 The final item of business is members' business debate on motion 1290 in the name of Neil Finlay on St John's children's ward still closed to out of hours in patients. The debate will be concluded without any questions being put and I would ask those members who wish to speak in the debate to press the request to speak buttons. I call on Neil Finlay to open the debate for around seven minutes please, Mr Finlay. Thank you, and a big thanks to those who have signed my motion. I have allowed this debate to go forward. There is an error, but there is an additional word in the motion that says out of hours, it is actually all in-patient so I apologise to the chamber for that I wish there was no need for this debate, I wish that parents with desperately sick children from yn gymi'r flwyddyn yn Llywodraeth hwyniad o Llywodraeth fel Llywodraeth, Yn Llywodraeth i Gwytburn, Armadal i Llywodraeth i Llywodraeth, Stoniburn a Bwrych i Llywodraeth i Llywodraeth i Gwytburn ac Beoredd, yn allan yn tredu i Llywodraeth i Llywodraeth i 93rynnyddau i Edinburgh i gael y pleidiau. Mae yna cael ei cael eu bwysig chi i'r gael a'r cael eu gael eich Llywodraeth i'r gael, a ei gallwch chi'n gael i'r gael i'r gael ar boligol, yn oed yn ei wneud i'r bobl yn gyfgaredd ar gyfer cînbeithio i gael ei myfaf i gael i'r cysyflen Pwg, ac mae ddegwyd y fwrdd enw. Byddwn i ysgrifeid ysgrifeid yng Nghymru, yw i gafio ar gyfer ei ysgrifeid yw'r gyflyniad rai gwiriau ar y bobl, ac mae'r mwybod nid o'r gael iawn i gael ei gyflyniad ar gyfer bwysigau ysgrifeid, oedden nhw i gan ymmoedd Cymru yw Jwgwn i sesrfytfyniad â'r Roswedd Llywodraedd. Maen nhw'r hyn yn rhywbeth o ein gwneud y gwneud mewn meddwl y tornau ysgrifun y Llywodraeth Llywodraeth Llywodraeth ym mwyafnol Cymru a'r gyffredin o'r llaquenol o'r cynnwys Cymru i'r llaw llaw Llywodraeth ym unrhyw llwyddu, peth wneud gyda'r llaw llwyddu am y llaw Llywodraeth i'r llwysr. Oherwydd i wneud rydych chi fyddwn yn gymhag i wasbylpaethu Llywodraeth ym Mwyafnol Felly, rwyf yn gweithio i gynrych ar y cyfnodol. Felly, mae'r cyhoedd yn y pethau, er mwyn i ni'n gyllidio'r problemau, ond ganallu cyfle i gynnwys gwrs yn gweithio a llwy fyddai. Felly, rwyf yn fwy o'r fathau'r ysgol i'r cyffredinol a'r gwaith o'r 2047 cyfreith mewn cyd-dynion i ymdriw sy'n cyfrifolau. Mae ydych chi'n gwybod hyn, mae'n gwybod i'u sicr i'w meddwl y ddechrau i ddawidol y cyfrifolau. why is it considered acceptable that a vital service is allowed to buckle because two members of staff, quite naturally, and I don't condemn them at all for that, choose to take leave at the same time? On each occasion that there's been a closure, NHS Lothian have told me that they were doing all they could to sort this out. They were scowling the globe for staff and it just wasn't possible to find any. The First Minister told me that this was just a temporary situation. He also advised that, despite consultants being employed by NHS Lothian as a whole, they were unable to make them travel to Livingston or work flexibly over different sites to provide a 24-7 service, but instead expected families and children to travel up to 33 miles when in need of emergency treatment. However, this latest closure is the longest and most worrying, almost 230 days ago, the ward was closed to inpatients. From then until January, almost 500 children had been sent to other hospitals with 414 admitted to a ward. Over 3,000 children were sent home from the emergency department after midnight and on 47 occasions, taxes costing almost £2,000 were paid to take them home. The children sent to Edinburgh from St John's didn't have a graze near a sprained ankle. Those were children with very serious conditions. Children like Matthew, who suffers from a serious respiratory problem, or Frankie, who has a rare condition that causes him serious seizures, require very regular and urgent hospitalisation, or Caden, who suffers from severe breathing difficulties. Only last week had to be hospitalised at Wisha General. Those are children for whom every minute and ambulance, every second stuck in traffic or in the bypass, put their lives at risk. Over the past two years, NHS Lothian has twice brought in the Royal College of Pediatrics to independently examine the need for the ward. On both occasions, they have confirmed that St John's needs a 24-7 children's service, hardly a revelation given that it sits in one of the youngest and fastest-growing communities in Scotland. Yet, despite that, we find the situation getting worse instead of better. Cabinet Secretary, I say to the public that I have had enough. A few weeks ago, on a bitterly cold day, I was joined by families and children outside St John's. Those parents contacted me as they wanted to demonstrate and vent their frustration at this situation. I want to thank the mums and dads, grandparents, carers and children who came that day, and the thousands who signed petitions, postcards and surveys calling for an end to the ridiculous situation. I will tell you of three quotes from randomly selected and assure you of that from some of the latest correspondence that I have had. The Scottish Government is fully accountable for this. It should be recruiting the necessary personnel to fill those posts. There is no excuse for a hospital in your doorstep and not being able to use it for my three-year-old child. I think that this is an outrage. The children's ward should be open at all times. There are hundreds more. Senior officers at NHS Lothian and ministers and civil servants in the Scottish Government have not got the ability or initiative to resolve those problems after six years. Maybe they should make way for people who can. Parents do not want to be fobbed off any longer. We need action to make this vital service sustainable. No more shrugs of the shoulders, no more platitudes, no more absence of any sense of urgency because children's lives are at stake. It is not a weakness to admit your failings. We should all show more humility and honesty at times. I genuinely appeal to the cabinet secretary to seek help to resolve this from wherever it can be found, whether that is from other nations of the UK or from some of our international neighbours. Admit your failings, apologise for this mess and seek help to resolve this unacceptable situation now. We now move to the open debate for speeches of four minutes please. I call Gordon MacDonald to be followed by Miles Briggs. Thank you, Presiding Officer. I am grateful for the opportunity to add my voice to those calling for the return of a 24-7 service at the paediatric inpatient ward at St John's hospital as soon as possible. I have to declare an interest as my daughter-in-law recently gave birth to my first grandchild at St John's, and I am thankful to the staff and the paediatricians for the care that my daughter-in-law and grandson received. The Royal College review report into the situation at St John's concluded not once but twice that West Lothian, with the same population as Dundee, and with a growing young population, merited and needed its own children's ward. A recommendation accepted by the Scottish Government and NHS Lothian. The Royal College updated report of September 2017 highlights that the health board has tried extremely hard to make this arrangement succeed with four rounds of active consultant recruitment. However, there are two issues impacting on the success of the recruitment drive. The first is the lack of paediatric consultants across the UK. The Royal College highlighted in 2017 that nearly a third of the UK's 195 NHS trusts and health boards have temporarily closed paediatric wards due to shortages in child health professionals and the vast majority of vacancies being consultants. In relation to St John's hospital, the Royal College updated review report states that it is a long-standing reputation as a unit that is under threat of closure and highlights that that is a significant blight on recruitment. That is despite the Scottish Government and NHS Lothian accepting the option that a 24-7 service should be delivered. It would be helpful if the cabinet secretary could highlight what steps the Government is taking to ensure that NHS Lothian follows through their commitment to respond to and implement the Royal College's recommendations in her closing remarks. West Lothian children have always had to travel into Edinburgh for particular types of care and treatment. That is well understood and accepted by the wider West Lothian community, but having the children's word that St John's prevents some children from being admitted to hospital miles away from home also enables children who have had to receive serious and intensive treatment at sick kids or your kill to return to their local hospital for rehabilitation. Lengthy hospital admissions miles away from home have a well-documented impact on the well-being of children and a heavy financial and emotional costs to families. Therefore, treating children closer to home whenever possible is not just the right thing to do, it is the smart thing to do and in everyone's interests. That is an important point made by the constituency MSP, Angela Constance and others in the evidence that was submitted to the Royal College when it was deliberating on paediatric services across the Lothians. I want to end by highlighting remarks that have been made by the West Lothian constituency MSPs, Angela Constance and Fiona Hyslop. St John's hospital is a first-class hospital with a children's word that is held in high esteem by the local community. It is imperative that politicians do everything to support the recruitment of paediatricians and advanced nurse practitioners by being positive about the future and what the hospital offers. We must not, in our devils, to protect and enhance local services, create a negative message on what the Royal College refers to as blight. That would be counterproductive and a disservice to the children and people of West Lothian. Finally, I want to put on record my thanks and that of my colleagues to the doctors, nurses and the wider support staff at the children's ward at St John's who do a tremendous job day in, day out in difficult circumstances and that we stand by them in their quest to continue to deliver for the children of West Lothian. Can I ask members to desist from shouting from a sedentary position at the back of the chamber, please? I call Miles Briggs to be followed by Anas Sarwar. I would like to start by congratulating my Lothian colleague Neil Findlay on securing today's debate. I am pleased that Parliament is debating an issue of such importance to so many families across West Lothian. It is difficult to overstate the level of concern, frustration and indeed anger felt by West Lothian residents at the continuing closure of the kids ward at St John's. When this latest closure was announced last June, the third in as many years, NHS Lothian and the Scottish Government indicated that a full service would be reinstated as soon as possible after the summer. The impression was clearly given that we would see a 24-7 service resumed last autumn, but many months later we appear to be nowhere near a reopening and local people are understandably disappointed and annoyed. Neil Findlay set out in a very effective way the impact this closure has had on hundreds of families across West Lothian who have had to see their children admitted to Edinburgh Sick Kids Hospital instead of St John's, with all the extra travelling times, expenses and stresses that that brings to parents who are already worried and anxious about the health of their child. The closure has piled also extra pressure on the sick kids and on overstretched ambulance services. Indeed, on this latter point, a recent freedom of information request has indicated that the number of patient journeys by ambulance from St John's to the sick kids increased fourfold when the ward was closed to inpatients, compared to when it is fully open. It is not only parents and families who are angry, but also the hard-working ambulance staff, as well as the brilliant paediatric nurses, doctors and consultants at both the Sick Kids and St John's, some of whom I met on a recent visit, who have been let down by an abject failure over many years now, both by NHS Lothian and by the Scottish Government, to put in place the robust, credible long-term workforce plans that we must see at St John's to allow the kids' ward to operate sustainably on a full-time basis, despite warning after warning. The inability to recruit sufficient consultants and tier 2s to cover the ward on a 24-7 basis is the fundamental short-term crisis that we need to resolve. I look forward to the minister updating Parliament on what any progress has been made on that and what innovative approaches can be taken to develop and recruit the staff whom we need to see at St John's, because it is quite clear from this debate and over the past six years that the current approaches are clearly not working and are not good enough. However, we also need to see a longer-term approach that raises the profile and, more importantly, the prestige of the paediatric services at St John's. That is why I have called on the Scottish Deanery to launch a review, a review of where paediatric training takes place in the south-east Scotland region, with a view to ensuring that trainee medics can choose to undertake to do part of their training at St John's. That is what the specialists there were telling me when I visited them, could help to make it a 24-7 unit once again. I hope that the Deanery can show flexibility and look at all possible options and systems to allow that to take place, with St John's children's unit possibly being deemed a satellite to the sick kids for training purposes. That would, I believe, raise the status of children's services in St John's, provide more medics to assist the consultants team there and mean that medical students have that experience of a hospital's kids ward and the fantastic opportunities above all that St John's can present for an early career and not just larger and more specialist hospitals like the sick kids when they are actually looking to full-time positions. I will write to the Deanery on that and I would welcome the cabinet secretary and other members' support for that initiative. To conclude, Deputy Presiding Officer, I welcome today's debate. I think that it's incredibly important that we do air these views and have these issues raised in our Parliament. I'm happy to give my full support to the motion and to my constituents across West Lothian who, above all, want to see the sick kids ward restored to 24-7-1. It should be an area with, as we've heard in this debate, this area has a growing population and clearly requires the level of paediatric service as other parts of Scotland enjoy. Above all, I hope that ministers will take decisive actions that are now required to ensure that the ward is reopened again and on a sustainable, long-term basis. That means that local families can have confidence that we will not experience any further closures and that we will be able to see that West Lothian's children are treated in West Lothian. I start like others in congratulating Neil Findlay on bringing forward this important debate. I say right at the outset to Gordon MacDonald that what lets down service users is the continued closure of the ward and the continued inaction of the Scottish Government and the health board, not the individual's campaigning to keep the ward open. It is an insult to suggest that those campaigners who, in their own voluntary time, many of the parents of children who need the use of that ward are somehow scaremongering or letting down the local community. I pay tribute to all the campaigners who are out there on the streets campaigning on the issue. However, the reality is that they should not be campaigning because they have been promised year after year that their ward was safe and that the ward would be open, fully resourced, fully staffed and give the care that their children deserve. It is a shame that we are now 230 days to that continued closure. I would like to say that this was an isolated case but, sadly, it is not. We only need to look at the decision of the paediatric ward at the Royal Alexander hospital, where it was promised that the ward would remain open, but it is now closed. Would you look at campaigning not in paediatrics but in other parts of our NHS, whether it be the maternity services at the Vale of Leven or at the Inverclyde Royal hospital, where, again, local campaigners who were promised that their service would remain open are having to take to the streets and sign petitions to protect the service that they were promised during the election would remain open? Fundamentally, this debate and other debates that we have had about NHS services come down to the integrity of this Government, public trust, transparency of our health boards and on-going workforce crisis, continued cuts that the health boards are having to make and the vital services that people need and that they need locally. The reality is that this is not happening in isolation. In freedom of information requests to health boards across Scotland, they have said that over the next four years, they expect to make £1.5 billion of cuts. That will impact on services. We have a workforce crisis where we have consultant vacancies across the country and 2,500 nursing vacancies, too, are already overstretched, undervalued and under-resourced NHS staff having even more pressure piled on top of them. What do the experts say? Because often we hear the Government hide behind what they claim as expert opinion, but what do the experts say on this? The Royal College of Pediatricians and Child Health is making it very clear that St John's requires a 24-7 inpatient service. Again, I want to put on record my thanks to those at the RCPCH, as well as all staff at the St John's who continue to go above and beyond. One of the excuses that we have repeatedly heard is that, due to safety issues, words cannot remain open. I would ask directly to the Cabinet Secretary why those words have been allowed to become unsafe in the first place under this Government's watch. It is simply not acceptable. On the same day that his survey was published, it shows that two thirds of NHS board members do not believe that the NHS board is transparent with the public. It is a complete shame and shame, quite frankly, for the people that they are supposed to serve. I think that it is incumbent on the cabinet secretary to address those issues head-on. I want to say in closing that we have heard platitudes before, we have heard warm words before, we have heard promises before, but what people will judge the cabinet secretary on and the Government on is action. What I hope to hear from the cabinet secretary today is her to set out a clear, realistic and honest timetable of when we will see this war reopen and how it will address not just the workforce issues at St John's, but the workforce issues across Scotland that are letting down too many of our patients. Thank you, Deputy Presiding Officer. I am sure that everyone in this chamber believes that the on-going closure of St John's inpatient services for pediatrics is unacceptable, and we all accept that it is hugely distressing to staff, to patients and their families. I, too, would like to thank Neil Findlay for bringing this opportunity to the chamber this evening. In June last year, I attended a meeting with other concerned local politicians and NHS Lothian in the Civic Centre in Livingston, where we saw assurances that this closure would be a short-term one. It is fair to say that NHS Lothian could not provide an exact date when the ward would reopen, but we are all dismayed to find ourselves debating this issue in this chamber nine months later. No resolution in sight. We know that NHS Lothian has recruited one paediatrician and confirmed that an offer has been made to another candidate, but those will not immediately solve the staffing situation and the staffing shortages at St John's. I, too, would like to reiterate that I fully support the recommendations from the Royal College of Pediatrics and Child Health on the future of St John's. Gordon MacDonald made the point that the review team reported that the population activity and demand for a full obstetric service in West Lothian merits the retention of inpatient pediatrics at St John's. With regard to uncertainty about the unit's future, putting off prospective consultants, I would say to them that the campaigning on this issue simply demonstrates the need for this hospital, for this service in this hospital, and that people in West Lothian and this Parliament would warmly welcome them. West Lothian is one of the fastest-growing parts in Scotland. It is a popular place to bring up a family, and families cannot afford to lose this vital service. As we have heard, it puts pressure on the sick kids, on our ambulance staff and on other services, too. It is the year of young people in Scotland, and it reflects badly on us that, in 2018, young patients in West Lothian do not have access to a local inpatient service. Telling families that they are not unique, that this is a problem that is affecting the whole of the UK, that is little comfort. I would ask the Government to really focus on this issue. We need to get this right. I do not see any specific proposals in the Government's health and social care workforce plans to address the serious shortage of paediatricians in Scotland. There are calls for changes to the paediatric training status of St John's. I will support changes that would help us to resolve this closure in a safe and effective manner, but, equally, I understand that bringing more postgraduate trainees into the hospital would not necessarily allow the services of the hospitals to be extended. I believe that new proposals to improve working across sites in NHS Lothian must be brought forward. It is unacceptable for such a needed facility to be closed for inpatients for this length of time. While recruitment is on-going, NHS Lothian and potentially other health boards should be working to provide cover from other facilities. If we think that it is unacceptable for unwell children to be taxied over to Edinburgh, then we have to consider arrangements put in place to support staff who could work on a temporary basis in St John's. We have also got to make sure that families are getting appropriate help with travel expenses and other immediate costs. I visited the family support and financial inclusion service at the Royal hospital for children in Glasgow and learned about the financial support that they give to families who arrive often in real distress at any time of the day or night with a sick child worried about what is going to happen next. I would like to see that approach embedded in every major children's hospital in Scotland with reliable funding. I would like assurances that families with sick children in West Lothian have the support that they need with regard to those expenses and that they know where to get that support. However, I must stress that fundamentally, those recruitment issues come down to a shortage of qualified doctors. We have to bring adequate numbers of students through our medical schools. We need to improve access and widen access to medical degrees. I know that universities in Scotland are leading some great work. The reach programme, for example, targets secondary schools with low rates of progression into higher education, but we need to do more. I would like the cabinet secretary to inform us as to what action is going to be taken that has not been taken to date, because this action is long overdue and it is needed now. Alex Cole-Hamilton, followed by Gordon Lindhurst. Thank you, Deputy Presiding Officer. I start by adding my voice in congratulations to Neil Finlay for bringing this important debate to Parliament and to the campaigners who are fighting tirelessly to keep this in the four of our mindsets in this chamber, not least for those of my constituency who have regular cause to use the children's ward at St John's. This Government is fair to say that it enjoys the support of every party and every individual in this chamber in its laudable aim to make Scotland the best place in the world to grow up. However, we will forever be a drift of that ambition when one of the principal children's wards to serve not just West Lothian but communities within the confines of our nation's capital can experience such a consistent manifestation of abject distress. It gives light to many failures of Government policy that those children who require admission are transferred to Edinburgh Sick Kids not just impact on their lives but also the capacity of that hospital as well. It is depressing that, once again, the challenges facing the ward are brought before this chamber for debate by Opposition members' debates rather than Government scrutiny or Government time, and once again I would ask the Cabinet Secretary to reflect on that and bring this kind of debate before Parliament in the future. It is a can that has been kicked down the road for six years. My friend and colleague and predecessor as a Lib Dem MSP in this place, Alison McInnes, said in 2012 that parents deserve to have faith that St John's is operating at world-class levels and not surviving from day to day. While, Deputy Presiding Officer, six years on, this ward is still surviving from day to day. Closures and partial service reductions happened in 2012 and happened again in 2015 and more extensively as we now know in 2017 and 2018. In many ways, the situation at the children's ward at St John's represents a microcosm of problems throughout the NHS in terms of upward pressure exerted on every department, every hospital and primary care setting. It simulates unmet demand, patient inconvenience and discomfort, and inadequate workforce planning. The record of this Government on both workforce planning and child health in general is not great when we have two-year waits for first-line treatment in child and adolescent mental health circumstances. In the closure of children's wards in other parts of the country—an Asawa rightly referenced the Royal Alexandria—and in the part-time provision that we are debating today at St John's, the treatment of our children should be the first priority, not just for the Cabinet Secretary for Health but for the First Minister and this Government in its entirety. It should be the alpha and the omega of every consideration around healthcare spending and healthcare priorities. We are talking about the lives and the welfare of some of the most vulnerable children in our society, some of whom are critically unwell, many on uncertain journeys, and it is at times like this that you need certainty in the care that we can offer them. We still hear, however, that 400 of them have been transferred from that certainty to an unknown destination, often times at the Edinburgh sick kids. We know demanders here. We have heard a lot about that in this debate. The Royal College of Pediatricians and Child Health rightly suggests that the population that is currently served by St John's is adequate enough to sustain a 24-7 service provision. In fact, it is required that 3,000 children a year use that facility with 1,000 or more requiring overnight care as a result. That is not a rural area, it is not an island community, it is just a short drive from this chamber yet over the past six years this Government has been found wanting in provision in terms of the staffing crisis that this chamber has been known about all that time. We have been lurching from crisis to crisis, so I am proud to stand today, alongside Neil Findlay, other Opposition members in this Parliament and indeed the campaigners in this chamber, in the gallery and outside, who want to see action and not words. Enough is enough, thank you. The last of the open debate is Gordon Lindhurst. Thank you Deputy Presiding Officer and let me also thank Neil Findlay for bringing this important debate to the chamber today. I have previously been updated in person together with him and other local politicians on this issue, but the matter has now dragged on beyond comprehension. When we sat together in early summer last year at the Civic Centre in Livingstone to be updated on the third prolonged period of closure in six years, one dared to hope that a solution might be in sight. Some progress seems to have been made. Last month we learned that a sixth and possibly seventh new consultant was to join the team, but it is still not enough to provide a safe and stable working rota, and safety must of course be paramount. My understanding is that the Royal College of Pediatrics and Child Health has said that inpatient services should remain suspended until such time as an eighth consultant has been employed. However, those appointments that I have just spoken about came one month after the ward was shut down entirely for two days in December. Progress was supposed to indicate moving towards option 1 rather than away from it by closing the ward altogether. The review of pediatric inpatient services in Lothian conducted in 2016 rightly concluded that inpatient children's services should be retained at St John's for the long term. That makes sense if we consider the local need that Miles Briggs, my colleague and others have already touched on. Those who know Lothian region and this part of it in particular know that it is a growing area popular with young families. The population is expected to grow by well over 10,000 over the next two decades, so there is an increasing need rather than a decreasing one. When the review was undertaken, the review team were told that the children's ward can often come very close to capacity. However, the second review into pediatric services concluded that there is no quick fix. However, to have ended up in such a dire set of circumstances in the first place is surely unacceptable. The Health and Sport Committee inquiry in December 2016 diplomatically perhaps stated that since previous concerns were raised years ago, quotes, planning does not seem to have become more successful. Well, the reality appears to be that it has actually been getting worse. If indeed there is no quick fix, then surely the pragmatic approach advanced by opposition parties today should be fully considered by the Scottish Government and to add in the flexibility of giving teaching accreditation mentioned by Miles Briggs for pediatrics to St John's could not only replenish staff levels in the here and now but also raise the profile of the ward to ensure future staffing sustainability and embedding some stability in staff levels could be brought about in that way by turning St John's into a pediatric teaching hospital. In conclusion, that could provide a service so desperately needed by the people of West Lothian and ensure its continuance. I look forward to hearing what the cabinet secretary has to say to that specific proposal. I call Shona Robison to respond to the debate for around seven minutes please, cabinet secretary. Thank you, Deputy Presiding Officer. I welcome the opportunity to respond on this important topic. I thank Neil Findlay for bringing this debate to Parliament. Let me begin by reminding members the reasons why an interim model of service for the impatient pediatric ward at St John's hospital has been implemented. Last July, the Scottish Government was advised by NHS Lothian that staffing levels for the ward were fragile and at risk, such that there would be no backup available if a member of staff was absent at short notice, for example if they had fallen ill. That could have caused confusion and anxiety for parents and staff and possible delays to emergency care. Therefore, the board chief executive supported by the medical director took the difficult decision to implement an interim model in the best interests and safety of children and their families. It is important to stress that the decision taken by the board to implement an interim model has resulted in the majority of children's services still being maintained at St John's so that the children's ward is opened from 8 to 5 days a week, providing a short-stay paediatric assessment service. Although the original plan was for children to be redirected to the sick kids at weekends, the board has been able to maintain a daytime weekend rotor on all but three occasions since July 2017. The paediatric ward has remained open for day surgery activities as well as planned day case procedures and programmed investigations. Paediatric outpatient services, neonatal services and community child health services have all been unaffected and, of course, the A&E service at St John's continues. A wide range of children's services continue to be available in West Lothian and the vast majority of children requiring services have continued to receive them locally at St John's. For those children who have had to travel, it is important that support is provided. In response to Alison Johnston's question, I can confirm that that is the case and the board should be making parents aware of that. At this point, I want to respond to Miles Briggs' comments about the position of St John's as a training facility. Firstly, it is important to be clear that any decision about training status rests with the Dean of the Postgraduate Medicine at National Education Scotland in accordance with standards set out by the General Medical Council. Members should also note that St John's is already a recognised training facility. There are currently six trainees in the paediatric unit at St John's, and those doctors are at a relatively junior level who need to acquire their skills and experience in paediatrics. I am advised that NHS Lothian has recently met the training programme directors to explore the placement of ST3 trainees for daytime experience within the unit, and further details of the experience that might be delivered to those trainees have recently been provided by the unit and are actively being considered by the training committee. If ST3 trainees are placed with St John's hospital on a daytime basis, I am advised that they will not be able to participate in the out-of-hours service because patient throughput does not provide the educational opportunities that such trainees need and therefore would not meet GMC standards. However, I am happy to ensure that members are kept informed on the progress of those discussions, because that would be an important step forward. I want to now come on to the consultant recruitment at St John's. NHS Lothian has taken a number of steps to improve consultant recruitment, in line with the college's recommendations. I understand that, following extensive recruitment campaigns, six new consultants are now in post, and interviews in January this year has resulted in an offer being made to another candidate. The board is now, as required, in the process of completing the necessary pre-employment checks and are hopeful of a successful outcome. I think that this is heartening and demonstrates the board's determination to put in place a safe and sustainable rota to allow the return of a 24-7 service. The board remains committed to recruiting an eighth consultant to fully meet the recommendations of the Royal College of Pediatrics and Child Health report of 2016. I am also aware of the board's commitment to strengthening its advanced nurse practitioner workforce. Two internal members of staff are currently being trained in this role within the children's ward. On top of that, NHS Lothian intends to rerun an advertising campaign for qualified practitioners, while running an internal campaign offering nurses the opportunity to train in this role following consideration by the boards in April. As I have said, NHS Lothian remains committed to reinstating the 24-7 service. I believe that the recruitment efforts to date demonstrate that, and I do not think that they are the actions of a board shrugging its shoulders. It is important, given the fragility of the service that Neil Findlay mentioned in his speech, to avoid the fragility in the future that we have to make sure that the Royal College's recommendations are delivered. It seems to me that the recruitment efforts and success so far have got the board quite far down the line towards those recommendations, and I think that that should give us confidence that they will complete that journey. The Royal College recognised in 2017 that there was no quip fix, and the development of the development is needing a long-term solution, depending on the successful recruitment of consultants and advanced nurse practitioners, as I have outlined that the board has been absolutely focused on that. The key recommendations were that the board should develop a three-year strategy and action plan towards full implementation of the college's report of 2016, increase the number of advanced nurse practitioners, and maintain and strengthen the short-stay paediatric assessment unit, all of which is in hand. Neil Findlay. The issue is that the Royal College report was in 2016. That is six years that has been going on. When you say that there is no quip fix, surely people can expect, after such a lengthy time, progress to ensure that the service is back up to full speed. It is taking quite some time to outline the progress that has been made. The college said that eight consultants were required to get back to a 24-7 position. They are just in the process of appointing the seventh consultant. I do not think that that says to any reasonable person that no progress has been made. The seven out of eight consultants is progress being made. Yes, they have to recruit the eighth consultant, and yes, they have to make sure that the advanced nursing staff are there. However, to say that no progress has been made is not a reasonable assessment of the situation. The paediatric programme board was set up to implement the recommendations of the college's report of 2016. I have been working hard to do that. I have been formulating a strategic plan and vision for services at St John's, which again is important. If we are going to recruit people who could go anywhere in the world to St John's, there has to be a good vision for the service, and we have to promote the hospital in a positive light. I think that that is why the board has had some success, because many of the posts have been recruited on a network basis. I think that that has made those posts more attractive. However, that vision for the hospital is important. Just a second, options developed by the programme board through the wider involvement from clinical stakeholders are going to be finalised at a workshop in early March, and those options will be presented at the NHS Lothian board meeting in April. So, again, there is a sense of momentum there, and the board is looking at what else can be done. The minister—sorry, the cabinet secretary—was just closing, but if the cabinet secretary is willing, yes, Miles Briggs. I thank the cabinet secretary for taking this intervention. As you have heard today, there is a lot of frustration from members and from all parties at the lack of progress, not only that but the lack of information being provided. Would you commit to update Parliament on the issue so that we can take that forward and that you take it to NHS Lothian? In my time in MSP, the information that has not been forthcoming from NHS Lothian on this issue has been pretty shocking, and we have been kept in the dark for too long on this. I remind members that they should always speak through the chair rather than have to direct conversations. First, we would all make NHS Lothian aware of the issues raised during this debate, and, of course, I am happy to do that. I am aware that NHS Lothian provides regular briefings to MSPs, and that is an opportunity to hear some of the detail, but I can certainly feed that back and make sure that it does, because communication, not just to MSPs but to the public, is important in knowing that progress is being made in the recruitment efforts. I want to just end by emphasising the Government's on-going commitment to sustainable, safe and high-quality NHS, of which the workforce is a crucial element. I think that that will be helped by the £400 million increase in the budget for 2018-19, which some of us have just voted for at decision time. I have asked NHS Lothian to keep me closely appraised of the outcome of the on-going recruitment efforts and have been assured that that continues to be of the very highest priority. I thank everyone for their contributions to this debate, and I am very happy to make sure that members are kept fully informed of the recruitment efforts in order to return St John's to a 24-7 service as soon as possible. I am sure that the cabinet secretary did not mean to mislead the chamber, but it is just to put on the record that NHS Lothian used to have regular briefings for members. There has not been one, to my knowledge, for nine months a year. There has been none. If I have written to NHS Lothian twice about this, I have never had a response. It was not actually a point of order, but I understand that the cabinet secretary is quite happy to respond with her point of view on that. I am certainly happy to suggest to NHS Lothian that members may want to brief elected members on a regular basis, but I think that there is also anonus on elected members to ask NHS Lothian to meet them, to fully brief them. I would imagine that they would be quite happy to do that should the member request a meeting. That concludes the debate. I have not been concluded in the point of order, and I close this meeting.