Scottish Parliament, 20 September 2001

432 contributions from 79 members. The official report.

Introduction

Juvenile Justice

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

The first item of business is a debate on Conservative motion S1M-2205, in the name of Bill Aitken, on juvenile justice, and two amendments to that motion. I call Bill Aitken to speak to and move the motion.

Bill Aitken (Conservative, Glasgow)

It is now well over 30 years since Scotland's system of juvenile justice was set up. On that basis alone, a review is long overdue. When the Social Work (Scotland) Act 1968 established the children's hearings system, that approach was hailed as progressive and effective in dealing with young offenders. However, since those days, there have been many changes in society, of which not all have been for the better. Therefore, it is essential for our entire approach to juvenile justice to be reviewed, in the light of both experience and changing attitudes in society.

As the system has evolved over the years, the work of children's hearings has changed radically. Children's panels face many of the unfortunate and frequently tragic problems in contemporary society, the most obvious of which is the scourge of drugs. The children's hearing system deals not only with offending and criminality among young persons, but with children who are at risk, usually from either abuse or neglect—sometimes from both. Against that background, it is unsurprising that the system has become geared almost totally to doing what is best for the child, following the basic principle that the child's interests are paramount. No other view can be taken when the deliberations of a hearing concern a child who is at risk. Many depressing tales emanate from children's panels, reflecting the way in which our society has deteriorated since the idealistic days of 1968. A child at risk is a problem that we must all share.

Frequent offending and child-at-risk syndrome are often manifest in the same cases. A young offender often comes from a background of abuse and neglect that has contributed significantly to his or her behaviour. Nevertheless, in some cases of offending behaviour and criminality the interests of our wider society become subordinate to the principle that the hearing system exists purely to assist the subject child. Frankly, that is no longer acceptable.

Over the summer, I carried out a study of the operation of the hearing system. I spoke to panel members and attended hearings. I also spoke to police officers, social workers and people who work with and have experience of the system. I found that there is almost universal unease about the way in which the system operates and that there is an almost unanimous view that, if the system is to retain credibility, an urgent review of its operation is necessary.

The police are becoming increasingly frustrated and concerned by the failure of the system to cope with consistent and persistent offenders. It is not unknown for youngsters to be detained two or three times in 24 hours. They are arrested following a theft or attempted theft, taken to the police office and released when a parent comes to collect them. The same depressing thing then happens again and they are arrested a few hours later. One can well understand the concerns of the police. The public now feel that it is a waste of time to report to the police acts of disorder or minor crime involving youngsters. The word has got through to members of the public that nothing happens and that if they report youngsters to the police there will be only one effect: their home, car or they themselves will be targeted. That, too, is unacceptable.

Social workers and reporters are committed to the system, but they too see the system breaking down due to a lack of resources. They advance the argument that the system is so geared up to dealing with the problems of children who are at risk that offending behaviour cannot be dealt with timeously, if at all. Their plea is for more resources. Although that plea is a regular clarion call from anyone who is involved in public service, there seems to be genuine justification for their complaints.

Panel members not only share the frustrations of the social workers, but have disappointments of their own. I have been very impressed by those who serve on the panels. Our society is fortunate to have people who give so willingly of their time and effort to try to help, but we are in real danger of sickening them. Frequently, they know that the only answer is to place a child in secure accommodation, but such accommodation cannot be found. They can make a supervision order, but sometimes weeks can pass before a social worker is assigned to the case. Increasingly, panel members feel that their range of disposals is inadequate and that some action must be taken to impress on the child the seriousness of the situation and to increase the level of parental interest, which is sadly lacking in many cases.

The most damning indictment of all, perhaps, is the attitude of offenders to the panel system. They hold it in derision and contempt. Youngsters openly show no respect at hearings, telling the police officers who are in charge, "You can't do anything to me—it's only the panel." They have sussed out the fact that the present system is, in many respects, a joke. It must be recognised that a 16-year-old in 1968 was a completely different animal from a 16-year-old or a person of 15 years and 11 months today. We have some suggestions of ways in which matters may be improved and credibility may be restored to the system.

We recognise that there must be greater provision of secure accommodation. It is no light matter to consider locking up a young person, but, sadly, in a growing number of cases there is no alternative. The Executive must recognise that there is no balance in much of its law-and-order policy. The interests of the perpetrators of crimes are often regarded as the only priority, with victims and society in general receiving scant support. That must stop. Many youngsters adopt a serious pattern of offending and Lothian and Borders police have recently highlighted the fact that a handful of young people can create mayhem in a community.

The Executive must also ensure that when a panel makes a supervision order, social work departments respond timeously and effectively. The current situation, in which weeks can elapse prior to the allocation of a case social worker, is simply not acceptable. We must also consider more innovative and effective ways of dealing with youngsters who offend and efforts must be made to force parents to take responsibility for the behaviour of their children. The SNP's idea of imposing fines that are payable by the parents has a degree of superficial attraction, but in common with many other realistic approaches to criminality, it is precluded by the European convention on human rights. It would also result in parents going to prison because of unpaid fines and I suspect that the SNP would not be too relaxed about that.

We suggest that there should be evening and weekend detention. Children's hearings could order a youngster to attend detention at a school or other premises from 5 o'clock in the evening until 9 o'clock, or from 9 o'clock in the morning until 5 o'clock on Saturday or Sunday. Parents would be required to pick up their children from those places and take them straight home. Such a detention system would have resource implications, but bearing in mind the limited number of youngsters who would be attending, the supervision could be carried out by retired police officers on a sessional basis.

Tavish Scott (Liberal Democrat, Shetland Islands)

Why were such suggestions not taken up when the Children (Scotland) Act 1995 was introduced at Westminster by Bill Aitken's colleague, Lord James Douglas-Hamilton?

Bill Aitken (Conservative, Glasgow)

All things change in this world. The situation was not nearly so acute in 1995 as it is today. I am sure that Tavish Scott will agree that things move on.

At the detention sessions, youngsters would be allowed to bring books or school work, but nothing else—no televisions, videos, Game Boys or Pokemons. The youngsters would be required to sit in silence and get on with what they had to do. For many, that would be an uncomfortable experience that would leave its mark.

We also suggest that there would be merit in making a community-service-type disposal available to the children's panels, which would require youngsters to work on a similar basis to that of an adult community service order. We are especially attracted to the restitution of damaged property. The orders would be made not as a diversionary process, but on the basis of an order from the children's hearing.

One of the sanctions that can be most effective within a family is grounding, whereby the child is required to stay in the house. We propose an amendment to legislation, whereby parents would be required either to keep children in the house or to accompany them when they go outside during certain periods. It is possible that that might run into ECHR-compliance problems but it is certainly worth consideration in any review.

In all of these considerations, we must recognise that the actions of the Executive have left parents with considerable difficulties with regard to how they may discipline their children. Last week, for example, we had a debate on the efficacy and desirability of corporal punishment. Personally, I express no view on the matter. How parents discipline their children is a matter for them and I will not comment on that.

Michael Russell (Scottish National Party, South of Scotland)

The fact that the member takes no view on the matter indicates that he did not listen to the debate. There was no debate about the efficacy of corporal punishment; there was a debate about a set of proposals—we were also concerned about them in so far as they had not been published—which related to abusing children by striking them with implements and in other ways. I presume that he is not saying that he thinks treating children in such a way is wise. Not even his colleagues said that.

Bill Aitken (Conservative, Glasgow)

I have no wish to rehearse the arguments that were advanced last week. Personally, I do not agree that striking a child on the head is in any way an acceptable way to discipline the child. However, I do not regard it as being for me, Mr Russell or any of us in the chamber to comment on how children are disciplined in the familial home. The parents have to live with the children; we do not.

Karen Whitefield (Labour, Airdrie and Shotts)

Is the member suggesting that it is perfectly acceptable for people to beat and abuse children?

Bill Aitken (Conservative, Glasgow)

The member should not put words in my mouth. I was particularly careful to make the point that I expressed no view on the matter. In my reply to Mr Russell, I said that striking children about the head with implements was, to my mind, unacceptable. However, in general terms, how parents discipline their children is a matter for them, not for me or Karen Whitefield. If the sanction of smacking is removed, it will be hard for parents, in extreme situations, to control the wilder elements. In that respect, the Executive would be wise to distance itself from the proposal.

The children's panel system is a sensitive and appropriate approach to dealing with children at risk, but its credibility in dealing with offenders is open to question. The Executive must examine ways in which the system can be toughened up to recognise the much more serious problems that exist involving youth offenders. If the Executive does not do so, the system will fall into disrepute and what was an innovative and exciting experiment will be seen to have failed.

I move,

That the Parliament recognises that the Children's Hearings system as at present constituted is manifestly failing to deal with criminal and offending behaviour and calls upon the Executive to carry out a full review of Scotland's system of juvenile justice, such a review to include consideration of giving Children's Hearings an increased range of disposals.

Nicol Stephen (Liberal Democrat, Aberdeen South)

We are all agreed that crime and the fear of crime blight the lives of many individuals and communities. We accept the scale of the problem. According to Audit Scotland's recent report on youth justice, one in 12 young people in Scotland between the ages of eight and 21 have either offended or are being dealt with for allegations of offending. In some areas, those young people account for more than 40 per cent of crimes such as housebreaking, vandalism and car theft.

However, the vast majority of those children offend only once. The real problem lies with the tiny minority of children who are repeat offenders. According to one study, 3 per cent of the young offenders—around 2,300 children in Scotland—are responsible for a quarter of all offences committed by that group. Tackling that minority is essential. Because tackling persistent offenders will produce the biggest impact, the Scottish Executive's programme for government target is to reduce re-referral rates to hearings on offence grounds by 10 per cent by 2004. Of course, we are committed to examining more innovative ways of dealing with the problem, provided that they are more effective—the crucial thing is that they have to work.

Michael Russell (Scottish National Party, South of Scotland)

I agree that any innovative measures have to work. Presumably, the minister also thinks that they have to be, at least in their origin, child centred, as that is the basis of the system.

Nicol Stephen (Liberal Democrat, Aberdeen South)

Of course. I will shortly talk about the work that we have already done to improve the effectiveness of the system.

The key reason for setting up an advisory group on youth crime was to examine ways to reduce offending—and particularly reoffending—by young people. The group involved the police, Victim Support Scotland, local authorities and other bodies—in fact, all the bodies that Bill Aitken said he had spoken to over the summer. Its report was unanimous in its support for the children's hearing system and its unique role in Scotland's justice system.

There was also remarkable consensus on how our children's hearings could be developed to tackle the problem of persistent young offenders. A hearing already has the freedom to attach any condition to a supervision requirement. Those conditions include contact with a social worker; participation in specific programmes to address offending behaviour and anger management; a requirement to stay away from certain places or people; and the removal of the child from home and their placement in foster care, a residential home or secure accommodation.

Annabel Goldie (Conservative, West of Scotland)

Those measures are encouraging and worth while. However, there is a deeper, more sinister issue involved: many children, from an early age, are displaying no understanding of right and wrong. That may be an axiom that has previously been stated, but is it not the case that we need to examine our education system to ensure that children receive some instruction in our schools on the basic rights and wrongs of life and on the need to have a regard for civic responsibility, however simply those concepts can be explained to them?

Nicol Stephen (Liberal Democrat, Aberdeen South)

In my speech, I am focusing on the children's panel system, but the member is right that aspects of education, deprivation, poverty, parental unemployment, chronic illness, alcohol abuse and drug misuse are factors in the problem. The Scottish Executive wants to tackle those factors and recognises that education is one of the key aspects. There is no one simple answer to the problem that we are dealing with.

The advisory group decided that children's hearings needed more, and more effective, community-based programmes to be available, to which young offenders can be referred to try to divert them from crime. If Mr Aitken has other suggestions to make, we will be happy to consider them, but I am not sure whether he was suggesting other disposals or conditions for supervision. We should clarify that point.

Bill Aitken (Conservative, Glasgow)

I am suggesting disposals that would be available rather than conditions of a supervision order.

Nicol Stephen (Liberal Democrat, Aberdeen South)

That is helpful. Many studies and research projects in Scotland, other parts of the UK and internationally highlight the fact that programmes that are developed to allow offenders to confront their behaviour and that involve their families, communities and—as Annabel Goldie suggested—schools are, in many cases, more likely to prevent reoffending than the placement of the offender in secure accommodation. That is true even among the most persistent reoffenders.

Two Scottish examples that have been or are being funded by the Executive demonstrate that point. The Freagarrach community-based project, which covers Falkirk, Clackmannanshire and Stirling, reduced the overall offending rate of its young people by up to 50 per cent by targeting the top 20 offenders in a particular area. A three-year invest-to-save project, the matrix project, which is run by Barnardos, covers the same geographical area. It targets children who are exposed to factors that might lead them to offend in the future. A package of support is offered to the children, who are aged between eight and 11, and work is carried out with their families. The project is a joint partnership between the police and education and health services. Joined-up working is a key part of such projects. As well as reducing re-offending, such programmes are more cost-effective than secure accommodation.

We have learned from examples such as the ones that I have mentioned and from projects in other parts of the United Kingdom. Local authorities have now been allocated more than £20 million over three years from April this year to enhance their programmes and develop more. The aim is to make young offenders stop reoffending and face up to the consequences of their actions and their impact on the community and individual victims.

The new initiatives must be challenging and must force young offenders to recognise what they have done. They must operate over a period of months, if not longer. They must be effective in the long term—they are the opposite of short, sharp shocks. The future consists of more intensive community support, initiatives to provide alternatives to secure accommodation, and specialist behavioural problem projects. The £20 million allocation to local authorities will support that.

We need to be tough on the children who cause misery to their neighbours and communities. The programmes that I have outlined are the way to do that. I emphasise that they are not easy options. Scotland's unique system of children's hearings serves us well. The network of local authority departments, the reporters, the police, health service staff and—primarily—the volunteers on whom the system depends deserve our praise, thanks and support. I thank Bill Aitken for his support and praise for the volunteers. Our hearing system provides an excellent framework within which the needs of the child can be assessed and acted on. A great deal more can be done to get the system right—greater partnership is needed. Let us build and reinforce that system.

I move amendment S1M-2205.2, to leave out from "recognises" to end and insert:

"confirms its support for the principles of the hearings system in dealing with children who are at risk whether through offending or anti-social behaviour or are in need of care and protection; considers that the children's hearings system provides the best framework within which to identify the needs of vulnerable children and young people and to determine the most appropriate response; praises the commitment and skill of the volunteers who are appointed as members of Children's Panels and Children's Panel Advisory Committees; welcomes the consensus achieved by the Advisory Group on Youth Crime and confirms its support for the Group's recommendations for reducing and stopping youth crime; further welcomes the increased expenditure by the Executive on children's services and Youth Crime Review to support targeted services in local authorities; supports the Executive in its drive to reduce re-offending rates among children and young people, as set out in Working Together for Scotland, as this will benefit communities, victims and young people, and encourages local authorities, service providers and other partners to develop programmes and services which seek to address the offending behaviour and underlying contributory factors in the lives of young people who offend."

Irene McGugan (Scottish National Party, North East Scotland)

I say to the Conservative party that society, not the children's hearing system, is, in the words of that party's motion,

"manifestly failing to deal with criminal and offending behaviour".

Youth offenders are young people with problems. We are failing to deal effectively with the causes of their difficulties.

I also remind the Conservatives that the Kilbrandon welfare principle, which underpinned the establishment of the children's hearing system, remains relevant today and that the system continues to provide a good framework for addressing the behaviour and underlying difficulties of young people with problems.

Perhaps the challenge is to bring justice and welfare together in new ways. The issue is not the system; it is the need for constructive engagement with young people, their families and communities. We need to shift thinking and resources.

We accept that the hearing system has to have at its disposal adequate and effective resources for young people who offend, but many referrals could be avoided if there were a greater emphasis on what are called preventive measures, but are in reality ordinary activities such as sport, leisure and drama.

We need a range of general recreation and sport provision for children and teenagers. Much of that has been eroded over the past 10 or 20 years. Children in deprived areas have less access to constructive leisure activities. School and community halls are shut. Sport and other activities are expensive. Football pitches are non-existent in most inner-city areas.

It is no exaggeration to say that the lack of facilities and transport infrastructure to access facilities is an overwhelming concern of many young people. That is confirmed time and again when the cross-party group on children and young people goes out to meet young people. If young people had opportunities for challenge and adventure, there would be less youth crime.

We also need diversion strategies. We must work with children and young people who are in danger of entering the crime world. We must identify them early and ensure that proper voluntary measures are available to them and their parents. We must also ensure that children's services plans—as well as education, health and other provisions—meet their needs.

For serious offenders, we need effective intervention. That means robust, evaluated and tested programmes under statutory supervision.

Little of what I have suggested differs much from the recommendations of the youth crime review. It produced good proposals, which achieved a wide consensus. The Scottish National Party supports those proposals broadly and they have already been accepted by the Executive.

The Scottish Executive's response to the review agreed to the calls for a national strategy, which was due to be in place by April 2001. We are still waiting for the draft consultation on that strategy. I ask the minister to confirm whether the strategy will proceed without delay.

We know what works. There are excellent examples of projects that work effectively with young people who are in trouble. NCH, which is the largest non-statutory provider of services, runs a number of projects that have proven to be highly successful in diverting high-risk young people away from crime.

Barnardos, which the minister mentioned, is also keen to reduce offending behaviour and provide intensive, community-based programmes that offer a positive alternative to secure accommodation, referral to the criminal justice system and—ultimately—custodial sentences. The most well-known Barnardos project for persistent juvenile offenders is probably the Freagarrach project. In the first 12 months of the Barnardos new directions project in Aberdeen, there have been clear indications that that cost-effective service is also having a positive impact and reducing offending. The project is a partnership initiative with Aberdeenshire Council and Aberdeen City Council. It is important to recognise that a multi-agency approach is required if a project is to be effective in addressing the offending and needs of young people.

Such schemes are not a soft option. They are a successful means of confronting what is going wrong and providing a challenging and effective alternative. We know what works. We should use what is known from research to contribute to improvements in practice and policy in Scotland by having a proper national strategy to resource and quality-assure the services evenly throughout Scotland. That provides the best prospect of helping young people to move towards a more positive future and to contribute to a safer community.

I move amendment S1M-2205.1, to leave out from "as" to end and insert:

"has served society and Scotland's children and families very well and that it will continue to do so in the future, provided that adequate and effective resources are applied to the system to help young people who offend, and calls upon the Scottish Executive to bring forward without further delay the national strategy and framework arising from the youth crime review in order to set out national programmes for effectively working with young people to prevent crime, ensure that measures are in place to support those at risk of offending and recommend proven intervention strategies for offenders."

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

I will take a few minutes to rebut some of the nonsense in Bill Aitken's opening speech. I am sure that he will not be surprised to hear me say that.

I take exception to the notion that, because someone is 15 years and 11 months old, and a child in the eyes of the law, they should be described as "a completely different animal". I do not think that that language is helpful or appropriate.

When we talk about working with young, vulnerable people, it is simply not the case that we can immediately differentiate between those who have been abused or suffered neglect in their homes and those who offend. Unfortunately, life is just not like that. It is later discovered of many young people who present because of offending behaviour that they have been subject to abuse.

Bill Aitken (Conservative, Glasgow)

Does Cathy Jamieson not acknowledge that I made that point in my speech? I said that it is sometimes difficult to differentiate between the offending child and the child who has been a victim of abuse and that the matters are sometimes related. In fact, I stressed that.

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

I am afraid that Bill Aitken did not take that argument to its logical conclusion in the disposals that he wanted to be made available to the children's hearing system. I will come on to that.

Many young people involved in low-level offending behaviour may, as the minister said, be involved on only one occasion or a couple of occasions and can be diverted from further involvement in the criminal process. I have no difficulty in saying that we should remove from the community those persistent offenders who clearly require to be removed for their safety or that of the community. However, it is simply not the case that, by increasing the number of secure unit places—at huge cost—and by locking young people up, we will tackle the problem. Nor will we address the problem by enacting Bill Aitken's suggestion for a disposal that is some kind of weekend or after-hours detention in which children are made to sit with books and nothing else.

I am sure that educationists would suggest that making books a punishment is not the way to engage young people and is not the way to get them to face up to the damage that they do in their communities. We can be a bit more imaginative. For a number of years many schemes have been operating that bring together children, young people and adult volunteers from the local community in order to tackle projects that give something back to the local community. They make young people face up to their offending behaviour rather than making them sit in silence.

Nor do I think that we should be considering alternatives that put further pressure on parents. Sometimes parents are struggling to make ends meet. Sometimes parents themselves have not had a particularly good experience of life and might need support. Projects that take a holistic approach to the child in the family and community setting will have more value than simply removing children and setting them aside without tackling their problems.

When the children's hearing system was set up, it was a radical departure from the way that youth justice had been dealt with previously. Scotland ought to be proud of the children's hearing system. Yes, the system might need changes and revision. However, the fundamental principles of putting the best interests and the welfare of the child first, have stood and will stand the test of time.

We need more imaginative ways of working with young people than spurious proposals for grounding them under the supervision of retired police officers. I am sure that some of those police officers would be useful to the process, but some of them may not want to be involved. Let us look at some of the projects that are currently under way and are giving young people opportunities to be involved in outdoor activities, sport and leisure activities and to make a contribution to their communities. They must be given the opportunity to be part of the solution rather than being described consistently as a problem.

I hope that we will consider the good work that has been done as part of the youth crime review. We will begin to examine how we can provide better opportunities within the children's hearing system for 16 to 18-year-olds. As Jack McConnell has already agreed, we will look at the inappropriate facilities in some of our secure units and consider upgrading them. We will, however, keep at the forefront of our minds the fact that the majority of young people in Scotland are not criminals and are not a problem. A small minority of young people cause the problems that the Tories have highlighted today. We ought to keep the matter in perspective. The children's hearing system has stood the test of time and it will continue to do so.

Phil Gallie (Conservative, South of Scotland)

It saddens me that Cathy Jamieson started her comments by making an attack on Bill Aitken. She was wrong to do so. Bill Aitken's motion is positive and looks at the issues that Cathy Jamieson commented on at the end of her speech. It addresses the issues that surround a small minority of youngsters who create mayhem in society. On that basis, Cathy Jamieson was wrong to have a go at Bill Aitken right from the start. Perhaps that is customary for her, but she should listen a little more to what is said.

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

Will the member give way?

Phil Gallie (Conservative, South of Scotland)

I will come back to Cathy Jamieson in a moment.

I listened intently to what Irene McGugan had to say. She fails to acknowledge the things that have been done for young people in our society in modern times. I believe that sports facilities for youngsters are better now than ever before. Access to drama activities is also better. Cathy Jamieson rightly referred to the other facilities that are open to youngsters and how we should encourage them to get involved in various projects that take them outdoors. It is not all depression.

We should consider the money that has been directed towards young people in priority treatment areas. Many young people, without looking for excuses, have the opportunity to pick themselves up and make something of their lives, no matter how bad their circumstances have been.

I will give way to Cathy Jamieson before I go on to talk about children's panels.

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

I was not making a personal attack on Bill Aitken. I was making an attack on Tory party policy.

Phil Gallie (Conservative, South of Scotland)

The Children (Scotland) Act 1995 was a Tory party policy that every party signed up to and of which we in the Conservative party feel proud.

Children's panels are not a subject of criticism in Bill Aitken's motion. He commends the people that work on those panels. They have cared for people and are intent on the best interests of children—that is their remit. However, the members of children's panels are also frustrated. At times, when they have persistent young offenders before them, they know that there is nothing that they can do with those offenders that will protect society.

The panels can say that the offenders should go into secure accommodation, but that makes no difference if the secure accommodation is not there. Our motion addresses that issue—Bill Aitken picked it up and decided that we should examine it urgently. The amendments to the motion are good, but they are waffly. They do not recognise the urgent need for action against the small number of persistent offenders.

An example of the situation in Ayr a few years ago demonstrates the difficulties—15 youngsters committed 700 criminal offences in less than a year. The police are fed up to the back teeth with pulling in youngsters and having to release them, knowing full well that 24 hours later they will have to go out, find them and bring them in once more.

I commend Bill Aitken's motion. I suggest that all members can identify with his intentions and could sign on to them. I recommend that members sign on to the motion at decision time.

Brian Fitzpatrick (Labour, Strathkelvin and Bearsden)

Sometimes we wish that Phil Gallie was still signing on.

Like many on the left—perhaps too readily—I succumb to the soft bigotry of low expectations of the right. I hope that that is the only bigoted view that I hold. Unfortunately that view, which is reinforced daily, is today backed up by the ready recourse of the Conservative party to more secure unit places. "Lock them up" is what their motion is about.

The problem is that we have evidence—perhaps, for once, too much evidence—that that approach just does not work. The failure of sending more youngsters into the adult court system and of making the juvenile system more formalised and adversarial is played out across the Atlantic, where adult and youth crime and incarceration are increasing.

Annabel Goldie (Conservative, West of Scotland)

Would the member be kind enough to give the chamber one instance of such a failure?

Brian Fitzpatrick (Labour, Strathkelvin and Bearsden)

I suggest that the fact that the United States, on a per capita basis, has the largest adult prison population might be one glaringly obvious example of that failure.

I welcome what the minister had to say about targeted action on persistent offenders and I recognise the substantial work that has been done in that connection. I want to pay tribute to the initial work on youth crime by the First Minister's policy unit and to the substantial work of the advisory group. I hope that the minister will comment on that.

We will tackle persistent offending by interventions. No one in the chamber is suggesting that there is not a real problem with persistent offenders. The issue is how best to address that. I suggest that interventions must be measured against their efficacy in addressing the issues affecting individual children in trouble and their efficiency in ensuring the safety of the community in which a child resides. That integrated approach to addressing the difficulties of children in trouble is the essential characteristic of our system. We should not be smug about Scotland's children's panel system, but neither should we be shamefaced.

There is some merit in Annabel Goldie's remarks on right and wrong. I grew up in Priesthill, one of Glasgow's toughest working-class areas, although at that time the Conservative party was in the business of taking work out of the working class. I am conscious of the direct and indirect effects that led me to the more legitimate end of the law and to this place and that kept me out of trouble—not least a faith-based home and parents who were in work.

Annabel Goldie (Conservative, West of Scotland)

rose—

Brian Fitzpatrick (Labour, Strathkelvin and Bearsden)

No—I am being nice about my parents at the moment. They were in work, together and cared for their children.

I hope that the Tories will raise their game and reduce their rhetoric, not least by acknowledging the blindingly obvious. The social characteristics of the core cohort of young, persistent offenders are the most telling problem demanding our attention, and we can only tackle that through determined, challenging interventions for such children. We must take account of the fact that the overwhelming majority of those youngsters are boys. We do not need much more evidence about the best ways of reducing offending among boys. They include providing the prospect of a decent job and of a supportive environment and, some say, the prospect of a demanding girlfriend.

That is why most Labour voters in Scotland are convinced, not just that we are tough on crime—the public are not stupid and know that the causes of crime are of particular importance. People in my constituency are prepared to give children a second chance. They want them to take that chance. I support the Executive's amendment.

Michael Russell (Scottish National Party, South of Scotland)

I find it surprising to say, but I agree with almost everything that I have just heard from Brian Fitzpatrick—except perhaps, at 10.10 in the morning, concerning demanding girlfriends.

Bill Aitken opened by saying that society has deteriorated since the children's hearing system was put in place. Many of us would agree. If we were students of government, we would quickly work out that, of those 30 years, the Tories were in power for 21. Much of the responsibility for a deteriorating society and for the difficulties that young people face, which Irene McGugan, Cathy Jamieson and Brian Fitzpatrick spoke about, lies at the Tory benches. It might have been wise had Bill Aitken remembered that on his way to the chamber, before giving us such bizarre spectacle.

I was struck that Brian Fitzpatrick accused the Tories of just wanting to lock young people up. He may not have noticed it, but I did: there were nods on the Tory benches. That is what the Tories want to do. It is a policy born of fear. Cathy Jamieson was right to say that any member who talks about young children as animals, or about a policy that is, from what I heard, very similar to reintroducing the workhouse, is devising policy out of fear. Mr McLetchie used the word "protect" or "protecting" more than once.

David McLetchie (Conservative, Lothians)

But I have not spoken yet.

Michael Russell (Scottish National Party, South of Scotland)

I am sorry. It was Mr Gallie.

Gordon Jackson (Labour, Glasgow Govan)

That is an easy mistake to make.

Michael Russell (Scottish National Party, South of Scotland)

It is, and considering how far to the right Mr McLetchie is drifting, he will in fact soon be Mr Gallie.

Mr Gallie used the word "protect" more than once. What we have heard in Tory members' speeches and what we see in their motion is a policy of fear. It is the exact opposite of how we should be helping young people.

Bill Aitken (Conservative, Glasgow)

Would Mr Russell accept that the phrase that I used was "a completely different animal"? I could, for example, describe him as a quite different animal from Mr Stevenson, who is sitting beside him, meaning no offence to either of them.

Michael Russell (Scottish National Party, South of Scotland)

I think that Mr Aitken's choice of word was significant. I took it to be significant, as did Cathy Jamieson. I think that those who listened to him found it significant.

Last week, the Education, Culture and Sport Committee visited New Lanark. I am sorry that its Tory member did not join us, because there was a lot to be learned there about what we are discussing today. When Robert Owen established New Lanark, there was a view that young people—and indeed many other people—were merely animals that had to be disciplined and kept in order and that workhouses were a good way to achieve that. What Robert Owen did at New Lanark was to look at things in the opposite way, saying that, if we help and support people, show kindness and encourage the best in people, we get a better society.

It is a great pity that those messages have not yet spread fully in this country and this society. It is, however, an interesting object lesson—despite dating back 200 years—of how a policy that does not focus on the needs of supporting individuals is bound to fail, not just socially but economically. Such a policy is wrong for all reasons: socially, politically and economically—yet the Tories have learned nothing. We do not need more of what Bill Aitken is talking about, but an emphasis on individuals.

When I listened to Irene McGugan, I was listening to someone who has been at the sharp end of working with difficult children, unlike Bill Aitken, who was on the bench judging them. That was the difference between their speeches. On the one hand was somebody who has worked with children and knows that we need more focus on individual children, on the choices in their lives, on the difficulties that they face and on poverty. We also need more focus on the fact that we are responsible for the society that we create and must do something about it. We require a broad-brush approach to help young people and must use it to decide how we focus down.

What we heard from Bill Aitken today was the broad-birch approach, which is absolutely unacceptable, certainly to this party and hopefully to most of the chamber. The Tories, now in the era of Iain Duncan Smith, are lurching wildly to the right—we have seen more signs of that today; fortunately, the people of Scotland are not.

Tavish Scott (Liberal Democrat, Shetland Islands)

I share Mike Russell's sentiments, particularly those of his latter comments. I am pleased to follow his contribution—and that of the distinguished former member of the First Minister's policy unit. I do not believe for a moment that

"the Children's Hearings system as at present constituted is manifestly failing",

to use the words of the Conservative motion. I think it curious that the Conservatives' approach today consists, as others have pointed out, of illustrating the fact that the problems of society have got immeasurably worse since 1995. That was, of course, when Lord James Douglas-Hamilton piloted the Children (Scotland) Bill through Westminster. The resulting act made, as I understand it, no great changes to, and in fact endorsed the Kilbrandon report's principles as far as the children's panel system was concerned—it made only a number of procedural changes. The Conservatives' approach today is at best curious—as Mike Russell said, it simply serves to point out that they were in power for 21 of the past 30 years—yet all has supposedly gone so wrong since 1995. That is typical of Conservative thinking.

The Conservatives' motion is superficial, and tries to appear tough on crime, as they often seek to appear in the chamber. There were nods on the Conservative benches adjacent to me when the idea of "locking 'em all up" was raised. It is deeply dispiriting to juvenile justice and to the related issues affecting our society that that is the approach emanating from a so-called serious party in the modern political world. That policy and emotion come through blue-tinted glasses, and that is inherently unsuitable for the Scotland that I believe in and that I want to develop.

There are one or two points on which I agree with Bill Aitken. He said that the panel system was "progressive and effective", if I have quoted him correctly, and that the basic principle is that the child's interests are paramount. With the Conservatives, however, that would obviously not include the area of physical chastisement.

The panel system has not been set in stone, as the Conservatives have tried to suggest. To suggest that the system and panel members have remained stagnant, and that only the children have changed, is a bizarre argument. Irene McGugan and Cathy Jamieson were right to raise the issues of the education of parents and of society as a whole. We need to take those issues seriously and develop them—instead of the superficial nonsense that I heard to my very far right.

I was interested in what the Lord Advocate said in response to questions on the children's panel system at yesterday's joint meeting of the Justice 1 Committee and the Justice 2 Committee, under Pauline McNeill's convenership. He clarified the point that the general policy is that children should be kept out of court as far as possible, and that only in exceptional circumstances should a child be prosecuted. That was what the Lord Advocate said. If I remember rightly, Bill Aitken and Lord James Douglas-Hamilton were last week defending in a spirited manner the Lord Advocate's independence from the legislature and the executive. They might recognise the importance of being consistent about their arguments.

I wish to make three brief points about the panel system itself. I share the views of the Deputy Minister for Education, Europe and External Affairs and of others regarding the importance of the work that volunteers do, particularly on staffing panels, as well the importance of the on-going national recruitment. However, will the minister comment on a point made to me by the children's panel in my constituency, concerning the difficulty of recruiting men in the 30 to 50 age group? Such men are invariably in work and, given the time commitment that the panel requires of them, may find it difficult to serve. A number of people who are involved with the children's panel in Shetland and to whom I spoke yesterday on the telephone said that that is a crucial issue.

Another point relates to the ECHR. I am sure that the minister will want to make clear exactly when guidance will be sent to panels, as such clarification is needed.

My final point is arguably the most important and was made to me yesterday by the chairman of the children's panel advisory committee in Shetland. It concerns the importance of early intervention—about which Irene McGugan spoke. We need to pool the resources available for early intervention measures.

I hope that in his response to the debate the minister will clarify some of the issues that I have raised.

Robin Harper (Green, Lothians)

Earlier this year I had the honour of chairing a debate at the University of Edinburgh. The audience was made up of 50 to 60 Lothian and regional children's panel members. On my right were members of the legal profession and on my left were members of the panel. The subject for debate was the problem posed for children's panels by the ECHR and the possibility of legal representation on children's panels becoming standard practice. I should have thought that the Conservative party would have wanted to debate that today.

I ask the minister to inform us at the end of today's debate whether the Executive is considering making legal representation on children's panels standard practice. Although the panel members won the debate on a vote—because the idea of creating an adversarial atmosphere on children's panels was not welcomed—the arguments presented by the legal profession were compelling. The issue of legal representation needs, therefore, to be addressed.

I turn now to the points made by Bill Aitken. My experience of a children's panel in 1985 was that we faced then exactly the same problems that the Conservatives are now flagging up as new. At that time there were shortages of secure accommodation. There were children of 15 and 16 who behaved quite atrociously at panels. People of that age are young men and women—they are no longer children. It is not surprising that those who have passed through the system have been failed all the way up. That is nothing new.

I was interested in what Nicol Stephen had to say and found it extremely encouraging. The Falkirk experiment, which produced a 50 per cent reduction in repeat offending, should be replicated as soon as possible throughout Scotland, provided that the results are sound. Will £20 million produce the same effect throughout Scotland within the next two or three years? That, rather than the measures suggested by Bill Aitken and the Conservative party, is the way forward.

I endorse the points that were made by Irene McGugan. The reduction in play spaces and free areas for children in Scotland is becoming a serious problem. Over the past 20 years in Edinburgh, there has been a 50 per cent reduction in access to free, open-air space for young people. I would like to pay tribute to projects such as the Canongate youth project and similar projects in Pilton, Wester Hailes and Craigmillar for the contribution that they make. Nicol Stephen is keen to encourage initiatives of that sort. However, all is not rosy. A new initiative called B-Friends, which allocates young people as friends to younger people with problems, and which has been extremely successful, has had to reduce the number of workers it employs by three and the number of projects that it runs from five to four. The minister should recognise that there are projects throughout the country that struggle each year to find the money to enable them to continue the good work that they are doing.

Finally, I want to support what Cathy Jamieson said. We need activities for young people that will help them to bolster their self-confidence and give them skills that they can take away with them. That means considering schemes such as outward-bound projects.

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

I apologise to Donald Gorrie, who sat through the debate without being called. I call Karen Whitefield to wind up on behalf of the Labour party.

Karen Whitefield (Labour, Airdrie and Shotts)

Today's motion says more about the current state of the Conservative party than it does about the real debate that is taking place on juvenile justice. In my view, today's motion is a rather obvious, if somewhat desperate attempt by the Tories to find some solid ground in Scotland.

What ground seems more solid than the real concern in our communities about juvenile crime? What more obvious way could there be to attack—or should I say exploit—the problem than by implying that fault lies with an overly liberal children's hearing system? However, the people of Scotland and the people whom Labour members represent will not stand for a party that plays politics with such a serious issue.

As Tavish Scott said, I am sure that many of my colleagues want to know why, if it had concerns about the juvenile justice system in Scotland, the Tory party failed to address them during the 18 years that it was in Government. If it had the answers, why did it not do anything? Why in the 18 years during which it destroyed our communities in Scotland did it preside over ever-increasing youth crime? We are talking about a party that believed that there was no such thing as society. It is ironic that it has now decided to challenge anti-social behaviour.

Brian Monteith (Conservative, Mid Scotland and Fife)

No doubt referring to our esteemed former leader Margaret Thatcher, the member alleges that the Conservative party believed that there was no such thing as society. Does she accept that Margaret Thatcher in fact said that individuals are responsible for their actions and cannot pass the blame for them on to society?

Karen Whitefield (Labour, Airdrie and Shotts)

It is nice of Mr Monteith to take the time to join us at the end of the debate. Maybe if he had been here earlier he would understand the real issues that we want to address. We do not want simply to lock children away.

In many communities there is real concern about the disproportionate disruption and violence that is caused by a very small number of young people. As many members said, there is a demand for effective action.

Some members on the Tory benches think that the solution is to lock children away, but the Audit Scotland report "Youth justice in Scotland" clearly states that

"prison is one of the most costly and least effective methods for reducing offending".

The same report points out:

"Significant reductions in prison population have been achieved in Finland, with no associated rise in offending."

In North Lanarkshire, where my constituency is situated, a project called the children's hearings over-16 initiative—CHOSI—challenges young people's offending behaviour. With appropriate education, training and employment opportunities, it has achieved a 78 per cent reduction in offending by those young people who participate in the project. That is a truly effective solution to youth crime.

No system is perfect and there will always be a need to develop innovative responses to youth crime. Unfortunately, it will always be necessary sometimes to take custodial action. Bill Aitken's real interest is not in alternative disposals, but in locking children away, while failing to address the underlying problems that may have led to those children's offending behaviour. This morning he quoted the report by Lothian and Borders police. He failed to point out that, according to the authors of the report, it is impossible to separate victims and offenders on children's panels, as 75 per cent of those referred to panels have been subjected to child abuse or domestic violence. Surely it is more appropriate to deal with those children in a non-adversarial justice system such as the children's hearing system?

The Labour party is concerned with changing our communities for the better and with responding to the concerns about youth crime that are expressed by the people whom we represent. Tackling youth crime effectively is not about locking children away nor is it about making political capital out of a real issue, but that appears to be the Conservative's priority this morning.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I have been fascinated by the speeches made by members on the SNP benches—I found much to agree with. Karen Whitefield also has my full support for much of what she said in her speech.

However, I am extremely puzzled. I have come to the conclusion that the Tory party has become dangerously left-wing. The two Tory motions for debate this morning appear to call for increases in spending. Bill Aitken may correct me if I am wrong, but I am sure that I heard him say that he wants more resources for the children's panel system and, in the next motion for debate, the Tories are looking for more resources for health.

It is all right, though—I soon recovered and the Tory party reverted to type. Bill Aitken wants to send the right signals to his new master in London, Mr Duncan Smith. Bill Aitken is a moderate man and would never physically abuse one of his children, or any other child in his house, but he would, on behalf of the Tories, permit others to do precisely that.

Phil Gallie (Conservative, South of Scotland)

Will the member give way?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Come on, then.

Phil Gallie (Conservative, South of Scotland)

I am grateful to the member for giving way. He referred to the fact that implementation of the Tory party's motion could add costs. Those costs are linked to an increase in the number of places in which to remove and confine the small minority of offenders who create a lot of mayhem in society. Does Stewart Stevenson acknowledge that the cost of those young offenders' crimes is quite considerable and that, overall, there would be a saving to society if young offenders were confined?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I am obliged to Mr Gallie for confirming that the Tories want an increase in resources. It is already well known that incarceration is the least cost-effective solution to the problems caused to society by our youngsters. That view is shared across the chamber.

That is all a bit of a sideshow. We come to the meat of the 50 or so words of Bill Aitken's motion and the bit at the end, where he talks about disposals. We heard from him and from other Tories about restitution and incarceration. Phil Gallie just confirmed that more secure accommodation is at the core of his demands. That is a move in a totally different direction from the child-centred system that was put in place originally.

It is curious to note that the Tory motion also includes a plea for yet another review. Audit Scotland is conducting such a review and will publish its findings in late 2002. In the Executive's response to the youth crime review, it mentioned that six reviews were on-going. That is why Irene McGugan, who drew up the SNP amendment, focused on taking action now. Reviews are fine, but when I was in business, I once helped to set up a bank in 12 weeks. We should take action much more quickly.

I was slightly surprised that no one referred to the Protection from Abuse (Scotland) Bill, which is being considered by the Justice 2 Committee. I am sure that we will come back to the bill, because it may well affect how young people are dealt with, as it will affect them in the same way as it will affect adults. We will need to watch the effects of the bill carefully.

We have all been felons at one time. Those who disagree with that assertion should indicate so now.

Brian Fitzpatrick (Labour, Strathkelvin and Bearsden)

indicated disagreement.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Well done, Brian. The First Minister was well advised.

We have been the lucky ones. We had loving, caring parents and a domestic infrastructure of support. We must focus on the unlucky ones, for whom the system must provide the support that they lack.

Nicol Stephen (Liberal Democrat, Aberdeen South)

I will start by examining the big picture and then I will focus in, as that is vital.

We must not forget the factors that affect offending. All the statistics show that the children and young people who are at greater risk of offending are those who grow up in environments with high levels of deprivation, poverty and unemployment and whose family life is chaotic and difficult because of illness and high levels of alcohol and drug misuse. That is the negative side, but on the positive side, we know that access to good education, out-of-school activities, community centres, drop-in facilities, sport—which Irene McGugan mentioned—drama and other activities will help lower offending rates in society. Such activities are provided not only for that reason, but because they help society in general. Young people need to be motivated, encouraged and inspired.

The Executive is determined to tackle juvenile offending and is doing a lot of work on both the negative and the positive aspects. We must do much more to help and support families, communities and individuals at an earlier stage. Initiatives should target not only youths who have reached secondary school age; they must target younger children.

Donald Gorrie (Liberal Democrat, Central Scotland)

The minister's comments are helpful. Will he guarantee that the Executive will put real resources into helping the voluntary sector, councils and other organisations to provide the facilities that he mentioned, to try to win over disaffected young people and to involve them more in society?

Nicol Stephen (Liberal Democrat, Aberdeen South)

I cannot announce new spending this morning, but I guarantee that the Executive is putting more money into those areas. We believe that the voluntary sector has an increasingly vital role to play in achieving success, both in the projects that I mentioned and those that I am about to speak about in relation to targeting.

As Mike Russell said, we must focus on the individual. That means that we must take a range of approaches, including a focused approach, to identify the persistent offenders.

The advisory group on youth crime confirmed that the powers of the children's panel system are sufficient and wide-ranging. It also advised that more community-based programmes must be developed to confront the problem of persistent reoffending.

It would be complacent of me to say that we are getting everything right. The statistics that I quoted in my earlier speech emphasise the scale of the problem that we face. That is why we have acted on several recommendations already, including the investment of £20 million from April 2001 in the three-year initiative. That will allow local authorities to roll out partnership initiatives and multi-agency programmes. We do not want only local authorities to deliver services; we want to involve the voluntary sector and other agencies.

Phil Gallie (Conservative, South of Scotland)

Will the minister give way?

Nicol Stephen (Liberal Democrat, Aberdeen South)

I am sorry but I am rapidly running out of time. I have given way to everyone who has asked me to, but I must draw the line.

We are considering the feasibility of conducting pilot projects to divert 16 and 17-year-olds from the adult criminal justice system, where appropriate, along the lines of the proposal in the youth crime review.

We have much to learn about youth justice from the children's panel system, but the operation of the system must be improved. It must be timely at all stages if it is to be effective. Concerns exist about the delays that arise at various stages. Those concerns must be tackled and they are being addressed by the time intervals monitoring group, which is a multi-agency working group.

The Executive will receive the first report of that group later this year. The sum of £12 million is being made available to the Scottish Children's Reporter Administration to develop a new information technology system that will, among other things, help to identify trends and provide profiles of children who offend. Currently, such information is not as good as it should be. Officials are working closely with Audit Scotland on its study into value for money in youth justice. We expect the results of that study to be available at the end of 2002.

We want to work with others across all the agencies to get this right. We must get better. We recognise the excellent work of volunteers in the children's panel system, but more young people and—as Tavish Scott highlighted—more men need to be involved. A recruitment campaign is considering how to tackle those issues.

We need to respond to the ECHR judgment and we will do that. I emphasise that the judgment confirmed the fundamentals of the children's panel system. We will not create a new adversarial adult justice-style system.

We are reviewing the need for secure accommodation places and the other specialist services that are at the extreme end of the range of disposals that are available to panels. We want those to be available across Scotland. Some of the secure accommodation facilities need significant improvement and the working group that is considering the issue has agreed that the need is for greater quality and availability of secure accommodation places rather than for extra places.

Ministers recognise that we must maintain momentum. More projects, more research and more investment are needed. Most important of all, we need more effective results.

James (Conservative, Lothians)

I sum up today's debate on the children's hearings system by saying that there have been a large number of lively speeches that have been refreshing to listen to.

The Conservatives believe that the approach to juvenile justice should be to protect the best interests not only of the child but of the community as a whole. I take issue with Tavish Scott, who said that the Children (Scotland) Act 1995 was relatively insignificant. That act was significant because it not only laid down the rights of the child but clarified procedures. I remember being severely disciplined on the floor of the House of Commons by Miss Betty Boothroyd for having too many amendments at the report stage. When I pointed out that they were concessions to Labour members who had made constructive proposals, she recognised that my actions were well meant. I believe that the Children (Scotland) Act 1995 will stand the test of time and will be well regarded in years to come.

Tavish Scott (Liberal Democrat, Shetland Islands)

What I said about the Children (Scotland) Act 1995 was said in the context of the paper from the Scottish Parliament information centre. I quote:

"the first major reform of Scottish child care law since 1968, the Children (Scotland) Act 1995 preserved the Children's Hearings System largely unchanged, although some procedural alterations were made by the Act."

That was my point.

James (Conservative, Lothians)

I am grateful to the member for clarifying his remarks.

The minister made a strong, constructive speech, in which he recognised the case that we have proposed. Let me give an example. In mid-July, the Evening News reported that some 10 children between the ages of 9 and 15 were responsible for a mini crime wave. One nine-year-old was responsible for 40 offences. The children were found guilty mainly of theft, driving offences, housebreaking or of picking on vulnerable groups such as the elderly.

The increase in youth crime has resulted in the number held in secure accommodation rising from 83 in 1998 to 87 in 2000. In due course, I would be interested to know from the minister whether the 200 young persons whom children's panels recommended for secure accommodation were in fact given that disposal. There is a reasonable apprehension that there may be an insufficiency of secure accommodation. I recognise that the disposal is a very serious one, but if a young person is creating mayhem in the community, recognition should be given to the interests of the community as well as to those of the young child concerned. The minister recognised that point, as did Phil Gallie and Brian Fitzpatrick.

I will give a reason why that correctly touches a raw nerve. A recent study in central Scotland showed that about 20 per cent of youth crime is committed by less than 2 per cent of offenders. The cost of youth crime in Scotland is some £730 million per year, which is about the same as the budget for the Scottish police. The minister said that there is room for significant improvement. I welcome his constructive approach.

The second point that I want to make in the brief time available is that there may, in certain circumstances, be a case for extending community service orders and—perhaps more appropriately—supervised attendance orders. Members are right to stress that each case must be weighed on its merits and that a comprehensive approach should take all the circumstances into account.

Michael Russell (Scottish National Party, South of Scotland)

We all welcome the constructive nature of the member's speech, but what connection does it have with Bill Aitken's aggressive opening speech, in which he proposed such things as grounding people and forcing them to read books in darkened rooms? What is the connection in the Tory philosophy?

James (Conservative, Lothians)

Had the member listened more closely to what my colleague Mr Bill Aitken said, he would understand that someone who, as a bailiff of many years, has had to deal with the issues and is familiar with the system, and who has studied it over the whole summer, is entitled to express his concern at the problems that a small minority are causing. The range of disposals should be considered constructively.

I believe that Scotland's system of criminal justice is rightly regarded as one of the best in the world. It has a great deal going for it. In fairness to the children's panel system, it should be recognised that it has succeeded extremely well in situations in which children are at risk. MSPs such as Irene McGugan, Kay Ullrich and Cathy Jamieson have played a part in that process. However, there is a problem with persistent reoffending by a small minority. That is why we call for a review. Even the best system in the world needs improvement. As Karen Whitefield said, no system is perfect. I reinforce her words. Even the best system in the world needs to be kept updated in the light of changing circumstances.

Patient Care

Patricia Ferguson (Labour, Glasgow Maryhill)

The next item of business is a debate on Conservative motion S1M-2207, in the name of David McLetchie, on improving patient care, and on two amendments to the motion.

David McLetchie (Conservative, Lothians)

Let me begin with a paradox. Opinion surveys show increasing dissatisfaction with the performance of the health care system in the United Kingdom, compared with comparable European countries such as France and Germany. At the same time, surveys also show a high level of satisfaction when patients are asked about their own personal experience of the national health service. How do we reconcile those apparently conflicting public perceptions?

My own view is that the level of personal satisfaction is a great tribute to the dedicated staff who work in the health service. I refer not only to the nurses and doctors, but to the forgotten foot-soldiers: the porters, ambulance drivers, receptionists, cleaners and laboratory staff without whom our hospitals, our clinics and our surgeries would cease to function. That is why I am particularly sorry that the Minister for Health and Community Care recently chose to attack those who work in the NHS for what she called scaremongering. Frankly, that was a bit rich, coming as it did from a party that, for its own cynical advantage, elevated scaremongering about the health service to a fine art.

Most people recognise that NHS staff assessments of the current state of the service are the concerns of dedicated people who are struggling to cope with the increasing pressures that have been placed upon them. They cannot forever paper over the increasingly apparent cracks. That is why we owe it to those who work in the health service, and to the patients whom they serve, to ensure that we have a modern health care system of which we can all be proud.

In creating and building such a system, we have to take account of the changes that have taken place in society since 1948 when the NHS came into operation. Society today is more affluent and more demanding, and people have a longer life expectancy and are more vulnerable to chronic diseases than our forebears of 50 years ago. Technological advances in medicine—such as those in the fields of surgery, pharmaceuticals, biotechnology and genomics—have transformed the scope of health care since the inception of the NHS. Those advances have, in fact, undermined one of the assumptions upon which the original NHS was based. In 1948, it was seriously believed that, once the backlog of ill health had been treated, demand on, and the costs of, the health service would be stabilised. Today, however, we know that the demands on the health service are huge, because health is the key to financial and physical independence, whether people are of working age or in retirement. Moreover, the pressures on the NHS have increased, because the extended family, which cared for elderly and frail members at home back in the early days of the NHS, is no longer the norm for a whole variety of social and financial reasons—although I would not wish to diminish in any way the important role that family carers still play in the care of many people in our society. However, we have to acknowledge that trend.

Despite those difficulties, the principles underpinning the NHS still command widespread public support. The NHS aims to provide a comprehensive service while ensuring equality of access. However, it is failing to meet those objectives. The NHS is far from comprehensive. For much of the life of the NHS, most people believed that comprehensive meant that everything that medically could be done, should be done. In reality, of course, and despite the rhetoric, the impossibility of providing every service that medically could be made available was well recognised by those who worked in the service. However, that truth was concealed by allowing doctors a wide discretion to ration—and thus to present decisions to treat or not to treat patients as if those decisions were purely clinical judgments when, in fact, they were not. Doctors went along with that strategy for a long time, but in recent years there have been increasing complaints that budgets are too restricted. The new reluctance to pretend that rationing is carried out on purely clinical grounds has contributed as much as anything else to the atmosphere of dissatisfaction within the health service.

The NHS promises equality of access, but I feel that that confuses two ideas. For most people—including me and my party colleagues—it means that everyone, rich and poor alike, should have guaranteed access to high-quality health care. It is vital that everyone is guaranteed access to health care and the fact that a system such as that in the United States fails to do so for 44 million people—16 per cent of the country's population—is morally unacceptable. That would not be tolerated in this country, and rightly so.

However, just accepting and applying the principle of guaranteed access does not produce equality of provision for all. It is patently obvious that standards differ in different parts of the country. The question that we have to ask is this: do we then establish a policy that seeks to eradicate those differences by levelling down, or a policy that, through the promotion of choice and competition, encourages standards to rise for everyone?

The reality is that the NHS provides a standard that is considered acceptable by doctors within the budgets that are available to them and, because of that, in many areas it fails to match the standards of care that we see in other western European countries. Instead of trying to sweep the realities of rationing under the carpet, it is high time that we had an honest debate about the failings of our health service and a constructive debate about how we can create a system that meets the objectives that we wish it to meet.

For too long, the debate over the NHS has been sterile and dominated by party-political point scoring. I hold up my hand and admit that I have not been immune from that myself. Mea culpa. I will not pretend today that all the problems of the health service in Scotland began on 1 May 1997. Indeed, I acknowledge that more is being spent on the health service in Scotland today than was being spent in 1997. I also acknowledge that some of the problems that we are seeking to tackle have been endemic in the system for a number of years. However, it is about time that the Executive stopped trying to blame the failings of the NHS on the previous Conservative Government, as if all the problems of the health service could be solved by Labour alone. Such an attitude ignores the reality of our record in office and ignores the fact that, under Labour, far from things getting better, and far from the NHS supposedly being saved, in many areas things have actually got worse.

Two weeks ago at question time, Hugh Henry told the First Minister of a constituent who had to wait 89 weeks for a barium meal. Just the other day, a Fife Labour councillor—Mrs Joyce Smith—wrote to Henry McLeish and told him that health services in her area were better under the Tories, with higher standards and shorter waiting times. She told Mr McLeish—and I quote from that fine paper, The Fife Free Press—that:

"Under the Tories patients were seen in less than 15 weeks.

Patients are now receiving appointments for June 2002.

Is that acceptable? I don't think so."

She is right. All I can ask Labour ministers is, although you may not listen to me or my colleagues, why will you not listen to your own people—people on the ground who can reflect the experiences of the people that the health service is meant to treat?

The previous Conservative Government, along with its predecessors, devoted an enormous amount of time and money to improving the health service. That is why we have a liver transplant service at Edinburgh royal infirmary; that is why we have had a massive increase in the number of whole-body scanners; and that is why we became the first country in Europe to introduce a nationwide breast and cervical cancer screening programme and to establish three brain injury rehabilitation centres in Scotland. On top of all that, we were also able to initiate seven of the eight new hospital developments, many of which were built as a result of private finance initiatives, which Labour opposed at the time and now seeks to steal the credit for.

Instead of Labour refusing to admit that real improvements took place during that period, and instead of Labour pretending that it has a monopoly of virtue and wisdom with regard to the health service, it is about time that Labour was a bit more honest about the fundamental flaws affecting the service as a whole.

Richard Simpson (Labour, Ochil)

Mr McLetchie's speech is very interesting and quite well balanced. However, in the interests of balance, will he talk about the vast increase in the number of administrators, and the reduction by 8,500 in the number of nurses, in the last 10 years of the Conservative Administration? The Conservatives' failure to increase the number of medical students landed us with an inadequate number of consultants, whom it takes a long time to create. If Mr McLetchie is really being honest, he must be balanced and talk about the problems that his party created for our party in 1997. Those problems were very severe.

David McLetchie (Conservative, Lothians)

I try to be honest about those matters. Problems with nurse recruitment and nurse numbers have not diminished; in fact, I think that they have become rather worse in the past few years.

A lot of nonsense is talked about bureaucrats and administrators. Good managers and administrators are needed to run the budget of a health service that costs more than £5 billion. It does no service to diminish the contribution that those people make to the running of that service. We have to know what the service costs and how resources can be allocated most efficiently. To do that, we need high-quality administrative staff. I really feel that Labour hits the wrong mark when it attacks those people. For an organisation of its size, the NHS is not overburdened with bureaucrats.

There is a problem of underfunding. Despite the money that has been put into the health service by Governments of all political persuasions, when compared with countries of comparable wealth such as France and Germany, we consistently spend a lower percentage of our gross domestic product on health. Although we spend less public money on health from taxation than is spent in those countries, the disparity is greatest in relation to private spending on health, which is far higher in those countries than in the United Kingdom. That means that we compare badly with western European countries in terms of the number of doctors, nurses and beds in our health service. There are twice as many doctors and hospital beds per 1,000 people in Germany as there are in the United Kingdom, and almost twice as many nurses. That lack of capacity has led to the most obvious failing of our system—long waiting lists and waiting times.

I will not rehearse all the numbers—we have been through them many times. However, even using the new measure—waiting times—that the Minister for Health and Community Care has introduced, nearly 60,000 people have had to wait more than three months for an operation and patients now have to wait, on average, an extra three days when compared with the situation in 1997. We have reached a deplorable situation, where, as the result of the recent European Court of Justice ruling, we now have to consider the export of our patients because our health service is unable to treat them within a reasonable time. That is damning evidence of our failure and should be a spur to action on all our parts.

The health service suffers from lack of competition, which many people wrongly assume has no place in health care. Competition and diversity of provision should be encouraged to raise standards. We should remember that the private commercial sector is not the only alternative to the state. Development of health care can come from the voluntary sector, as exemplified by the hospice movement. Hospices are perfect examples of modern care, combining innovative developments in palliative care with compassion for those facing terminal illnesses and support for their families. Does anyone seriously believe that our world-renowned hospices would be better off being run by a state monopoly? I think not.

In any case, as has been stated, we know that the Executive is happy to take the credit for all the Tory-initiated new hospital developments. All that we are asking is that the Executive extend its pragmatic attitude, so that the principle of partnership with the independent sector is extended to the delivery of health care to raise standards and improve access.

Tony Blair and Alan Milburn have signed a concordat with the independent sector to utilise spare capacity for the benefit of NHS patients in England. That concordat is described as not just a short-term fix to reduce waiting lists and waiting times, but something that is intended to turn partnership between the two sectors into a matter of routine. Such a concordat should be signed in Scotland to give our patients the same benefit.

Only this morning, we read that 40 heart patients from Liverpool who have waited six months for bypass surgery are to be operated on at Health Care International in Clydebank, but in Scotland patients would have to wait for 12 months before that would be done or even considered. Just how stupid and blinkered can we get? We have a wonderful facility on our doorstep, but we will not use it properly.

The potential to use the independent sector for the benefit of NHS patients is undoubted. Mr Chapel, the Scottish director of the Independent Healthcare Association has stated that the independent sector in Scotland has the capability to perform an extra 100,000 operations a year. Co-operation could significantly reduce waiting lists and waiting times for hundreds, if not thousands, of NHS patients.

Many of the reforms that have been introduced by the Labour party have been going in the wrong direction. Labour has diminished choice, increased centralisation and refused to use the spur that competition can bring to improve services. We need to reconsider some of the areas that I have mentioned today.

We know that we cannot start again from scratch and nor would we wish to do so. We must find ways in which the current system might be modified so that we build on where we are succeeding and what is best in the system and we improve standards where we are failing. That requires a debate that is open and influenced by developments in other countries and which is not inhibited by outdated political dogma. We need to guarantee everyone access to medical care, but that objective does not require a public sector monopoly or putting our whole system into an ideological straitjacket.

There is no single solution to the problems of the NHS. All systems of health care are imperfect. Neither social insurance, nor total tax funding, nor private health insurance alone can provide all the answers. One size no longer fits all, if indeed it ever did. The complexity of modern society demands a pluralistic approach that is flexible enough to change as circumstances alter. We need a less doctrinaire and more flexible approach involving different forms of funding and greater choice, as well as the adaptation of some of the more successful features of international experience and practice to British conditions and preferences.

I do not often agree with the First Minister, but in relation to health I certainly share his view that "what matters is what works". I hope that he and the Executive are willing to practise what he preaches and initiate the open-minded debate that is so badly needed to improve health services in Scotland.

I move,

That the Parliament welcomes the opening of the new hospitals built thanks to the PFI programme initiated by the last Conservative governments but notes with grave concern that the delivery of health care in Scotland has fallen far short of the standards people expect, with local hospital services under threat and patients waiting longer for treatment and facing the prospect of being forced to go abroad to get the treatment they need in a reasonable time; calls upon the Scottish Executive to extend the principle of partnership with the independent sector to the delivery of health care and begin discussions with the independent sector with a view to signing a "concordat" in similar terms to that already established in England, and further calls upon the Executive to initiate a debate in Scotland about how to improve standards of health care to the levels of the best European countries without raising taxes to unacceptable levels and whilst ensuring that access to high quality care is guaranteed for all.

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I welcome this morning's debate and I have listened with interest to David McLetchie's opening remarks. I welcome his acknowledgement of the complexity and scale of the task of modernising and developing the NHS. I also welcome his desire for a balanced and measured debate about the NHS, which is something that I have been calling for for some time. Indeed, I have come under attack from David McLetchie for saying just that, but I will give him the benefit of the doubt and will remain pleased to engage in such a debate.

I am sure that I am not alone in finding it difficult to take the Tories too seriously on this issue. The Tories feign sincerity, but I find it unconvincing. Their record in Government speaks louder than any amount of warm or weasel words from their leader. I will use my time to focus on the facts of what ministers in the coalition Scottish Executive are saying and doing, and on what is going on in our NHS.

Let us remind ourselves that the NHS is our nation's biggest and most important public service. It is our country's largest employer and accounts for one third of the budget of this Parliament. It serves our entire population and it is a service of which we can and should be proud. The service is facing enormous challenges, but it is responding to those challenges day in, day out.

We have made clear our determination to work for and with the NHS in Scotland to address the challenges through investment and reform and to do so in partnership with staff and with patients. We are under no illusions about the scale of that task, but that makes us all the more determined to take forward the programme of work that we have set out. We will build on success as well as tackling failure.

Last December, we published "Our National Health: A plan for action, a plan for change". The plan set out a radical and ambitious, but achievable, programme for our NHS. It made clear our determination to rebuild our NHS as a truly national service: replacing competition with collaboration, combining investment with reform, setting national standards to be met locally and working to deliver services built around the needs of users, not the convenience of providers. Crucially, the plan was clear in its determination to improve health, not just to improve the treatment of ill health.

Since then, a massive programme of work has been under way to implement that plan. It has commanded widespread support throughout the country. I am delighted that a wide range of individuals and organisations are working with us and the NHS to ensure that the plan is translated into practical action and that it delivers real results for patients across Scotland.

In just over a week's time, new unified NHS boards will come into being across the country. The first of those boards is already in place in Tayside. That part of the NHS has a troubled history—blighted by fragmentation and poor leadership. However, we are starting to see a much-needed sea change in the way that the NHS in Tayside does business. There is meaningful teamwork, proper local dialogue and better performance. That is the way forward for the NHS in Scotland.

Across the country, the bureaucratic, over-layered machinery of the Tory internal market is being replaced with proper integration and improved accountability. Staff and local authorities are being given a meaningful voice around the NHS board table. That reflects our commitment to ensuring that partnership working, within the NHS and between the NHS and other organisations, is the norm in the future.

Brian Monteith (Conservative, Mid Scotland and Fife)

The minister mentioned improved accountability. What does she say to those members of the public in Perthshire who feel that there has been no accountability to the health board in the review of the provision of paediatric care? Does the minister believe that accountability has improved for those people?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I believe that accountability has improved in that area as in others. There is still some way to go, which is why we continue to make changes and improvements in the accountability of the service. Compared with what was happening two or five years ago, the extent of the dialogue and consultation that is taking place on that issue, in that area, is fundamentally different. That must be the direction for the future.

Let me be clear: the creation of unified NHS boards is a means to an end, not an end in itself. The test will be the results that those boards deliver. That is why, alongside the creation of unified boards, we are introducing new performance standards for the service, better financial systems, clear national priorities, and a renewed emphasis on the things that matter to patients, such as reducing waiting, improving communication, and working to ensure that people get the right care in the right place at the right time. That can be achieved only by the NHS working together as a whole.

At the heart of our approach is a clear focus on the clinical priorities of the NHS: cancer, heart disease and mental health. What is radical and different about our approach is the degree of ownership and control that is being given to staff and patients to take forward the work. National leadership is required, and we are giving it, but we recognise that change is achieved not by issuing diktats from the centre, but by harnessing the skills, expertise and enthusiasm of staff and patients.

Shona Robison (Scottish National Party, North East Scotland)

There is little that I disagree with in the minister's speech so far, but will she clarify how far she is prepared to see private finance being used in the national health service?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I am glad that Shona Robison welcomes what I have said. Of course, the difference between our policies and the SNP's policies is that we have some, and we have translated our commitments and aspirations into practice. In a moment I will address private sector involvement, because it has featured prominently in the debate, but for now I will concentrate on investment, which rightly often features in debates on the NHS.

We recognise that delivering results requires investment. That is why the health budget in Scotland will rise from just less than £5 billion in 2000 to almost £7 billion by 2003—a substantial increase by any measure. Yesterday, Angus MacKay and I announced the release of a further £90 million to the NHS in Scotland to give our new boards a fresh start, to wipe the slates clean, to clear the accumulated deficits of the past, to enable the NHS to prepare for winter, and to continue to build for the future.

We are determined to ensure that that investment delivers results, that it reaches the areas of greatest need, and that it gets to front-line patient care. We have resisted the temptation to indulge in quick fixes, gimmicks or cosmetic changes, all of which have blighted the NHS in the past. We are investing in a way that is meaningful and sustainable.

The implementation of the Arbuthnott review is resulting in resources being allocated more fairly across the NHS in Scotland. Much-needed investment in infrastructure is now taking place. We are seeing the biggest-ever hospital-building programme; replacement and refurbishment of health centres across the country; redevelopment of accident and emergency departments to provide better and more responsive patient care; and investment in information technology to support telemedicine, the transfer of patient records, better appointments systems, test results and discharge information. That much-needed equipment has been long neglected but, together, those developments are beginning to transform the patient experience. Common sense tells us that new buildings and major IT projects are not developed overnight, but no one should be in any doubt about the correctness of investing in those areas or of the results that are being, and will be, achieved.

Of course, we continue to invest in staff: 10,000 nurses will qualify in the coming five years, 1,500 more than was originally planned; 475 more junior doctor posts have been funded; additional consultant posts have been created; and there has been major investment in the development of family health services. Alongside that, we continue to work with the Scottish Partnership Forum, which brings together all NHS staff groups in Scotland, to develop a better, safer workplace through improved health and safety measures, more flexible working, better child care, and better education and training. All those measures will ensure that we have the work force that we need now and for the future. But we are not complacent. This week, I will be writing to all those with an interest in the future of nursing in Scotland to invite them to attend a nursing summit, so that together we can continue to take action to recruit and retain the nurses that we need in the NHS in Scotland.

I have said quite a bit about investment, but let me be clear that money alone will not deliver a modern, patient-centred NHS; new ways of working, better communications and a change to culture are also required. That is why I am delighted that we now have more than 300 one-stop clinics in Scotland. We are slashing waiting times and delays, giving people more personal specialised care, and transforming the patient experience. That is the solid foundation upon which we are determined to build.

Much has been said here today, and elsewhere, about the role of the private sector. Much of what is said is confused, some of it is misleading, and some of it is just plain wrong. The fact is that the private health care sector has co-existed with the NHS since its inception. The fact is that the NHS in Scotland, from time to time, uses the private health care sector for the treatment of NHS patients where the capacity exists and where it is right for patients. There is nothing new in that, but the fact is that here in Scotland, capacity problems do not exist on the scale or in the concentration that they exist in some parts of the UK. The fact is, also, that the private health care sector in Scotland is significantly smaller than in other parts of the UK. The Tories' suggestion that concordats and the like between the NHS and private health care providers are the way forward for the NHS in Scotland simply ignores the reality.

David McLetchie (Conservative, Lothians)

Will the minister give way?

Patricia Ferguson (Labour, Glasgow Maryhill)

The minister is winding up.

Susan Deacon (Labour, Edinburgh East and Musselburgh)

There has always been, and there will continue to be, a role for partnerships between the NHS and various parts of the private sector, where that can add value to the work of the NHS.

Today, the SNP asks for less private involvement and the Tories ask for more. Our guiding principle is simple: what matters is what works for patients. We reject the tired old Tory dogma of private good, public bad. Our emphasis is on the quality of service, not just the cheapest price. What came through in David McLetchie's speech was the true subtext of the Tory agenda—to have a two-tier health care system and to build up the private sector in Scotland. I know what our priority is: to build up the NHS in Scotland. We are committed to that task. We are working with the NHS to achieve it, and we will stick to it, because it is the right priority for the people of Scotland and our health service.

I move amendment S1M-2207.2, to leave out from "built" to end and insert:

"; notes the progress that has already been made across Scotland in improving services for patients and believes that continued implementation of Our National Health: a plan for action, a plan for change will deliver increasing benefits for patients, with the objective of high quality care for all."

Shona Robison (Scottish National Party, North East Scotland)

I agreed with one thing in David McLetchie's speech, which was that not everything started to go wrong in the health service from 1997 onward, which is why the Tories have no credibility when it comes to the health service. When they open their mouths, it reminds everyone of 18 years of butchery of the health service, from which it has not recovered.

Ben Wallace (Conservative, North East Scotland)

Will Shona Robison take an intervention?

Shona Robison (Scottish National Party, North East Scotland)

No thank you.

It reminds people of the madness of the internal market, which David McLetchie seems to want to re-establish, unless I misunderstood, and the privatisation of public assets. The really irritating thing about all this is that it gives new Labour the excuse time after time to say, "What do you expect after 18 years of Tory rule?" That is beginning to wear a bit thin. Everyone accepts that there are major problems to be resolved in the NHS, except perhaps the Minister for Health and Community Care, who tells us that everything is rosy and condemns staff for daring to complain, which reminds me of a rather famous Tory lady and her "moaning minnies" speech some years ago.

Successive Tory and new Labour Governments have failed the NHS in Scotland. Under the Tories, waiting lists stood at around 80,000. Between 1992 and 1996, the number of nurses in the NHS fell every year, while the number of health service managers quadrupled. New Labour has admitted defeat on waiting lists and scrapped the pledge to bring them down, yet at the same time the median waiting time for out-patients has risen to 51 days. There are 1,000 fewer nurses under Labour than there were under the Tories and nearly 2,000 fewer ancillary staff. In addition, there are almost 3,000 patients awaiting discharge from hospital, and they are occupying more than one in 10 NHS beds.

The NHS has its problems, but privatisation is not the answer. The Tories are in danger of never learning the lesson that ideological dogma is not the solution for public services. However, with the election of Iain Duncan Smith I suspect that we have not seen anything yet. Today's debate shows the direction that the Tories are heading in—the mass privatisation of the NHS, as I am sure that Ben Wallace is about to confirm.

Ben Wallace (Conservative, North East Scotland)

I wonder whether Shona Robison agrees with her principal spokesman, Nicola Sturgeon, who in an interview with The Economist on 14 July mentioned that perhaps we should move to the European system of a partly social-insurance based system instead of a taxation-based system for the provision of health care. Health care in Europe is private and public, and in many countries it is private.

Shona Robison (Scottish National Party, North East Scotland)

Ben Wallace has misunderstood the concept of the privatisation of the health service, which his party wants to happen.

I find myself in the somewhat strange position of facing a pro-privatisation alliance among the unionist parties in the chamber. The question is just how far each of them will go. The Tories are right about one point in their motion—PFI was their idea, but the Labour party has well and truly stolen the Tories' clothes, making Scotland the PFI capital of Europe.

The question is how much further Labour will go.

Tony Blair wants to go all the way. He still has the scars on his back from the previous big ideological fight, but he won that one and I think that he will win this one too. Henry McLeish was not keen at first but, in true Henry style, he changed his tune and started to talk about how traditional public services had lost sight of their main goal—to serve the public. Does that mean that he believes that the private sector could do better? Does the Minister for Health and Community Care agree with him? The assumption of private sector good, public sector bad has no foundation other than the fact that Tory politicians, and an increasing number of Labour politicians, tell us that that is the case.

Let us consider the reality of Scotland's experience of privatisation. The Tory motion extols the virtues of using PFI to build Hairmyres hospital, yet it fails to mention the problems that have been experienced there. The records of 200,000 patients have gone missing; raw sewage has been seeping through the floor; staff have been receiving electric shocks—I am sure that the people sitting in the gallery will find it strange that some members find that so funny—because of faulty work; meals are being prepared by contractors 200 miles away and the air conditioning is faulty and is causing the building to overheat. Is that success on a plate, minister?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

I wonder whether the SNP's deputy health spokesperson has ever visited Hairmyres hospital. Will she tell us whether she has ever spoken to the staff there or whether she has ever investigated any of the allegations, printed in tabloid newspapers, that she has just repeated? I have done all those things; I have heard directly from patients and staff about what is and what is not working. I have heard from them the effect that such false allegations have had on their morale. Will the SNP tell the truth on those issues?

Shona Robison (Scottish National Party, North East Scotland)

I will do better than that; I will quote one hospital worker who said:

"Morale couldn't be any lower. We are no longer working as a team because half the staff is employed by a private firm, while the rest are NHS. One team has patient welfare as a priority, the other has profit as a priority."

That came from a hospital worker.

The true cost of the Edinburgh royal infirmary—with the loss of 500 staff, including consultants—has emerged. That is another example of how the price of PFI has to be paid.

The great privatisation itself—of the hospital cleaning services—started under the Tories and continued under new Labour. It is no coincidence that in recent years the incidence of hospital-acquired infections has risen dramatically. That is no surprise, given the fivefold decrease in the number of domestics in the NHS since services were contracted out. While the Government estimates that hospital-acquired infections cost the NHS £21 million a year, a recent report suggests that they could cost it as much as £186 million. We are supposed to believe that privatisation is cost-effective and efficient. I do not think that it is.

I turn to HCI in Clydebank. The Tories are trying to turn logic on its head with that. Instead of highlighting the solution for the NHS, the Tories are highlighting the problem—there is a lack of capacity in the NHS. That shows the absolute absurdity of the NHS being reliant in any way on the private sector. Instead of pouring more and more money into the private sector we should be building up the capacity of the NHS. The Tories appear to be happy to play the tune of the private sector. However, spending extra money on the private sector would not provide one extra nurse or doctor for the NHS.

Iain Smith (Liberal Democrat, North East Fife)

Will the member give way?

Shona Robison (Scottish National Party, North East Scotland)

No. I am just winding up.

The Scottish National Party would spend Scotland's money more wisely. An SNP administration would never allow £718 million—money that could have been used for public services—to be underspent. We would make Scotland's wealth work for Scotland's health. Seven hundred million pounds a year could be freed up through spending resources that are raised in Scotland. That £700 million could be spent on Scotland's public services and health service. We would use Scotland's wealth to build up the family silver, not sell it off to the private sector to be lost for ever to future generations. I am happy to move the amendment in my name.

I move amendment S1M-2207.1, to leave out from "welcomes" to end and insert:

"notes that, as a result of successive government policies, Scotland has become the PFI capital of Europe and that PFI is the most expensive method of financing hospital building; further notes that the privatisation of domestic services in hospitals presided over by the last Conservative government has resulted in a deterioration of standards of cleanliness in hospitals and record levels of hospital-acquired infections; believes that further private involvement in the delivery of health services is not in the interests of patients, and is committed to rebuilding a public health service in Scotland that is capable of delivering the highest quality of care for all our citizens."

Margaret Smith (Liberal Democrat, Edinburgh West)

I found myself in the unusual position of welcoming much of what David McLetchie said, until he got further into his contribution and then, unfortunately, it all fell apart. I welcome his comments about the contribution made by national health service staff and his statement that no party in this chamber or elsewhere will have all the answers to health service problems, of which there are, undoubtedly, many.

His motion opens up a thorny debate about the involvement of the private sector in Scotland's health service and in Scotland's wider health. The Liberal Democrats view with concern any plans for the privatisation of the national health service by the back or front door and any attempts to build a two-tier health service that is based on the ability to pay. However, we must also acknowledge the crucial role that private companies play in the health sector, whether they be pharmaceutical companies that are advancing new drugs and funding research, private companies such as Agilent Technologies in my constituency or those in other members' constituencies that are investing in effective employee health programmes that assist the public health of Scotland.

Scotland has made it clear to the First Minister that Mr Milburn's concordat approach is not being followed here, but it is also clear that there is a role for the private sector. Indeed, the minister said in her speech that the national health service occasionally uses the private sector when it is necessary and when there is capacity, and when it is the right thing to do for a patient. I believe that to be the right thing to do.

We will have this discussion time and again between now and the next Scottish parliamentary elections, not least because Mr McLetchie and his party will be intent on building a new, free-market, two-tier health service now that the rest of us have managed to dismantle their last one. The internal market is a recipe for division and for a massive increase in the number of NHS managers instead of—as Shona Robison, the minister and others said—an increase in the number of nurses. The Tories' agenda is driven by ideology and cheered on by their new London master.

I make it clear that I believe that there are two dogmas that we should adhere to for health services in Scotland. The first and fundamental one is to put quality patient care at the top of our agenda. The second is to preserve, protect and improve our NHS and to give real support to the 130,000 staff who work within it. It is essential that those staff are motivated, nurtured and supported to continue to deliver quality services in what are often difficult circumstances. My colleague George Lyon will talk about that at some length in a few moments.

Shona Robison's amendment is right in highlighting some of the difficulties that have arisen because of the privatisation of cleaning services in hospitals. That circumstance plays a small part only in the problem of hospital-acquired infection, but an important point is that sometimes the private sector does not get things right and sometimes people can see a difference in the quality of service. We should be saying that our No 1 dogma and ideology should be driven by what is going to deliver best-quality patient care. That is our approach.

Brian Monteith (Conservative, Mid Scotland and Fife)

Will the member give way?

Margaret Smith (Liberal Democrat, Edinburgh West)

Yes.

Brian Monteith (Conservative, Mid Scotland and Fife)

Would the member accept that the introduction of competitive tendering exposed many of the problems in catering and cleaning in the health service? Those companies who took on contracts no longer enjoyed Crown immunity, so that when there were problems there was also the ability to solve them. Would the member accept that that was not possible previously?

Margaret Smith (Liberal Democrat, Edinburgh West)

I accept that anecdotal evidence and other evidence such as the report that Andrew Walker produced, which Shona Robison mentioned and which was published a couple of weeks ago, say that hospital-acquired infection is a problem. All our constituents say that the cleaning levels in some hospitals are unacceptable. I do not care too much who does the cleaning. I just want to ensure that we have good value for money and good-quality patient care. The people who work in those services should be treated with respect, accorded dignity and given a decent wage for a job well done that will retain them in those hospitals to do that quality work. That is what I am bothered about.

Sometimes we need to find the pragmatic approach to private involvement and ensure that we make that work, whether that be through support for new PFI projects, such as the new Edinburgh royal infirmary. I assure Shona Robison that I support that through gritted teeth. Members should not get me started on the new royal infirmary from a parochial position. However, having toured the new hospital and talked to people there, I know that we will have a state-of-the-art hospital that will deliver good-quality patient care. I would prefer hospitals and schools to be paid for from the public purse, because they are fundamental to public services, but the pragmatic view that we have had to accept is that in order to deliver those hospitals, that is the only game in town. The Parliament has been able to improve matters in connection with PFI, such as contracts. We must make the fundamental acceptance of that fact.

About a year ago, Audit Scotland produced a report that covered the hiring of agency nurses. Sometimes that gives the service flexibility. If a nurse is required at short notice, it may be easier to get one from a bank or agency. However, a price tag is attached to that in the phenomenal amount of money that that costs the NHS in Scotland, in the continuity of care and in the limited access to protocols that those nurses can maintain on the wards. We must weigh up whether using the private sector will deliver better-quality care.

The jury is still out on the effectiveness of PFI in the long term. I look forward to the Audit Committee's examining PFI. A recent Treasury task force review of PFI suggested that it represented excellent value for money, whereas a report by the Office of Health Economics, which focused on PFI in the NHS, claimed that net benefits appeared to be small and might involve higher costs of borrowing, after accounting properly for risk. That office said that PFI would probably yield better-maintained hospitals over the 30-year period, but concluded that public sector managers should not be forced to adopt a PFI solution. That leads to the suggestion that PFI sometimes may be the right way forward, given further work, and sometimes may not be, as with the Western general theatre extension in my constituency.

The Health and Community Care Committee has not been able to gain information about the cost involved in current PFI projects. We have a problem in the clash of cultures between an increasingly open and accountable Parliament and a secretive, competitive business sector. That breeds suspicion, whether correct or not.

The Tory motion attacks the state of the NHS. We can applaud the barefaced cheek of this discredited right-wing party, but no members should take lessons from the Conservative party on how to run the health service. The Conservatives tried to privatise the health service and turn it into a business. Although we have seen the repentant, acceptable face of the Conservative party in Mr McLetchie, we must never forget that behind him lies Ann Widdecombe. In January 1999, she said:

"I think if someone wants to pay to see their GP they should be encouraged to do so ... The problem with the NHS is that we do not charge for much of what we do."

Miss Widdecombe missed the point. The NHS does not charge for what it does because we believe in a service that is free at the point of need and at the point of delivery. We do not charge for it.

Liam Fox has said:

"Philosophically we have moved on, insurance companies could cover conditions that are not high tech or expensive, like hip replacements and cataract operations ... we would then leave expensive treatment like cancer therapy to the NHS".

Members can imagine the bureaucracy that that would involve and the difficulties that those who could not afford to pay for health insurance would face.

The Scottish Liberal Democrats are committed to increasing spending in the NHS.

Mary Scanlon (Conservative, Highlands and Islands)

Will the member give way?

Patricia Ferguson (Labour, Glasgow Maryhill)

No interventions. Margaret Smith is winding up.

Margaret Smith (Liberal Democrat, Edinburgh West)

The Liberal Democrats are committed in the Executive to record investment across the board, as the minister said. Everyone will receive a 5.5 per cent increase this year. A record number of operations is being carried out. New measures are being taken to tackle waiting times. A new emphasis is being placed on investment in our housing stock, free personal care, healthy living centres, one-stop clinics, NHS 24 and cancer plans, to name but a few of the initiatives in which we are investing.

We want to ensure that all the people of Scotland have the best-quality public services and NHS. Ensuring that will involve an element of working with the private sector, but not to the extent that the Conservative party would go in taking that road.

Patricia Ferguson (Labour, Glasgow Maryhill)

We now move to the open part of the debate. Several members wish to speak. In the time that is available, I will be unable to call all those members. I ask the members who participate to keep their speeches brief, to allow me to try to accommodate as many members as possible.

Mary Scanlon (Conservative, Highlands and Islands)

It is unfortunate that Shona Robison did not deal with improving patient care, but concentrated on the outdated assumption that only state monopolies work. SNP members would be better spending their time in Dundee today, because their contribution to the debate has been zero.

I say to Margaret Smith, my colleague on the Health and Community Care Committee, that she can continue to quote Ann Widdecombe, Liam Fox and whoever, but she does not realise that in the Conservative party, Scottish health policy is devolved to members of the Scottish Parliament. Perhaps policy is not devolved in Margaret Smith's party or the Labour party. If she wishes to quote members of the health team in the Scottish Conservative party, we will take responsibility for those comments.

Shona Robison (Scottish National Party, North East Scotland)

Will the member give way?

Mary Scanlon (Conservative, Highlands and Islands)

No.

We all agree that health care has moved to new ground. I will start by briefly considering the European Court of Justice ruling that patients can challenge their health authorities to obtain treatment abroad if that cannot be provided domestically in an acceptable time scale. In Germany, any wait for treatment of more than four weeks is considered too long, and in France, any wait of more than two months is unacceptable, yet in the UK, six months is the norm. Many patients in Scotland would be delighted to see a consultant within six months, let alone to wait six months for treatment.

The idea of patients going abroad is not new. I would like to claim that it was a Tory idea, but in 1951, the Labour Scottish Office minister Peggy Herbison organised a scheme for patients with pulmonary tuberculosis to be treated in Switzerland. Seventy patients from Edinburgh—more appropriately known as Auld Reekie at the time—were flown out to Switzerland and joined later by patients from Glasgow. In 1951, Labour recognised that what mattered was what worked.

I would like to correct what Margaret Smith said about the Department of Health's concordat, by Alan Milburn, with the private and voluntary health care sector, which sets out a partnership approach that enables NHS patients in England to be treated free in the private and voluntary health care sector. The concordat says:

"The key test"

for this relationship

"is that it must represent good value for money for the tax payer and assure high standards of care for the patient."

In Scotland, are we saying that we do not endorse those key tests? Is politics in the Scottish Parliament overwhelmed by ideology?

Dorothy-Grace Elder (Independent, Glasgow)

I must correct Mary Scanlon's comparison of the 1951 TB epidemic to patients possibly going abroad today. I have written quite a bit about that epidemic, which was of massive proportions. People were dying in this country and the authorities were only too happy to shift patients out to Switzerland, Germany and anywhere that they could send them. It was the national health service that beat TB in the long run, so that TB hospitals had closed by the late 1960s.

Mary Scanlon (Conservative, Highlands and Islands)

I thank Dorothy-Grace Elder for her contribution. The national health service also found the best care for patients by sending them abroad.

Can we be absolutely clear about the new definition of waiting time? The British Medical Association suggested that the definition of waiting time should be the time from referral by the general practitioner until treatment. Will the minister confirm whether the new definition of waiting time is the time taken from being put on a list following the patient's appointment with the consultant or the time taken to wait to see a consultant? If we are to have an honest debate about waiting times and waiting lists, we need to be clear about the definition.

Some waiting lists are closed, including the list for the communications clinic at Raigmore hospital in Inverness. That clinic is where the diagnosis of autism and other disorders—

Patricia Ferguson (Labour, Glasgow Maryhill)

Will the member please come to a close.

Mary Scanlon (Conservative, Highlands and Islands)

What matters is what works. The SNP misleads members when it talks about hospital-acquired infections. Can Shona Robison prove that hospitals that are run by private contractors have lower, or higher, hospital-acquired infections than those in the public sector? We all need to hear that information.

Patricia Ferguson (Labour, Glasgow Maryhill)

The member must now come to a close.

Mary Scanlon (Conservative, Highlands and Islands)

My mother was in a hospital in Dundee that is run by an in-house contractor. That hospital was far from clean.

I will wind up with a final point—

Patricia Ferguson (Labour, Glasgow Maryhill)

The member must do so very quickly.

Mary Scanlon (Conservative, Highlands and Islands)

I want to mention the case of Alec Grant, a patient who has spent three years being assessed and diagnosed inappropriately. He saw a doctor again yesterday, but he has to wait until December to get on a waiting list—

Patricia Ferguson (Labour, Glasgow Maryhill)

The member must close.

Mary Scanlon (Conservative, Highlands and Islands)

He will have to wait a year. If the Executive does not reduce waiting times, clean up hospitals, unblock beds and give patients appropriate care, the money will follow the patient to Germany, France and other countries.

Des McNulty (Labour, Clydebank and Milngavie)

For the Conservatives to have initiated this debate is breathtaking, given the years of underinvestment that we suffered while that party was in power.

In Glasgow, the rate of new hospital building and of lack of equipment is worse than in other parts of Scotland. That situation is only recently being put right through the application of the Arbuthnott formula. It is also being put right through the recently initiated £300 million per year programme of hospital building—double that which was spent in 1997.

It is also important to recognise, as did Susan Deacon, the £400 million increase that has been put this year into patient care. There is more money, but there is also an increased need for patient care. We need to address that increased need in different ways.

I have recently begun to follow up the incidence of oesophageal cancer in north Glasgow. Over the past decade, oesophageal cancer has increased significantly in Scotland; we now have the highest incidence of oesophageal cancer in the world. Projections indicate that for the next 10 years, the incidence is likely to increase. Oesophageal cancer is a dreadful form of cancer because of where it is found in the body and because the survival rates are so low.

In recent years, major advances in the management of oesophageal cancer have taken place. These include better staging of the disease, improved endoscopic techniques for curative treatment in its early stages to reduce the need for major surgery and better palliation of the more advanced stages of the disease. We can do more for patients who suffer from oesophageal cancer. We have to look critically and imaginatively at what can be done to assist this group, and other groups, of patients. If patient care is to be our focus, we need to look at patient care from the patient's point of view.

Many of our debates on health are pretty sterile. People can often seem to be chucking figures at each other from one end of the chamber to the other. What is important are patients and what happens to patients. I am angry about what happens to patients in some of our hospitals. I am angry about the time that they have to wait and about the misapplication of invasive techniques because diagnostic techniques are not in place. That is not the responsibility of one political party, but it is for all political parties to do something to put right the situation.

We can prevent much of the distress that patients suffer by engaging in better co-ordination and management. In Glasgow, oesophageal cancer is dealt with in three different places. Every surgeon says that the best people, equipment, research and resources should be concentrated in one place so that people get the best form of treatment. If we engage in a process of better management and co-ordination, we can assist people to make better use of the additional resources that are in the system. We need to focus our attention on the patient's needs and requirements throughout the patient's journey.

I disagree with one point that was made by Susan Deacon—there is a capacity problem in the health service. That is especially true in the area of diagnostic testing. We need more machines, equipment and organisation. That would speed up diagnosis. However, the additional resources will begin to make a difference to diagnostic testing and to improving elective surgery.

I agree that we have to focus our attention on the priorities of cancer care and cardiac care. If we do that, we can achieve better outcomes for patients.

Patricia Ferguson (Labour, Glasgow Maryhill)

Will the member please wind up.

Des McNulty (Labour, Clydebank and Milngavie)

We have, and can, achieve better outcomes for patients within the integrity of the NHS. Everybody in the Scottish Parliament would subscribe to that. We should not move outside the NHS, but we must work—

Patricia Ferguson (Labour, Glasgow Maryhill)

The member must now close.

Des McNulty (Labour, Clydebank and Milngavie)

We must work imaginatively to ensure that people get a better service.

Dorothy-Grace Elder (Independent, Glasgow)

The Tories really are one of the wonders of the ancient world.

Ben Wallace (Conservative, North East Scotland)

That is you.

Dorothy-Grace Elder (Independent, Glasgow)

You are older than me, sunshine.

Along with the hanging gardens of Babylon and the Colossus of Rhodes, the Tories are talked about, but defunct. However, a fresh breath of stale air seems to have wafted through their ranks since the election of their new leader—the well-known Mr what's-his-name.

In the Scottish Parliament, Tory members, led by Mary Scanlon, have served on the Health and Community Care Committee with distinction and without bias and they have produced some ethical work. However, when grouped together as they are today, only one collective noun can be applied to them—Thatcherism.

A direct attack was made, once again, on the national health service, but the health service is something that every member of the Scottish Parliament must be committed to defending. It is amazing to see the Conservatives continuing to promote zealously the principles of PFI and the private-public partnership. A Treasury committee regards PFI as outdated and attacked those principles in a report. The principles were also attacked in the Office of Health Economics report, which Margaret Smith, convener of the Health and Community Care Committee, mentioned.

Those distinguished bodies could find no PFI deal in Britain that could be proven to be worth more than a public deal. That would have to be the case as, for starters, thousands of millions of pounds are lost in the VAT shelter that is applicable to public, but not to private, deals. Before the first brick is laid, one finds a large open drain and starts to chuck public money down it. At the end of the day, in a PFI hospital deal, the public do not own one brick. Who would call that a good deal? Only the private market and the financiers would call that a good deal.

Phil Gallie (Conservative, South of Scotland)

Will whoever-it-is give way?

Dorothy-Grace Elder (Independent, Glasgow)

I say to the Conservatives that it is natural for the markets and the private financiers to call that a good deal. Do the Conservatives think that those institutions are into building hospitals because of their love for humanity? Oh, no. They are in it because of their love of lucre. That is the raison d'être for many in the Conservative party.

Phil Gallie (Conservative, South of Scotland)

Will the member give way?

Dorothy-Grace Elder (Independent, Glasgow)

To Phil Gallie, of course.

Phil Gallie (Conservative, South of Scotland)

Dorothy-Grace Elder is always generous.

The member attacks the Conservatives for their longings and desires for PFI. Surely we are no longer the party of government. Surely she should be looking at the Labour benches, as Labour members seem to have embraced the principles of PFI hook, line and sinker.

Dorothy-Grace Elder (Independent, Glasgow)

It has embraced it like something from "The Kama Sutra".

Brian Monteith (Conservative, Mid Scotland and Fife)

Which page?

Dorothy-Grace Elder (Independent, Glasgow)

It has indeed gone further than Phil Gallie's party. As my colleague Shona Robison said, it has stolen the Conservative party's clothes—after it had been stripped naked of all credibility—and run off with them and now it zealously pursues PFI, to no end whatever. The Minister for Health and Community Care says that there is no quick fix. I am terribly sorry, but I do not even see a slow fix emerging—not in Glasgow, where I operate.

The health minister must know from her constituency work the number of people who are trying desperately to have a simple operation done. Her statistics claim that, in Glasgow, for instance, the wait for a hip replacement operation is eight months. The reality is that people have a year's wait to get on the queue to wait for an operation—people in Glasgow, queueing for operations at the Glasgow royal infirmary, have to wait almost a year to see a consultant. Here is a letter from someone in the east end of Glasgow. The man says that his lifespan is limited, that he is in agonising pain and that he can wait no longer for the operation. Patients are deteriorating because they have to take so many painkillers.

I submit that the shambles that is the NHS in Scotland—under new Labour and inherited from the Tories—is cruelty to the Scottish public. I ask members to support the SNP amendment.

Iain Smith (Liberal Democrat, North East Fife)

Following that speech, I will try to restore some decorum and decency to the debate.

We should not doubt the commitment of every member to improving health care and services for patients. That is a priority of the Liberal Democrat-Labour partnership Government and has already resulted in record investment in the health service in Scotland and improvements to the way in which the NHS operates, such as streamlining and getting rid of the disastrous Conservative internal market.

However, no one pretends that all is well in the NHS in Scotland. We all recognise that it will take time to reverse decades of neglect, particularly under the Conservative Government. The NHS cannot be changed overnight. As David McLetchie said, the NHS was formed in 1948. For 35 of its 53 years, the Conservatives were in charge. No wonder it is in such a mess.

I agree with some of Des McNulty's points about diagnostic issues. Money alone is not enough. Huge capital investment in the NHS has been made, but that is not sufficient. We have to get more nurses, doctors and radiographers in place, which takes time. Nurses, doctors and radiographers cannot be conjured out of thin air; they have to be trained. One big area of neglect during the Conservative Government and the first two years of the Westminster Labour Government was the underinvestment in training for the various health professionals whom we need to improve the health service.

The SNP's amendment is typical of the SNP, as it fails to address any of the key issues.

Shona Robison (Scottish National Party, North East Scotland)

Will the member give way?

Iain Smith (Liberal Democrat, North East Fife)

I am sorry, but I have only four minutes.

Cleanliness is important with regard to hospital-acquired infection, but it is not the be-all and end-all. The public are being led to believe that, once our wards are sparkling clean, the problem of hospital-acquired infection will disappear. That is not the case. The issue is about control. The Liberal Democrats were the first to highlight the matter, during the general election. We called for a national strategy and, in particular, for the introduction of infection-control nurses and teams in every hospital. We believe that that is the right way forward. It will result in significant savings to the health service—money that can be reinvested in patient care.

I am confused by the SNP's amendment. It says that

"further private involvement in the delivery of health services is not in the interests of patients".

However, today's The Scotsman reports Nicola Sturgeon on the HCI project. She is quoted as saying that

"the deal would mean patients in Scotland will wait twice as long as their English counterparts before being referred by their NHS trust to private hospitals for treatment."

She says:

"This will further disadvantage Scottish patients who have been waiting too long for operations."

Does the SNP believe in private involvement or not?

Shona Robison (Scottish National Party, North East Scotland)

Will the member give way on that point?

Iain Smith (Liberal Democrat, North East Fife)

The member did not give way to me, so I will not give way to her.

The SNP contradicts itself. It wants one thing for some people and another thing for others. It either believes that people have to be admitted to private hospitals or it does not. It cannot say that it thinks the involvement of the private sector is bad for patients and then say that it is bad that that sector is not being given an opportunity in Scotland. That is a typical SNP contradiction.

As for the Conservatives, David McLetchie was right to address issues such as the backlog of ill health. The Liberal Democrats have long said that the problem with the national health service is that it is actually a national illness service. That was why health promotion has been an important part of the Liberal Democrats' commitments in government—£26 million a year will go into the health promotion fund.

David McLetchie referred to Joyce Smith's comments on the situation in Fife. I know Joyce well—we were councillors together in Fife for many years—but she has got this totally wrong. Under the Conservatives, Fife had the worst waiting lists and the longest waiting times in Scotland. We did not have a good health service under the Conservatives and no one should pretend otherwise.

The problem with the Conservatives is that they want a health service paid for by an acceptable level of taxation, but they do not tell us what that acceptable level of taxation would be or how much money they would spend. In particular, they do not tell us whether that acceptable level of taxation will comprise direct taxes such as income tax or whether it will comprise the charges that it will impose on people, such as prescription, eye and dental charges. The Conservatives are dishonest on taxation and dishonest about the health service.

Richard Simpson (Labour, Ochil)

David McLetchie's interesting analysis, which I listened to carefully, contains many truths. I welcome his acknowledgement of his own part in the sterile inter-party debate that has gone on. I would not call it a debate, however; I would call it scrapping. To call Susan Deacon the worst health minister that we have ever had is pretty rich coming from the party that spawned Michael Forsyth, a total zealot who gerrymandered the health service.

The Conservatives' solution, which was outlined in the second part of Mr McLetchie's speech, is not about pragmatism—which we embrace—but about the creation of a much more substantial private sector. One of my constituents recently had a heart operation in HCI. He was given a deadline by which he would either receive the operation in the public sector or at HCI. When that deadline approached and it was clear that he was not going to have the operation in the public sector because of winter pressures, for example, he had it at HCI. That certainty was important to him and his family. That sort of pragmatism—using the extra capacity of the private sector—is not a problem. The Scottish health service is using the private sector for about 5 per cent of services.

Our pragmatism and the creation of the one-stop clinics—as Susan Deacon said, there are now 300 of them—have meant that another of my constituents was seen in 48 hours at the pain clinic. That was followed up by NHS cardiac laboratory results inside a week and a triple bypass inside three weeks. That is faster than anything I could have achieved for my private patients when I was in practice. That is pragmatism and prioritisation and it is partly what this issue is about.

Ben Wallace (Conservative, North East Scotland)

On privatisation and coming to an arrangement with the private sector to use spare capacity as the need arises, does the member agree that it is perhaps better to do that on a nationwide basis—as has been done in England—so that we get best value for money?

Richard Simpson (Labour, Ochil)

No, I do not. If we set specific waiting times and invite the now unified health boards to spell out those waiting times to their local populations, those should be guarantees, beyond which we use the private sector. Alternatively, we should use other health boards, if that is appropriate and if they have no waiting times, as can happen. That is a totally pragmatic approach. We do not need a national concordat in Scotland.

Although pragmatism is important, so is the building of capacity. I referred in my intervention on David McLetchie to the fact that the number of nurses in Scotland fell by 4,500. We have increased the number to previous levels and are just about to go beyond that. We will have a 15 per cent increase on the planned levels over the next few years. We are improving retention and reducing drop-out rates, although that is still a significant problem and we are not pretending that it has been completely solved.

Doctors are also important. The consultants that Susan Deacon talked about employing do not just drop out of thin air. We have decided, on a UK basis, to increase the number of medical students from 5,000 to 7,500, but that increase will take time to come through. We are building capacity for the long term. As Susan Deacon said, we are not going for a quick fix.

Des McNulty gave the best example of the problems that are created by the internal market—the three oesophageal cancer centres in Glasgow. In my constituency in the Forth valley, competition between Falkirk and Stirling meant that, every time Stirling appointed a consultant, Falkirk had to appoint a consultant, too. That is totally inappropriate for the size of population in the area.

The immediate task of restoring the structure that will create the public sector ethos is now almost complete, and I welcome that. We now have the beginnings of a truly patient-focused, accountable service, whose modernisation is important. In modernising, we must have an open debate with the professions about their undoubted territoriality. As with some politicians, there are medical politicians who need to be told that shouting from the rooftops is inappropriate. I am not talking about the generality of health service staff, who are excellent, get their job done and are a caring set of professionals. However, there is no doubt that some professionals simply shout "Rubbish!" from the rooftops.

What Shona Robison said about Hairmyres sounded reasonable until she said that profit was unacceptable. Some profit is always involved in a private contract, so that is not a problem. I have not had enough time to speak at length about the SNP, but I think that it should look carefully at the Finance Committee's PFI investigation, which I believe will show that the transfer of risks is important in the PPP.

Murdo Fraser (Conservative, Mid Scotland and Fife)

On Monday evening, Tayside Health Board and the Tayside NHS trusts held a public meeting in Forfar to present their annual report and accounts. No members of the public turned up. In light of the fact that the NHS in Tayside accrued a cumulative deficit of £16.7 million over the past two years, it is perhaps not surprising that members of the public show no interest in hearing the presentations of health service managers. That is regrettable, because a lot of time and effort must have gone into preparing those presentations.

It is clear that the focus of interest of health service users in Tayside is on patient care, not on reports and not on well-publicised overspends. There is a perception locally that patient care and the interests of health service users have been ignored in recent years. At a time when the future of Stracathro hospital in Brechin, which has served Angus and the Mearns well over many years, is still uncertain, and as Perth royal infirmary will maintain maternity and children's services only because of the tireless efforts of local campaigners who took on the bureaucrats and won, it is hardly surprising that the public are somewhat disenchanted with the local health board.

Across Tayside, patient groups have spent the past two years fighting to ensure the provision of the best possible locally provided health care, whether at Stracathro, at Perth royal infirmary or more locally, and I applaud their efforts. We should remember that the reason given by Tayside Health Board for the removal of acute services from Stracathro was the budget deficit. Now that the minister has announced that the deficit is to be written off, will she tell Tayside Health Board that the acute services have to go back to Stracathro? That decision has to be reviewed.

Richard Simpson (Labour, Ochil)

Murdo Fraser should be aware of the fact that the overwhelming majority of community hospitals in Scotland were closed by his party. It was the Conservatives who removed local care instead of adapting it, and it was only in the last few years of their Administration that they suddenly realised that that might be a big mistake and conducted a review that concluded that it was a big mistake.

Murdo Fraser (Conservative, Mid Scotland and Fife)

Richard Simpson will appreciate that Stracathro is not a community hospital. It was an acute hospital.

Richard Simpson (Labour, Ochil)

Murdo Fraser referred to local services.

Murdo Fraser (Conservative, Mid Scotland and Fife)

Stracathro was an acute hospital, and it is the removal of the acute services from Stracathro that concerns me.

I welcome the introduction of schemes such as care together in Perth and Kinross, and I am delighted that PRI will be a demonstration model for the delivery of maternity services in Scotland through the introduction of midwife-consultant partnerships. However, I am concerned that there is still uncertainty about the long-term future of paediatric services at PRI. I have met many parents from across highland Perthshire, some of whom have to cover great distances to get access to maternity services. It is for them that we must ensure 24-hour cover. Mothers must be given the choice of giving birth at their local hospital and we must ensure that, wherever possible, first-class local services are available.

Shona Robison (Scottish National Party, North East Scotland)

Will Murdo Fraser give way?

Murdo Fraser (Conservative, Mid Scotland and Fife)

I am running out of time.

I welcome moves to improve health care provision in Angus, another area where patients often have to make long journeys to receive care. It is vital that the new hospital that we are promised for Angus is constructed on the Stracathro site and not at Arbroath or elsewhere in the county. The necessary infrastructure is already in place at Stracathro and the site is readily accessible from most parts of Angus. Most important, an excellent, dedicated work force is already available. The economy of north Angus, which has suffered a great deal in recent years and months, needs the jobs at Stracathro. Just as there was a cross-party campaign to fight for services at Stracathro, I hope that there will be a cross-party campaign to fight for the new Angus hospital to go to the Stracathro site. It should not be elsewhere in the county and, in particular, it should not be split between different sites.

It is essential that any future changes to health care in Tayside take into consideration the need to ensure that the patient's experience is a satisfactory one. Transportation of patients to and from hospital, and arrangements for visitors, are issues that directly affect an elderly patient's experience of hospital.

Communication systems between those who deliver health care and those who receive it must be improved. In its report on the consultation on the acute services review, Tayside Health Board concluded:

"It is no longer sensible to plan services in any one part of the system in isolation."

I am sure that none of us would argue with that sentiment. It is for the Parliament to ensure that every person in Scotland receives the highest possible standards of health care.

David (None, Lothians)

We are running out of time, so there will be only one more speech in the open debate. I call Stewart Stevenson.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I remind members of the voluntary declarations that I have made in the register of members' interests with regard to my pension from the Bank of Scotland and my shareholdings there. I do that because I have been one of the happy beneficiaries of PFI. Bankers everywhere love PFI and, when we come to the nub of the matter, this Tory debate is about money. In fact, I am holding a bank note that depicts one of the most famous Tories of the 19th century, Sir Walter Scott, who is immortalised on our money even today.

Brian Monteith (Conservative, Mid Scotland and Fife)

Will the member give way?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

We are very short of time. Perhaps Brian Monteith and I can discuss his point privately.

Let me give credit to the Tories. In their 160-word motion—quite the longest sentence that I have seen for a long time—the 15th word is "PFI". At least they are honest about PFI being their policy. In a 10-minute speech, the minister got to 10 minutes and 38 seconds before she mentioned PFI, and yet that is at the core of the policy that the Government is pursuing.

It has been said that there are three kinds of bankers: those who can count and those who cannot. Well, even a former banker like me—[Laughter.] They got it. Good. The Tories are awake. Well done. Even a banker who cannot count can see that this debate is about money. The Tory motion is about money, not health.

Richard Simpson made some interesting remarks about community hospitals, building on what Murdo Fraser said. The minister referred to the Arbuthnott formula. In Grampian, 10 per cent of Scotland's population now receives 9 per cent of health funding, and community hospitals are under threat as a result. In my constituency, the Chalmers hospital in Banff, which has been promised redevelopment for 10 years, is now under serious threat. Community hospitals are a cost-effective way of delivering health care.

Competition has been mentioned, but I have to ask whether it really drives up standards. Supermarkets, which are at the forefront of competition in this country, deliver cheap food rather than quality food by and large, and the Labour party is the McDonald's party rather than the new party. However, what concerns me most about PFI is much more long term. PFI locks us into long-term commitments—typically for 30 years—and that is a big threat to community health care. We cannot get out of paying for those large facilities that are being developed in many places through PFI.

Mary Scanlon (Conservative, Highlands and Islands)

Will Stewart Stevenson give way?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I am sorry, but I am in my final minute.

If we are going to have to focus the expenditure when it is reduced by the Arbuthnott formula, as it has been in Grampian, we will be at serious risk of not delivering the health service that people want.

I shall conclude with a personal recollection of how patients feel. In the 1970s, when I was doing some parachuting, I came out of a plane, looked up and saw that my parachute had not opened.

Mary Scanlon (Conservative, Highlands and Islands)

Had the member packed it himself?

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Yes, I had packed it myself. I plummeted towards the ground, but the reserve parachute saved me.

David McLetchie (Conservative, Lothians)

Aw.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Well, that is why I am here today.

These days, many of the people who are on NHS waiting lists feel exactly as I felt 25 years ago as I plummeted towards the ground. PFI is taking money out of the health service that we should be spending on health, not on bankers' profits.

David (None, Lothians)

We now come to wind-up speeches. As we are over time, it would be helpful if members could take less than their allotted time.

George Lyon (Liberal Democrat, Argyll and Bute)

I shall try to be brief.

I welcome yesterday's statement by the Minister for Health and Community Care to the effect that all NHS trust debts will be written off. That demonstrates to the Scottish public the fact that the coalition is committed to improving health care and the fact that that we are making substantial increases in investment in our health services. I shall raise some points specifically on rural health services.

Since the Lib-Lab coalition came to power, investment in the NHS has risen dramatically, which is to be welcomed. That investment is beginning to pay dividends on the ground. In my constituency, there is the prospect of a new hospital. Improvements are being made to medical centres and there has been a general improvement in services. Nevertheless, there is still a fundamental problem in delivering better services in rural areas.

During the summer, Margaret Smith and I spent three days touring my constituency, visiting hospitals, meeting general practitioners and finding out from the front-line troops what specific problems they face daily. The simple message was delivered to us time after time that the fundamental problem that faces general practitioners, nursing staff and practice nurses in the delivery of better services is the recruitment and retention of staff.

The provision of decent housing for medical staff in rural areas is often an issue. GPs also told me that a big issue is partners' jobs. If the partner of a GP working in an urban area wants a career, there is no problem, because the partner would be guaranteed a job. However, in rural Scotland—in small villages and towns such as Campbeltown—that possibility does not exist, which puts a lot of people off applying for jobs. If their partners cannot secure a job that has career prospects, medical staff are not willing to move to those areas.

Probably the biggest issue, however, is out-of-hours work for GPs in community hospitals. In Campbeltown, some GPs are on call for three or four days a week, which is a huge commitment. They are not on call only as GPs, but as hospital doctors. That can mean up to four or five hours' work a night if there is an emergency in the area. I hope that that issue will be tackled.

A document has been produced by our lead GP, Eric Jesperson, on behalf of the local health care co-operative in my constituency, entitled "Integrating primary and community emergency care services within Argyll and the Islands". That document was commissioned and paid for by the Scottish Executive and contains many good suggestions for ways in which we might tackle the problems. The issues that arise in my constituency arise throughout rural Scotland, so I hope that the minister will look closely at the recommendations in the document, and that the coalition Government will implement some of them.

The Tories' motion calls for the Executive to

"improve standards of health care to the levels of the best European countries without raising taxes to unacceptable levels".

None of the Tory speakers has defined what on earth an unacceptable level of taxation might be. Of course, we all know what the Tories think—Oliver Letwin, the new shadow Home Secretary, certainly has a view on public spending and taxation, which is of cuts worth £20 billion. Iain Duncan Smith is on record as saying that public spending should be reduced to 35 per cent of gross domestic product. The only way in which the Tories can square the circle of making those cuts while bringing health care up to the levels of the best European countries is to abandon the principle of free health care at the point of delivery. The Liberal Democrats and the other parties will oppose that tooth and nail.

Colin Campbell (Scottish National Party, West of Scotland)

I will deal with the Swiss issue first. When my late father was first lectured to in Edinburgh University on the subject of tuberculosis, he was told that sending people to sanatoria did no good and that they might as well be quietly put down. Fortunately, the situation moved on a bit during his career as a chest specialist and he saw tuberculosis off. However, the notion that sending people to Switzerland was a ringing endorsement of privatisation, rather than something pragmatic, is naive to say the least.

Mary Scanlon (Conservative, Highlands and Islands)

I should point out that I did not connect tuberculosis patients with privatisation. I was speaking in the context of the European Court of Justice ruling.

Colin Campbell (Scottish National Party, West of Scotland)

Thank you. I will crack on.

All of us have been in hospitals and have sat with people in the casualty department. We will have been aware that the staff were harassed, overworked and thin on the ground. Indeed, we know that throughout the UK, the health service is trying to recruit people from abroad to make up the numbers. We all recognise the problems and I am confident that we would all try to address them if we were in power.

Susan Deacon got a little bit tetchy about one specific visit to one particular hospital. However, on three occasions recently, I have spoken to various representatives—senior and not so senior—on health boards and it is clear to me, even from the coded language that officials use, that they are a bit short of dough and resources.

I find it incredibly crass that the Tories lodged the motion. Their doctrines produced the experience of PFI—I suppose that they are proud of that. When PFI was introduced, the SNP objected to it on principle, as did the Labour party. The SNP objects to it on the ground that it duplicates the negative aspects of hire purchase: the product can be had sooner, but the eventual price will be greater. That has been known to people for a long time. Paying for hospital construction from Government resources is the cheapest and most sensible option. We agree with Margaret Smith on that point.

In Iain Smith's slight assault on Nicola Sturgeon, he missed out the last part of the quotation—which of course is good politics. Nicola Sturgeon was quoted as saying that the deal

"shows the absolute absurdity of the NHS being reliant on the private sector".

I wonder what the purpose of the motion is. Is it a self-congratulatory memorial to a Tory initiative? Is it designed to test Labour's support for PFI, which it took on board from the Tories? Is it supposed to find whether there are chinks in Labour's commitment to PFI? If it is, I must point out that I have not seen any so far—I have heard none of the Labour members railing against PFI. Is it a doctrinaire attempt to give succour to the independent sector in health and to aid and abet those whose motives, however pure, are underpinned by the profit motive? The Tories seemed to object when Shona Robison suggested that that might be the case. Methinks they did protest too much.

My bottom line on health is that when I require health care—non-urgent or urgent—it should be provided timeously, efficiently, compassionately and to the highest professional standards. I believe—as, I am sure, all members do—that that applies to every citizen of Scotland. Health care should be free at the point of delivery. We all agree on the objectives: we want the very best—a world's best standard—for all our citizens. That will not come cheap.

It is interesting that, as George Lyon pointed out, the Tories did not address the part of their motion that talks about improving services

"without raising taxes to unacceptable levels".

I wondered what they meant by "unacceptable levels", but they did not tell us. Do they mean unacceptable levels of income tax or indirect taxation, which has gone up by the equivalent of 8p in the pound since Labour came to power in 1997. Is that little phrase an admission that Mrs Thatcher's policy of slashing direct taxation was a mistake or that that policy—and Labour's subsequent commitment to it—is a major reason for the resource shortcomings in the NHS?

The Tories' choice of motion raises more questions than they can hope to answer. It highlights the party that led the nation to starvation of resources in health and local government, reduced employment and depressed large sections of the population—probably some of them clinically. The motion reminds us of a party that increased the number of hospital managers from 523 in 1991 to 2,392 in 1996 and reduced ancillary staff from 15,000 to 11,000. I cannot believe that the Tories have been naive enough to embrace the motion and thus draw attention to their appalling record. I exhort all MSPs of intelligence, perception and sense to vote for the Scottish National Party's amendment.

Malcolm Chisholm (Labour, Edinburgh North and Leith)

The debate has been good. On a day on which there is good news for the health service in Tayside, I welcome the pupils from Lochee Primary School, which is in Kate MacLean's constituency.

We all appreciated the first half of David McLetchie's speech. He made an interesting point at the beginning: the majority of people are satisfied with the treatment that they get from the health service, but still have serious concerns about the health service as a whole. We need to remember such facts and perspectives in any health debate.

Clearly, for many people, treatment is good. In fact, it is getting better in many cases. For example, Richard Simpson reminded us of the one-stop clinics that are fast-tracking treatment for so many people. In the context of the references that many members made to heart surgery we should remember, for example, that the median wait for coronary artery bypass grafts is down from 120 days in March 2000 to 73 days in March this year.

There is progress, but we acknowledge the problems that remain. The 89 weeks' wait to which David McLetchie referred is totally unacceptable. Indeed, I used those words in letters to Wendy Alexander and Hugh Henry who wrote to me on that subject.

Mary Scanlon emphasised the importance of waiting for the first out-patient appointment. We are certainly focusing on that now, although I say to Dorothy-Grace Elder that the median wait for the first orthopaedic appointment in north Glasgow is three months not, as she said, a year.

More controversially, in the second part of his speech, David McLetchie turned his attention to the independent sector. We have nothing against the independent sector: I met the Independent Healthcare Association recently. We are supportive of the voluntary health sector and have several new initiatives for it. Many health boards also use private hospitals. The fact is that the independent health care sector has a role to play, but the size of that sector in Scotland is not remotely comparable to its size in England. There are already local links between the NHS and independent providers and we can see no reason to change that to a national relationship, because it would add no value.

David McLetchie (Conservative, Lothians)

Is the minister aware that his department, in an answer from the Minister for Health and Community Care over a year ago, told me that it collated centrally no information about links between health boards, health trusts and the independent sector in Scotland?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

Such links are a matter for local determination. The lack of information does not mean that such links do not happen.

In the second half of his speech, David McLetchie veered towards the traditional Tory dogma—private sector good, public sector bad. Shona Robison, however, appeared to turn that on its head. We are quite happy to use both sectors. We are proud to be supporting the largest building programme in Scotland since the NHS was established. That means funding some new hospitals by PPP, but it also means using traditional funding. Traditional capital expenditure has increased from £136 million when Labour came to power in 1997 to £295 million this year.

Shona Robison (Scottish National Party, North East Scotland)

Is the minister equally happy that 500 staff have had to be lost from the Edinburgh royal infirmary due to the costs of PPP or PFI?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

There has been a lot of activity to protect the rights of staff under PPP contracts. That is one of the main changes that we have made to the arrangements that we inherited. Margaret Smith was absolutely right when she said that we should be driven by what delivers best quality patient care.

Shona Robison talked a lot about cleaning services. Earlier in the year, we said that contracting out of cleaning services should no longer be the norm. We are therefore now following the principle that I quoted from Margaret Smith. For the first time, there are national standards for decontamination, cleaning services and infection control. Those standards will be closely monitored. The new Clinical Standards Board for Scotland will establish and oversee those new standards.

David McLetchie pointed out that standards differ in different parts of the country and he proposed competition as the answer to that problem. That has been tried and it has failed. We are rebuilding the NHS as a national service—partly through new bodies such as the Clinical Standards Board for Scotland and partly through the new performance assessment framework, which is starting this year. That framework will examine standards and will also consider issues such as public involvement and other issues across the board.

Mary Scanlon (Conservative, Highlands and Islands)

Will the minister give way?

Malcolm Chisholm (Labour, Edinburgh North and Leith)

I might give way in a minute, but I am running out of time so I had better press on.

Des McNulty and Richard Simpson referred to capacity problems. Those problems exist and Susan Deacon acknowledged that. However, they do not exist on the same scale as they do in the rest of the UK. Shona Robison used the figure of 1,000 fewer nurses—a figure that has been thrown around recently by the SNP. The fact is that there are 450 more qualified nurses now than there were when Labour came to power. We must also remember the closing of learning disability hospitals, which meant a reduction in the numbers of nurses, although they might still be working in the community.

Des McNulty also referred to cancer and to oesophageal cancer in particular. Recently, I was pleased to visit Gartnavel hospital to talk to the gastrointestinal surgeons. We clearly acknowledged, in the recently published cancer strategy, the capacity issues in relation to cancer. I am pleased to see that there have been two new radiotherapy machines installed at Gartnavel. I was also pleased to see new endoscopy equipment.

The cancer strategy and many other initiatives that were announced over the summer all have extra sums of money attached to them. We all know that results matter, but results cannot be achieved without money. Members should remember that there has been an increase in funding of more than £0.5 billion from last year to this year and that there will be an increase of more than £0.5 billion from this year to next year. There have not been such sustained funding increases under any Government in recent times. Everybody should welcome that important development.

The new distribution formula takes account of deprivation and rurality. I hope that that meets with the approval of George Lyon, who majored on that topic. The Executive has already established an expert group—the remote and rural areas resource initiative—to develop responses on the delivery of health care in remote and rural areas. RARARI has established a short-life working group to examine specific recruitment and retention issues that affect staff in the full range of national health service work.

My time is up. I thank members for their contributions to an interesting debate. I hope that everybody will acknowledge the progress that has been made and accept that we know that there is a long way to go.

Ben Wallace (Conservative, North East Scotland)

I thank the Minister for Health and Community Care and I welcome the new money that was paid yesterday to Tayside Health Board to cover up its deficit. As identified by Professor Clark, many of the problems in that health board were management problems. It was right to prevent patients in that region from being punished for those failings.

Alan Milburn, the Labour Secretary of State for Health, said:

"I honestly couldn't sit here and say that for some bizarre ideological reason I was not prepared to contemplate the use of spare private sector capacity in private sector hospitals for the benefit of NHS patients if they are waiting in pain and discomfort."

Closer to home, Iain Smith was right to highlight Nicola Sturgeon's remarks about how the use of HCI by English patients from Merseyside would disadvantage Scottish patients, who would end up waiting longer—far too long.

Shona Robison (Scottish National Party, North East Scotland)

Will Ben Wallace give way?

Ben Wallace (Conservative, North East Scotland)

I will come to Shona Robison in a minute, so there is no need to give way to her. After four and a half years under the present Government, I am afraid that Susan Deacon's record does count. Patients are waiting longer, and more of them are waiting. They are experiencing services that are much worse than when we left office. Some of the Government's targets are only just on course to match in about two years' time the targets that we left it with.

I believe that Labour has forgotten about patients. Contrary to Johann Lamont's comments last week—to the effect that no one will trust the Tories with the NHS—people are quickly seeing that we were getting it right and that some of Labour's major policy objectives are failing and failing badly.

The fact that Susan Deacon did not even recognise that there was not spare capacity in the NHS is worrying and Des McNulty pointed that out. One reason why waiting times are increasing is that lack of capacity. Who are we not to use the spare capacity that might be on offer today or tomorrow to prevent patients from having to wait in pain and suffering?

Susan Deacon (Labour, Edinburgh East and Musselburgh)

Will Ben Wallace kindly acknowledge that the NHS uses the private sector in Scotland to deal with capacity issues? Those capacity issues exist in the NHS in Scotland, but the scale and concentration of those capacity issues is not on a par with certain other parts of the UK.

Ben Wallace (Conservative, North East Scotland)

I acknowledge the minister's point, but why are waiting times still growing larger in many sectors if there is spare capacity? Why are people not being sent to use the spare capacity in HCI? I rang Liverpool Health Authority this morning. People waiting for cardiological treatment wait less time in Merseyside than any normal NHS patient in Scotland, yet it was still felt best to cut their waiting time by using HCI's capacity. If the Executive cannot explore such options, it is doing a disservice to patients.

Malcolm Chisholm (Labour, Edinburgh North and Leith)

Will the member give way?

Ben Wallace (Conservative, North East Scotland)

I must push on.

Much of the root of the problems lies in the differences between our Minister for Health and Community Care and the Secretary of State for Health for England and Wales. His reform and action plan is called "The NHS Plan: A plan for Investment. A plan for Reform". He builds on our reforms, going back to 1979, and at the same time strives to achieve best value for patients in England and Wales. Our action plan, "Our National Health: A plan for action, a plan for change", however, wants to change us back to how we were in the 1970s—pre-Griffiths report—to vandalise the empowerment that general practitioners got through fundholding and to remove any element of private partnership or contracting out.

This is the point at which to turn to Shona Robison's amendment. She obviously did not read the Audit Scotland report of a year or two ago, which clearly identified the fact that the main reason for hospital-acquired infections is lack of controls, lack of strategic plans on infections and lack of personal hygiene. Until recently, the only in-house cleaning contract—in Tayside Health Board—had the worst record in Scotland. That does not show that public is best, nor that private is bad.

Shona Robison (Scottish National Party, North East Scotland)

Is Ben Wallace really trying to tell me that a fivefold decrease in the number of domestic staff working in hospitals could in some way have helped maintain clean hospitals?

Ben Wallace (Conservative, North East Scotland)

If Shona Robison had read Audit Scotland's study, she would have seen that it was predominantly about control teams. The Executive has rightly introduced infection control and staff to make sure that the problems in that area are put right. It is not about numbers of people. Shona Robison claimed that 500 people are losing their jobs because of the opening of the new Edinburgh royal infirmary. There is something called efficiency—sometimes it works better.

I turn now to the points that were made by Richard Simpson—the pragmatist in an ideological party. He talked about publishing waiting times for health boards and commissioning from one board to another. That sounds a bit like league tables and a form of internal market to me.

I agree with Des McNulty that there were problems with fundholding and that there was fragmentation, but Labour did not have to throw the baby out with the bath water, something that I have heard previously from the Labour benches in relation to the Conservatives. When fundholding was introduced—when 25 per cent of the United Kingdom was covered by fundholding—£65 million was saved by GPs. GPs were allowed to reinvest that money in their practices for treatment on the front line; it was not skimmed off for tax cuts. There were a many very good things about fundholding, and we will not apologise for that.

George Lyon talked about acceptable taxation. We do not want to put in a penny this year, two pennies next year and so on. Where would the Liberal Democrats stop? Drug inflation is running at 10 per cent a year. Do the Liberal Democrats intend to keep raising the rate of income tax by 1p in the pound? To give it its due, the Labour party has matched the Liberal Democrats' spending commitments and doubled them, without raising taxes by the 1p that the Liberal Democrats continually boast about. We do not want an open-ended commitment. We want to tackle the problems of the NHS for the future. We want to give the NHS a future. To do that, we must start a debate on rationing and on ideology—on what is best done by the private sector and what is best done by the public sector.

Dorothy-Grace Elder talked about sending people abroad. We should remember that in the SNP's Scotland, Carlisle and Newcastle are abroad. As for her reference to the "Kama Sutra", on policy the SNP has had more positions than the "Kama Sutra". Funnily enough, I noticed that the SNP spokesman on defence was present in the chamber this morning. He was obviously trying to avoid the debate on NATO that is taking place in Dundee. However, we do not want to talk about that.

The Scottish Conservatives can live with the compliment that many of the hospital building programmes that have been commissioned were started by us. We can live with the compliment that PFI is an acceptable way of funding some projects, although not all projects. However, we will not stand by while patient care is put to one side for ideological reasons. We want to build an NHS for the future. We will be brave enough to discuss the future funding of the NHS. We will be brave enough to discuss rationing and what we can and cannot do. I urge members to support the Conservative motion.

Business Motion

David (None, Lothians)

The next item of business is consideration of business motion S1M-2235.

Motion moved,

That the Parliament agrees the following programme of business— Wednesday 26 September 2001

2.30 pm Time for Reflection followed by Executive Debate on its Support for the Voluntary Sector followed by Motion on the Publication of the Ombudsman for Scotland Annual Report 2000-2001 followed by Parliamentary Bureau Motions

5.00 pm Decision Time followed by Members' Business - debate on the subject of S1M-2221 Irene Oldfather: European Languages Day Thursday 27 September 2001

9.30 am Scottish National Party Business followed by Business Motion

2.30 pm Question Time

3.10 pm First Minister's Question Time

3.30 pm Stage 1 Debate on the Police and Fire Services (Finance) (Scotland) Bill followed by Parliamentary Bureau Motions

5.00 pm Decision Time followed by Members' Business - debate on the subject of S1M-2054 Margaret Smith: RCN Scotland's "Value Nurses" Campaign Wednesday 3 October 2001

2.30 pm Time for Reflection followed by Executive Debate on a Forward Strategy for Agriculture followed by Parliamentary Bureau Motions

5.00 pm Decision Time followed by Members' Business - debate on the subject of S1M-2118 Mrs Mary Mulligan: Oxfam Thursday 4 October 2001

9.30 am Committee Business followed by Business Motion

2.30 pm Question Time

3.10 pm First Minister's Question Time

3.30 pm Executive Business followed by Parliamentary Bureau Motions

5.00 pm Decision Time followed by Members' Business - debate on the subject of S1M-2098 Christine Grahame: Borders Children with Special Education Needs—[Euan Robson.]

Fiona Hyslop (Scottish National Party, Lothians)

I have some concerns about the motion that is before the Parliament. On Tuesday, when the Parliamentary Bureau discussed the business timetable, we were unaware of information that has since appeared in the press and in a written answer yesterday. We would like to know how on earth the Government managed to underspend this Parliament's and the public's money by more than £700 million. We would have expected an explanation to be provided in a ministerial statement.

It is interesting to note that the Minister for Finance and Local Government had an unfortunate experience when making ministerial statements in the chamber. On 28 June, he thought it appropriate to make a statement in the chamber about a budgetary matter that involved only £489 million in new money and realignment cuts. However, he is unable to make a statement to Parliament on a matter involving almost double that amount.

Although I am minded to oppose the business motion, on this occasion I will support it. However, the matter that I have raised should be referred back to the Parliamentary Bureau for its meeting next week.

Euan Robson (Liberal Democrat, Roxburgh and Berwickshire)

I hear what Fiona Hyslop is saying. There is an opportunity to raise the matter to which she alludes at next Tuesday's meeting of the Parliamentary Bureau. Equally, the SNP could have the issue debated as part of Opposition business.

The underspend should not come as a surprise to Fiona Hyslop, because on 8 June Peter Peacock made it clear to the Finance Committee that

"In the short term, the committee can expect there to continue to be significant sums of EYF."—[Official Report, Finance Committee, 8 June 2001; c 1335.]

I do not doubt that we can discuss the matter on Tuesday.

Motion agreed to.

Question Time — Scottish Executive

Cathie Craigie (Labour, Cumbernauld and Kilsyth)

To ask the Scottish Executive what discussions have taken place between it, Strathclyde Passenger Transport and ScotRail regarding the provision of parking at Croy railway station for travellers wishing to travel from Croy by train. (S1O-3784)

Sarah Boyack (Labour, Edinburgh Central)

That is an operational matter for ScotRail and Strathclyde Passenger Transport Executive, but I understand that there are on-going negotiations on the matter.

Cathie Craigie (Labour, Cumbernauld and Kilsyth)

I understand the minister's reply. The extension of services from Croy station to Glasgow and Edinburgh has been a great success in encouraging many more people to travel by train, but the station has been a victim of that success because it is unable to provide adequate parking. I have had discussions with those who are involved, but I ask the minister to do all in her power to encourage Strathclyde Passenger Transport Executive and ScotRail to examine long-term solutions and provide adequate parking at the station, which would encourage many more people to use the service.

Sarah Boyack (Labour, Edinburgh Central)

I am happy to acknowledge that the member has been trying to persuade the two parties to get moving on this issue. Being able to access directly the Edinburgh and Glasgow services has been a huge benefit to people in the Croy area. As the member said, we now have a car-park problem because so many people are using the station. I am happy to make people aware that there are opportunities under the public transport fund for operators and local authorities to work together to submit partnership bids. However, we will have a while to wait because we have just gone through the round for this year's public transport fund. I hope that the fact that Cathie Craigie has raised the issue and has been pursuing it will lead to a speedy resolution in the next year.

Andrew Wilson (Scottish National Party, Central Scotland)

I endorse Cathie Craigie's sentiments. I ask the minister whether she will go one stage further and take an active interest by meeting local representatives of all interested bodies and parties. Negotiations between the local landlord and the public agencies that have been referred to have been going on for three years. In the letter I have in my possession just now—

David (None, Lothians)

Order. Supplementaries must be brief, according to standing orders. They cannot be statements.

Andrew Wilson (Scottish National Party, Central Scotland)

Right. So if I may continue and clear up my point—

David (None, Lothians)

No. Can we have the answer, please?

Sarah Boyack (Labour, Edinburgh Central)

I accept the member's point that he wishes action to be taken on the issue, as does the whole chamber. It would be highly inappropriate for me to involve myself in land-acquisition negotiations on every railway issue in the country. The key issue is that ScotRail and SPTE work together with the council, as Andrew Wilson suggested.

Brian Fitzpatrick (Labour, Strathkelvin and Bearsden)

As MSP of the next-door constituency and neighbour of Cathie Craigie in the chamber today, I am grateful for her work with ScotRail and SPTE. This morning, I saw evidence at Croy station of people from my constituency parking in Cathie Craigie's car park, so will the minister assist us to maintain fraternal relations by examining how she may use her good offices with ScotRail to improve the frequency of stops at Lenzie and Bishopbriggs, which would reduce our perhaps excessive demands on Cathie Craigie's car park?

Sarah Boyack (Labour, Edinburgh Central)

That was a helpful contribution. Access to our railway network is a key issue, on which the public transport fund and discussions on the next franchise come into play, as it was a clear issue in the consultation exercise that we conducted last year. I am happy to reassure Brian Fitzpatrick on that point.

Colin Campbell (Scottish National Party, West of Scotland)

To ask the Scottish Executive what plans it has to fund increased numbers of uniformed police and police support personnel. (S1O-3786)

Jim Wallace (Liberal Democrat, Orkney Islands)

The numbers of police officers and police force support staff in Scotland have reached record levels. The funding that we have put in place for the police service should be sufficient to sustain those increased levels. However, as Mr Campbell will know, decisions on the deployment of police officers and police support staff are a matter for chief constables.

Colin Campbell (Scottish National Party, West of Scotland)

The minister will understand that I understand that it is chief constables' business to deploy their police. Does the minister agree that there are too few police available when members of the public need them; that communities feel let down when their community police are withdrawn for demonstrations and emergencies; and that police managers have difficulty in matching their human resources to Scotland's needs? Does he agree that a £3 million contribution would provide for a further 1,000 police? Will he press for such expenditure?

Jim Wallace (Liberal Democrat, Orkney Islands)

We should perhaps get the issue into perspective. When I announced the investment of an additional £8.9 million for police recruitment in May 2000, the number of police officers stood at 14,699. The latest available figures show an increase over that period of 413 to 15,112. We expect current levels to be sustained as police forces increase their intake of recruits. Support staff numbers have increased over that same period by 184 to 5,340.

I take Mr Campbell's point about visibility. He may be aware that HM chief inspector of constabulary is undertaking a study on the impact of police visibility; public reassurance; the accessibility of policing, given modern technology; and how best to deal with demands. Ultimately, those are matters of deployment for chief constables, but there can be no doubt that the Executive is making resources available to have police numbers at record levels.

James (Conservative, Lothians)

Is the Deputy First Minister aware that although extra police have been drafted in for the Scottish Parliament police unit, the Executive pays for only 75 per cent of their cost? As those officers are serving the interest of Scotland as a whole, does he not think that that is unfair and that the matter should be rectified?

Jim Wallace (Liberal Democrat, Orkney Islands)

I am aware that there is an issue regarding the Parliament's contribution to police funding when the Parliament is in session—obviously the same officers are kept when Parliament is not sitting. That matter is under active discussion between the Scottish Executive and the chief constable of Lothian and Borders police.

Dennis Canavan (Independent, Falkirk West)

Does the minister agree that in the campaign against crime it is not just police numbers that are relevant but the size of police forces and the areas that they cover? Will he take this opportunity to reject any suggestion that one police force should cover the whole of Scotland, bearing in mind the good track record of many smaller forces, such as Central Scotland police, in crime detection and community relations?

Jim Wallace (Liberal Democrat, Orkney Islands)

Yes.

Dennis Canavan (Independent, Falkirk West)

That is the best answer I have ever received in this place.

Jamie McGrigor (Conservative, Highlands and Islands)

To ask the Scottish Executive what it is doing to alleviate problems in the scallop industry. (S1O-3780)

Rhona Brankin (Labour, Midlothian)

The value of scallops landed by United Kingdom vessels in Scotland this year has been as high as it has ever been. The Scottish scallop advisory committee has been set up and has met several times this year. Consultants have been appointed and are working on research into the economic impact of algal toxin closures on shellfish-dependent communities.

Jamie McGrigor (Conservative, Highlands and Islands)

Is the minister aware that the recent proposal from the Food Standards Agency to substitute the action level of 20 micrograms for a trigger level of 4.6 micrograms will make matters much worse for scallop fishermen and growers and could easily result in the closing of the industry? Is she also aware that the other FSA proposal to move from a gonad test to a whole-animal test might easily reduce the scallop fishery to three months a year?

Rhona Brankin (Labour, Midlothian)

I am aware of those concerns within the industry. Next week, I will meet the Deputy Minister for Health and Community Care and officials from the FSA to discuss the implications of the moves to which Jamie McGrigor refers. However, I am sure that Jamie McGrigor will agree that protection of the public must be a key consideration.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

A recent written answer to Tavish Scott from the minister confirmed that in the past five years there had been no outbreaks of food poisoning caused by scallops. Why has the inshore scallop sector, which is probably the most environmentally friendly commercial marine activity, had more draconian rules applied to it? Will the minister now consider relaxing the rules on processing so that live scallops can be marketed?

Rhona Brankin (Labour, Midlothian)

I reiterate that protection of public health is a key consideration that underpins every decision that we take about the scallop industry and some of the problems that it has been facing recently.

Tommy Sheridan (SSP, Glasgow)

To ask the Scottish Executive whether its review of cities will take into account the effects of the council tax system on low-paid and pensioner citizens of Glasgow. (S1O-3815)

Peter Peacock (Labour, Highlands and Islands)

The review's terms of reference are deliberately broad and those who participate will be able to contribute evidence on issues as they see fit.

Tommy Sheridan (SSP, Glasgow)

Every objective observer agrees that the council tax system is extremely unfair and regressive. It hammers the pensioners and the low paid of Scotland while pampering the well paid and MSPs such as the minister.

David (None, Lothians)

Mr Sheridan, we must have a question.

Tommy Sheridan (SSP, Glasgow)

Will the minister guarantee that he believes that the council tax system must be re-examined so that we can have a fairer system of local taxation?

Peter Peacock (Labour, Highlands and Islands)

As I said, the cities review is an open process. If Mr Sheridan or anyone else wishes to raise those points in that context, they are free to do so, although it is not immediately apparent why council tax is a cities issue per se, because it applies to the whole of Scotland. Mr Sheridan is probably aware that the Local Government Committee is conducting a thorough investigation into local government finance. The Executive has pledged to examine the outcome of that inquiry closely.

Johann Lamont (Labour, Glasgow Pollok)

Will the minister acknowledge the significant burden that is carried by Glasgow's council tax payers? That is a council tax issue that relates to cities. Glasgow's council tax payers have that burden because of Glasgow's wider responsibility to the west of Scotland and to Scotland as a whole. Does the minister acknowledge that in giving a commitment on the cities review, it is important that he considers that broader role? My constituents have told me that they feel that they carry a burden because of Glasgow's broader role in the west of Scotland and other places. Will the minister commit the cities review to considering that matter seriously?