 Beth gweinwch, mae'r un ffordd arwain hynny o maelod yn funud ffaleigidydd, ac yn pwyntio 05, mae'r ddechrau Jackie Baillie. Mynd i ddwy'r gwirionedd Gwybaint, mae'r iawn i'n gwestiynau mynedd teitturiaeth ai'n gweld rimbog i gael o ddweud~! Gweithio'r jimddiad i gweithio i'r apodd o gy hacking yn gweithio'r cychwyn nadau'r cyhoeddiad yn gweithio i gweithio gyda'r cyhoeddiad? I am immensely grateful to GPs and, of course, GP practice staff up and down the country who do an incredible job during a period of significant challenge. We are absolutely committed to ensuring that being a GP remains an attractive career choice with a manageable workload. Despite the pandemic, we have recruited 3,220 whole-time equivalent healthcare professionals to provide support to GPs underpinned by an investment commitment of over £500 million since 2018. We have a record number of GPs working in Scotland and we are committed to 800 additional GPs by the end of 2027. Jackie Baillie, I thank the cabinet secretary for his response, but he should know that statistics for 2022 show that the whole-time equivalent number of GPs has actually fallen to 3,493. That is 81 fewer than in 2017, when the SNP announced its intention to boost GP numbers. Does the cabinet secretary agree with Dr Andrew Bueyce of the BMA, who says that the SNP's Government's failure to boost GP numbers and provide sufficient funding has locked primary care into a vicious circle of rising workloads forcing GPs out of the profession? I am sure that Jackie Baillie knows, but it may be just an oversight that our target for between 2017 and 2027 was based on headcount numbers. Of course, overall GP headcount numbers have increased by 291 from 4,918 to 5,209, so there has been an increase in headcount GPs and we are making good progress towards that 800 figure. In terms of whole-time equivalents, Jackie Baillie raises the issue. Of course, we are engaging both with Dr Andrew Bueyce, who I meet very regularly. The RCGP and what more we can do in relation to retention, although it should be recognised that more flexible working patterns are a good thing. It helps with that work-life balance, which in itself we hope can help with retention. I commend the RCGP report that it released just before Christmas, focusing on a number of initiatives that the Government might want to explore in relation to retention of GPs, and we will continue to engage both with the BMA and with the RCGP on those important issues. Announcing total funding hides the fact that the Scottish Government made cuts this year to GP in primary care. Pressure on GPs is only going to increase, given that we have 23 fewer GPs than last year. Greater Glasgow and Clyde announced yesterday that they are pausing non-urgent elective surgery and going to an emergency footing despite the money. This is going to increase care in primary care. Also, long Covid, we heard today many people on BBC Scotland radio who are suffering and who are saying the service is failing them. A nurse we cheered and clapped for during the pandemic said that she will lose her job and her home because of long Covid. If patients are saying they cannot get help from hospitals, they are going to go to GP and increase pressure. What more are you willing to do to help long Covid patients? What I would say to Dr Sandish Gohani is that he is right. We did have to make some difficult choices around our budget this year, including the reprofiling of funding from primary care. We did that because his party completely mismanaged the economy of the United Kingdom. High inflation costs meant that our budget health and social care portfolio was worth £650 million less than when we set it the previous December. Those difficult decisions had to be made because we did not have those full fiscal levers in our own hands. What we will do is continue to ensure that we invest in those multidisciplinary teams. That will help to spread the workload from GPs right across other members of staff. We will also continue to invest in NHS 24, for example, where people get really excellent advice. I announced additional recruitment of 200 staff on long Covid. He knows that we have a commitment of £10 million over three financial years, and we will continue to invest in that funding to help long Covid sufferers, as well as anybody else suffering any condition at a time of great pressure on our NHS. A Shetland GP surgery posted on social media this week that, due to high demand and staff availability, we are currently dealing with clinically urgent requests only. If your request is of a non-urgent nature, please consider contacting us next week. What can the Scottish Government say to those seeking medical help and the staff under pressure in our island NHS services? That has been and continues to be, of course, but it has certainly been in the last few weeks. One of the most difficult periods I think that the NHS has ever faced in its existence. We know that that is a result of the cumulative impact, of course, of the pandemic. Rise in Covid cases, which she will know from the last ONS data—that was sitting at 1 in 25—when the data was released on Friday, flew cases higher than they have been in many, many years, strep A cases rising, and other viral infections rising, too. All of that, and then during the festive period, of course, coming at a time of cold snap weather, too. All of those factors combining have made this a really difficult period for the NHS and social care right up and down the country. What are we doing? I stood up on Tuesday to give some detail of what we are doing to support, including helping with the issues around discharge, investing further on NHS 24 service available up and down the country. Difficult decisions will have to be made at a local level, whether it is in NHS Shetland or elsewhere. I hope that those difficult decisions that are being made will be time-limited, while additional support that we have provided kicks in. And, as those flu cases, Covid cases, I hope, in time, of course, begin to abate, that helps the health service through what is a really, really difficult time in my gratitude once again to every single member of the NHS and social care working so hard during the difficult times. Question 2, Gordon MacDonald. I wish the Government, when it last met with the Chancellor of the Exchequer. Cabinet Secretary, John Swinney. Presiding Officer, I have not yet met with the current Chancellor and I did not have the opportunity to meet with either of his two predecessors. I last met the chief secretary to the Treasury on 17 November, after the United Kingdom autumn statement. Gordon MacDonald. I thank the cabinet secretary for that answer. Forecast compiled by Consensus Economics show the UK facing the worst and longest recession in the G7. The Office for Budget Responsibility predicts that we are facing the biggest fall in living standards since record began due to inflation and more than three quarters of members of the British Chambers of Commerce say that the UK Tory Brexit deal is not helping them to increase sales or grow their business. Can the cabinet secretary outline what economic levers the Scottish Government needs in order to escape a future of Westminster failure, build on Scotland's economic strengths and become as successful as comparable independent European countries? Cabinet secretary. Presiding Officer, it is becoming very clear with all of the available evidence of the economic damage that is being done by the Brexit that was imposed upon Scotland by the United Kingdom Conservative Government. The specific areas where we are suffering is obviously in relation to free trade with the European Union, where companies are suffering just now, so an independent country with the ability to rejoin the EU would be an advantage. We know from the failures of the energy market that the ability to redesign the energy market would be an important attribute for Scotland to have. The ability to use employment laws to ensure fairer work would be an advantage and, crucially, the ability to have a migration policy designed to boost our working age population would be an advantage, which can only come with Scottish independence, given the hostility to such approaches by the United Kingdom Government. I think that Mr MacDonald correctly highlights the severe economic damage being undertaken by Brexit and the opportunities that Scottish independence would give to create much more fiscal flexibility for the Government of Scotland. To ask the Scottish Government whether it will provide an update on its response to the climate change committee's reports, progress in reducing emissions in Scotland 2022 report to Parliament and Scottish emissions targets first five-yearly review. Scottish ministers will take the appropriate time to consider the recommendations from the climate change committee's advice and respond in the spring. We will work closely with the climate change committee as part of our continuous review of policy to ensure that we benefit fully from its expertise, while progressing delivery and considering possible new actions. The committee's advice will also support the development of the next climate change plan, which will be published in full later this year. I thank the cabinet secretary for that answer, but the committee said that the SNP targets were not accompanied by deep thinking about policies and rather accused ministers of magical thinking. Clearly, the portfolio must be prioritised, but I have discovered that the Scottish Government has only six people working on its climate justice fund, while just four are dealing with the loss and damage fund announced at COP 27. Compare that with the 25 civil servants working on an independence prospectus costing £1.5 million a year, and this Government's skewed priorities are very clear. Will the cabinet secretary be taking steps to realign Government resources away from the manufacture of grievance and division and, instead, direct it towards delivering practical priorities to address the climate emergency? We always deploy staff within the civil service to make sure that we take full order areas of policy priority. That is why Scotland's emissions are down by well over 50 per cent on the 1990 baseline, which takes us over halfway and, of course, has us ahead of other parts of the United Kingdom in addressing climate change. I assure the member that we will continue to take forward a range of policies to tackle the issue of climate change and to ensure that we do so in a fair and just way. I gently point out to the member that we will not tackle climate change effectively if we are opening up new coal mines. The Climate Change Committee report recognises key policy areas, for example in industry and electricity supply sectors, are reserved to the UK Government. To what extent is meeting our net zero targets here in Scotland, reliant on decisions taken by the UK Government, and how is the Scottish Government working with the UK Government to ensure that our ambition in Scotland is matched by the rest of the UK? There is a range of areas that are the responsibility of the Scottish Government, and we take them seriously and pursue policies to make sure that we deliver on our climate change, our statutory climate change targets. However, there are also areas that are reserved to the UK Government that have a direct impact on climate change policy here in Scotland. In the energy sector in particular, for example, negative emission technologies play an extremely important part in helping to make sure that we meet our climate change targets here in Scotland and across the whole of the UK, which is why taking forward carbon capture and the ACORN project is mission critical, not only to Scotland's climate change targets, but also to the UK's climate change targets. Any further delay in making a decision about supporting something such as CCUS and ACORN projects just creates uncertainty, risks around employment, a lack of investment in key areas and places a greater burden in other policy areas, which is why we need the UK Government to step up to the plate and show leadership in this area and give the go-ahead to the ACORN project here in Scotland. If we are to meet our national target of reducing car mileage by 20% by 2030, reliable, affordable and readily available public transport will be key. One of the climate change committee's recommendations to achieving this is to invest in sustainable forms of transport, yet the Scottish Government is proposing widespread service cuts to Scotland's railway. Will the minister think again and rule out service reductions to demonstrate his Government's commitment to Scotland's railway to protect jobs and to reduce transport emissions? I recognise the access to good public transport as an important part of helping to get people out of their cars into public transport, which is why we have been making significant investment in our railways in order to decarbonise them. We are now at the point where more than 75% of all journeys on Scotland's railways are in electrified routes, which has been decarbonised as a result of the investment that the Government has made. Why we have made significant investment in helping to decarbonise the bus system by investing in through grant schemes to support the electrification of the bus network through electric buses, which are now being rolled out? I am sure that the member will recognise that. We are now at the point where almost 50% of people in Scotland travel on our bus network for free as a result of the concessions travel scheme that we have for those who are over 60 and for those who are under 22. I am sure that the member would welcome that as an example of showing leadership and encouraging people on to our public transport network. We are moving on to question 4. I appreciate concise questions and responses, and I call Michelle Thomson. To ask the Scottish Government what steps are being taken to reduce bladder cancer deaths. Minister Marie Todd. Bladder cancer mortality reduced by 14% over the period 2010 to 2020, and we are committed to continuing to improve that. As outlined in our endoscopy and urology diagnostic recovery and renewal plan, we will refresh and implement once for Scotland's clinical pathways to prioritise demand for cystoscopy apologies, including bladder cancers. We have also introduced six urology hubs in Scotland. These hubs provide rapid access to diagnostic procedures to enable earlier cancer diagnosis and treatment. I thank the minister for her response. Bladder cancer is one of the highest mortality rates of all cancers currently around 50%. It also has a high rate of reoccurrence, making it one of the most expensive cancers to treat fully. With Scotland's ageing population, it will likely result in longer-term or complex treatments. To that end, could the minister confirm what funding has been made available specifically for research into bladder cancer, including treatment of the disease and data gathered to enable correlative research? Minister. The funding schemes supported by the Scottish Government's chief scientist office, the CSO, provide opportunities for applied health research across a whole range of health challenges, including bladder cancer. Applications are assessed through independent expert review, with funding decisions based on the recommendations of independent expert committees. They would be very happy to consider any applications for research into bladder cancer. CSO also contributes financially to a range of national institute for health and care research funding schemes, which are open to applications from researchers in Scotland. In addition, CSO invests through NHS Research Scotland in a cancer research network to support the delivery of studies in this area. Finally, our national cancer quality programme has developed quality performance indicators for bladder cancer, first published in November 2021, and it is encouraging that targets relating to 30 and 90-day mortality rates indicate a good performance. Do you ask the Scottish Government whether it will provide an update on what it is doing to support young people's mental health services, including in colleges and universities? Presiding Officer, the Scottish Government continues to provide record funding in mental health services to ensure that all children and young people have access to the right mental health support at the right time. That includes continued investment in improving CAMHS services, funding 230 new and enhanced community supports and services for children, young people and their families, and providing access to counselling services for all secondary school pupils. In addition, we have exceeded our commitment to deliver 80 additional counsellors in further and higher education, with 89 additional counsellors now working to support students across institutions. If that is the case, I am flummoxed as to why the Government is even considering cutting those very mental health counsellors that he just described in colleges and universities at the end of this academic year. I can remind him that two-thirds of college students report having low wellbeing and more than half report moderate to severe symptoms of depression. If that is the case, why is it that when students need their help, the Government withdraws the support of the very people who are designed to give them the help? As I said in my previous answer, we have exceeded the 80 counsellors that we planned for with 89. The student mental health plan, which is being taken forward by the student mental health and wellbeing working group and will sit alongside the Scottish Government's forthcoming mental health and wellbeing strategy, will inform the Scottish Government's future approach to student mental health and wellbeing. Upon publication in spring of 2023, it will provide the framework for institutional actions on the issue. As part of that, officials will work with the universities and colleges to move to a position where they fund elements of student mental health support, including counsellors, as part of their core offer to students. Six was withdrawn question seven, not lodged, I call Richard Leonard at question eight. To ask the Scottish Government when it expects the replacement booking system for CalMac to be fully operational. Minister Jenny Gilruth CalMac's new booking system, Arturus, is expected to go live across all CalMac routes in the spring of 2023. I am extremely disappointed that there has been a delay in the introduction of Arturus, which I do not think is acceptable. My officials in Transport Scotland have engaged with CalMac and have been informed that it will be operational by this spring. I will be meeting CalMac next week to seek further assurances to that end. The benefits of Arturus include better live deck space management for the use of capacity, better communication around disruption, a standardised accessible digitally enabled service, both online and apps, as a means to purchase tickets and also to apply any changes instantly. Richard Leonard Can I thank the minister for that reply, but the problem that the minister has got is this. The project started as far back as August 2016. More than five years on, in December 2021, we were told by the government that it would be completed and operational by February 2022. In July 2022, we were told that it would be completed and operational by November 2022. Then, just last month, on 8 December, we were told that it would go live in the spring, but 11 days later, on 19 December, we were told that it would not be operational now until November 2023. Do not Scotland's islanders, dependent on lifeline services, working in fragile economies, deserve an explanation, deserve urgent action, and do not they deserve a lot more honesty from this government? I will provide Mr Leonard with an honest response. I hope that he heard in my initial response my own disappointment and my own commitment to seek further assurances from CalMac in relation to the repeated delays on the introduction of the system. It is absolutely important and vital, I think, for islanders that we get the implementation of the new system right for Scotland's island communities. CalMac has advised my officials in Transport Scotland that their user acceptance testing has highlighted a number of issues that have been anticipated, given the complexity of the number of routes that CalMac serves. It is really important that those issues are addressed before the system is launched and its supplier has been working to address those issues. The member will also understand that I require to have confidence as Minister that this new system is going to work for islanders and for visitors to our islands alike. To that end, I will continue to work with CalMac on achieving that cast-iron assurance to ensure that this new system will deliver the improvements that passengers and islanders need to see.