 The next item of business is debate on motion 12445, in the name of Jackie Baillie, on bringing down NHS waiting lists, as the encouraged members wishing to participate to press the request to speak buttons. I call on Jackie Baillie to speak to and move the motion up to six minutes, Ms Baillie. Thank you very much, Presiding Officer, and can I start by thanking all the staff employed in the NHS? We know that they are working incredibly hard to care for us, but they are being let down by this SNP Government. It has been two years and seven months since Humza Yousaf published the Scottish Government's NHS recovery plan. The First Minister at the time, Nicola Sturgeon, said that this plan will drive the recovery of our NHS, not just to its pre-pandemic level but beyond. That was August 2021. Since then, we have a new First Minister who was, of course, the former health secretary, and we are on to our third health secretary. They are all committed to the recovery plan. They promised to build 10 national treatment centres to provide an additional 55,500 procedures per year by 2025-26. They promised to increase diagnostic procedures by 78,000 in 2022-23. They promised to deliver 800 additional GPs by 2027 and to give every GP practice access to a link worker. However, the truth is that those promises have been broken. Only three national treatment centres are up and running, with the rest delayed and over-budget. Diagnosting waiting lists are up by 55,000 since 2020, and only 271 whole-time equivalent GPs have been hired in the last six years, and work has not even started on the much-needed link workers in GP practices. Why is that important? Since the SNP promised Scots that they could fix the crisis in our NHS, the number of people on a waiting list has grown by almost 20 per cent, from 608,000 to 825,000. Just picture the scale of that for a second. That is enough people to fill Murrayfield stadium, not just twice or four times over, but 12 times over. Those are real people living in pain and discomfort, living with anxiety and uncertainty about when they will get the treatment that they need. The Scottish Government can spin it any way that it wants, and we know that it will try. The reality is that it has fundamentally failed people right the way across this country. Here are some facts that might be uncomfortable for those on-government benches. Ten years ago, just over 800 people on an inpatient waiting list still hadn't been seen after 12 weeks. In 2023, that figure was more than 101,000 cases. That is an increase of 125 times. That is not the only thing going up. Since 2013, the outpatient waiting list doubled. The inpatient waiting list more than doubled. The number of cancer referrals longer than the 31-day target has more than tripled. The number of cancer referrals longer than the 62-day target rose sevenfold, and the number of referrals for outpatient care waiting over 12 weeks rose 27 times. Here are some more facts about A&E, because in 2023, over 7,300 Scots waited more than a day in A&E. An FOI that we lodged revealed that patients waited in A&E as long as 122 hours. That is almost five days waiting to be seen in accident and emergency. In January this year, the number of people stranded in A&E for more than eight hours soared to over 17,800, while the number waiting more than half a day rose to over 8,800. That is the highest number on record. In the same month, there were 57,860 days spent in hospital by people whose discharge was delayed, higher than the same point in 2023, and the SNP promised to end delayed discharge way back in 2015. The reason it is serious is that the Royal College of Emergency Medicine has calculated that there will be an excess death for every one in 72 patients who spend between eight and 12 hours in an emergency department. Based on those figures, that would equate to up to 2,000 excess deaths last year alone, and that is heartbreaking because it is preventable. Broken promises matter because failure to clear these waiting lists has real life consequences, and that is the legacy of the SNP Government. It has even broken the rune statutory 12-week treatment time guarantee 680,000 times since it introduced it and 320,000 times before the pandemic itself, but it still denies any responsibility. What about the long waits? It was Humza Yousaf who promised to eradicate two-year waits by September 2022, but that date has come and gone and we still have 7,170 Scots who have waited two years for treatment 25 times more than the 282 patients waiting in England. That is utterly shameful. Please do not insult our intelligence by trotting out the same old excuses. Health is devolved. You have been in charge for 17 years. Tell the people of Scotland the people who have failed what your plan is now. Tell them what the SNP will do to stop the delays with the new national treatment centres, delayed in Esher and Arran, in Grampian, in Lanarkshire, in Lothian and in Tayside. Tell them where the £300 million for waiting lists announced last year will come from because it is not in the budget. The SNP is out of time and out of ideas, and when it comes to the NHS, the SNP's record is a blizzard of rhetoric to hide a litany of deadly failures. I move the motion in my name. Thank you. Just to advise the chamber, there really is no time in hand for this debate, and with that I call Neil Gray to speak to and move amendment 12445.2, cabinet secretary, up to five minutes please. First of all, to address one of the criticisms that Jackie Bailey set out around responsibility. I absolutely accept responsibility. I want to apologise to anyone who has waited too long for treatment. We have been repeatedly clear that our NHS needs continual investment and reform to help recovery from the impact of the Covid pandemic, and pressures are evident before the pandemic as well. For most people, the NHS offers an incredible service, delivered by dedicated professional staff and, in a timely manner. For too many, that is not the case. I accept that, and I feel that that is the key driver behind the need for reform that we will be embarking upon. Our accident emergencies face pressures for two principle reasons—the demand that they are facing and the challenges of patient flow through hospitals. We are working with health boards to address both those challenges. Of course, we know that Scotland is not unique as services across the UK continue to experience similar challenges. On long waits in accident emergency, the latest comparable 12-hour statistics for England in January, 13.2 per cent of patients waited for 12 hours compared to 7.7 in Scotland, and 15.5 in Wales. Planned care data for the last quarter of 2023 shows that in Scotland there were 124 patients waiting per thousand population for treatment time guarantee and new outpatient appointments. On the measures used in England and Wales, which I accept are distinct from our own, they show that in England there were 134 patients per thousand on the referral to treatment list, while in Wales there were 244 per thousand. That is, of course, no comfort to those in Scotland waiting too long, but it serves to underline the shared challenges and pressures across the UK, in spite of some of the commentary, including some of what I expect to hear today. Those challenges in performance are not unique to Scotland. There are signs of progress. Over 2023, new outpatient activity increased from the previous year, and the new outpatient list decreased for the first time since the end of 2021. Add to that in-patient day case activity for the last quarter of 2023 was the highest since the start of the pandemic. We have seen a substantive reduction in new outpatient waits over two years since the targets were announced, with the number waiting over two years for a new outpatient appointment down by 66 per cent from the end of June 2022, and waits over two years for in-patient day case treatment also down by 25 per cent. Cancer remains a priority, which is why we published our 10-year cancer strategy, along with an initial three-year cancer action plan in June last year. To support cancer services with the highest waits, there is additional focus on urology, colorectal and breast, and clearing diagnostic and treatment backlogs. We are also working to ensure that all capacity is maximised, including our network of robots, to support cancer patients in receiving timely access to surgery. When it comes to investment in reformer in NHS, we are determined to go further, and I will set out my thinking on the process of engagement and how the process of engagement comes about soon. However, we are trying to do that with one high tide behind our back from the UK Government. Last week, the chancellor had the opportunity to invest in public services like the NHS and the needed public infrastructure. Instead, he cut tax. In fact, the Tory chancellor delivered a real-terms cut to front-line health spending in England. Funding for NHS pay deals in England were not baselineed, which means that the consequentials from health were a reduction on what was provided in 23-24. He promised investment in providing and improving productivity in the NHS, when not a single penny of that promised investment will be spent in 24-25. In short, the chancellor's budget brought yet more pain to the NHS to pay for tax cuts and put off the necessary investment in reform. It was the last desperate act of a Tory Government that is gliding towards the exit door with all the grace of a hippo on roller skates. Sadly, the Labour election co-ordinator Pat McFadden MP confirmed last week that there were no specific policies in the Tory budget that Labour disagreed with. By backing the national insurance cuts from the Tories, Labour is backing £1.7 billion that could have been spent in the NHS and infrastructure should now not come to Scotland. Labour in Scotland has also decided that it seems no longer to back progressive taxation. By adopting the progressive model that we have in Scotland, we have made £1.5 billion available for services such as the NHS. Labour seems to abandon that. At the very least, if we follow the course that Annas Sarwar set out before his conference, it would reduce the income tax taken in Scotland by more than £560 million, Presiding Officer. I am sorry, in time of short, just as it was for Jackie Baillie's contribution, I apologise. I suppose that the question for Labour is this. Whether informing the next UK Government or your policies here, what will you cut? It is not enough to promise that you will fund the NHS. You need to put your money where your mouth is. You have to will the means as well as the end, because we have not seen any evidence of that thus far. Be straight with the people of Scotland. If they are pursuing tax cuts, where will Labour's cuts fall? As for the Tory amendment, I would suggest that Mr Galhany might want to double-check his figures. If he checks the Treasury, Country and Regional Analysis, I think that he will find that, had front-line health spending and Scotland match-per-head spending levels in England, this would have seen our NHS get cumulatively around a £15 billion less investment than it had received under the Scottish National Party Government. I am committed to making the changes that are essential for facing on-going challenges, ensuring that we provide a sustainable future for our NHS, and I move the amendment in my name. We really have no time in hand. I will be cutting speakers short at their allocated time just to give due warning. I will now call Sanders Galhany to speak to and move amendment 1245.1 up to four minutes. Dr Galhany. I wish to draw members' attention to my register of interests as a practicing NHS GP. I also wish to draw members' attention to the SNP Government's 2021 manifesto, where they promised to deliver a new Monkland hospital, renew the east of Scotland cancer care centre and enhance primary care facilities throughout the country. Let's not forget whom is the use of the so-called NHS recovery plan, one of the most underwhelming and poorly thought-out pamphlets in NHS history. This promised to boost inpatient and day-case activity through rolling out national treatment centres during the term of this Parliament, but instead of investing, the SNP have frozen all investments in new NHS projects over the next two years at least. That's at least a dozen facilities on ice across six health boards. So, if you live in NHS Lothian, Ayrshire and Arran, Tayside, Lanarkshire, Highlands or Grampian, it's not happening. The SNP, big on words, woeful on delivery. Under Humza Yousaf's Government, one in 10 outpatients are now waiting nearly a year for an appointment. One in 10 inpatients are waiting a year and a half. Fewer operations are now taking place than before the pandemic. The cabinet secretary states that cancer is a priority. Just 65 per cent of patients referred for colorectal cancer refer treatment within 62 days. Of course, the SNP Green Government blames anyone else but themselves, and that's because they don't take responsibility for their own failings. Instead, they'll cry it's all Westminster's fault. Now, I know they don't like to hear this, but the Scottish Government decides how to spend its budget, what to prioritise. The fact is that the SNP Government, year in, year out, has chosen not to fully pass on the full Barnett consequentials for healthcare from the UK Treasury in Scotland's NHS, and that's some £17 billion of healthcare spending that the SNP has spent elsewhere on pet projects. While waits for diagnostics and treatments grew, health care is devolved and Scotland needs solutions. We agree with healthcare professionals who argue for a national conversation on our NHS. We are the first of Scotland's political parties to put pen to paper and develop a vision, a detailed credible contribution to this conversation. We call for a modern, efficient and local approach to healthcare delivery. We would invest 12 per cent of the NHS budget into GP clinics to open new facilities, recruit more staff and make more appointments available, particularly in rural areas. We would introduce an online booking system. We would also hold NHS management to account for their decisions, and unlike the SNP Government, which rewards executives in failing health boards, we would provide better conditions for front-line staff and reward them, allow flexibility so that they can enjoy a better work-life balance, which is key to staff recruitment and retention. We must be strategic and ditch SNP-style short-term solutions. That, we know, buys a little time between health secretaries but results in devastating long-term consequences. I move the amendment in my name. Thank you, Dr Gilhoney. Alex Cole-Hamilton is up to four minutes. Thank you very much indeed, Presiding Officer. Presiding Officer, again and again and again we come back to this, and only it seems in opposition time. The facts laid out in Jackie Baillie's motion for today's debate make grim reading. Almost 825,000 patients in Scotland languishing currently on an NHS waiting lists for tests or for treatment. This Government is out of ideas for how to address this crisis. It seems content to make empty promises and then do very little indeed to keep them. Like Humza Yousaf's failed promise to eradicate waiting lists, which are only continuing to rise, or the statutory 12-week treatment time guarantee broken 680,000 times since it was introduced, or their promise made in the NHS recovery plan to deliver over 55,000 additional in-patient and day-case procedures next year or by next year. The hard stop on the construction of those national treatment centres means that that now will not be met. That too goes down as yet another broken promise by this half-hearted SNP-Green Government. Unexceptible weights have become synonymous with Scotland's NHS. I also feel compelled to mention, on today of all days, as they gathered outside our Parliament, that there are 180,000 Scots whose lives have been shattered by long Covid. Many of them long haulers are entering their fifth year of grappling with that terrible condition, and yet they are still forced to wait in vain for recognition, support and for treatment pathways from this Government. I have lost count of the number of times we have had debates like this in this chamber. I fear that this Government has become all too comfortable with crisis. It is almost enured to it, but, Presiding Officer, something has got to give, it simply must. Every time we raise the state of the NHS in this place, ministers will often seek to blame the pandemic. When they do so, they insult the intelligence of us all, and they seriously test the patience of staff and people seeking care. We all know that the issues in our NHS were there long before anyone had heard of Wuhan, China or Covid-19, and people are tired of those excuses. Nowhere is that true or more true than in NHS staff themselves. The chair of the BMA Scotland has said that NHS staff are, and I quote, exhausted and facing burnout. Staff and patients alike need new hope. Our health service needs leadership and it needs stability, but when it comes to the position of health secretary, it seems that there is no stability to be had. Just a grim game of musical chairs. Neil Gray now needs to show this chamber and the watching public that he is capable of innovative thinking and that he is also open to reform. When Humza Yousaf was in his position, he repeatedly ignored my party's calls for a plan to address staff burnout and to set up a health and social care staff assembly, that this Government have shown pig-headed contempt for policies that would guarantee annual leave, ensure safe staffing levels and champion the expertise of those who know our health service best. We need to retain experienced staff if we are to bring down waiting lists. Rather than making the meaningful investment that our health service needs, this Government is relying on short-term fixes to plug the gap. It is also failing to tackle the huge issue of delayed discharge, which is leaving people languishing in hospital wards when they should be at home. That too causes an interruption in flow throughout our whole of our NHS and is manifest in emergency care delays. Instead, it is indulging its bureaucratic tendencies in the name of a vast, expensive and unwanted centralisation of social care. I could go on. Such is the list of problems in our NHS under this Government's watch. People need to know that they can rely on a health service. They need to know that they will be tested, diagnosed and treated in a timely fashion so that they have the best chance of recovery. The competent management of our health service is perhaps the primary thing that we elect a Scottish Government to do. It is failing in that regard. The health secretary needs to do three things. You need to conclude, Mr Cole-Hamilton. I will tell you about that in the next time that we come to this in opposition time. Thank you. Thank you very much indeed. We now move to the open debate. I call Carol Mochan to be followed by Ruth Maguire up to four minutes. Thank you, Presiding Officer. Today's debate is of critical importance, and it is right that we continue to use our time in this chamber to debate the topics that match the priorities of the Scottish people. Although the SNP Government might want to hide from the responsibilities and its record when it comes to the NHS, we on these benches have a responsibility to hold them to account on behalf of patients and staff who for too long have been let down. The NHS is my party's proudest achievement. It is our country's most beloved asset and it is an asset that belongs to everyone. When Bevin and Atley established the NHS, it had the key founding principles of being free at the point of need, being a high-quality employer delivering first-class service and being an institution that would never discriminate when it came to the provision of healthcare. The founding principles of the NHS were important in 1948, and I argue that they are even more important in 2024. BMA Scotland chairman Dr Ian Kennedy has said that we have sleek walked into our current situation. He goes on, we are now seeing the founding principles of the NHS, namely that it should be free at the point of need, threatened and he says that this is the inevitable consequences of years of ducking the hard decisions. Yet it continues, the Scottish Government and its amendment today has managed to believe just about every factor other than its inability to meet the challenges facing the NHS today. I think that its self-congratulatory amendment will not be well received by the hundreds of thousands of Scots from across the country who are needlessly on long waiting lists. Indeed, the truth is that waiting lists are soaring, people are waiting in pain and our NHS is under extreme pressure. The Cabinet Secretary knows that I am never fearful of calling out Tory austerity, but in this instance this Government is responsible for the devolved powers for NHS. Because of the serious mismanagement and the broken promises, along with the arrogance of not accepting any responsibility, we are not in a good place for patients or staff here in Scotland's NHS. The SNP wants to be in power, but they refuse to take responsibility. I think that patients and staff are tired of the endless excuses. Our NHS needs change and there is a recognition that this tired Government is not up to delivering that change. I accept that the Cabinet Secretary is only just in post, but, thanks to his predecessor, the challenge before him is a significant one. One in seven Scots on NHS waiting lists and Rising, despite the First Minister's we've heard, commitment to eradicating lists and a treatment time guarantee, which I am going to repeat has been broken 680,000 times. No one underestimates the impact of the pandemic on our health services. Staff agree, but the reality is, as is outlined in the Labour motion, that the guarantee has been broken far too many times, 320,000 times before the Covid-19 pandemic. It is fair to say that key commitments in the NHS recovery plan are not being made. Those issues are being exacerbated by the Scottish Government's decisions to hold NHS capital projects, projects that are so desperately needed. Not only has the Cabinet Secretary let down my constituents in south of Scotland who will be waiting longer for the national treatment centre air, but he cannot seem to even get a hostel built in his own backyard. The impact of this decision will see waits lengthen and lengthen. People must see the Government act. Under the Scottish Government, a tremendous NHS staff have been pushed to the limit. Services are breaking point, and this Government must take action. Ruth Maguire has to be followed by Edward Mountain up to four minutes. Waiting for an operation or treatment undoubtedly adds pressure and stress to what's an already stressful time for some intolerably so. I appreciate that waiting can exacerbate the problem and that the patient is waiting for treatment. It brings additional issues, stress and anxiety. I will never minimise that human impact. Challenges facing Scotland's NHS are not unique and the significant impact of Covid-19 since 2019 on the normal operation of the NHS cannot be underestimated. In saying that, I am not pretending that everything is perfect prior to the pandemic, I am simply acknowledging the reality of where we are now and the scale of challenge that we face. Opposition parties should of course put whatever they want in their motions, but it will not be lost on folk that Labour has brought forward a motion about NHS pressures and not included a single mention about the impact of Covid in the pandemic. All MSPs receive regular contact from their local health boards. We should all know the impact it has had. There is no doubt that the pandemic has been the biggest shock that the NHS and health services in Europe and globally have faced. That is not unique to Scotland and cannot be ignored. The pandemic has clearly impacted on health services right across the UK. Acknowledging the reality of where we are is important. The member rightly mentions Covid, but, as she may know, we met people who have suffered from long Covid and there is no support coming from her SNP Government. What does she suggest to them? I acknowledge the difficulty faced by those with long Covid. The cabinet secretary outlined a number of steps that the Scottish Government is taking. Ministers have published a national health and social care workforce strategy that sets out a long-term vision for achieving sustainable health and social care workforce. The fact that the Scottish Government values the NHS workforce and is committed to investing in the NHS workforce is demonstrable. There are a number of steps that we have taken that are so short of time that I will not go through them all. However, I would say that, of course, Scotland remains the only country in the UK to have been successful in averting NHS strikes. I point that out not by way of self-congratulation, but because actions around staffing are what will make the difference to the running of our NHS and how our citizens experience their care within it. Recruitment and retention of staff, their wellbeing—that is what is important to the sustainability of NHS Scotland's ability to provide efficient services amidst the current challenges that it faces. I think that we need to look closely at routes to a rewarding career of public service within the NHS and reflect where previous decisions may have had unintended consequences. For example, where surgeons now specialise at the beginning of their careers, there is a lack of general surgical consultants causing some challenge within my own health board. For allied health professionals and nursing, can we look at more apprenticeships, earn as you learn, and work-type programmes that could also provide progression and development opportunities for existing health and social care staff, as well as being attractive to other adults who would wish for a career change, but for whom four years at university is not an option? I would welcome the minister's comments on those. I know that there is some work on going, but it feels like something that we need to pick up the pace on, and indeed something that could be really beneficial for individual citizens and the healthcare system as a whole. Edward Mountain, to be followed by Sarah Boyack, up to four minutes. Thank you very much, Presiding Officer. I would like to thank the Labour Party for bringing this debate on health issues. It is something that we only seem to discuss during Opposition time, and I think that it is a disgrace. I also think that it is a disgrace for the Cabinet Secretary to sit there and amend the motion, putting a lot of the blame on Covid. Let me give you some of the facts. In NHS Highland, prior to Covid, waiting times for the orthopedic list was well in excess of 2,000 people. The ophthalmic list was so long that we were flying people up from south of the border to do operations at a weekend, and treatment times were appalling. On top of that, we had an unappreciated staff workforce where bullying was rampant in NHS Highland, and we paid, end up having to pay, £2.8 million in compensation to those people that were bullied. There were high sickness rates and huge amounts of vacancies, especially within the radiology department. Those are the facts, Cabinet Secretary, and that happened before Covid. Now, post Covid, we are in the situation where we have orthopedic waiting lists, which were judged by a university the other day that could extend to seven years, and that these people cannot be treated within the national treatment centre because they are too sick. Their orthopedic operations require too much care to go into the national treatment centre. Look at audiology. If you are in Inverness, it is not bad news as far as waiting lists are concerned. You have got a 28-week wait to get an appointment. When you get your appointment, you then have 49 weeks to wait before you get a hearing aid. But if you are in WIC, it gets substantially worse. You have got 31 weeks to wait for an appointment and 64 weeks to wait for a hearing aid. That is nearly two years from start to finish to get a hearing aid. You can pop down to boots and get them in three weeks. This is a disgrace and it is not acceptable. When it comes to the national treatment centre, I applaud the Government for taking what they have done on that. It was late and it was over budget. It is working, though, for our orthopedic patients but only a certain amount of them, those that are less ill and can be treated overnight. But we have got ophthalmic theatres within the national treatment centre not being used. Why is it not being used? Because they have not managed to recruit the surgeons to do that. You can build as many as you like, but if you cannot get the staff cabinet secretary to work them, that is no help. I want to talk specifically about something that I find deeply disturbing, and that is neurological development assessments. This is about waiting lists. I have tried to find out what the waiting list in the NHS Highland area is for neurological development assessments. It is not easy because it is partly held by the Highland Council and partly held by NHS Highland. Last figures I got that there were 800 people, children waiting for neurological development assessments on the NHS Highland list, and a further 600 waiting on the Highland Council waiting list to get on to the NHS Highland waiting list. You have approximately 1,400 children waiting to get a neurological development assessment. That, to me, is unacceptable, especially when I was told, cabinet secretary, that they would have to wait 15 years. The person at the bottom of the list would have to wait 15 years to get a neurological development assessment. That means that they would be finished in school before they got the help that they needed. I would also just point out very briefly, and I know that my time is running out. No, you are not going to have time, Mr Mate. That it appears in NHS Highlands that when there is a waiting list, not a waiting list, it is not a waiting list when you are on a waiting list to get on a waiting list. Thank you. We are now going to have to move on, of course. Sarah Boyack, to be followed by Emma Harper, up to four minutes, please. I want to start by commending the work of our incredible NHS staff across Scotland, and I hope that we can all agree that they have been doing remarkable work given the challenges they face. However, their already challenging work is being made significantly harder by the neglect inflicted upon the NHS by the SNP Government. While the NHS is struggling across all of Scotland, I want to highlight in particular the pressures facing services in Lothian, where our hospitals are already under huge pressure and waiting times for vital operations are increasing. Those pressures will continue as our population grows. 84 per cent of Scotland's future population growth will be in Lothian, and our NHS services urgently need investment. Nowhere is this clear in the case of the eye pavilion. The building was declared unfit for purpose in 2014, a decade of unsuitable facilities for people who need vital, life-changing services, such as eye surgery. How did the SNP Government respond to that? Yet more broken promises and ultimately freezing capital spending on this desperately needed new eye hospital, along with other national treatment centres that are urgently needed across Scotland. It is not just an issue for Lothian residents. A quarter of people with sight loss in Scotland are having to rely on facilities that are not fit for purpose, with zero reassurance and nothing in the way of timescales from the Scottish Government to give them any confidence that things are going to change. The end result for our patients is that life becomes significantly harder and treatment becomes often inaccessible. People experiencing sight loss are often more restricted in their transport options, yet they are being made to travel to Clydebank or even to Newcastle if they want to retrieve NHS treatment for their eye condition at personal cost. That is not acceptable, because every patient on that waiting list is not a statistic. They are a real person with a real experience. We spoke to a constituent facing a 17-month wait for treatment, and she simply could not wait that long as her sight was deteriorating. When she wrote to my office that she was about to take on significant debt just to pay for simple but life-changing experience in the private sector because she could not wait for that NHS treatment, that is unacceptable. It is an unthinkable choice going into debt or losing your sight. It is a choice that she should never have faced, a direct result of the failed promises of this SNP Government who continued to let down patients across Scotland and, as Carol Mocken highlighted, undermining the key principles of our NHS. Those stories are commonplace, and her members across the chamber have similar tells to tell. In the Lothians, waiting times have trebled over the last nine years, but just take the number of people waiting more than 16 weeks. That has increased from 156 to more than 9,000 patients. As Jackie Baillie and Carol Mocken highlighted, the pressures that our NHS faces have created and compounded by the lack of support from the SNP Government is not enough just to blame the UK Government. That is a refusal to take responsibility from the problems on our doorstep over the past 17 years. It is not just the eye pavilion that is not happening. The National Treatment Centre in Livingston urgently needs a new cancer investment centre in Edinburgh. The SNP Government needs to act now to bring down waiting list times to ensure that everyone in Scotland gets the treatment that they need when they need it. Waiting times are not regrettable with the delays, they are utterly unacceptable and our constituents deserve better. I start by reminding members that I am a registered nurse, former clinical educator and peri-operative clinical practitioner. Of course, it is important to reduce NHS waiting times. For an example, the complexity of working for me in the peri-operative environment in theatre is a complex environment that requires specialist surgical teams, consultants, surgeons and anesthetists, nurses, peri-operatives and sport workers, as well as ancillary co-ordination with labs, blood banks and rheology, and everyone requires knowledge, skills, competency and training. Everyone working in those areas and across the NHS must be commended for their commitment to providing the best care for their patients. Tackling waiting times is no easy feat. The Scottish Government is choosing to invest more than £19.5 billion in health and social care in 2024-25, giving our NHS a real-terms uplift despite the UK Government's austerity. That includes £14.2 billion of investment in our NHS boards with additional investment of more than half a billion. It is worth noting that the NHS to Fries and Galloway and the Scottish Borders in my south Scotland region are receiving a real-terms uplift in funding. Of course, that is not without its challenges though. I think that it is worth noting that this current budget passed by this Parliament will do more for our NHS. It provides an additional £230 million to support delivery of the pay uplift to a minimum of £12 per hour for adult social care workers in third and private sectors from April 2024, representing a 10.1 per cent increase for all eligible workers. It also invests in over £2.1 billion for primary care to improve preventative care in the community, supporting the development of multidisciplinary teams in general practice, sustaining NHS dental care through enhanced fees and continuing free at eye examinations. It also supports spending in excess of £1.3 billion for mental health services for which there is an ever-increasing demand. Those are welcome commitments given the current strain on all budgets due to economic mismanagement from Westminster. However, despite the investment, the system is under extreme pressure as a result of on-going impacts of pandemic recovery, Brexit and inflation and UK Government spending decisions. I welcome that the Scottish Government will continue to target resources to reduce waiting times, particularly for those waiting longest for treatment through maximising productivity and additional resource. Investing in Scotland's NHS is non-negotiable for the Scottish Government. Against the challenging economic and financial context, the Scottish Government is taking the difficult and necessary decisions to ensure continued investment in health and social care services. The UK spring budget was nothing short of a betrayal of public services across the whole of the UK. The budget provided less than Barnett consequentials for health than in-year health consequentials of 2020-23-24, and it has failed to deliver more capital funding for infrastructure. Based on the latest forecast, Scotland's block grant for capital is now expected to reduce in real terms by £1.3 billion by 2027-2028. I know time is short, Presiding Officer, but I was interested to hear Carl Mawkin when she said that she was proud of her party that created the NHS. Will I wonder if she's proud of Labour's shadow health secretary saying that he would hold the door wide open to the NHS for the private sector if his party wins the next general election? We have major challenges in our NHS with lots of things to consider, but the threat to Scotland's NHS that comes from Westminster parties of all colours is going to be damaging for us in Scotland, but if we had independence, we would be able to manage much better. I thank all the staff who work throughout the NHS. Today's debate is on the issue that we MSPs probably hear about the most from our constituents. Wherever you represent, the dire and depressing problems in our NHS are having a terrible impact on people across Scotland. Our NHS has been in a constant state of crisis for many years under the SNP, and this sorry situation is getting worse, not better. I want to briefly reiterate some of the shocking statistics that others have highlighted here today in the hope that the Government will finally take notice. Over 820,000 people are on the NHS waiting list in Scotland. January 2024 was the worst month on record for long A&E waits. One in 10 patients are waiting nearly a year for appointments. It was hard to imagine these statistics getting any worse, but then Humza Yousaf introduced his recovery plan, and yet somehow he did get worse. His recovery plan did not improve treatment times, but it let them spiral further. He made big bold promises when he launched that plan, but almost none of them have been delivered. That is the really damning thing about the SNP's handling of our health service. It is bad enough that they preside over repeated failures, but it is a real slap in the face to patients that they keep making promises that they do not keep. They promised to increase the number of GPs by 800 by 2027. So far, GP numbers have decreased by 26. In rural areas, getting an in-person GP appointment can now be a nightmare. They promised to end the lay discharge and free up hospital beds. The problem is as bad as ever, and it is costing Scotland's NHS a fortune. Today, I want to focus on one particular broken promise to people in Ayrshire, the promise to deliver a national treatment centre at Carrick Lane. That centre has been delayed for years, and judging by the SNP's track record, who knows if it will ever happen. The network of national treatment centres across the country were originally an SNP election pledge. Not this year, not in 2022, 2021, 2019, 2017 or even 2016. This national network was promised way back in 2015. At the time, then SNP First Minister Nicola Sturgeon said, if we do not act to prepare now for 10 and 20 years ahead, our NHS will be overwhelmed by the demand. Will she get one thing right? Nearly 10 years on, the NHS is now overwhelmed by demand because the SNP did not act. Humza Yousaf doubled down on her grand promises when he came to Ayr for a photo op to announce the Carrick Lane centre before the 2022 election. He said that day that the network of national treatment centres will be central to NHS recovery. Just like photo ops with the doomed fairies, this one was clearly all for show. Humza Yousaf added later, the national treatment centre programme will deliver the single biggest increase in protected planned care capacity ever created in NHS Scotland. The single biggest increase in care has turned into the single biggest letdown of patients across Ayrshire. Local people are waiting times for treatment rise. They are seeing ICU beds moved away from their hospital to crosshouse because they cannot recruit staff. They are seeing long waits for a GP appointment. However, it is an election year, so no doubt they will soon, once again, be seeing Humza Yousaf in a pair of scrubs, making another big promise that he will not deliver. The problem for the SNP is that local people also see right through this charade. They deserve a lot better than another batch of soon-to-be-broken promises. We can always rely on Labour to put up a motion complaining about the management of the NHS, full of negativity, not a word of encouragement to the thousands of staff working extremely hard day and day out to deliver healthcare and keep us all safe. The SNP motion does that, and I am happy to put in record my thanks to the NHS staff that I know personally and the entire workforce who are still working under the most difficult times we have faced in the generation. The Labour motion is little more than numbers and criticisms, but there is another story to tell, and I will share a few facts and figures from Ayrshire and Arran that might help to balance out their narrative a bit. First, a gentle reminder that it was our Labour friends who planned to shut the accident and emergency unit at Ayr hospital, and it was the incoming SNP Government who kept it open. Much to the delight of the 55,000 or so people in Ayrshire who signed that petition and the many thousands who have continued to benefit since, a decision never welcomed by Labour from that day to this, how dare the SNP reverse Labour's closure plans for air and save the unit and save lives as a result. Presiding Officer, Covid hasn't disappeared and its impact will ripple on for some time yet. Not my words, but the words of our excellent chief exec in Ayrshire and Arran Claire Burden, who is working tirelessly to get through these times. Last year, there were over one and a quarter million GP consultations carried out in Ayrshire and Arran. That's real people getting a fantastic service from their dedicated GPs. We have 465,000 outpatient appointments satisfied, a huge demand met involving a range of NHS staff to achieve that. We have satisfied over 100,000 out-of-hours appointments through our Ayrshire urgent care service. Our emergency departments, including Ayr, dealt with over 93,000 life-or-death situations, saving lives every day. Currently in Ayrshire and Arran, the situation is as difficult as anywhere else, but the pause in the national treatment centres has not affected the service provision there, according to our chief exec. In the meantime, we have managed to benefit from the recruitment of additional staff down there and an orthopedic surgeon. We have more capacity than in previous years. At Ayr hospital, we now have a dedicated station for orthopedic surgery, and that team has some of the highest productivity and high performance figures Scotland-wide. Waiting times for outpatients are increasing. There is no doubt about that, because demand is currently outstripping Ayrshire's ability to get through the backlog. Recruitment is on-going, though, thanks to the additional budget support provided by the SNP Government. In terms of other performance achievements, the numbers of inpatient day cases continue to fall. Performance in relation to the 31-day cancer treatment target also continues to meet the 95 per cent level, and it was actually 100 per cent in November last year. Compliance with the endoscopy target has also improved to its highest level since 2020. Lastly, compliance with the Child and Adult Mental Health Services target also reached 100 per cent in November last year, exceeding that target by 10 per cent. It is a huge well done to Ayrshire and Arran NHS staff. Not that we would hear any of that good news from Labour, but you will hear it from me and the thousands of patients who are getting high-quality care and life-saving treatment on a daily basis in Ayrshire and Arran. One final note is a request from Ayrshire and Arran for the public to engage more directly with the legal processes to establish power of attorney for their family members. That will significantly help all health boards to improve the situation relating to discharge, delayed discharge. Over half of the delayed discharge cases in Ayrshire and Arran involving loss of capacity are caused by this issue alone and not by performance or lack of community care provision. The worst figures are in Tory run south Ayrshire for this problem. Who knows? Maybe even Labour will welcome this news and our resident Tory GPs who is in the chamber might be aware of this too. Presiding Officer, I support the amendment from the Government and ask the Parliament to reject the relentlessly negative Labour motion in Tory amendments. Thank you. We now move to the wind-up speeches and I call for test white. Test white, up to four minutes, please. Thank you, Presiding Officer. Audit Scotland hit the nail on the head when it said that there has been no unified vision for the NHS since 2013 under this SNP Government. That's Audit Scotland. A decade later, and patients and front-line staff are paying the price for the SNP's mismanagement of the NHS. Only the SNP Green Government could make the national treatment centres the lynch pin of its NHS recovery plan and then yank the funding for them. You just couldn't make it up, Presiding Officer. National treatment centres in NHS Lothian, NHS Ayrshire and Arran, NHS Lanarkshire, NHS Tayside and NHS Grampian in my own region have all been left in limbo. Meanwhile, as we've heard today, patients in chronic pain have been left to languish on waiting list for months and even years. MSP inboxes are full of heart-wrenching accounts of people desperate for treatment. A constituent contacted me earlier this week after being referred for a gastroenterology appointment by her GP. The NHS-informed website said the current weight to be seen was six weeks. After speaking to staff, she was told it would be 42 weeks, and that's a different La La Land to the La La Land that Mr Coffey is talking about. She said she came off the phone lost for words. Sharon Dowey talked about the SNP's broken promise to people in Ayrshire who've been waiting years for a national treatment centre at Carrick Glen. She highlighted that the SNP knew nine years ago what would happen if the capacity in NHS wasn't increased there, but they hadn't been delivered. They've dithered and delayed. Ruth Maguire today blamed Covid, but Edward Mountain raised serious concerns in NHS Highlands before Covid. The SNP might try to blame everyone but themselves for these failures, but the SNP amendment today certainly takes a crack at it. The SNP green government has full control over the NHS in Scotland. As the Scottish Conservatives amendment emphasises and Dr Sandesh Gulhane highlighted, it has full control over healthcare investment and how it spends that budget, and the Cabinet Secretary might shake his head, but that's the truth. Dr Gulhane was right to say that year in, year out the SNP government has chosen not to pass on the full Barnett consequentials from the UK Treasury to Scotland's NHS. Take note, the SNP government is responsible for the decisions it makes, but the SNP seem to enjoy the trappings of power and not the responsibility. Yet today Neil Gray is the new SNP Cabinet Secretary of Health did publicly accept responsibility, and that's rich after 17 years of inertia and in action of successive health secretaries. Nicola Sturgeon, Shona Robison, Jean Freeman, Humza Yousaf, Michael Matheson has left our NHS in a desperately sorry state. Despite the heroic efforts of NHS staff on the front line, there are record waits for treatment, record waits to be seen in A&E, massive increases in private operations, major blockages in ambulance turnaround times. The SNP government is out of ideas and out of time. It must adopt the Scottish Conservatives' plans for a modern, efficient local NHS to secure the future of our healthcare system and save lives. First and foremost, I thank those who are at the heart of our NHS for their commitment, hard work and dedication to provide the best care possible to the people of Scotland. I am going to focus much of my response on mental health, which is in my portfolio. We remain committed to our priorities driving down waiting times and improving mental health, and in our CAMHS waiting times, we have seen sustained improvement, which gives us good grounds for optimism. The CAMHS system performance has recovered to better than pre-pandemic levels, and we can take our learning from that and apply it to other areas. We must recognise where we see improvement in national and performance against the 18-week CAMHS standard in the last quarter is the fourth highest since records began and the highest achieved since the quarter ending in March 2016. I have very little time. The last two years, 22 and 23, showed the highest number on record of people starting treatment from CAMHS in one or two people referred to CAMHS and now start treatment within six weeks down from 10 weeks in the previous quarter. That has been made possible firstly by the hard work of our CAMHS workforce, which has more than doubled under this Government, but also improvements have been supported by direct investment from the Scottish Government firstly through the recovery and renewal fund, from which £40 million was allocated to implement the CAMHS specification, then by the outcomes framework, which amounted to £55.5 million in 2324 for improvements to mental health services, including CAMHS. Now, through additional investment, we have been setting the conditions needed for long-term sustainable improvement to the CAMHS system. It has taken time for our investment to be reflected in national waiting times performance as boards worked hard to clear their backlogs, but now we are seeing evidence of significant and sustained progress, including high levels of activity in CAMHS and significant improvements in waiting lists. We have, and we will continue to provide enhanced support to those boards where waits are the longest. This enhanced support package will focus on the delivery of national CAMHS specification, local improvement plans and trajectories to meet the standard and to plan to clear backlogs. I am afraid that I have very little time, Mr Mountain. The issue of delayed discharges is absolutely a challenging one also in my portfolio. We know that the delays in receiving the most appropriate care in the right environment can be detrimental to a person's physical and mental health. We know that delayed discharges also have significant consequences for the normal flow of patients through hospitals. How do we rise to face this challenge? Well, it is helpful that in Scotland we have more beds per head of population, more health professional staff, and those staff are better paid. Hospital at home is another response. The older people's service is now similar to hospital the size of university hospital Wishaw. Whilst it is absolutely true that the level of delayed discharge is unacceptable in Scotland and we take responsibility for that, it is very clear that this is a problem that is not unique to Scotland. It is difficult to make comparisons between UK nations, but the numbers speak for themselves. In Scotland, 22 patients are delayed in acute hospitals per 100,000 adults. In Tory-run England, that number is 31 per 100,000 adults, much higher. In Scotland, the total number of delayed discharges is 42 per 100,000. In Labour-run Wales, that number is, wait for it, 62 per 100,000. A number of members made some excellent suggestions. Ruth Maguire's suggestion on considering alternative training pathways for health professionals is very welcome. Nursing and midwifery task force are already considering that. You do need to conclude, minister. The challenges and opportunities that we face need action. Our NHS is our most cherished published service, and we must work together to deliver the changes that we need for the future, to deliver sustainable and high-quality services that the people of Scotland deserve. Thank you, and our call on Paul Sweeney to wind up the debate up to five minutes. Thank you, Deputy Presiding Officer. Of course, Labour has used its opposition day-to-day to raise the critical issue of waiting times in our national health service here in Scotland, because it is a reflection on an issue that every one of us has a stake in. It is our communities, our family members, our relatives, our colleagues and friends who are at risk as a result of the NHS not performing to the best it can. That is a responsibility that this Parliament must take a nice and so on, because it is the single most important area of public policy that this Parliament has to deal with. The facts, I am afraid, are stark and are incontrovertible. Despite the Government's attempts to erase those facts and their amendment to Labour's motion today, they remain. Almost 825,000 patients are currently on NHS waiting lists for tests and treatment in Scotland. That is more than the combined population of Glasgow and Dundee. It is simply unsustainable and unacceptable. That keeps a huge national pressure. It means that we have a sicker population and a vicious cycle that continues to affect every area of public life. Long waits have continued to rise, despite the First Minister's promise to eradicate them entirely, so we are not seeing an effort to get ahead of the problem at a sufficient rate. The 12-week treatment time guarantee has been broken 680,000 times since it was introduced, the equivalent of more than the entire population of Glasgow alone. The Government has committed to delivering 55,500 additional procedures that have not been met. Indeed, the minister in her closing remarks mentioned that areas of improvement include CAMHS waiting lists. I am afraid that this is a bit of a mirage because I investigated what was going on in Glasgow and discovered that the only reason it has been going down in Glasgow is because face-to-face consultations have been substituted for telephone consultations. That is simply not good enough, minister, and it is not good enough to come to this chamber and make that misrepresentative characterisation of what is actually going on in our CAMHS system. As I have said, those are our families and friends who are languishing on these waiting lists and waiting care that they desperately need while their health and overall outcomes worsen. Those are the people who email us on a daily basis. Those are the people who have come to our constituency advice surgeries in desperate situations, eager to get support, and it is not good enough for the Government to simply deny their lived experience, their reality. It is our duty as parliamentarians to give voice to their frustrations and their difficulties. The Scottish Government talks about waiting well, but unfortunately people are dying while waiting. We have heard numerous examples of the terrible situations that are going on. Indeed, 18,390 patients died in 2022 while stuck on an NHS waiting list, and there has been a 39 per cent rise in deaths since before the pandemic in 2019, so it simply is not good enough for the Government to use the pandemic as an excuse. I think that the member for Kilmaric and Irvine Valley ought to listen more to his constituents in that regard instead of patronising them in the way he did in his speech. In fact, Ms Boyack, the member for Lodians, highlighted our excellent NHS clinicians, but they are being betrayed, too. They are not just working in obsolete facilities such as the Edinburgh Eye Pavilion, but oncologists who have come to this very parliament in the past few weeks told us in devastating terms that they are watching cancer patients go from being treatable at the point of diagnosis to terminally ill, and I have met them personally in Glasgow's hospices. That is a betrayal. It is an extra judicial death sentence that has been visited on the people of Scotland in some instances. That is the reality of what is going on. That is what caking responsibility means. It is not just saying it, it is dealing with it, it is addressing it, and we all have a stake in this matter. Yes, I have to give away. I thank the member for giving away. Does he also accept that taking responsibility means not committing yourselves for two years to Tory spending plans? Paul Sweeney. That is simply not a characterisation. It is true. The fiscal rules being set are about improving economic growth by applying discipline to public spending. Here is a good example. The Government sits here impotently denying that they can invest in national treatment centres because of capital spending constraints, although, while wasting £1.2 billion on delayed discharge, that is incompetence. It simply does not stand any scrutiny to say that the ability to undertake capital investment is not available. That is about addressing a vicious cycle. I urge the Government ministers to stop thinking like accountants and economists, such as the Audit Scotland reports, because that is all about connecting up a whole system. The member for Highland and the Tories, Mr Mountain, highlighted just one example, which might be more benign, about hearing aids. That is backdoor privatisation, because it basically means that you cannot access dental treatment, you cannot get hearing aids, you cannot get eye tests, so those who can pay and those who cannot languish and suffer cannot go to work and cannot function as citizens. We get a sicker population in a less economically productive society. That is the vicious cycle that the Government has to address. It simply does not stand to stand in point at other parts of the UK, take responsibility and address those issues, as we should here as parliamentarians in Scotland. That concludes the debate on bringing down NHS waiting lists. There will be a brief pause before we move to the next item of business to allow the front benches to change.