 It's now time to move on to the next item of business, and the next item of business is a debate on motion 12108 in the name of Anna Sarwar on waiting times. May I invite those members who wish to speak in the debate to press the request to speak buttons? I call on Anna Sarwar to speak to and move the motion for up to eight minutes, please. Thank you, Deputy Presiding Officer. In March 2012, the then Cabinet Secretary for Health, the now First Minister, enshrined in law a legal guarantee for patients in Scotland. The legal guarantee was clear, and let me read to you what the legal guarantee says. I quote, "...you have the right to start to receive agreed inpatient or day-case treatment within 12 weeks of agreeing to it. Some examples of treatments include hip or knee replacements. If your agreed treatment has not started within 12 weeks, your health board must explain the reasons for this, and your health board must also take steps to ensure that you start your treatment at the next available opportunity." This charter of patient rights is explicit and clear. There is no ambiguity unless, of course, you are the Scottish Government or a health board. When is a guarantee, not a guarantee, apparently, when this Government and this Health Secretary give you one? As we now know, tens of thousands of Scottish patients are waiting longer, much longer than the 12-week guarantee that Shona Robison and Nicola Sturgeon promise them. Since Nicola Sturgeon made that promise, that legal guarantee to the people of Scotland in 2012 has been broken nearly 120,000 times. That is 120,000 broken promises to individuals and families across our country. However, what is the consequence of that failure? Patients waiting on treatment in Limbo. Told by the health board, they have a 12-week guarantee, yet in some cases 20, 30, 40 or more weeks later, they are still waiting. That impacts on their family life, that impacts on their social life and that impacts on their ability to work. In some cases, we are actually actively prolonging people's time of work, impacting on their income and further encouraging their isolation. It further impacts on their physical and mental wellbeing. For many patients, not knowing is worse than if they knew that they had to wait longer than the 12 weeks in the first place. Every single day, the health secretary and the Scottish Government break that law. Every single day, individuals are being let down and left in Limbo, a shocking breach of a guarantee enshrined in law. I want to share just one shocking example of a lack of honesty and transparency with patients. A recent case, one of my constituents was referred for orthopedic surgery. That is what he received in writing from Greater Glasgow and Clyde health board. I quote, under the patient's right Scotland Act 2011, you have a guarantee to be admitted for treatment within 12 weeks. This is the maximum you should wait for. We will, of course, endeavour to see you sooner. He thought great, waited the 12 weeks and heard nothing. When he spoke to his GP, the GP called for an update and was advised that the actual wait would be 40 weeks. It would be laughable if it wasn't so serious. Why wasn't he just told the truth? Why was he deliberately misinformed? Sadly, we know that this is not an isolated case. Nearly 120,000 patients will have received similar letters, given false hope. They will have read the word guarantee and taken it at face value, a breach of a guarantee and a breach of trust. A lack of transparency surpassed only by a clear lack of honesty on the part of the health board. A complete failure to communicate honestly with patients and behaviour condemned by the ombudsman. Over the last decade, the number of complaints to the Scottish Public Services ombudsman related to the NHS has trebled. Trebled in the last decade. Rosemary Agnewt on the weekend said, and I quote, increasingly our public reports seem to be about health matters and the theme that has emerged to me is one of communication. That is clinicians to patients and communication across different parts of the NHS. Presiding officer, it is simply not good enough for patients to be treated this way, but I think that we need to recognise the stress and impact on our NHS staff too. With the rising complaints, staff are often bearing the brunt of concerned patients, expressing frustration at their delay in treatment, when those staff themselves are under increased pressure, being overworked, undervalued and underresourced by this Government. I welcome the Scottish Government's commitment today to amending the charter of patient rights to ensure that health boards are, at all times, open, transparent and honest with patients. That is a real win for patients across the country, but the Government should commit to delivering it by the end of the month. While accepting, in good faith, the Scottish Government's amendment and its new commitment to ensure that patients receive honest communications from the health boards on waiting times, it is absolutely unbelievable that the Scottish Government is admitting today that this has not always been the case. However, there is a wider point. The amendment of the patient's charter cannot just be a fig leaf for a much greater failure by this Government, that tens of thousands of patients in Scotland's NHS are being forced to wait longer for treatment than they should. If this Scottish Government was not failing patients as Scotland's NHS, they would not have to worry about changing guidance on patient communication in the first place. I go back to the charter. It sets out six clear principles by which patients should be treated, and the Government is in breach of at least three of them. 1. Access your rights when using NHS health services in Scotland, not being met by this Government and this Cabinet Secretary. 2. Communication and participation. The right to be informed and involved in decisions about health care and services, and the Scottish Government's own amendment recognising a complete failure in this regard, again not being met by this Government and this Health Secretary. 3. Respect in this area perhaps more than any other. Patients being disrespected by the system, being disrespected by health boards and being disrespected by this Government and this Cabinet Secretary. That can no longer go on. We must stand shoulder to shoulder with all our patients who are being failed by this Government. We must stand shoulder to shoulder with all our NHS staff who continue to go above and beyond in the most difficult of circumstances and move the motion in my name. I now call Shona Robison to speak to and move amendment 12108.1. Up to six minutes please Cabinet Secretary. Thank you, Deputy Presiding Officer. Our NHS is a remarkable institution, it is our nation's largest employer and its staff, along with those in the care sector, work day in, day out to provide care for the people of Scotland. As I said last week, it is a large and complex system and things sometimes do go wrong and fall below the standards that we would expect. I am sure that we will hear examples of that today, but those challenges are not unique to Scotland, but we are committed to doing all that we can to address them. Since the introduction of the 12-week treatment guarantee, more than 9 in 10 patients—that is 1.5 million people—have been treated within the target since it was introduced on 1 October 2012. That is down to the tremendous effort of NHS staff—not just doctors and nurses but porters, admin staff and cleaners—who all contribute to ensuring the running of our hospitals and community services every day. We want to drive improvements in acute performance and also in shifting the balance of care where possible. That is why we are taking forward the twin approach of investment and reform of our NHS to meet the rising demand and challenges now and into the future. Throughout all of that, clear engagement and communication with patients is vital, whether on the subject of their own weight for treatment or the broader design of services. That is why we are happy to support the motion today and make clear in our amendment the actions that we will take. All parties in this chamber have been consistent in recent years in their support and advocacy of shifting the balance of care and spend towards community health services to help people to live longer, healthier lives at home or in a homely setting. That is one of the reasons that, by the end of this Parliament, we will ensure that at least 11 per cent of front-line NHS spend is in primary care and, as a result, 50 per cent will be outwith acute settings for the first time. Boards across the country are working very hard to try and deliver waiting time standards and the guarantee, and I have made it clear to boards that exceptionally long waits must be eradicated and improvement made towards delivery. We are actively working with all boards to implement better demand and capacity planning and delivery. We also have specific work under way with clinicians and managers and a number of specialties experiencing the most significant pressures, for example orthopedics and ophthalmology. In the last year, that was supported by £50 million across the whole patient pathway. On communication of waiting times, boards are required to advise patients by letter that they are covered by the legal guarantee. We also expect that, if the board is experiencing difficulties in seeing patients within 12 weeks, it would advise the patient of the reason for the delay and an indication of the likely wait. Communication is important in a patient-centred NHS and patients should be kept informed of any changes or delays in treatment. We will address that through the revision of the charter of rights and responsibilities and work with boards to ensure the communication of that revised guidance. Neil Findlay I wonder what advice you would give to my constituent who waited 44 weeks for an orthopedic session just to see a specialist not to receive treatment and, in that time, was threatened with dismissal by her employer. What advice do you give her? Can I remind you to speak through the chair, please, Mr Findlay? As I am about to set out more, we recognise that those long waits have an impact not just on patients but on their families. That is why we are taking the action that we are taking to address those increasing pressures on the system. Last autumn and along with the academy of medical royal colleges, health service leaders and in partnership with patient representation, a new Scottish access collaborative emerged. This is a clinically led initiative designed to make the connections between existing services, putting patients more in control of their care and ensuring primary and secondary care clinicians and patients are leading on service reform. I have committed £4 million to support the development of this programme, which will ensure that people can experience timely care with the most appropriate staff in the most effective place. Of course, as part of our programme for government commitments, £200 million will be invested in the lifetime of this Parliament to expand elective capacity for routine operations, both at the Golden Jubilee hospital and in the new treatment centres across Scotland, including in Neil Findlay's area in the east of the country. In conclusion, the Labour motion talks about honesty, and I firmly believe that that is vital. That works both ways. Last week, Labour sought to actively misrepresent a report on waiting times produced by cancer clinicians. To be clear, the 31-day and 62-day targets for cancer care are being retained, as the report makes clear. Sadly, a number of cancer clinicians are very angry that this recent report was misrepresented. Here is what leading cancer doctor David Dumlop from Anasawa's own home city of Glasgow said in response to his comments last week. From a cancer doctor, it is disappointing that Labour has sought to cherry pick from the text of the remit and report of this group and seek to exploit the sensitivities of patients and the public in relation to cancer waiting times. The report states from the outset that the agreement was to retain the current standards and the intention was to improve them. The remit was to source professional opinion on whether the standards could be improved to better select patients for the urgent suspicion of cancer pathway and consider whether additional cancer types should be subject to the cancer waiting times target of 31 and 62 days, potentially increasing the number of referred patients subject to the standard. Wide cross professional engagement has taken place. No scrapping of cancer targets, but rather potentially extending those covered by the target. I welcome some honesty in the debates that we have about our health service. Our clinicians and patients deserve nothing less. I move the amendment in my name. Before I call Miles Briggs, can I remind those who wish to take part in the debate to press the request-to-speak buttons, or else we do not have any speakers? I call Miles Briggs for up to five minutes, please. Thank you, Deputy Presiding Officer. I would like to start by thanking the Labour Party for bringing this debate forward today. It is right that we are debating the 12-week treatment time guarantee for patients due to receive planned inpatient and daycare treatment. As this subject does not often get the same focus as Government A&E targets, for example, the planned inpatient and daycase treatment is yet another area where, sadly, this SNP Government's rhetoric on our NHS simply has failed to match the reality for too many patients across Scotland. Indeed, ministers, including the First Minister herself, who steered a legislation through this Parliament, must be extremely embarrassed that the number of patients waiting more than the target treatment time has increased tenfold since the guarantee was even introduced in October 2012. That means that one-fifth of all eligible patients are having to wait for more than 12 weeks to receive the vital treatments that they require. All of us will be aware of extreme cases where some patients have faced waits of up to 22 months for outpatient appointments or daycase treatments. The impact on individuals, patients and their families can be severe, and, as Anas M Sawa has already outlined, a number of cases that we have heard today. Within my own Lothian region, between the end of 2012 and the end of 2017, no fewer than 25,288 patients had to wait for longer than the 12-week period, the worst performance by far of any NHS board in Scotland. That is yet another indication of the particular pressures affecting capacity within NHS Lothian as our population continues to grow and demand for services rises year on year. While I acknowledge that some individual cases may be complex and therefore the specific needs and requirements of a patient based on clinical advice might prevent a 12-week treatment time, the vast majority of those missed targets are down to capacity and staffing pressures within our local health services. The failure to put in place a proper national workforce plan is the thread that runs throughout all of this SNP Government's NHS failings. The motion today rightly talks about transparency and the need for NHS boards to communicate honestly and accurately about expected waiting times, and I wholeheartedly agree with that. As Anas Sawa has already stated, there is nothing more disheartening for a patient to expect treatment within a set period only to be told towards the end of that period that they will have to wait for vastly longer periods of times, often weeks and months more. Rather, NHS boards need to be open and honest with patients in terms of the realistic and likely waits that they will experience before they can be confident of receiving inpatient and daycare treatment, and they should be up front about this from the very beginning of the process. As we have already heard, clearly procedures vary across health board areas and there is vast room for improvement here, but what we need is for the best practice to be spread across Scotland. Deputy Presiding Officer, the treatment time guarantee has failed too many patients in Scotland. As one constituent recently said to me, it felt that they had been simply given false hope. We need to see action to help to drive improvements in waiting times for planned inpatient and day cases so that we can reduce excessive waits. Clinicians across Scotland want to see a focus on best outcomes and crucially ensure that all patients are communicated with about their treatment on a transparent, open and realistic basis. It is welcome that almost six years on, the SNP Government has realised that the treatment time guarantee has failed too many people and too many patients in Scotland and has now committed to amend the charter of patient rights and responsibilities to ensure that patients can accurately receive a waiting time estimate. However, the NHS under the SNP stewardship has now seen over seven out of 10 waiting targets missed just last year. What we must now see is a total improvement and a renewed focus on patients receiving the treatments that they need and the driving down of unacceptable waiting lists. I hope that today's debate will help to achieve that and start a real debate about how we can see patients given the realistic times that they have to wait for that treatment, and I support Anasawa and Labour Party's motion this evening. I imagine that very few MSPs have not been contacted by a constituent about NHS waiting times, although the majority of people receive treatment within 12 weeks. That is far from the reality for everyone. As mentioned by others, sometimes severe delays have a big impact on those who have to wait. I have recently been helping a constituent to get some clarity on how long they would have to wait for a hip operation. They were told that it would be 12 weeks that NHS Greater Glasgow and Clyde was meeting the target. They were even specifically reassured that the recent severe weather would not impact that 12-week waiting time. The problem was that they were put on the list in December and by late April they would still hear nothing. They were checking the mail every day. It is fair to say that they were, and they still are, quite desperate for this much-needed operation. When my office got involved, we found out that not only were they assigned to a hospital other than the one that they expected, which they found understandable but wished someone had told them, the actual queue for their operation was nine months. We can all understand how frustrated and angry they were to find out that an operation that they expected to be imminent will now, in fact, take place around September, hopefully. They say that, if they had just been told this from the start, it may have been frustrating, but having that information would have dramatically reduced their anxiety. The stress felt every single morning when the post was coming through the door. In this case, it was clearly inappropriate for a member staff to go as far as reassuring them that the 12-week target would be met despite the weather, at a point where it was about to be eminently missed and where the real nine-month waiting time was clearly well known and had been for some time. However, it should not have taken the intervention of an MSP to get that information for a patient. We know that that is not an isolated incident. Members have already brought up other examples. Only around 70 per cent of patients receive treatment within the 12-week timescale of being referred. The situation is getting worse. Audit Scotland reported that demand for healthcare services is increasing and more people are waiting longer to be seen. We need to understand why waiting times are increasing. I understand that funding for the NHS has increased under this Government, but we need to ensure that money is well spent and that it matches demand. At this point, I should wear my usual European affairs hat and point out that the harm already being done to our health service by the UK Government's irrational and hostile immigration policies, such as the minimum income threshold, which in many cases even prevent the nurses that we so desperately need from coming and from staying here. That is before we deal with the coming disaster for our healthcare and other public services, which European freedom of movement ceasing to apply after Brexit will bring. Given how dependent our NHS is on citizens of other European nations and how dependent our care services, which should be preventing avoidable hospital admissions and extended stays are as well, it is clear that current waiting time situation may be very far from ideal, but the cat-handed anti-evidence approach of the UK Government is about to make it much worse. We learned within the last few weeks that Theresa May overruled her own ministers to veto a plan to allow more overseas doctors to come and work in the UK. Last year, we found out that EU nurses registering to work in the UK, the numbers dropped by 96 per cent in a year, thanks to Brexit. While the UK Government's chaotic infighting and the uncertainty that it imposes on EU citizens, it is little wonder that nurses are not coming to work here. We also face the impact of sanctions of universal credit of social security cuts, driving more people into avoidable health problems and, in turn, increasing demand. Today's Labour motion is one that the Greens are more than happy to support. It is a reasonable proposal and one that will be welcomed by patients across this country, including constituents who have got in touch with myself and, as I said, I am sure every other member in this chamber. Beyond that, however, we need to look at the wider preventative measures that will reduce demand on the NHS. Our healthcare challenges cannot be solved in a silo, a holistic whole system approach is needed and the Greens will be more than happy to support one. Will the Government put it on the table? I thank the Labour Party for securing time for this important debate this afternoon. It is a very elegant motion that we are debating. It is very easy for us, as opposition parliamentarians, to throw rocks at the Government about waiting times—sometimes unfairly, sometimes for reasons beyond their control, but that is not what the motion does. The motion looks in granular detail at profound failure of expectation management, which our constituents are experiencing every single day. We all have examples of constituents who have been failed in this manner. It starts with that profound mismanagement of expectations. It is often then characterised by pain and anxiety as that delay manifests and then almost universally leads to deep frustration and anger. That is all typified in one example that I will give you. I was visited at the turn of the year by an elderly woman in my constituency. She had been referred to the dental hospital for investigative surgery around signs that could be linked to an early stage of mouth cancer—a very worrying prognosis. She got her automatic letter, which we have heard about this afternoon, of the 12-week waiting time guarantee. A few months later, she got another letter saying that her weight would actually be nine months, rather than the 12-week that she had advertised. That was troubling for her, because she had to cancel a holiday that she had booked, which was going to fall in and around that timeframe. What added insult to injury for that lady was an astonishing admission at the top of the piece of paper on which that letter was written. The fact that somebody had thought to write that the date that it had been dictated was October 15, but the date that it was typed was December 17. At two months, that letter had lain in a dictaphone somewhere, waiting to be typed up. This is 2018, and we are relying on 1970s technology in the cogwheels of our NHS. All of that time, she had to wait with a very troubling anxiety about what was causing the pain in her mouth. I am sure that we have all got stories like that. That is not about the waiting times themselves. It is about the profound mismanagement of expectation that we are subjecting our constituents to through the current application of that waiting time guarantee. I used to think that that was all to do with delayed discharge, and that is a huge part of it. There is a delayed discharge that causes that interruption in flow through every level of our health service. I want to take this moment to put on record my thanks to the cabinet secretary for intervening in the case that I raised with her last week of William Valentine, who I am very happy to say that he got home before the weekend, and I am grateful to her for that. I used to think that bed blocking and the 1,000 people who languish in hospitals every day who are fit to go home but have no home to go to, no social care package to go home to would be the solution. It is just part of the problem. We learned yesterday in the health committee that NHS Greater Glasgow and Clyde, although it has the lowest level of delayed discharge of any health board in the country, has some of the worst breaches of that 12-week waiting time guarantee, going up to something like 30,000 double in terms of in-patient weights in just last year alone. It is not just delayed discharge, it is care pathways, it is bureaucracy, not leaving letters lying around and dictaphones waiting to be typed up, it is demand and it is workforce planning. All of those are key to the solutions around waiting times, but it is around the expectation management that the Labour Party is right to bring the issue to Parliament today. When credited with the facts about the delay that it will have to endure, at brass tanks, being open and honest with patients at the start, we can expect that our constituents will accept that, will tolerate that, but what they cannot tolerate, what we cannot expect them to tolerate, is dangling the false hope of a 12-week guarantee that their health board has absolutely no way of meeting. Jackie Baillie to be followed by Ivan McKee. Presiding Officer, four minutes is not a lot of time, so let me cut to the chase. Waiting times are far too long and they are growing longer with each day that passes. It is a problem in NHS Greater Glasgow and Clyde and it is a problem across Scotland. Almost 120,000 people have had their waiting time guarantee breached. That is effectively the Scottish Government breaking the law 120,000 times. Their own law, Presiding Officer, is the one that they are breaking. Almost 16,000 people in Greater Glasgow and Clyde alone, and what lies behind those statistics are patients. Patients desperately in need of treatment, waiting in pain for months and in far too many cases over a year. In my area, the waiting list for ophthalmology is too long. I have cases where patients who require cataract surgery are being told that it will be 30 weeks before they see the consultant. Never mind receiving treatment, so there are delays that do not even count against the treatment time guarantee and the NHS is front loading the weight in order to massage their figures. That is nothing short of gaming the system. The waiting list for orthopedics is frankly shocking. There are people waiting in excruciating pain that are now housebound because they haven't received treatment. One constituent has crushed discs. She can barely walk. She screams with pain. She had to wait seven months for the results of a scan. One year on, she has been told to go back to her GP for a further assessment. When what she needs and everybody acknowledges she needs it is surgery, another example of gaming the system. Another constituent required a hip replacement. They got their treatment time guarantee letter. Oh, yes, they did. But when they phoned, they told that it would be at least 50 weeks, but we won't put that in writing to you. I've raised numerous cases in the chamber directly with the cabinet secretary months ago. I have written to her on several occasions on behalf of individual constituents. In fact, I could paper my walls with all the letters and her formulaic responses. Every letter tells me how concerned the cabinet secretary is and I quote, to read some of the information contained in my correspondence about the delays in the wait for treatment. Every letter tells me how grateful the cabinet secretary is and I quote, for bringing this to her attention and how it's vitally important that she hears about patients' direct experiences. Despite all of that, no, but despite all of that, nothing changes. The health boards are simply not listening to her. The cabinet secretary tells us that there's an extra 50 million made available last year, 11 million for Glasgow alone. I have to tell her. I don't see evidence of that in my area. Waiting times are not improving. The same problem remains. For people from my area, the Golden Jubilee—no, the Golden Jubilee put it in writing. The Golden Jubilee, the national waiting times hospital, is just down the road. They can do the orthopedic surgery, they can do the cataract surgery that my constituents are in desperate need of. Yet Greater Glasgow and Clyde rations access. They don't want to pay for patients to go to the Golden Jubilee. The last time I looked, we were all the one NHS. It would be quicker, more convenient, for patients from my area to go straight to the Golden Jubilee without Greater Glasgow and Clyde's interference. Audit Scotland has reported on waiting times on many occasions. It doesn't make pleasant reading. It has also suggested in the past that strengthening patients' rights, giving them more choice about where they are treated, will reduce waiting times. The cabinet secretary, when in opposition, agreed that she wanted patients—perhaps she should listen—to have greater involvement and choice about where and when they are treated. She believed that patients should be given a clearer indication of what their waiting time was likely to be. That was in 2006. It has only taken 12 years, but I am glad that it is now going to happen. I welcome the commitment today that all my constituents waiting beyond their treatment time guarantee will actually be told how long they will have to wait. However, let me invite her to make one other commitment that my constituents can have their operations quickly in the Golden Jubilee hospital without any more gaming of the system. Ivan McKee, to be followed by Edward Mountain. The motion before us today aims to tackle the issue of lack of predictability around waiting times by requiring health boards to communicate an accurate expected waiting time range to patients, which is a fine objective that we all share. The human impact of poor waiting time predictability is something that we recognise, including the economic cost to individuals and society as a whole. However, as often as the case with instant solutions to complex problems, the devil can be in the detail. Many questions arise from how such predicted waiting times are to be calculated, communicated and verified, and I hope to consider in my brief remarks today some of the many issues that we need to address to implement this process improvement. The motion introduces the concept of output predictability. It calls for health boards not only to achieve targets in terms of the 12-week statutory waiting time requirement, but also to predict the degree by which they will miss targets and to do so at the level of individual patients. That, while superficially attractive, raises some interesting questions. If health boards are to communicate anticipated waiting time ranges to patients, what steps are to be in place to ensure the accuracy of those predictions? A process would, of course, be required—indeed. Neil Findlay Key's business analysis of the health service all the time does not understand that the health service is about people waiting in agony on waiting lists. When he tries to apply a business principle to everything, it takes away that human element. Ivan McKee As Mr Findlay does not understand that I am standing up and ranting for 30 seconds, there is absolutely nothing to solve the problem. The problem will be solved by people who understand the problem, implementing solutions to make the situation better for the people of Scotland, not by Mr Findlay standing there and ranting. Back to the real world where we solve real problems. I hope that I get some extra time for that, Presiding Officer. I order. Continue the debate, please. Supply and demand variation. Sorry, where are we at? A process would require to measure whether helpless predicted waiting times were realised or not. I know that Mr Findlay does not care about that, but that is important if you are serious about implementing what you have in your motion. Supply and demand variation and unco-forecast events mean waiting times today, at the point where operation is scheduled, may well be very different to the waiting time that we realised several months down the line. Once indicators are in place, it is by a small step to setting targets against those indicators. Further questions exist around determinology. What is meant by the term range? A wide range could be specified by the health board, which would meet the requirement, but it would be of course limited value to patients. Work needs to be done to delineate the parameters of the anticipated allowable ranges. Similarly, the term accurate requires some clarification. What level of accuracy is acceptable and how to measure it? The track performance health boards would need not only to collect data on the number of procedures that are failed to meet the statutory targets as at present, but also on the variance between predicted and actual outcomes for each individual procedure. Verification would be required as to whether the IT systems are actually in place to collect that data and what the cost of data collection is going to be. The question then arises as to the definition of the indicator. The simplest might well be to track the percentage of operations that were completed within the predicted time range. That then raises the question of which is more important. For a waiting time of 16 weeks, you might want to listen, you might learn something. If a waiting time of 16 weeks is initially communicated to the patient and the operation is then completed in 13 weeks, is that a good thing or a bad thing, as initial prediction was inaccurate? That would perhaps depend on the individual circumstances of the patient. As always with target setting, there is of course the issue of unintended consequences. Any new indicators to track predictability performance will need to be aligned to Harry Barnes's on-going review of indicators and targets and with the Scottish Government's national framework indicators review. In conclusion, I welcome the intent of that motion. I have gone through it in a bit of detail unlike the people who have proposed it clearly have. Predictability is a virtue and I additionally look forward to the many hours that we can spend on the health and sports committee discussion on how we are going to go about implementing that process of improvement. Presiding Officer, it is only last week that I stood up in this chamber and discussed with the Scottish Government the mismanagement of the national health service. It seems to be little surprise to me that I am back here to do again the same as I did last week. Now, when thinking about which waiting time issues to talk about today, truly I was spoilt for choice. I could have gone with the issues based on NHS Highland figures such as Highland patients having to wait 26 weeks for routine orthopedic surgery, 47 weeks for routine ophthalmic surgery. That means that they are waiting from receiving a referral from their GP in many cases for over a year for treatment. Speaking with local consultants who deliver care in the Highlands, they all know and state that Highlanders are resilient and uncomplaining. However, there are times when those strengths, as I perceive them to be, become weaknesses. Many decide when they first become ill not to make a fuss too soon about their poor health. The result is that GPs and consultants are alerted to health problems in the Highlands much later than they should have been, and often symptoms are more advanced when they are diagnosed. That is why the issue of waiting times in the Highlands is indeed so critical. What ties the diagnosis and treatment together is a simple fact in my mind, radiology. Last year, I spoke to Cabinet Secretary about the poor state of radiology in the Highlands. That was because a letter signed by more than 50 members of the Department of Medicine and General Surgery at Rhaig Maw expressed their deep concerns about the current state of the radiology department at Rhaig Maw. Why staffing shortages had led to serious delays in elective and emergency reporting, with more than 8,000 films being unreported? Eight months on, there are still far too many unreported films. Neither medical diagnosis or surgical operations can take place in many cases until radiologists have interpreted scans and x-rays. Since I last spoke, the radiology department in Rhaig Maw is now lacking, Cabinet Secretary, a clinical director, a head of service and a radiologist services manager. The Scottish radiology transformation programme was meant to link up all departments across Scotland to cover short-term staffing issues, allowing reporting images to be undertaken in any radiology unit—an admiral idea. As the NHS IT system is so clunky, it does not assist speedy sharing of patient data between health authorities. I am unclear in my mind if this is a realistic solution without huge technological advancement. As to recruiting, the plans that you have done on this seem clearly not to be working. It seems to me that new thinking is desperately needed. I am going to give you a suggestion, Cabinet Secretary. One solution would be for you to consider starting a radiology training scheme based in Inverness to encourage more consultants to come and live and work in the highlands. I am sure that, once we have them there, we can encourage them to the benefits of staying there. Similar schemes have been developed across the remote areas of Australia, Canada and Alaska and have proved hugely successful. I know that this is not a short-term solution, but let us not forget that this problem has been 10 years in the making and we need the time to sort it out that much I will give you. Our NHS is something that we should all really be proud of. In many ways, I think that we are. The staff who deliver healthcare have risen to the challenge created by the lack of leadership and innovation. Across Scotland, I believe that the shortcomings in our NHS emanate from the top. Cabinet Secretary, it is time for you to step up and provide the leadership that has been severely lacking and which our NHS desperately needs and really, truly deserves. Thank you. Kate Forbes, to be followed by Neil Bibby. Thank you, Presiding Officer. It is probably quite appropriate to follow Edward Mountain's speech because I, too, would like to focus on some things that are going on in the highlands. It was this Government that brought in the patient rights act that Anna Sarwar quoted to ensure that patients must be supported properly and that their voices should be heard, that patients are seen as quickly as possible. Since then, despite the fact that not all patients are being seen, since then, more than 1.5 million inpatients in day cases have benefited from the 12 weeks treatment target. The Government amendment recognises that there is still room for improvement. Like Ross Greer, I, too, am contacted by constituents who are affected when the systems or processes do not work perfectly and things fall through the cracks, and long-term waits have serious implications, as Jackie Baillie outlined. It is about pain and discomfort that patients experience that none of us can properly understand. To see improvement, of course, needs to be targeted investment in services and reform of those services. As we are often faced with the challenges and difficulties, we did have a breakthrough yesterday in the highlands. We had a breakthrough on the Isle of Skye. I want to share some lessons from that experience, which demonstrates that when there is proper engagement with patients, when there is a focus on community services and when money is targeted well, it does make a difference. As Alex Cole-Hamilton said, it is very easy to throw rocks. In fact, it must be the easiest politics going. It is far harder to build consensus, seek solutions and deliver results, and to be honest along the way. After months, if not years, of severe challenges in the north end of Skye about the future of Petrie hospital, the last three months have started to turn the tide, and yesterday was the light at the end of the tunnel, as I am sure my fellow highland MSPs in all parties would agree. Yesterday, Professor Sir Louis Ritchie shared his findings of the review of Petrie hospital in Skye and stated unequivocally that Petrie hospital would remain open. The review was announced last October after meetings with campaigners early in the year to discuss their legitimate fears and concerns about the future of Petrie hospital, where out-of-hours and new admissions were being fairly regularly suspended. They were deeply concerned about local services, but it is a lot bigger than that. That demonstrates that where services are being cut in one area, it adds pressure to another area. Last summer, I was speaking to a healthcare professional at Regmore hospital, who shall remain nameless, about local residents' fears about Petrie hospital. She said to me in frustration that the problem with closing Petrie hospital is that it would just put greater pressure on big hospitals like Regmore, and it makes it even more difficult for places like Regmore to meet waiting times targets. In other words, the Government's motion amendment says that we need to get more services into the community, and in so doing, we will reduce pressure on hospitals like Regmore, which, incidentally, adds a minimum of a two-hour drive to the patient's journey for basic services. Edward Mountain. I will be very brief, Mr Mountain. I join with Kate Forbes and welcome the report by Sir Louis Ritchie. I think that it shows that the report is very important. I think that the report is very important. I think that it showed a novel and innovative thought process, one that has not been shown by NHS Highland. Does she agree with that? Kate Forbes. Absolutely. What I am saying quite strongly in this debate is that it is easy to identify where the challenges are. However, I think that this entire process demonstrated that where a clinician, an independent reviewer can come in, can build trust and faith between healthcare providers and the public and look for novel solutions. We are indirectly reducing waiting times by ensuring that investment is targeted well and that services are reformed. That was all done with the very welcome backing of the cabinet secretary, which demonstrates that leadership is working, that leadership right from the top is working in Scotland and that it has a direct impact on patients' concerns in the north end of the sky. Thank you very much. I call on Neil Bibby to be followed by Michelle Ballantyne. Neil Bibby. Thank you, Presiding Officer. I support the motion in Anna Sarwar's name, and I am pleased that other parties in the chamber intend to support it. True patients should get the treatment that they need on time, but if they do not, then health boards need to be opened and up front about how long patients will be expected to wait and why. It is important to tell people why, because all too often breaches of the treatment time guarantee and other waiting time standards are a symptom of the wider problems in the NHS. As always, we hear lots of rhetoric from the SNP on staffing levels and resources, but the reality is that health boards have already had to make what Audit Scotland described as unprecedented savings. We also know from Audit Scotland that operating costs are up, demand for services is up, improvements in life expectancy have stalled, health inequalities persist, recruitment is in crisis and the NHS itself remains underfunded. Those challenges are significant, but none of them are new. The Scottish Government put in place a Patients' Right Act in 2012, but the problem is that it has not put in place a proper plan or adequate resources to deliver it. For years, the SNP Government has been warned about mounting pressures on the NHS. For years, they have been told that they need to deal with the NHS workforce crisis, but what we see is a situation where the NHS is overstretched and underfunded and that the NHS workers are overworked. The Government's failure to rise to foreseeable challenges has prevented patients from getting the care that they need and when they are entitled to get it. It is time that the Government admitted it and addressed it. Across the country, patients are waiting too long for the care that they need. In my own region, a constituent recently phoned a hospital about an appointment just to be told to go to A&E and complain of heart pains. She has told us because otherwise she would be waiting months to see a specialist about her heart complaint. A number of families who once had access to the RAH's children's ward, the health minister closed, have told me that they now have to wait longer to see a doctor in Glasgow. As Jackie Baillie said, official statistics show that there are thousands of cases of patients in NHS Greater Glasgow and Clyde and Frout Scotland where the treatment time guarantee has been breached. Of course, the SNP's waiting time guarantee is a legal one. It has been written into law to put it simply if the guarantee has been broken. That means that the law has been broken. The First Minister tells us that we are to judge the SNP on the record where we can, and when it comes to health, it is criminal. We have already heard this afternoon that the SNP Government and Health Secretary have broken their own waiting times law over 118,000 times. Breaking a law can hardly make Shona Robison Scotland's Al Capone, but it is certainly guilty of failing Scotland's NHS. In the next reshuffle, Shona Robison might find out that she is not untouchable. The health secretary is running out of excuses. Shona Robison told us last week that adequate funding was being given to the NHS. Scottish Labour disagrees, because if there are sufficient resources going to the NHS, then why are we seeing 3,000 operations already cancelled this year, A&E waiting times up, children's wards being closed and 118,000 people waiting longer than the SNP's treatment time guarantee. 118,000 people waiting for hip replacements, knee replacements, stents, cataracts and heart surgery. Real people with real needs let down by this Government. It is welcome that patients should start to get open and honest information on how long they are expected to wait for treatment and why, but that is the very least that they deserve. We now need to see urgent action so that far more of Scotland's patients get their treatment on time, and that is why I urge members to support the Labour motion. Today's debate on waiting times is not a new issue. Back in 2006, Audit Scotland reported that the NHS in Scotland had made significant progress in reducing waiting times. However, some of that had been achieved by using the Golden Jubilee National Hospital, private providers and waiting times initiatives, all of which had been at relatively high cost. Evidence suggested that, then, that short-term increases in activity at particular points in the system did not lead to sustained reductions in waiting times. Despite that knowledge, in 2011, the Government brought forward the Patients' Rights Act which enshrined 12-week waiting time guarantees. For many of us, it is not surprising that we are here today listening to statistics of breached waiting times and the distress and suffering behind those statistics. Why do we have waiting time targets and what do they mean for us as decision makers? For Government and indeed our communities, waiting time targets signal that healthcare is being monitored, governance is in place and patients' rights are being protected. As a nurse, operational and strategic manager in the NHS for over 25 years, I witnessed the impact that Government targets and guarantees have on our healthcare systems. The operational imperative of not breaching a target, driving decision making and leading to some of the scandals that we have seen over the years. Waiting time targets are not clinically led. If you are in pain of suffering with acute mental health problems, being told that you will be treated within 12 weeks feels like a lifetime, but then to discover the information that you receive is not accurate and your expectations will not be met can be devastating both to your physical and mental wellbeing. Patients want to be given accurate, timely information. Health and community care is a complex system whose efficiency is dependent on all its interrelated parts. Waiting lists and waiting times are affected by each part of the system and by the links between them. Of course, there is a place for short-term approaches to tackle delays, but they need to be part of a wider strategy that looks at the whole system for achieving a sustainable reduction in waiting times. At around £12.9 billion, our NHS spending accounts for 43 per cent of the overall Scottish Government budget. Whilst rising operating costs have meant that health boards have had to make unprecedented savings of almost £390 million just to break even, in October 2017 Audit Scotland concluded that simply adding more funding was no longer sufficient to achieve the step change that is needed across the system. Now we in this chamber can trade insults, cast aspersions of blame and try to outdo each other on who is most virtuous, but the reality is that this will not address the real problems that our NHS faces. So in conclusion I would say this. Do I blame the SNP and their Government for the failure to meet waiting times? No I don't. They don't control patient demand or indeed many of the bottlenecks and realities in individual areas that impact on waiting times, but do I hold the SNP and their Government responsible for their failure to meet waiting times? Absolutely. They introduced the Patients Rights Act, they established the measures, they took responsibility and they would after all want the credit if it was achieved, so yes of course they are responsible when the promises are broken. That is the bottom line in this debate. Thank you very much. I remind the chamber and the parliamentary liaison officer to the health secretary. The Patient Rights Scotland Act 2011 created a statutory treatment time guarantee of 12 weeks and already over 1.5 million in patients in day cases have already benefited from the 12 weeks treatment target since it was introduced, as has been mentioned by others. We can see a programme of record investment in reform taking place in our NHS, which is resulting in care being removed from hospitals where appropriate and integrated back into the community and that is the right thing to do. Our budget for health has seen significant increases under the SNP Government and will continue to increase the spending by £2 billion. We must accept that these changes will not happen overnight but we are taking the correct steps to see real change in reform in our NHS and we have the best possible treatments readily available in the future. It is a responsibility of course of health boards to ensure that eligible patients receive their treatment within 12 weeks. That may mean that with patients concerned that the health board makes arrangements for a patient to be treated in another health board area to ensure that the 12-week guarantee is met. No-one in this debate today is saying that all waiting times are met. We know that this is not the case in the cabinet secretary herself has never said this. As a constituent MSP, I often have exasperated patients come to me who have waited over their time and they often relate, as others have said, to orthopedic operations. What I do is I work with the NHS board to try to resolve their situation and many times we are able to get the situation resolved to the constituent's satisfaction. However, the vast majority of those times are met. Of course staffing is an important issue in the cases where the targets are not met and that is why I was defending agency staff against what I perceived as attacks from both Labour and Tory politicians locally last week. Not because I want agency staff per se, but I realise that with the health staff leaving in the face of Brexit among other factors such as austerity from the UK Government, there is a reality about how we meet the needs of the service and agency staff when they are there to do a very valuable and good job. I am not going to have time, Mr Briggsory. The Scottish Government has always made clear to boards that patients with the greatest clinical needs such as cancer patients continue to be seen quickly. There are two national cancer standards in place that NHS boards are asked to deliver against. The current standard is that 95 per cent of all patients meeting the criteria should wait no longer than 62 or 31 days as set out by the Scottish Government. I am pleased to say that a briefing from NHS Lanarkshire this morning, NHS Lanarkshire is consistently delivered in both cancer standards. The most recent figures published show that NHS Lanarkshire had 96.1 per cent of patients starting treatment within 62 days, Fudgford and Rhaffero, with a suspicion of cancer, and 98 per cent cancer patients starting treatment within 31 days of decision to treat. Those targets were made in other health boards areas as well, but it is an example of NHS Lanarkshire's continued excellent performance in this area and, as an example, the dedication and hard work of the staff. I know that they will continue to maintain and improve the performance and ensure that patients continue to receive the highest standards of care while also avoiding delays where possible. In the short time that I have left, I would just like to end in a positive story, because a lot of the time in the chamber we hear of situations where things have maybe went wrong. For some months now, I have had the pleasure to assist my constituent, sadly diagnosed, with stage 4 colorectal cancer, in assessing various treatment programmes for his terminal cancer diagnosis. I low-face with aggressive treatment for an aggressive cancer in my constituent, an otherwise healthy father to a young adoptive family who is keen to explore all available treatment options, including treatments available through clinical trial. Unfortunately, my constituent was placed in the placebo group for the trial that he joined, and seeing no benefit continuing with the treatment offered essentially no different to standard-blind chemotherapy seeking to address his particular course of treatment, not routinely funded by the NHS or by any other means. Without getting into any great detail of my constituent, he was devastated to be informed by his MDT that the treatment that he was seeking to access was not considered to be appropriate at that point in time. However, the UK lead clinician for the treatment in question found my constituent actually to be the optimal patient for this course of treatment and feeling that he should be offered treatment. I agreed to support my constituent in his appeal to be treated in Scotland with NHS funding. I am delighted to say that the funding has been agreed with my constituent's treatment due to start later on this month. My constituent at the start of this year is expected to have a short number of months left to live, and now he can possibly look forward to many more years with his young family. I will leave it on that, Presiding Officer. I move to closing speeches now called Brian Whittle to be followed by the minister, Eileen Campbell. Thank you, Presiding Officer. I am going to start by referring members to my register of interest in that I have a close family member who is a healthcare professional in the Scottish NHS. Today, we are debating the patient charter, which states that there is a 12-week guarantee for treatment that was set in stone by the SNP. In the interests of patient care and the principles of honesty and transparency, NHS boards should communicate an accurate, expected waiting-time range to patients. I am sure that we all agree that it is the Opposition's responsibility to scrutinise Government policy and to hold the SNP to account wherever it has failed to deliver for Scotland. In the Labour's motion, which the Scottish Conservatives will support, that scrutiny is being exercised. The fact is that it is such an obvious point where debating is one that should concern us all. It should not take an Opposition debate to raise such a basic fundamental principle to get the SNP to take action that I think is Annas Sarwar pointed out in his opening address. It is important, Presiding Officer, that when we are debating health, we do so in a manner that does not undermine work that has been done on the front line every day. I think that Michelle Ballantyne was at pains to highlight, and using her 25 years of experience in nursing, she highlighted how important it is that when we debate health, we are cognisant, we are attempting to improve the health outcomes for patients and healthcare professionals. The debate today has given other speakers the opportunity to raise their own local issues. We have heard from Miles Briggs, Annas Sarwar and Ross Greer and Jackie Baillie, among others. Edward Mountain took his time to raise care on the highlands and raised the issue of radiology in Ragmore. To his credit, he came up with some positive solutions for the cabinet secretary. As I said, Presiding Officer, I do not think that this is a typical health debate, the tone that was set in the opening speeches. It was obvious, quite honestly, that this would be a non-debate debate. We need to address waiting times in the round. We need to look at the acute waiting times, things like mental health, which deteriorate over time with that increasing financial time and personal cost, as we have heard all too clearly highlighted in the previous debate. Physiotherapy for musculoskeletal conditions, where a waiting time of a year for what is essentially an immediate requirement, makes an acute issue long-term, costly, with a potential impact on physical and mental health. Alex Cole-Hamilton highlighted the anxiety of his constituent waiting for treatment and what could have been a very serious issue. In that delay and that false hope of treatment impacts in all areas of her life and we wish her well. As I have said today, Presiding Officer, today's debate for me is a non-debate. I think that the net result is that Labour, using their debating time, has been taken up with what the Scottish Government had already agreed to in law. We could have been debating how we deal with waiting times, what they mean in the language that we use when we discuss them. If you are cynical, you may consider that the Scottish Government has agreed to the obvious to take the heat out of an issue that they should have already dealt with. Perhaps they have become so paralysed for fear of doing anything wrong that they are reticent to do anything of note at all. There is so much more to do if we are to tackle the issues that we face within the health service. We have talked about education, nutrition and physical activity, and planning, the environment and the rural economy all have a footprint in improving the health of our nation. If waiting times are the barometer for the health of our NHS, then it reads that change is required. I welcome that change will be taking place as a result of this debate, but I struggle to see how today's debate will impact on the real issues facing our NHS staff and their patients. It is important that this issue is addressed, and for that I thank Labour for bringing it to the chamber. It does not need any amendment from the Scottish Conservatives, so it is obvious. However, the fact that it had to be raised should concern us all. Like all MSPs, I want to take my opportunity to thank all our NHS staff and recognise the phenomenal work that our NHS does day in and day out. An institution that is 70 years old this year, founded and based on the principles of being free at the point of delivery, universal, not based on wealth, equitable and of high quality. Those principles may be 70 years old, but they are as relevant now as they have ever been. While the core principles remain a constant, what has undoubtedly changed has been the context, the demand and the challenges that the NHS and we all, as a society, now face. Meeting those challenges requires matured debate, and we have heard some of that this afternoon. That is why, in this Government, we seek to meet those challenges with a twin approach of investment and of reform. That is why we will drive improvements in performance and shift the balance of care from acute to primary and social care, as our amendment makes clear. As we rightly celebrate all that is good and all that is positive about the NHS, we all recognise that, sometimes, things fall below the standards that we would expect. We heard some of that today, and it is important that we hear that, and it is important that we learn from that direct experience. Situations that will be very real for those individuals but who require and deserve a clarity of information and reassurance. Ross Greer's contribution captured the essence of that. That is why, as the cabinet secretary, articulated in her opening remarks, we are committed to revising the charter of patients' rights and responsibilities, and to work with the boards to ensure the communication of that revised guidance. That experience of people and patients is what motivates our determinations to make the improvements that we know we need to see. For taking that intervention, will she commit to bringing to this Parliament the suggested amendments to the charter so that they can be discussed and debated, and to bring forward what guidance she will give to health boards so that we can see what language they will be using when writing to patients? The health boards process and, of course, we will publish that. Again, perhaps it might be a lesson if you seek to have those things discussed in chamber. Perhaps it is an approach to come to this chamber with constructive ideas and solutions to the challenges that we face. Of course, the cabinet secretary and we will publish the revised guidance in due course. That dedication to make improvement is why £50 million was allocated to support the reduction in hospital waiting times. That is why the cabinet secretary launched, back by £4 million, the new access collaborative that seeks to improve the way elective care services are managed and reduce weights. That is why £200 million will be invested in the life of this Parliament to expand elective capacity for routine operations at the Golden Jubilee hospital and in the new treatment centres across Scotland. That will reduce waiting times and take the pressure off. That is also why Scotland has been the first nation in the UK to publish a national health and care workforce plan and also the only nation committed to safe staffing legislation, building on the record high levels of NHS staffing delivered under this Government. A list of actions from this Government relentless in its pursuit of enabling our NHS to meet the needs of the people it serves, but not blinded by the challenges that we face or the experiences of people who are in the here and now. Where there have been contributions that seek to be constructive and solve the challenges, we will of course listen. We will listen and respond to the ideas from Edward Mountain on radiology and attracting professions to the highlands. Won't he necessarily agree with everything that he said or that of his colleague Michelle Ballantyne, but dently appreciate the attempt to be constructive and of course the professional experience of Michelle. We will absolutely listen to the example from Kate Forbes, where engagement and consultation with people and communities enabled a better decision in the Isle of Skye and what that means for future engagement between the NHS boards and the communities that they serve. That is also why we will heed the words from Ross Greer, who urged a broader examination of the issues to understand, for instance, the impact of the hostile immigration environment that has been established, and of course the impact of the freedom of movement restrictions under Brexit. You will notice that there was not a mention of the Labour MPs who come to this chamber and do well to criticise but do not do as well when it comes to coming with ideas to remedy the concerns that they have aired. We will get on with the job of supporting our NHS, building on the high satisfaction rates that fell across Scotland, that is improving on the target, seeing 9 out of 10 patients, 1.5 million people being treated within the 12-week treatment guarantee since introduction in 2012, and we will continue to build on the strengths of our NHS to ensure that it is in a position of strength for the next 70 years to come. Thank you, Presiding Officer. This has been an excellent debate on a vital issue, and I want to thank members from across the chamber for their insightful, knowledgeable and strongly felt contributions. Waiting times are always difficult, and when a patient is suffering from an illness or an injury, any time between cause, diagnosis and treatment is unwanted. It prolongs the pain, as well as adding additional stress to mental and physical well-being. Members this afternoon, such as Jackie Baillie, Anasawa Ross Greer, Alex Cole-Hamilton, Edward Mountain, Kate Forbes, Neil Bibby and Michelle Ballantyne, have illustrated this perfectly by quoting dissatisfied constituents who felt let down by the system. A system, Presiding Officer, that put in place the patients rights Scotland Act 2011 in place to guarantee a 12-week treatment time, this allowed hospitals and boards to manage expectations and patients to have a known time frame. What we can't forget, Presiding Officer, is that waiting times aren't just simple facts and figures. Behind every delay in getting an operation or seeing a consultant, there's an individual often with anxiety, pain and stress. I remember, Presiding Officer, when an 18-year-old and a nice writer, Beth Mac Hardill, came to see me, because she was told that she had to wait 11 months for a relatively simple cataract operation. She said, It's vital that we, Oxygirianians, are able to lead independent lives and still contribute to society, and it has to be remembered that many are still caring for a partner or family member. Without the basic support of maintaining adequate eyesight, we rapidly are more dependent on the NHS and care services in cost of the state, so every statistic holds similar stories. Now, why I can't fall in NHS Highland and trying to clear the backlog and reduce the waiting time is concerning that these procedures are going to be outsourced to private companies and other boards at great costs. For the second year in a row, NHS Scotland failed to meet seven out of eight of the key performance targets, according to Audit Scotland's report. One of the key problems identified as the widespread difficulty meeting demand and the impact that it is having on waiting times. Frontline NHS staff worked tirelessly to try and ensure that staffing issues, lack of resources and underfunding, do not compromise patient care, but they do so in the face of growing pressure. I don't just take my word of it. Audit Scotland in its 2017 report said in a quote, People are waiting longer to be seen with waiting lists for first outpatient appointment and inpatient treatment, increasing by 15% and 12% respectively in the past year. The other big issue is life expectancy. The life expectancy gap is increasing, with men from the most deprived areas now living on an average 12.2 years less than the more affluent counterparts, and women is 8.6 years. Those from deprived areas increase their likely to spend more time in ill health with nine years for men and 11.5 years for women. On top of that, one key area for waiting times for mist cancers higher rate among disadvantaged communities but lowest detection rates. Those from deprived communities are most likely to be diagnosed with breast and lung cancer at stage 4. For those with the least deprived, most likely to be diagnosed at stage 1 or 2. For those with the most disadvantaged areas being diagnosed later, early access to treatment is key to improving outcomes and reducing the life expectancy gap. That disparity must be addressed as a matter of urgency. In conclusion, the NHS turns 70 on July 5, and we are still having to fight to protect it. As the founder and Ibevan said, discontent arises from a knowledge of the possible as contrasted with the actual. Those debates are frustrating because we know we can do better. Do better for the NHS, for the front-line staff, for the patients and for the families of patients, and I ask you all to submit our motion at decision time today. Thank you. Thank you, Mr Stewart. That concludes our debate on waiting times. The next item of business is consideration of business motion 12137. Point of order, Ms Harper. I am wondering what is the process of amending the official record when information shared in this chamber is incorrect or inaccurate. I am asking him because yesterday, during the dangerous dogs debate, when referring to the take the lead campaign, Finlay Carson made an incorrect statement referring to me. He said that it is somewhat disappointing but not surprising that Emma Harper, the parliamentary liaison officer to Fergus Ewing, who originally backed the campaign, has now backed off and supports the far from satisfactory postcode lottery option of additional local authority bylaw powers. I was not in chamber for the debate to respond, so I would like to note that I have never made any personal comment or statement about amending bylaws, so I am therefore seeking your advice on how Mr Carson can amend his mistake on the official record. Can I thank Ms Harper first of all for the advance notice, the point of order. She will know that the official report for yesterday cannot be amended. That was a correct record of what was stated in the chamber at the time. However, Ms Harper has drawn the matter to the attention of Mr Carson and Ms Harper has herself put her own comments on the record for all to see. The next item of business is consideration of business motion 12137, in the name of Joe Fitzpatrick, on behalf of the bureau sitting at a business programme. If anyone wishes to speak against it, please press your button now, and I call on Joe Fitzpatrick to move the motion. Formally moved. Thank you very much. And no one wishes to speak against it, therefore the question is that motion 12137 be agreed. Are we all agreed? We are, thank you. We turn now to decision time. The first question is that amendment 12107.3, in the name of Shona Robison, which seeks to amend motion 12107, in the name of Anas Sarwar, on NHS Tayside Public Inquiry, be agreed. Are we all agreed? Yes. We are agreed. The next question is that amendment 12107.2, in the name of Miles Briggs, which seeks to amend the motion in the name of Anas Sarwar, be agreed. Are we all agreed? Yes. We are agreed. The next question is that motion 12107, in the name of Anas Sarwar, as amended, on NHS Tayside Public Inquiry, be agreed. Are we all agreed? Yes. We are agreed. The next question is that amendment 12108.1, in the name of Shona Robison, which seeks to amend motion 12108, in the name of Anas Sarwar, on waiting times, be agreed. Are we all agreed? Yes. We are agreed. The final question is that motion 12108, in the name of Anas Sarwar, as amended, on waiting times, be agreed. Are we all agreed? Yes. We are agreed. And that concludes decision time. We'll move now to member's business, the name of Rachel Hamilton. On the condition of Scotland Roads, we'll just take a few moments for the member and ministers to Chainsies.