Scottish Parliament, 19 February 2020

256 contributions from 55 members. The official report.

Smoking Ban (Play Parks and Outdoor Sports Facilities)

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-20554, in the name of Rachael Hamilton, on a smoking ban for play parks and outdoor sports facilities. The debate will be concluded without any question being put.

Motion debated,

That the Parliament notes the view that Scotland should ban smoking in play parks, outdoor sports facilities and other similar outdoor areas; understands that section 4 of the Smoking, Health and Social Care (Scotland) Act 2005 does not provide powers to do so; acknowledges that the Welsh Government introduced the Public Health (Wales) Act 2017, which imposes a ban there on smoking in these types of places; believes that such a ban in Scotland would improve public health, especially in helping to alleviate the effects of passive smoking on children in the Borders and across the country, and notes the calls for the Scottish Government to legislate accordingly.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

I thank all the members who signed my motion and those who will contribute to today’s debate. I also thank Alison Johnstone, who has sent her apologies—she is convening a cross-party group meeting. She supported my motion and is sorry not to be here.

We are all too aware of the effects of smoking and passive smoking. Smoking damages the lungs of the smoker and the smoke that is inhaled by people near the smoker causes passive smoking damage. Today, I want to focus on the damage that smoking causes to children and young people in particular.

There is a strong evidence base that suggests that the implementation of smoke-free environments can contribute to a reduction in smoking rates across populations. As maintaining smoke-free areas in certain outdoor and indoor places can discourage smoking behaviour in general, making more places smoke free could have a positive impact on adult smoking figures.

On 26 March 2006, Scotland became the first place in the United Kingdom to make it an offence to smoke in any wholly or substantially enclosed public space. Fourteen years have passed since the ban was implemented and the prevalence of smoking has decreased. However, the Scottish schools adolescent lifestyle and substance use survey shows that smoking prevalence rates among 13 and 15-year-olds have flatlined since 2015, with 12 per cent of 15-year-olds and 4 per cent of 13-year-olds smoking regularly or occasionally.

That was the starting point for my desire to bring about positive change and for us in this Parliament to take additional steps. I saw the excellent work that was done in my Welsh homeland in 2016, which inspired me to think about implementing the same changes in Scotland.

I want to recap on where we are today. Through parliamentary questions, I established that the Smoking, Health and Social Care (Scotland) Act 2005 does not cover play parks or outdoor sports facilities. I was given assurances by the Minister for Public Health, Sport and Wellbeing, Joe FitzPatrick, that, as part of its 2018 action plan, the Scottish Government would monitor the smoking ban in Wales before taking additional action.

I was advised by the Scottish Parliament information centre that it could be possible to add a category to the list of no-smoking premises in the 2005 act. However, in the previous parliamentary session, when Jim Hume introduced a member’s bill to prohibit smoking in vehicles in which children were present, the approach was taken of creating a standalone piece of legislation that did not amend the 2005 act in any way—it simply created a new offence. As we are fast approaching 2021, I regret that there is simply not enough time for me to introduce a member’s bill and take that approach.

I then looked at section 4 of the 2005 act, which allows the Scottish ministers to define by regulations what is covered by the term “no-smoking premises”. Such premises must be “wholly or substantially enclosed”. They must also meet one or more other criteria, one of which is that the public or a section of the public has access to the premises; others are that the premises are a place of work, are used by a club or informal association, or are used for education or health or care services.

Accordingly, ministers can, through regulations under section 4 of the 2005 act, ban smoking in any workplace, public place, school or hospital, but only if the place in question is “wholly or substantially enclosed”. The regulations can further define what is meant by “wholly or substantially enclosed”. It is our understanding that, so far, that has been defined to mean closed in by walls and a roof, which means that entirely outdoor areas could not be classed as “no-smoking premises”. However, it might be possible for ministers to make regulations that ban smoking in play parks based on a revised definition of “wholly or substantially enclosed”, which could, for example, include an area of grass that is enclosed by a fence.

After that long-winded explanation of how I got to this point, I look forward to hearing from the Minister for Parliamentary Business and Veterans about the calls on the Scottish Government to consider changing the definition of “wholly or substantially enclosed” in order to enact change.

When we change the definition, it is right that we look at Wales, where that has been done successfully. In part 3 of the Public Health (Wales) Act 2017, an entire section—section 12—relates directly to the banning of smoking in play parks and playgrounds. I have a copy of the bill with me. There are clear definitions of what play parks, playgrounds and school grounds are. In Wales, it is illegal for people to smoke on hospital grounds, school grounds and playgrounds, with those who flout the law facing fines.

Turning closer to home, I note that there has already been positive action to stop smoking in play parks and in other outdoor areas in Scotland. The measures, which have been successful, are voluntary in nature. Many local authorities have embraced smoke-free play parks, albeit without there being enforcement powers in legislation. Do not get me wrong: that is a good place to start. Dundee City Council, for example, created a code under which the public complies voluntarily with a smoking ban, with a request not to smoke in particular areas. The code does not ban smoking outright, but it sets best practice. Children and young people have already engaged positively with the voluntary bans. Creating smoke-free zones and encouraging more local authorities to campaign accordingly would be a positive initial step.

In my constituency, I have the support of the Scottish Borders Council, and I will work with councillors and local schools later this year to create a competition to design signs that can be displayed in play parks to discourage people from smoking and to encourage them to adhere to a voluntary ban.

I believe there to be substantial cross-party support on the issue. I very much thank ASH Scotland and other organisations that have supported me for today’s debate. I want to be clear: I do not want to stigmatise smokers, nor do I want the state to deny people the right to smoke. To simply call it a ban would throw up negative connotations. It is about sending the right message—a positive message—to our children. Politicians should bring people along with us on the journey to a smoke-free Scotland.

A simple change to a definition in the Smoking, Health and Social Care (Scotland) Act 2005 would ensure that play parks, playgrounds and outdoor sports facilities are brought into line and made smoke free. A simple consultation with the relevant stakeholders could be carried out, after which the relevant definition change could be made. As I have said, when defining such public places, it is right that we turn to the successful 2017 Welsh act.

The motivation behind my call today aligns with the broader aims of the Scottish Government to have a smoke-free generation by 2034 and to prevent the harmful effects of passive smoking. I hope that the public will understand my motivations for restricting smoking in particular areas and that they will respect playgrounds as much as they would places that are covered by no-smoking legislation. We know that making play parks and outdoor sports facilities smoke free would help to de-normalise smoking for children and young people, as the environment in which children grow up strongly influences whether they are likely to smoke when they are older.

I could go on, but I have no time left.

Kenneth Gibson (Scottish National Party, Cunninghame North)

I congratulate Rachael Hamilton on bringing this important issue to the chamber.

As members might be aware, since I first became an MSP more than 20 years ago, I have taken a keen interest in reducing the harm that smoking causes. In July 2001, I proposed a regulation of smoking bill, with strong support from colleagues across the chamber—notably, from Labour’s Dr Richard Simpson, the Conservative’s Bill Aitken and the Liberal Democrat’s Robert Brown. After 2003, my proposal was progressed by Stewart Maxwell and, ultimately, by the Scottish Executive, which led to the Smoking, Health and Social Care (Scotland) Act 2005.

Unfortunately, about 1.1 million people in Scotland still smoke. In 2017—the last year for which figures are available—there were 9,332 smoking-related deaths compared with 1,136 alcohol-specific deaths and 1,187 drug-related deaths in 2018. Although the number of smoking-related deaths has declined by about 30 per cent over the past two decades, tobacco still kills about one in six Scots, which is shocking. Furthermore, there are 128,000 smoking-related hospital admissions a year in Scotland—that is 2,500 a week, 250 a day or 15 an hour.

Cigarette smoke contains more than 4,500 compounds, including: acetaldehyde, which is a carcinogen; acetone, which damages the liver and kidneys; and ammonia, which is a cause of asthma and high blood pressure.

Smoke-free spaces bring many benefits to children and adults, particularly because other people’s smoke is much more than a nuisance—it has serious health risks.

Living with a smoker increases a non-smoker’s chance of developing lung cancer by 20 to 30 per cent. Children are more vulnerable to second-hand smoke, because their lungs are still growing and their immune systems are not fully developed; they are also at greater risk from toxins in cigarette smoke. Tragically, it is estimated that second-hand smoke exposure in Scottish children causes, among other problems, at least 2,000 new cases of wheeze and asthma a year and one in five of all cot deaths.

I am proud of the Scottish National Party Government’s track record and the action that it has taken to stub out smoking, but we must do more.

Scotland is among the first countries in the world to set a target of being tobacco free by 2034. For years, the SNP Government has taken important steps to protect young people from the harm of smoking—notably, in 2007, milestone legislation raised the minimum age for buying tobacco from 16 to 18. Tobacco sports sponsorship was banned 15 years ago, and it is now unthinkable for any high-profile team to be brand ambassadors for tobacco.

Places where children play should be free from the stain of tobacco. For years, the Chartered Institute of Environmental Health has said that smoking should be banned in all parks and anywhere that children play, in order to reduce the chances of them growing up thinking that using cigarettes is normal.

A YouGov poll, which the institute commissioned in 2016, found that 89 per cent of 4,300 adults who were surveyed backed a ban on smoking in children’s play areas and that 57 per cent wanted an end to smoking in public parks.

I am delighted that, this year, as the latest in a long line of progressive and bold policies to protect people from the harm that it causes, smoking will no longer be permitted around hospital buildings. There is always more that we can do to protect people, particularly children and young adults, from smoking.

Two thirds of adult smokers in the UK say that they started smoking regularly before the age of 18 and two fifths say they started before the age of 16. In fact, so few adults start smoking that 99 per cent of first cigarettes are smoked before the age of 26.

Despite its vehement denials, the tobacco industry targets young people. It is vital that, wherever possible, cigarettes and smoking should be out of sight and out of mind for our children.

I hope that we can all commit to help raise Scotland’s tobacco-free generation and to ensure that children’s play areas and outdoor sports facilities are free of the scourge of tobacco. Again, I thank Rachael Hamilton for bringing this important matter to the Parliament.

Brian Whittle (Conservative, South Scotland)

I thank my colleague Rachael Hamilton for bringing this debate before Parliament. As she said, there is support across all political divides for what she is trying to do. This Parliament is rightly proud of the work that it has led on the workplace smoking ban. As Kenny Gibson said, that ban is being extended into hospital grounds, which is long overdue.

However, when we quote the overall reduction in smoking, we need to look behind the figures. I was alarmed by recent statistics that indicate that, for the first time since the ban, there might be a small increase in smoking. When we look behind the reduction that there has been since the smoking ban was introduced, it is worth noting that, in the highest Scottish index of multiple deprivation quintile, only 9 per cent of people smoke, but in the lowest SIMD quintile, the figure sits at 34 per cent.

I looked over the notes that I took a while ago, when I was working with ASH on a report. As Kenny Gibson said, around 1 million Scots still smoke. My figures showed that, annually, around 10,000 people die of smoke-related diseases. If we could tackle that and make inroads into that figure, it would save the Scottish national health service an estimated £100 million. The biggest stat for me is that it would also save the poorest 20 per cent £100 million. It is worth mentioning that, because we are always discussing the sustainability of funding our NHS, the preventable health agenda and the steps that we could take to lift people out of poverty.

The statistics that I was looking at say that such a measure would save 1 million sick days that are lost to business because of ill health related to smoking conditions. It would also save 1 million working hours lost in productivity due to smoking breaks, and if those hours were then offered for participation in physical activity, the health of the nation would greatly improve, and productivity would skyrocket. It is not necessarily about reclaiming the time that people use for smoking breaks; it is about reallocating it to something that would be more beneficial.

We recognise where the next piece of work needs to take place. Rachael Hamilton focused on the practical legislative requirements that need to be met before we can get to the next stage. We all recognise that passive smoking has a bad effect on children’s health.

That brings me to Rachael Hamilton’s motion. Much work has been done on curtailing tobacco sponsorship and advertising, so I have been thinking about marketing and what the main influences are. For children, one of the main influences on smoking uptake will be seeing their parents or peers smoking. That is the inadvertent marketing tool that is working to the benefit of the tobacco companies. It is therefore entirely logical to extend the smoking ban to places where we are promoting a healthy lifestyle and opportunities for family interaction—play parks, outdoor sports facilities and activity sites. I cannot see how there can be any resistance to such a suggestion. It comes down to the practicalities and how we would legislate, so I am interested to hear the Scottish Government’s position on that. Is it an extension to the legislation that we have not quite got around to yet? If there is no resistance, why do we not just get it done?

David Stewart (Labour, Highlands and Islands)

I congratulate Rachael Hamilton on securing this important debate. As the member has already acknowledged, there is clearly broad support across this chamber for a change in the law and for increasing the protection from the damaging effects of smoking that is afforded to Scotland’s young people.

The Scottish Parliament has a strong record of taking action on smoking and seeking to improve public health outcomes. The previous Scottish Labour-led Administration introduced the Smoking, Health and Social Care (Scotland) Act 2005, which established that, from 26 March 2006, it would be an offence to smoke in any wholly or substantially enclosed public space in Scotland, with a small number of exceptions. I acknowledge Kenneth Gibson’s contribution to the origins and creation of that legislation.

That was groundbreaking legislation. Scotland became the first part of the United Kingdom to legislate for a smoking ban, with England and Wales following our lead the following year. It is worth remembering that, when that vote took place here in 2005, it passed by 83 to 15, with only the Scottish Conservatives opposing the legislation. However, I believe in sinners repenting. I am pleased that they brought the motion to Parliament today, and I am pleased to see Rachael Hamilton now acknowledging the health and social inequalities caused by smoking and her desire to see further improvements.

In 2016, the Scottish Parliament took further steps, by banning smoking in a car if a child is present. That was another welcome move, and evidence from England and Wales, where the legislation was first introduced, and from Scotland shows that the ban has worked and has led to fewer children being exposed to cigarette smoke.

In Wales, the Welsh Government has now legislated to expand the smoking ban to play parks, playgrounds and outdoor sports facilities where children might be playing or participating in sport. I believe that that is the next stop in delivering a smoke-free Scotland.

John Mason (Scottish National Party, Glasgow Shettleston)

Vaping has not been mentioned today. Does the member think that it should be treated differently from how smoking is treated?

David Stewart (Labour, Highlands and Islands)

It is certainly worth having a look at it. There has been long debate about vaping. Some critics have argued that it should also be banned because it can cause serious health issues. As a member of the Health and Sport Committee, I would certainly welcome any thoughts that Mr Mason might have on such an important subject.

Despite those very positive steps, smoking remains a significant public health issue in Scotland and it is a leading cause of preventable ill health, premature death and disability. All the evidence shows that tobacco use has clear links with inequality, and therefore with health inequalities, which the Parliament must work to tackle if we are serious about improving public health outcomes.

We heard from Brian Whittle that smoking rates are still the highest in the most disadvantaged areas: 35 per cent of people living in the most deprived areas of Scotland smoke, compared to 10 per cent of those living in the least deprived areas. In my region, the Highlands and Islands, recent Scottish index of multiple deprivation statistics ranked parts of Merkinch in Inverness as being among the most deprived communities in Scotland. I have a certain affinity with Merkinch, because I grew up and went to school there.

That means increased ill health and reduced life expectancy for far too many people. Part of the route to reducing inequalities is cutting smoking rates and encouraging active living and significant lifestyle changes. The link between poverty and smoking is stark and we should note the work that organisations such as the Poverty Alliance are doing in conjunction with ASH Scotland to better support the collaboration between public health and antipoverty interests.

Although compliance with the current smoking restrictions in Scotland is high, policing the introduction of a smoking ban in areas such as play parks would be considerably more challenging. Any changes in the law would require a comprehensive compliance strategy and a public education programme to be put in place.

The World Health Organization has described clean air as a basic human right and has said:

“Scientific evidence has unequivocally established that exposure to tobacco smoke causes death, disease and disability.”

Just 30 minutes of exposure to tobacco smoke changes the way that blood flows and clots, which increases the risk of heart attack and stroke. Second-hand smoke kills more than 600,000 people globally every year and, in many countries, it causes more than 10 per cent of all tobacco-related deaths.

Despite the progress and the increase in public awareness of the damages of smoking that have been made over the past decade, the challenge remains as real and as stark as ever. The motion is welcome and it offers an opportunity for the Parliament to demonstrate that we are willing to build on the work that has already been done to prevent the damage that smoking causes society and to take further and bolder action to improve public health, protect our young people and, ultimately, move towards a smokeless society. I congratulate Rachael Hamilton for the excellent motion and the debate.

Rona Mackay (Scottish National Party, Strathkelvin and Bearsden)

I thank Rachael Hamilton for bringing this important debate to the chamber.

Children have a right to play, as enshrined in article 31 of the United Nations Convention on the Rights of the Child. We all know that play teaches our children social skills: how to compromise, be tolerant and be resilient. Play is the universal language of childhood. I believe that children must be able to play safely, and that means without the risk of being affected by passive smoking. We know that passive smoking is especially harmful to children, because they have less well-developed airways, lungs and immune systems. Children who live in a household where at least one person smokes are more likely to develop asthma and chest infections such as pneumonia and bronchitis. The bottom line is that smoking is dangerous—we know that. It is dangerous for those who smoke and for those who inhale other people’s smoke on a regular basis, particularly children.

As Rachael Hamilton mentioned, a law making it illegal to smoke in a car with anyone under the age of 18 came into force in Scotland in 2016, and people caught breaking the new law face a fine of up to £1,000. Public awareness of the dangers of smoking has greatly reduced the risk to children, with fewer parents smoking in the home and around non-smokers. I suspect that any right-thinking parent who smokes would have the sense not to smoke around children, and I would be interested to see whether there has been any research on that.

However, despite the hugely successful Smoking, Health and Social Care (Scotland) Act 2005, which we have heard about and which prohibited smoking in enclosed public spaces, smoking remains the most significant cause of ill health in Scotland. There are up to 100,000 hospitalisations per year and more than 9,000 premature deaths as a result of smoking. We must protect our children from the effects of passive smoking and the perceived normality that it is okay for adults to smoke around children in their play areas, which is why I support Rachael Hamilton’s motion.

As has been mentioned, last month saw the closure of a consultation on smoking outside hospital buildings. The Health (Tobacco, Nicotine etc and Care) (Scotland) Act 2016, which amended sections of 2005 act, introduced offences in that area. Although the guidelines that have been issued to hospitals to stop smoking in and around hospital buildings are partially effective, they are not being strictly adhered to, so the consultation asked whether legislation should be brought in to create a legally enforceable offence.

As I understand it, the 2005 act gives the Scottish ministers the power to introduce secondary legislation to prevent smoking in play parks and outdoor sports facilities. Rachael Hamilton outlined suggestions as to how that could be done. I would support that, subject to scrutiny of the effectiveness of the measure south of the border and how it is policed. As Rachael Hamilton’s motion states, the Welsh Government introduced the Public Health (Wales) Act 2017, which imposes a ban on smoking outdoors in areas where children play or participate in sport. That is a good model to look at.

We want Scotland to be the best place in the world for children to grow up. The Scottish Government has introduced groundbreaking initiatives such as the baby box, the best start grant and much more. Any future legislation would be a natural extension of our intention to promote healthy lifestyles and wellbeing in future generations by protecting them from the harmful effects of passive smoking. Scotland’s children have the right to be able to play without endangering their health.

Graeme Dey (Scottish National Party, Angus South)

I thank Rachael Hamilton for securing the debate and so allowing us to hear members’ thoughts on an important issue on which there is largely consensus.

As a society, we have made considerable progress on smoking prevention. Figures from 2018 showed that 19 per cent of adults in Scotland were smokers, which of course is still too high, but it is a big improvement on the figures of 28 per cent in 2003 and almost 34 per cent in 1998. Among youngsters, the number of 15-year-olds who smoke regularly has dropped by more than two thirds in the past decade.

People are getting the message, but we are not letting up. Annually, health boards are provided with around £10 million in funding to deliver local stop-smoking services. We continue to work tirelessly towards our target of reducing smoking prevalence to 5 per cent or less by 2034, to tackle inequalities and to address the risks around the use of e-cigarettes. We have worked with our partners in local government and others to develop a set of jointly agreed and owned public health priorities for Scotland, which focus the whole system on the things that have the greatest potential to improve healthy life expectancy.

One of our key priorities is focused on reducing the use of, and harm from, tobacco and other drugs. The public health priorities, which are informed by the best available evidence, are based on partnership working and engagement with the wider public and the third sector, and of course local authorities. It is important that we work together in partnership as part of a whole-system approach that delivers real improvements in the nation’s health and wellbeing.

Although much has been achieved, we cannot be complacent or lose sight of the fact that smoking remains one of the most damaging contributors to Scotland’s poor health record. If we are to succeed and achieve our ultimate goal of a non-smoking Scotland, we need to keep moving the agenda forward on all fronts. We need to find new ways to engage with harder-to-reach groups and to step up efforts to prevent children and young people from starting in the first place. The tobacco control action plan is aimed at doing just that. The measures that are set out in the plan leave no one in any doubt that we are determined to continue to be a world leader in tobacco control.

Sadly, health inequalities between Scots in affluent areas and those in deprived areas are widening, which Brian Whittle touched on. It is clear that we need to be innovative if we are to drive down smoking rates across the board in order to reach the 2034 target. I am pleased that our laws are soon to be extended to include a smoke-free perimeter around NHS hospital buildings. It is logical that we should go further and target smoking in and around play parks and outdoor sporting facilities. The main reason for play park restrictions and hospital building legislation is to remove the visibility of smoking. The restrictions do not focus on harm, because smoke quickly dissipates in open air, which minimises the risk. They are actually about reducing the normalisation of the activity.

That said, the Scottish Government has no immediate proposals to legislate further on smoking outdoors, not least because many local authorities already have restrictions on smoking around playgrounds in parks and other areas. In particular, Scotland’s two biggest cities—Edinburgh and Glasgow—have policies in place. In Edinburgh, the smoke-free policy has resulted in smoking restrictions being extended from the workplace and vehicles to surrounding areas, for council properties. The rules include entrances, car parks and play areas.

Brian Whittle (Conservative, South Scotland)

Graeme Dey says, quite rightly, that there are councils that are leading the way. However, does he agree that it should be for the Scottish Government to lead from the top, or the front, and to deliver such policies around the whole of Scotland?

Graeme Dey (Scottish National Party, Angus South)

I will continue to expand on my explanation, but, in general, what Brian Whittle referred to is the direction of travel that we need to be heading in. However, there are some complications, which I will come to in a minute.

Glasgow City Council has a policy to ban smoking in children’s playgrounds, where notices are displayed to prohibit smoking. Such restrictions are replicated in most local authority areas.

In response to what I have been asked today, my initial reaction is that separate primary legislation would be required to address the matter. Rachael Hamilton suggested changing the definition of “enclosed” to provide a means to get around the problem. However—I am sure that members will recognise what I am about to say—lawyers would undoubtedly tell us that the definition of “enclosed” is commonly recognised and is drawn from other relevant pieces of legislation. If we were to move to change the definition, that would have to be proportionate, for legal reasons. For example, saying that “enclosed” was the same as “fenced off” would be disproportionate, as it could capture vast areas. I say all that not to provide reasons not to act, but to offer a degree of perspective.

Our focus in the current tobacco control action plan is to address health inequalities and cut smoking rates in the communities where people find it most difficult to quit. We are committed to conducting a public information campaign on that subject.

Since 2006, the Scottish Government has been encouraging local government to restrict smoking, wherever possible, around schools, playgrounds, outdoor sports facilities and play parks. Smoke-free local authority implementation guidance was published in 2017 to support councils to implement their policies for publicly owned sites, which means delivering smoke-free buildings and grounds and outlining the responsibilities of partner organisations. To be clear, the guidance covers schools, playgrounds, nurseries, day centres, parks, local authority premises and other grounds.

As Rachael Hamilton pointed out, my colleague Joe FitzPatrick, the Minister for Public Health, Sport and Wellbeing, has said publicly that we are supportive of the Welsh approach and that we will monitor it. However, to be clear, as I understand it, the terms of the Welsh act are still to be fully implemented. Partly because of Brexit pressures, there is no definitive timetable in place for bringing the regulations forward. Therefore, we have not yet been able to take the Welsh experience into account. Again, I offer that not as an excuse, but as a recognition of the facts.

Our action plan states that we will monitor the implementation of smoking bans in Wales and the implementation of guidance that is produced by the Convention of Scottish Local Authorities and NHS Health Scotland to assess whether legislation is needed here. As parliamentary business minister, I note in passing how incredibly well populated the legislative landscape is between now and dissolution. It is populated by not only Scottish Government bills but a large number of members’ bills and committee bills, so it is unlikely that we will be in a position to legislate in this parliamentary session.

Rachael Hamilton (Conservative, Ettrick, Roxburgh and Berwickshire)

I understand what Graeme Dey says about the restrictions to changing the definition of “enclosed” and possibly having to introduce primary legislation. However, the issue goes back to 2017. Joe FitzPatrick stated that he would look at monitoring the implementation of the guidelines that were issued to local authorities in 2017, so it has been rumbling on for quite a long time. I have received no indication of how that implementation has been going.

Graeme Dey (Scottish National Party, Angus South)

As I touched on in my speech, yes, there was a commitment, but it sat in tandem with a commitment to look at what was happening in practice in Wales. Bringing those two things together has not yet been possible. I stress again that I say that not to deflect or ignore what is an important issue. Those were the commitments that were given. We need to look at both aspects and also recognise, as I said a moment ago, that it is highly unlikely that there will be capacity to legislate in the current parliamentary session. However, it is a direction of travel that needs to be looked at.

On taking account of the Welsh experience and the success of the guidance, any decisions that we take as a Parliament on the introduction of any new approaches or legislation should always be taken on the basis of robust evidence. We should also look at appropriateness and effectiveness.

It is quite clear that, in principle, not a great deal separates any of us on the issue. I thank Rachael Hamilton for securing the debate. I suspect that it is a topic to which we will return.

13:50 Meeting suspended.

14:00 On resuming—

Transport, Infrastructure and Connectivity

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

The next item of business is portfolio questions. As usual, short questions and snappy answers would be very helpful. Transport, infrastructure and connectivity questions 4 and 5 have been grouped together. I will first take those questions with the supplementary questions that are included in the group, and will then take any further supplementaries.

A9 (Electronic Signage)

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

1. To ask the Scottish Government when electronic signage will be installed along the A9, north of Inverness. (S5O-04121)

Michael Matheson (Scottish National Party, Falkirk West)

Transport Scotland has four existing variable message signs on the A9 north of Inverness. Two cover the southbound approach to the Kessock bridge, one is on the northbound carriageway approaching Helmsdale, and the fourth is on the southbound carriageway beside Georgemas Junction railway station. As part of the national high-wind management strategy, Transport Scotland will install an initial phase of four additional variable message signs to cover the approaches to both the Dornoch Firth and the Cromarty Firth bridges. They are planned for installation in spring 2020.

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

The Scottish National Party

has committed to upgrading that lifeline road, and improvements are well under way at Berriedale, with the new road being due to open this spring. However, will the Scottish Government commit to further improvements to ensure that other notorious sections of the A9—the Tomich junction, the Tain section and the Cambusavie bends, for example—are safe and fit for the 21st century?

Michael Matheson (Scottish National Party, Falkirk West)

The safety of the trunk road network is assessed annually, and programmes of interventions are developed and delivered where it is expected that particular locations could benefit and there is evidence to support investment to improve safety. As part of that programme, work is on-going at Tain to improve junctions on the bypass, and the proposals are the subject of on-going engagement with stakeholders in the area.

We have published “National Transport Strategy: Protecting our Climate and Improving Lives”, and we are working to complete the second strategic transport projects review. The A9 north of Inverness is part of consideration in the STPR2 process, which will determine the Government’s priorities for future transport investment, including for the northern parts of the A9.

Jamie Halcro Johnston (Conservative, Highlands and Islands)

I met electric vehicle users in Orkney on Monday, and they raised concerns about the lack of charging points on the A9. There is also concern that existing charging points are often single points that are unavailable because they are being used by

other drivers or are, in some cases, broken. Given that that infrastructure is essential, what plans are there to improve availability of electric vehicle charging points, in particular in remote and rural areas, such as are found across my region?

The Deputy Presiding Officer

That question was a little wide of the mark, but the cabinet secretary looks ready to answer.

Michael Matheson (Scottish National Party, Falkirk West)

I do not know whether we have any electric signage for charging points, but I can say that we have an extensive car charging network across Scotland. Jamie Halcro Johnston might acknowledge that Scotland has the most extensive public charging network in the United Kingdom outside central London. We are building on that to ensure that we increase the number of charging points that are available for low-emissions and electric vehicles. That includes work that we are taking forward with local authority partners—including in the Highlands, Orkney, Shetland, the Western Isles and other areas across the country—through the substantial investment that we are making to support people to move to low-carbon and electric vehicles.

Road Safety (Rural Areas)

Oliver Mundell (Conservative, Dumfriesshire)

2. To ask the Scottish Government what action it is taking to improve road safety around schools in rural areas. (S5O-04122)

Michael Matheson (Scottish National Party, Falkirk West)

The Scottish Government is committed to achieving safer road travel in Scotland for all, including around schools. It provides funding to local authorities to create new or improved infrastructure, including around schools, through the places for everyone programme.

Transport Scotland funds Cycling Scotland to deliver bikeability training, which is available to all schools. Additionally, Road Safety Scotland has developed online learning resources for three to 18-year-olds, which is particularly useful for school teachers.

In accordance with local authorities’ statutory responsibility for local roads, it is for them to consider the most appropriate measures to safeguard schoolchildren in their areas.

Oliver Mundell (Conservative, Dumfriesshire)

As local parents are, I am concerned that Dumfries and Galloway Council is systematically ignoring its obligations in relation to rural schools. At Duncow primary school, there have for years been broken flashing signs on a 60mph-limit road, and at Hottsbridge primary school large volumes of lorry traffic have been forced to drive past the school daily as a result of a long-term road closure. Will the cabinet secretary ask transport officials to approach the local authority to see what more can be done to support them to ensure that we do not have a very serious accident?

Michael Matheson (Scottish National Party, Falkirk West)

I am more than happy to ask my road safety colleagues in Transport Scotland to contact the local authority on those matters. Oliver Mundell is right to highlight safety issues, but that does not remove the statutory responsibility of the local authority to take the appropriate measures. I encourage him to continue to press the local authority and its executive leaders to make sure that they take the appropriate measures to address the safety issues that he is concerned about.

Rural Bus Routes (South Scotland)

Claudia Beamish (Labour, South Scotland)

3. To ask the Scottish Government what its position is on reported rural bus route reductions in South Scotland. (S5O-04123)

Michael Matheson (Scottish National Party, Falkirk West)

We recognise the vital importance that bus services have for millions of Scots across the country, especially those who, for whatever reason, do not have access to cars or live in places that are not served by the rail network.

Bus usage has been declining across the country over many decades. Rural areas present distinct challenges for delivering viable local bus services. Local authorities and regional transport partners already have powers to secure additional services to meet local needs, and we are extending the range of options that are available to them through the Transport Scotland Act 2019, which received royal assent towards the end of last year.

The Deputy Presiding Officer

Two members, Finlay Carson and Joan McAlpine, have supplementaries—[

Interruption

.] Oh! Have I not asked Claudia Beamish for her supplementary? That was disgraceful of me. Please ask your supplementary.

Claudia Beamish (Labour, South Scotland)

I do not know about “disgraceful”. Thank you for letting me in.

Since the start of December, about 4 per cent of services on Stagecoach’s 101 and 102 services, which run from Dumfries to Edinburgh, have been delayed due to mechanical and operational issues. What can be done to ensure that there is robust regulation, such that timetabled rural bus services are provided unless there are exceptional circumstances that are outwith the operator’s control?

Will the cabinet secretary consider extending the parameters of what is covered by bus regulation to include reasonable levels of comfort, such as adequate temperature control, sufficient seating and adequate shelter at bus stops?

Michael Matheson (Scottish National Party, Falkirk West)

Claudia Beamish has raised an issue that is largely an operational matter for Stagecoach, with regard to the mechanical nature of the fleet that it uses, which of course needs to comply with the regulations that have been set down by the traffic commissioner. It might be that the issues that she has concerns about can be addressed by the commissioner, or she could go to Bus Users Scotland, which we fund and which helps to support people who have concerns about bus services. However, the practical operation of the bus is a matter for the operator. Claudia Beamish could address some of the issues through the commissioner, who might be able to assist in addressing some of those concerns.

Joan McAlpine (Scottish National Party, South Scotland)

I welcome the budget’s £83 million investment in the future transport fund. Can the cabinet secretary outline how local authorities will be able to apply for and make use of the funding?

Michael Matheson (Scottish National Party, Falkirk West)

The future transport fund will have £83 million, as is set out in the draft budget. It will support a range of low-carbon programmes and projects, including initiatives to support the transition to deployment of zero-emissions buses on local routes.

The programme for Government also set out our commitment to take forward our Scottish ultra-low-emissions bus scheme—it is open for applications and bids can be made between now and 27 February—to support the industry to move to low-carbon buses.

The fund will also support the development of cycling infrastructure through the places for everyone programme, which is administered by Sustrans, and improved bus-priority infrastructure, which includes consideration of how the new bus partnership fund can be used by local authorities to develop proposals that they might consider for their areas. The fund covers a number of different areas. Local authorities and other organisations can contact Transport Scotland and look to make applications with regard to the various aspects of the fund.

Finlay Carson (Conservative, Galloway and West Dumfries)

Can the cabinet secretary outline what discussions, if any, he has had with Dumfries and Galloway Council about establishing a local bus service franchise? Can he also outline what support the Scottish Government can provide to local authorities if it is their intention to improve rural bus services in that manner?

Michael Matheson (Scottish National Party, Falkirk West)

Any intention in Dumfries and Galloway Council to establish a franchise would be a matter for elected members of that council. Transport Scotland officials can give them advice on the legislation that is in place, but that would be a matter for the council to take forward.

Transport Procurement (Processes and Criteria)

Daniel Johnson (Labour, Edinburgh Southern)

4. To ask the Scottish Government whether it has reviewed its transport procurement processes and criteria, in the light of recent issues relating to ferry contracts. (S5O-04124)

Paul Wheelhouse (Scottish National Party, South Scotland)

The Scottish Government continually reviews its procurement processes and levels of governance for major infrastructure and vessel investment projects.

Daniel Johnson (Labour, Edinburgh Southern)

The ferries that are being procured through Ferguson Marine raise serious questions regarding oversight and governance.

We need answers from the Government on why it has decided to build two dual-fuel ferries that CalMac Ferries apparently did not want. There are questions about whether the ferries’ propulsion systems are appropriate for the distance of the routes and whether the design specification was properly signed off. Either the procurement process was deficient, or it was not followed. Which of those does the minister think it is?

Paul Wheelhouse (Scottish National Party, South Scotland)

Mr Johnson is obviously trying to get in ahead of the committee inquiry, which I am pleased to be taking part in. Unfortunately, the date on which I will appear has now been moved back by the committee. I will look to answer all of the questions that are raised with me at the appropriate time.

I do not agree with Mr Johnson’s assertions about the design of the vessels. We believe that the vessels are of a good design for the services that they will provide. Clearly, we are trying to move to decarbonise the fleet and dual-fuel propulsion systems are one means of doing that. We are looking forward and will ensure that we take full account of the need to decarbonise ferry travel for passengers and vehicles as we develop our future ferries plan and the vessel replacement and deployment plan.

On procurement, I remind the member that we are supporting a very important business in Inverclyde. I appreciate that his party are supportive of that, but I hope that it recognises that, in awarding the work to the yard, which is a good yard, we will ultimately see good vessels being delivered, notwithstanding the challenges that we had with previous management.

Ferry Procurement (Competition and Markets Authority)

Jeremy Balfour (Conservative, Lothian)

5. To ask the Scottish Government what its response is to the Competition and Markets Authority’s analysis of its handling of ferry contracts and the potential effect that has on future procurement. (S5O-04125)

Paul Wheelhouse (Scottish National Party, South Scotland)

The Competition and Markets Authority's paper is not an analysis of our handling of ferry contracts; rather, it notes the CMA’s view on competition in the future procurement of vessels.

Jeremy Balfour (Conservative, Lothian)

I am sure that we can all agree on the importance of securing Scotland’s shipbuilding industry. However, does the minister also agree that the disastrous mismanagement by the Scottish National Party that we have seen at Ferguson Marine is not sustainable?

Paul Wheelhouse (Scottish National Party, South Scotland)

I am glad that Mr Balfour is not a member of the judiciary, because it is customary at an inquiry to hear the evidence from witnesses before coming to conclusions. As I said in my response to Mr Johnson, we fundamentally disagree with that assessment of the situation, and my colleagues and I are prepared to defend our position when we come before the committee as part of its inquiry. We will respect the results that come from the inquiry.

Not all of Mr Balfour’s colleagues have previously expressed support for shipbuilding in Inverclyde; not all of them have previously agreed with that position. I am glad to see a sign that the Conservative Party is, perhaps, beginning to support the shipbuilding industry after decades of neglect.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

The Law Society of Scotland has stated that importance has to be placed not only on financial and commercial matters but on ensuring that procurement

“takes full account of other relevant considerations”.

Can the minister give an indication of some of the wider benefits that the recent issues relating to ferry contracts will have on the 300 jobs and on the local economy that the shipyard, which is in my constituency, supports?

Paul Wheelhouse (Scottish National Party, South Scotland)

As Mr McMillan will know—because he has been closely engaged throughout the process, since 2014—our efforts saved Ferguson Marine from closure. As he said, we rescued more than 300 jobs. We also ensured that the two vessels that are under construction will be completed, and secured a future for the yard. The alternative was to walk away. That was unpalatable for us and we were not prepared to do it. In addition to saving the jobs in the yard, stepping in to save the yard supports jobs in the supply chain locally and further afield, including local businesses and suppliers that depend on business from the yard and its workers.

In the past few weeks, we have heard suggestions—including at the committee sessions that were referred to earlier—that vessels should be built in China and South Korea. Although I respect the individuals who made those points, and they are entitled to their view, we believe that such a view betrays a staggering lack of commitment to the workforce and local community in Inverclyde. I assure Mr McMillan, who represents his community with great passion, that we are absolutely behind the people of Inverclyde.

Liam McArthur (Liberal Democrat, Orkney Islands)

As part of any review of procurement and the Government’s ferries plan, will the minister agree a timeframe with Orkney Islands Council for the procurement of the replacement vessels that are urgently needed to operate on Orkney’s internal lifeline routes?

Paul Wheelhouse (Scottish National Party, South Scotland)

I recognise Mr McArthur’s strong interest in the issue as the constituency member for Orkney. He will know that those services are currently provided by Orkney Islands Council. I undertake to have continued discussions with the council as we move forward but, at the moment, our focus is on the immediate issues that are before us, in the context of developing the vessel replacement and deployment plan for our supported ferries and the ferries plan for the next period, and supporting the workforce in Inverclyde to ensure that we maintain employment in the area, as I said in response to Mr McMillan, and deliver hulls 801 and 802 as soon as possible, which are needed to provide vital services to communities in the Clyde and Hebrides.

Scottish 4G Infill Programme (Aberdeenshire)

Gillian Martin (Scottish National Party, Aberdeenshire East)

6. To ask the Scottish Government whether it will provide an update on the progress of the Scottish 4G infill programme in Aberdeenshire. (S5O-04126)

Paul Wheelhouse (Scottish National Party, South Scotland)

We are making good progress with the 4G mobile infill programme. Thirteen masts have been built or are under construction and I am pleased to be able to advise the Parliament that the mast at New Luce in Galloway went live last weekend.

Unfortunately, progress has been slower at the two candidate sites that were identified in Aberdeenshire: Pennan and Collieston. No confirmed interest has yet been expressed by any of the mobile network operators. I assure Ms Martin that Scottish Government officials and I will continue to use every opportunity to secure mobile operators’ interest in those and other candidate sites.

Gillian Martin (Scottish National Party, Aberdeenshire East)

The minister has largely answered my supplementary question, which was about Collieston, because I was informed recently that there is no interest from operators. What can be done to encourage operators to get involved in the process and give us the coverage that we desperately need?

Paul Wheelhouse (Scottish National Party, South Scotland)

It would be wrong to say that there is no interest whatever, but we have not had confirmed interest in taking on the mast at Collieston. It is important to recognise that a fundamental principle of the Scottish 4G infill programme is that, unless at least one operator is committed to delivering 4G services from a candidate site, the site will not progress to build.

We are in discussion with an operator that has expressed interest in the site at Collieston, but I reiterate that that is not yet a confirmed interest. We are pressing for the operator’s commitment to using the site. If that can be achieved, the site will progress to build. We will publish updates to the programme on our website and I will write to Ms Martin with a further update on Collieston when that is available.

Of course, I welcome interest from members about sites in their areas in relation to the Scottish 4G infill programme.

Get Glasgow Moving Campaign

The Deputy Presiding Officer

I call Johann Lamont to ask question 7.

Johann Lamont (Labour, Glasgow)

To ask the Scottish Government, in light of the River Clyde bursting its banks, what impact and risk assessment it has made in relation to Glasgow’s flood defences.

The Deputy Presiding Officer

I do not think that that is the question as written—

Michael Matheson (Scottish National Party, Falkirk West)

It is not the question that I have before me—

The Deputy Presiding Officer

No, it is not. Sorry, Ms Lamont, will you ask your question as published in the

Business Bulletin

?

Johann Lamont (Labour, Glasgow)

I apologise. I think that I have got my weeks mixed up. No doubt there will be some investigation. I will not give my justification for the mix-up. [

Laughter

.]

To ask the Scottish Government what its response is to the Get Glasgow Moving petition calling for publicly owned buses. (S5O-04127)

The Deputy Presiding Officer

Now, that is a wee bit different from the other question.

Michael Matheson (Scottish National Party, Falkirk West)

Flood prevention in Glasgow, no.

We welcome Get Glasgow Moving’s commitment to improving public transport in Glasgow. The Transport (Scotland) Act 2019 provides a range of new tools that local transport authorities can use to meet local needs and circumstances, whether they wish to pursue partnership working with local bus service providers, local franchising or the running of their own bus services.

Alongside the 2019 act, we are bringing forward transformational long-term funding for bus priority infrastructure of more than half a billion pounds.

Johann Lamont (Labour, Glasgow)

I thank the cabinet secretary and, given the mix-up in my questions, I just ask him to consider carefully how he might encourage communities to develop co-operative models for the provision of local bus services. A number of campaigns, from the Co-operative Party and others, recognise that the co-operative model can provide an effective means of bringing bus transport to communities. I ask the cabinet secretary to commit to looking further at the issue.

Michael Matheson (Scottish National Party, Falkirk West)

I would be more than happy to look at that issue, which is a very interesting concept around providing local bus services. Particularly in rural areas, there is the potential for co-operative models to be one of the means by which bus services could be provided. If Johann Lamont will provide me with further information on the specific proposals that she believes are worth considering, I will be happy to engage with her and to look at those in further detail.

The Deputy Presiding Officer

That concludes questions on transport and infrastructure. I apologise to Annie Wells for failing to reach her question.

Justice System (Support for Serious Crime Victims)

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

1. To ask the Scottish Government how the justice system provides support to victims of serious crime and keeps them informed at every stage of the process. (S5O-04129)

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I welcome the member’s question, particularly as this is victims awareness week. The victims code for Scotland sets out victims’ rights to information. Victims of serious crime will be allocated a family liaison officer by Police Scotland to update them during the police investigation. If that leads to criminal charges, victims can also access support from the victim information and advice service at the Crown Office and Procurator Fiscal Service. Following a conviction, information on prisoners is available through the victim notification scheme. Support is available via Victim Support Scotland, including its support for families bereaved by crime service, and via the national advocacy project for victims of sexual violence. The victims task force is also considering ways to improve support and information.

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

How does the Scottish Government ensure that victims of crime, especially the most serious crimes, have suitable emotional support and receive practical information specifically about their rights to make representations to the Parole Board?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

That is a hugely important area and a very important question; I thank the member for raising it. He will be aware that we recently held a consultation on parole and the analysis and response from that has been extremely welcome. We are actively looking at the support that Victim Support Scotland can provide and what it already does, and it can provide further emotional and practical support to victims when they are making written or oral representations to the Parole Board.

On the back of the consultation, we are looking at whether victims can perhaps even attend Parole Board hearings and a key part of that will be ensuring that they have welfare and emotional support. A transforming parole implementation group is taking that work forward. The group has met once, on 28 January, and it is due to meet again next week. I am happy to keep the member informed of progress as that work develops.

Liam McArthur (Liberal Democrat, Orkney Islands)

A key feature of the Victims and Witnesses (Scotland) Act 2014 was police restitution orders, which would help to finance an expansion of the support that officers receive following an assault in the line of duty. To date, there is no sign of those orders being implemented. Why has there been a delay and when can we expect those orders to be brought forward?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

There has been good progress on restitution orders. I will write to the member with more detail. As he probably knows, some of the delay arose because of conversations that we had to have with the United Kingdom Government, which have been constructive ones. I made a commitment when I first came into this role that I would like to bring forward restitution orders and it was certainly an ask from the Scottish Police Federation. There has been significant progress and I will write to the member with more details.

The Deputy Presiding Officer

Question 2 has been withdrawn for an obvious reason.

Transdermal Alcohol Monitoring Tags

Elizabeth Smith (Conservative, Mid Scotland and Fife)

3. To ask the Scottish Government whether it will provide an update on the introduction of transdermal alcohol monitoring tags. (S5O-04131)

Humza Yousaf (Scottish National Party, Glasgow Pollok)

Last year, through the Management of Offenders (Scotland) Act 2019, the Scottish Government introduced a legislative framework to enable the expansion of electronic monitoring, including through deployment of new technologies for remote substance monitoring. In October 2019 following a procurement exercise, we announced a new electronic monitoring contract, which will commence on 1 April 2020 and will include those technological capabilities.

While the provisions of the Act that enable remote substance monitoring have not yet been commenced, the next steps will be to work closely with justice stakeholders to discuss how this enhanced monitoring may be most effectively used in future.

Elizabeth Smith (Conservative, Mid Scotland and Fife)

I thank the cabinet secretary for that interesting answer. He will know that recent evaluations from two separate United Kingdom pilots—the first in Humberside, Lincolnshire and North Yorkshire and the second in London—saw a combined total of more than 1,400 offenders subject to compulsory sobriety when monitoring took place with alcohol tags. Those pilots yielded a 94 per cent compliance rate.

Does the cabinet secretary agree that continuous alcohol monitoring tags could play an important part in ensuring that we are tackling alcohol-fuelled crime here in Scotland?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I certainly think that the pilots that have been taking place in England and Wales are worth exploring and that the technologies that we are discussing can absolutely play a role. I previously welcomed a positive comment that was made by the Conservative justice spokesperson, Liam Kerr, about the technologies, and we think that they have a role to play. However, there will not be one silver bullet to tackle the issue; I know that Liz Smith is certainly not suggesting that that is the case. We will want to work very closely with individuals who are suffering from alcohol and substance abuse and work on the preventative agenda where we can.

Transdermal technologies could absolutely play a role, and we are working very closely with partners here in Scotland, as well as looking at what the pilots in England and Wales are demonstrating. I thank Liz Smith and her party for keeping an open mind about using such technologies in the future.

Access Rights for Grandparents

Willie Coffey (Scottish National Party, Kilmarnock and Irvine Valley)

4. To ask the Scottish Government whether it is considering a policy of granting a right of access for children to their grandparents in cases of family separation. (S5O-04132)

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Government recognises the important role that grandparents play in many families in bringing up children.

We have not included a specific provision in the Children (Scotland) Bill on the relationships between a grandparent and a child, as we believe that such a provision could cut across the key principle in the legislation that the welfare of the child is the court’s “paramount consideration”.

Willie Coffey (Scottish National Party, Kilmarnock and Irvine Valley)

The minister will be aware of the United Nations convention that sets out the fundamental rights of a child, including the right to live with a family that loves and cares for them. Will the minister consider enshrining that basic right in our own legislation as we take forward the Children (Scotland) Bill, such that there is a requirement on anyone who is seeking to deny children that basic right to seek a court order to do so?

Ash Denham (Scottish National Party, Edinburgh Eastern)

Currently, a grandparent can apply for a contact order under section 11 of the Children (Scotland) Act 1995. In making a decision, the welfare of the child will be the court’s “paramount consideration”, taking into account the views that are expressed by the child. The bill would require the court, when considering the welfare of the child, to take account of the effect of its decision on the child’s important non-parental relationships, which could of course include grandparents. My view is that the present position complies with the UN Convention on the Rights of the Child.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am grateful to the minister for taking the time to meet my constituents, Gordon and Shonia-Maree Mason, who, after involuntary estrangement from their grandson, have been campaigning on the issue. They recognise the problems that the minister has outlined about extending the right to grandparents, but does the minister agree that the French model of giving children the right to have connections with their ancestors when it is appropriate and in the interests of their welfare to do so, is a way forward here?

Ash Denham (Scottish National Party, Edinburgh Eastern)

I thank Alex Cole-Hamilton for raising the matter and mentioning that I met him and his constituents to explore the issue with them. We want to ensure that children can expect to know and maintain contact with their wider family, except in very exceptional circumstances. However, I do not consider that an automatic right of contact, such as Alex Cole-Hamilton is describing, is appropriate for a number of reasons, including that it may not be in the child’s best interest in every case and it could, as I said earlier, cut across the key principle of the 1995 act that the welfare of the child is the “paramount consideration”.

Grandparents can of course apply to the court for contact under the existing legislation, and a decision will then be made by the court about what is in the child’s best interest in that particular case.

Jeremy Balfour (Conservative, Lothian)

Like other members, I have had a number of constituents contact me about the issue. As the minister will be aware, in other jurisdictions across the world there is a presumption that the grandparents would have a right of access—it is not an automatic right, but a presumption. Will the minister look at including in the bill a presumption that grandparents would have a right to see their grandchildren while also recognising that such a right must be in the best interest of the child?

Ash Denham (Scottish National Party, Edinburgh Eastern)

We have already looked at such a presumption during the passage of the Children (Scotland) Bill. It is a very complex area. As members might expect, such a presumption was strongly supported by organisations such as Grandparents Apart UK. However, there was considerable opposition to it, and concerns were raised that any such provision would cut across the key principle in the bill, which is that the welfare of the child should be taken into account.

We consider that the arguments against having such a provision in the law are stronger than the arguments for including such a provision in the bill.

Management of Offenders (Scotland) Act 2019 (Implementation)

James Kelly (Labour, Glasgow)

5. To ask the Scottish Government what progress has been made on implementing the provisions in the Management of Offenders (Scotland) Act 2019. (S5O-04133)

Humza Yousaf (Scottish National Party, Glasgow Pollok)

The 2019 act covers four distinct topics: electronic monitoring, disclosure, the Parole Board for Scotland and the control of release from prison, including the use of home detention curfew.

To date, there have been three sets of commencement regulations that have brought in different aspects of the act. In October 2019, initial commencement regulations brought into force a number of provisions in relation to home detention curfew and prisons, including those that provided for the new offence of remaining unlawfully at large, improved powers of recall from HDC and the duty on public authorities to co-operate in relation to early release from prison.

In December 2019, commencement regulations brought into force a number of provisions in relation to disclosure ahead of wider commencement of the substantive provisions later this year. In the same month, we also commenced section 44 of the 2019 act in respect of periods of appointment of the chairperson and members of the Parole Board.

James Kelly (Labour, Glasgow)

It is a matter of real concern that no date has been set for the implementation of provisions in part 2 of the 2019 act on spent convictions. A case has been drawn to my attention involving an individual who was convicted and fined £400 in December 2015. Under the new law, that conviction would have been spent in 12 months and the record withdrawn from disclosure. However, last month the individual concerned had a job offer withdrawn because a record of the conviction was still on their disclosure. That is unacceptable.

Why has there been a dereliction of duty in that area? What is the point of Parliament passing laws when, six months down the line, no action has been taken to introduce that aspect of the 2019 act?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

I express sympathy with James Kelly’s constituent. Mr Kelly will understand that the Scottish Government’s intention is to have a fairer system of disclosure. That is why we introduced the

Management of Offenders (Scotland) Bill, which I am pleased was supported by Labour.

I take exception to the way in which Mr Kelly framed the question. There has not been a dereliction of duty. We sometimes take time to commence provisions because, for a variety of reasons, it can take partners time to be ready. When it comes to disclosure, some work needs to be done in relation to Disclosure Scotland’s information technology systems. The work to update Disclosure Scotland’s IT systems is progressing well, and we are confident that it will be completed in the next few months. [

Interruption

.]

Mr Kelly shouts, “Six months,” from a sedentary position. If he has ever been involved in projects to update IT, he will know that they can take some time.

James Kelly (Labour, Glasgow)

I have been.

Humza Yousaf (Scottish National Party, Glasgow Pollok)

We are working on the basis that the new IT systems will be up and running and ready to commence operation in the next few months. There is no delay, dithering or dereliction of duty. We are talking about pragmatic, practical things that have to be worked through.

However, the policy intention is absolutely sound, and I can give Mr Kelly an absolute guarantee that there would be no reason for us to want to delay. We want the relevant provisions to be implemented, but it would be a dereliction of duty if I allowed that to happen when Disclosure Scotland’s IT systems were not ready to cope with those changes.

I will continue to make sure that Mr Kelly is kept up to date with progress, and I give him a reassurance that there has been no unnecessary delay in introducing the measures in question.

The Deputy Presiding Officer

I ask for shorter questions and answers so that we can get in the other members who have questions.

Scottish Fire and Rescue Service (Investment)

Shona Robison (Scottish National Party, Dundee City East)

6. To ask the Scottish Government how increased investment, outlined in its draft budget, will help support the Scottish Fire and Rescue Service. (S5O-04134)

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Fire and Rescue Service continues to adapt to the changing risks that Scotland’s communities face. With the additional £6.1 million funding that was announced in the draft budget, this will be the third year in a row in which the Scottish Government has provided increased investment to enable SFRS modernisation. That funding will allow the SFRS to have a renewed focus on prevention to keep vulnerable people safe in their homes.

Shona Robison (Scottish National Party, Dundee City East)

I understand that firefighters are being balloted on a new pay and conditions offer, with the ballot closing at the end of the month. Will the minister provide an update on the negotiations and let us know what progress has been made so far with the main representative body, the Fire Brigades Union?

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Government is not part of the negotiations on firefighters’ pay and conditions, because those matters are between the SFRS, as the employer, and the FBU. The SFRS made a final pay offer that amounted to a 17 per cent increase for the period until July 2022, for the expanded role from November 2019. The FBU is balloting members on that offer, with a closing date of 28 February.

I have written to the SFRS and the FBU to make clear the Scottish Government’s position, which is that additional investment in the SFRS can be supported only if real progress is made on broadening the role of firefighters in Scotland. I hope that a deal can be reached soon.

Drug Supply Routes (Police Surveillance)

Liam Kerr (Conservative, North East Scotland)

7. To ask the Scottish Government what discussions it has had with Police Scotland regarding surveillance of drug supply routes. (S5O-04135)

Humza Yousaf (Scottish National Party, Glasgow Pollok)

As the chair of the serious organised crime task force, I have regular discussions with partners, including Police Scotland, about our collective enforcement activity in disrupting the drugs trade.

As Liam Kerr will be aware, the nature of the threats that our communities face is changing, and therefore our response to, for example, online offending against vulnerable people, human trafficking and other cyber-based crimes, such as child sexual exploitation, must change, too. The chief constable needs to make decisions about how best to use resources that reflect the changing nature of threats.

The best way of protecting people in all of Scotland’s communities is to ensure that the chief constable has the overall capacity and capability to address the threats that are faced by communities, including those in Dumfries. The decision regarding the surveillance team in Dumfries is an operational matter for the chief constable within that broader context.

Liam Kerr (Conservative, North East Scotland)

From his discussions, the cabinet secretary will be well aware that it has been reported that a vital police surveillance unit that is based in Dumfries and Galloway will be shut down, despite the fact that the area’s ports and roads make it a choke point for the supply of drugs. It has been reported that cuts to police budgets are directly responsible for such decisions. A former member of the unit has said:

“Removing the team from Dumfries will give organised crime gangs more scope to carry out their criminal activities.”

Is he not correct?

Humza Yousaf (Scottish National Party, Glasgow Pollok)

It is utter nonsense to suggest that the decision has been taken for resourcing reasons. It has been taken for operational reasons, and it is right that the chief constable has the independent discretion to make such decisions.

It is quite something for Liam Kerr and the Tories to think that it is appropriate for politicians to direct the operational activity of the chief constable. I am certain that Liam Kerr thinks very highly of himself, but the chief constable has 30 years of operational experience, which is far more than that of Liam Kerr or, indeed, any other politician in the chamber.

It is right for us to leave operational decisions to the chief constable. There should be no political interference in his decisions. If Liam Kerr has concerns, he should raise them directly with the chief constable; he should not be demanding that the justice secretary intervenes. However, I suspect that the chief constable will take a very dim view of Liam Kerr telling him what he should be doing in his capacity and with his assets.

Children (Scotland) Bill (Engagement)

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

8. To ask the Scottish Government how it is engaging with interested parties, such as Families Need Fathers, during stage 1 of the Children (Scotland) Bill. (S5O-04136)

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Government has engaged with stakeholders since the Children (Scotland) Bill was introduced in the Scottish Parliament on 2 September 2019 and continues to do so. I have met Shared Parenting Scotland—which was formerly called Families Need Fathers Scotland—twice since my appointment as Minister for Community Safety. Officials have met Shared Parenting Scotland on a number of occasions since the bill was introduced. For example, officials attended the relaunch of Shared Parenting Scotland on 10 February.

Keith Brown (Scottish National Party, Clackmannanshire and Dunblane)

I have been contacted by not only Families Need Fathers but a number of constituents regarding the bill’s provisions relating to estranged parents and the need for them to maintain personal relationships and direct contact with their children. Would the minister be willing to meet me to discuss my constituents’ views?

Ash Denham (Scottish National Party, Edinburgh Eastern)

The Scottish Government believes that both parents should be fully involved in a child’s upbringing, as long as that is in the best interests of the child. I would, of course, be happy to meet Mr Brown and/or his constituents to discuss the matter in more detail.

National Health Service

Linda Fabiani (Scottish National Party, East Kilbride)

The next item of business is a debate on motion S5M-20882, in the name of Monica Lennon, on standing up for national health service staff and patients.

Monica Lennon (Labour, Central Scotland)

I am grateful for the opportunity to use Scottish Labour’s debate time to stand up for our NHS. The motion is titled “Standing up for NHS Staff and Patients” and highlights key challenges and risks that face our health service.

Governance issues and resource pressures are unprecedented and put our most precious public service in jeopardy. That deserves the full attention of Parliament and not for just a couple of hours. We all rely on and are grateful to the NHS and we all have constituents who lobby us to raise their experiences in Parliament.

It is a troubling reality that our health service is not always available to us at the point of need. We have been told that by families who have been bereaved by suicide in Tayside; by chronic pain patients who have travelled to this Parliament from all over Scotland; by staff whistleblowers in Glasgow, Highland, Ayrshire and Lothian; by organisations worried that delays in diagnosing cancer are risking survival rates, including Cancer Research UK and this Parliament’s cross-party group on cancer. Audit Scotland has warned that the Scottish Government’s 2020 vision for the NHS will not be met.

In her questions to the First Minister before recess, Alison Johnstone nailed it when she outlined the growing gap between resources and demand and the pressure that our amazing NHS staff are under. The Green amendment rightly highlights the challenges that are faced in achieving the 2020 vision, which is in no small part due to the growing gap between available resources and growing pressures. We would gladly have supported Alison Johnstone’s amendment.

In his amendment, Miles Briggs rightly draws attention to staff wellbeing. Many of us attended a round-table meeting that Miles Briggs hosted in the Parliament, at which Brian Connolly—the father of Lauren Connolly, a junior doctor from East Kilbride, who died on her way home from work—addressed us and asked us to do something to help not only junior doctors but everyone on the front line of our health service. Minutes from the Scottish Government working group on the issue indicated that it would not be possible to achieve the 48-hour working week and maintain safe staffing levels without a 35 per cent increase in junior doctor numbers, which is an increase of approximately 2,200 more doctors. We are happy to work on a cross-party basis on issues like that, in order to improve staff wellbeing and the working culture within our NHS. Therefore, we will support Miles Briggs’s amendment.

We also want to work with the Scottish Government. I urge ministers to be more willing to work with Opposition parties to address those fundamental concerns about working culture and the impact of resource pressures.

Today, we have had many briefings—including those from the British Medical Association and the Royal College of Nursing—that are clear on the challenges and the solutions. There must be no more sticking plasters. We need to address immediate problems, such as long waiting times and delayed discharge. However, we need strong leadership, governance and a culture that values collaboration, openness and transparency, so it was disappointing to see the Scottish Government’s attempt to wreck our motion.

The motion reflects the serious concerns of patients and families, NHS staff, trade unions and professional bodies, and third sector groups that often fill the gaps and pick up the pieces when people are let down. Yet, ministers have used their amendment to delete all those concerns. That “nothing to see here” attitude is an insult to patients and staff.

Let us look at the laundry list of problems on the cabinet secretary’s desk. The Queen Elizabeth university hospital and the sick kids in Edinburgh need no further commentary. The legal 12-week waiting time guarantee has been broken over 250,000 times. The cabinet secretary’s much-vaunted waiting times improvement plan has missed its promised milestones and abjectly failed to improve patient waiting times; instead they have got worse.

The 62-day cancer waiting time target has not been met since 2012. The most recent statistics show that NHS Greater Glasgow and Clyde and NHS Lothian also failed to meet the 31-day cancer treatment time target.

The 18-week waiting time target for child and adolescent mental health services has not been met while Nicola Sturgeon has been First Minister and, last year, over 5,000 young people waited too long. The most recent figures have shown performance falling again, with more than a third of young people waiting more than 18 weeks for a first appointment.

In 2019, almost 7,000 operations were cancelled because hospitals could not cope.

Despite repeated promises to end delayed discharge, patients are still spending thousands of unnecessary days in hospital when they should be at home. Figures for December showed a 6 per cent increase compared to the year before, and delays to hospital discharge have cost the NHS almost £200 million since the cabinet secretary took up her post.

I want to mention chronic pain. Thousands of patients who are living with chronic pain are regularly being forced to wait over four months to get a first appointment at a pain clinic, but in the past financial year, services received only £27,000 in additional waiting times improvement funding. Dorothy-Grace Elder and members of the cross-party group on chronic pain are having to pursue answers through freedom of information requests just to get standard information on waiting times. I pay tribute to them and to patients, such as Catherine Hughes, who are exhausted but are fighting the good fight because they do not want other patients to go through the same. I urge the cabinet secretary to find the time to meet that group and those patients.

Many issues in our health service have come to light thanks only to the tenacity of brave whistleblowers, patients and journalists, who have asked the hard questions and not been fobbed off by health board and Scottish Government spin. I pay tribute to families affected by the tragedies and serious events at the Queen Elizabeth university hospital. They have shown us what courage looks like.

Many journalists are involved in that, but I have been speaking to Hannah Rodger from

The Herald

and

Herald on Sunday

. She has spent more than a year using freedom of information to get access to specific information about the handling of outbreaks at the Queen Elizabeth, and she has faced repeated resistance from NHS Greater Glasgow and Clyde. It is concerning that other bodies, including Health Protection Scotland, are following suit in their reluctance to provide information. There is more hiding behind patient confidentiality and legal excuses, yet they break those exemptions when the timing suits, to serve their own spin or narrative.

NHSGGC told Hannah Rodger that there was nothing new in the leaked reports that she was passed detailing the warnings about wards not being purpose built, the fact that the ventilation system throughout the campus might be exacerbating the spread of infection, and the concerns that information was missing from building logs. We got to the point at which the cabinet secretary called a public inquiry, but it should not have taken a year of campaigners, journalists and others meeting brick walls.

It feels as though patients and families are taking on the medical establishment—in fact, at times, it is like a medical mafia. Speaking out and standing up against their shocking treatment by the health board has meant that some staff have lost their jobs; that is the reality. Worryingly, the problems with transparency are not isolated to one health board or one part of Scotland. Sarah Boyack, Daniel Johnson and Anas Sarwar, who will speak in the debate, have all been tenacious in standing up for patients and staff in their areas.

We have the ridiculous and scandalous situation of the new sick kids hospital in Edinburgh lying empty and unable to treat a single patient, even though the health board is paying millions of pounds to the contractor for it. It is right that there will be a public inquiry into the construction of those hospitals in both Glasgow and Edinburgh. The dots needs to be joined, we need accountability and lessons must be learned.

In other health boards, such as NHS Tayside, so many families have had their lives turned upside down by the tragedy of suicide. Families have felt shut out and let down by the decisions of NHS Tayside. The Strang report, which we discussed in the chamber before recess, is a hopeful step towards changing that for good.

Miles Briggs’s amendment notes the Sturrock review, which highlights the culture of bullying and harassment in our NHS that needs to be stamped out.

I mentioned the Strang report, which was fuelled by the courage of families who have spoken out. Some of them are experiencing post-traumatic stress disorder themselves. I pay tribute to Gillian Murray, Mandy McLaren and others. It is not just a Tayside issue; the Minister for Mental Health is aware that there are patients who are our constituents in Lanarkshire who are saying the same things. That is why Gillian Murray in Tayside is working with Karen McKeown in Lanarkshire to petition the Parliament to make sure that the fragmentation among services for mental health and substance use ends and that we get to a point at which there is no wrong door—we are far away from that.

In the motion, we talk about health boards being in special measures. There is nothing special about that. The only thing spectacular about it is the fact that it has become so unprecedented. So many opportunities have been missed to step in and support boards and to have a deep dive into some of the problems. So many chief executives and chairs have resigned or been moved on that it feels like a game of NHS musical chairs.

We need a plan for reform, not a Government that shies away from acknowledging the challenges that we face. We need the Government to be open and transparent and to set the bar so that our health boards operate at a high level. We must end the culture of secrecy. That is why I am disappointed that the Government amendment seeks to delete all those concerns. I want the people of Scotland to know that not just the Labour Party, but all of us as a Parliament, with the support of the Government, will stand up for the NHS, no matter what. We will stand up for patients and for staff.

I move,

That the Parliament has serious concerns about governance, leadership, performance and financial sustainability within the health service, noting that six territorial NHS boards are at level three or higher on the performance escalation framework; notes the forthcoming public inquiry into the scandals in NHS Lothian and NHS Greater Glasgow and Clyde; considers that challenges and risks within the NHS are not being satisfactorily addressed by the Scottish Government, to the detriment of patients and NHS staff; pays tribute to NHS staff for their dedication to patient care and is worried that more than half of doctors and nurses surveyed by BMA Scotland and RCN Scotland link heavy workloads to negative impacts on their own health; believes that the Scottish Government must be more transparent on its stewardship of the NHS, in accordance with Open Government principles, and that the culture of secrecy must end; calls on the Scottish Government to ensure that ministers are accountable to the public and staff through the chairing of annual health board meetings, and agrees that the Parliament should have the power to take evidence from all departing health board chief executives and chairpersons.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I am pleased to take part in the debate. We are all living longer lives now, and that is indeed good news. It is a testament to the work that our NHS undertakes throughout the lives of every person in this chamber. The change in population brings challenges. Long-term conditions and comorbidities all place significant demands on health and social care. That is one of the reasons why it is so vital, both for our society as a whole and for our health and care services in particular, that Scotland continues to attract people to come and work here.

Our health boards face difficulties in recruiting staff to specialisms in certain areas, and the Scottish Government works with them to try and address those challenges. Their job and ours is made harder because of the additional complexities imposed on us by Brexit, the United Kingdom Government’s changes to pension and taxation and potentially an even more draconian immigration system that looks likely to be imposed against Scotland’s needs and against Scotland’s choice.

Daniel Johnson (Labour, Edinburgh Southern)

I struggle to understand how increases in demand led to bad decision making regarding the building of two hospitals at both ends of the M8.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

If I had been suggesting that, then I would have struggled along with the member. I am one minute and 13 seconds in to my speech, so give me a moment.

Where our system falls short of our expectations, we demand that action is taken to address it, because the consequences of shortcomings can be terrible. In the case of the sick kids hospital in Edinburgh, the impact includes the cost to the public purse.

Where bullying has taken place, the impact has clearly been to the detriment of staff who are trying to work to care for their fellow citizens. In the most tragic circumstances, shortcomings have ultimately resulted in the loss of life. I cannot begin to imagine the pain that is experienced by families who have lost loved ones in that way, particularly when that loss is of a child. As the health secretary, I again say how sorry I am that anyone should have had those experiences. They are not acceptable and they must be addressed and we are doing that.

Some members, including Mr Sarwar and Ms Baillie, have raised with me incredibly serious issues and have played a part in starting to see them addressed. Contributions such as theirs help to inform our on-going monitoring of boards through the escalation framework and to change the level of support and direction that boards get so that we can fix problems and failings.

As I have said before, I welcome constructive proposals from anyone to improve our health service for the benefit of patients, families and staff. Sadly, however, Ms Lennon’s motion has no such proposals. It calls for two things only: for ministers to chair annual board reviews, which we do, and for the Parliament to be able to call witnesses, which it can. If Ms Lennon has serious proposals to improve services, I will listen, but if the only contribution remains weak lines for press releases, I do not think that we will get very far.

Monica Lennon (Labour, Central Scotland)

Will the cabinet secretary give way?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

No—let me finish.

Three years ago, in February 2017, Labour announced that it was establishing an NHS workforce commission. Three years on, what is that commission proposing on workforce? Nothing. In those three years, we have produced workforce plans for acute care, primary care and social care. We have worked with the Convention of Scottish Local Authorities to produce an overarching workforce plan that draws all that together. We have seen 2,700 whole-time equivalent more staff join our NHS, which is an increase of 2 per cent, and we have passed the most comprehensive safe-staffing legislation anywhere in the United Kingdom. Overall, under the SNP, NHS staff numbers are up by 11.3 per cent, which means that more than 14,300 extra whole-time equivalent staff are working in our NHS to deliver the quality of our services that our citizens need.

Monica Lennon (Labour, Central Scotland)

We have been busy meeting the people who cannot get in front of the cabinet secretary, although she claims to have an open door. She made it a priority to establish staff whistleblowing champions, but that is only happening now. We are working with stakeholders on policy development. We have an election next year, but there has been no press release from us to trail the debate. The cabinet secretary’s response is an insult to all the people I mentioned in my opening remarks. It is more spin and more denial. Take responsibility—you have been in charge for 13 years.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

My response is absolutely none of those things, because that long list that Monica Lennon produced is a list of actions that we are taking—I have met those people. I am able to meet people, devise policy and lead our NHS. If you would like to try to do some of that, we might have a constructive discussion—

Monica Lennon (Labour, Central Scotland)

rose—

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

I will take no more interventions.

The Deputy Presiding Officer

Excuse me, ladies. You should not have private conversations and arguments across the chamber. Everything should come through me.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

My apologies, Presiding Officer.

Under this Government, since 2006-07, the annual resource investment in health has risen by 62.9 per cent, and our draft budget for 2020-21 will take total health spending to more than £15 billion, which is a rise of 4.2 per cent over and above the demand that we recognised in our medium-term financial framework. However, under Labour’s manifesto, health spending would have been down by £1.4 billion in this year.

Investment must of course be matched with reform. While social care reform in England remains in the long grass, we have backed integration, not with warm words but through our partnership with COSLA and the additional resources that are proposed in the budget, which take our total investment in health and social care partnerships to more than £9.4 billion. Investment in our NHS and in health staff, who are our most valuable resource, is vital and is producing improvements. That is not happening as fast as we want, but there is real, tangible and sustainable improvement.

In the year to September 2019, the number of out-patients waiting more than 12 weeks was down by 14 per cent, while there was a 50 per cent reduction in patients waiting more than six weeks for scopes and an 18 per cent reduction in patients waiting more than six weeks for one of the eight key diagnostic tests.

Edward Mountain (Conservative, Highlands and Islands)

Will Jeane Freeman take an intervention?

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

No—I have a lot to get through.

A 95 per cent performance rate for the 31-day cancer target has been met and improvements are coming through on the 62-day target. There is more to do—absolutely—but those improvements should be neither ignored nor dismissed.

There is innovation across our NHS every day: in home-based hypertension testing that is linked to social prescribing; in the growing number of patients that use the attend anywhere platform, or NHS near me; and in developments in optometry, community pharmacy, robotic surgery and orthopaedic in-patient stays and much more. Our job is to harness such innovation, gather the evidence of what works and enable it to be spread, as we did only yesterday with the NHS Lanarkshire hospital-at-home model.

I do not deny that there are challenges or problems. I am clear that the whole-system approach that we are taking and the whole-system engagement that we are nurturing—from our work with local authorities to our engagement with royal colleges, regulatory bodies and third sector organisations—are the right things to do.

I ask Opposition colleagues for recognition of the progress that our NHS staff are delivering, and I note that criticism and challenge should come along with constructive engagement, ideas and mature discussion. Our NHS, the staff who dedicate their lives to it and the patients who need it deserve nothing less from any one of us.

I move amendment S5M-20882.3, to leave out from “has serious concerns” to end and insert:

“pays tribute to NHS staff for their dedication to patient care and safety, commending them for the work they are doing in implementing plans for workforce development, waiting times improvements and enhancing mental health services; welcomes that the draft budget for 2020-21 would ensure that health funding will be £1.4 billion higher than had there been only real terms funding increases since 2016; notes that Lord Brodie will chair the public inquiry into the Royal Hospital for Children and Young People in Edinburgh and the Queen Elizabeth University Hospital and that the terms of reference for this inquiry are currently under development; welcomes that the Scottish Government ensures that ministers are accountable to the public and staff through the chairing of annual health board meetings, and notes that, should they choose to do so, the Parliament’s committees already have the power to take evidence from all departing health board chief executives and chairpersons.”

Miles Briggs (Conservative, Lothian)

Anyone out in the real world who has been watching the debate so far will think that the cabinet secretary does not have a grasp of what is going on in our health service. Her turning up for a photo call is one thing, but the daily emails that I receive from members of the NHS workforce show the trouble that they are in and that the cabinet secretary is not listening.

I welcome the debate, which builds on the debate that I led in the chamber in April 2019 on standing up for all those who work in our health service.

As in last April’s debate, I put on record my party’s gratitude to and support for each and every member of NHS staff in Scotland. Our NHS staff are, fundamentally, our NHS. They are the most valuable resource that we have. They are incredibly hard working and, despite the pressures that are put on them by ministers, they provide each of our constituents with first-class healthcare.

I am disappointed that the Scottish Government has not done more since last April’s debate to introduce some of the positive measures that members suggested to address workforce issues, staff workload concerns and working conditions, or to tackle the severe staff shortages in the NHS.

Earlier, Monica Lennon mentioned junior doctors working hours, which I have raised before. Last year, I was pleased to host a round-table meeting in Parliament with Brian Connelly, the father of a 23-year-old junior doctor who, sadly, was killed driving home after a 12-hour night shift. I pay tribute to Mr Connelly again on his campaigning. However, we need action on the issue, so I would be grateful if, in closing the debate, ministers could use the opportunity to tell us about what has come out of the work of the expert working group that is chaired by Professor Cachia. We should have heard about that earlier, and it is important for members and any junior doctors in the public gallery to understand where the Government is going with that work.

I have given my backing to the Royal College of Anaesthetists’ excellent fight fatigue campaign, which is a suggestion-based solution to how to support NHS staff.

The briefings from the BMA and the RCN for the debate highlight workforce concerns that we should all be acutely aware of. In the RCN’s 2019 employment survey, 60 per cent of respondents agreed that they are “under too much pressure” at work, with 70 per cent reporting that they work over

“their contracted hours at least once a week”

and 52 per cent reporting that they work beyond their contracted hours in each hospital shift. That demonstrates just how much more needs to be done to support NHS staff in Scotland. We need to look at such support holistically, which means looking at pre-shift and post-shift support.

Having rest facilities in hospitals and properly timetabled rotas so that staff can get a break are measures that could improve NHS staff wellbeing and effectiveness and, most important, their safety. For example, we have been calling for the Scottish Government to introduce sleep pods in hospital campuses, where which staff can rest before they head home or start shifts. I urge ministers to work with our health boards across Scotland to take that issue forward.

We want every health board to provide quality mental health and financial support and advice to NHS staff. With NHS staff absentee rates at such high levels, we need to look to invest now in better mental health support for our NHS workforce.

Issues and difficulties around parking are constantly raised with me. NHS staff at hospitals in Edinburgh and Glasgow and at Ninewells hospital still have to face parking charges. In campaigning to end that unfair charging, the Scottish Conservatives have put forward a solution: a refund scheme for NHS staff. The Government can take that forward, and I hope that all members can get behind it. The Scottish Government’s proposed budget does not include a refund scheme, but we can implement one—and it is costed. I hope that ministers will look to implement such a scheme. The charges must come to an end for NHS staff who work at those sites and still pay them. Ministers have had the powers to deal with that for 13 years.

We also want to see a comprehensive national review of parking for patients. In many cases—including many in Edinburgh, as I know from my own mailbag—when people go to hospital, they find the stress of parking, or there being no capacity to park, a significant issue. As a Parliament, we can address that. Money can be made available, given the £7 million in Barnett consequentials for parking that is coming to the Parliament. I hope that ministers will try to take that issue forward.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Will Miles Briggs accept two things and clarify one thing for me? First, does he accept that it was an SNP Government that abolished parking charges in those hospitals in respect of which we are not obliged to continue to pay more than £240 million a year for private finance initiative contracts? Secondly, does he accept that our approach on climate change should—as the attend anywhere programme and the near me services do—produce significant improvements so that people will perhaps no longer need to use their cars as much? Finally, will he clarify whether the £700 million that he claims is coming from Barnett consequentials is for car parking or for something else?

The Deputy Presiding Officer

Mr Briggs can have extra time.

Miles Briggs (Conservative, Lothian)

Thank you very much, Presiding Officer.

On Jeane Freeman’s first point, yes, but that was not the case in three hospitals where NHS staff still have to pay to park. We can do something about that: we can refund staff their parking charges. That is now planned to take place in England and Wales, and some £7 million will come to the Scottish Parliament in Barnett consequentials because of parking charges that staff will not pay in England and Wales. Ministers can decide to stop making staff pay at hospitals in Edinburgh and Glasgow and at Ninewells hospital and to use that money, or they can decide to see the charging approach continue. I do not believe that our NHS staff in Edinburgh and Glasgow and Ninewells hospital should continue to pay those parking fees.

I repeat the call for the Government to bring forward a full debate on the Sturrock review without further delay. My Highlands and Islands colleague Edward Mountain has also rightly and repeatedly made that call.

On the Scottish Government’s failure to meet a raft of NHS targets and its appalling oversight of key NHS infrastructure projects, I associate myself with the content of Monica Lennon’s motion. In speaking to my constituents across Edinburgh and Lothian, I am always struck by the fact that they are increasingly losing confidence in the SNP’s ability to lead and manage our NHS. That should not be any surprise to ministers when they look at all the problems that are mounting up.

However, there are innovative new solutions that we could take forward if ministers looked to implement them and listened across the Parliament.

As a co-convener of the Parliament’s cross-party group on cancer—Anas Sarwar is the group’s other co-convener—I have highlighted in recent months our report, which pointed out that cancer survival rates are being impacted by the lack of workforce; it also pointed out the SNP Government’s work on tackling cancer has not taken a long-term approach.

As Monica Lennon outlined, chronic pain patients across our country feel that they are completely ignored, and they have had enough—they want to see action to address chronic pain. We need to take that forward, and the Parliament needs to take a serious role in considering how people who suffer from chronic pain access services in Scotland. Many of our fellow Scots who have chronic pain are fighting day in, day out just to be believed.

I hope that ministers will use the debate to understand the problems that our health service faces and will listen to the calls from across the Parliament for cross-party action. I welcome the debate. We should all be scrutinising the Government’s failing record on our NHS.

I move amendment S5M-20882.1, to insert at end:

“; believes that there is a need to improve the holistic care and support provided to NHS and social care staff, including pre- and post-shift support, in order to promote wellbeing; condemns bullying in any part of the NHS, and calls on the Scottish Government to bring a full debate on the Sturrock review before Parliament at the earliest opportunity.”

Alison Johnstone (Green, Lothian)

I thank the Labour Party for bringing these issues to the chamber. Given the challenges that our health service has been facing in the past few months, the debate is extremely timely. I also pay tribute to our incredible health service staff, who are working in increasingly tough conditions and are still managing to deliver excellent care. It is important to acknowledge that. Audit Scotland’s report on the NHS, published in October, revealed that, despite the existing pressures, patient safety and experiences of hospital care continue to improve. The NHS in Scotland has a committed workforce that continues to provide high-quality, safe care. I am extremely grateful for that. It is essential that we in Parliament take time to highlight the challenges that the NHS faces but we must also thank our dedicated healthcare staff and celebrate the work that they do.

I agree with the principles that are contained in the motion in Monica Lennon’s name. It is vital that we have transparency across our public services, not least in our health service, where lives are at stake. My amendment, which was not selected for debate, urged the Scottish Government not only to publicly report on the progress of the health and social care plan but to urgently develop a new health and social care strategy. The Scottish Government’s 2020 vision, which stated that, by 2020, everyone would be able

“to live longer, healthier lives at home, or in a homely setting”,

has obviously not been realised. The Scottish Government needs to outline the revised timescales for realising its ambition.

The motion also refers to the sustainability of the health service. The same Audit Scotland report on the NHS was clear that wide-scale reform is necessary to address the increasing pressures on the NHS and to reduce demand for acute services. That is not happening, however. Delayed discharge figures are consistently poor and, between 2017-18 and 2018-19, the NHS saw an increase of 2.8 per cent in A and E attendances. Acute services are struggling at both ends of the pipeline, and patients are suffering as a result.

John Mason (Scottish National Party, Glasgow Shettleston)

I agree with a lot of what the member says. Does she accept that we will need to disinvest in hospitals if we are going to put more money into the community?

Alison Johnstone (Green, Lothian)

That is a big question, which I do not have time to cover in this debate.

Health inequalities, which drive a great deal of the pressure on our NHS, continue to permeate our society. The Royal College of Paediatric and Child Health’s 2019 update of its “State of Child Health” report said:

“The proportion of children at risk of being overweight or obese surges ahead in the most deprived areas but is falling back in the least deprived areas. Child poverty rates are increasing and child mental health services are struggling to meet demand.”

If we do not improve the health of our children, we have little hope of improving the health of the nation as a whole.

Of course, although accountability for any failings is essential, we need to avoid perpetuating a blame culture and instead ensure that NHS staff and leadership are supported and valued. As has been well described, there have been deeply concerning reports of a negative workplace culture in the health service. The departing chair of NHS Lothian, Brian Houston, stated in his resignation letter that the health board has not been treated with

“the values of openness and honesty, dignity and respect by some areas of the Scottish government”

and said that the board had been bringing the challenges that it was facing to the Scottish Government’s attention for years. Martin Hill, the vice-chair, similarly stated that

“the Scottish Government contrived to put Brian in a position where he felt it necessary to resign”.

Monica Lennon (Labour, Central Scotland)

When Alison Johnstone mentioned Brian Houston’s resignation, the Minister for Mental Health rolled her eyes. Do we have complacency at the heart of Government, given that it is not taking more seriously the letter from Brian Houston, which Alex Cole-Hamilton raised during topical questions before the recess?

Clare Haughey (Scottish National Party, Rutherglen)

On a point of order, Presiding Officer. I find the remarks that Monica Lennon has just made about me to be insulting. What my gestures are when I am not making a speech or an intervention, and when I am in conversation with a colleague sitting beside me, should not concern her.

The Deputy Presiding Officer

You have placed your feelings on the record, minister. We will now go back to Alison Johnstone.

Alison Johnstone (Green, Lothian)

It is clear that

people in management at NHS Lothian are not feeling wholly supported or valued. That is concerning in any workplace but, in our health service, which is critically important to the health and wellbeing of Scotland, it is alarming.

Failings in a health board are frequently indicative of wider issues and they should not be dismissed as being the fault of one individual.

I will not support the Scottish Government’s amendment, because it seeks to remove any reference to staff wellbeing despite the abundant evidence that NHS workers are under considerable strain. We must not ignore what front-line staff are telling us. Both the cabinet secretary and I attended the reception in the Scottish Parliament for the Royal College of Emergency Medicine a couple of weeks ago, and we were left in no doubt about the situation in emergency departments.

As Miles Briggs’s amendment points out, the Sturrock review revealed a culture of bullying at NHS Highland, and the independent inquiry into mental health services in NHS Tayside revealed that

“Some staff do not trust the organisation’s motivation, experiencing a culture of fear and blame. They see a failure of the organisation to take responsibility, and evidence of defensiveness and lack of transparency.”

There is a disturbing pattern here. As health boards struggle to meet demand and cope with staff shortages, stress and tensions increase, and it is clear that staff are too often bearing the brunt of that.

Those conditions will only worsen with the introduction of the UK Government’s post-Brexit immigration plans, which were revealed this week. The Home Secretary said that the plans are about bringing

“the brightest and the best”

to the UK and that the Government wants to

“reduce the levels of people coming to the UK with low skills.”

That devaluation of so many of our foreign-born workers is simply appalling. Historically, people who work in the care sector have been low paid and classed as low skilled, but caring for vulnerable people with multiple, complex conditions requires a particular skill set that we would do well to appreciate. Our health and social care system relies on so-called low-skilled workers, and the UK Government’s refusal to acknowledge that is short sighted at best.

I will support the Conservatives’ amendment because it makes some valuable points about workplace culture and the Sturrock review, but the Conservatives need to take a long, hard look at themselves and decide whether the best way to promote wellbeing is to devalue vital staff and worsen recruitment issues at a time when demand for NHS services has never been higher. I hope that they will work with other parties and with their Government at Westminster to lessen the impact of the new immigration rules on our health and social care services.

I am sure that staff and the public do not appreciate our NHS being used as a tool with which to score political points. We must work together constructively as a Parliament to better support our NHS workers, because they need us and we need them.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

It often sounds slightly clichéd to begin a speech such as this one by thanking NHS staff, but I do thank them, because they have saved the lives of two of my three children on several occasions. They work miracles even though they are on their knees and we sometimes ask them to do more with less. They have my thanks—particularly the junior doctors in the gallery—and so does the Royal College of Nursing Scotland, which has provided us with an excellent briefing for the debate.

I also pay tribute to some people who do not often get a lot of thanks, and they are the board chair, the board chief executive and the head of the health and social care partnership in my area. I have cause to work with Brian Houston, Tim Davison and Judith Proctor nearly daily and I know that they recognise the problems in their health board. I do not hold them responsible for a lot of those problems and I know that they are doing their very best.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member take an intervention?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

Not at this time. I need to make some progress.

I recognise that the departures of Tim Davison and Brian Houston, coming as they do, side by side, will create a massive leadership gulf in NHS Lothian, but I am conscious that we have some organisational memory left there.

There are warning lights across the dashboard of our NHS. We see that day in, day out in our constituency surgeries, including in cases where there are breaches of the 12-week waiting time guarantee. We hear that people, who are sometimes in abject pain, have been asked to wait 40 or 50 weeks for basic surgery even though they are clutching the letter that we still cruelly send them to say that they have a legal right to be seen within 12 weeks.

Not only that, but the systems for mailing things out to people are still stuck in the 1970s. A lady came to see me who had had a referral for suspected mouth cancer. At the top of the referral letter that she was clutching was an admission that it had been dictated in October and typed up in December. Delays of that kind, which are caused by information sitting in a dictaphone somewhere, cost lives.

I have previously referenced Dr Patrick Statham, my meeting with whom was the first time that I had had a consultant neurosurgeon come to my surgery to complain about delayed discharge. He is turning people away from the Western general hospital every single week because there are insufficient in-patient beds in that hospital due to its inability to discharge well patients into social care packages in the community.

That is typified by the constituents whose issues I have raised several times. George Ballantyne was declared well but had to wait 150 nights in the Liberton hospital at a cost of £500 a night for the want of a care package that would have cost £80 a night. That is the myopic problem in the integration agenda and we all need to address it.

The problem is that we do not value social care staff enough. The recognition that we pay people more to stack shelves in a supermarket than to provide round-the-clock intimate care to some of our most vulnerable citizens is an outrage. It is part of the reason why there is an interruption of flow throughout the health service, which is evident in our A and E delays and the waiting times problems there.

I will speak about NHS Lothian because it is creaking at the sides. I do not hold the board or the social care partnership responsible for that. GP surgeries are groaning under the weight of the new housing that has been forced on Edinburgh and are often closing their lists to new entrants. Added to that is the fact that our population is getting older.

John Mason—who I will let intervene in a minute, because I know that he wanted to—asked Alison Johnstone whether we need to divest from hospitals to invest in healthcare in the community. I would start by not wasting £1.4 million a month on a hospital that is currently lying empty and waiting for children.

James Dornan (Scottish National Party, Glasgow Cathcart)

Will the member take an intervention?

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I will take an intervention from James Dornan, if John Mason is not ready to intervene.

The Deputy Presiding Officer

Hold on. I call James Dornan.

James Dornan (Scottish National Party, Glasgow Cathcart)

What would Alex Cole-Hamilton do now with the hospital? He has to accept that we are where we are, and he has not answered John Mason’s question. We need to get the money from somewhere, now.

The Deputy Presiding Officer

Excuse me. We seem to be having private conversations again. I ask members to bear in mind that everything goes through the chair.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I am grateful for James Dornan’s intervention, but part of the issue is baked into the fabric of the design for the building. Eight years ago, the hospital was meant to open. It was first commissioned in 2012 and was due then. Of course we are not now going to put people into an unsafe hospital, but we need to learn those lessons and not put the blame for them at the feet of the chief executive and the chair of the health board, as this Government has sought to do. It is easy to lay blame.

I will come to the resignation of the board chair in one minute, but the cause of the fiasco was baked in eight years ago. It could have been stopped several times and it was not. I hope that we will get answers on that in the coming inquiry. However, Brian Houston in his resignation letter talked about the blame culture that goes from this Scottish Government to health boards around the country. The letter suggests that he was told to accept the blame for the sick kids hospital delay by this cabinet secretary. His words are that he felt a “rush to judgment” that

“appears to reflect a desire for blame that is unfair and inappropriate.”

I agree with him. I am shocked by it. At no point have I ascribed the blame for the sick kids hospital to this cabinet secretary, so I am dismayed to learn that a senior high-ranking official in the health board was meant by her to feel blame.

The culture of blame from this Government is not new. When the SNP cut funding to drug and alcohol services by £1.3 million in the capital, the cabinet secretary’s predecessor blamed NHS Lothian for not meeting the gap through NHS Scotland resource allocation committee funding. This NHS is in crisis and the answer to none of it is further centralisation.

Brian Houston’s resignation letter spoke to the heart of the problem in NHS Lothian when he wrote that

“we have consistently drawn the ... attention”

of the Scottish Government

“to the requirement for a fundamental step change in infrastructure and capacity to serve a population that is growing at twice the Scottish average.”

This Government has its fingers in its ears and it is not valuing the people on the front line who are trying to make it right.

The Deputy Presiding Officer

We now move to the open debate. Speeches of six minutes, please. It would be appreciated if people try to keep to time.

Jackie Baillie (Labour, Dumbarton)

It is perhaps unsurprising that I will focus on NHS Greater Glasgow and Clyde. It is Scotland’s largest health board, which covers the people who I represent in the Dumbarton constituency. I welcome the fact that the cabinet secretary has recognised how poor the health board is by ordering special measures for it at stage 4 of the NHS board performance framework.

The truth is that NHS Greater Glasgow and Clyde is failing—even the Scottish Government recognises that. It is failing its staff, who work so hard often with insufficient resources; it is failing patients, who are languishing on ever-increasing waiting lists; and it is failing our communities, as services are centralised away from their areas—making it difficult for those who are disadvantaged to access the services that they need.

The health board used to argue that centralisation delivered better outcomes, but, for the first time since records began, life expectancy in Scotland has fallen. That is a scandal in 21st century Scotland, and it is the measure on which the SNP Government should be judged—and judged harshly.

I welcome some of the things that the cabinet secretary has done, but I also think that she has been too lenient with those at the very top of NHS Greater Glasgow and Clyde. Frankly, I have had enough.

Jeane Freeman (Scottish National Party, Carrick, Cumnock and Doon Valley)

Will Jackie Baillie accept that there is a contradiction between a Labour member arguing that I should escalate NHS Greater Glasgow and Clyde to a higher level and the Labour motion citing escalation as an indication of failure by the NHS? Is it not, rather, an indication of a Government that is getting a grip of what is going wrong and acting on it? [

Interruption

].

Jackie Baillie (Labour, Dumbarton)

As the cabinet secretary will have heard my colleagues shouting, the two are not mutually exclusive. We do need action, and I am about to call for an increase in the action that is taken.

The level of complacency and downright incompetence that I have witnessed merits the escalation of special measures to stage 5—the most serious intervention possible—and the removal of the chair and chief executive, who have presided over that shocking series of failures.

Let us not forget that those failures include the cases of children such as Milly Main, who died needlessly in the Queen Elizabeth, Scotland’s flagship hospital, because of infections due to the condition of the building. How devastating for those families affected, and how outrageous that there appear to have been attempts to cover up the scandal.

The culture of secrecy and the lack of openness and transparency comes from the very top of the health board. I witnessed that first-hand when I worked alongside families who experienced the Clostridioides difficile outbreak in the Vale of Leven hospital where 38 people died. There was an independent review and a public inquiry, but it appears that lessons have not been learned by the health board. I suspect that the problems are not with the infection control team, and instead rest with the leadership at the very top, who did not act on the information that they had and effectively covered up the problems. It really does not get more serious than that, and it is symptomatic of the wider failures at the very top of the board.

Waiting times for scheduled and unscheduled care are now through the roof. Despite the additional resource being provided by the cabinet secretary, things appear to be getting worse, not better. Let me illustrate that.

John Christie is a well-liked local teacher. He was referred for a left knee replacement in June 2017. In July 2019, two years later, he was told that he needed a hip replacement first. He went for his pre-op in October 2019, but his surgery is unlikely to take place until August 2020. He is in so much pain that he had to be hospitalised. He is now barely able to walk. Almost three years on from his first referral, Mr Christie is still waiting. That is intolerable.

Fergus McMurdo is five years old. He needs his adenoids removed. He will wait until October 2020, more than a year after being seen by the consultant, for his operation. In the meantime, he is in pain and his condition is slowing his reading development at school. That is the tip of the iceberg. In my casework bag, I have the details of hundreds more cases in which people are being failed by NHS Greater Glasgow and Clyde. The treatment time guarantee in that health board is, simply, a joke.

I turn to the out-of-hours service at the Vale of Leven hospital. In 2018, there were 82 closures due to a lack of GP cover. In 2019, the number of closures soared to 179. That is a 118 per cent increase, and that is despite me challenging the health board—and, indeed, the cabinet secretary challenging the health board, during a meeting, with me, at the hospital in June 2019.

The problems are repeated at Inverclyde royal hospital. The Sir Lewis Ritchie review of primary care out-of-hours services reported in 2015. What has the health board been doing in the past five years? It has singularly failed to resolve the problem. I raised out-of-hours services again in the chamber in December 2019, and I was told that seven out of 70 salaried doctors had been recruited.

An iceberg is currently melting faster than the speed at which NHS Greater Glasgow and Clyde acts. The consequence of all that incompetence is that patients end up at the front door of A and E, increasing waiting times for conditions that can best be treated locally.

The level of inaction and incompetence is truly outrageous, and the contempt of the chair and chief executive for MSPs is all too evident.

John Mason (Scottish National Party, Glasgow Shettleston)

Will the member give way?

Jackie Baillie (Labour, Dumbarton)

No, I do not have time.

The chair and chief executive have not bothered to hold meetings with us in more than two and a half years. It is bad enough that they ignore MSPs, but to ignore the cabinet secretary, in effect, is scandalous.

There is no accountability, there is no transparency, and there is a litany of failures. I ask the cabinet secretary, for the sake of my constituents and the NHS, which we all hold close to our hearts, to sack the chair and chief executive. They are out of time and they should be out of office.

Emma Harper (Scottish National Party, South Scotland)

I welcome this debate, which affords the opportunity to discuss, positively, the progress that is being made on addressing many of the challenges that are mentioned in the Labour Party’s motion.

As a nurse educator who worked on the front line of the NHS until May 2016, I want to recognise the outstanding work that our dedicated, hard-working and competent NHS staff do, day in and day out, the length and breadth of Scotland.

The NHS in Scotland is our most important public resource and we must do everything that we can to ensure that it is properly funded and protected as a public service. As members will be aware, almost 50 per cent of this Parliament’s budget is spent on health. That clearly demonstrates this Government’s commitment to healthcare.

Indeed, in the budget that was announced by Kate Forbes, whom I welcome as our new finance secretary, funding for the NHS in 2020-21 will rise to more than £15 billion for the first time since this Parliament’s inception. The funding boost will allow our health service to continue to grow its workforce, which, over previous years under this Government, has risen by more than 14,300 whole-time-equivalent staff. That increase represents doctors, nurses, healthcare assistants and many allied health professionals and should be welcomed by all parties in the Parliament.

In addition, patient satisfaction rates in Scotland are soaring above the rates in other parts of the UK. Some 86 per cent of people in Scotland rated their full in-patient experience positively in 2018, and 83 per cent rated the overall care that their GP surgery provided as “good” or “excellent”.

In addition to the positive patient feedback, over the past five years there has been a decreasing year-on-year trend in rates of MRSA and C diff infection, which demonstrates that the Scottish patient safety programme is working to protect patients. As a result of that programme, we have some of the lowest rates of hospital-acquired infection in the UK.

When I was preparing for today’s debate, I contacted my Westminster colleague, Philippa Whitford MP, to talk about the Nuffield Trust’s research into the NHS in Scotland, which led to the report, “Learning from Scotland’s NHS”, by Mark Dayan and Nigel Edwards. The key findings and themes of the research show the strength of our NHS in Scotland compared with health services in the rest of the UK and even the rest of the world.

In the research, NHS Scotland was comprehensively compared with NHS services in England, Wales and Northern Ireland. The authors found that

“Scotland has a unique system of improving the quality of health care”

that is delivered to patients, which

“focuses on engaging the altruistic professional motivations of frontline staff to do better, and building their skills to improve.”

The authors went on to say that, in Scotland,

“Success is defined based on specific measurements of safety and effectiveness that make sense to clinicians.”

The vast majority of the clinicians who were interviewed for the research agreed with that.

The authors went on to say:

“Scotland’s system provides possible alternatives for an English system with a tendency towards too many short-term, top-down initiatives that often fail to reach the front line. It also provides one possible model for a Northern Irish NHS yet to have a pervasive commitment to quality improvement, and a Welsh system described as needing better ways to hold health boards to account while supporting them in improving care.”

That independent research and the findings speak for themselves and serve as an example of how the NHS in Scotland, under the Scottish Government, is showing leadership across the board.

The cabinet secretary mentioned technology that can reduce the need for travel, helping to mitigate the effects of climate change. In NHS Dumfries and Galloway, a lot of great work has been done by the respiratory team using the telemedicine approach for the past 10 years and the transforming Wigtownshire team has been engaging with the attend anywhere, community health synchronisation—CoH-Sync—and mPower programmes. A lot of great work is being done.

Alison Johnstone mentioned the Royal College of Emergency Medicine’s event. I was the sponsor of that event and I welcomed the words from Dr David Chung and from Kirsty, the doctor who spoke. She presented an overview of a really challenging work environment with many competing priorities on one particular night shift. However, she also said that she loved her job and how busy it was.

Alison Johnstone (Green, Lothian)

No one who attended the event that night could be in any doubt as to the commitment of the people who work in our emergency departments. However, the young doctor said, “It’s not safe”; those were the words that had gone through her head about the night that she spoke about. That must be of grave concern to every one of us.

Emma Harper (Scottish National Party, South Scotland)

As an operating room nurse who worked in the recovery room in what were sometimes really stressful and difficult environments, I know that it is sometimes challenging to support a safe environment. However, the doctor who spoke also said that that part of her work was what drew her to the emergency room environment. I agree that it can be challenging to create an environment that meets safety requirements, but everybody tries to meet those challenges in order to support the safest and most effective person-centred care.

I want to address the specific point in the Labour motion about staff morale. We know that a positive staff experience makes for a better health service overall and I am pleased that the Scottish Government is clear that the staff working in our NHS are our most important asset. I realise that I have gone over my six minutes, so I will just say that I welcome the debate and the opportunity to highlight the fantastic work that is going on in our NHS in Scotland. We must make sure that we preserve that and keep the NHS safe for everybody who uses it.

Annie Wells (Conservative, Glasgow)

This is a welcome debate and I begin with a thank you to all our NHS and social care staff. At key moments throughout all our lives, the Scottish NHS has been there to support us. We can probably all remember a particularly compassionate doctor or nurse who helped us at a difficult time and made sure that our loved ones were looked after and comfortable. When my son was born and when my dad passed away, our NHS was there, as it has been for so many of us at crucial moments.

We are incredibly lucky to have a health service of such quality that is ready to help when we need it. The backbone of our health service is, of course, its staff. Its people are the most valuable resource that our NHS has and we must look after the people who look after us. However, under the SNP Government, that is not happening. Scotland’s NHS has suffered in each and every year that the SNP has been in power. We all value the NHS greatly, but it has been mismanaged by this Government at almost every turn.

Gillian Martin (Scottish National Party, Aberdeenshire East)

Will the member take an intervention?

Annie Wells (Conservative, Glasgow)

Not at the moment; I have just started and I have a lot to get through.

There are the visible headline problems that everyone can see. We have a sick kids hospital that was supposed to open years ago but is still lying shut, treating no patients. Staff are having to work in older buildings instead and do not have access to new facilities where they could do their jobs better.

In my home city of Glasgow, the Queen Elizabeth university hospital has gone from one scandal to another. The problems just keep coming. The handling of water contamination has been shambolic from the start. Information was withheld from a parent that the death of her child in 2017 might have been linked to water contamination, and since that death was reported, it has emerged that Health Protection Scotland reports identified contamination risks as far back as 2016, with dozens of individual cases.

Then there are the headline targets that have been missed: a 12-week treatment time guarantee that has never been met, even though Nicola Sturgeon set the target herself in 2011; one in six patients with urgent cancer referrals is waiting more than two months for treatment; and, in A and E, nearly one in seven patients is waiting more than four hours to be seen, 600 patients are waiting more than eight hours, and 185 patients are waiting longer than 12 hours. How is that acceptable?

Gillian Martin (Scottish National Party, Aberdeenshire East)

Annie Wells says that in every year that the SNP has been in government, the health service has got worse. Will she not accept that funding has increased by 50 per cent under the SNP, £14 billion is coming this year and there are 14,300 more staff than there were in 2006?

Annie Wells (Conservative, Glasgow)

I absolutely welcome the increased funding from the UK Government—that is why the SNP has the money to spend on the health service. Members should listen to the end of what I am saying about the numbers of people—

Clare Haughey (Scottish National Party, Rutherglen)

Will the member take an intervention?

Annie Wells (Conservative, Glasgow)

Sorry, but I need to make progress. I am halfway through my time and not even halfway through my speech yet.

It is not the fault of our staff—not at all. They do their absolute best in dire situations that are caused by those blunders. Those are the headline problems, but under the surface, the picture gets even more depressing. Doctors and nurses do not get to do their job to the best of their ability because of the workforce crisis that has been created.

The Royal College of General Practitioners expects there to be a shortfall of 856 doctors in Scotland by 2021, which is only going to be made worse by the ageing workforce—

Clare Haughey (Scottish National Party, Rutherglen)

Will the member take an intervention?

Annie Wells (Conservative, Glasgow)

I have got too much to get through—sorry about that.

Clare Haughey (Scottish National Party, Rutherglen)

I thought that it was supposed to be a debate.

Annie Wells (Conservative, Glasgow)

Yes, it is a debate and I have taken an intervention, thank you very much.

Let us not forget that Audit Scotland has found that the SNP will struggle to meet its promise of an extra 800 GPs over the next decade.

Away from GPs, the problems are just as severe. There is an increasing lack of nurses and midwives. Recent figures showed that 3,826—

Emma Harper (Scottish National Party, South Scotland)

Will the member take an intervention?

Annie Wells (Conservative, Glasgow)

I am sorry, but I need to make progress. Recent figures showed—[

Interruption

.] Am I allowed to carry on?

The Deputy Presiding Officer

Carry on, Ms Wells.

Annie Wells (Conservative, Glasgow)

Recent figures showed that 3,826 whole-time nursing and midwifery posts for qualified and support staff were vacant. There were 802 more vacant nursing and midwifery posts in September 2019 than there were in September 2018. That

is the cost of a distracted SNP Government that is more focused on finding and inventing grievance with the UK Government than stepping up and sorting out the problems in our hospitals.

Gillian Martin (Scottish National Party, Aberdeenshire East)

Will the member take an intervention?

Annie Wells (Conservative, Glasgow)

I am in my last minute.

H

ow do we fix it? How do we start treating our NHS staff with the respect and support that they deserve? The UK Government’s huge funding increase to the Scottish budget over the next few years means that there really are no excuses.

As my colleague Miles Briggs said, we have set out plans to support the health and wellbeing of NHS and social care staff. One of those policies is free parking for NHS staff, which seems to be the bare minimum that we can do for doctors, nurses and all the staff who make our health service what it is.

We have set out ideas for better mental health support, more financial advice, health checks and sleep pods in hospitals for NHS night-shift staff to rest after shifts. All our plans have one thing at their heart, which is freeing up NHS and social care staff to focus on what they do best: caring for patients.

We should not take NHS staff for granted any longer. Let us support them and give them the backing that they deserve for being there for every single one of us, every single time.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

For Annie Wells’s benefit, I say that, proportionally, there are more GPs, more hospital consultants and more qualified midwives and nurses in Scotland than there are in England and Wales.

Emma Harper (Scottish National Party, South Scotland)

Will the member take an intervention?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

Okay.

Emma Harper (Scottish National Party, South Scotland)

I thank Stuart McMillan for taking the intervention, even though he is sitting beside me.

Does Stuart McMillan agree that Brexit is not helping, because we are seeing a 90 per cent reduction in the number of nurses and midwives from the European Union who are registering?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

Unsurprisingly, Emma Harper is absolutely correct in the point that she makes. [

Interruption

.] Some members might want to laugh but, unfortunately, Brexit will have a negative effect on many aspects of society in Scotland, including the NHS.

Miles Briggs (Conservative, Lothian)

Why did the First Minister cut the number of student nurse and midwife places when she was health secretary?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

The SNP Scottish Government has increased the numbers each year for the past eight years. Mr Briggs needs to do a bit more homework.

No member could say that the NHS is perfect, nor could any member highlight any organisation that is perfect. If they were to do so, they would be lying. However, although the NHS has its challenges, it is a magnificent organisation that delivers and which saves and rehabilitates lives. It is absolutely right for members to highlight the challenges that are faced in the areas that they represent, which are sometimes a result of a service failing to meet the usual high standards. Every one of us will write to our health boards, local GPs and health and social care partnerships regularly to highlight cases involving our constituents. If we see a pattern developing, that must be addressed.

The NHS is sometimes portrayed—we have heard this already, particularly from the Tories—as being close to Armageddon, but it is not. Talking down our NHS does not help the morale of the staff; it puts them under even more pressure and, coming on top of the extra demands that are being placed on the NHS, it will make it harder to recruit into the service the people whom we require.

Daniel Johnson (Labour, Edinburgh Southern)

Will the member give way?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I am sorry; I have already taken two interventions.

Monica Lennon’s motion highlights a few things that are happening in the health service, one of which is the public inquiry into what has happened in NHS Greater Glasgow and Clyde and NHS Lothian. It is right for that public inquiry to take place, because the public deserve to know what has happened. I do not disagree with Monica Lennon’s mentioning that in her motion. After all, we are talking about taxpayers’ money. If such an inquiry had not been set up, the Scottish Government would have been accused of trying to brush everything under the carpet.

On a similar note, the escalation to level 4 of NHS Greater Glasgow and Clyde and NHS Lothian and the putting in place of additional measures to examine the areas that have not operated as they should have done ought to be welcomed. Calls were made for special measures to be put in because of the concerns about those health boards. If the Scottish Government had not introduced the escalation process, it would have been accused of trying to cover things up. Thankfully, the Government put in place the required measures, and I think that that is the act of a responsible Government. The aim of the Government’s intervention is to ensure that a robust recovery plan is developed so that the boards improve their position on performance and other issues as quickly as is practicable.

Jackie Baillie (Labour, Dumbarton)

Will Stuart McMillan take an intervention?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I am sorry, but I have already taken two.

In her motion, Monica Lennon makes two asks. I have been to a few of the NHS Greater Glasgow and Clyde board meetings that she mentions in her motion. Both the current and the previous health secretaries were in attendance, as were Labour politicians.

Committees of this Parliament regularly bring in people to provide evidence. When I was first elected in 2007, I was a member of the Audit Committee, which undertook an inquiry into NHS Western Isles, which was an absolute basket case. If anyone would like to do a search on

Official Reports

of that committee, I am sure that they will find the phrase “basket case”. At one point in time, that board had three chief executives on its books: the one who had been put on gardening leave; the one who was brought in to fix the problem, who had to be put on gardening leave; and the one who came in and fixed the problem.

Monica Lennon (Labour, Central Scotland)

Will the member take an intervention?

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

I am sorry—I am in my final minute.

There are challenges in my constituency, which I have raised with the cabinet secretary and the health board. However, a number of positive actions have been taken, which I welcome, such as the building of Orchard View hospital, which is a continuing care facility that serves extremely vulnerable people. I welcome the building of the new Greenock health centre, which will be a state-of-the-art facility in my constituency, and the fact that lnverclyde was used as a pilot area for the minor ailment service that has now been rolled out elsewhere. There are areas of progress locally.

Jackie Baillie (Labour, Dumbarton)

Will the member take an intervention?

The Deputy Presiding Officer

Mr McMillan is just closing.

Stuart McMillan (Scottish National Party, Greenock and Inverclyde)

There are some challenges, one of which relates to

the out-of-hours GP service. I have raised that matter directly with the cabinet secretary and the health board. Clearly, the issue is of concern and needs to be fixed, but the Tories in London could help to fix the problem if they sorted out the pensions and overtime issues that are having an adverse effect on GPs who want to provide an out-of-hours service. I hope that the Tories will fix that problem when the UK budget takes place on 11 March, but I doubt that they will. The UK Government and the Tories have a bit of a cheek on the issue. People who are a bit more cynical than I am would probably say that the Tories’ actions are one way in which they are trying to downgrade the NHS, so that they can sell it off in a trade deal with the USA.

I am conscious of time, so I will conclude. I support the Scottish Government, which is trying to ensure that our health service is fit for purpose.

The Deputy Presiding Officer

We are running out of time—even for interventions—so please bear that in mind.

Anas Sarwar (Labour, Glasgow)

I put on record my thanks to all our amazing NHS staff. I make it clear to them that any criticism or failure that is highlighted, and any intervention that the cabinet secretary makes, is despite their efforts, not because of them.

It is very clear that all is not well with our NHS and that we have systemic problems, including a lack of strategic direction, poor management, a lack of accountability and a culture of secrecy and cover-ups. The end result is that patients and their families are being let down every day in Scotland. Such a situation cannot go on. Two thirds of Scotland’s population—more than 3.5 million people—now live under a health board that is in special measures. Six out of 14 NHS boards in Scotland are in special measures. If that is not a sign of systemic failure, what is?

There have not been only isolated incidents. Mental health services are failing patients in Tayside. Patients are being failed at the Queen Elizabeth university hospital in Glasgow. A new hospital has not opened in the Lothians. Health boards are unable to manage their budgets properly year on year. The law on waiting times has been broken more than 250,000 times and, last year alone, more than 500 children waited too long for mental health treatment. Staff are suffering, with sickness absence rates higher than they should be in every health board. The number of reports of staff bullying is up, vacancy rates are up and treatment waiting times are up. The only thing that is going down under the SNP Government is life expectancy.

I recognise that the mess is not of Jeane Freeman’s making. She is trying to clean up the mess that has been left by her predecessors. The reality is that she is trying to clean up the mess that Nicola Sturgeon caused when she was health secretary. I say to Jeane Freeman directly that sticking-plaster approaches will not do. If she does the right thing and takes the appropriate action, I will support her, but she does not have the luxury of time.

I turn to the leadership of NHS Greater Glasgow and Clyde. What will it take for the leadership to be removed? Over the past two years, nine out of 14 boards have had a change of chief executive. The chief executive and chair of NHS Tayside were forced to resign because of financial mismanagement. The chair of NHS Lothian resigned over differences with the cabinet secretary. What will it take for the clique at the top of NHS Greater Glasgow and Clyde to go? Its members are responsible for cover-ups, lies, misinformation and patient deaths, but they are still in place.

What will it take for those responsible to move aside? There has been a catalogue of failure after failure from the leadership of that board and, in particular, at the Queen Elizabeth university hospital. Equipment was contaminated by blood and faeces. Faulty, Grenfell-style cladding had to be removed; wall panels fell from the building; and pigeon droppings inside the hospital led to patient deaths. Repeated incidents related to unsafe water supply led to the closure of cancer wards, patients were moved out of unsafe wards and children had to go out of the hospital and into a hospice to get washed. Whistleblowers were silenced and bullied. Water reports showed that, in the week that the hospital opened, there was a high risk but the hospital still opened. The true cause of patients’ deaths was hidden from their parents and doctors’ infection control reports were hidden and suppressed.

Milly Main’s death was not reported to the procurator fiscal at the time that it happened. When whistleblowers spoke out, health board press releases spread misinformation and outright lies. The way in which Milly’s parents were treated was unacceptable and disgusting. Every day for three years, they have had to relive the tragic loss of their daughter. All the while, the health board leadership has tried to duck, to dither, to be evasive, to bully and to silence; that is not acceptable.

What will it take for the cabinet secretary to lose faith in those people? What will it take for her to remove the failing leadership team, chief executive and chair of that health board? The public have lost confidence and patients and their parents have lost trust in that team. We all deserve better. The parents, the public and the patients deserve better. I will not stop until Milly Main’s parents get the justice that they deserve. I implore the cabinet secretary to do the right thing—to remove the chief executive, the chair and the people who are responsible for what I regard as a crime scene. She should start an independent investigation to get the answers that Milly’s parents deserve, so that it never happens again and we can restore trust in our treasured and loved national health service.

Gillian Martin (Scottish National Party, Aberdeenshire East)

It is right that we debate our health service. As MSPs, it is our job to scrutinise how the most vital of public services is run and whether it achieves its outcomes.

Anyone who has lived in a country with no national health service understands how fortunate we are to have healthcare that is free at the point of need and a service that is staffed by dedicated, caring professionals, to whom we owe so much.

When a Government’s health spending goes down, or ministerial decisions endanger the fundamental principles of healthcare for all or impact negatively on staffing, we should jump up and down—absolutely. That is why I cannot take Tory members seriously when they talk about the NHS.

In managing the NHS, our Government has increased spending in real terms in every budget since it took office and, when required, it has taken targeted action to improve patients’ experiences. That is often done under a great deal of pressure. Those pressures include an ageing population, the constraints of a fixed allocation of block grant and—more recently—immigration policies in the offing that do not take Scotland’s needs into account.

Alex Cole-Hamilton (Liberal Democrat, Edinburgh Western)

I agree with Gillian Martin that we want to improve patient experience, but does she agree that sending patients time after time a letter that says that they will be treated in 12 weeks’ time, when they have to wait 40 weeks or 50 weeks, does not improve patient experience?

Gillian Martin (Scottish National Party, Aberdeenshire East)

Absolutely. For every satisfied patient—surveys prove that most patients are satisfied—there will always be those who are let down. As MSPs, our job is to make sure that our health boards look at that. It is the job of the Government to have schemes in place to improve waiting times.

Austerity measures from the UK Government impact on people’s physical and mental wellbeing—that is a pressure. The cessation of freedom of movement in the European Union and the withdrawal of research funding from that institution are added pressures. NHS staff bear the brunt of the pensions squeeze by the Tory Government, which leads to staff retention issues.

Despite these pressures, in the proposed budget we have the highest-ever allocation of Scottish Government budget to our health and care sector—over £15 billion, which is a record amount. Nobody here can dispute that.

Staffing levels are up to a record high. The Government has proposed a safe staffing bill. As a result of our efforts, staffing levels are up 11 per cent from when Labour was in government. There has been an 8 per cent increase in the number of nurses and midwives, despite what anybody in the Tory party tries to assert. We have protected the student bursary for nurses, which is the highest in the UK. England scrapped the bursary completely, and Wales offers only a quarter of the amount that we offer in Scotland.

Members have quoted the Auditor General. Last year, she said that more people had been treated on time than ever before. However, we still need to improve on waiting times because if even one patient is not satisfied with the service, we always need to rectify that.

The motion highlights a lot of negative points for debate, and that is Labour’s job. It is what the SNP did when we were the Opposition and Labour was in power. Back in the days of the Labour coalition Scottish Government, the SNP challenged Labour on the fact that we had limited NHS dentistry places. When we got into power, we sorted that, and now 96 per cent of the population is registered with an NHS dentist.

We also complained about waiting times; in particular, we complained about the condition of the ageing hospital estate—rightly so, because it was in a shocking state as a result of underinvestment going back years. When we took power, we put our money where our mouth is and embarked on the biggest capital investment programme ever seen in the NHS estate. In my area, we have seen the Foresterhill health campus energy centre project; a new emergency care centre; a new major trauma centre; the new Aberdeen community health and care village; and a new dental school, children’s hospital and breast screening facilities at Aberdeen royal infirmary and across the Grampian area. The new Inverurie healthcare hub was opened for the first admittance last year. We look forward to the new Baird family hospital and the Anchor cancer centre on the ARI campus. That is record investment by a Government that, in opposition, complained about the lack of it but had a suite of proposals to put into action and delivered on them.

Like many of my colleagues, I looked at the Labour manifesto that brought Monica Lennon into the Scottish Parliament in 2016. Under Labour’s proposals, NHS Grampian would be looking at a 13.7 per cent reduction in budget, which is £136 million less than it is getting from the SNP Government.

I am disappointed that the Labour motion neglects to mention mental health. In my area, we have a new dedicated CAMHS centre, which the SNP Government invested in. The centre, which opened last year, provides a modern care setting for adolescents with serious mental health diagnoses while reducing referral waiting times. We have also put in place plans to put counsellors in schools for early intervention.

Anyone who is in a shadow position and has the underlying ambition to do the job for real one day might want to reflect on whether their motion or speech brought any solutions or serious demands to the debate.

Monica Lennon (Labour, Central Scotland)

Will the member give way?

The Deputy Presiding Officer

Ms Martin is just closing.

Gillian Martin (Scottish National Party, Aberdeenshire East)

If a motion is, like today’s motion, just a litany of complaints with a mere two asks of the Government, which have already been met, one wonders what that member would bring to the post if they were ever in government. I suggest that Labour’s shadow person takes up Jeane Freeman’s offer to come up with constructive proposals; if they do not, they are just carping from the sidelines.

Edward Mountain (Conservative, Highlands and Islands)

I thank the Labour Party for bringing today’s debate to the chamber.

Let me be clear—under the Scottish Government, NHS Highland has risen to level 4 on the escalation framework and is struggling with a series of crises. It has a £13 million deficit this year after numerous deficits year on year, there have been three chief executives in 15 months and treatment targets have been missed in almost all areas. Finally, when it comes to leadership, we hear from the GMB that bullying that was identified more than 18 months ago is still going on, and there is no evidence that action has been taken against the bullies who were identified in the Sturrock report.

I have had meetings with healthcare professionals and I know that they feel undervalued and unsupported. I want to be clear that I believe that NHS Highland has the best doctors, nurses and healthcare professionals. We should therefore be careful to make sure that their positions are protected. However, asking them to do the impossible with limited finances places unbearable and unrealistic stresses on them and their families. Doing that demonstrates poor leadership.

I will never forget the motto on the cap badge that I was given when I joined the army. It said simply, “Serve to lead”: a simple motto that some managers forget when they get into the offices that go with their appointments. We need to ensure that they remember it, because putting service before self and spending more time looking after those below them than those above them will ensure that those who follow them do so enthusiastically and are prepared to go the extra mile without even needing to be asked.

I believe that NHS Highland has lacked, and still lacks, such leadership. I will give members an example to show that. In October 2018, I was contacted by a mother who was worried about her daughter; she was worried about a child who was finding life to be too much. Her child was a nurse, who was struggling at work. I contacted NHS Highland and when I finally got hold of the chairman of the board, I was told not to worry as there was a process in place and that the nurse’s manager would make contact. That did not happen and matters dragged on.

Only last week, I was approached again by that nurse’s mother. Again, I wrote to NHS Highland and I was told not to worry as a process was in hand. I replied saying that that frankly was not good enough and that a more personal and compassionate approach was needed. NHS Highland has still not responded to that request. The cabinet secretary now has that correspondence and I look forward to seeing what she will do. The leadership that I believe is being demonstrated by NHS Highland is not a form of leadership that I recognise. It lacks true compassion and humanity.

In the short time that I have left in the debate, I turn to performance. In 2011, the Government promised Scotland a treatment time guarantee of 12 weeks. Yesterday, I checked online to see how NHS Highland was doing. In the quarter ending September 2019, NHS Highland was the worst-performing health board in Scotland, with only 57 per cent of patients receiving treatment within 12 weeks.

Last week, I spoke to someone who is waiting for a hip replacement. They cannot walk properly or sit down for more than five minutes and they sleep for only two hours a night. Despite that, they have to go to work every day and, let me tell you, they work hard. Believe it or not, they still find time to smile. They have been told by the NHS that the waiting time for a hip operation is now 46 weeks: that is nearly a year of pain, suffering and no sleep. They could not face that, and nor could I. Nor, may I suggest, could members—frankly, no one should have to.

The solution that they have chosen is to raid their savings and pay for a private operation. They should not have to pay that money because they have paid tax all their life and expect, like I do, that healthcare will be free at the point of delivery. The most galling part about this is that, within a short time of booking their surgery, they received a call from the NHS saying that they would be delighted to know that they had been removed from the waiting list: the waiting list that they had never been anywhere near the top of. To me, that is truly galling.

The motion identifies the problems that our health boards face with poor management and poor performance. The issue, of course, is how to resolve these problems. I have plenty of ideas on how we could rebuild our cherished NHS, which one day we will all need.

Let me be clear: I am prepared to work across the chamber to make things better, as is my party. To start with, we need to lead and look after our excellent front-line staff. We are not doing that at the moment. If we do, we will get the best from them, but to do so, we need good leaders. Let us be under no illusion, cabinet secretary: leaders are guided from the very top. Let us be honest: the problems that our NHS faces today are caused by the very leaders that seem to blame everyone else for their failures—but the people of Scotland see through that, and we know where the blame lies. I am afraid, cabinet secretary, that the blame lies with the Scottish Government.

John Mason (Scottish National Party, Glasgow Shettleston)

As others have said, there is a lot of good in the NHS and a lot of patients have had a good experience. Like me, colleagues might get messages through Care Opinion. They are sometimes critical, but they are often positive. For example, the following was posted two weeks ago by a service user from my constituency:

“Unbelievable care received from all staff at Stobhill MIU tonight. In under one hour I left home, travelled to MIU was checked in, triaged, assessed, x-rayed, diagnosed and treated for a wrist fracture. I feel this is world class healthcare in action, thanks to SCN Lisa, the reception staff, healthcare assistant and radiography staff for a first rate service. Nurse led care is in my opinion the way forward for Scotland. Well done all!”

Unfortunately, not many Opposition members sit a happy patient in the public gallery and say what a good experience they have had in the NHS. Rather, a suffering patient is installed in the gallery and their case is raised in the chamber as a way of bashing the SNP. I have to say that that verges on abuse and is not the way we should make decisions about healthcare in Scotland.

Miles Briggs (Conservative, Lothian)

Will the member give way?

John Mason (Scottish National Party, Glasgow Shettleston)

No—not at the moment.

I want to touch on some specific points in the Labour motion. First, I suggest that it is contradictory, as it says that

“the Parliament ... pays tribute to NHS staff”,

but it also refers to

“serious concerns about governance”

and

“leadership”.

Perhaps Labour means that it pays tribute to junior staff but not to senior staff. I have to disagree with that because, as I think Alex Cole-Hamilton said, many managers and senior staff do an excellent job, albeit within tight constraints.

Labour is greatly overstating the problems in the NHS. I suspect that Labour members will accuse me of being complacent, but I am not. Of course there is room for improvement, but let us keep things in perspective because, otherwise, staff get discouraged and patients get unnecessarily worried.

Daniel Johnson (Labour, Edinburgh Southern)

I wonder what perspective a closed hospital down the road provides the member and what perspective he gets from a hospital at the other end of the M8 that makes people sick.

John Mason (Scottish National Party, Glasgow Shettleston)

That is an example of what I was talking about. The member says that the Queen Elizabeth university hospital “makes people sick”, but the statistics show that it is not an outlier compared with other large hospitals of similar size that deal with similar specialties.

Miles Briggs (Conservative, Lothian)

Will the member take an intervention?

John Mason (Scottish National Party, Glasgow Shettleston)

No. Sorry, but I cannot take one after another.

As it happens, a number of MPs and MSPs attended an NHS Greater Glasgow and Clyde briefing on Monday. Some of what was said may have been confidential, but a lot of it was already in the public domain. That has helped me to form a clearer view of the Queen Elizabeth university hospital situation.

The Labour motion uses the word “scandal”, but we do not have reason to call it a scandal. There are different definitions of the word “scandal”, but one is that it is

“an action or event regarded as morally or legally wrong and causing general public outrage.”

We have not yet established whether there has been an action or event that is morally or legally wrong. My feeling from what I have read and heard is that a range of issues have sadly led to infections and deaths among young people there. I hope that we all extend our sympathies and concerns to the families involved, as others have done. We will understand more once inquiries and other work are concluded but, as I said, my understanding is that the QEUH is not particularly different from similar hospitals.

Our thoughts go out to the families—the loss of a young person is always a tragedy.

However, as members across the chamber know, infections and deaths have, sadly, always happened in hospitals and that is likely to continue to be the case, although in recent years the numbers have been reducing here and elsewhere. Healthcare has moved on amazingly in my lifetime and, today, many younger and older people are alive who would not have been in the past.

Anas Sarwar (Labour, Glasgow)

Will the member take an intervention?

John Mason (Scottish National Party, Glasgow Shettleston)

No—not after the way Mr Sarwar spoke. To talk about a “crime scene” is ridiculous and outrageous, and it totally undermines the NHS.

Anas Sarwar (Labour, Glasgow)

Will the member give way on that point?

John Mason (Scottish National Party, Glasgow Shettleston)

Because of what Mr Sarwar said, I will not take an intervention from him.

If death is caused by negligence or deliberate harm,

yes, let us hold someone to account. However, not every death is preventable and we need to be mature in facing up to that.

The BMA briefing makes the point that we need

“a more mature and less blame focussed approach to targets”,

which I agree with.

I remain uncertain as to whether escalation was necessary at the Queen Elizabeth hospital. There is of course always room for improvement, but the health board was already taking the situation seriously.

The motion mentions performance, and I will make a few comments on that. One measure of performance is A and E waiting times, which is fair enough. However, the reality is that people turn up at A and E who do not need to be there and could be dealt with more suitably elsewhere. That includes my mother who, aged 92, has been referred to A and E a number of times. I am convinced that that is not the best place for her to be.

The Labour motion also mentions “financial sustainability”, which is all very well. However, we are again left to wonder what Labour means by that. If it means, “Let us have more money for the NHS,” would Labour cut local government funding to pay for it? However, if it means putting more resources into primary care and potentially cutting resources for hospitals, that is worth looking at. Financial sustainability includes living within our means. It does not mean always hoping for or demanding more money yet never explaining where that money will come from.

We should stand up for the NHS, for staff and for patients, but I hope that the Opposition will also be prepared to look at the difficult challenges in a mature and balanced way.

Daniel Johnson (Labour, Edinburgh Southern)

The NHS is a remarkable institution and, in a sense, it will always be under pressure. In that, I agree with the cabinet secretary’s opening remarks. Ever-expanding knowledge and technology mean that we can do ever more, growing expectations mean that we want the best for those who we care about, and a population that is living longer means that more people have more conditions that need more involved and prolonged interventions.

The NHS faces many issues that are driven by those forces, and austerity only exacerbates them. The most fundamental element of the crisis that the NHS faces today is not born solely of a lack of resource, although the broken waiting time guarantees and spiralling levels of bedblocking, as outlined by other members, are there for all to see.

In today’s NHS Scotland, we have a brand new hospital that costs £1.4 million a month to keep closed and another hospital whose water and ventilation systems have caused infections and deaths. In that regard, John Mason should look at the

Official Report

and think about how his words sounded and how they will read to anyone who has been affected by the issues and circumstances at the Queen Elizabeth hospital.

We have a health system with the issues that I just mentioned, as well as health board chairs resigning, health board chief executives sidelined and sacked, and two thirds of the population living in health board areas that are under special measures.

Those issues are not driven by demand and those incidents were not created by cuts. They are signs of bad decision making and poor governance. Any examination of either of the beleaguered hospital projects tells us that there is something fundamentally wrong with oversight, accountability and basic decision making in our NHS.

In the Edinburgh case, the new sick kids hospital has remained shut and without a committed opening date, because ventilation systems are not up to standard in critical care. However, the board signed off a contract variation to downgrade the required ventilation rates. The variation reduced the standards for four-bed rooms, but no one thought to join the dots and ask whether the four-bed rooms in critical care would be impacted. Worse still, it was a health board document that provided the contractor with the incorrect ventilation standards in the first place. That was a typo that will cost millions, if not tens of millions, of pounds.

If the situation in Edinburgh is not bad enough, the situation in Glasgow, where there are questions about whether key facts have been suppressed, raises more serious and sinister concerns. In 2017, Health Protection Scotland reports showed a spike in hospital-borne infections, yet no action was taken. It took political pressure for that to be acknowledged and acted on. It took a whistleblower for the board to even get in touch with those who were affected, including, most tragically, those whose family members had died.

In both situations, the basic oversight that we expect did not happen. Critical questions were not asked and processes to ensure compliance with standards were either not in place or not up to the job of identifying those issues.

Ultimately, in both cases, there seems to be a basic problem with health boards’ ability to make decisions and take responsibility, all of which is exacerbated by a culture of obfuscation and secrecy. Those are failures in governance of the most fundamental and serious nature that are not confined to NHS Lothian and NHS Greater Glasgow and Clyde. Nationally, the Auditor General criticised the financial management and lack of long-term planning by the SNP Government. Four health boards are in the highest categories of special measures, with others plagued by serious allegations of bullying. In the past two years, nine out of the 14 health boards have changed their chief executive and only two boards have had the same one for more than three years. That is a management turnover that would make Manchester United blush.

With such fundamental failures exposed and the public’s trust so badly dented, we have the right to ask where the buck stops. Who will take responsibility? We have reached a point where the glaring errors in governance must give rise to a fundamental question about the Government. It is not good enough for ministers to hide behind the excuse of structures and, although I recognise Jeane Freeman’s commitment to making progress, we cannot treat these matters as simply circumstantial issues to be dealt with by process. They are systemic issues that must be treated as such.

Ultimately, the Government must take ownership of a system that has been shaped by 13 years of SNP stewardship, which can be summed up by one hospital that cannot be opened and another that should not have been opened.

I understand that, given her 20-month tenure, the cabinet secretary is clearly not to blame for all those issues, but she must take responsibility for what has gone wrong and, if she wants constructive engagement—which I welcome—she must begin by acknowledging the seriousness, gravity and scope of the failures that have taken place. Only when we hear that the Government is not simply treating these matters as business as usual can we have serious engagement and get together to look at the problems. Unless the Government faces up to the issues that it has created, it will be letting those hard-working staff down, but it will also be letting down all of us who depend so much on the NHS.

George Adam (Scottish National Party, Paisley)

Sometimes I listen to debates in the chamber and wonder whether the Opposition parties live in some alternative universe—cue laughter and noise from the Opposition. Miles Briggs spoke of real-world scenarios. Sometimes I wonder whether he knows what the real world is. He is possibly a stranger to it. However, do not get me wrong.

Daniel Johnson (Labour, Edinburgh Southern)

Will the member take an intervention?

George Adam (Scottish National Party, Paisley)

I have just started.

I am aware of the challenges that the health service faces and I believe that we need to be looking at ways to address them. However, my constituents appreciate the NHS and the people who work hard within it. My constituents value the fact that, when they really need medical support, our Scottish health service and the people who work for it are there for them.

Many of my colleagues on the Health and Sport Committee are probably too polite to say anything when I mention my wife, Stacey, who has a daily fight with multiple sclerosis. I find myself talking again today about how well our health service supports her and people like her who are dealing with long-term conditions every day. Is it always perfect? No, but it can make a difference to all of their lives.

I want to give this example of what happened this week. Stacey went to see her consultant regarding her on-going mobility issues. She believed that they were not going to get any better. Her story is the same as that of thousands of men and women with multiple sclerosis in Scotland. She went to the assessment and, within minutes, the consultant came up with a solution to her problems; within minutes of receiving five Botox injections, she walked from the treatment table to her wheelchair. To many people that may seem trivial, but to us, it was close to a marvel.

When the consultant worked out what I do for a living, he started to talk to me about the NHS. That consultant works not only in Glasgow but in London and he sees the massive difference between our NHS and the one in England. He used the Botox injection that he had just administered to Stacey as an example. He told me that in London he would have had to get five separate signatures to get access to the cupboard that contained the solution. In Glasgow, he just unlocked the cupboard and administered the solution to Stacey. He told me that there were challenges in Scotland, too, but that he was happier when he worked here. Stacey is now happier than she was beforehand, because our health service worked for us. I know only too well that the NHS is our most important public resource, and we must do all that we can to ensure that it remains properly funded.

On that issue, let us look at what Labour offered in its 2016 manifesto. It proposed to give the health service real-terms funding increases. That sounds good and dandy until we look at what that would have meant. As the cabinet secretary has already said, in this year alone, it would have meant a cut of £1.4 billion to our health service—that is how much the Labour Party’s plans would have cut the health budget by this year, yet Labour members come and lecture us about the current state of our health service.