 Ie avoided if we can recycle some of the drugs provided safety hasn't compromised in recycle some of the drugs to Africa and elsewhere? Before we move to next item, business members will wish to join me in welcoming to the gallery Mr Raphael at Catatonia President of the Regional Council of London Barrrly. we are now move to First Minister's question. Questions number one, Johann Lamont. Thank you very much, Presiding Officer. To ask the First Minister what engagements he has planned for the rest of the day. First Minister. Engagements to take forward the Governance programme. Johann Lamont. Thank you. Last year, the Scottish Government again missed its accident and emergency target, meaning that thousands of Scots had to wait for more than four hours for treatment. The First Minister's response was to lower the target. Tyddiwedd Llywodraeth Cymru, rydyn ni'n gyddwch i'r darglwyddau originalnau, rydyn ni'n gyddwch i'r darglwyddau newid byw hwn yn y gwybod. Rhywbeth yng nghaelwch ar gweithiemaeth. Rwyddnifat y byddai sgwr yn gellydd yng nghyntdoedd. Rwy'n gyrdd yng nghymru ymddwrm yn shiftriwll. Mae'r gyrdd gynnal ar eu bodi rhoi trafnog�fhau c factories. Gynnwch chi'n ffordd o'r awsiau, yn ddigonfodol. Central not大概 12-13 on the statistics that they gave not. It is the same year that Johann Lamont talked about. First of all, I will say what we are doing about the situation, because that is the real issue. Jordan Lamont heard Dr Martin McKethney, the vice-chair of the College of Emergency Medicine, and on raids this morning. He said that we have had a lot of support and investment in the last 18 months from the Government. We are I hope to feel and see the effects of some of these changes. 12.13 was a hugely tough year for the emergency services of the national health service in Scotland. We had a substantial number of ward closures through norovirus but the emergency action plan announced by the health secretary has been welcomed by the profession, as indeed has the substantial increase in the number of consultants and staff and facilities around Scotland. Working together, we are going to bring about the sort of improvement that Scotland requires and the patience of Scotland deserves. That is what is happening in the statistics already and if Johann Lamont was fair about it, she would know that Audit Scotland remarks on the substantial improvement since the yearly statistics ending in the financial year 12.13. Yes, but Audit Scotland were pointing out that the improvement was against the worst ever statistics in relation to the matter. I know that the First Minister will have plenty of facts and figures in there that prove that there is not really a problem but we know in our hospitals that there is a problem because healthcare workers are telling us so. Let us hear what patients think. Margaret Watt, chairwoman of the Scottish Patients Association, said that people have died as they could not get into hospital because they were kept waiting in A and E. The distress it causes patients and families is huge but the situation seems to get worse year on year. I have never known it as bad as this and our national treasure, the NHS, is becoming a nightmare for patients. Last year alone more than 100,000 people had to wait for more than four hours, more than half a working day, and nearly 1,500 people waited more than 12 hours for treatment. The First Minister has been in office for seven years. Why have waiting times trebled on his watch? I do not know how familiar Johann Lamont is with the statistics but, since she said that, and I quoted it, the waiting times were the worst ever in A and E. Let me just correct her. I will give her the statistics exactly and then hopefully she will be able to admit how wrong she was. She was right in quoting the statistics for 12.13. There were 103,782 people waiting for more than four hours. That is exactly the situation that we are trying to tackle. That is out of a total of tendencies at A and E of 1,618,610. Let me say again that we are seeking to tackle those figures and bring them down to what we believe is more acceptable levels. She said that those were the worst figures ever. Let me give her the figures for 2006-07, when Johann Lamont was a minister. There were 1,342,737 attendancies, some 300,000 less than in 12.13. The number of people waiting more than four hours was 125,753. Now that Johann Lamont has heard those figures, will she withdraw the suggestion that the 12.13 year was the worst ever, since clearly it wasn't? Will she acknowledge that, while we are trying to improve the performance, it is substantially better than when she was a minister? Will she start agreeing with us to concentrate on the action plan that will serve the people and patients of our community in the best possible way that we can? The degree of complacency in that response is staggering. Let's go back to a comfort zone that a politician makes a debating point, rather than responding to what patients are saying, what staff are saying and what Audit Scotland is saying to. The reality is that the First Minister does not seem to understand or actually care about the problem. We have a social care crisis which is fuelling an A&E crisis. People attending A&E need a bed, but they can't get them because patients are being parked in inappropriate wards waiting to be discharged but with nowhere to go. Hard-working nurses and doctors are not to blame. They are doing their best. Is the First Minister going to get serious about this crisis or is he just going to fiddle with the target again? The First Minister should accept that it is rather more than a debating point to point out that she is fundamentally mistaken in her claim, the 12.13. I am afraid a 125,750 free is a much bigger figure than the one that she cited. She accuses me of complacency, and let me say that I reject that totally. The First Secretary has set out the action plan, which has been widely welcomed by health professionals. This Government, unlike the Labour Government, pledged to protect real spending in the national health service and we have done so. If Johann Lamont—this last December, the figure in terms of December and the heart of winter increased to 93 per cent of patients who were being seen within the four hours, we want to get that figure higher to the interim target at 95 per cent and then on to 98 per cent. If she wants to hear about complacency, perhaps she should recall when she was a minister and Andy Kerr was health minister—it is quite recent history—when the figure was 87.5 per cent. That figure was hailed by Andy Kerr by showing that the vast majority of A&E departments are meeting their four-hour target investment in the NHS is paying off. In terms of her and her party's credibility, she should explain why, when she was a minister, if 87.5 per cent was wonderful, why 93 per cent under this Government is such a disaster. Will she accept that, thanks to the hard working professionals in the national health service, there is an improvement? An improvement that we intend to drive up further, thanks to the investment plan, but will she acknowledge that, when she comes to this chamber and makes up figures because she cannot substantiate a point, then she and her party are fundamentally lacking in any credibility on the national health service? The fact that the SNP-backed wenchers so warmly respond to that answer tells us everything about the problem that we have got. Dr Nicky Thomson, who is chair of the BMA Scottish Consultants, said that medical staff are working under considerable strain to try to maintain high quality care in an overstretched system. Clearly, that is not sustainable, but what we get from the First Minister with an unsustainable NHS is a First Minister coming up with unsustainable answers. Let's be honest about what is happening here and what the Scottish Government's approach is. It is revealed in this line in the Audit Scotland report. It says that the Scottish Government has indicated that it will review the 95 per cent interim target after September 2014. What could possibly be happening in September 2014 that matters more? While we are not prepared to wait for his referendum before we make sure that the ill and the injured do not have to wait for treatment, isn't it the case that the First Minister cares more about the constitution of our country than the health of our people? In dealing with the situation, we have announced the £50 million emergency care plan. We are reviewing the 95 per cent figure towards the end of the year because we want to drive upwards towards 98 per cent. I have been critical of the Labour party and the health service, because, in either 2007 or in the run-up to the 2011 election, would they follow or commit to protecting the health service budget in real terms? Lord McConnell said that every other service, including the health service, would have to cut its cloth because he was going to put all the consequentials into education. There is another Labour administration, which decided because of the pressure of spending cuts from Westminster that it could not protect the health service in real terms. I have the figures for emergency care in Wales. Not in a single occasion over the past few months have they even reached 90 per cent. Never mind the 93 per cent. I have failed every time. In contrast in Scotland, we have rising staff in the national health service. We have £127,000 when we took office in September 2006 and £135,000 at the end of last year. We have rising medical staff, £9,600 to £11,438, rising staff in nursing and midwifery, all made possible because we are protected to health service in real terms. If the Labour record in office in this place was so lamentable and if the record currently in Wales is so much worse than this administration, then how on earth can we have any credibility in the national health service? Why not welcome the investment that has been put in to drive up the figures in terms of emergency care? Welcome by the health professionals. Get behind that action plan and stop trying to rewrite the dismal history of their administration or the present practice in Wales. Ruth Davidson is going to ask the First Minister when he will next meet the Prime Minister. I would like the Prime Minister—I have no plans in the near future—to say to Ruth Davidson that the First Minister's question is in 27 March about the implementation of a Scottish Clare's law. That is the information that can be provided on the issues of domestic abuse. I tell the chamber that the Scottish Government is carefully considering the solicitor general's proposals this morning for a new offence of domestic abuse. Ruth Davidson wishes to know that the chief constable has proposed a multi-agency group today to set up to develop a pilot on Clare's law disclosure scheme in Scotland. I know that Ruth Davidson will welcome those initiatives and I can assure her that she will be carefully considered as she unfolds. I would like to thank the First Minister and welcome the pilot of Clare's law, which I raised with the First Minister on 27 March. While he is in a listening mood, I also ask him to reconsider my repeated calls for a full public inquiry into the baby's ashes scandal. The First Minister seemed awfully keen just a few moments ago to talk about Wales, but slightly less keen to talk about his own record in Scotland. We have heard an awful lot of statistics today, but the First Minister cannot get away from the facts. He missed his target for treating people in A&E, so he lowered his target, and then he missed it again. This is not just about the thousands of people waiting more than four hours in A&E, it is not just about the thousands of people waiting more than 12 hours. This is about everybody expecting to wait almost half an hour longer than they did just five years ago. The First Minister likes to blame almost anyone else when things go wrong, but is it not the case that it is this Scottish National Party Government that has overseen the NHS in Scotland for the past seven years? Doesn't this failure land squarely on the First Minister's desk and won't he start to take some responsibility for it? The First Minister's responsibility that we have taken for it was to announce the emergency healthcare action plan, the £50 billion that is making a substantial difference. I read out the quote from Martin McKethney from this morning, the chair of emergency medicine in Scotland, of the College of Emergency Medicine, who welcomes the action plan and the close working relationship with the health secretary, which is unveiling that action plan across Scotland. I should also say that there are proposals in the Audit Scotland report that the Government will adopt and implement because they are entirely sensible, but this matter has been treated with the utmost seriousness. However, I have to say that it is reasonable to put forward the situation as it was when we took office. It is reasonable to put forward the position that there are more staff, there are more nurses, there are more doctors in the national health service, there are more than double the number of consultants working in accident emergency than there were when we took office, and there are far, far more people being treated in A&E. It is entirely reasonable to put forward those points, because all of them are true. Therefore, when the Government announces that action plan, when that action plan is welcomed across the national health service, whether there is already signs as detailed in the Audit Scotland report of an improved position, that is a Government that is looking at an issue and a problem, a serious problem for many patients across Scotland in taking affirmative action to do something about it. Ruth Davidson We know that more people are being treated. We know that the NHS is under pressure. That is why the Conservatives are committed to delivering an extra 1,000 nurses for Scotland, but that does not get us away from the record that this SNP Government is creating. A&E targets missed. Nursing numbers down from their peak. Bed numbers slashed by more than 20 per cent. One of the fastest declines of hospital beds anywhere in the western world. Last week, the finance secretary, John Swinney, said that this Government had absolute control over the NHS. I will quote him. We have control to decide what type of national health service we want, what direction we want it to take and what reforms we want it to undertake. With this complete control over the NHS, are all those cuts by SNP design, or has the First Minister been so busy with the referendum that they have just happened by accident? The health service budget has been protected in real terms. That was the right decision to make. I will defend that decision to anyone at any time. That has not been easy because of the cutbacks from Westminster, as Ruth Davidson well knows, but nonetheless the health service budget has been protected. It is therefore entirely reasonable to point out that the fact that we have the staff numbers working in the NHS that I have pointed out, higher than when we came to office, is a virtue of that investment. It is also true to say that the NPD programme, the non-profit distribution programme across the national health services, is really doing great results. We look forward to the direct investment in Glasgow of the new southern general hospitals, and those are improving healthcare radically across Scotland. I think that that is a substantial achievement given the cutbacks elsewhere. I do not like talking about Wales, which is interesting because the Prime Minister talks about little else in terms of the national health service at Westminster. Can I point out that, while we have a challenge, a major challenge in some of our health boards in Scotland in the accident emergency that we are meeting, none of our health boards anywhere in Scotland are registering the 81.7 per cent, the 85.6 per cent, the 86 per cent in south end, which shall be registered by health boards under pressure south of the border. One of the reasons why people of confidence in this health service in Scotland is the unbending commitment of this Government to fund it in real terms, but also the fact that we are committed not to fragment and privatise it south of the border. For any Tory politician to come to this or any other chamber and ignore the dismay that has been caused in the health service across England by the policies of our Government, almost beggars' belief, this is a health service that shall be kept in public hands. We will respond to crisis by investing more. We will meet challenges as they come, but it will be a public national health service for the people of Scotland. I have a constituency supplementary from Tavish Scott. Thank you very much, Presiding Officer. The First Minister will know that European structural funds for the Highlands and Islands are important in terms of delivering economic growth. Can he confirm that the £172 million for the new structural fund will all be spent in the Highlands and Islands and that decisions on which projects are to be supported will be taken locally rather than removing as function to Edinburgh as Shuttle Islands Council and others now fear? The First Minister's matters are under discussion, but I am sure that Tavish Scott will look carefully at some of the recent substantial investments that are being made in Shetland, not least in the airport and other things that I could list. We will know this Government's substantial commitment to Shetland and the other island communities of Scotland. However, those decisions are under discussion at the present moment. To ask the First Minister what issues we will discuss at the next meeting of the cabinet. Matters of importance to the people of Scotland. Audit Scotland said that lack of hospital beds is a major problem for accident emergency. Hospital beds are at a record low, but last week the health secretary said that there was not a strategic shortage of beds. Is not the case that his Government has only really woken up to this problem two years ago? He mentioned Dr Martin McEchnie from the Royal College. That is exactly what he said this morning. Does not he think that we are in this position because he failed to act early enough? We are in a position where, quite clearly, the waiting times are improving in accident emergency, where our staff in accident emergency all over the country are treating more patients than ever before. We are implementing lessons where best practice is ensuring already very substantial results, as in Tayside and elsewhere. We are seeking the terms of the infrastructure and the health service to bring about facilities such as the emergency care centre in Aberdeen, which is absolutely superb in terms of managing the flow of patients. Those things are all happening. New facilities are not things that have been planned over the last 18 months. They have been continuing investment in the national health service over the last few years. It is absolutely right that the health secretary, together with health professionals, has put together that action plan to deal with the pressures on the national health service. However, I think that there should be some acknowledgement that this national health service is treating more patients than ever before, and that the public has fantastic confidence in our national health service. They have nothing but admiration for the staff, the doctors and the nurses who are performing to such an exceptional degree. Willie Rennie talked about the NHS and keeping it in Scotland in public hands. That is exactly the point that I want to tackle the First Minister on, charging people for continuing care. It announced last Friday that it was ending the principle that people who need continuing care can get it free in their community. The only way that people can avoid hundreds of pounds of charges is to stay in hospital. Is not that going to increase the pressure on bed numbers and make the waiting problem worse? He has one half of his Government trying to get people out of hospital, and the other half giving them all the financial incentives to stay in hospital. That does not make sense, does it? The health secretary will be making a statement on continuing care and explaining exactly the proposals and not the version that has been presented by Willie Rennie. I am sure he wants to participate in that discussion. In terms of the success that we are committed to of free personal nursing care in Scotland, that would have been substantially enhanced if the Westminster Government hadn't withheld the attendance allowance, which would have helped extraordinarily with the finances of that. That was a Labour Government. In terms of financial pressures on the national health service, one of the most significant continuing pressures that we cannot unfortunately do anything about is the disaster of the private finance initiative, which, in key hospital and key hospital boards across Scotland, is resulting in continuing payments of eight to ten times the actual cost of hospitals because of the disastrous contracts that his colleagues signed when they were in Government in this office. Our commitment to a public national health service is not just to protect the funding, it is to have a public health service not paying over the odds to private contractors. To ask the First Minister what the Scottish Government's position is on the increase in Scotland's population. We are very pleased indeed that Scotland's population is its highest ever level. The healthy population growth is vital to future economic growth and the continuing increase in our population is welcome news indeed. I thank the First Minister for that answer. It is very encouraging that our population is at its highest ever level, but, like other countries, Scotland faces demographic challenges. Does the First Minister share my regret that the Westminster's UKIP-driven agenda is completely ignoring Scotland's needs and that only the powers offered by a yes vote will enable us to optimise our population and build a fairer and more prosperous society? I do agree with that. I think that one of the signs, not over a few years but over a century of the failure of Westminster control of the Scottish economy was the lack of population growth in Scotland over 100 years, about 10 per cent compared to about 60 per cent population growth in England. Thankfully, since the advent of this Parliament and particularly over the last few years, those trends are reversing. They will reverse even more with an independent Scotland. I cannot think of anything dafter as a policy, whether it is UKIP-driven or not, than to educate students up to a high degree of human capital in our fine universities and then to deprive them of the opportunity to work and to contribute to our economy. What could be a dafter policy than the one being pursued by the present Liberal Tory Administration at Westminster? That is why we should welcome the fact that the new population statistics show a substantial increase in population. I note that already, in the space of one year, they seem to be very substantially higher than the estimates that the Institute of Fiscal Studies used last November. I think that we should accept that if we pursue the right policies, we can get a population growth that is beneficial to economic growth in Scotland. To ask the First Minister, in the light of the reported 162 per cent increase since 2004 in the cost of providing free personal care, what action the Scottish Government is taking to ensure that local authorities' social work budgets can meet demand? The Scottish Government is proud of the fact that free personal care improves the lives of over 77,000 older people in Scotland. We are fully committed to the policy, and I hope that when we eventually see the labour cuts of you and it sees the light of day that Sarah Boyack will have been successful in defending free personal care from that cuts commission set up by Johann Lamont. As Sarah Boyack was aware, we protected the local government budget in relative terms and in 2015-16 it will stand at £10.6 billion. In addition, since 2008, payments for free personal nursing care have risen in line with inflation, and the Scottish Government is also providing an additional £5 million to local authorities in 2014-15 for care of older people. Given the view of COSLA's spokesperson, SNP councillor Peter Johnson, that council social work budgets are under huge pressure with some nearly-up-breaking point, what is the Scottish Government going to do to address the fact that local government revenue spendings had a real-terms cut of 1.2 per cent, while costs have risen 10 per cent since 2007? With demand for care services growing, with more older people living longer, isn't it time for the Scottish Government to sort out the squeeze on local government funding? I do not have Sarah Boyack's woken up to the fact that there is a squeeze on public spending in Scotland because of the squeeze being administered from the Westminster Government. That is the reality. However, in terms of where the various aspects of public spending are being protected, chiefly protected, there has been the health service for the reasons that we have already specified. Labour, of course, did not commit to that. However, secondly, only to the health service in terms of protection of public spending has been local government. In 2006-07, when the Labour Party were in office, Johann Lamont and others were ministers in that administration, then the percentage of local government funding was 34.7 per cent. In 2014-15, it is 36.7 per cent. So, yes, times are tough. How could they be otherwise? As a result of the financial crisis induced by Alistair Darling and the Labour Government, and the policies pursued of austerity from the Tory Government, local government spending has risen since the Labour Party were in power. So, wherever that squeeze and difficulty is, we know it to have been a lot worse if Sarah Boyack and her colleagues had continued in office. Thank you, Presiding Officer. As the First Minister alluded to earlier, Westminster retained attendance allowance when we introduced pre-personal care. To date, that is around £300 million. Surely the whole chamber would agree that the issue should be returned to Scotland even when the Labour Party was in power here. The Labour Government Westminster asked for that and was refused. It should be returned now, surely, to help with our elderly. First Minister. It is a hugely important issue, and does amount now. That is the withdrawal of attendance allowance. If I remember right, Henry McLeish, as First Minister, said that it was unfair that, as a result of a Scottish Government policy, attendance allowance should be withdrawn from Scotland. I think that I am right in saying that it was Jim Murphy, as the Westminster Minister, who said, no, that we are going to keep the attendance allowance money. Over the years since then, that amounts to more than £300 million, which would tell us two things. One, would it not be a grand idea if we considered and controlled all aspects of policy, not just spending but revenue and social security? Secondly, how useful would that £300 million now be to help funding the things that the Labour Party says it cares about, but, when in office, we have drew funding from Scotland? Thank you, Presiding Officer. To ask the First Minister what the Scottish Government's position is on the minimum pricing plan for alcohol being referred to the EU Court of Justice. Well, we look forward to making the case before the European Court of Justice for this vital public health tool that will help to rebalance Scotland's relationship with alcohol. Each week, on average, in Scotland, alcohol misuse is responsible for more than 20 deaths and almost 700 hospital admissions. Minimum pricing would save lives when, in months of its introduction, the Scottish Government remains committed to implementing it as part of that concerted package of measures that are already being rolled out to reduce alcohol-related harm. Scotland is leading the way on this issue and understanding that the Governments of Ireland and Estonia have outlined that they would like to move to their own minimum unit pricing systems. Thank you, First Minister, for that answer. Does he recall the wise words of the European Health Commissioner, Borg, when he said that he was in favour of minimum pricing in principle? Along with the empirical evidence from Canada and the support of each of the UK's chief medical officers, does that not demonstrate further that minimum pricing is essential if we are to reduce alcohol-related harm, cut violent crime and save lives in Scotland? Well, we welcome the backing in principle of minimum unit pricing from the European Health Commissioner. As the member points out quite rightly, that adds to the very substantial weight of support for the policy, particularly from those who work daily with the effects of alcohol misuse and abuse. Minimum unit pricing took place in Canada and has resulted in reductions in alcohol-related harm. A 10 per cent increase in minimum price has led to an estimated 32 per cent reduction in wholly alcohol attributable deaths. I welcome the referral to the European Court. I look forward to implementing minimum unit pricing, a policy in which the evidence shows will save lives. Thank you, that ends First Minister's question. We now move to members' business. Members should leave the chamber, should do so quickly and quietly.