaching to be an attractive career. I remind Mr Sarwar that, over the past 12 months, the number of teachers in post in Scotland has increased by 543, which is very welcome.

Early Learning and Childcare (Funding)

James Dornan (Scottish National Party, Glasgow Cathcart)

9. To ask the Scottish Government what progress has been made with the Convention of Scottish Local Authorities regarding funding for increasing the provision of early learning and childcare to 1,140 hours per year. (S5O-02035)

I suspect that I know the answer.

Maree Todd (Scottish National Party, Highlands and Islands)

On 27 April, the Scottish ministers and COSLA leaders reached a landmark agreement on a multiyear revenue and capital funding package for the expansion of early learning and childcare. The agreement, which is the culmination of more than two years of hard work by local authorities and the Scottish Government, represents a shared understanding of the costs that are required to deliver the expansion in entitlement to funded early learning and childcare to 1,140 hours from August 2020. It is evidence of real partnership working to deliver a shared ambition to give all our children the best start in life. Under the agreement, the Scottish Government will provide local authorities with additional recurring revenue funding of £567 million per year by 2021-22, which will be the first full financial year of the expansion. In addition, the Scottish Government will provide local authorities with capital funding of £476 million over four financial years, from 2017-18 to 2020-21 inclusive.

James Dornan (Scottish National Party, Glasgow Cathcart)

I congratulate the minister on her role in reaching that landmark deal with local government, which will ensure that our children get the best possible start in life. Will she outline how the expansion will deliver the flexibility that parents need to support them in work or training, and will she say whether she thinks that flexibility is already improving?

Maree Todd (Scottish National Party, Highlands and Islands)

I believe that the simple increase in the number of hours available to parents will make a massive difference to every family in the land. It will save £4,500 per year per child for each family. The funding follows the child model, which is underpinned by the national standard, will be a provider-neutral means of delivering flexibility to parents, which will absolutely transform their opportunity to work and to pursue education.

Aberdeenshire Council (Meetings)

Mike Rumbles (Liberal Democrat, North East Scotland)

10. To ask the Scottish Government when the education secretary last met the director of education and children’s services for Aberdeenshire Council. (S5O-02036)

John Swinney (Scottish National Party, Perthshire North)

I last met the director of education and children’s services for Aberdeenshire Council on 7 March.

Mike Rumbles (Liberal Democrat, North East Scotland)

Will the cabinet secretary meet the new director when they are appointed and discuss with them the overall state of staff morale in our schools in the north-east? Will he outline today what, specifically, he can do to improve staff morale?

John Swinney (Scottish National Party, Perthshire North)

I am happy to engage with Mr Rumbles about his perspective on those matters but, when I go around schools, I meet teachers who are positive and utterly motivated by the work that they are doing to educate young people. I was in Smithycroft secondary school in Glasgow this morning, where the staff and leadership team are buoyant about the condition of Scottish education.

We are taking a range of different measures to enhance the recruitment of teachers in the north-east of Scotland, including some of the new routes into teaching that we are developing. We are directly supporting the delivery of education, and Aberdeenshire Council is benefiting to the tune of £3 million in pupil equity funding into its schools.

If Mr Rumbles has particular concerns, I am happy to consider them and to do what I can to address them with the director of education at Aberdeenshire Council when they are appointed after the retirement of Maria Walker.

Young People (Rights)

Ivan McKee (Scottish National Party, Glasgow Provan)

11. To ask the Scottish Government how it enshrines the rights of young people, and how it plans to further embed these. (S5O-02037)

Maree Todd (Scottish National Party, Highlands and Islands)

We are committed to enhancing children’s rights in all aspects of Scottish life. The Children and Young People (Scotland) Act 2014 places specific duties on all ministers to consider steps that might give better or further effect to the United Nations Convention on the Rights of the Child. Those provisions take us further than any previous Scottish Government. We continue to look for opportunities, issue by issue, to apply the principles of the convention when we consider it right and proper to do so, for example, in raising the minimum age of criminal responsibility from 8 to 12 years old, and in supporting Mr Finnie’s proposals to introduce a legislative ban on the physical punishment of children.

It is fitting that, in the year of young people, which is a global first, we have commenced a comprehensive audit of the most effective and practical way to further embed the principles of the UNCRC into policy and legislation, including the option of full incorporation into domestic law.

Ivan McKee (Scottish National Party, Glasgow Provan)

Will the minister outline the Scottish Government’s position on the right of young people to opt out of religious observance in schools? Will the forthcoming education and governance bill enshrine that right?

Maree Todd (Scottish National Party, Highlands and Islands)

As Mr McKee might be aware, the Scottish Government’s statutory guidance on religious observance, which was amended in March 2017, states:

“schools should include children and young people in any discussions about aspects of their school experience, ensuring their views are taken into account.”

The law currently provides a right for

“parents to withdraw their children from participation”

in religious observance. The statutory guidance makes it clear that local authorities must ensure that pupils’ view are taken into account, rather than providing pupils with a direct opt-out. The Scottish Government’s view is that pupils’ views should be supported to make their views and preferences clear. Ministers are open to exploring the best way to give effect to children’s rights, as expressed under the UNCRC. However, any changes to the current statutory position would need to be subject to full consultation with all key stakeholders.

Newbattle High School (Digital Centre of Excellence)

Colin Beattie (Scottish National Party, Midlothian North and Musselburgh)

12. To ask the Scottish Government whether it will provide an update on the development of the Newbattle high school digital centre of excellence. (S5O-02038)

John Swinney (Scottish National Party, Perthshire North)

The development of a digital centre of excellence as part of the new high school in Newbattle is an initiative of Midlothian Council. I commend the collaborative approach that is being taken by the council in seeking to ensure that young people across all Midlothian secondary schools have access to specialist digital learning and a diverse range of pathways to follow into digital jobs. I am aware of a funding shortfall for the digital centre of excellence at the new school and have asked my officials to explore opportunities for supporting the project’s progress.

Colin Beattie (Scottish National Party, Midlothian North and Musselburgh)

The cabinet secretary will be aware that Newbattle high school’s catchment area has too many pockets of relative deprivation. Does he agree that all those involved in the creation of the centre should be congratulated on this groundbreaking and forward-thinking initiative, which will have a considerable positive effect on the life chances of young people in the area?

John Swinney (Scottish National Party, Perthshire North)

Yes, I agree. It is an excellent initiative by Midlothian Council. It recognises the need to ensure that there are clear pathways for young people to access education and have links into the world of work.

It fits comfortably into the developing Scotland’s young workforce agenda and, as I indicated in my earlier answer, I am very keen to see whether there is any way in which we can be of assistance.

Music Tuition (Schools)

Elizabeth Smith (Conservative, Mid Scotland and Fife)

13. To ask the Scottish Government what discussions it is having with local authorities regarding the provision of music tuition in schools. (S5O-02039)

John Swinney (Scottish National Party, Perthshire North)

The Scottish education system devolves decision making to the most appropriate level, which enables local education authorities to make choices that meet their local circumstances and needs. I am, however, concerned about the decision by a number of local authorities to reduce access to instrumental music tuition for young people. I have asked my officials, while respecting the autonomy and responsibility of councils, to assess the impact and identify ways of working with key stakeholders to ensure that instrumental music tuition remains accessible in the future.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

Local authorities of all political persuasions are having great difficulty on the issue. What is the timescale for your working group to report to Parliament? As you rightly say, it is a very urgent matter.

John Swinney (Scottish National Party, Perthshire North)

There is work under way that has been led by John Wallace, who was formerly the principal of the Royal Conservatoire of Scotland. I look forward to meeting the members of the music education partnership to discuss their thinking on this matter. It is an issue in which both I and the

Cabinet Secretary for Culture, Tourism and External Affairs are actively involved. I do not have a specific timescale to offer Liz Smith, but I assure her that I will be happy to engage in dialogue with members of all political persuasions to ensure that this important characteristic of education in Scotland is available for young people across our country.

The Presiding Officer

That concludes portfolio questions.

National Health Service (Financial Accountability)

Kenneth Macintosh (Labour, West Scotland)

The next item of business is a debate on motion S5M-11984, in the name of Miles Briggs, on national health service financial accountability. I urge members who wish to speak in the debate to press their request-to-speak buttons—whenever they wish, or as soon as possible.

For members’ interest, I note that the Scottish Conservative Party has asked to use the new flexibility in debate management to increase its number of speakers from three to four. That means that Conservative speakers will have one minute less: they will have five-minute rather than six-minute speeches. However, we have quite a lot of time available over the afternoon, so I encourage all members to take interventions.

Miles Briggs (Conservative, Lothian)

Our Scottish national health service faces many challenges. I believe that it is the job of all of us in this Parliament to work to create a sustainable and financially secure NHS for Scotland.

Recent weeks have demonstrated the level of financial mismanagement in our NHS that the Scottish National Party Government has presided over. Perhaps the most obvious example has been the scandal in NHS Tayside, which brought the issue to the public’s attention in the most shocking of ways, when it was revealed that NHS Tayside had taken more than £2 million from its charitable endowment fund. Donations from the public or from bequests in wills were being used simply to help to cover the day-to-day running costs of that health board.

The current financial situation in NHS Tayside is one that Audit Scotland has, over a number of years, highlighted as “high risk”. According to Audit Scotland, NHS Tayside must make more than £205 million of savings over the next five years, and it has overspent in areas such as workforce costs, prescribing and clinical supplies.

The situation in Tayside is shocking, but that board is far from on its own. Last week, my health board of NHS Lothian revealed to the Parliament’s Health and Sport Committee that it will require £31 million just to stand still at 2017 levels. NHS boards are queuing up at the door of the Cabinet Secretary for Health and Sport to beg for financial brokerage just to be able to keep delivering the health and social care services that people across Scotland rely on.

It is worth reflecting that, when the SNP Government entered office in 2007, Audit Scotland noted that the Scottish NHS had a budget surplus of £50 million. Today it is predicted that our Scottish NHS could be overspent by more than £400 million, and it is struggling to find the cuts that it needs to bridge the current gaps. All that comes despite the Scottish Government receiving additional Barnett consequential funding from the UK Government of more than £2.45 billion.

Presiding Officer, for every MSP in this Parliament, it must often seem that every warning light is lit on NHS Scotland’s dashboard. NHS Scotland has failed to meet seven out of 10 key waiting time targets. More than a quarter of children who are waiting for mental health services are waiting too long—some for up to a year. More than one in eight cancer patients is waiting more than 62 days for urgent treatment. One in four general practices in Scotland has a vacancy. A number of GP practices have been taken over by health boards because of staff shortages. Nearly one in 10 GP surgeries in Scotland is turning away new patients. There are more than 400 vacant consultant posts and more than 2,500 vacant nursing and midwifery posts.

Gillian Martin (Scottish National Party, Aberdeenshire East)

What impact will Brexit have on NHS staffing?

Miles Briggs (Conservative, Lothian)

That is a very interesting point, because, 11 years into the SNP Government, Brexit is the excuse. The First Minister has cut training places. Any vacancies in our Scottish NHS are the result of decisions by the SNP Government—no one should forget that.

Care homes across Scotland, which provide care, are closing at a rate of one per month. Just yesterday, figures were published that showed that instances of delayed discharge of patients have increased by 11 per cent from February. Delayed discharge has a huge impact on people’s lives when they are stuck in hospital and unable to get home, or when the appropriate care package cannot be put in place.

Graeme Dey (Scottish National Party, Angus South)

Will the member take an intervention?

Miles Briggs (Conservative, Lothian)

I would like to make progress, but I will come back to the member later.

The Cabinet Secretary for Health and Sport will be acutely aware of the cases—I have raised them with her a number of times—of my constituents in Lothian who are stuck in hospital, sometimes for hundreds of days, and are unable to get in place the care package that they need. The increasing level of delayed discharge is a significant indicator of a crisis in our health and social care services, and the crisis is increasing in many communities.

John Scott (Conservative, Ayr)

Does the member agree that it is absolutely appalling that 33,000 bed days have been lost in NHS Ayrshire and Arran in the past year? Can he tell me the overall number of bed days that have been lost due to delayed discharge across the health service in Scotland? [

Interruption

.]

Miles Briggs (Conservative, Lothian)

SNP members do not like to hear the truth for some reason.

Such stories are a shocking indictment of the SNP Government’s record in charge of our health and social care services.

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

Will the member take an intervention?

Miles Briggs (Conservative, Lothian)

No. I want to make some progress.

The issue is not just about numbers on a spreadsheet; it is about people’s lives—the lives of our fellow Scots and loved ones. The cabinet secretary and the SNP Government must get a grip of the situation.

That is why the Scottish Conservatives have called for specific action and for the strengthening of the Parliament’s oversight and scrutiny of our NHS finances. That is why we have called in our motion for the cabinet secretary to publish the full details of the current financial position of every NHS board and integration joint board, which is information that I believe we should all have. The Scottish Government should commit to provide Parliament with monthly updates.

I welcome the email that the cabinet secretary sent to me at half past 12 today, which accepted those very points and outlined how she will take forward enhanced reporting of NHS finances, which will begin in June. I have other asks that I will be making beyond that.

Perhaps the most concerning issue that we should be highlighting today is that the financial crisis in our NHS that is being faced by the 31 integration joint boards has yet to be revealed.

Graeme Dey (Scottish National Party, Angus South)

Among other things, the Conservative motion talks about IJB finances and being held to account. Will Miles Briggs join me in condemning the actions of Angus Council, which has failed to pass on to the local IJB more than £1 million of an additional £1.56 million that was provided by the Scottish Government to support health and social care activities? Does he agree that the ruling coalition in Angus Council, which includes Conservative councillors, should be held to account for depriving the IJB and my constituents of much-needed funding?

Miles Briggs (Conservative, Lothian)

That is why we are debating the issue today. The member needs to understand the problems that are faced by the health and social care sector in Scotland.

We all agree that the integration of health and social care is the right direction of travel to ensure that people receive the vital care that they need at the right time and in the right place, with a focus on community-based and preventative care models.

However, the cabinet secretary and Graeme Dey need to be clear that the SNP reform is not delivering and that there are growing concerns, which the member has outlined, from those who sit on IJBs and take the decisions. That includes many SNP councillors across Scotland, some of whom have contacted me about the role, the remit and the effectiveness of the decisions that are being taken—even SNP councillors have given up on the Government.

The integration joint boards are now responsible for almost £8.73 billion of taxpayers’ spending on our health and social care services, yet the financial accountability and reporting within IJBs is inconsistent and erratic at best.

Fulton MacGregor (Scottish National Party, Coatbridge and Chryston)

Will the member take an intervention?

Miles Briggs (Conservative, Lothian)

No. I want to make some progress.

Increasingly, the budget pressures that IJBs face are directly influencing their decision making in relation to proposals such as cutting mental health beds and services.

Audit Scotland has called on the Scottish Government to make fundamental decisions about how services are provided. I welcome the Government’s acceptance that we need greater financial accountability in relation to IJBs, but I believe that we need to take time now to make sure that they are truly fit for purpose. This is a major reform that the Parliament passed in the previous session, and we need to ensure that it is fit for purpose for our communities in this session. Scottish Conservatives, therefore, have also asked in our motion for the cabinet secretary to commit to a review of the integration joint boards in order that we can not only fully understand their current financial position but look to how effective they have been and what future reforms are needed. We cannot and will not just stand on the sidelines and watch a crisis in social care in Scotland build ever greater.

I did not want to make this debate personal. I believe that the future of our NHS and its financial sustainability are too important for that. [

Interruption

.] As I have said, in recent weeks—perhaps SNP members should start to listen—when Labour and the Liberal Democrats have called for the cabinet secretary to be sacked, I have not gone down that road. The truth is that I do not think that there is anyone on the SNP benches who could step up to the challenge. We have had a look around the cabinet secretary. Fergus Ewing—is he in today?—has presided over the farm payments fiasco. Our once world-class education system has declined under Angela Constance and John Swinney. Further, where do we start with regard to Michael Matheson and the problems and issues that are facing Police Scotland and the SNP’s centralising agenda?

The question is, who on the SNP benches thinks that they can do any better? I ask them to put up their hand if they think that they can. Anybody?

Christina McKelvie (Scottish National Party, Hamilton, Larkhall and Stonehouse)

rose—

Miles Briggs (Conservative, Lothian)

I did not have her in mind, but—

Christina McKelvie (Scottish National Party, Hamilton, Larkhall and Stonehouse)

On a point of order, Presiding Officer. I am interested to hear what the Conservatives say in the debate, but personal attacks, personal slights on members of this Parliament and bringing down the reputation of this chamber are not what we should be hearing from the Tories today. I would like Mr Briggs to speak to his motion instead of impugning the reputations of members in this chamber.

The Presiding Officer

I am alert to any personal attacks that take place. However, there is some room for robust exchanges and, on this occasion, I think that the remarks were within those bounds. Nevertheless, I encourage all members to keep to the substance of the debate and not to personalities.

Miles Briggs (Conservative, Lothian)

I will be clear to the cabinet secretary. The mismanagement and financial chaos that are facing our NHS cannot continue. They are impacting the morale of our health service staff. That is exactly why the Scottish Conservatives are putting the SNP Government on notice over its handling of the financial crisis that faces Scotland’s health boards.

There is a need for action to prevent the next major financial crisis in the integration joint boards from happening.

The two critical issues that face our Scottish NHS have developed on the SNP’s watch over the past 11 years, and we now need a Government that will get a grip of the dire situation that has been created. That is why I believe that the Parliament needs to seek the urgent action that we propose. We must return our NHS to a secure and sustainable financial footing.

I move,

That the Parliament notes the financial problems in NHS Ayrshire, Tayside and Lothian; understands that these issues are being faced across Scotland; notes the ongoing lack of transparency on the state of board and integration joint board finances; calls for the immediate publication of the current financial position for all NHS bodies and for a progress review of integration joint boards, and believes that, failing sustained and immediate action, the Cabinet Secretary for Health and Sport should be held accountable for the ongoing problems.

Shona Robison (Scottish National Party, Dundee City East)

I will start by saying that I am immensely proud of our NHS. Our staff do an excellent job day in and day out. They often go the extra mile, as witnessed during the severe winter weather, when heroic efforts were made to get to work to keep patients safe. Further, with our world-leading patient safety programme, we have one of the safest systems in the world, with international interest in how that has been achieved. The vast majority of patients get a fantastic and timely service, and the fact that patient satisfaction levels are higher than ever—with 90 per cent of Scottish in-patients saying that their hospital care and treatment was good or excellent—suggests that that is the case.

I have no problem being held accountable for our NHS. That is my job. Is it a perfect system? No, it is not. Sometimes, in a system that is the size and scale of the NHS, things go wrong, and I am sure that we will hear examples of that today. However, in each of those cases, what is important is that there is an openness to reflect and learn from them, which the new duty of candour encourages.

On the point about patient safety, members may be aware that news is emerging of a breast screening error that affects 450,000 women in England. Jeremy Hunt has just made a statement to the House of Commons on the matter. Given the significant public interest in it, I reassure members and the public that the issue does not affect the NHS in Scotland. Patients should be reassured that there are no problems with our breast screening programme records or information technology systems. As usual, all women should continue to be aware of changes to their breasts and, if they have any concerns, should see their general practitioners. Scottish Government officials will work with Public Health England to identify any women affected in England who have subsequently moved to Scotland.

Like every health system in these islands and beyond, our NHS sometimes struggles to cope with rising demand. Despite record high NHS staffing—it is up by more than 13,000—our performance on key targets is not what I would want it to be. Although Scotland’s core accident and emergency services have been the best performing in the UK for more than three years and are 10 per cent better than they were three years ago, some sites still struggle and need to improve. Although there is now a downward trend in delayed discharge, with a reduction of 7 per cent in total bed days lost compared to the previous year, there is still much work to be done, especially in areas such as Lothian. That is why we are driving forward investment in, and reform of, our NHS to meet the rising demand and challenges now and into the future.

Miles Briggs (Conservative, Lothian)

In 2014, the cabinet secretary stood where she is and said that she would achieve zero delayed discharges in our hospitals. When will that target be met?

Shona Robison (Scottish National Party, Dundee City East)

Miles Briggs is absolutely right. I want to eradicate delayed discharge, but it is a difficult thing to do. He alluded to some of the challenges earlier on. Integration joint boards work hard, but there is huge variation in performance on the matter. For example, delay has almost been eradicated in Glasgow, whereas in areas such as Edinburgh it has not. A new chief officer is in place who will do a fantastic job in that domain. I do not underestimate the scale of the problem, and good ideas are always welcome, wherever in the chamber they come from.

On investment in the NHS and care services, I turn to the financial issues in the motion. I am more than happy to address them. Ensuring that there are sufficient resources in the NHS is something that I do every day. The Scottish Government’s budget for 2018-19, supported by the Greens, delivered additional investment in health of more than £400 million. That takes the resource budget to £13.1 billion. The Government remains on track to deliver its commitment to increase health resource spending by £2 billion by the end of this parliamentary session.

It is clear that that level of investment has been made possible without impacting on other public services only through the progressive tax policies that we have implemented. Health spending has been £360 million more than inflation since 2016-17. Had we not taken the budget decisions that we have done, the resources that are available to our health and care services would have been considerably less.

Mike Rumbles (Liberal Democrat, North East Scotland)

The cabinet secretary will be aware that, as I have pointed out before, over the past 10 years, NHS Grampian has been short-changed by £165 million from her target figures. That difference is being reduced now, but will NHS Grampian ever get that money back?

Shona Robison (Scottish National Party, Dundee City East)

As I have said to Mike Rumbles on a number of occasions, NHS Grampian is one of the biggest gainers from the NHS Scotland resource allocation committee formula and it gains again this year.

I turn to the Tory motion. If the Tories are suggesting that the health and care budget is inadequate, which I think that Miles Briggs suggested in his speech, they have a responsibility to set out what level of funding they propose and how it would be funded, particularly in the light of their opposition to the progressive use of taxation. Under the Tory tax plans, there would have been £500 million less available for public finances, including the NHS. Therefore, Miles Briggs has a responsibility to address that. Perhaps in the Tories’ closing speech, we will hear about the level of resources that they think the NHS should have and where they would come from.

Many of the areas that Miles Briggs raises in his motion are areas on which I have been engaging with the Health and Sport Committee for some time. In response to the financial issues raised and the asks made in the Tory motion, I have today written to the committee, providing information on the first round of consolidated financial reports for integration authorities, an update on NHS boards’ financial performance, and the development of a medium-term financial framework for health and social care. I have agreed to review the progress of the integration authorities, and I believe that that is best done through the ministerial strategic group. I am happy to share with the Health and Sport Committee the outputs and any further actions that arise from that.

I have also set out my proposal to provide monthly information on NHS boards’ financial performance for 2018-19. Data for boards’ first formal reporting period for the financial year will be available in June, and we will report monthly thereafter to the Health and Sport Committee. I hope that Miles Briggs and others agree that what has been set out is a reasonable proposal to address the concerns raised in the motion and to provide greater transparency and accountability to this Parliament.

In responding to the recommendation from the Auditor General for Scotland, I have committed to publish a medium-term financial framework, which will take account of key programme for government commitments, along with an understanding of the financial environment and the approach required to ensure financial sustainability. That framework will be published in the coming weeks and will set out clearly the environment in which we are operating. In particular, it will set out longer-term funding needs. I am confident that the publication of the framework will play an important part in giving greater clarity to NHS boards and integration authorities as they develop plans for the coming years, and it supports the principle asked for by the Greens.

Miles Briggs (Conservative, Lothian)

As I said in my speech, I welcome the fact that the Government has accepted the reforms and has accepted the terms of our motion. Can the cabinet secretary tell Parliament what NHS Scotland’s level of overspend actually stands at today? Does she have that figure?

Shona Robison (Scottish National Party, Dundee City East)

We will get financial data for the first two months of 2018-19 at the end of June. I am sure that, like me, Miles Briggs wants accurate, robust information, so I say that the health finance reporting cycle has data for the first two months of the financial year published in June. That is how it happens every year. That will be made available to the Health and Sport Committee and then there will be monthly reporting thereafter.

Miles Briggs (Conservative, Lothian)

Will the minister also publish data on past years’ situations? It is important that the Parliament see the direction of travel as well.

Shona Robison (Scottish National Party, Dundee City East)

I am happy to provide that information. The 2017-18 position has already been made available to the Health and Sport Committee, but if there is any more information that I can provide I will be happy to do that. I want to meet the needs of the Parliament in terms of the budget scrutiny process.

The Auditor General has previously called for greater financial certainty for NHS boards, so I will say at this point that a UK multiyear funding settlement—as has been proposed by the Prime Minister, no less—along with this Government’s commitment to pass on all health consequentials, will go a long way to providing our health and social care partners with the greater certainty of funding that they need.

I welcome the opportunity to discuss with members the steps that we are taking at a local level in response to governance and accountability issues. I have given a detailed statement in Parliament setting out my response to the issues at NHS Tayside, and the details on the investigations will be scrutinised by the Public Audit and Post-legislative Scrutiny Committee in the coming months. It will be important that all parties take stock following those reviews, and that we all learn lessons from the situation in Tayside and make improvements for the future.

I set out in my statement that we would be receiving returns from all boards by 30 April. I can, however, confirm that all boards that hold endowment funds have now responded to a letter from the director general for health and social care about their approach to, and use of, endowment funds. Those responses have been passed to the Office of the Scottish Charity Regulator to review, but I can confirm today that there was nothing in the responses that is a cause for concern and that no boards are showing retrospective use of endowment funds in order to improve their financial position, as happened in Tayside. The returns have now been passed to OSCR for external scrutiny and review. I will ensure that any recommendations from OSCR in relation to the future governance arrangements of endowment funds are fully supported.

In my time as Scotland’s health secretary, spending on health has seen the largest increase of any country in the UK, and Scotland has had the largest increase per head on health spending in the UK. I will always fight for the best interests of our NHS. Reform of the NHS is equally as important as investment in it. I have set in train a huge range of actions to make the improvements that we need to see, both now and into the future, including the new primary care workforce plan, published on Monday, which will sit alongside the previous two workforce plans.

There is much in our NHS and care services to be proud of, but I am not complacent. That is why I have set out the range of actions that are already under way. I have listened to calls for greater transparency around finances and I have agreed to the actions to deliver that. That is why this Government will continue its approach of meeting the challenges that we face, delivering sustained improvement and serving the people of Scotland, now and for the years and generations ahead.

I move amendment S5M-11984.4, to insert at end:

“; supports calls for the implementation of any recommendations from the Office of the Scottish Charity Regulator (OSCR) on the future governance arrangements for NHS board endowment funds; notes the Scottish Government’s commitment to publish a financial framework for health and social care, in line with the recommendations of the Auditor General, following publication of the Scottish Government’s forthcoming medium-term financial outlook; believes that the Health and Sport Committee should have the opportunity to consider the framework to give further parliamentary oversight to the finances of boards and integration authorities; recognises that progressive financial and fiscal planning is necessary to ensure investment in Scotland's health, care and wider public services, and believes that the UK Government should set out its long-term plans for health and care funding in advance of the 2019 UK Spending Review, and that all health resource consequentials from this should be passed on in full in Scotland.”

Anas Sarwar (Labour, Glasgow)

Another week, and more appalling figures on the performance of the Cabinet Secretary for Health and Sport. This is not a one-off; it is the latest in a series of failures by this cabinet secretary. Although the Tory motion and the Government amendment focus on the financial impact, which is an important issue, both ignore the human consequences: the consequences for NHS staff, who continue to go above and beyond, and for NHS patients, who are being let down by the failings of this Government.

Every time that there is a failure, we get the same old warm words and tired excuses from this health secretary when, year on year, her performance is declining. The declining performance on workforce includes more than 3,000 nursing vacancies; one in three GP practices reporting a vacancy, with GP practices closing lists and some closing down; hundreds of consultant vacancies; and a doubling in the rate of early retirement on the health secretary’s watch.

Shona Robison is right to thank the staff, but her thanks are not enough. We cannot continue to overwork, underresource and undervalue staff without there being human consequences. We heard last week from the British Medical Association and the Royal College of Paediatrics and Child Health that, such is the pressure on staff, there are now real fears over patient safety. Members should not forget that it was the cabinet secretary’s best friend, Nicola Sturgeon, who as health secretary cut the number of nurse and midwife training places. We are now living with the dangerous consequences: our NHS is in the midst of a workforce crisis, for which Shona Robison must take responsibility.

I turn to the failure over delayed discharge. In February 2015, Shona Robison promised:

“I want over the course of this year to eradicate delayed discharge ... and I am absolutely determined to do that.”

However, since that promise, more than 1.6 million bed days have been lost to delayed discharge and that has cost the NHS £380 million. Worse than the financial cost has been the human cost. More than 1,000 patients have died while trapped in hospital as a delayed discharge—another failure of this health secretary.

Cancer is a national priority. In the past year,

more than

1,700 people who were suspected of having cancer had to wait longer than the expected treatment standard. Even after being referred for treatment by doctors, more than 1,200 people with cancer had to wait longer than the expected treatment standard. Those are shocking figures that expose the failure of this health secretary. Today, unbelievably, the health secretary has sneaked out the report that I am holding up, which shows that, rather than improving its performance, the Government’s plan is to scrap the waiting time standard for cancer. That is shameful behaviour from a shameless health secretary. [

Interruption

.] I am holding the report here, and the cabinet secretary wrote the foreword. There was no press release alongside it—it was snuck out today.

So far in 2018, in our A and E departments, more than 52,000 people have waited longer than four hours. More than 7,000 have waited longer than eight hours. Unbelievably, almost 2,000 have waited for more than 12 hours. That figure is the same as the figure for the whole of 2017—another failure of this cabinet secretary.

To date, more than 3,000 operations have been cancelled in 2018 due to capacity or non-clinical reasons because hospitals could not cope. That is the consequence of the health secretary’s workforce crisis. On the ambulance service, last week, Richard Leonard shared the terrible story of Margaret Goodman, but we know that that is not an isolated case. In 2017, more than 16,000 people waited more than an hour for an emergency ambulance. That is 16,000 emergency patients failed by Shona Robison.

On budgets, health boards are having to make more than £1 billion-worth of cuts over the next four years. In the health secretary’s own backyard, NHS Tayside is having to make £200 million-worth of cuts over the next five years. The result is the health secretary’s own health board taking money from charitable donations to support an IT system because of budget cuts imposed on it by the health secretary.

So many people have been failed—3,000 on operations, 16,000 ambulance patients, 52,000 in A and E, 1,200 on cancer waiting times and 1,700 who have been suspected of having cancer. Some 1.6 million bed days have been lost to delayed discharge. She owes not just one apology but thousands of apologies to patients across the country, yet there is no shame, no accountability and no responsibility from Shona Robison.

The uncomfortable truth is that it is not just Opposition parties, NHS staff and patients who have lost confidence in her. Even SNP back benchers are now briefing the media and calling on Shona Robison to go. We have the bring back Alex Neil campaign, led by Alex Neil, and we even have Jeane Freeman telling the media about how brilliant Jeane Freeman would be as the health secretary. In fact, it appears there are only two people in the chamber who do not think that Shona Robison should go: Nicola Sturgeon and Miles Briggs. Although I understand why the Tories would not want to talk about failing Government ministers resigning, who would have thought that it would be they who provided a fig leaf for the failings of Shona Robison?

Miles Briggs (Conservative, Lothian)

Will the member take an intervention?

Anas Sarwar (Labour, Glasgow)

I am in my last 30 seconds, so I will not.

Christine Grahame (Scottish National Party, Midlothian South, Tweeddale and Lauderdale)

You can if you wish. There is some extra time.

Anas Sarwar (Labour, Glasgow)

I am happy to take the intervention.

Miles Briggs (Conservative, Lothian)

How many times has the member called for the cabinet secretary to go? At the last count, I think that it was 11. Is that effective opposition?

Anas Sarwar (Labour, Glasgow)

I think the interesting stat is the number of the health secretary’s constituents who want her to go. Let us talk about that. A poll for

The Courier

showed that 73 per cent of people in Dundee want the cabinet secretary to go.

Scotland’s NHS needs change that starts right at the top of the organisation, because the First Minister has misplaced loyalties. Her loyalty should be to Scotland’s NHS, not to her friend. I ask the First Minister to do the right thing for NHS staff and patients and, for the sake of Scotland’s NHS, sack this failing health secretary. [

Interruption

.]

I move amendment S5M-11984.1, to insert at end:

“; further believes that all NHS boards are experiencing financial pressures, which are added to by a need to deliver financial efficiencies; notes the patient care issues that are being experienced by boards across Scotland, as evidenced by consecutive Audit Scotland reports showing that seven out of eight key performance standards, including cancer waiting times, are not being met; understands that BMA Scotland believes that many staff are ‘under pressure like never before’, and considers that, as well as financial accountability, the Cabinet Secretary for Health and Sport should be equally accountable for the staffing and patient care issues that are being experienced in Scotland’s health service.”

The Deputy Presiding Officer

Thank you. I call—[

Interruption

.]

Mr Arthur, nobody can hear me calling the next speaker because you are being so noisy. I call Alison Johnstone.

Alison Johnstone (Green, Lothian)

I regret

that we are being called on to address the financial problems that are facing NHS boards. In October, Audit Scotland’s annual report on the NHS warned of “intensifying” pressures on our health service. It told us that financial balance is

“becoming harder to achieve each year”

and that current approaches to making savings are “unsustainable”.

Since then, new issues have come to light, not least the inappropriate transfer of e-health funds in NHS Tayside. We must therefore turn to the matter of charity endowment funds being misused, and to financial difficulties that stretch way beyond Tayside. Many boards require brokerage, and in my health board—NHS Lothian—there is an indication that there is a £31 million gap in funding, as we have heard.

The picture is not uniform, but throughout Scotland there are boards that are struggling with delayed discharges, boards that continually fail to meet child and adolescent mental health services targets and boards where ambulance response times are not adequate. As the Royal College of Paediatrics and Child Health has highlighted, paediatricians, too, are under huge pressure. It advises that we need an additional 110 paediatric consultants over the next five years just to make sure that sick children get the care that they need.

All that raises the most serious questions about oversight and governance of our health service and social care system. However, we cannot place on health boards and IJBs additional pressure to restore financial balance by making unsustainable short-term cuts to spending and services. Labour’s amendment is right to emphasise that financial pressures can be

“added to by a need to deliver financial efficiencies”.

As the Government’s amendment acknowledges, we need to address funding pressures at their root with

“progressive financial and fiscal planning”,

which

“is necessary to ensure investment in Scotland’s health, care and wider public services”.

NHS boards must be given a greater ability to deliver long-term budget planning. My amendment, which was not selected for debate, called for that.

Audit Scotland has often recommended a longer-term approach to financial planning across the health service. Last year, it said:

“driven by one-year funding allocations from the Scottish Government, and the need to break even each year ... a short-term approach ... makes it difficult for boards to plan and invest in longer-term policy aims”,

which are aims that we all share.

I know that the Government intends to introduce a financial framework for health and social care, but boards need more adaptability in their own right. In 2016, Audit Scotland recommended

“providing NHS boards with more financial flexibility, such as three-year rolling budgets rather than annual financial targets”.

It has also suggested reducing the pressure on boards to break even each year. It has stressed that

“Even a small amount of flexibility at financial year-end ... can make a difference.”

In November, the Health and Sport Committee published its report looking ahead to the draft budget. Many witnesses for that report stressed the need for a more sophisticated budget process. The Convention of Scottish Local Authorities said:

“A short-term input-focused budget process is an inhibitor to genuine reform.”

The Royal College of Nursing Scotland said that

“the constant annual cycle requiring budgets to break even does not allow a step change”.—[

Official Report, Health and Sport Committee,

12 September 2017; c 5, 45.]

We all seek that step change, which is desperately needed. I urge the cabinet secretary to act on that advice.

The committee’s report also found that scrutiny of integration authority budgets proved

“very challenging as there is little by way of information available on IA’s financial position even at the most basic level.”

Given that astonishing lack of transparency, I agree that it is wholly appropriate to hold a progress review of integration joint boards. We must afford Parliament greater opportunity to scrutinise the financial reporting, external audit and governance of the health service and social care system. My amendment would, had it been selected for debate today, have called directly for such additional scrutiny. As part of a review of integration joint boards, we should consider new ways of supporting the local services that contribute so much to our health and social care system.

I am confident that a review of integration authority finances and oversight of the challenges that they face will clearly indicate the need for local tax reform. As we know, local authority budgets are under pressure, and are hampered by the out-of-date and regressive council tax. If we are really serious about an integrated approach to health and social care, we cannot simply focus on NHS budgets every time we have a debate about strains on our health service.

John Scott (Conservative, Ayr)

If Alison Johnstone’s amendment had been accepted, would such a review have included her concerns about the 494,123 days that have been lost to the health service through bed blocking? Is she happy that her party is supporting the Government in that?

Alison Johnstone (Green, Lothian)

If we review the issue in the round, we see that the pressures on local authorities make it difficult for the change that we need to be delivered in social care. If local authorities were better supported, we would see more social care being delivered in our communities, which would have a significant and positive direct impact on what is happening in our health service.

Neil Findlay (Labour, Lothian)

Alison Johnstone is pleading for better support and better finance for local government. Will she explain why she voted for the budget?

Alison Johnstone (Green, Lothian)

I voted for the budget precisely because I care about local government and I could not countenance sitting back, shouting from the sidelines and doing absolutely nothing.

We have to look to local authority finances, too, and give communities new opportunities to prioritise key services, including social care. More progressive local taxation will benefit not only health and social care but public health. Our being

“bold on local tax reform”,

as Naomi Eisenstadt recommended that we be, will have important implications, especially for working households that are at or just above the poverty line. The Government amendment recognises that

“progressive financial and fiscal planning”

is needed to sustain our health and social care services.

On the recruitment challenges, I have made the point that we need to open up access to medical training places to students from low-income backgrounds. Many of our universities are leading excellent work in that regard, but I worry that the Government is focusing too narrowly on increasing applications from the most deprived postcodes in Scotland. It is not right that a student from a low-income background might miss out on widening access opportunities because they do not live in a priority postcode or go to a target school. I ask for a broader approach.

I would also like members of this Parliament to work together to tackle drug-price inflation.

We must take it as a given that the cabinet secretary is accountable for NHS governance and performance—indeed, she has made it clear that she would not have it any other way. The Greens will support the motion and both amendments at decision time. Demands in the motion and the Labour amendment are reasonable and the Government must take action to realise them. There is no room for complacency.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am grateful to the Conservative Party for lodging its motion and bringing the debate to Parliament. However, given the national coverage and outrage that met the NHS Tayside scandal over Easter, I am dismayed that the debate is taking place in Opposition rather than Government debating time, in which Parliament could have given the matter the oversight that it deserves.

Shona Robison (Scottish National Party, Dundee City East)

I remind Alex Cole-Hamilton that I came to Parliament and made a statement on NHS Tayside, which gave members an opportunity to ask any questions that they wanted to ask. We are waiting for reviews: I will be happy to come back to Parliament when we have them.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I freely accept that. I welcomed the statement at the time, but it did not provide Parliament with the opportunity to give the matter the full analysis that it deserves. The issue affects other health boards, too.

Miles Briggs reminded members—it is a matter of public record—that I have called for the cabinet secretary’s resignation. That is not a view that I came to lightly, and I take no joy in it. I have an immense amount of personal respect for the cabinet secretary. However, as Miles Briggs reminded members, there are light bulbs flashing all over the dashboard of our NHS, warning of the many problems that it faces. The cabinet secretary and her Government have repeatedly ignored the will of Parliament on, for example, service redesign—in particular the closure of hospital wards. There has also been a string of missed targets, as Audit Scotland highlighted in its report.

The events at Easter were very much the straw that broke the camel’s back for my party, in that we could go that far and no further. We found that in NHS Tayside not only was there an element of cooking the books, with £5.3 million of digital health money having been recycled to make the books look more healthy, but there was the revelation that charitable donations, which were given to the health board to contribute to things like patient comfort and to make extraneous purchases, were being used to plug gaps in the board’s IT system. The board now has a £44.1 million shortfall. This week I learned that GPs have been banned from prescribing paracetamol, as a means of plugging the gap, such is the abject distress of the board.

The response was to manage out the chair of the health board, Professor John Connell. He was asked to resign. I was intemperate in my response to that, because I thought that it was right that someone should take responsibility, but then I learned that the events that led to Professor Connell’s departure predated his tenure. That was the nature of the cabinet secretary’s search for a fall guy in the case.

Shona Robison (Scottish National Party, Dundee City East)

I hope that Alex Cole-Hamilton recognises that the events also predated my term in office, but I am taking responsibility for them. [

Interruption

.]

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Perhaps in her remarks at the end of the debate, the cabinet secretary—[

Interruption

.]

The Deputy Presiding Officer

Just a wee minute. Order. I cannot hear anything.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Perhaps the cabinet secretary will want to address exactly what Professor Connell was not doing fast enough that led to his resignation, and consider whether she can extend comfort to chairs of other NHS boards who might be worried that they will have to take the fall for this Government, irrespective of who the cabinet secretary was at the time.

As Miles Briggs has rightly pointed out, we then heard that NHS Lothian, my home health board, is £31 million adrift from where it needs to be in order to keep services at 2017 levels.

I am very grateful to the Labour Party for lodging its amendment today, because it widens the debate. It is not just about finance; it is also about the litany of missed targets in the health service. We saw the impact of poor Government policy measured out in the fact that a 23 per cent cut to alcohol and drug partnerships has led to the highest level of drug-related deaths in Europe, which is absolutely scandalous. At times like this, we need to turn to the Government and tell it that it, and its party, have been found wanting.

There is also bed blocking: on any given night in this country, a thousand people who are fit to go home will stay in hospital beds because social care coverage is inadequate to allow them to go home. I pay tribute to the cabinet secretary and thank her for taking up the case of William Valentine, which I raised with her at the Health and Sport Committee’s meeting yesterday. I am grateful for the correspondence that I received. However, William is just one of a thousand people who, on any given day, spend time in hospital that they do not need to spend there. That causes an interruption to flow through the rest of our health service, which sees elective surgical operations being cancelled and four-hour waiting times in A and E being unachievable because there are no in-patient beds for people in acute receiving units.

John Mason (Scottish National Party, Glasgow Shettleston)

Will Alex Cole-Hamilton tell us what he is arguing for? Is it for a reduced budget for the health service and more for local authorities so that they can provide more care for people at home? Is that what he wants?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am very grateful to John Mason for setting me up to make this point. The indicators that underpin the health outcomes in our national performance framework contain not one reference to social care. The landscape of social care in this country is the problem. We are not paying

our social care workers enough and there is not enough provision. As a result, people are languishing in hospital when they should be in their communities.

I will finish by making a point on mental health. I always come back to mental health provision because it is a national outrage. If a child were to fall off her bike and break her arm, a parent could expect her to be in plaster by the end of the day. However, if she were to come to them with anxiety, depression, an eating disorder or any other kind of mental health problem, they could expect her to join one of the longest queues in our health service. That is a national outrage—not just in child and adolescent mental health services, but in adult services, as well. This very morning, James Jopling from the Samaritans responded to the national suicide action plan by saying that the Government is not taking suicide seriously, which is an astonishing assertion for the director of that organisation in Scotland. We waited for a year longer than we should have for that action plan, and it has been found severely wanting.

The Government needs a whole-system-change approach to our health service. For my party, unfortunately, such change now needs to start at the top.

The Deputy Presiding Officer

We move to the open debate.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

Everyone in the chamber can agree that the creation of the NHS 70 years ago was one of this country’s greatest achievements, mainly because it was a universal service based on clinical need rather than on patients’ income. With the passage of time, however, those needs have changed—in some cases, beyond all recognition—and, with them, the ability of the NHS to deliver on its founding principles.

Demographic changes are largely the issue but so, too, ironically, is the success of the NHS. With many more people living so much longer as a result of vastly improved treatments, the challenge of delivering universal care will always be one of the most difficult to confront any Government. There are also many more people living longer with chronic ill health, which includes mental health problems.

Many experts and health professionals believe that the situation makes the case for integrated health and social care incontrovertible. In particular, we need to find ways to ensure that older people do not overstay their time in hospital if they can be looked after at home and in their communities. It is hard to argue against that, which is why no political party is standing in the way of the integrated services approach.

However, debate is raging about how the approach should be managed. It is in that context that Conservatives are this afternoon challenging the SNP on its record. I want to use the example of recent issues in NHS Tayside to give substance to my argument.

I have no doubt that the serious problems that have been exposed in recent weeks at NHS Tayside—and, indeed, in other boards—will have a long way to run until the detail is uncovered about who authorised those bad decisions, including on misuse of charitable endowment funds, which is an issue that has rightly appalled the public. Both the official inquiries and the spotlight from the media will eventually spill the beans on who knew what and when, and who made the mistakes.

It is not for me to comment further until the inquiries report. However, in the meantime, the controversy has thrown up other issues about the SNP’s running of NHS boards. How can it be right that trustees who sit on the boards are responsible for overseeing spending of taxpayers’ money and of charitable donations that are given by patients and their families?

Shona Robison (Scottish National Party, Dundee City East)

That is an important question, and one that Liz Smith has asked in the chamber before. I hope that she will acknowledge that, as I have said to her previously, the Office of the Scottish Charity Regulator has signalled that it wants to work on the guidance and look at the governance issues. I agree that the situation must be fundamentally changed.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

I am glad to hear that, because serious questions have to be answered on those matters. As I have said, I will not comment further until the reports are published, but there will be serious questions to answer about the workings of the OSCR process and how the Scottish Government oversees a lot of the NHS’s financial management.

On the issue of the charitable endowments, four years elapsed before any real action was taken. In a letter to one of my constituents, OSCR confirmed that it did not know about the NHS Tayside scandal until 4 April; it looks as though the Scottish Government might not have been aware of the issue until about the same time. That begs the question: how can four years pass before such events are known about? I know that Jenny Marra has taken up the topic at the Public Audit and Post-legislative Scrutiny Committee. It is inexcusable.

Shona Robison (Scottish National Party, Dundee City East)

Does Liz Smith agree that lessons are to be learned by all of us, including about the auditing processes? It is important that such issues are flagged and qualified in reports that come to the Scottish Government or to any other public body.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

Yes, I do, but the Government has to understand its responsibility in that context, too.

I turn to IJBs. I do not consider—the cabinet secretary has a letter from me about this—that IJBs have clear lines of responsibility. There appears to be inequity in the balance between health and social services expertise, and the tendering process that allows third sector organisations to play their part in assisting in provision of services is not working well. It puts councillors in impossible situations when they serve on an IJB; it undermines the accountability that all our constituents should expect from their local health boards.

After speaking to several councillors, NHS officials and patients, it appears to me that there are considerable concerns about the functioning of IJBs, which is something that I am led to believe the cabinet secretary has been told by members of her own party. Senior health officials are making the point that they find it difficult to know who has ultimate responsibility for many decisions within health and social care, which results in a lack of accountability.

I hope that the seriousness of those concerns will lead the cabinet secretary to authorise a full review of IJBs as they have functioned in their first two years, to examine the issues that have been raised and to make the necessary changes that will ensure that our health and social care services are fully equipped to deal with the extensive demands on them.

As has been mentioned, running the health service will never be easy, but it would surely be given a better chance if ministers were to get a grip of what is wrong with the management process. In that respect, it is an urgent and pressing issue.

I support the motion in the name of Miles Briggs.

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Government openly acknowledges—and rightly so—that there is still progress to be made within the NHS. The cabinet secretary has been similarly open about the situation at NHS Tayside. She has addressed the matter and put in place measures to resolve it in a timely way and to support positive change.

New leadership is in place—an experienced interim chair has been appointed—and work is under way with NHS Scotland to appoint a new acting chief executive. An independent investigation by Grant Thornton has been commissioned and the Scottish Government is providing on-going support to the board through the transformation support team.

The Scottish Government is also developing a medium-term financial framework to support national, regional and local financial planning for the next five years. That framework will, among other things, outline the broad direction that the NHS and care services need to take to meet the changing needs of the people of Scotland, including shifting the balance of care towards community health services.

However, there is a wider point to be made here about working towards the very highest standards of organisational governance in the public sector, as I believe we are. We need to improve levels of public engagement, transparency in decision-making, and—in the case of health boards—diversity on boards. There also needs to be on-going training and support for members of boards so that they can carry out what is a very demanding role well.

The Health and Sport Committee recently looked at governance in the NHS and some of the board members who came in to give evidence to us expressed frustration about how difficult a role it was to fulfil effectively. They said that a greater level of training and support could be given to them, as well as more opportunities to learn from what is working well in other board areas. I believe that those were constructive comments.

The Conservative motion makes mention of the financial pressures on the NHS but it fails to make the obvious connection to the source of those pressures. They are a direct result of the austerity policies enforced on the UK and on Scotland by the UK Government in Westminster. Under the Conservative Party’s misguided ideological approach—and let us never forget that austerity is a choice, abandoned now by countries across Europe—

Elizabeth Smith (Conservative, Mid Scotland and Fife)

In preparation for today’s debate, I looked through a lot of the evidence from the Health and Sport Committee and various other health professionals. Not once were UK Government issues mentioned. However, issues around structures and spending here in Scotland were mentioned.

Ash Denham (Scottish National Party, Edinburgh Eastern)

But the Conservative motion explicitly makes reference to financial pressures on our public services and that is what I am addressing.

We know that the block grant is being affected by declining amounts of money coming to Scotland from Westminster. I would like to know when the Conservatives in this chamber will concede the effects of their own policies on Scottish families across the country.

Miles Briggs (Conservative, Lothian)

rose—

The Deputy Presiding Officer

Please sit down, Mr Briggs.

Ash Denham (Scottish National Party, Edinburgh Eastern)

Until that is done, we cannot have a sensible conversation about any of this.

The Scottish Government has faced an 8 per cent cut to its discretionary budget over 10 years, worth £2.6 billion in real terms. The block grant from the UK Government for day-to-day spending over the next two years is projected to fall by £500 million. The Scottish Conservatives are right to draw attention to these cuts and to the financial burden that they place on the Scottish Government to deliver its ambitious plans for the NHS in Scotland, but they fail to explain—again—how they would do anything differently.

The Scottish Government has mitigated and continues to mitigate these cuts and to protect and prioritise our NHS. There was an increase to the health portfolio resource budget this year of more than £400 million, taking it to a record high of over £13.1 billion. The Scottish Government is investing £2 billion more in health resource spending by the end of this session of Parliament—the highest investment commitment of any party in this chamber. The Scottish Government is also increasing support for primary care by a further £500 million over this session of Parliament.

These commitments are made possible by an ambitious budget that prioritises the NHS, and aims to create a Scotland that is fairer, more equal and more prosperous. It is a budget that both the Labour and Conservative parties failed to back. The budget is an exercise in the Scottish Government using its devolved powers to protect investment in our NHS and it is delivering that—it is delivering an additional £867 million for investment in public services that would otherwise not have been available.

If I remember correctly, the Tories have made over 100 demands for increased public spending, while also demanding a £500 million tax giveaway to high earners and businesses. It did not add up then, and it does not add up now.

In conclusion, I would like to tell a story that I found this morning on the Care Opinion website, about a patient who was in a hospital in my constituency—Edinburgh royal infirmary.

The person said:

“My Dad was in Ward 106, Base A for his last few weeks. I just wanted to say how amazing all of the staff were, not only did they look after him and gave him great treatment, they were also very friendly and understanding. They were very patient with my Dad even when he was delirious and when he was causing them a lot of work. They were all amazing people and I couldn’t have asked for anyone better to look after my Dad in his last few days. I know he was treated well, with respect and care.”

For parties in this Parliament to come to the chamber without any or many constructive suggestions for how to improve the health service is not credible. It is not the serious approach that this subject and Scotland deserve.

Edward Mountain (Conservative, Highlands and Islands)

There has been much talk already this afternoon about NHS Tayside, but the issue is not just about NHS Tayside: my mailbag is full of letters from constituents who are rightly scared about the future of local provision. The time for excuses, especially in the Highlands, is definitely over. Why? Because we seem to lurch from one crisis to another, and enough is definitely enough.

Let me be clear: closing wards and centralising services comes at the expense of care to patients. If it is not the suspension in the Highlands of out-of-hours services at Portree hospital, it is the downgrading of wards such as the Caithness maternity unit; if it is not the reduction in the number of beds in New Craigs psychiatric hospital, it is the cuts to palliative care and psychiatric care in Badenoch and Strathspey; and if it is not the fact that more operations are being centralised in Raigmore when patients could be treated in hospitals such as the one in Golspie, it is the constant threat of closure that hangs over the Town and County hospital in Wick and the Dunbar hospital in Thurso. It does not stop there, though, because there are cancellations of operations at Raigmore for just about every reason imaginable and there is the failure to meet the 12-week waiting time target for cancer patients, the shortage of GPs across the Highlands and increasing local costs—I could go on and on and on.

Such shameful leadership in NHS Highland means that patients are not receiving the standard of care to which they are entitled.

Tom Arthur (Scottish National Party, Renfrewshire South)

Will the member take an intervention?

Edward Mountain (Conservative, Highlands and Islands)

No. I am short of time and I want to give way to the cabinet secretary in a minute. I will see whether she intervenes; if she does not, I will perhaps let Mr Arthur in.

We know at this stage that there is about £15 million of overspend in 2017-18 in NHS Highland, and we also know of the maladministration of health contracts. Those issues all have an underlying theme of mismanagement and lack of leadership. If the Scottish Government truly had confidence in the management of NHS Highland, why did it commission John Brown to undertake a review of the corporate governance of the health board?

Shona Robison (Scottish National Party, Dundee City East)

rose—

Edward Mountain (Conservative, Highlands and Islands)

No, cabinet secretary, that is not the one that I will let you come in on.

Questions are being asked, so I will try a simple one—here is your moment, cabinet secretary. Does the Scottish Government think that it is acceptable that NHS contracts that have been awarded have not been audited for 20 years? Would the cabinet secretary like to come in on that?

Shona Robison (Scottish National Party, Dundee City East)

I would like to come in on both those points.

The Deputy Presiding Officer

Wait a wee minute, cabinet secretary, because I have to call you first. Yes, you can intervene.

Shona Robison (Scottish National Party, Dundee City East)

First, the member will be aware that one of those contracts dates back to 1998. It is not acceptable that it has not been audited and NHS Highland has said that that is not acceptable and that it will act on the recommendations of Audit Scotland.

Secondly, John Brown’s governance review in NHS Highland is a pilot that is about strengthening governance within our NHS. It has started in NHS Highland, but lessons can be learned from it for elsewhere. Surely the member welcomes that.

Edward Mountain (Conservative, Highlands and Islands)

First, I am delighted that the cabinet secretary believes that handing over money for 20 years with no record of outcomes is unacceptable. As far as the John Brown review of governance goes, I will wait to see what he says before I comment on what he has produced.

To go back to contracts, Audit Scotland recently condemned NHS Highland by saying that its “contract monitoring” was

“inconsistent, informal and not documented.”

Audit Scotland concluded that

“NHS Highland cannot demonstrate the achievement of value for money.”

Apparently, when it came to it, NHS Highland could not even list the names of patients who had undergone treatment. That is a pretty damning verdict that shows how far the management of NHS Highland has lost control. NHS Highland has promised to fix that and to monitor its performance via its own audit committee—the audit committee that is dysfunctional will audit itself. I am struggling with that one, cabinet secretary, I really am. Surely if there is a problem, it is put out to somebody else so that they can find the true extent of the problem and resolve it.

Real change is needed. I join Miles Briggs in calling for more parliamentary scrutiny of NHS finances and I urge the Scottish Government to publish the current financial position of all NHS boards. The public have a right to know the scale of the financial crisis affecting the NHS, including NHS Highland, and how that will impact on the standard of care that they can expect to receive.

NHS Highland has been tasked by the Scottish Government to find £100 million of savings by 2020, but how will that be achievable when the board failed to achieve the savings that it needed this year and has had to seek £15 million of brokerage for next year? That means that, next year, NHS Highland will have to find not only the £15 million of savings that it failed to find this year but the money to pay back what the Scottish Government is lending it on top of that. That means more pain for the people who are expecting services that they are not getting.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member give way?

Edward Mountain (Conservative, Highlands and Islands)

No, I am in my last minute.

The Deputy Presiding Officer

The member is in his last few seconds.

Edward Mountain (Conservative, Highlands and Islands)

What does that mean for our health service in the Highlands and Islands? It probably means closing more wards and centralising local services, which I do not believe is the answer.

In times of adversity, our doctors, nurses and healthcare professionals, who continue to work harder than ever before, are being let down by the management of NHS Highland and by the Scottish Government. It is not too late for NHS Highland and the Scottish Government to improve the financial health of our NHS, but it will require good leadership, which we do not seem to have. It is time for change and somebody needs to rise to the challenge—I just wonder who that will be.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

A few points have been raised regarding finance and challenges. Anas Sarwar’s amendment refers to finances and Alison Johnstone and Edward Mountain also touched on that. The issue of brokerage has been raised. Brokerage is not new—it has been in the NHS system for some time. Back in 2007, the Parliament’s Audit Committee undertook work regarding the situation of NHS Western Isles. Brokerage was used to try to get that particular health board out of the mess that it was in and into a manageable situation.

Miles Briggs talked about challenges, and the one point that I will agree with him on relates to challenges. There always have been challenges in the NHS, there are challenges now and there will be challenges in future. As the cabinet secretary said in her opening comments, with an organisation the size of the NHS in Scotland, clearly, challenges will always come up from time to time. I think that across the chamber we can all agree on that. If politicians on all sides are going to be fair, it is extremely important that they genuinely recognise the success stories as well as the challenges that the health boards and, accordingly, the Government face. However, it is an important aspect of the health journey to learn the lessons of the past and to work to deliver a service that does not make the same mistakes in future.

I will touch on some of the positives as well as the challenges. Faced with £2.6 billion of Tory cuts over 10 years, including £200 million in this year, the Scottish Government is using the devolved powers to protect investment in our NHS. The Scottish Government is fully funding the NHS, with a £400 million increase in spending this year. Changes to tax mean that we do not have to reduce other services to back the NHS. The budget is now £13.1 billion.

Miles Briggs (Conservative, Lothian)

Stuart McMillan and Ash Denham have misled the chamber in relation to funding changes in England and Scotland. NHS funding in Scotland is growing at half the rate of the increase in England. Had health spending under the Scottish Government kept pace, we would have had an extra £1 billion a year in our health service. Those are the facts that members need to tell people about.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

Miles Briggs should know that every penny that has come to Scotland as a result of NHS increases in England has gone into the NHS here. If he says otherwise to the Parliament and to the electorate in Scotland, he is being disingenuous.

There is another positive element with regard to finance. The amounts mean that there is an uplift of 3.4 per cent in cash terms and 1.9 per cent in real terms. According to the Scottish Fiscal Commission, the changes to the draft budget that were announced at stage 1 of the budget bill will raise £290 million in 2018-19 to support public services and Scotland’s economy.

In March, there was unseasonably cold weather and we had Scotland’s first ever red weather alert for large swathes of the country. The army provided assistance to get staff and patients to and from hospitals through deep snow. In total, 25,399 operations took place in March 2018 compared with 23,664 in the previous month, which is a 7.3 per cent rise. Members should be saying, “Well done” to our hard-working NHS staff for their dedication and for fighting through snow and dangerous weather conditions to get to work and deliver services.

Only last week, a report to the Inverclyde Council health and social care committee highlighted that Inverclyde’s performance in ensuring that people spend the minimum time in a hospital bed when they are ready to be discharged is among the best in Scotland.

Jackie Baillie (Labour, Dumbarton)

Will the member take an intervention?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

In one wee moment.

The report also marked a reduction in bed days lost, which is the number of days that individuals wait to be discharged. The chair of the committee, Labour’s Councillor Robert Moran, is quoted as saying:

“This is excellent news for patients, families and carers ... The Council - through Inverclyde Health & Social Care Partnership - have made delayed discharge a priority to ensure older people do not spend longer than they need to in hospital.”

The Deputy Presiding Officer

Briefly, Ms Baillie, as the member is coming to the end of his time.

Jackie Baillie (Labour, Dumbarton)

I am delighted to hear Stuart McMillan praising a Labour council, and I am sure that they will enjoy that, too.

Will the member comment on the fact that £90 million-worth of repairs are required at Inverclyde royal hospital? What is he doing to progress that?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

As my constituents know, I am on record as saying that no building lasts forever, as everybody in the chamber will understand. There will have to be either repairs to the current building or a new hospital at some point in the future. The fact that the building was built on the top of a hill is a ridiculous situation.

My final positive point is that we have had the great news that the new Greenock health centre will be progressed and built this year. We also had the official opening last year of Orchard View, the replacement for Ravenscraig hospital.

Those are the positives and, because of interventions, I do not have time to speak about the challenges. However, like any fair-minded MSP, I recognise that every health board has to live within its means. We only have to look back to NHS Argyll and Clyde under the shambles that was the Labour-Lib Dem Scottish Executive. The board had to be disbanded and needed £82.3 million to plug its debt. There was also the NHS Western Isles shambles, which happened when Murdo Fraser and Claire Baker were on the committee. Therefore, I will take no lessons from Labour or the Lib Dems, or from the Tories with the mess that the NHS is in down south. Although there are and will continue to be challenges for the NHS in Scotland, it is only this SNP Government that places NHS Scotland at the forefront and will deliver for the people of Scotland.

The Deputy Presiding Officer

I remind members that if they intervene, they must press their request-to-speak button again. You are not listening to me, Ms Baillie, but that was for you.

Neil Findlay (Labour, Lothian)

I declare an interest in that my wife works for the NHS. I hear from her every day about the good that goes on in the health service.

The Scottish Government is very skilled at public relations when it comes to the NHS in Scotland. The First Minister, along with the cabinet secretary, is often seen out and about with the cameras when there are good-news stories, and rightly so. We would be forgiven for thinking that the NHS in Scotland is streets ahead and a beacon of best practice for everyone else to follow but, sadly, the reality is often different.

The NHS must be at or near the top of the postbag of every MSP. Week in, week out at question times and in the media, MSPs of all parties raise cases and concerns about health and social care. Accident and emergency department waiting times are growing; cancer waiting times are again not being met; last year, 16,000 people waited over an hour for an emergency ambulance; Scotland has the highest level of drug deaths in Europe, which is three times the level elsewhere in the UK; and 363,000 bed days were lost last year in Lothian due to delayed discharge.

Before we hear any more patronising nonsense about talking down the NHS or undermining its staff, let me say this: it is the staff who are raising many of those issues with us. They are burned out, shattered, under pressure and stressed like never before in their careers. They are the ones who care most and who have invested their careers in the NHS. We have a duty to stand up for them and be their voice in the Parliament.

Let me focus on how the situation is impacting people on the ground. In Lothian, patients are having to wait 44 weeks just to see an orthopaedic specialist—not for treatment but merely for a consultation. A constituent of mine who works in a gym was forced to go off work with a leg injury. She waited so long for an appointment that her employer was threatening her with the sack. She is far from alone. I have many orthopaedic cases in my constituency case load.

I see patients who have moved into new communities and are unable to register with their local GP because 40 per cent of the lists in Lothian are closed. I have a relative who is in St John’s hospital. She is ready and willing to go home but cannot because she is waiting on a package of care. That bed space could be freed up for another patient. A total of 1.6 million bed days have been lost since the cabinet secretary said that she would eradicate delayed discharge.

We are rapidly heading for the first anniversary of the closure of St John’s children’s ward to in-patents out of hours. Parents are having to drive—if they have a car—their sick and injured children past their local hospital to Edinburgh because the ward is closed at evenings and weekends. The Royal Alexandra hospital children’s ward has already closed.

We all know that general practice is so critical to the wellbeing of the NHS, yet it is in crisis. According to the Royal College of General Practitioners, there is a shortage of 856 GPs across the country. Last night, in the village of Stoneyburn in my region—a village of just 2,000 people—300 residents turned out to a public meeting to protest with one voice against the proposal to leave the village with no GP provision. That is more than one in seven of the population. As in many other practices across the country, the local GPs there are retiring, and there have been zero applicants to take over. I am told that, 10 years ago, there would have been a dozen applicants—now there are none. What does that mean for people? If they have a car, they can travel. If they do not, as there is no footpath to walk, they need to use the very poor and infrequent bus service at a cost of £4 for a return ticket or £7 if they have a sick child with them. I have to say to the cabinet secretary that, for people in that position, healthcare is no longer going to be free at the point of need.

This situation is an abject failure of long-term planning for general practice across Scotland by successive health secretaries. The age profile of GPs cannot have been a surprise to the Government. We now have a system that would collapse without locum cover, which costs around £500 per day in Lothian and £850 a day in Lanarkshire. In Orkney, the health board is paying up to an eye-watering £1,400 a day for locum cover to try to keep the system going. When we add to that the millions lost through the increased use of agencies that charge extortionate amounts, is it any wonder that health board finances are at a critical level?

The Government’s stewardship of our NHS has been dreadful. In the past, a First Minister resigned because of an issue with an office lease and Stewart Stevenson resigned because it snowed. Today we have a cabinet secretary who is overseeing the worst waiting times on record, delayed discharge increases, a crisis in general practice, wards being closed and NHS finances in such a state that boards are robbing the charity box to try to keep services going, yet she retains the confidence of the First Minister.

The Government likes to claim credit for good things. Now the cabinet secretary and the Government must accept responsibility for the bad.

Clare Haughey (Scottish National Party, Rutherglen)

I refer members to my entry in the register of members’ interests, as I am a registered mental health nurse and I currently have an honorary contract with NHS Greater Glasgow and Clyde.

As a mental health nurse who has worked in the NHS for more than two decades, I am well aware of the challenges that it faces today. Thankfully, our population is now living longer due to advances in medical treatments and care, but that means that the pressures and demands on our NHS are growing. To meet the challenges that our health service faces, the Scottish Government has undertaken major reforms by integrating health and social care, as well as investing record levels of funding in our NHS, which has topped £13 billion this year, in spite of on-going Tory austerity.

Today’s Conservative motion refers to financial difficulties that are being faced by health boards across Scotland. That is, of course, true, but I would go much further. Financial problems are being experienced in Northern Ireland and in the NHS in Tory-run England and Labour-run Wales. The challenges that are faced by NHS Ayrshire and Arran, NHS Tayside and NHS Lothian are not unique to Scotland. For example, 83 per cent of acute hospital trusts in England were in deficit to the tune of £1.5 billion according to figures that were released in September last year. The Hywel Dda University Health Board in Wales, which serves Carmarthenshire and Pembrokeshire, has a budget deficit of around £69 million. The largest health board in Wales is also subject to a charity cash probe.

Being a healthcare professional myself, I fully appreciate the concerns of the public and politicians regarding the spending of charitable donations in NHS Tayside. It is imperative that health boards use such money appropriately and for its intended purposes. The inquiry into the NHS Tayside endowment fund by OSCR is the correct step and, rightly, NHS Tayside has proactively agreed to repay the money to the endowment fund. If any expenditure in any health board across Scotland is deemed to be inappropriate, I agree with the Scottish Government that it must be paid back to the charitable funds from which it came.

I hope that Opposition parties will join me in welcoming the request that was made by the Scottish Government to the chief executive of NHS Scotland to write to every NHS board chair seeking assurances that endowment moneys are being spent for the correct purposes. When the issue was brought to the attention of the cabinet secretary, she took the “immediate action” for which the Conservative motion is calling. She has taken the decisive step to replace NHS Tayside’s leadership team, she has authorised further brokerage to the health board and the Scottish Government is continuing to work to improve governance and organisational performance across the public sector.

I hoped that today’s debate would be one in which proposals and ideas about how we can improve the governance and performance of our NHS would be forthcoming from Opposition parties. Instead, Opposition parties have merely sought to add to the witch hunt against the Government. Labour and the Conservatives have been incredibly predictable. When a challenge faces the Government—rather than suggesting reasonable proposals and working with it—they revert to the only two things that they know: calling for the Government to spend more money and urging ministers to resign.

Miles Briggs (Conservative, Lothian)

Will the member take an intervention?

Neil Findlay (Labour, Lothian)

Will the member take an intervention?

Linda Fabiani (Scottish National Party, East Kilbride)

It seems clear that Clare Haughey is not taking interventions.

Clare Haughey (Scottish National Party, Rutherglen)

I will take them later.

It is noticeable that the Scottish Conservatives have been silent on the sham of the health service that Jeremy Hunt is presiding over in England. The Red Cross once described the English NHS as facing a “humanitarian crisis”, and it was rocked by junior doctors’ strikes. Indeed, the silence has been deafening from Scottish Labour, too. The Welsh NHS is consistently among the worst performing in the UK, yet the cabinet secretary who is presiding over it is a favourite to become the next First Minister of Wales.

Neil Findlay (Labour, Lothian)

I am a member of the Scottish Parliament and responsible for my constituents, as is the member. What comfort or advice can she give to the 300 people who came to the public meeting in Stoneyburn last night? They said that they did not accept the fact that they will no longer have a GP in their local community.

Clare Haughey (Scottish National Party, Rutherglen)

We cannot always compare health systems across the world, but we can compare health systems across the UK. [

Interruption

.]

The Deputy Presiding Officer

I would like to hear Clare Haughey, please.

Clare Haughey (Scottish National Party, Rutherglen)

The Scottish NHS consistently outperforms every other NHS on these islands. The fact that Labour and the Conservatives voted down the Scottish Government’s budget earlier this year shows that they are happy to play political football with our health service. The budget would have allocated more than £400 million in additional funding, yet neither party voted for it. The fact remains that, at the last Holyrood elections, Labour promised less money for the NHS than the Tories did. If we couple that with Tory austerity, I do not know how either party can keep a straight face when it complains about health service finances.

I am resolute in my belief that our NHS is better off in SNP hands. The proof of that lies in the woeful state of the NHS in England and in Wales, where the Tories and Labour are in charge. They do not want to hear that, but hear it they must. Privatisation by the back door and the front door, trusts cancelling weeks of planned surgery and eye-watering waits at accident and emergency departments—you would almost think that there is a plan to run down this most cherished of services so that wholesale privatisation is seen as the only viable alternative. [

Interruption

.]

The Deputy Presiding Officer

Can we have some quiet please?

Clare Haughey (Scottish National Party, Rutherglen)

Today’s debate comes in the same week as three positive news stories about Scotland’s health service. [

Interruption

.]

The Deputy Presiding Officer

Mr Dornan, you will get your turn shortly.

Clare Haughey (Scottish National Party, Rutherglen)

Part 3 of the national health and social care workforce plan was published, with £7 million of investment in nurse training, and I warmly welcome that. Scotland’s A and E figures were once again shown to be the best in the UK. Further, this was the week when the Scottish Government’s minimum unit pricing policy finally came into force.

Yes, our health service is under pressure and, yes, particular health boards have more challenges than others, which must be addressed. However, we have not heard from any MSP today why the issues that are facing particular health boards are the direct fault of the cabinet secretary, and petty games such as those being played in this chamber today trivialise our politics. We should let the cabinet secretary get on with her job of improving our NHS, which is already outperforming all the other ones in these islands.

The Deputy Presiding Officer

I remind members that they should always speak through the chair.

Annie Wells (Conservative, Glasgow)

I am pleased to have the opportunity to speak in today’s debate about the severe financial problems that are facing NHS Scotland. We see daily news articles on financial problems up and down Scotland, and people are rightly very worried. The Scottish Conservatives wish to see a Government that has control over health spending and one that promotes financial transparency, which is why I, too, echo the calls that have been made by Miles Briggs.

The SNP has been in charge of the NHS in Scotland for more than a decade, so it is absolutely right that we shine a light on this issue. Despite the SNP’s spin, spending is not keeping pace with increased demand, nor is it keeping pace with increases that Scotland has seen in Barnett consequentials. Health spending in Scotland has increased by just 5 per cent between 2012-13 and 2016-17.

Shona Robison (Scottish National Party, Dundee City East)

Does Annie Wells accept that every penny of health resource consequentials has been passed on to the health budget in Scotland, and that there has been more money in addition to that? If she thinks that more money is needed for the NHS, will she tell us how much, and from where it will come?

Annie Wells (Conservative, Glasgow)

Maybe we need to look at how the money is being spent in the NHS to make sure that we are focusing on the places where it is needed.

In my region, Glasgow, spending has stagnated. In the Government’s draft budget, the NHS Greater Glasgow and Clyde budget shows a real-terms cut of £22.5 million, and it has been reported that the health board is facing a funding deficit of up to £20 million. Quite clearly, it is under huge financial pressure, and that is only being made worse by the mismanagement of the NHS by the SNP Government.

As confirmed by last year’s Audit Scotland report, the SNP has failed to plan effectively for the future when it comes to the workforce. One in four GP practices in Scotland has a vacancy, for example, and there are more than 2,500 nursing and midwifery posts lying vacant. As a result of that, spending on temporary staff has soared. Last year, spending on plugging staffing gaps broke the £300 million mark for the first time. That was an increase of more than £100 million on 2014-15 figures.

As a ripple effect of the SNP’s failure to provide adequate community care for elderly people, we have also seen increasingly high levels of bedblocking. In 2016-17, more than half a million bed days were accounted for by patients who were fit to leave, the majority of whom were elderly. Delayed discharge is estimated to cost £132 million a year and, only yesterday, new figures showed a 3 per cent rise between March 2017 and March 2018.

I would argue, too, that there is little preventative spending, which would ease financial pressures in the long run. On alcohol and drugs, for example, there has been a 22 per cent cut to ADP funding, which the BMA described as a false economy. In Glasgow—a city that has a complex history with drugs and alcohol—NHS Greater Glasgow and Clyde has used endowment funding for a proposed safe heroin injecting space when that money could instead have been used to get people off drugs altogether.

The impact of that is huge. We can see the effect that understaffing and underfunding have had on performance. Last year, the NHS achieved only one of its eight key waiting time targets. More than one cancer patient in eight waits more than 62 days for urgent treatment and more than a quarter of children wait far too long for mental health treatment.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member give way?

Annie Wells (Conservative, Glasgow)

Not at the moment, thank you.

I am currently dealing with the case of a young girl in Glasgow with spina bifida who needs an operation that could dramatically change her life. However, she has to wait until the end of the year due to a lack of consultants. That means that, since March last year, she has been attending A and E on average twice a week. I say to the cabinet secretary that that is not on.

I echo my colleagues’ calls for better control of, and more transparency about, NHS spending in Scotland. The SNP can no longer bury its head in the sand when it comes public health spending. We have a health service that is underfunded, understaffed and, to put it simply, under pressure. Our hard-working front-line NHS staff throughout Scotland are suffering as a result of the SNP’s inability to deliver proper investment and resources.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

Will Annie Wells give way?

Annie Wells (Conservative, Glasgow)

I am just concluding.

Those staff deserve better for the great work that they carry out each day in difficult circumstances. I hope that the debate finally jolts the SNP members into action.

James Dornan (Scottish National Party, Glasgow Cathcart)

I was going to start by doing one thing, but I have just decided to go in another direction.

The party that sits to my left but is politically to my right—the party to my right is still to my right—calls itself the party of the union but, as soon as there are any comparisons with other parts of the union that it holds so dear, that we are all so much a part of and that it, the Labour Party and the Lib Dems worked so hard to keep together, its members go up in smoke and say that it is not right and nothing to do with anything. We all work under exactly the same conditions. The national health service might well be in Scottish control, but the budgets—[

Interruption

.] The budgets are dictated by what happens in Westminster.

The only way that we could see what the NHS in Scotland would look like if the Tories were in control would be to look at what they do, not what they say. Therefore, we have to look at what the NHS is like in England. It is an absolute shambles. The BMA itself said that the NHS in England is in complete chaos, that the health service could

“suffer a repeat of scenes experienced during winter 2016”

and that that

“would equate to just 87.5% of patients being seen”,

as opposed to the 90-odd per cent that are seen in Scotland.

I have not even started on the Labour Party yet. We have the ridiculous situation—[

Interruption

.] We have the ridiculous situation of the two parties with the worst health service records where they are in power trying to get rid of the best health secretary in the United Kingdom. If it was not for petty party politics, you would not come to the chamber and blooming demean it with motions such as the one that we are debating.

Last week, Ruth Davidson came and told us that our party was working in the nationalist interest and not in the national interest. I would have thought that she would have been here today to tell us how that was all wrong but, of course, Labour and the Lib Dems put a stop to that when they said that she would be the isolated one on the UK Withdrawal from the European Union (Legal Continuity) (Scotland) Bill. The best way to reunite that unholy trinity is for you to jump on the back of the bandwagon that was started by Willie Rennie and Anas Sarwar.

Oliver Mundell (Conservative, Dumfriesshire)

rose—

James Dornan (Scottish National Party, Glasgow Cathcart)

Sit down.

The Deputy Presiding Officer

Excuse me, Mr Dornan. I ask that members speak through the chair, cut down on some of the noise and remember that we should always be courteous to fellow members.

James Dornan (Scottish National Party, Glasgow Cathcart)

Willie Rennie and Anas Sarwar were fighting over who could be first to demand the sacking of the cabinet secretary. It was unseemly, and the speech that Anas Sarwar made today should be taken out of the records of the Scottish Parliament. It was nothing but scandalous.

Labour members have a record that nobody could be proud of—not even their mothers, and certainly not their founders. We come here today on a motion that is based on the misuse of charity funding. If we look at Labour in Wales, we find a situation with an organisation called Awyr Las, serving the Betsi Cadwaladr University Health Board in north Wales. It did exactly what NHS Tayside has been accused of here in Scotland, but that was agreed by the Welsh Government, which is run by Labour. It was a system in which £450,000 of charitable donations was being used for staff improvements—and Labour members are trying to tell us that we have got it wrong.

The health secretary was not in post when the charitable trust in question was put in place. If she had been, it would not have been put in place in the way that it was. She is dealing with it in the way that she has been asked to deal with it, and we still get the ridiculous situation of Labour members asking for her to go—for something that is completely outwith her—

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Will the member give way on that point?

James Dornan (Scottish National Party, Glasgow Cathcart)

Of course.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

If it is not at the feet of the current health secretary that the blame should rest, should it rest with the former health secretary, by which I mean the First Minister of this country?

James Dornan (Scottish National Party, Glasgow Cathcart)

The difference between you and I, Alex—

The Deputy Presiding Officer

Speak through the chair, please.