Scottish Parliament, 3 February 2000

429 contributions from 78 members. The official report.

Introduction

David (None, Lothians)

There are two debates this morning. The first is a non-Executive debate on motion S1M-482, in the name of Mrs Kay Ullrich, on the national health service in Scotland, and an amendment to that motion. The debate will end at around 11.30 and will be followed by a debate on air passenger and freight links to Scotland. Members who want to speak in the first debate should press their button now.

National Health Service

Kay Ullrich (Scottish National Party, West of Scotland)

First, I must say how sorry I was to hear the news this morning that Rhona Brankin has been diagnosed as having breast cancer. Rhona is to be commended for speaking out openly and publicly about her illness. It will give support to many other women throughout Scotland. I am sure that everyone in the chamber will join me in wishing her a full and speedy recovery. [Applause.]

The last health debate took place in the middle of the flu crisis. The debate was somewhat marred by the Minister for Health and Community Care's refusal to accept the obvious—that the health service in Scotland was struggling to cope and was only able to cope thanks to the dedication and good will of health service staff, who worked extra hours, forwent days off and, in many cases, worked back-to-back shifts. I am sure that every member of this chamber will want to acknowledge the debt that we owe to health service staff for seeing us through the flu outbreak.

The outbreak exposed the fact that the NHS in Scotland is struggling throughout the year to provide high-quality health care. The previous health debate was a somewhat heated affair, with the minister desperately trying to stick to the new Labour line of, "Crisis? What crisis?" Of course, that was before noble Tony Blair's admission that there are

"fundamental problems we have to address".

Tony said that we need

"more doctors, more nurses, more beds, more long-term financing and a different system and structure in the health service".

We can all agree that, coming from the Prime Minister, those words are a damning indictment of the state of the NHS after almost three years of Labour rule.

Now that Mrs Deacon no longer has to pretend that all is well and to view the health service as she would the emperor's new clothes, I hope that we will be able to examine the problems that exist and have an open and constructive debate on the state of Scotland's health service.

Before I leave the subject of Tony Blair, I ask the minister whether, in the light of the Prime Minister's commitment to increase health spending south of the border by 5 per cent each year to bring NHS spending up to the European average, she will give the same commitment for the national health service in Scotland? Blair says 5 per cent. What does the minister say?

I admit that I was a little saddened by the tone of the minister's amendment to the Scottish National party motion. There is still a clear reluctance to accept responsibility, in spite of now having permission from above to do so. The minister seems unable to grasp that in order to address a problem, one must first acknowledge that a problem exists. By consistently denying that there is a problem, the minister is rapidly becoming a substantial part of the problem.

I will spend a little time examining the cost in human terms of the failures within the health service today. There cannot be a member in this chamber whose mail has not included harrowing stories of people suffering pain and distress because of the inadequacies in health service delivery. All over Scotland, patients, relatives and health service workers are genuinely concerned about the state of the NHS. We in this Parliament have a duty to address those concerns, and to do so without resorting to the spin-doctoring of figures. We should resist the temptation to indulge in party political posturing.

I am sure that we were horrified to hear recent stories of patients being driven across Scotland in search of intensive care beds. One patient was taken from Inverness to Glasgow; another was taken from Shetland to Edinburgh. It was a sobering moment when we learned of three patients from Fife being sent to the private Health Care International hospital at Clydebank because no intensive care beds were available in their health board area. Let us be clear: those patients were transferred to a private facility because the NHS had failed them at their time of need.

Throughout the year, it is common practice for patients in the Greater Glasgow Health Board area, for example, to be transferred from one hospital to another in search of any available intensive care bed. The figures speak for themselves. In the first six months of last year, there were 270 intensive care transfers within the Greater Glasgow Health Board area, more than double the figure for the same period of the previous year. The minister will claim a 12 per cent increase in intensive care beds, but, given that 50 intensive care beds have been lost in the past 10 years, we still have a long way to go before the crisis in Scotland's intensive care units is addressed.

As ever, we are subjected to the usual smoke-and-mirrors approach on what actually constitutes a new bed. Take the situation at the Southern general hospital in Glasgow. It had four intensive care beds and one high dependency bed. It received additional funding for half a nurse, and the high dependency bed was upgraded to an intensive care bed. Instead of four, they now have five intensive care beds, but no high dependency bed. Is that what the minister calls progress?

The Labour Executive makes great play of improvement in waiting times and waiting lists. Here again, we have a tale of failure. The real failure, however, is the Executive's inability to recognise the price being paid in human suffering for its failure.

I have selected a few examples from my mailbag. An elderly woman in Edinburgh waited 20 painful, immobile months for a hip operation. A man in his 60s has two growths on his back, which tend to bleed on contact. He has been told that his earliest appointment with a consultant dermatologist is in 11 months' time.

Surely the most poignant example is of a man of 76, living in Lanarkshire. He is a widower, living alone. He was diagnosed as suffering from cataracts in both eyes, and was told that he would have to wait at least eight months for an operation. In the meantime, his sight deteriorated quickly, and he was virtually blind. He returned to his general practitioner, who advised him that he could still not expect to receive treatment for seven to 10 months. On receiving that news, he used his life savings of £2,500 to have one eye operated on privately, because he could not afford an operation on both eyes. That was in December 1999, and he has now been told to expect to wait another seven or eight months before his other eye can been operated on under the NHS.

All those examples have been of painful, distressing, but probably not life-threatening, conditions. It is in considering life-or-death situations that we begin to realise the full truth behind the waiting list claims.

I learned from the letter of the daughter of a man who had been diagnosed on 19 November last year with lung cancer that he was told that his radiotherapy treatment, at the Beatson oncology clinic, would not start until 24 January this year, a wait of eight weeks. The daughter knew that that was too long. She wrote to the clinic and was told:

"The waiting times are unacceptable . . . It is difficult to explain to patients each week that they will wait unacceptably long times . . . We do not enjoy the hopelessness of it all."

Those are directs quotes from a letter that the cancer sufferer's daughter received from the Beatson clinic.

People are given waiting times of eight weeks, when the waiting time recommended by the Joint Council for Clinical Oncology is no more than two weeks. The situation is truly dire. The Beatson clinic is possibly Scotland's finest but it has to buy time at HCI in Clydebank to enable 30 patients a week to have radiotherapy treatment there. The clinic is four radiotherapy machines short of being able to offer treatment within recommended guidelines. Scotland needs a further 11 radiotherapy machines to stop those life-threatening delays.

The Executive has pledged £12.5 million for the purchase of new linear accelerators. That is to be welcomed, but let us not kid ourselves: due to the fact that more than 40 per cent of the equipment that is currently in use is more than 10 years old and in need of immediate replacement, the new machines will probably only replace the machines that are in use; and, of course, there is no funding for the extra staff to deliver the treatment.

A GP told me about a 70-year-old woman whom the GP suspected had the symptoms of early bowel cancer. She was given an appointment to see a specialist in four months' time. She, too, spent her savings on private treatment, which was carried out within a week. Her GP is in no doubt that, had she waited four months to see the NHS specialist, her chances of a full recovery would have been greatly reduced. We are told that cancer is the No 1 health priority of the Executive. We have heard the pledge. When will we see the action?

The NHS is unable universally to provide the most up-to-date and effective treatment for cancer—that is a scandal. Drugs such as Taxol and Taxotere are widely accepted to be the best drugs available and are widely used in the treatment of cancer in the United States of America, which has a substantially better recovery record than Scotland. In Scotland, health boards are unable to fund the use of the drugs, which cost around £8,000 for a course of treatment. That is expensive, but we spend roughly the same amount of money on drugs to treat cancer as we do on drugs to treat acne. Professor Elaine Rankin, professor of cancer medicine at the University of Dundee, says:

"The Government is talking about making cancer a priority, but it is not making the money available to build on that public promise."

The people in the front line are speaking out. Is the minister listening?

The minister is fond of talking about how much extra funding is being invested in the health service and boasting of how well the NHS is doing under her stewardship. It is obvious, however, that there is a wide gap between what new Labour claims is happening and what is actually happening in the health service. Now that Tony Blair has spoken and the minister is allowed to admit failings in the health service, I await her response with interest. More important, the patients, health service staff and the people of Scotland want answers—not spin. They deserve nothing less.

I move,

That the Parliament recognises the debt owed to NHS staff at all levels in relation to their commitment over the winter period and through the flu outbreak; acknowledges that without this commitment on the part of the staff, the NHS in Scotland would not have coped over this period; recognises that the flu outbreak exposed an NHS in Scotland that is struggling to deliver high-quality patient care, and calls upon the Scottish Executive to acknowledge the problems that exist and to provide the necessary resources to ensure that the health service is adequately equipped and funded to provide optimum health care for the people of Scotland.

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I am pleased that the Opposition has chosen health as the subject for debate today. I welcome the opportunity to set out the Scottish Executive's policy on health and to put on record our thanks for the contribution of and the commitment shown by all NHS staff.

Brian Adam (Scottish National Party, North East Scotland)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

Over this winter, they have faced unprecedented pressure, as I set out in some detail in my statement to the Parliament a few weeks ago.

More than 136,000 people work for the NHS in Scotland, both within the NHS and as self-employed contractors, such as GPs and dentists. Their work embodies the best values of public service in this country, and it is those people who are at the heart of our NHS.

Brian Adam (Scottish National Party, North East Scotland)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

We need to support them, if we are to improve care and treatment for patients.

Brian Adam (Scottish National Party, North East Scotland)

On several occasions, the minister has rightly praised the commitment of NHS staff and their hard work. However, will she explain to us why she has persisted in the Tory habit of paying the non-pay review body staff less than the pay review body staff? If there is such great appreciation of the staff, will she show that by treating the staff equitably?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

As Mr Adam and other members will be aware, there is proper machinery for negotiating pay in the NHS, which has existed for some time. We are reconsidering the way in which that machinery can work most effectively in the future. The non-pay review body staff have an offer on the table and are consulting their members. I, as much as anyone, hope that a settlement will be reached as soon as possible.

If we are going to act effectively in the interests of NHS staff, we must address real issues and devise practical policies for pay and other issues. That means that we must deliver real change. It is easy to stand up and identify problems; it is much harder to deliver solutions. However, that is what this Executive is determined to do, for staff and for patients.

I now turn to what we are doing for NHS staff. I shall focus on the record of this Executive and its plans for the future. I have said before that investing in our NHS means investing in our staff. Two weeks ago, I announced pay increases well above inflation for all NHS staff in Scotland who are covered by the independent pay review bodies. For the second year running, those pay increases will be implemented in full, with no staging. Real increases, not empty promises.

Experienced nurses will receive pay rises that are worth more than £100 per month—that is 7.8 per cent, way ahead of the rate of inflation. NHS consultants will start to benefit from an extra £5 million per year to fund payments in recognition of their work load and work intensity, and their commitment to the NHS. General dental practitioners will benefit from a £2 million package to reward quality and commitment to NHS dentistry.

We can afford those increases as a result of the additional resources that this Executive has earmarked for the NHS. We are committed to fair pay for NHS staff. However, pay is only the start.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

As NHS staff and their representatives tell me, day in, day out, staff want more. They want to be valued, to know that their views count and to have their needs recognised. They want action, not words.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I shall tell members just some of what this Executive has done, in just seven months in office, for those NHS staff.

We have taken action to reduce junior doctors' hours and to provide training and development opportunities for all NHS staff, through the first NHS education and training strategy. We have taken action to bring about a safe and healthy NHS working environment, through new occupational health and safety measures. We have taken action to raise the number of entrants for graduate nursing courses, and that number has increased by 14 per cent this year.

We have taken action to involve trade unions and staff representatives in decisions that affect them through national and local partnership forums. We have taken action to put in place child care and flexible working to retain staff by creating family-friendly working environments. We have taken action to recruit and train more doctors and nurses, and to retain experienced nurses in front-line patient care through the introduction of nurse consultants posts.

It is not just what we have done, but the way in which we have done it that matters.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

All those measures have been developed, and are being implemented, in discussion, in co-operation and in partnership with NHS staff.

Hand in hand with that, we have taken steps to improve the care and treatment of patients.

Ben Wallace (Conservative, North East Scotland)

If the Executive's staff policies are working so well, why, in January 1999, according to the Unison survey, was staff morale lower than it had ever been? That reflected the fact that staff morale is lower under this Government than it was under the Tories. In December of last year the Royal College of Nursing conducted a similar survey and found that after a year of Labour policy the situation was no better. Twelve months after the Unison survey, morale was still low.

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I speak to NHS staff week in, week out. The one thing that they do not believe is that life was better under the Tories than it is now. The RCN survey to which Mr Wallace refers shows improvements in many areas, and it shows that there is recognition among nurses that steps have been taken to improve the value that is assigned to them by the NHS. I am never done saying this and I will repeat it here today—we can always do more and I want us to do more. We can do more for staff and more for patients.

Allow me to set out some of the action that we are taking for patients. We have started taking action to develop new measures to speed up treatment and reduce waiting times. Cataract operations have been mentioned. In one major service redesign project in Ayrshire, cataract operation waiting times have been reduced from 12 months to one month through staff teams working together to redesign services to meet patients' needs.

We have taken action to ensure better joint working between the NHS and local authorities so that they can provide effective care of the vulnerable and elderly. We have taken action to take forward radical proposals to direct NHS resources fairly and according to need throughout Scotland.

We have taken action to set up a Clinical Standards Board for Scotland, to drive up the quality of care that is delivered by the NHS. Just this week, we have taken action to take forward our mental health policies through the creation of a new national mental health support group and we have taken action to develop a new national framework for maternity care.

This week we have also taken action to further strengthen the bond of trust between patients and family doctors in the wake of the horrific Harold Shipman case. I am sure the whole Parliament will want to join me in extending sympathy to the families of the victims of that evil man. I want to assure the people of Scotland that, in conjunction with the medical profession, the Executive will ensure that every step is taken to prevent such an occurrence ever happening here in Scotland.

Let me turn now to the issue of NHS spending and resources, which have, of course, featured in the debate.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will the minister give way?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I stress that much of what I have described is dependent not only on money, but on changes to the way we work. However, our programme of change is backed by real additional investment, including £300 million more for health next year.

Duncan Hamilton (Scottish National Party, Highlands and Islands)

rose—

Susan Deacon (Labour, Edinburgh East and Musselburgh)

That will allow health boards' allocations to be increased by more than 5 per cent at a time of historically low inflation.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

rose—

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I find it interesting when Opposition members make comparisons between England and Scotland. It might be worth noting that health spending in Scotland is 20 per cent higher than it is in England.

Dorothy-Grace Elder (Independent, Glasgow)

rose—

Susan Deacon (Labour, Edinburgh East and Musselburgh)

Health service spending in Scotland is already at the level of the European average as a proportion of gross domestic product.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

rose—

David (None, Lothians)

Order. There cannot be three members standing when the minister is not giving way.

Susan Deacon (Labour, Edinburgh East and Musselburgh)

In Scotland we have more consultants and nurses per head of population than England does, and we are training and recruiting more.

Kay Ullrich (Scottish National Party, West of Scotland)

rose—

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I am keen to set out constructively and openly the Executive's actions and policies on the NHS. We are investing more in health, but I have said repeatedly that that is not an end in itself—it is what we do with the money that matters. We must ensure that resources are channelled directly to front-line patient care.

That is why we have taken action to abolish the expensive and divisive bureaucracy of the internal market and, instead, to put in place new controls over senior managers' pay. That is also why we have taken action to develop proper work force planning by linking today's spending on training with tomorrow's patients' needs.

Cancer care has been mentioned. We have taken action, through the Scottish cancer group, to address not only the needs of cancer patients today, but the needs of those five and 10 years from now, through long-term planning and long-term investment, including £12.5 million for radiotherapy equipment for cancer care.

We have also taken action to establish the Scottish health technology assessment centre, which will provide independent, expert advice on the clinical effectiveness and cost-effectiveness of new drugs. We have invested in infrastructure and taken more steps to end mixed-sex accommodation. Along with that action, we will take steps to improve accident and emergency services and to undertake more planning for the future.

Kay Ullrich mentioned intensive care, which I also spoke about in my statement a few weeks ago. This week, the Scottish Intensive Care Society audit group published its latest report. We will work with the society to examine the implications of that report for future provision. Again, actions, not words; planned improvement, not arbitrary promises.

As I have said repeatedly, of course we will learn from the events of this winter. There is always scope for learning and room for improvement. To develop that work, I am commissioning a group that represents a wide range of interests to reflect on existing winter planning arrangements and to consider how those arrangements can be improved in future, for the benefit of patient care—exactly as I said I would do when I spoke about winter planning in the chamber a few weeks ago.

It is just seven months since we assumed our powers as a devolved Government. In that time, we have taken action to set about the task of building an NHS in Scotland that is fit for its purpose, fit for patients and fit for the 21st century. We are doing that not just through warm words or empty rhetoric, but through real, practical action, and not just through offering quick fixes but through taking steps on the road to lasting, sustainable change.

The issues are complex and the challenges are immense, but we will not shirk from addressing them. We want continuous improvement in the NHS in Scotland. That is the road that this Executive has started upon and which we will continue to take, now and in the future.

I move amendment S1M-482.1, to leave out from "without this commitment" to end and insert:

"the hard work and outstanding commitment of NHS staff, better preparation and contingency planning than ever before, record levels of investment and effective partnership working brought about by the abolition of the internal market has enabled the NHS to deal effectively with exceptional pressures and unprecedented levels of activity over the winter period; and welcomes the commitment of the Scottish Executive outlined in Making it Work Together: A Programme for Government to work in partnership with the health service for the people of Scotland."

Mary Scanlon (Conservative, Highlands and Islands)

There is certainly room for improvement and scope for learning. I am delighted that the minister now talks about "action, not words" because that will delight the NHS in Scotland. However, we will wait and see.

The saddest part of the NHS debate in Scotland to date has been the arrogance and complacency of the Minister for Health and Community Care in terms of the unwillingness to accept responsibility and the refusal to acknowledge serious problems that exist in our NHS.

If the Labour Government is able to take pride in the success of the economy for three years, surely it can take responsibility for the failures of the NHS in the past three years. If the minister would acknowledge the difficulties and work together with us—although it looks as if there is a change in mood this morning, which I welcome—the people of Scotland might just feel some reassurance. Instead, so far we have had constant political dogma.

The worry about this Executive is that the Minister for Health and Community Care believes her own spin-doctors, who say the opposite of what is happening in the world of patient care. I will talk about the contrasting situations in Scotland, many of which were raised by Kay Ullrich.

Raigmore hospital, in its January update, probably reflects the situation of the NHS throughout Scotland. In fact, Raigmore is in a much better financial position than the majority of hospitals in Scotland. An overspend of more than £1 million is likely to worsen by year-end. Staff work 16-hour shifts, and many have forgone days off and holidays to keep the service running.

In January, all routine elective surgery at Raigmore had to be cancelled for two weeks. Out-patient waiting times have increased and there is a shortage of intensive care beds. When the intensive care consultant prayed for help, the reply from the Scottish Executive was that

"no additional funding will be made available this year to address the ITU situation, millennium pay costs and winter pressures"

or to cover the inflation element of the pay award for staff covered by the pay review body. Yet Raigmore's difficulties are minute in comparison with many other health trusts in Scotland, particularly Tayside University Hospitals NHS Trust, which faces a deficit of more than £12 million. That picture is replicated throughout Scotland.

Today, I ask the minister what she will do for Scotland's hospitals, given the total financial deficit of in excess of £50 million. How can that serious financial deficit be overcome? What would the deficit be if all the staff, including doctors, were paid for the long hours that they work, well outwith their contractual hours? I hear what the minister and the SNP say about the commitment of staff, but should we be asking staff to work double shifts? Should it always come down to the good will of the staff? Is it not the Government's responsibility to support the staff?

I also hear what the minister says about the nurses' pay rise, announced at the height of the flu epidemic. Is she aware that hundreds of GP practice nurses have not yet received their pay increase for last year? She may laugh, but it would do her some good to listen sometimes.

Iain Gray (Labour, Edinburgh Pentlands)

Will the member take an intervention?

Mary Scanlon (Conservative, Highlands and Islands)

No chance.

The system of payments to GPs and their nurses for Tayside, Grampian and the Highlands and Islands, newly centralised in Aberdeen, has been described by GPs as a system in chaos, a total shambles. Let us stop talking about this year. How about paying the GP practice nurses for last year? That would be very welcome. Again I say, "Get a grip on reality".

Iain Gray (Labour, Edinburgh Pentlands)

Will the member give way?

Mary Scanlon (Conservative, Highlands and Islands)

The deputy minister will have an opportunity to speak. He can write down what I am saying and answer the points that we raise, breaking the habit of eight months.

Instead of using agency nurses, which reduces the continuity of care and is more expensive, the Scottish Executive should start looking after the nurses that it has. According to the Royal College of Nursing, nearly half the nurses in Scotland agree that they are unable to take time off for training, compared with only a quarter of nurses in England. Nurses have to fund their education and study in their days off. I quote from the RCN:

"If the NHS is to be a good employer, it must stop taking nurses for granted."

With funding so tight, the training budget is often the first to be cut, affecting health and safety, the updating of skills and career development.

With regard to the flu vaccine, there is no consistent approach throughout Scotland. Grampian Health Board managed the flu vaccination programme by obtaining a list from GPs of all those at risk, writing to them, inviting them in and advertising the centres that people could go to. In the Highland Health Board, by contrast, GPs were sent a letter outlining the at-risk group and left to get on with it, with no assistance. There, again, is the difference between the minister's rhetoric and spin-doctoring and what is happening to people in Scotland.

One Highland GP practice, serving a population of 10,000, identified around 1,500 in the at-risk group. It estimated a staff time of around 240 hours, with no payment. If partnership means anything, we must appreciate that preventive care saves money in hospitals and that it should be given financial support. It would be helpful if the minister would recognise the inconsistent approach across Scotland's health boards that leads to inequalities in access. We might then be able to move forward.

Waiting times were mentioned. The latest report, covering the period up to 30 June 1999, shows an increase in waiting times of 7 per cent, compared with the previous quarter. Again, the minister needs to keep in touch with reality.

The minister boasted about the abolition of the internal market. I would like to give a prime example from this city of what has happened as a result of that. Previously, GP practices in Edinburgh could refer patients to private physiotherapy clinics, where they were seen within days. Now, because of political dogma, all those patients have to be referred to the NHS. Instead of being treated in days, they have to wait months. That not only increases pressure on the NHS but damages patient care, as conditions worsen because of the long time that more complex treatment takes. Yet Alan Milburn said:

"there is no reason why the NHS should not be collaborating with independent sector and other providers in developing new innovative forms of intermediate care."

Will health policy in Scotland be driven by political dogma or by the needs of patients? The Minister for Health and Community Care should get a grip on the NHS, get in touch with it, stop bullying and dictating to it, and start working with it to solve problems, rather than deny that they exist.

Robert Brown (Liberal Democrat, Glasgow)

I welcome the minister's announcement of a study group into winter care arrangements. That is a good idea, which will allow—this was one of the few positive points in Mary Scanlon's speech—the disparity of approach by health boards to be examined in detail and appropriate measures to be taken to deal with it. I congratulate the minister on the tone and content of her speech, which I hope will set the style for this debate.

We must consider realities. Few things are more important to the people whom we represent than the state of the health service. All sensible commentators accept that there is a growing gap between aspiration and reality. Modern medicine can do amazing things. It can enable people who suffer from epilepsy or diabetes to live normal lives. It can carry out on a day-care basis microsurgical techniques that previously involved long stays in hospital. It can help people who have had heart attacks and—on another illness about which we have sadly heard—it can make steady progress against the once unnameable scourge that is cancer.

However, the cost of those miracles, of people living longer and of treating the ill-health that is caused by tobacco, alcohol, drugs and poverty—not least in Glasgow—has led to growth in demand that is significantly above the rate of inflation. It is to the credit of the Executive that, in only seven months, the list of measures to which Susan Deacon referred has been introduced in such a pointed and targeted fashion.

The SNP called the debate—

Duncan Hamilton (Scottish National Party, Highlands and Islands)

Will the member give way?

Robert Brown (Liberal Democrat, Glasgow)

I will not take interventions until I have made some progress.

This debate offers a further opportunity to explore the issues. To the SNP's credit, its amendment does not seek to blame the Scottish Executive for the flu outbreak. It identifies the growing pressure on the NHS and calls for more money. The Liberal Democrats accept those calls and have argued at Westminster that to cut the standard rate of tax in April by a further 1p is nonsense. We did not get rid of the Tories in 1997 so that we could continue with a Thatcherite economic agenda at Westminster under new Labour. In the furore surrounding Lord Winston's attack on the Labour Government's position, Tony Blair, whose populist instincts are more finely tuned than those of most people, might consider that 76 per cent of the public would forgo the 1p tax cut so that more money could be spent on health.

Politics, as they say, speaks the language of priorities. In the farrago of examples given by Mrs Ullrich, I listened in vain for positive suggestions on how, within budget constraints, we might meet the calls for more and better spending on health.

Bruce Crawford (Scottish National Party, Mid Scotland and Fife)

Does Robert Brown agree with Tony Blair's sentiments about increasing health spending by 5 per cent? Is he aware that the impact of such an increase in Scotland—we did not hear whether it would apply to Scotland—would be £500 million less over a five-year period, because the Barnett formula would deliver only an increase of 4.3 per cent in Scotland? Perhaps that is the reason why the minister did not ask us about that and was afraid to give us the figures.

Robert Brown (Liberal Democrat, Glasgow)

The minister dealt with that in her speech. I am sorry that the SNP continues to peddle the tale of the Barnett formula. Health spending is at significantly higher rates in Scotland than in England. In an independent Scotland, additional resources would have to be found to make up for the benefits that we derive from membership of the United Kingdom.

My colleague Keith Raffan told the chamber on 5 December that the SNP had made spending commitments of £1,381 billion.

Duncan Hamilton (Scottish National Party, Highlands and Islands)

Million.

Robert Brown (Liberal Democrat, Glasgow)

I am sorry; I meant £1,381 million. Since then the SNP has made further spending commitments of £930 million, including £755 million on health and community care. The running tally is now £2.3 billion—£16.2 million a day, which is equivalent to 10p on income tax. A separate Scotland would come with an expensive price tag. Let us get back to the real world.

Our immediate concern is to get best value from existing resources. We need to look at the drugs budget and at the increased cost of hospital infections—a problem recently identified in a Public Health Laboratory Services report—which is running at about £100 million a year. A targeted attack on such problems could yield additional financial savings.

In summary, we need to spend a greater percentage of our national resource on health but we need to be scrupulous in wiping out unnecessary costs and waste in the system. We cannot avoid the issue of NHS priorities. I support the Executive amendment.

David (None, Lothians)

Thank you. Speeches should be limited to four minutes.

Bruce Crawford (Scottish National Party, Mid Scotland and Fife)

Looking through the Official Report of last week's budget debate, I was struck by the number of times that Jack McConnell repeated the claim that Scotland's health service receives substantial extra financial support. That repetition of that misleading spin reveals the true level of insecurity and anxiety that the Lib-Lab Government feels about its spending record. Repeating and spinning one's message ad nauseam to ensure that it becomes received wisdom might work on the voting fodder who sit on the Government back benches, but it does not work with us and I am sure that it does not work in the hospital waiting rooms and wards throughout Scotland.

The spin is also not working with the chief executives of Scotland's acute services trusts. Perhaps the Deputy Minister for Health and Community Care will explain when he is winding up why 19 of the 26 acute trust managers have said recently that they cannot meet the financial targets set by the Government. He might go further and tell us which of the acute trusts will meet the financial targets set by the Government.

We have all seen press headlines such as "Budget threat to 600 health jobs". That is a reference to Tayside, where the Tayside University Hospitals NHS Trust is struggling to come to grips with a so-called budget deficit of £12 million. The director of finance for that trust recently issued a statement saying:

"To assure safe and sustainable services in Tayside there is a need for a major injection of additional resources."

In Fife, the health board is in disarray as it struggles to deal with the financial constraints placed on it by the Government. Fife Health Board stated in its integrated health care consultation document:

"Health services in Fife will not be affordable within the next five years given the existing resource framework and demand projections."

That is, for Fife Health Board, what living with the realities behind the Government's propaganda means.

Robert Brown (Liberal Democrat, Glasgow)

Mr Crawford was kind enough to intervene on finance in my speech. Let us assume that we have heard and accepted the point about the problems. Can we hear about the SNP's financial approach to the solutions?

Bruce Crawford (Scottish National Party, Mid Scotland and Fife)

One word would sort that out: independence. It is obvious from what we have heard today that you lot have swallowed hook, line and sinker the spin put on by the Government—I apologise, Presiding Officer, for using the word "you".

The reality is a 0.8 per cent real-terms increase in health spending that is predicated on inflation of 2.5 per cent. However, everyone in the health service knows that inflation means nothing as an indicator because the pressures with which the NHS must deal are over and above inflation. Those pressures include: increases of about 10 per cent so that medical staff can deal properly with the issues identified in the Calman report; drugs and radiology costs rising by anything up to 20 per cent; the increase in the number of patients treated, owing to advances in technology and drugs; and increases in the ratio of nurses to beds, due to the complexity of care—increases that are between 16 per cent and 21 per cent. We need to add to that the cost of the recently announced increases—the Minister for Health and Community Care announced them again this morning—in salaries for some NHS staff that are well above the rate of inflation.

Iain Gray (Labour, Edinburgh Pentlands)

Can I take it from that last remark that the SNP sees above-inflation pay increases for NHS staff as a problem?

Bruce Crawford (Scottish National Party, Mid Scotland and Fife)

What I am saying is that we have heard spin after spin. In fact, ministers are like a bunch of peeries now, they are spinning that much. They are not putting enough money into the system to pay for the reality, despite the pressures that I have outlined.

What do we hear from the minister in parliamentary question after parliamentary question? She attempts to pass the buck by telling members that the matters that they raise are for the health boards to deal with. She is happy to indulge in spinning and misleading statements about the financial position of the national health service in Scotland, but she is not prepared to carry the can in Parliament for the reality of her own propaganda. She and the Government are damaging Scotland's health.

Scott Barrie (Labour, Dunfermline West)

As Robert Brown said, Kay Ullrich outlined a catalogue of perceived problems in our national health service but did not give us an inkling of how she thinks they could be tackled.

Kay Ullrich drew attention to the case of the three people who received treatment at HCI in Clydebank rather than in Fife. When I visited Queen Margaret hospital last week, I spoke to one of those people who had received treatment at Clydebank. I think that that example shows that, when faced with difficulties, the health service can come through. Someone who needed treatment for a tumour that was diagnosed early last month was treated within two weeks because they needed that life-saving surgery. That is the story of the health service. When the people of Scotland need life-saving treatment, our national health service provides it, and provides it well.

The motion and the amendment that we are debating today both pay tribute to the hard work that health service staff at all levels have done over the past two months. I certainly echo that sentiment. Anyone who has received treatment in a hospital, as I did last year, will know about the sheer dedication of the staff who provide care at all levels.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will Scott Barrie join me in condemning the actions of Fife Acute Hospitals NHS Trust, which has betrayed the staff and patients of Fife by seeking to introduce car parking charges at the Queen Margaret hospital in Dunfermline and at the Victoria hospital in Kirkcaldy? Will he also condemn the fact that the trust claims that it needs the £300,000 that it will raise through those charges to pay for vital patient care? Does he agree that it is a betrayal of the low-paid workers of Fife Acute Hospitals NHS Trust that they must now pay for car parking?

Scott Barrie (Labour, Dunfermline West)

Tricia Marwick raises an important point. I am concerned about the fact that, as a result of yesterday's decision, charging is to be introduced at Forth Park, Victoria and Queen Margaret hospitals. However, I do not condemn the trust for taking that action, because we must consider why it has done it. One of the main reasons— [Interruption.] Just let me answer, please. The trust claims that one of the reasons for introducing charges is that there is insufficient car parking space. When I visited the Queen Margaret hospital a week past Monday, I could not park my car there.

The policy needs to be revisited. I certainly do not want parking charges to be introduced. In the case of the Queen Margaret hospital, it would result in neighbouring residential areas and the carpark at the new railway station being used by those people visiting the hospital who wanted to avoid charges. I join Fife Council in calling for that policy to be considered again.

Mary Scanlon touched on the subject of training. Last August, I attended the launch of a training partnership between Lauder College, Fife College and Fife Acute Hospitals NHS Trust. That partnership is an innovative way of approaching training at all levels in the health service and demonstrates the commitment of those three bodies. It could act as a model for other parts of Scotland, and I urge other colleges and trusts to study it.

We have already heard comments about the percentage of resources spent on health in Scotland and in Britain compared with what is spent in other European countries. Sometimes, however, people's aspirations for health spending are greater than the available resources. Only this morning, I heard on the news that industrial action is being taken in the French health service because people feel that insufficient resources are being allocated. However, France is often cited as a country that spends a greater percentage of its gross domestic product on health. We must consider what we expect from our health service and what resources we will put into it.

Dennis Canavan (Independent, Falkirk West)

First, I pay tribute to the dedicated staff in our national health service for all the hard work that they do in treating and caring for patients, often in difficult circumstances. I am pleased that the motion and the amendment recognise the work of NHS staff. I pay particular tribute to the staff at Falkirk and District royal infirmary in my constituency. That hospital has a fine reputation, and I am sure that many of my constituents are grateful for the standard of service that it provides.

However, I would be grateful if Iain Gray, in replying to the debate, would comment on recent revelations about certain operations at Falkirk and District royal infirmary. I refer to the amputations of limbs from patients with body dysmorphic disorder. I find it almost incredible that any reputable surgeon would amputate a perfectly healthy limb, and I am surprised that the General Medical Council does not have an ethical code or guidelines on such a practice. Apparently, few surgeons anywhere in the world are prepared to do such operations in such circumstances.

I am sure that many people will be concerned about the report in today's Daily Record that one of the patients who had a leg amputated at Falkirk runs a website for those attracted to people with disabilities, and that the website features pictures and stories of amputees and those who are sexually aroused by them.

I am also concerned that, without even informing the chairman of the trust, the hospital management accepted fees for the operations to be done in private practice. I understand that the surgeon waived his fees and that the entire sum of £8,000 was put into the hospital budget, but the fact remains that the operations were done in private practice in an NHS hospital, using NHS facilities and NHS staff, at a time when NHS patients are having to wait for essential operations. I would like all private practice removed from NHS hospitals so that, when people have to wait for an operation, the person at the head of the queue will be the person who is most in need, rather than the person who is able and willing to pay.

As the Minister for Health and Community Care is aware, I have lodged parliamentary questions asking her to investigate those operations and to issue to all NHS trusts in Scotland appropriate instructions or guidelines. I understand that the chairman of Forth Valley Acute Hospitals NHS Trust has given an assurance that such operations will not be done again privately at Falkirk, and I welcome that assurance, but I would be grateful if the minister would say what actions the Executive intends to take at national level.

Dorothy-Grace Elder (Independent, Glasgow)

While we are paying tribute to NHS staff, we must make it clear that we are not limiting that tribute to hospitals alone, but extending it, of course, to the ambulance service and to the blood transfusion service.

As a member of the Health and Community Care Committee, I was out in Glasgow on hogmanay and new year's day visiting ambulance stations and hospitals. Some of the staff were ill, but had none the less turned up to do their public duty. I wish that, instead of just paying tribute by talking—talk is cheap—the Government would give the staff a bonus for what they did in bringing us through the millennium and in coping with the flu crisis against all odds.

Instead of rewarding the staff for their work, we see that the situation in Glasgow's hospitals is so bad that the hospitals are £11.5 million in debt—hospitals that are manned by the very staff whom we are praising today. I say to the minister, "Please attend to those hospitals." The Executive has refused them extra help, despite the investment that they and their staff have had to make to tackle the flu epidemic and the millennium problems.

The NHS is no longer the NHS. It is the PHS—the private health service. That is why bizarre and disgraceful operations, such as those at Falkirk, can happen. They were done not just through the decision of an individual surgeon, but through a horrible climate, which says, "Okay, we will take the money." Scotland chopped off those healthy legs when no other country in the world would take those two very disturbed patients—one from Germany and one from England. What a reputation to land Scotland with, minister. That is what Blairism has done to our reputation internationally.

The country that gave the world its key medical advances—the land of Fleming, Simpson and Lister—is now degraded internationally by the atmosphere created by this Government and its money-first approach, which in the long run has led to legs being chopped off that should not have been chopped off. That is utterly disgraceful. We do not need the macabre entering into surgery in Scotland.

I will now talk about Glasgow—the most sick city in Britain. In modern Europe, it is mathematically almost impossible for one city to contain six of the most unhealthy constituencies of more than 600 in the British Isles. However, Glasgow has that toll of shame, despite the fact that it consists of only 10 constituencies. That is what the health service has to cope with.

I visited a young mother in Easterhouse—I hope that this Parliament or its committees will meet in Easterhouse and see the schemes and how the people suffer—who is a chronic asthmatic with an asthmatic nine-year-old child. She lives in a house that has so much damp that I felt it settling round me like a clammy shroud. The young woman had been admitted overnight to Glasgow royal infirmary—for the eighth time in one year, she was admitted as an emergency case who needed oxygen. The child was also in a bad state in that house, which was immaculately kept but had damp seeping through the walls.

There are no proper housing repairs in Glasgow; 47 per cent of Glasgow council housing is damp. That is a disgraceful record for Labour, particularly for the First Minister, who has been a Glasgow MP since 1979—what has he done about the suffering of our people?

In Glasgow, angiograms for heart patients were being cancelled because of a shortage of beds. One patient, Mrs Denise O'Kane, who has a severe heart condition, is calling for an inquiry. She could not obtain an angiogram at Glasgow royal infirmary because of the flu crisis.

Our people are being treated shamefully. Why should Scotland, at the beginning of this new century, be the only country in western Europe with such a shocking and degrading health record? I will tell you why: it is because Mr Blair and his smarmy army are ripping us off. The Trident programme costs £30 billion to run. Just think what only £1.5 billion would do for our national health service.

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

I stand here with a sense of déjà vu, because it seems that yet again this morning we have had the single transferable whinge about the health service rather than a positive attitude about what can be done to bring about change.

The last time that I spoke on health, I said that I hoped that members would not continue to use the NHS as a political football and that we would get into a no-blame culture and away from the notion that the Opposition just attacks the Government without proposing any positive solutions. I am disappointed that we have not moved forward.

I will move forward and talk about some of the positive initiatives in health care. This morning, there has again been a fixation with beds. Let us remember that the health service is not just about beds and in-patient services; it is much wider than that. The health service includes all the community care services, many of which deliver day in day out—without any reward—a positive service that is welcomed by people in local communities.

I echo the comments made in support of NHS staff. However, I take it ill when the Conservatives lecture me—a trade unionist all my working life—about positive working practices and the need to recognise the workers. When Mary Scanlon talks about—

Mary Scanlon (Conservative, Highlands and Islands)

I used figures from the Royal College of Nursing about training, about nurses working double shifts and about nurses not being valued; I also used figures from Unison. Does the member agree with the Royal College of Nursing and Unison?

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

I have probably spent more time talking to people in Unison and other trade unions than many of the Tories have had hot dinners. Again, I take it ill having the Tories lecture me on trade unionism. [MEMBERS: "Hear, hear."]

I want to talk about the positive issues. I agree that Unison and others have raised serious questions, as have some people in the health boards and the health trusts. However, the answer is not for us to sit here and whinge; the answer is to look for positive action.

I attended the primary care trust board meeting in Ayrshire last week. The question of how we improve patient care services was discussed. For example, we talked about dental provision—which constituents of mine, among others, have been saying does not meet their requirements—and the possibility of extending it out of hours. A positive plan is being drawn up to improve the way in which complaints procedures are dealt with. Again, that is being carried out in conjunction with the local health council. In the "Designed to Care" health care programmes, the minister has discussed such measures, which are aimed not only at reducing waiting times but at giving a better patient experience.

The minister visited Ayr hospital, as I did, at the height of the flu epidemic in Ayrshire. She will have seen for herself the dedication of the staff. However, those staff were saying that their priority was the patients who were in the hospital at that time. Despite the difficulties, and despite knowing that they would have to cancel some non-urgent appointments, they continued to provide a service. What is more, they took the decision that they would not scaremonger; the last thing that the staff wanted was for people out in the community not to approach their GP or hospital for the health care that they needed. The staff coped with the situation under difficult circumstances—we can all learn from that.

Duncan Hamilton (Scottish National Party, Highlands and Islands)

If the SNP is being accused of whingeing when we ask for adequate resources in the NHS, are the staff also whingeing when they ask for more resources?

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

My point about whingeing is that the SNP is not making any positive proposals. I would be delighted to hear the SNP describe its approach rather than merely promote independence as a solution.

I hope that the minister will give more information about what she will ask health boards to do in relation to the Shipman case. It has been brought to my attention that people are concerned that there may be people working in the NHS somewhere in Scotland who have been convicted of serious offences. I would like some reassurance for my constituents on that point.

Brian Adam (Scottish National Party, North East Scotland)

I do not want to labour some of the financial points that have been debated back and forth on many occasions; for example, the wonderful spin about the £1.8 billion that, in reality, is an additional £300 million this year, £300 million next year and £300 million the year after that. Such doubling—or tripling—of the figures, by the use of mirrors, is now utterly discredited.

I should like Mr Gray, who I assume is summing up, to address a point that was made earlier. Mr Blair has committed 5 per cent, year on year, to put our health service on a par with other European ones, instead of at the bottom of the league. Can Mr Gray tell us whether we will receive the same 5 per cent—not 4.3 per cent or any other form of Barnett squeeze effect—in Scotland in the coming years? I should like such a commitment from him.

I have just had the usual response from the minister on my question about how we differentiate between pay review body staff and non-pay review body staff. It is my impression that, consistently since 1982, the Government has differentiated between those two groups of staff and has given the latter group lower pay rises. As far as I am aware, the offer that is currently on the table is again less for non-pay review body staff than it is for pay review body staff. We must ask why that differentiation is persistent in the health service under the Lib-Lab Government.

While we welcome £12.5 million for new oncology equipment, we want to know how much of that will be spent on additional equipment and how much will replace out-of-date equipment. One of the ways in which budgets have been met in recent years is by continually extending the lifespan of equipment that is often redundant, less safe and less efficacious than it should be. Will Iain Gray tell us how much of the additional £12.5 million for that equipment will be spent on new, additional equipment, rather than on replacement equipment?

The health debate that is taking place outwith the Parliament has brought to my attention the effect on individuals. The local newspaper in Aberdeen, the Evening Express, highlighted the case of a 25-year-old marine engineer, a non-smoker, who was diagnosed with lung cancer. His consultant advised him that he should have an operation immediately. The NHS was not in a position to offer him the operation for another month. However, he and his family raised enough money for the same consultant to carry out the operation, privately, within a week. That is the reality of our health service.

The national health service is not capable of coping with immediate needs, unlike the private sector. Like Dennis Canavan, I am concerned that we are abusing NHS facilities to deal with private practice. This is not the SNP whingeing—we are public representatives saying that the NHS has never been in such a poor state.

In response to the articles that appeared, further issues were raised in the newspaper. When a GP sends a referral letter to the hospital, requesting an out-patient consultation, the letter is processed—sat on—for six to eight weeks before an appointment is sent to the patient. Out-patient waiting times are being massaged. Another story that was reported was that of a patient awaiting a crucial hernia operation, which had also been delayed. The minister must accept that clever figures and a positive spin do not reflect the current situation.

Margaret Smith (Liberal Democrat, Edinburgh West)

I welcome the opportunity to debate health and to pay tribute to the hard work and dedication of the 136,000 professionals working in our health service.

I want to focus on some of the issues that have arisen from the winter pressures. During the past few weeks and months, NHS staff have been working extra shifts and have given up their holidays to deliver the best possible health care in difficult situations. In Lothian, for example, there was a 42 per cent increase in admissions compared with last year's worst seven-day period. The peak activity also came earlier than last year, demanding flexibility not only from the system, but from the staff.

I am particularly glad that the minister outlined the reasons why the Executive is engaging with staff to tackle issues such as training. I am also glad that the Executive has agreed above-inflation pay rises for many NHS staff, ranging from 3.3 per cent to 7.8 per cent for grade E nurses. I hope that that goes some way towards improving morale, which is lower than it should be. The Executive must examine the situation of non-pay review body staff as a matter of urgency. It cannot be right that cleaners and auxiliary staff in the NHS have to do themselves out of money to give of their best to the public, rather than earning more by cleaning city centre offices.

It is clear that there has been a particularly bad bout of flu. We must learn from such outbreaks. I have already alerted the minister to the fact that the Health and Community Care Committee wants to consider the wider issue of on-going winter pressures, to discover the lessons that can be learned. The situation could have been so much worse if winter pressure funds had not been available and used to open 160 beds in Lothian. If the winter weather had been more severe, if acute and primary care trusts and services had not worked together to plan ahead and if the millennium bug had caused problems—today we heard that the worst thing that happened at the millennium was Dorothy-Grace Elder roaming the streets of Glasgow—things could have been much worse.

We have heard a great deal over the past few months about the role of general practitioners. The committee will address that role. GPs obviously have a crucial part to play in handling winter pressures and in being gatekeepers to the acute service.

Health boards also have a crucial role. Mary Scanlon is right to say that there are inconsistencies in service provision, but those inconsistencies are there not because the Executive wants them to be there, but because of decisions taken by local health boards. She talked about equity of access, but then gave an example of people being able to pay for better care. There was inconsistency in her approach.

People live longer nowadays, and survive diseases that once would have killed them. More people are admitted to hospital time and again. There is evidence that when they deal with elderly people in winter, GPs, locums, out-of-hours service practitioners and hospitals are practising more defensive medicine. That leads to more admissions and, crucially, longer hospital stays. That is why pilot schemes that enhance domiciliary care and support patients in their homes—which allows them to leave hospital sooner—must be encouraged and properly funded in the long term, once the pilot comes to an end. They represent good practice and good value for money. There was one such scheme at the Royal Victoria hospital in my constituency, which was visited by the minister and me on new year's eve—so Dorothy is not alone in roaming around at new year.

Various pressures—including a lack of social work cover over the winter holiday—lead to problems such as bed blocking. We have lessons to learn. Across Scotland, much planning has gone into working through those problems. I have seen some of that in Edinburgh and, I say to Dennis Canavan, in Falkirk. Innovative ideas are being channelled into providing appropriate care pathways that focus on the patient much more closely than before.

Demand will always outstrip supply in the NHS. Despite our Executive's best efforts, there will be unmet need. Despite record spending levels, all parties in the Parliament should urge Gordon Brown to think again and to reverse his decision to cut tax by 1p this spring. Liberal Democrats would rather see that £200 million freed up to allow greater additional investment in the Scottish health service next year. While politicians and the public buy into the big lie that service can improve at the same time as taxes are slashed, staff will continue to struggle to cope year on year.

David Davidson (Conservative, North East Scotland)

I welcome the Scottish National party motion, and I heartily agree with the sentiments that have been expressed in all parts of the chamber towards health service staff, who have been struggling at tremendous personal cost.

The second part of the motion relates to resources, and unfortunately it exposes once again the nationalists' naive approach. They believe that simply throwing money at the health service is a solution; it is not.

The Executive must take on board the fact that, after 1,000 days of the Labour Government, problems due to underfunding of the health service are being compounded by mismanagement and lack of planning, by the Executive in particular.

Last year, we held a debate on public health, in which I called for a more creative approach to health provision. I hope that Cathy Jamieson notices that I am attempting to give details of that.

The first step is to ensure that we run effective and timely advice campaigns for the public. Why did the Executive not run the same advertising campaign on flu that was run elsewhere in the United Kingdom? Any public health campaign must also give practical advice in a form that the public can act upon. I was disappointed that there was no mention by the minister of community pharmacists, professionals whose services are freely available all over the country, and who are ready, willing and able to filter out some of the problems so that the health service does not suffer the full impact. We cannot have a situation where every time there is a cough or a sniffle, people start to queue at the doctor's door. Pharmacists are a resource that we must use more carefully, and I was disappointed that the minister made no mention of the role that they can play.

The debate is not really about flu; it is about the ability of new Labour, and the Executive in particular, to manage our health service. The Executive fails to demonstrate that management responsibility lies in its hands. I agree with the Executive when it expects people working in the health service to deliver more service for the same buck—but they are not miracle workers.

Although Jack McConnell grinds on about the 2.6 per cent deflator—which was mentioned by an SNP member—it cannot be applied as a blunt instrument to a service that sees year-on-year demand rise by three or four times that figure before sectoral inflation kicks in.

Where is the recognition that new treatments and procedures require additional investment and resources? We hear many pathetic claims from the Minister for Health and Community Care and the Minister for Finance that there is no rationing in the health service. The same claim is made in the occasional written answers that I receive from Susan Deacon, one of which was published in the journal of the Royal Pharmaceutical Society of Great Britain and went worldwide. I am sure that that is a first for the minister.

The idea that there is no rationing in the health service is nonsense. In the real world, prioritisation and good management cause rationing. We have to plan to make sure that resources are correctly applied, and if resources are not available, alternative means must be found to provide services.

Is the Minister for Health and Community Care clairvoyant? When she writes to me regularly, if belatedly, she states that she does not know the answers to my questions because the statistics are not available centrally. If the Executive does not have those figures, how does it make strategic management decisions on health? It is incredible; no other organisation in the world can be run in that way. For example, I find it appalling that the Executive does not know how many diabetics are diagnosed each year and whether they are type 1 or type 2. How can we plan long-term to invest in Scotland's health service in a truly focused way that will save money for the health service and prevent personal suffering for the individual? I ask that question time and again, and I am disappointed that I have not received an answer.

Iain Gray (Labour, Edinburgh Pentlands)

Will Mr Davidson give way?

David Davidson (Conservative, North East Scotland)

I am sure that the minister will use his time at the end of the debate to answer my question. I have to press on.

The Executive should recognise what the health service could gain from contracting out into the private sector and use that expertise, which is cost-effective and well managed. That would not be privatisation, but it would be co-operation between the public and private sectors to provide the health service that we need. Finally, the next time a member of the Executive goes down to London, could he or she ask the Chancellor of the Exchequer to give back about £1 billion from the stealth taxes that he has taken out of Scottish pockets in the past two years?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

January was a very important month in the history of the NHS. Michael Portillo said that a health service that was free at the point of use and funded from general taxation was a "historical accident", and Tony Blair reaffirmed the fundamental principles of the NHS as laid down by Aneurin Bevan, when he rejected insurance models and established the best demonstration that we have ever had of socialism in action. That is what so many Tories do not like, and why William Hague and Liam Fox are so obsessed with private health insurance rather than a fair NHS.

David Davidson (Conservative, North East Scotland)

rose—

Malcolm Chisholm (Labour, Edinburgh North and Leith)

As I know that Scottish Tories are often embarrassed by their English colleagues, I hope that David Davidson will take this opportunity to distance himself from Michael Portillo, William Hague and Liam Fox.

David Davidson (Conservative, North East Scotland)

I am happy to answer Malcolm Chisholm's point, which is the point that I made a few minutes ago. We need to examine creative alternatives, so that the health service is available for people who cannot afford health care elsewhere. We need to expand opportunities in and access to health. If someone is prepared to buy insurance and go to a private hospital in Glasgow, that saves money for the health service and allows more services and access for others.

Malcolm Chisholm (Labour, Edinburgh North and Leith)

David Davidson could not be more wrong. Private health insurance is expensive; is focused on people who are good medical risks; rarely extends to the over-75s; is deeply divisive and creates a two-tier service; and would not ease any burden on the NHS.

Ben Wallace (Conservative, North East Scotland)

Will Malcolm Chisholm give way?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

I have to move on; I have only two and a half minutes left.

Margo MacDonald, in her Edinburgh Evening News column, recently supported an alternative social insurance model. That would be a more expensive and bureaucratic system, in which costs would perpetually escalate. By contrast, in an important interview, Tony Blair said that the public finances had been sorted out and the economy had been put on a stable path, so that the Government could afford to put the money in.

Kay Ullrich (Scottish National Party, West of Scotland)

Does Mr Chisholm agree with our Health and Community Care Committee colleague, Dr Richard Simpson, who said on "Newsnight Scotland" on 17 January:

"We are going to need some higher expenditure. There is no doubt about that"?

Dr Simpson is becoming our Lord Winston—a very honest man indeed.

Malcolm Chisholm (Labour, Edinburgh North and Leith)

Of course I do, and on this occasion I agree with Tony Blair, who said that more money was going in.

Kay Ullrich asked what money was going in. The answer is: the same per head as in England. It is a matter of basic maths—because we have a higher base, we receive a lower percentage. If Kay Ullrich has £10 and I have £12, and we each get a £1 increase, Kay gets a higher percentage increase than me, but I still have more money.

Kay Ullrich (Scottish National Party, West of Scotland)

Will the member give way?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

I am sorry—I have only one minute left.

Whether we look at the increase in terms of percentages or money, in the current three-year period there will be 11 per cent—or £546 million—real growth in the health service.

Kay Ullrich outlined several real problems, which I acknowledge; I believe that the Executive acknowledges them, too. She talked about intensive care beds; a review of such beds is being carried out. She talked about unacceptable waiting times; a commitment on waiting times is central to Executive health policy. She also talked about the recent flu outbreak and other January difficulties; a commissioning group that represents a wide range of interests has been formed to reflect on existing winter planning arrangements and how they can be improved.

There is no room for complacency and I do not believe that anyone is being complacent, but we must have a sense of proportion. A Scottish Association of Health Councils report, this week, said that waiting times in Scottish accident and emergency departments had been halved since last January.

I am not complacent—we need to go further—but let us remember that much activity is going on. For example, in Edinburgh, three wards were opened in January especially because of the flu emergency. Perhaps that is how we must move forward. If, instead, we just have massive increases in bed numbers throughout the year, we must realise the cost implications for the development of primary care and the broad public health agenda that we all support.

Fiona McLeod (Scottish National Party, West of Scotland)

I will speak about children's health. I am disappointed that I, as the last speaker from the floor, am the first to raise that issue. I should have thought that the minister, in her opening speech, would have wanted to talk about health and services for our future. She also failed to mention children's health services in her introduction to her first annual report, "Making it work together".

We must consider two aspects of children's heath services, the first of which is acute services. We must ask, again, why the 1998 review of acute services had to be persuaded to set up a sub-group to examine children's health services in Scotland. That area has to be given a higher priority than it receives at the moment.

We have heard much this morning about how we have adequate funding in our health service. I question that view, when—for children's health services—we have had to move from funding to fund raising. We have to wait for the likes of the Evening Times to hold an appeal to buy a scanner for Yorkhill sick children's hospital in Glasgow. This year, the Blue Peter appeal raised money for incubators for hospitals not in Peru or Africa, but in the United Kingdom. Is that the way in which we should fund health services for children in this country?

Palliative care is particularly close to my heart. In Scotland, we have one hospice for children, Rachel House; it does a wonderful job, but it is a charity. We are looking for a second such hospice and we will raise the money by public appeal and by charity. Is that the way in which we should treat the most vulnerable people in the health service?

Secondly, many children's health services are about prevention, so that we can give children a good start in life and continue in that way. The statistics on children's dental health show that Scotland has a dreadful record. What is worse is that the target that the Government set itself to reduce cavities, fillings and extractions in the under-fives was missed this year and has had to be extended to 2010. Why did we miss that target? Again, it comes down to funding.

Funding for the dental service is put into general dental practice rather than into the community dental service. We need general dental practice, but the community dental service is at the forefront of prevention in our most deprived areas, which is where the targets have been completely missed.

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

Does the member accept that it is a question not just of throwing more money at dental health problems, but of tackling the Scots' traditionally appalling diet? We need a programme of education and work on healthy eating and nutrition, as well as measures to improve opportunities for children and young people to attend dental clinics.

Fiona McLeod (Scottish National Party, West of Scotland)

That is exactly the point that I was making. Dental health is affected by diet and nutrition, but dentists will explain that the problem is also one of poverty. The way in which we fund the service is another issue. If we fund dentists through payment for treatment rather than for prevention, the dental service will continue to treat the caries rather than prevent their occurrence.

Recently, I attended Breakfast Daze, the breakfast clubs' annual conference. Within two years, a 50 per cent reduction in cavities had been achieved by introducing young children to healthy eating, fruit and daily teeth brushing. Breakfast clubs need to be supported with resources and—just as important—through joined-up government.

I echo what David Davidson said about the evidence base in the health service. I tried to get statistics on child health services; it was a nightmare. It was difficult to extrapolate statistics on psychiatric services for teenagers from the statistics on provision for adults. If we want to provide resources and a health service that treats people when they need it, we need to collect statistics on children and undertake research into child health.

I leave the minister with two thoughts. We are doing away with mixed-sex wards, but what about mixed-age wards? Teenagers continue to fall between the lines, sometimes being put in with children, sometimes with the dying elderly. Finally, article 24 of the UN Convention on the Rights of the Child says that every child has the right to a healthy life.

George Reid (Scottish National Party, Mid Scotland and Fife)

Before we move to winding-up speeches, I inform business managers that we are running about 15 minutes early. Business managers should inform their colleagues that the debate on air freight may start 10 or 15 minutes early.

Nora Radcliffe (Liberal Democrat, Gordon)

I join everyone else in paying tribute to NHS staff. It almost goes without saying that we owe them a tremendous debt for their dedication. They care deeply about the services that they provide and the way in which they deliver them.

In the NHS, as elsewhere, service delivery is all about resources, which means money and people. Money is important. Bruce Crawford said that we must face financial reality. There is not an infinite amount of money, so emphasis must be put on the way in which to make good use of resources.

David Davidson pointed out that we need good information to make good decisions about how resources are allocated. Cathy Jamieson said that we should not have a blame culture. We should have a culture that ensures that we know where we are, where we want to go and how to get there. It is therefore important to think about the information that we collect, how we collect it and how to make effective use of it.

There are issues about money in the health service that must be faced, one of which is the fact that inflationary pressures on the health service are far greater than general levels of inflation. That is especially true of the drugs bill and spending on equipment.

We must examine the way in which we fund pay awards. If we spend more on pay, we take money away from services. Members have raised the issue of staff in different categories being treated differently. I do not know whether that is right or wrong—we should not apportion blame—but we must examine the issue and find the best way forward.

If there is one message about using money wisely that former health service colleagues want me to give, it is to stop wasting money on organisation and reorganisation. They say that they have all the organisation and reorganisation that they can take, and want us to leave the structure alone, stop managing change and start managing services. I am glad to have been given the opportunity to pass that message on.

On the sensible use of resources, let us consider what it costs to train a nurse: £35,000. If we then take the fact that 3,000 nurses leave the service every year, which poses a real problem, we need to consider ways in which to retain staff.

Positive measures have been taken to do that, including reasonable pay awards—although Mary Scanlon identified the question of how to look after ancillary staff and staff employed by practices, not trusts.

I was delighted to hear about the training budget for staff who are not doctors. Doctors' professional development is well catered for; other health service staff have been envious of that. Having a decent budget for training will raise morale and increase retention. We must take account not only of how much it costs to train somebody, but of how much it costs to provide realistic cover to give that person access to training.

I want to mention a matter that Brian Adam raised, on the sensible use of resources: consultants who work both in the national health service and privately. Again, I will not say what is right or wrong, but it is an issue that must be addressed.

Mary Scanlon talked about health boards. I have no difficulty with different health boards having different priorities. That is a good thing. The boards are given a budget to manage, to provide local services with local accountability. If they do things differently, some will do better than others, but that will give rise to examples of good practice, which will then be shared.

Cathy Jamieson correctly reminded us that the health service is not just about acute services. We should appreciate the enormous amount of work that is carried out in community health services. David Davidson mentioned community pharmacists, who form an important resource that has been underutilised in the past, and which should be used better in the future.

Dentists deserve a mention. We need to consider how they are reimbursed so that we retain them in the health service, and how we do so in a way that changes the emphasis from filling holes in teeth to preventive measures.

Malcolm Chisholm mentioned public health, and Dorothy-Grace Elder talked about the underlying causes of ill health. Cathy Jamieson talked about education, and persuading people to take better measures to protect their own health.

I should like to finish by returning to money. Where do we get the resources? Some come from private fund raising—that is fine. Mainly, they come from taxes. Tax is not a dirty word. We cannot have services without taxes. I join my colleagues in urging the Chancellor of the Exchequer to forgo his 1p decrease in income tax and to put the money into front-line services.

Ben Wallace (Conservative, North East Scotland)

Just over 1,000 days ago—not seven months ago—the Labour Government came to power. It does not get two starts to this race, I am afraid. In opposition, Labour used the words "crisis", "verge of collapse" and "sick". It then declared that waiting lists were the be-all and end-all of health measurement and that staff were better off in Labour's hands.

A thousand days later, we are all lectured about the reckless use of the word "crisis". We are told to grow up, to forget waiting lists—in the same way as the Executive has been forgetting about the people on them—and that winter pressures, which I am sorry to inform the minister do happen annually, have been a one-off event.

The Minister for Health and Community Care chose to ignore the warnings given by the SNP and us last June, as she did those given by the British Medical Association. Dr Kenneth Harden said in January that the BMA had argued strongly for an orchestrated campaign; that, in fairness, some health boards took that up and resourced and arranged a proper flu campaign, but that the majority did not and that, sadly, there was no central support from the Government. That is not from me—it is from the BMA.

The minister talks about action. She says that she is happy to compare statistics from England and Wales with those from Scotland. However, she is not too happy to compare statistics from different parts of Scotland. She talks about the dubious record of increases, but the highest increase in health spending in Scotland was 10.4 per cent in 1992-93. Health spending between 1993 and 1996 rose by 23.3 per cent. Under Labour, from 1997 to 2001, the increase will be 23.7 per cent. That 0.4 percentage point difference does not take into account the much higher rate of health inflation that goes on every year.

Perhaps Malcolm Chisholm, who quoted Michael Portillo, agrees with Alan Milburn, who said that there is no reason why the NHS should not collaborate with the independent sector in developing new and innovative forms of intermediate care. The wonderful thing about devolution—which the Scottish Conservative party fully supports—is that we can take a different view from our colleagues in England. It remains to be seen whether we do that with regard to our health policy.

The Executive amendment acknowledges the role of staff—but that is all it does. Actions speak louder than words. The Executive's amendment refers to the document, "Making it work together". I infer from that title that the minister is trying to spread the blame. If everyone is working together, why is morale in the NHS now at its lowest point? Why do half of the staff express a wish to follow another career? Why were the staff at Stracathro left out in the cold while their future was discussed?

Perhaps the minister means that her department should work together better with the Parliament. Her department gives the Health and Community Care Committee statutory instruments once they have become law, not 40 days earlier so that they can be discussed.

Young doctors know all about Labour's idea of working together: they were almost forced to take strike action last year by an Executive that chose to ignore their demands. At the moment, there are 140 unfilled consultant posts in Scotland—the number of doctors in training does not keep pace with the number of doctors leaving. That information comes from the BMA.

I am afraid that the Executive is determined to do the opposite of working together. It is doing its thing its way and hell mend them. With professionalism and hard work, the NHS staff is saving the skins of the Executive. From my past as a soldier, I know that morale is built by talking straight, not by coming out with doubtful statistics on spending and pay increases that are not backed up by new money. When new Labour talks about new money, it should understand that that money must be new, not a collection of fiddled statistics.

Morale is built up by making people feel valued and important. One of the reasons I got into politics is that I believe that staff in the NHS feel undervalued. The Executive is doing nothing to improve that situation. I see bad leadership every day from the Executive when it deals with staff in the NHS.

Morale is built not by leading through rank but by example. People will not respect the Minister for Health and Community Care simply because she is a minister. They will respect her because of the initiatives that she brings forward and the way in which she deals with staff. Susan Deacon is failing in those respects and that is why morale is low. We want the Executive to acknowledge the problems, to make fair and necessary changes and—above all—to recognise the contribution of all staff in the NHS.

One thousand days ago, people voted for Labour in the hope that it would do better in health and education. The Executive is failing in both areas. The electorate will not forget that. I will be interested to see the result of the Ayr by-election, as I doubt that the people of Ayr will forget it either.

I support the motion.

Iain Gray (Labour, Edinburgh Pentlands)

This has been an interesting, if rather short, debate. When we last debated health—just before the recess—I said that the relentless denigration of the national health service, which amounted to a counsel of despair, failed to acknowledge the care delivered by NHS staff 24 hours a day, 365 days a year—366 days this year. I am glad that the Opposition has seen its error and has attempted to put that right in its motion today.

There has been a lot of loose talk about private health care in this debate. I want to make it clear that NHS staff deliver 95 per cent of health care in Scotland—we have only a tiny private sector. The only people who are interested in privatising the NHS are the Tories, as David Davidson made clear.

David Davidson (Conservative, North East Scotland)

Will the minister give way?

Iain Gray (Labour, Edinburgh Pentlands)

Not just now.

David Davidson's speech was also extremely confusing, as it seemed to criticise us for not running the NHS as some kind of soviet-style command-and-control centralised organisation.

Back in December, in the debate I mentioned, Susan Deacon and I expressed our confidence—not complacency—in our doctors, nurses and ancillary staff and their preparations for the winter period. We did not know then that they would in many cases face unprecedented levels of activity in January. Nevertheless, they did and our confidence was not misplaced. Our confidence was based on visits to hospitals, meetings with staff and the close examination of planning. The Opposition could choose to have confidence, too, as Cathy Jamieson did in forming an excellent contribution to today's debate.

We are already—just into February—beginning to plan for next winter with staff. We are looking forward, not back.

Jamie McGrigor (Conservative, Highlands and Islands)

The minister said that she found it difficult to find solutions. Lorn and Islands district general hospital in Oban has had the generous offer of a new computed tomography scanner worth £310,000 and a further offer, from another charity, to run it for two years. Why is that offer not being accepted, if the Executive is pushed for money?

Iain Gray (Labour, Edinburgh Pentlands)

As we have said many times, such decisions are for local planning. The on-cost of a decision such as that must be properly taken into account by the health board.

I want to talk about a different kind of investment in the health service. Susan Deacon called the 136,000 NHS staff in Scotland the heart of the service, which they are. That is why the pay increases that were announced in January are among the most important and effective investments that we can make in the health service. Investment in staff pay is not the problem, as the SNP seems to think, but part of the solution. Those pay increases are significantly above inflation—7.8 per cent for experienced nurses—to reward them, recognise them, respect them and retain them.

Mary Scanlon (Conservative, Highlands and Islands)

Will the minister give way?

Iain Gray (Labour, Edinburgh Pentlands)

No, sorry.

Mary Scanlon raised the specific case of GP practice nurses. Indeed they should be recognised and rewarded by their employers. The point is that practice nurses' employers are the GPs themselves, who are independent contractors to the health service. Not for the first time, Mrs Scanlon's grasp of the facts is sorely lacking.

Mary Scanlon (Conservative, Highlands and Islands)

Will the minister give way?

Iain Gray (Labour, Edinburgh Pentlands)

No, I am sorry. You did not pay me that courtesy, Mary, and I shall not pay it in return.

Mary Scanlon (Conservative, Highlands and Islands)

That is bad manners.

Iain Gray (Labour, Edinburgh Pentlands)

This is an especially significant investment in Scotland, where there are 808 nurses per 100,000 people, compared with 620 in England. That is a reflection of the 20 per cent higher spend on the health service, which is being spent where it matters most—at the heart of our service.

The fact bears repeating that public health spending in Scotland, as a percentage of gross domestic product, is one of the highest in Europe—and we are increasing health boards' allocations by more than 5 per cent next year although Scotland will receive the same spending review increases per head of population as England. All staff who are covered by independent pay review bodies will receive their pay increases in full—with no staging and no messing—backed up by a further range of measures on training, health and safety, and involvement in decision making. They will receive reward and respect.

If staff are the heart of patient care, it must also have a home. That is why we are delivering the biggest ever hospital building programme in Scotland. This very day, Grampian University Hospitals NHS Trust will announce the go-ahead for the new children's hospital in Aberdeen.

This is about investment in the future, but let us, for a moment, look at the past. We are reinvesting in and rededicating ourselves to a service that was ill served for 18 years under the Tories. No investment was made in radiotherapy equipment between 1992 and 1997, but we are now investing £12.5 million to try to put that right.

Phil Gallie (Conservative, South of Scotland)

Will the minister give way?

Iain Gray (Labour, Edinburgh Pentlands)

I do not have time to give way.

Phil Gallie (Conservative, South of Scotland)

But the minister is wrong.

Iain Gray (Labour, Edinburgh Pentlands)

I am sorry—I will not give way.

That investment of £12.5 million is part of the process in which we are replacing outdated buildings, eliminating mixed-sex accommodation and improving NHS pay in real terms. That is action.

Robert Brown was right to draw attention to the absence of positive suggestions from the Opposition. Kay Ullrich mentioned the story from her mailbag about someone having to wait eight months for a cataract operation. She is right to be concerned about that, but Susan Deacon described how redesigned health care in Ayr has reduced the waiting time for such an operation from 12 months to one month. We acknowledge that there are problems and we seek solutions to them—that is government.

Saying that independence from the UK is the solution to the problems of the NHS is nonsense. Of the SNP members who have spoken, I can excuse Fiona McLeod, who made a constructive contribution. I assure her that children's health is a priority.

Can we do more? Yes. Are we listening? Yes. This week, Susan Deacon and I met 30 leaders in mental health. Today and tomorrow we will meet the chairs of all Scotland's health boards and trusts so that we can push forward the modernisation of the NHS. We must match the commitment of staff with resources and vision.

The problem with the SNP motion is that it calls for an optimum health service. I do not know what that means. We will never reach the optimum—we can always do better. There must be continuous improvement and endless action to drive up the quality of care. There must be no limit to our vision.

An endless quantity of words that are used to drive down confidence in the NHS, and vision with no beginning is, sadly, what passes for opposition in the chamber.

Duncan Hamilton (Scottish National Party, Highlands and Islands)

I enjoyed part of the minister's speech, which is more—I can say with some confidence—than can be said for Fiona McLeod, whose political career with the SNP has just been ended by the minister's praise of her constructive contribution.

I would like, if possible, to do three things in the 10 minutes that are available to me. First, I would like to look at what we, as the Opposition, keep being told we should be doing. We have been accused of whingeing every time we complain. We are accused of having nothing positive to contribute. We should examine those accusations.

Secondly, I would like to talk about the main focus of the SNP's proposal. We want to refocus the debate in the Parliament and throughout the country. We want to move it away from being a debate that sometimes alienates people, towards being a debate that concentrates on the needs of patients. That is something Susan Deacon, when she started out in office, said that she wanted to do in regard to patient-centred care. That is not what has happened. What the SNP wants to do today is highlight real-life human problems to show why we need further action.

Thirdly I will examine what has happened in terms of financial commitments. The minister has called that debate sterile—it might be so to her, but it is vital to the health service that it knows what funding is dedicated to it.

On the accusation of whingeing, I suggest that it is the Opposition's role in the Parliament to point out what exactly is wrong with the current situation and how we can improve it. All we hear from the Executive is that the SNP has nothing to say. That simply does not stack up against what we say must happen, particularly in financial terms, in the NHS.

Nora Radcliffe seemed to suggest that everybody is right. She nearly pulled out a candle and started to sway at one point. She was saying that there are major problems in the NHS—we all accept that. She also said, however, that no one is to blame for them—that no one should be criticised. That is the route to the death of debate and of proper accountability. Real accountability means that the Executive and the ministerial team that is before us should be called to account.

The main thrust of the SNP motion, lodged in the name of Kay Ullrich, is the human cost of the failings in the NHS. We heard what that means from a wide range of members, representing all areas of the country. Kay talked about patients being driven from Inverness to Glasgow for intensive care beds. We talked about what that means for people's lives and the problems that that represents for them. She talked about a woman in Edinburgh who had to wait for 20 months for a hip operation. There was talk about patients being unable to access the drugs that would be most effective in treating their condition.

Those problems affect people day in, day out in the health service. Brian Adam mentioned a case in Aberdeen, which highlighted exactly that problem. An operation performed by a consultant could be undertaken privately in two weeks, whereas the NHS was unable to cope with that kind of proper, optimum health care.

The Deputy Minister for Community Care seemed to be confused about what the SNP means by the optimum health care in Scotland. If this Parliament does not aspire to the optimum health service in Scotland, we are not doing our job. It is simply not enough to sit back and agree, "Yes, there are problems, but we're going to make progress."

Hugh Henry (Labour, Paisley South)

Will the member give way?

Duncan Hamilton (Scottish National Party, Highlands and Islands)

No, not at the moment.

The Executive must say, "Here is where we can go. Here is our strategic vision. Here is the kind of health service we want in Scotland. Let's work together to get there." We are not getting that vision from the Executive, which is why there is frustration in the chamber.

Iain Gray (Labour, Edinburgh Pentlands)

While we can argue about the meaning of optimum, we must have a vision of the kind of health service to which we aspire. The point that I was making, which has been made by many members during this and other health debates, is that we have no concept of the SNP's vision, because it has not been presented to us.

Duncan Hamilton (Scottish National Party, Highlands and Islands)

Our vision is right at the heart of the SNP motion—the health service should be driven by the needs of real people. The whole idea behind this Parliament was that it should be accessible to the people of Scotland, but it is in danger of becoming divorced from mainstream Scotland. Today, we have an opportunity to refocus.

Some points about finance have been raised. We hear a great deal these days about joined-up government, but it appears that not only is the Executive not joined-up, but ministers do not talk to one another.

The minister said that the percentage of gross domestic product in Scotland spent on health is already above the European average, but that does not seem to match the figure of 6.9 per cent given by Mr Jack McConnell in an answer to Andrew Wilson. That point is important because it is the very measure that the Prime Minister, Tony Blair, chose to evaluate the success or failure of his policies.

Let us compare Jack McConnell's 6.9 per cent with the 8.9 per cent of GDP spent on health in France, or with the 10.4 per cent spent in Germany. Those figures suggest to me that France and Germany are nearer to the elusive optimum that the Deputy Minister for Community Care does not appear to understand. We can even compare the 6.9 per cent with the European Union average of 8.02 per cent. These are not my figures; they come from the Organisation for Economic Co-operation and Development. The minute we start to approach those kinds of figures, we can consider being self-congratulatory about where we are with the health service—but where we stand now is not good enough.

George Lyon (Liberal Democrat, Argyll and Bute)

Will the member give way?

Duncan Hamilton (Scottish National Party, Highlands and Islands)

No thank you, George.

We should also bear in mind where we are heading. If underfunding, in terms of the percentage of GDP being spent on the health service, is the context of where we are now, what are the Executive's proposals for future years? It depends which one of the Executive's budget statements we read: next year's increase will be either 0.8 per cent or 1.6 per cent, in comparison with an increase of 4.4 per cent south of the border. Figures published in October show that the three-year average increase in Scotland is 3.5 per cent, in comparison with 4.3 per cent south of the border.

Throughout the debate, we heard the argument that those figures are justifiable because Scotland already spends 20 per cent more on health per capita. It is fair to say that Scotland gets more per head of population, but why is that? Perhaps the Minister for Health and Community Care, during one of her late-night television sessions, saw Richard Simpson on "Newsnight Scotland". When asked why Scotland gets more per capita, he highlighted the fact that the needs of rural Scotland and the historic detriment in the Scottish health system meant that that 20 per cent was justifiable. On 17 January, he said:

"There are two problems: we have a poorer health record and rurality. The difference is accounted for therefore."

Does the minister accept that? Which member in the chamber would want to admit that the current settlement is overgenerous? Do we really believe that the extra 20 per cent is not justified? I do not think that there is one member who would stand up to contradict that.

George Lyon (Liberal Democrat, Argyll and Bute)

rose—

Duncan Hamilton (Scottish National Party, Highlands and Islands)

As ever, George Lyon surprises me.

George Lyon (Liberal Democrat, Argyll and Bute)

We have heard Duncan Hamilton mention numerous figures. Can he say to what figure the SNP believes spending should rise? Is it the French figure or is it the German figure?

Duncan Hamilton (Scottish National Party, Highlands and Islands)

Of all the parties to intervene on this issue, the Liberals are the most interesting, because today they have adopted the penny for Scotland that was much derided by Mr Lyon and his colleagues throughout the election campaign. Every Liberal member to speak has jumped on the back of a poll in The Observer suggesting that people want to forgo the cut in income tax and invest that money in the health service. If that is where the Liberals are at, I welcome their latter-day conversion.

On this I agree with Malcolm Chisholm—for once, perhaps, Tony Blair has got it right. Maybe when Tony Blair says that the NHS is chronically underfunded and that we must do better, he is right. However, the Scottish Executive has still not given us an adequate answer to whether the 5 per cent real-terms increase will happen. At this week's meeting of the Finance Committee, Jack McConnell gave us two answers.

Hugh Henry (Labour, Paisley South)

Will the member give way?

Duncan Hamilton (Scottish National Party, Highlands and Islands)

No, thank you.

Jack McConnell gave us two answers. He said, first, that the money would be available, but then he added that that would not be the case in areas where Scotland gets historically higher spending per capita. Which is it? The Executive must tell the people. If Tony Blair is claiming in London that there will be a 5 per cent increase, what is the Executive saying in Scotland? If it is suggesting that the NHS will get 5 per cent, what does that mean? Does it mean 5 per cent, or does it mean 4.3 per cent, taking into account the Barnett squeeze on health spending? I refer members to the comments not of an SNP researcher, but of a parliamentary staff researcher, on what this proposal would mean. Mr McVicar said:

"Therefore, in total, Scotland will lose over £500 million through this process."

That is the result of the iniquitous system of funding in Scotland. Until the Executive recognises the problem, all the warm words and self-congratulation will not count for anything—not in this chamber, not in the NHS and not in wider Scotland.

Air Transport

Patricia Ferguson (Labour, Glasgow Maryhill)

The next item of business is a debate on motion S1M-483, in the name of Mr Kenny MacAskill, on air passenger and freight links to Scotland, and amendments to that motion. I call Kenny MacAskill to speak to and move the motion.

Kenny MacAskill (Scottish National Party, Lothians)

What is the purpose of this motion? It is to highlight the importance in the 21 st century and in a global economy of air links and infrastructure. It has been suggested that the strength of the Scottish economy can be observed in the vibrancy of the Edinburgh to London shuttle, but it should be clear that air links, if not an economic weather vane, are certainly an integral part of economic growth.

We must not compound the problem of our geographic peripherality by imposing a cost penalty on access to our markets. At the moment, however, we restrict access by routing almost everything through London and compound that by having a pricing structure that economically disadvantages our nation in general and individual areas of it in particular.

Air links are not simply about flying our businessmen to London for a mid-morning meeting or packaging our tourists off for a fortnight's break in Benidorm. They are about bringing in business and tourists. For too long we have been looking through the wrong end of the telescope. We must set our sights higher, because in the 21st century nobody owes Scotland a living. We must access the markets and promote our industry.

What do we face at the beginning of the new millennium? Privatisation of the national air traffic control system. Surely the word "national" should indicate the responsibility that the service has to the nation and the clear duty that the nation has to retain it in public hands. I will not say too much on that issue, as my colleagues will speak on it in greater detail, but I believe that there is neither an economic case nor a safety argument for privatisation. I am taken by the comments of the former transport minister—

Murray Tosh (Conservative, South of Scotland)

Will the member give way?

Kenny MacAskill (Scottish National Party, Lothians)

Not at the moment.

Gavin Strang said in the Edinburgh Evening News on 29 July 1999 that the three priorities for air traffic control should be safety, safety and safety. He added:

"I do not believe that privatisation should have a role in the future of our air traffic control."

He said that privatisation of air traffic control was not proposed to make air traffic management safer, but was put on the political agenda last July as part of the comprehensive spending review.

It is a pity that the Minister for Transport and the Environment has chosen not to say what her position is or who speaks for the Labour party in Edinburgh. Moreover, who speaks for the Edinburgh East and Musselburgh constituency Labour party—Dr Strang or Nurse Deacon? Are they for or against privatisation?

In preparing for this speech, the SNP conducted significant research to try to find out whether any other nation has privatised its air traffic control system. We had been misled by Dr Strang, who had misdiagnosed the situation. He had said that no other country had done so, but I can reveal to this chamber that Fiji has sold its air traffic control system to Australia. That is an absurdity.

In this part of the chamber, we had assumed that the unedifying race to privatise any asset that stood still long enough had ceased, but what have we seen? Harold Macmillan said that the Tories were selling off the family silver; new Labour is selling out the family safety.

Secondly, I will address the issue of job losses at Federal Express. It is a bit like the Hampden fiasco.

Phil Gallie (Conservative, South of Scotland)

What about the Wembley fiasco? [Laughter.]

Kenny MacAskill (Scottish National Party, Lothians)

One month the Executive trumpets a supposed success, the next its cover is blown and the gaffe is shown.

What has happened? On 25 August 1999, the eminent and esteemed new transport minister, Lord Macdonald of Tradeston, told us:

"Prestwick's emergence as an economically important air cargo hub could be encouraged by granting US companies 'fifth freedom' rights there, while continuing to pursue a wider deal—and this is what we have done today."

So proud was the Department of the Environment, Transport and the Regions in its boasts that its press release, a copy of which I have here, is entitled,

"Prestwick cargo cleared for take-off."

The proposal did not even get to the end of January before it crash-landed at Prestwick causing casualties to the work force in Ayrshire. Ayrshire and Scotland have been sold out to preserve the interests of bigger corporations in the south of England.

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

Does the member agree that although the decision by FedEx was regrettable, it was made for commercial reasons and that FedEx appears to be more interested in securing rights at Stansted than in the future of jobs at Prestwick?

Kenny MacAskill (Scottish National Party, Lothians)

I will explain when I come on to that matter.

Glasgow Prestwick international airport will tell inquirers that it can turn around cargo in four hours, whereas it takes 48 hours to do that at Heathrow. Rather than having companies pulling out and workers being laid off, the area and the work force should be booming.

Let us examine the situation. I received a short call yesterday from a quasi-autonomous non-governmental organisation seeking to blame FedEx. I then received a call requesting that I speak to a representative of FedEx. Although I was engaged on other matters at the time, I arranged to meet the representative last night for a lengthy chat. I understand that Mr Scott of the Liberal Democrats took advantage of the opportunity to speak to the representative this morning before he flew out.

I understand that FedEx met the Minister for Transport and the Environment in July, prior to Lord Macdonald's gushing declaration. I was advised that FedEx had offered to meet her on several occasions between then and the recent announcement of job losses, but that she had declined. I asked whether FedEx had met other members of the Executive about this crisis and was told that it had not. That is an absolute disgrace. When Scottish jobs are on the line, is it not the duty of the Executive at least to discuss with the employer the possibility of action or assistance? The Executive did nothing.

Success was claimed south of the border and Labour sought to bask in its afterglow up here, but when everything goes belly up, Labour shies away. We will not let it do so. Air transportation may be a reserved power, but Scottish jobs remain a devolved responsibility, and this is nothing short of a shameful abrogation of responsibility. At the meetings that matter on air transportation, the First Minister, the Minister for Transport and the Environment, and the Minister for Enterprise and Lifelong Learning sit voteless, voiceless and anonymous, like the three wise monkeys—hear no crisis, see no crisis, speak no crisis.

I return to Cathy Jamieson's intervention: what is the background to this? FedEx did not arrive in August—it has been here for 10 years. It was not a new business start with the possibility of exponentially boosting air freight from Prestwick. FedEx's main European hub is not at Prestwick or Stansted but at Charles de Gaulle in Paris—because it does not have full UK rights. In a nutshell, it operated big and small spokes. Prior to August and since 1978, the routes were Prestwick to Charles de Gaulle and back via Stansted.

Since 1978, FedEx has had rights to go to nine centres—what are called beyonds in the trade. Were and are those centres the main hubs, the vibrant economic bases, of Europe and the European Union? For sure they include Germany, the Netherlands and Belgium, but thereafter they are Iran, Jordan, Syria, Lebanon, Turkey and India. I do not wish to be disparaging of those nations, but they are not economic powerhouses. FedEx wanted fifth freedom rights throughout the UK, particularly in Stansted, to pick up and go beyond on routes from the USA.

In August, nothing was agreed. Labour trumpeted its achievements and FedEx pressed on, on the basis of good will and negotiations. To be fair to Lord Macdonald, the small print of the press release of 25 August says:

"Discussions with the US will include consideration of Federal Express's parallel application for full rights".

Although FedEx welcomed fifth freedom rights at Prestwick, it wanted similar rights at Stansted. It welcomed continuing negotiations and proceeded in expectation of a successful conclusion—an opening up of the skies. FedEx made that very clear.

Notwithstanding the PR hype and fawning praise Labour heaped upon itself, no deal was concluded, no document was signed and no jobs were secured. New Labour claimed to have built a future, but it was built on sand. What FedEx saw as an advantage for itself would also have been an advantage for others—its competitors would have been boosted by Stansted's operation being opened up. It was made abundantly clear that the price for Prestwick was fifth freedom rights in the UK. Labour trumpeted a success, but the jury was still out. At national level, Labour was still negotiating with the USA, with parallel discussions with individual operators. Labour decided to play poker with the USA and Prestwick was a chip to bet with.

Lord Macdonald was negotiating not for Tradeston, but for London. What were the other bargaining chips in that game of international poker? The USA wanted fifth freedoms and the UK companies that lobbied Lord Macdonald wanted access to US domestic markets. Those UK companies wanted not to boost incoming freight and trade, but the right to fly in the US domestic cargo market.

The opportunity to boost companies that wanted access to the American cargo market was the goal, not the growth of Prestwick as a cluster zone. The British Cargo Airline Alliance represents the interests of those companies and none are located in Scotland—they are located at co- ordinates south, such as Bournemouth and Stansted. They are nothing to Scotland and do not represent our interests. They are Channel Express, a supplementary air operator; Atlantic Air, which operates one scheduled flight from Liverpool to the Isle of Man; and Air Foyle—its speciality is filling up large planes of east European origin. What do they want?

Patricia Ferguson (Labour, Glasgow Maryhill)

Wind up please.

Kenny MacAskill (Scottish National Party, Lothians)

I am trying to. Those companies want not fifth freedom rights but access to the US domestic cargo market. Lord Macdonald gambled that he could get that for those companies and boost them. The bluff was called and Scotland and Prestwick paid the price.

Fifth and even sixth freedom rights are not a threat, but an opportunity, for Scotland. What Scotland needs in fifth freedom rights is not unusual in Europe. The USA has long-standing agreements with the Netherlands and Luxembourg. On 22 December 1999, while negotiations between Lord Macdonald and FedEx were still going on, Portugal signed an open skies agreement with the USA. At the same time as we were being sold out, Portugal was signing up for economic advantage.

We have seen it all before in Scotland. As a West Lothian boy, I saw it at BL Bathgate. The day that factory closed every product that was assembled there was still being produced—but south of the border. We saw it at Ravenscraig when Scotland was sold out for Shotton and Llanwern. We saw it when Rosyth was sacrificed for Devonport.

The fact of the matter is that an independent Scotland would not allow that to happen to Prestwick. We would put Prestwick, not the interests of big business south of the border, first. It does not need to be this way; we can fly Scotland into the 21st century. The solution, as I said earlier, is political will, political power. We can make Scotland fly, so I condemn the motion and I condemn the Executive.

Patricia Ferguson (Labour, Glasgow Maryhill)

Mr MacAskill, I was expecting you to move the motion. [Laughter.]

Kenny MacAskill (Scottish National Party, Lothians)

I move,

That the Parliament recognises the vital importance of air links and air infrastructure to Scotland and the Scottish economy in the 21st century; acknowledges the potential for economic growth through improved air links; condemns the proposed privatisation of National Air Traffic Services and Her Majesty's Government's failure to ensure that FedEx remains at Prestwick, and calls for government action to retain air traffic control in the public sector, save associated jobs and promote economic prosperity by increasing direct air passenger and freight links to Scotland.

Murray Tosh (Conservative, South of Scotland)

I think that Mr MacAskill was wound up from the moment he took to his feet.

In moving my amendment, I must comment on the extraordinary situation in which a major public policy matter is before the House of Commons and in the public domain, but our Executive has not lodged a motion in its own name defending its own Government policy. I wonder what conceivable reason there can be for that. Are the Liberals speaking for the Executive here? Why is the Labour party silent? Will the Labour party really try to smuggle its position through this debate, hiding behind an amendment that notes the views of the Liberal Democrats?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I notice that the Conservatives really struggle with the idea of devolution. They are supposed to be on board about devolution. Do they understand it? Will Mr Tosh address the point that there is a UK Government that has nothing to do with the Scottish Executive?

Murray Tosh (Conservative, South of Scotland)

I understood that, under devolution, parties in this Parliament were entitled to speak up in defence of their party policy here and in other places. Mr Rumbles's position comes close to saying that devolution means that the policy of the Labour party in this Parliament is not to support the bill that is before the House of Commons. That is an extraordinary confusion that Mr Rumbles has planted in this chamber.

Let us talk about the Liberal position. In another chamber, the Liberal party has spoken adamantly against any private capital approach to air traffic control. In the House of Commons, Michael Moore has insisted that it is a scandal on air safety grounds. Does the Liberal Democrats' amendment say that? It notes "that there are concerns". They do not dare speak out here in support of the policies that they issue in another place. I shall come to the SNP's policies in just a moment.

Let us be clear about this. Safety in air traffic control is a function of investment, and that investment must be put in place.

Des McNulty (Labour, Clydebank and Milngavie)

Will Mr Tosh give way?

Murray Tosh (Conservative, South of Scotland)

It is a function of regulation, which is there, and a function of culture, which is also there. The important issue is investment in a second air traffic control centre, but neither the SNP motion nor the Liberal amendment—

Des McNulty (Labour, Clydebank and Milngavie)

Will Mr Tosh give way?

Murray Tosh (Conservative, South of Scotland)

No.

Neither the SNP motion nor the Liberal Democrat amendment adequately addresses that issue. The position of the Conservative party is clear. [Laughter.] Jim Wallace may laugh, but I think that he knows that our position is clear. For many years, we have embraced the idea of a second air traffic control centre at Prestwick. The previous Conservative Government was well down the road to preparing a private finance initiative. We have no difficulty in supporting a public-private partnership. We have no difficulty in accepting commercial freedoms for National Air Traffic Services similar to those proposed for the Post Office. We accept that massive investment is needed, that the money is simply not there and that it must come from the private sector.

We regard it as ludicrous and scaremongering to suggest that a private capital approach would in some way imperil the safety of air passengers. In that respect, I am actually quite happy to support the founding principle behind the Labour Government's House of Commons bill, and I am surprised that the Executive is not.

Let us deal with the SNP. How would it fund a new air traffic control centre? SNP members come here and spend Gordon Brown's war chest several times every week. They are going to raise the money from the public sector. How? How will they fund it? What is the SNP's approach? We heard very little from Kenny MacAskill because, since he lodged his motion, the world has moved on and we have a better issue with which to bash the Government in the Ayr by-election—FedEx.

Kenny MacAskill is a curious combination. Sometimes he is the oldest of Labour, a pure tax-and-spend, old-fashioned socialist. Today, what is he? He is the unashamed apologist and spokesman for a multinational American company that has ratted on Prestwick airport this week, has issued 17 redundancies to its local staff and is going to sack another 40 people. This is an airline that has been here for a decade, and which won a significant concession from the UK Government in advance of all negotiations between the two countries to get rights to fly from Prestwick. Now, within months, the company has flown off.

Michael Russell (Scottish National Party, South of Scotland)

I want to give Mr Tosh a chance to pause for breath. May I make the point that, as a South of Scotland MSP, he will have had a letter from FedEx, which says:

"We continue to be surprised that a Government so committed to ensuring that the UK is globally competitive remains firmly wedded to an aviation policy clearly focused around a small number of interests concerned with access to Heathrow to the detriment of Scottish jobs".

Will Mr Tosh condemn the Government for that policy, instead of defending it?

Patricia Ferguson (Labour, Glasgow Maryhill)

Mr Tosh, wind up, please.

Murray Tosh (Conservative, South of Scotland)

Mike Russell's comments prove that he can read and that he has no more grasp of this issue than does Kenny MacAskill. Clearly, in any game of poker, there are two parties. FedEx has been playing a game of poker with Prestwick airport, and with Scotland, and deserves condemnation for what it has done.

Kenny MacAskill (Scottish National Party, Lothians)

Will Mr Tosh give way?

Murray Tosh (Conservative, South of Scotland)

No, the Deputy Presiding Officer would not allow it.

Patricia Ferguson (Labour, Glasgow Maryhill)

Mr Tosh is winding up.

Murray Tosh (Conservative, South of Scotland)

If the SNP wants to do something for Prestwick airport, and if it wants to do something for the Ayr constituency—which is what this debate is all about—it will support our amendment calling for urgent action to ensure that alternative carriers are allowed to carry freight.

Mr Salmond may smirk. There are three companies who want to carry this freight. One of them already has fifth freedom rights. We want to be sure that that freight can go by other carriers. This is an continuing matter and, frankly, the issue of independence is irrelevant, because, in the context of an independent Scotland, the SNP will neither raise the investment that is required, nor be able to influence UK-US negotiations on fifth freedoms.

It is time to get real. It is time for the SNP to stop this posturing and fishing for votes, and address the real issues and come forward with a motion that is about a strategy for airports, rather than a strategy for votes for the SNP.

I move amendment S1M-483.1, to leave out from "acknowledges" to end and insert:

"and, acknowledging the potential for economic growth through improved air links, supports the development of a new Air Traffic Control Centre at Prestwick funded by private capital, calls for the acceleration of the Scottish Airports and Air Services Study and effective surface access strategies for Scotland's major airports, and calls for urgent assurances that other freight operators will be authorised to carry freight traffic currently carried through Prestwick Airport by FedEx."

Tavish Scott (Liberal Democrat, Shetland Islands)

I was just thinking that I go home on a Saab 340 turboprop every week, and at least I know now that there are more than two things that are wound up on an average morning.

I will speak to the Liberal Democrat amendment in my name—and I say this for Murray Tosh's benefit—which sets out the Liberal Democrat position that:

"the Liberal Democrats are opposed to the development of the air traffic control system by public private partnership".

That is clear, even if Mr Tosh is having some difficulty with comprehension this morning.

Murray Tosh (Conservative, South of Scotland)

rose—

Tavish Scott (Liberal Democrat, Shetland Islands)

No, he can hold his horses.

I would welcome a serious debate about external transport links and our air infrastructure but, unfortunately, we have not had that this morning. This debate is not about air links, freight to and from Scotland, air passenger duty or the Scottish airports and air services study—matters that we should discuss, but have not had the chance to discuss this morning. This debate is about the Ayr by-election. There are no two ways about it.

The SNP's apparent diminishing popularity obviously has called for desperate measures. The BBC reported yesterday morning that the SNP had launched a premier chatline. Members may have heard that story on "Good Morning Scotland". Apparently, callers press 1 for a chat with Alex Salmond, 2 for a chat with Dorothy-Grace Elder, and, obviously, they press 999 for a chat with Kenny MacAskill.

I want to concentrate briefly on air traffic control, because it is an important issue. I agree with Murray Tosh when he says that there is a need for more investment—no one doubts that—but we disagree on how that investment should come about. It is predicted that the number of flights will increase by 15 per cent in the coming 15 years. The question is how we make the investment.

Alex Salmond (Scottish National Party, Banff and Buchan)

rose—

Tavish Scott (Liberal Democrat, Shetland Islands)

I wish to make some progress, Mr Salmond.

I visited Prestwick airport with my Westminster colleague Mike Moore in December. We met the chief executive of NATS and the general manager of Prestwick. We listened to the concerns about the need for £350 million of investment in Prestwick. We saw controllers at work. I fly every week, and along with many people I feel literally that our lives are in their hands. I was impressed by the dedication, professionalism and coolness of those staff in difficult circumstances.

There is no doubt about the need for investment. We discussed with the union and staff representatives at Prestwick their concerns about the proposed part privatisation. Why are there so many concerns about those proposals? Air traffic controllers, who have a strong public sector ethos, believe—and made the point forcefully to us—that that will be undermined by commercial pressures. The point was made at Prestwick that the prevailing culture should be one of safety, not profit.

Alex Salmond (Scottish National Party, Banff and Buchan)

The Liberals agree with the private finance initiative in schools, as part of the Executive, and they agree with PFI in the health service, as part of the Executive agreement. Does that mean that if air traffic control was a devolved responsibility, they would agree with PFI in that sector?

Tavish Scott (Liberal Democrat, Shetland Islands)

The Liberal Democrats do not agree with PFI, as Mr Salmond is well aware. The partnership Government has introduced a form of finance for those methods that makes progress on all the concerns that we had at the time of the election.

This debate is on a reserved matter, and I will deal with the issues. Why are pilots also worried about those proposals? Why do the trade unions and operators oppose part privatisation? Those are not irrational, emotive people taking a short-term political view; they are pilots and air traffic controllers who make a cool, professional judgment about those decisions.

Murray Tosh (Conservative, South of Scotland)

Will Tavish Scott give way?

Tavish Scott (Liberal Democrat, Shetland Islands)

I will make some progress, Mr Tosh. I have only five minutes.

The Government states that the public-private partnership model is the only method of making the necessary investment. There are two important points here. First, National Air Traffic Services does not cost the taxpayer one penny. The chairman of the Civil Aviation Authority confirmed that in a recent speech. NATS recovers all its cost because of the structure and the way in which it is financed, and indeed made a profit.

Secondly, there are alternatives. The Liberal Democrats favour an independent, publicly owned company. Those alternatives were outlined in the speech that my colleague Mike Moore made in the House of Commons on 20 December. The Environment, Transport and Regional Affairs Select Committee of the House of Commons also produced many viable alternatives.

The Institution of Professionals, Managers and Specialists, the union that represents more than 3,000 air traffic controllers in the United Kingdom, illustrated that an independent, publicly owned company would protect the NATS safety culture, it would promote investment and it would, above all, allow NATS to remain a publicly accountable organisation.

Last Friday, the Government gave the Post Office the commercial freedom to act, while remaining in the public sector. I am sure that I am not the only member who has received a letter from the chairman of the Post Office in Scotland illustrating the benefits and extolling the virtues of commercial freedom in the public sector.

There are sensible and viable options that could mean the investment that everybody is agreed on, while reconciling the potential difficulty between safety and profit. I will not take lectures from the Tories on this. NATS explained to me at Prestwick that the Conservatives' ideological pursuit of their policies on Prestwick meant that the Scottish centre has been subject to delay after delay.

Phil Gallie (Conservative, South of Scotland)

Will Tavish Scott give way?

Tavish Scott (Liberal Democrat, Shetland Islands)

No.

It is interesting that the Tories' Westminster transport spokesman, Bernard Jenkin, advocated complete privatisation. I see today that Murray Tosh has joined the Hague Conservatives, just in time for the visit this afternoon. The Tories' approach is to flog it and forget it.

It is understandable, given the Ayr by-election, that the SNP has suddenly become interested in this issue. However, for example, the standing committee on the Transport Bill is debating this matter today, but the SNP could not care less. SNP members are not at Westminster, where it matters and where they could change the bill. Where was the SNP on 20 December when the Transport Bill was debated in the House of Commons? Not one SNP member spoke in that debate, when they had the chance to oppose it. They did not bother to turn up. What does the SNP do? It raises this matter in the Scottish Parliament, where members can debate it all day and cannot change anything.

Alasdair Morgan (Scottish National Party, Galloway and Upper Nithsdale)

Will Tavish Scott give way?

Tavish Scott (Liberal Democrat, Shetland Islands)

The SNP can no longer be trusted to fight for Scotland on reserved matters. It is never, ever there; it does not care.

I move amendment S1M-483.2, to leave out from "in the 21st century" to end and insert:

"and acknowledges the potential for economic growth through improved air links; notes that the future of air traffic control and associated issues are a reserved matter outwith the remit of the Parliament, but recognises that there are concerns and that the Liberal Democrats are opposed to the development of the air traffic control system by public private partnership; strongly supports a two centre strategy to protect jobs at Prestwick; underlines the need to give the highest possible priority to air safety, and further notes that during the second reading of the Transport Bill in the House of Commons on 20 December 1999, no Scottish National Party MP spoke in the debate, and only one voted against the second reading of the Bill."

Henry McLeish (Labour, Central Fife)

I am pleased to speak in this debate. It is interesting that while Kenny MacAskill was wound up this morning, I do not think that many members thought that he took off. It was a remarkable rant, even by the standard of Kenny's activities this week. Independence was in the news earlier this week—that is still on the runway and is not taking off—and then we had the internet story.

Colleagues may be interested to know that Kenny MacAskill has a wide brief in the SNP. Not only is he transport spokesman, he is now a disconnected sports minister. He suggested that we should all support the German bid to hold a competition rather than the English bid. We could make frivolity out of that, but the serious point is that if his rant today was anything it was a traditional recipe of anti-Englishness, anti-Westminster and, sadly, a refutation of the fact that we are still living in the United Kingdom, with all the attendant benefits that can accrue to us.

What was more remarkable than anything—and it was highlighted by the Conservative spokesman—was that a spokesman of any party should swallow, hook, line and sinker, one company's view of the pending departure from Scotland—

Kenny MacAskill (Scottish National Party, Lothians)

Can the minister tell me when he met a representative of Federal Express? If he did not do so, which of his colleagues in the Executive has done so since 25 August 1999?

Henry McLeish (Labour, Central Fife)

What I would like to say—[MEMBERS: "Answer the question."] Before Gus Macdonald made his marvellous intervention on behalf of Prestwick, I met FedEx representatives and I met Brian Souter. In addition to all the other weaknesses and inconsistencies of the Scottish National party, it continues to try to sap the confidence of Scottish industry. It plucks out one immediate problem of FedEx, then belittles the fabulous success story that is Prestwick today. For the SNP's embarrassment, I want to detail that success.

However, there is another serious issue today. The Parliament can, rightly, debate any issue that it wants to debate. It is a fabulous institution, representing the Scottish people, but it will fall into disrepute if the SNP continues to use it for its party benefit, instead of for the benefit of the Scottish people.

I ask the SNP to imagine our colleagues at Westminster debating tuition fees, housing or local government. The SNP would say that such a situation would be ridiculous. The point is that the right of debate here is sacrosanct. In a devolved context, it is surely not right that the SNP should pretend that certain matters are reserved, while asking the chamber to come to decisions on areas that, following the devolution settlement, are for our colleagues from Scotland in the Westminster Parliament to debate. I raise that as a serious issue that the nationalists will never respect. I believe that for the credibility, respect and integrity of this chamber, the SNP should look closely at what it does with the time that has been allocated to it.

Turning to FedEx and the letter that has been circulated, I will use polite language and say that I do not think that it tells the whole story about Prestwick and FedEx.

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister give way?

Henry McLeish (Labour, Central Fife)

I want to set this in the context of Prestwick generally. In 1992, FedEx was handling about 11,000 tonnes of cargo; it is now handling 4,000 tonnes. We have observed a situation in which the tonnage of what was regarded as the world's largest carrier was not increasing. Lord Macdonald intervened last year, and secured a unique deal of fifth freedoms for Prestwick, after a consultation process in which Scotland said, "This would be good for business in Scotland." The Westminster Government accepted that, but we then heard that Stansted should have been given the same rights. However, what the SNP will not say this morning is this: if a substantial number of airports are to be opened up to this cargo deal, it has to be based on reciprocity. The Americans did not provide that reciprocity.

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister give way?

Henry McLeish (Labour, Central Fife)

I will not give way just now.

Why on earth should the open skies policy, the question of Stansted, be the reason that, after nearly a decade in Scotland, FedEx walks away from its commitments to 16 permanent jobs and 40 related jobs—56 in total—and blames it on the Westminster Government? On behalf of this chamber, I say to FedEx, "You are there and you have not left yet. Reconsider your position, because not one part of your argument would justify your leaving Scotland, at a time when Prestwick is enjoying unparalleled success."

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister give way?

Henry McLeish (Labour, Central Fife)

I will not give way just now.

Let us detail that success. In 1992, Prestwick dealt with 16,000 tonnes of freight. In 1998, the figure was 40,000 tonnes. Cargolux has 44 per cent of Prestwick's market share, Air France has 15 per cent, Polar Air Cargo has 13 per cent and Lufthansa has 14 per cent—FedEx has only 10 per cent. Singapore Airlines also uses the airport.

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister give way?

Henry McLeish (Labour, Central Fife)

I want to make this point decisively, because Kenny MacAskill must listen to it. FedEx is leaving a success story. It is part of the fastest-growing cluster in Scotland. One of our key businessmen, Brian Souter, has invested multi-millions in Prestwick.

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister give way?

Henry McLeish (Labour, Central Fife)

No. I am not giving way. I want Kenny to listen to my point.

Brian Souter is also investing in passenger traffic. In 1991, there were no passengers travelling through Prestwick; there are now 600,000 passengers per annum. In 1991, there were 100 jobs; now there are 400.

Kenny MacAskill (Scottish National Party, Lothians)

What about a supplementary?

Henry McLeish (Labour, Central Fife)

If Kenny MacAskill continues to rant, people watching the debate and looking for common sense and maturity from his party will see neither quality.

Prestwick is a success story that Federal Express should recognise. FedEx should not leave on the pretext that the UK Government is responsible. The real issue is Stansted. I urge FedEx to get involved in the unfolding success of the Scottish economy.

Kenny MacAskill (Scottish National Party, Lothians)

Will the minister clarify what he meant by the continuing negotiations to which he referred? The press release from the Department of the Environment, Transport and the Regions on 25 August notes that

"Discussions with the US will include consideration of Federal Express's parallel application for full rights at Stansted Airport".

It goes on to say that

"the absence of reciprocal rights in the US would have a negative effect on UK carriers and jobs."

What was the reciprocal right that the UK was seeking in the USA? Was it fifth freedoms or was it to allow the British Cargo Airline Alliance the opportunity to carry internal cargo in the United States? Is it true that Prestwick lost out because the Government supported the British Cargo Airline Alliance in its desire for access? What were the negotiations about?

Henry McLeish (Labour, Central Fife)

The simple answer is that the Americans would not concede reciprocal rights of any kind.

Reciprocity is crucial, but the key issue is why Prestwick should get caught up in a fifth freedom issue relating to Stansted. That is the point. Gus Macdonald achieved the fifth freedom objective for Prestwick with no strings attached. That was a huge bonus for Scotland. Why does FedEx want to walk away from something that was done for its benefit?

I do not want to go into technicalities, although I am happy to send details to Kenny MacAskill. Under wet lease agreements, crews and planes can be transferred to other carriers for use at times of peak capacity. The US will not allow any UK carrier to wet-lease its aircraft, despite the fact that the UK provides a reciprocal arrangement. Let us not parade the problems of the US in this Parliament to justify the bogus arguments of the SNP.

We have talked about passengers, freight and investment, but I want to point out that, due to our industrial strategy, we have one of the fastest-growing clusters at Prestwick. BF Goodrich, Woodward Governor, British Aerospace and GE Caledonian are companies that want to do well. It does not help for the SNP to give radio and television interviews, in which it sends out a negative view of Scotland's economy.

Let them read the facts, let them assume and acknowledge that we are making progress. There are many areas in which we want to see further investment. The confidence of a nation is not helped by a group of people who constantly carp, girn and whinge about the real progress that has been made.

The Executive is very pleased to acknowledge that aviation and air transport are vital to the Scottish economy. We will continue to work with all concerned, including the UK Government, to ensure that we make progress. I will finish as I started. I invite FedEx to reconsider its decision and to appreciate the success story of Prestwick. I invite every member of this chamber to applaud the progress that has been made in Ayrshire at Prestwick. It is good for FedEx, and it is good for Scotland.

Patricia Ferguson (Labour, Glasgow Maryhill)

There is very little time left for open debate, so I ask members to stick strictly to the four-minute time limit.

Alex Neil (Scottish National Party, Central Scotland)

Presiding Officer, I am standing in for Adam Ingram who has had a family bereavement. He has a special constituency interest in this debate.

I would like to concentrate on the privatisation of the air traffic control service. Our position is clear—to sell off NATS is nuts. The minister talks about the Scottish Parliament being brought into disrepute. If anything were going to bring the Scottish Parliament into disrepute, it would be a failure of the Scottish Parliament to speak up on behalf of the vast majority of the Scottish people who are totally opposed to the privatisation and sell-off of the air traffic control service.

If anything or anybody is being brought into disrepute, it is new Labour. When the Tories were in power, it was new Labour that led the fight against privatisation. Andrew Smith, its transport spokesman prior to 1997, said: "Our air is not for sale." That was before the election. After the election, new Labour is saying: "The air is for sale

to the highest bidder."

George Robertson said that the privatisation, in part or in whole, of the air traffic control service would be outrageous and disgraceful. How can it be outrageous and disgraceful prior to 1997, but okay in 2000, and outrageous and disgraceful to criticise it? Privatising air traffic control would be nuts for two reasons. It would be dangerous and economically ridiculous.

Murray Tosh (Conservative, South of Scotland)

rose—

Alex Neil (Scottish National Party, Central Scotland)

Normally, I would love to let Murray Tosh intervene, but he had 10 minutes and I have only four. I intend to use them.

Murray Tosh said that what matters in terms of safety is culture and investment. The culture of safety is the predominant reason why the only country in the world to privatise air traffic control has been Fiji. Every other country, including the United States, has its air traffic control in the public sector. They have it in the public sector for safety reasons.

Murray Tosh (Conservative, South of Scotland)

rose—

Alex Neil (Scottish National Party, Central Scotland)

We should not underestimate the importance of air traffic control as an industry for the future. Projections for the next 10 to 15 years show a doubling of air traffic worldwide. Over the past year alone at Prestwick and at the Oceanic centre, there has been an 8 per cent growth in the number of flights. Prestwick now handles more than 1,000 transatlantic flights every day of the year. That employs more than 650 people.

Privatisation will lead to profit coming before safety. It would be madness from an economic point of view as well as madness from a safety point of view. If there is one organisation that more than pays its way in the public sector, it is National Air Traffic Services. If its external borrowing limit were raised to the necessary levels, it could fund any investment required. It can and does provide a return on capital to the public sector of around 8 per cent a year.

The move to privatise, which will generate perhaps £350 million of one-off capital investment over a period of 10 to 15 years, will cost the public sector an enormous amount of money and will lead to asset stripping. A total of 60 per cent of the costs of NATS is on staff costs. The only way in which it can be made profitable to get a return for the private investor is to make it unsafe by cutting down staff and by making staff conditions worse. The policy is total madness.

Murray Tosh (Conservative, South of Scotland)

rose—

Andy Kerr (Labour, East Kilbride)

rose—

Patricia Ferguson (Labour, Glasgow Maryhill)

The member has come to a conclusion.

Des McNulty (Labour, Clydebank and Milngavie)

The difference between the SNP's approach and that of my party to this issue is summed up by, on the one hand, Kenny MacAskill's almost hysterical posturing and, on the other, the measured, pragmatic stance that has been adopted by Sandra Osborne, Ayr's Labour MP.

Although people might instinctively have preferred a public sector solution for National Air Traffic Services, it is clear to members who have discussed matters that have come before Parliament that investment requirements across the range of public sector services cannot be met entirely from public borrowing. That is a plain financial fact, and public-private partnerships have provided an effective means of injecting sizeable amounts of capital into improvements in service provision.

Investment of more than £1,000 million is now required in air traffic control because of delays under the previous Conservative Administrations—a fact to which Murray Tosh, despite his comments, should own up.

Before the voters threw him out in 1997, Phil Gallie did not contribute very much to Westminster debates, despite the implications of those delays for his Ayr constituency. Since Sandra Osborne's election in 1997, she has fought a strong campaign with the trade unions to secure a sizeable proportion of the new investment for Prestwick. That investment will secure 700 jobs that the Conservatives failed to provide in 800 years of rule— [Laughter.] Well, it felt like 800 years of rule, even though it was only 18 years.

As Sandra Osborne pointed out in her excellent speech on the Transport Bill in December 1999, the question about NATS is not the principle of proceeding with new investment through PPPs, but the form that any PPP should take. Sandra has constantly highlighted the need to consider the implications of any proposal on the work force, the quality of the ensuing service and issues of safety, which must be the overriding consideration for the Minister for Transport, Lord Macdonald.

We must be clear about these proposals. The public sector will continue to control the specification and contracts associated with the air traffic service. The Civil Aviation Authority will remain within the public sector.

As Tavish Scott pointed out, the Westminster debate on transport was on 20 December 1999, when this Parliament was not meeting. Not one SNP member spoke—

Kenny MacAskill (Scottish National Party, Lothians)

rose—

Alasdair Morgan (Scottish National Party, Galloway and Upper Nithsdale)

rose—

Des McNulty (Labour, Clydebank and Milngavie)

—and only one SNP member, Alasdair Morgan, bothered to turn up to vote. Perhaps the rest of the SNP MPs were too busy eating their mince pies.

Alasdair Morgan (Scottish National Party, Galloway and Upper Nithsdale)

rose—

Kenny MacAskill (Scottish National Party, Lothians)

rose—

Des McNulty (Labour, Clydebank and Milngavie)

However, a month and a half later, the SNP is prepared to devote precious time in this chamber to debate matters for which we have no responsibility. Who can be surprised at that? Certainly not the people involved in the Skye bridge campaign, who have already had an opportunity to experience Kenny MacAskill's fickleness at first hand.

While I am handing out advice, I suggest that Kenny MacAskill and Alex Neil leave fundamentalist rants about public ownership to Tommy the Trot, who is not here today. At least Mr Sheridan has a consistent record of opposing private sector involvement.

Kenny MacAskill (Scottish National Party, Lothians)

Come on—give way.

Des McNulty (Labour, Clydebank and Milngavie)

Prestwick will survive and thrive as an international freight operator if its potential can be marketed to top companies here and overseas. Its interests are not best served if potential investors see the main Opposition party in Scotland delivering the kind of rant that we have heard today from Kenny MacAskill.

The problem with the SNP position is inconsistency. On the one hand, we have this rhetoric about public sector ownership but, on the other, we have a defence of FedEx. Six minutes of Kenny MacAskill's speech were devoted to 16 jobs that will be lost as a result of a commercial decision by FedEx. However, he did not mention the 700 jobs that will come to Prestwick as a result of Labour's policy and the work of Sandra Osborne in particular.

The SNP has to learn to engage seriously in the debate. If it wants to engage in discussions about air transport strategy, it has the opportunity to do so when those discussions take place at Westminster. I hope that we can have more sensible, intelligent contributions to the wider transport debate. Lots of issues are available for which this Parliament has responsibilities—why does not Kenny MacAskill choose one of them for debate?

George Lyon (Liberal Democrat, Argyll and Bute)

As my colleague Tavish Scott said, today's debate should be renamed the Ayr by-election debate.

The issues that we are debating are vital for Scotland, as Kenny MacAskill and Mr Neil pointed out. I want to deal with the privatisation of the NATS system. As Tavish made very clear, the Liberal Democrats are opposed to that privatisation. We believe that real concerns exist over safety, which must be given a high priority. It is not just political parties that are saying that—as Tavish rightly pointed out, unions and management have real concerns about the possible consequences of privatisation.

Murray Tosh (Conservative, South of Scotland)

Will the member give way?

George Lyon (Liberal Democrat, Argyll and Bute)

I have only three minutes, Murray; you had your six-minute rant, so you have said more than enough.

We ask that the UK Government reconsider the matter and address the safety issues that have been raised. Alternatives exist; as we have seen with the Post Office, other mechanisms can be used.

As our motion notes, air traffic control is a reserved matter and, as such, the fight needs to be taken up at Westminster. The Liberal Democrats are doing that, with support from many Labour colleagues in the House of Commons—Gavin Strang, for example. However, time after time in this chamber, the SNP has chosen to hold debates on reserved matters, as Henry McLeish said. In fact, the nationalists have used nearly 50 per cent of the parliamentary time available to them to debate reserved matters. The same is happening today. The SNP claims that air links and infrastructure are a vital issue for Scotland. I agree, yet when the issue was debated at Westminster on 20 December, on second reading of the Transport Bill, when widespread opposition was voiced by the Liberal Democrats and many Labour members, not one SNP MP spoke.

Alasdair Morgan (Scottish National Party, Galloway and Upper Nithsdale)

Will the member give way?

George Lyon (Liberal Democrat, Argyll and Bute)

Not one SNP MP spoke for Gavin Strang's amendment against privatisation and only one voted for it.

Andrew Welsh (Scottish National Party, Angus)

Will the member give way?

Alasdair Morgan (Scottish National Party, Galloway and Upper Nithsdale)

rose—

George Lyon (Liberal Democrat, Argyll and Bute)

Poor Alasdair Morgan was the only MP whom the SNP could persuade to make the effort to travel to London for this important issue for Scotland. When he got there, such was the importance of the matter that he did not even bother to speak. That demonstrates how important the issue really is to the SNP. Today's debate is nothing more than gesture politics of the worst kind—the kind that brings the Scottish Parliament into disrepute.

I reaffirm today that the Liberal Democrats will continue to oppose at Westminster the privatisation of the air traffic control system. I am sure that they will enjoy the support of some of their colleagues on the Labour benches. It would be a great pity if the battle were lost because one party could not be bothered to turn up.

Phil Gallie (Conservative, South of Scotland)

Despite Des McNulty's words, Hansard records my tremendous involvement in the issue between 1992 and 1997. Perhaps the difference between Sandra Osborne and me lies in the fact that, when she speaks with the Labour Government nationally, she appears to support privatisation, whereas locally she does not.

If we look back over that period, we find that the Conservative Government achieved much in relation to air traffic control systems. The Conservative Government established the two-centre approach, which has been maintained. It also identified a preferred bidder—Lockheed Martin—for the private finance initiative. During the next stage, in September 1997, the phase 2 contract was due to be placed and work started on the site.

The Labour party should be criticised for its handling of the matter. Since 1997, a succession of transport ministers, all from Scotland—Gavin Strang, John Reid, Helen Liddell and now Gus Macdonald—have failed to deliver on this issue. All that they have done, all the way through, is to push the issue backwards.

The new air traffic control centre is essential to the local economy. As Alex Neil pointed out, it will sustain 650 good-quality jobs. However, the local impact is not the most important issue. Nationally, air safety is all important. Whether the air traffic control system is privatised, funded through the PFI or even funded using the same model as the Government is using for the Post Office, Conservative members will support anything that puts money into the project and gets it off the ground.

We recognise the need for the project and the need to improve the flow of air traffic across the United Kingdom. The Conservative Government gave the go-ahead to the Oceanic PFI, which is now under way. Oceanic handles the flow of air traffic into the UK. It is important that we are able to pick up en route.

I identify with almost everything that Henry McLeish said about FedEx, but it is a pity that he did not make the same comments when he was in opposition.

In relation to the United States, I warn members that they should consider what happened to the British Merchant Navy. We opened up our ports and gave freedoms to sea trade. The USA did not, and where is the British Merchant Navy today?

We want the project to get under way. Labour members should support our amendment, which is in line with the objectives to which they profess to aspire.

Michael Russell (Scottish National Party, South of Scotland)

Even after only seven or eight months of this Parliament, one recognises some things in the chamber the moment a debate starts. I predicted earlier this morning that we would see panic among those members who have a common interest in defending the union. We saw it first from the unusually agitated Mr Tosh. I have never seen him like that before, but then he is due a visit from Mr Hague later this afternoon—clearly the Conservatives are trying to put the ideological iron into his spine before Mr Hague appears.

There has been panic, too, on the Labour benches. One always knows when there is fear among Labour members, because—

Duncan Hamilton (Scottish National Party, Highlands and Islands)

They do not turn up.

Michael Russell (Scottish National Party, South of Scotland)

That is certainly true. Moreover, Henry McLeish is put in charge to attack the SNP for talking about things that are forbidden. Then, to ram home the message, a loyalist is found to read out the new Labour line. Today, the lottery was won by Mr Des McNulty, who read out the new Labour line with great aplomb. He also gave me the most unusual opportunity of my political life. [MEMBERS: "No."] Absolutely—and there is more to come.

After all Mr McNulty's affirmations that there would be guarantees and safeguards, I am able to quote, with approval and total agreement, the words of Mr Brian Donohoe, the MP for Cunninghame South, who is a member of the Transport Sub-Committee, as members will know from recent publicity. This is an historic moment. It is the first time that I have done this. He said:

"It doesn't matter what guarantees there are. We've all seen the past history of golden shares. They are worthless".

We are talking today about three vital matters. First, we are talking about public safety. Opposition to privatisation of the National Air Traffic Services has come from across the spectrum and has even involved loyalists such as Mr Brian Donohoe.

It was fascinating today that Mr McLeish did not mention once in his speech any defence of the Government line on national air traffic. The line is indefensible. It is a piece of worthless ideological baggage, scraped from the bottom of the Tory barrel and taken over by new Labour and Gordon Brown for financial reasons. There is no support for the Government line in the United Kingdom or in Scotland.

Andy Kerr (Labour, East Kilbride)

rose—

Michael Russell (Scottish National Party, South of Scotland)

Not just now, Mr Kerr.

The only defence is that the Government needs money from a get-rich-quick scheme. I am ashamed for the Tories that they cannot see that and that they cannot put public safety before ideology. It is shameful.

Murray Tosh (Conservative, South of Scotland)

Is Mr Russell aware that safety in this country is regulated by the CAA, and that in no proposals does that change? Is he not aware that the most pressing safety issue is the lack of investment? Does he not realise that the same issues were raised over the denationalisation of airlines and airports? Does he believe that our airlines and airports are inherently unsafe and lack a safety culture? That is scaremongering of the basest kind.

Michael Russell (Scottish National Party, South of Scotland)

It is not scaremongering of the basest kind. It is reflecting the public concern about the railways, for example. We need safety first, second and third, not profit first, second and third. If the Tories have not learned that, they will be in the political wilderness for even longer than expected.

The Tories' amendment is worthless. It is designed from ideology and adds nothing to the debate. At least they have lodged it for a reason: to please Mr Hague, who will be here later today.

Tavish Scott (Liberal Democrat, Shetland Islands)

Here we go.

Michael Russell (Scottish National Party, South of Scotland)

Well, I am delighted to turn to the Liberal Democrats. The only reason that the argument is coming from the Liberal Democrats is that they have been let off the leash today. They are being let out a wee bit today to take part in this debate—