 That is a key priority moving forward, and I can keep the member updated about that progress. Thank you. That ends the statement by Shona Robison on NHS Grampant and Healthcare Improvements Scotland reports. The next site of business is a debate on motion number 11763, in the name of Mary Phee. On private sector rent reform, members who wish to take part in this debate should press a request to speak button now. I call on Mary Phee to speak to move the motion with Fee 10 minutes. In opening for Scottish Labour, I want to put on record our party's support for Shelter Scotland's making, renting, right campaign. Shelter Scotland, as always, are at the heart of putting forward proposals on what is best for Scotland's residents. The campaign, among others, best exemplifies why Shelter is important to our housing sector in Scotland, as its proposals come from the experience of its users. Much of what is requested by Shelter was also put forward by Labour in the recent housing bill. However, the Scottish Government blocked our amendments. A consultation asking for views on a tenancy for the private rented sector has been launched, and yesterday Scottish Labour submitted our response. Will a bill follow the consultation? Can the minister tell the chamber the timetable of that bill? We support many of the proposals put forward by the Scottish Government for others we feel they could go further. For example, we believe that the minimum duration of a new tenancy should be three years and less requested to be shorter, specifically by the tenant. We also believe that a 28-day period for repossession might be too short in some circumstances. It is important to consider why Scottish Labour has brought this debate to the chamber today. The private rented sector in Scotland is broken and in need of reform. Over the last 10 years, the number of tenants in the private rented sector has doubled. The gap between private and social rents in Scotland is the second highest in the UK. Private tenants are spending more of their income on housing compared to a decade ago. With that in mind, let us assess what the Scottish Government has achieved. Housing bills that fail to address new and existing pressure in the private rented sector are fewer houses built than at any point since 1947. An expert working group reported on what could happen with a yes vote with no ambition set for Scotland's place in the United Kingdom. That being said, we do hope for a consensual debate this afternoon, given that many Government backbenchers have signed up to support the Shelter campaign. As I have repeated many times and will continue to do so many more times, the housing act of 2014 was a missed opportunity. Although there were aspects of the bill where Labour agreed with the SNP Government, we remain disappointed that the Scottish Government and its backbenchers voted against our amendments, which would have made a real difference to tenants in the private rented sector. We are making renting right campaign calls on the private rented sector to offer stability, flexibility and fairness to its tenants by modernising tenancies. That can only be achieved with the full support of this chamber and, indeed, through the political will of this Government. A modern tenancy must strike the right balance between tenants and landlords' rights. In our consultation response, we stress that the tenant must have the utmost protection from unnecessary evictions, poor security and unfair rent rises, while the landlord has a right to see returns from their investment in their property. I recognise that there are many exemplary landlords. We do not seek to punish landlords as many of our proposals will not apply to them. That is why Scottish Labour believes that the proposals that we put forward in the housing bill and to the private rented sector consultation can standardise the protection for all tenants and their families. We know that a quarter of Scots living in poverty do so as private renters, and that almost half of private rented sector households are families with children. Supporting a cap when rent rises was the sensible and practical option for the minister and her Government earlier this year. However, since new figures have shown an average rent rise of 2.7 per cent across Scotland and higher increases in different regions, I hope that the minister will see the error of her judgment and act sooner rather than later. That is not just an English or a London problem, as the Scottish Government would like us to believe. For example, in Aberdeen City and Shire, average monthly rents have increased by almost two-fifths since 2010, and in the Lothians private rents have increased by 17 per cent over the last four years. The cost of such increases pushes more families and tenants into poverty while the SNP refuses to take action. The average monthly cost for a two-bedroomed property in Aberdeen is £898, while the Scottish average is £537. There is a clear postcode lottery here. In June, a Nippsos Murray-Paul, on behalf of the Chartered Institute of Housing, showed us that four in 10 private renters worry about meeting rent payments, and 43 per cent express concerns about not affording their rent in 12 months. A cap on rent rises to £1 per year would allow tenants to manage their finances much better and allow landlords to plan for investment while maintaining the tenancy. Let me be clear that Scottish Labour does not back rent control, nor are we advocating rent control. Living with a disability can present many challenges, and one challenge that often goes unmentioned is access to suitable housing, especially within the private rented sector. As more people turn to private rented housing as a result of growing waiting lists for social housing, those with disabilities also find themselves looking to private lets. Recent statistics from the Scottish housing regulator show that the average number of days for social landlords to complete adaptions for medical reasons is 66 days, and in some cases social tenants are waiting almost a year for such adaptions to be completed. That is shameful and backs up what the Leonard Cheshire disability warn us about in their briefing ahead of today's debate. It is often expected that social landlords have the resources available to meet demands for repairs and adaptations that private landlords can't compete with. With no statistics available for comparison, I have to share my support for the changes that Leonard Cheshire would like to occur. As I worry that many disabled people in private housing are not having their needs met, there are means of financial support where grants can be applied for. However, with pressure on local government, the demand is not matched by supply. Leonard Cheshire says in their briefing why disabled friendly homes are more cost effective in the long term. For example, the cost of installing a stair lift in lifetime homes costs around £2,500. However, if the wall is not suitable for stair lifts, the cost to adapt this could exceed five or ten times the original cost of the lift. Building homes that meet the needs of the elderly and disabled requires commitment from government and developers, and without that, the standards cannot be met. I talked a few minutes ago about the worries about meeting rent payments, and it cannot be overemphasised the stress on finance, health and mental wellbeing that is caused through lack of security. Children can suffer in education if they have to relocate every year or two. Research suggests that anxiety and stress can develop with children because of the stress of moving. The average length of time spent by a family at the same address in the private rented sector is two to three years compared to 10 years in the social rented sector. Modernising the tenancy by scrapping the short Scottish secure tenancy, creating greater security of tenure and introducing an annual cap of rent increases, will help to mitigate and tackle many of the direct and indirect problems resulting from lack of security. Our motion does not seek to create division between members of this chamber. It highlights the need for change in how the private rented sector works. The number of private tenants has doubled in a decade, as have the number of households living in poverty in the private rented sector. Across the chamber, I hope that we can all agree that we want a well-regulated, stable private rented sector. I move the motion in my name. Many thanks. We have absolutely no spare time at all this afternoon. I now call on Minister Margaret Burgess to speak to you and move amendment 11763.3, Minister, up to seven minutes, please. I am glad to have the opportunity to debate the private rented sector. The growth of the sector may be news to some in this chamber, but the Scottish Government identified it as an issue as far back as 2010, as we recognised that an increasing number of people, including families, were spending part of their housing journey in the sector. At that point, we committed to developing a strategy for the private rented sector and set out to do so working with a Scottish private rented sector strategy group, which comprised stakeholders representing tenants, landlords and others with interests in the sector. The result was the first-ever strategy for the sector in Scotland, which we published in May 2013. The strategy set out our vision for the sector and identified three aims—improving quality, delivering for tenants and landlords and enabling growth and investment to help to increase overall housing supply. In those aims, we recognise that the private rented sector plays a valuable part in meeting housing needs for many people, but also that more could be done to make it more attractive to those who, for a range of reasons, prefer not to buy. We have made good progress in taking forward the strategy. The housing act that Parliament passed in June will improve quality through a regularity framework for letting agents and additional powers for local authorities to deal with poor landlords. The consultation on a new tenancy for the private rented sector that I launched in October sets out proposals to give tenants improved security of tenure. I thank the minister for taking an intervention. She tells the chamber that the Government has made good progress in relation to issues in the private rented sector. Can she perhaps tell us then why there was nothing in the legislative programme to address the issues of rent rises and the lack of security of tenure? We had the strategy group that consulted and met together, and that at that point was not recognised as an issue. It was not part of our bill when it was introduced, nor was it introduced by any of the consultation. It did not come up in the consultation, nor by the Labour Party during our consultation. What we did commit to do was consult on a new tenancy for the private rented sector, and that is the right way to do it. That is what we are doing, and we are currently consulting on that. We want to ensure that that provides safeguards for landlords, lenders and investors, as well as security for tenants. I am pleased that Shelter welcomes our ambition for changes in the sector. I want to confirm to Shelter and to the other stakeholders that this Government remains committed to passing in this parliamentary session the legislation that is necessary to establish a new tenancy regime for the private rented sector. We will say more about that in spring next year, once we have considered the responses to the consultation. The Scottish Government is also supporting homes for Scotland in its work to drive forward initiatives to build more homes for rent by attracting new sources of investment. As part of that commitment, we have funded the appointment of a private rented sector champion to lead on that. However, in the context of this afternoon's debate, increasing supply is particularly relevant. Where rents are high, the long-term answer is more supply in every tenure to meet growing demand. I recognise that rents are indeed high in some hotspots across the country, and where that is the case, it reflects conditions in local housing markets. Statistics published by the Scottish Government last month showed wide variations in average rents. For example, average monthly rents for two-bedroom properties range from less than £450 a month in Dumfries and Galloway to almost twice that in Aberdeen City and Aberdeen Shire. Likewise, increases in rents also vary, but our statistics show that between 2010 and 2014, most average rents increased below the rate of inflation with some rents falling. In particular, a total of 16 out of the 18 rental market areas across Scotland have seen below inflation changes in average rents for two-bedroom properties, the most common size of property in the private rented sector, and the exceptions to that. In terms of rent levels, I think that you have been listening too much to the letting agents saying that there has been below the rate of inflation. Do you think that the average level of monthly rent of £537 a month, do you think that that is acceptable? I would say to the member that we weren't listening to letting agents to get that information. That is Scottish Government research, and that research shows quite clearly that 16 out of the 18 rental markets areas have seen below inflation changes in average rents. As I say, where rents are higher rising, the answer is to build more houses, not just for private renting, but in all tenures. We have taken decisive action on that. To take the particular case of Aberdeen, we recognise that funding affordable housing has been causing difficulties in the recruitment and retention of key staff in the NHS and other parts of the public sector. Those workers are now set to benefit from various forms of affordable housing that will be developed on the Craigings site in the city and, importantly, targeted at those key workers. In terms of supply generally, we have boosted housing supply budgets by investing £1.7 billion in affordable housing in the lifetime of this Parliament. Last month, we announced £200 million in increase in funding to stimulate Scotland's housing industry. Despite challenging economic conditions and Scottish budgets being cut, our rate of house building per head continues to outperform other parts of the UK. We have delivered over 22,700 affordable homes, three quarters of the way towards our 30,000 affordable homes target. Over 15,900 of those are for social rent, which is 80 per cent of our social rent target. I remind the chamber that, in the past four years of the previous administration, just over 20,000 affordable homes were completed. In the following four years, we increased that by 34 per cent. In fact, there was not one single year during this period when this Government did not complete more homes. Therefore, this Scottish Government is working with our stakeholders to deliver better quality and more security in the private rented sector and to deliver the variety and number of affordable homes that are the answer to high rents in the sector. I move the amendment in my name. I now call Alex Johnstone, up to five minutes, please, Mr Johnstone. I take the opportunity to move the amendment in my name. Also, however, I welcome the motion in the name of Mary Fee because it gives us an opportunity to address something that is the centre of discussion in the private rented sector, and that is the party's various positions around rent controls. I hear what has been said in the opening speech that the Labour Party apparently are not in favour of rent controls, but I also hear that they are in favour of annual limits on rent increases, and I am beginning to have some difficulty in understanding what is meant by rent control if we are going to have one of those things and not the other. However, when it comes to housing, it is sometimes said that there is nothing new under the sun, and rent control is something that has been tried often enough before. It was first introduced in the UK in 1915, and maybe the opportunity exists next year for us to celebrate its 100th birthday by burying it deeply in our history. Any student of housing policy history will recognise that the 1915 rent controls had a catastrophic effect. The number of houses to rent in the private sector collapsed dramatically as landlords sold off their stock and investment in improvements also fell. Their reintroduction today could also make it more difficult for landlords to access finance, as lenders may be nervous of future interest rate increases against a backdrop of severely limited rent increases. That was not the only time rent controls have been attempted in this country, of course. They did return during the Second World War with significant effects, and I think that it is important that we do not make the mistake, whoever we are, of going forward with a third-time lucky approach and our fingers crossed. Although rent controls were abandoned in the UK many years ago, various forms of them continued in many places across Europe, but in those examples the effect of rent controls actually keeps them at or around market levels. It may then be that introducing rent control of that kind could either result in the negative impacts that I described earlier or actually have little or no impact on rent levels if the Scottish Government chooses to follow that European model. Of course, it no longer surprises me that Labour, bereft of its own ideas, appears to use the position of shelter as a default setting for their housing policy. However, having discussed the private rented sector with shelter, it seems obvious to me that it enjoys a much more sophisticated and realistic understanding of the issues than perhaps some in this chamber do. The position is very briefly. Just in terms of a realistic understanding of the housing situation, do you recognise that one in four of those living in the private rented sector are living in poverty? What are the Conservatives offering in terms of help to those who need much needed assistance? What we have to be careful of is using inappropriate statistics. We have already heard one set of statistics balanced with the Government statistics in the two opening speeches. Far from showing that tenants in the Scottish private sector are concerned about escalating rent levels, a recent poll found that 86 per cent of tenants surveyed had never received a request for a rent increase during their lease. 90 per cent had never experienced a rent rise that was deemed to be unreasonable. 91 per cent of tenants think that the frequency of rent reviews on their property has been reasonable. I think that those statistics demonstrate that, unlike the claim that was made by the Labour Party earlier in this debate, the system is not broken. If we do that correctly, we can continue to rely on the private rented sector to make their contribution to the housing problems that we have in Scotland today. Recently, I have met a lot of representatives of the private rented sector, all of whom are hoping to work in a constructive manner with the Scottish Government to improve the industry. They are ready to engage, but they are also deeply concerned at the impact that some of those proposals might have. The private rented sector is playing an increasingly important role in accommodating home seekers at a time when the private sector is picking up the slack from the lack of investment in affordable housing by successive Governments, both the current and its predecessors. For that reason, I think that it is essential that we take a constructive and engaged approach, a measured approach, in one that does not have the negative impact on the private rented sector, which all of us would regret should it happen. Many thanks. We now move to the open debate, and I call on John Mason to be followed by Ken Macintosh up to four minutes, please. Clearly, the private rented sector is changing and growing, and we need to keep legislation up to speed with those changes. In a constituency like mine in Glasgow-Shetleston, there was a large, a huge number of council or housing association houses and a fair number of owner-occupiers and also a traditional private rented sector. However, that has changed hugely now, especially through right to buy and previous council or housing association properties, as well as bought houses, now having moved into the private rented sector. It seems to me that there are a number of reasons why people use a private rent. One is younger people who just want it for the very short term, and I am sure that other members have been in that situation. Two, they cannot get affordable housing, so they are forced unwillingly into the private rented sector. Now, the answer to that has been to end right to buy, which has been absolutely correct and, over time, hopefully to build more affordable homes. But thirdly, there are those who can't or don't want to buy, and private rent is their preferred route for the long term. I think that this is much more common in other countries and seems to be becoming more common here now. Quite a number of the antisocial behaviour issues that I get come from private rented flats. Clearly, that can be because you will get difficult tenants, difficult residents anywhere, but I think that the lack of stability for private tenancies is making things worse. If a tenancy is likely to be very short term, where is the incentive to build up relationships with neighbours and the wider community? Where is the incentive to maintain, improve or invest in the property? Especially if improving your property means that the rent goes up, as one of my colleagues told me they had experienced, that is a positive disincentive to improve it. Looking at Shelter's Making Renting Right campaign, it is very much the word stability and security that attracts me. If there is a phrase in Shelter's campaign that I was less comfortable with, it would be, quote, to stay as long as they want, which came in under the flexibility heading. However, I was interested to see today that the briefing that we received from Shelter today said flexibility for people to stay in their home as long as they need, and I suspect that that is something that people will be more comfortable with, because I think that some of Alex Johnson's chums were maybe about frightened off about people staying as long as they wanted. When we look at the social rented sector, we see a reasonable balance. On the one hand, there is security and stability, but on the other hand, people can be evicted if the worst comes to the worst. I am encouraged by the positive relationship between police and housing associations who work together so that the neighbour from hell can, at the end of the day, be evicted, and we would certainly want to see that in the private rented sector. The minister and members may not be surprised that, as we are debating housing today, I want to mention the Bellgrove hotel in my constituency. It is privately owned and the residents are renting, although I accept that it may not be typical of what Mary Fee is talking about today. I think that one of the lessons from the Bellgrove hotel, which is effectively a hostel, for all of us today is the condition of private rented accommodation, which is another factor in all that. If I took you into a range of tenements in Parkhead or Shedleston, you would know within seconds of entering them which were private lets and which were housing association run. I do hasten to add that there are some very good private rented flats, but others are pretty grim and you see it immediately. Link to that is electrical safety, another issue that has been raised, and the electrical safety first campaign on this type of issue. I hope that the Government will be open to input from them going forward. Clearly, there is work to be done in a changing landscape, but I think that we also have to be very positive about achievements so far. Ending the right to buy has been a huge improvement. Investing in new affordable housing whenever there is spare money has been great. Initial steps to register landlords and letting agents are all very much moves in the right direction. I see that you have run out of time. I appreciate your brevity. I now call on Ken Macintosh to be followed by Claire Adamson. Thank you, Presiding Officer. In our last debate in housing, I described the difficult and anxious situation facing our resident in East Renfrewshire who had come to see me for advice and any assistance that I could offer. This is a young man with two children at local schools but whose partner had left and who could no longer afford to live in the family home. With few priority housing points, there was no chance of him getting a council or housing association property on the eastward side of the authority. Although he has worked all his life in fact, a mortgage in this area was also well out of his reach. I am pleased to tell you that, along with his children, he has now found a private rented flat on the south side of Glasgow, close enough to get the bus up to school and more importantly just about affordable. How many cases have we all heard about over the last few years, some with far less satisfactory outcomes? Problems with housing supply are helping to drive huge changes to the way that we live in Scotland. We are simply not building enough homes. The number of new private homes has more than halved in recent years while the population is increasing. In terms of council or housing association property, Audit Scotland has identified a shortfall of almost 14,000 homes in the last decade alone, and there are up to a dozen local authorities in the same situation as East Renfrewshire, where the waiting list for a council house has increased over the last five years. An estimated 150,000 people find themselves in this predicament in Scotland. The fact that the number of Scots now living in private rented accommodation has doubled over the last decade demonstrates precisely how important this sector has become. My constituent and his family landed on their feet, but for many more families, moving into a private let leaves them feeling insecure or worse. It becomes a move into poverty. The Joseph Rowntree Foundation has found that private renters spent 23 per cent of their income on housing up from 18 per cent just 10 years ago. The number of families in the private rented sector on housing benefit has increased from 60,000 in 2008 to 97,000 in 2013. Last year's Scottish household survey highlighted the insecurity of tenure in the private rented sector compared to the alternative. The average length of time for someone in the private rented sector staying at the same address is between two and three years compared to over 10 years in the social rented sector and 15 years at an owner occupied home. Some of that, as John Mason just pointed out, may reflect choice or people in transition to home ownership, but with so many families now leasing privately, there is the danger of such instability having a detrimental effect on the more vulnerable. There is not one solution to Scotland's housing problems and we clearly need to build more homes, but reform of the private rented sector should at least be part of the way forward. At the moment, many people are fearful of moving into a private let but are forced by circumstance to do so. The constituency case that I gave as an example is far from unique, but as I am sure most colleagues recognise, for the majority of constituents, renting privately is their least favoured option. Similarly, many landlords are increasingly wary of renting to bad tenants who they then can't get rid of. I don't believe that this is a sustainable way on which the sector can develop. Shelter's campaign to make renting right could help both tenants and landlords. It could provide stability and security for both and introduce a fairer system for resolving problems where they occur. There are plenty of examples in Europe where private renting is seen as safe, affordable and a desirable option. Here in Scotland, on the other hand, the gap between the tenancy regime for private and public landlords simply aggravates the sense of inequality created by the difference in rent levels between the two. According to the Joseph Rowntree Foundation, the average private rent is 86 per cent higher than the average social rent in this country. That is not an anti-lander measure. Shelter has shown the way forward. Labour has put that into parliamentary practice and I urge members of small size to support our motion. Thank you, Presiding Officer. Can I start by picking up on some of the comments by my colleague John Mason on the quality of the tenancies? I chair the cross-party group on accident prevention and safety awareness, and we are very aware of some of the dangers that are in the home. I have covered that issue on many occasions. Indeed, our last meeting was about the challenges of electrical and gas safety and the responsibility for landlords. That was a very informative meeting. We had presentations from Select, from Electrical Safety Council and from SGN on the gas issues. All those organisations provide guidance to landlords and to tenants on information. Those presentations are available on the Roswell website, and I commend them to members who have tenants who have concerns at this stage. I can also say that I will be welcoming an update of the electrical guidelines following the amendments that were passed and championed by my colleague Bob Doris in tightening up some of the issues around electrical safety. I will welcome any further information that the Government might have on tightening up on regulation of electricians in Scotland. I have to take issue slightly with the very good debate that we have this afternoon, and we all recognise that there is more that we could be doing in Scotland. I did take issue with Mary Fee saying that this is a Government that hasn't taken action. I think that this is a Government that has acted very responsibly in the area of housing. We have had action on affordable homes. We have had actions on tackling the problems in the private sector that has just outlined. We have had actions on— Yes, certainly. Mary Fee. It's just on the point when you say that the Government has acted responsibly. Would a responsible Government be in a position where the record on building affordable homes or building housing is the lowest since the Second World War? Is that responsible? Perhaps I could remind Mary Fee of the Labour and Liberal Democrats record in this area. According to the housing statistics for Scotland 2014 key trends summary published by the Government shows that, on average, every year, when you look at housing association, local authority build rehabilitation and conversion, the record of your former Government was to build an average of 5,856 houses. The average of the Government under austerity with its capital budget slashed is 6,193 houses. In local authority levels, on average, 43 from the Labour and Liberal Democrats, that Government is 658. That is a responsible Government taking action and being responsible at housing in Scotland. We have taken action in the tenancy deposit schemes. We have launched the consultation on tenancy, which will gather the information that is relevant to Scotland that will allow us to take forward a tenancy bill that will be relevant to what is happening in Scotland. We also took action on the right to buy, which is transformational for the opportunities for local authorities to build housing. We have taken action on landlord registration and tackling supply with innovation. As announced by the cabinet secretary this morning, we will be using the charitable bond model to put a further £25 million next year into that could lead to 450 additional affordable homes in Scotland. Alex Neil said today that in a fair society, just society, we want to make sure that everyone in Scotland has access to good-quality housing that meets their needs. I am very glad that this Government is taking that forward. I am pleased to be able to take part in this afternoon's debate. I highlight just one of the issues being faced by my constituents with regards to housing. I was contacted some months ago by my constituent who works as a porter within the NHS. My constituent has been forced to take a private rented flat after his long-term relationship broke up. As a result, he now finds that his NHS wage only meets his rent and household bills. His situation is so bad that he has had to go to his parents every night for his evening meal. That man is in his forties and has worked his entire adult life and he cannot afford his rent. That is nothing short of scandalous and it is one of the many reasons that I am supporting Shelter's making renting right campaign. I am particularly pleased to support Shelter's call for more flexibility with regards to the tenancy agreement. As Shelter stated, the private rented sector is changing. Currently, the man suggests that while some people want the option of a tenancy that lasts for as long as they need it, others want flexibility if they need to move. We want a tenancy regime that can respond to people's needs and work for landlords and tenants. For tenants, it is about striking the balance between being able to live as long as they need in a property with due consideration given to their landlord in terms of adequate notice when they want to leave. I believe that that is a practical measure that will not only benefit tenants but will benefit landlords too. By offering an agreement that benefits both parties, greater trust and commitment will be established. As a result, there will be a greater belief in the system, something that is missing from the agreement now. We need to take action now on the spiron cost of private rent. It is simply not good enough that hard-working people are finding that they have no other choice than to get themselves into huge amounts of debt simply to keep a roof over their heads. Given that 13 per cent of housing stock is in the private rented sector and that one in four private rented households have children, we need to address the massive problem in this sector quickly. It must be a priority for the Government and for this Parliament. Only a few weeks ago, I asked the minister a very straightforward question in this chamber. I asked her if she supported the children's campaign or not. It was a simple yes, no answer. However, I got neither in return. I hope that she will now be definite in her answer today and, once and for all, pledge her support for the campaign and confirm what action she will now take given that the Government has known about this problem in her own words since 2010. To hear that the number of people living in poverty in the private rented sector has doubled in the last decade should make all politicians extremely uncomfortable. That is why we need action now and that is why I asked the minister not only to support Schelter Scotland's campaign but to back Scottish Labour's proposals to introduce a specific bill on the private rented sector. We want to see a bill introduced to provide people with greater security with regards to the tenure and, importantly, we wish to see a cap on rent rises. I believe that that would make a huge difference to tenants' lives and it is something that could be legislated on quickly. I hope that the minister will now back our proposals. On a separate note, I was delighted that the Smith commission has suggested that our Parliament receive the power to legislate in relation to socioeconomic areas. I hope that that will mean establishing an equality impact assessment in this area. That is something that I call for in my own submission to the commission. I believe that that power would allow the Government to truly assess if their policies are making the difference that they would like to see on reducing poverty in our communities. I believe that that will be particularly useful in assessing just how effective the Scottish Government's policy on housing and housing stock has been in reducing inequalities in Scotland. I hope that the minister is listening to the request that has been made to her today and that she finds a way to address the concerns of members, charities, campaigners and, most importantly, tenants as they need action now, not more warren words. I welcome this debate because it is a very important and basic need and it is an issue that I believe that the Scottish Government takes very seriously. As all the members have already mentioned, it is a major issue within all of our constituencies with some of the cases that we could deal with on a day-to-day basis. Within my constituency there is proof of the Scottish Government's investment in private and social housing that has currently been built right smack in the centre of town, not a case of a Scottish Government refusing to take action. Those homes are right in the heart of town and are not only creating homes for families but also helping to regenerate the town centre as we look at the many challenges that town centres like Paisley have at the moment. There are many challenges regarding the private rented sector, but for me the main solution and the one that I believe the Scottish Government has taken is to go down the route of affordable housing. As the minister has already stated, the Scottish Government plans to spend over £1.7 billion over the lifetime of this Parliament on affordable housing, but that is part of an on-going, bold and ambitious plan for housing. In 2015-16, £390 million will be invested to deliver—unfortunately, I have only got a short time, Mr Finlay—to deliver 6,000 more affordable homes. 4,000 will be in social rented area and that is the type that is making a major difference in our constituencies. It appears that, even though I said no to Mr Finlay, he still wants to shout from afar. That happens across the whole country, but that is a very important issue and one that we should take seriously and not bring the chamber into disrepute. The council housing of £135 million has been spent by the Scottish Government since 2009, and housing is our main priority of the Scottish Government. I am aware that the Scottish Government is making steps to realise its vision in the private rented sector and dealing with the many issues. One of those is obviously mentioned by the Government as the fact that the strategy that the Government has already set out for the private sector. Those will help many of our constituents to improve the quality of property, management, condition and service, to deliver for tenants and landlords and meeting the needs of people living. Unfortunately, I am running out of time and the more intervention we seem to get, I seem to lose more on my time. If the Labour Party actually believed in doing something for some of the constituents in my area, like Mr Bibby, if they truly believed in that, they would have taken more than a short, last-minute debate in housing and had taken their full time for it. That issue affects every single one of our constituents. I am not going to listen to members of the Labour Party just show-bloting when we are dealing with people's lives, because those are the people that we represent and those are the people that we have to make sure that we can make the difference. That is not just about politics, it is about the basic need of people getting a home, a roof over their head, and ensuring that we can debate that in a mature manner. I urge the Labour Party to become serious about those issues and not just sit here and play some political game, such as a game of tennis. I have already stated that housing is a very basic need. It is also an extremely complex and challenging issue. I appreciate the work and the on-going vision of the Scottish Government, and I am only too aware that the differences that its policies are making in constituencies are like ours throughout the country. It is time for everyone else in the chamber to look at the debate, take it very seriously and start representing our concessions. I appreciate your bravery to be followed by Richard Lyle. I thank the Labour Party for bringing this debate, which, to be fair, is by no means the first debate that opposition parties have brought on the issue of housing during the current session. In those debates, I have argued repeatedly, that we cannot afford to treat housing as just like any other commercial transaction. Housing is different. Housing is intimate. It impacts on our health, physical and mental, on our access to friends, family and neighbours, our ability to live as part of a community. It impacts on our access to employment and public services. It impacts on our dignity and our very identity. Not just because of the nature of housing being something beyond other kinds of commercial transactions, but also because of the lack of availability and choices that people have. As John Mason referred to earlier, so many people in our society now no longer have availability of social rented housing and no longer can find it affordable. For many of them at any point in their lives to become owner occupiers, private rented housing is the only housing that our society is making available to them. For large parts of their lives, that means that we need to take it seriously. That means that we need to recognise that this is social provision and regulate it as such. Expect that orbit. Mary Fee says that there are many exemplary landlords out there. I suspect that everybody would recognise that there is a wide spectrum of experience that tenants have from the private rented sector. From exemplary landlords to quite the opposite. There are those who recognise that providing housing is something significant, meaningful and that if you charge for rent more than you are paying to service the debt that is secured on a property, that profit that you are making needs to be earned. Being a landlord is doing a job. There are landlords who understand that and have pride in providing a decent standard of service and making sure that their tenants are well looked after. There are also landlords who simply think that it is a sense of entitlement to rake in the profit. Both parts of that spectrum are there and there are all forms of behaviour that we can see. It is not enough simply to say that more people are going to be in that sector. The sector has doubled in 10 years and wants to double again. It is not enough simply to say that that is going to be part of the mix until we have to support all landlords. We should support good landlords and good landlords who provide a standard of service that they should be proud of will have nothing to fear from imposing a decent regulatory expectation on the sector. Margaret Burgess recognised in her speech that many families spend time in the private rented sector as part of their housing journey to where. Just recently, the Joseph Rowntree foundation report entitled Young, Working and Renting, looking at the changing nature of poverty and inequality in this country, recognised that the number of private landlord repossessions is now higher than the number of mortgage repossessions. At the end of a private rented tenancy, it is the primary reason for people becoming homeless. Those are UK statistics and I would be interested to know whether the minister can confirm whether those are true at Scottish level as well. In closing, I finally have a note of caution about a word that we heard from Mr Johnson. We have already seen the euphemism of terms like job seekers instead of unemployment. Let's not make the same mistake and talk of home seekers instead of recognising that the reality of homelessness is something very significant in our society. Richard Lyle, after which we should move to closing speeches. Thank you, Presiding Officer. Can I compliment Mary Fee on her sword voice? I hope that it gets better. I read over the Labour Party's motion with interest. I must say that it was indeed interesting to see that it stated that the Labour Party believes that the private rented sector tenancies should be reformed to provide tenants with greater security of tenure. Well, this is an area where I understand that this Government has taken the action to improve. They are already doing it. Members may have read as I did the private rented sector tenancy review group report. This is the report of the private rented sector strategy group, a group set up by the Scottish Government in 2013 with a purpose to examine how suitable and effective the current private rented sector system was and, crucially, to consider whether changes in the law were needed. It will be interesting to the Labour Party that I noted that the Scottish Government did accept the main recommendations of the report of the group, which was the current tenancies for the private sector, the assured tenancy and the assured tenancy being replaced by a new tenancy for all future lads. The Government published the draft consultation, no, I want to get four minutes, thanks, into the proposed new type of tenancy for the private rented sector. After considering the views of the people who responded to the consultation, the Government I am sure will act accordingly. I believe that the Government has a track record of looking carefully at the issues facing the private rented sector. They have been clear, particularly in their strategy, a place to stay, a place to call home regarding the private rented sector. They have set out vision, the strategic aims for the private rented sector, with clear aims to improve and grow the private rented sector by enabling a more effective regulatory system, targeting tougher enforcement action and attracting new investment. That can only improve the situation for tenants. In a nation rich in natural resources like ours, it is simply an utterly scandal that people are living in poverty. That is mainly, and I would suggest, due to the UK Government benefit cuts and austerity measures that are increasingly hurting Scottish families. We are also now seeing an increase in the use of food banks. I believe that the Scottish Government is doing everything it can to help those in this situation by working with stakeholders to mitigate the worst impacts of welfare reform for those in the lowest incomes through various measures and decisions that this Government has taken. I also note that the Government is providing nearly 33 million of support to the most vulnerable through the new Scottish welfare fund. Last night, Mr Finlay will find this interesting. Last night in an event, I had a very interesting discussion with an official involved in the housing sector. No, he wasn't lobbying me. He informed me that there are presently three types of renting—social rent, middle rent and private rent. In his opinion, the proposal made today by the Labour Party is totally unworkable. We caused many owners in the private rented sector to withdraw from that sector. That would put undue pressure on families who presently rent. Also in an event before I come into this chamber today, I had a discussion with the representatives from G. No, I don't have the time. GGF informed me that the UK Government is charging 20 per cent and 35 per cent in replacing windows. It is another example of where we could improve and help fuel poverty if we were so minded to do so and if the UK Government would do so. I am sure that this Government is clearly committed to taking action on the issues facing the private rented sector more and more. It is committed wholeheartedly to tackling poverty in Scotland and the various symptoms of poverty. I support this amendment by the Scottish Government. Many thanks. We now move to closing speeches. I call on Alex Johnson. Up to four minutes, please, Mr Johnson. There have been a couple of mentions of shelters making a make-renting right campaign and the fact that they have been asking politicians to sign up to it. I have discussed it with them. I have not signed it yet. To be honest, there is much in there that I support. I have come very close to agreeing to put my signature on that document. The strange thing is, though, if it turns out that what it means is what the Labour Party thinks it means, then it would be impossible for me to sign. The fact is that, as we have demonstrated during the course of this debate, people have different opinions in different corners of the chamber, and there is a disconnect about what we are talking about. We have heard, for example, much talked about the average rents that exist in the private sector in Aberdeen and Aberdeenshire, yet no attempt to understand that the nature of the private rented sector in the north-east at the moment includes people who are extremely high earners renting extremely expensive property. The kind of property, the kind of rents, certainly would make our eyes water in this chamber, but yet those figures are being taken into the average and misrepresented in this debate. I think that it is important that we also realise that the comment that was made about many people renting as part of their housing journey is in fact the case. Many of my own family have rented in the private sector for a while in preparation for taking on a mortgage. That happens all over the country, and they, too, are included in those statistics. I am afraid that I do not have the time to get to a conclusion here. Ultimately, what we need to understand is that the private rented sector does different things in different parts of the country, does different things in different streets close together, and those things are not easy to compare. This is a complex marketplace and one that some during this debate have demonstrated a much greater understanding of than others. The fact is that the private rented sector has, by accident or design, become an essential part of our housing strategies as we stand at the current moment. Yet there are those out there who are very tempted to blame the private rented sector for many of the problems that we face. I do not think that that is a justified approach in every case. The last thing that the industry needs is some kind of politically inspired witch-hunt, similar to the one that is currently being invested on our land owners. There are aspects of the Scottish Government's proposals that are worthy of consideration and support, but the bottom line is that rent controls in any form, tinkering with the tenants, will achieve little when the primary issue is a lack of investment by the Scottish Government into bricks and mortar. I was surprised to find myself agreeing very strongly with George Adam when he made some comments a moment ago, and that is that you cannot legislate your way out of a housing crisis. You can only build your way out of a housing crisis. More houses in available for rent means that landlords in the private sector will have to compete for tenants and offer higher standards and lower rents. If we build houses, the market will deliver the changes that many of us have asked for today. Yet at this moment the private rented sector is plugging a gap that we cannot do without. We need the private rented sector until we reach these days when we can build adequate numbers of houses. If we make the wrong decision, if we make the mistake of undermining the private rented sector without taking alternative action to plug a gap elsewhere, homelessness will be the only result. I think that the debate has certainly confirmed the growing significance of the private rented sector and the increasing role that it plays in helping to meet our people's housing needs. I think that it has been mentioned a number of times about the Shelter campaign. The Scottish Government has been working with Shelter and other stakeholders in developing our proposals for a new private rented tendency. Indeed, Shelter's campaign is supporting the Scottish Government in making rent right across Scotland. That is because we have already put forward, I will take them in a moment, proposals that seek to improve the security of tenure of tenants. I thank the minister for taking me in to mention the question was do you support Shelter, not does Shelter support you? That was the question. What I said is that I support the wider aims of Shelter's campaign in making rent right across Scotland. I have never said that I did not support that. We are working with Shelter but we are currently consulting just now on the proposals. It would not be appropriate for me to come down on one set of proposals against another. That is what a consultation is about. It is about talking to all those involved in the housing sector. That is what we are doing and that is what we consider the right way before we change any policies in terms of the private sector. I think that when we are thinking about to do where rents we are, we are seeking views on rents as part of this tenancy reform in terms of our consultation. It does not close to 28 December, so we will reflect very carefully at all the responses to the consultation before deciding on what we will be in our forthcoming bill on tenancy reform. We will announce our plans in the spring of next year and hope to introduce our bill in the autumn. I think that this afternoon I have stressed—I do not have many other speakers in the debate—that the best way to tackle high-level rents is to take one more intervention. I thank the minister for taking the intervention. Even on the timetable that the minister has outlined, by the time that any bill is enacted, it is going to be another two years before tenants in the private rented sector get any support for the issues that they face around security of tenure or rising rent levels. That is unacceptable. Does the minister not accept that legislation should have been introduced in the programme last week? No, I accept that we are currently consulting and we have to take time to consult and look at the responses, and that is a proper and measured way to do it. We did that with our stakeholders in the sector. We are aware that that was the timescale that we were moving forward to. We said that we would do it within the lifetime of this Parliament, and that is what we intend to do, and that is what was said from the outset. A couple of other things have been mentioned. Patrick Harvie talked about the housing journey. I want to make it clear that I was talking about that it is different for different people at different times in their lives. It is not automatic that you transcend from social rent to private rent to owner-occupied. Some people will stay in one section because that is what suits them and that is what suits their needs, so it was not in any way suggesting that it was a transitional way. In terms of the figures that Patrick Harvie asked about in terms of homelessness, I cannot tell him if I have those figures, but what I can do is we will look at that, and if we record that, I will pass that information on to Patrick and to the chamber. However, as we talked about increasing supply, I want to remind some of the Government's achievements on that score. I will say it again that we are building more houses in the past seven years than any previous administration in this Scottish Parliament. In terms of social rent, housing associations, social rent and affordable housing, and we have also boosted the house building industry in a time of recession. We are in track to deliver homes, but we are also helping the house building industry with our help to buy scheme, which has boosted the industry and jobs. We have boosted our affordable housing supply budget over the five years. We have committed more than £300 million to help to buy. We have a national housing trust scheme, so we are constantly looking at ways of boosting the housing supply. I am also proud that we have legislated to end the right to buy, and I think that John Mason mentioned that in his contribution. We are also proud that we have provided £90 million in the period from 2013-16 to mitigate the effects of the bedroom tax. We continue to work with partners to develop new housing investment models that are capable of attracting large-scale long-term funding from the capital markets to expand the delivery of housing for affordable and private rent. An example of that is Hearthstone investment plans for £150 million fund to invest in more than 1,000 homes across Scotland, which has secured £30 million from Falkirk council pension funds. We continue to use innovative financing approaches such as our successful national housing trust, which is the first guarantee-based model for housing in the UK cave, which is helping hundreds of households to secure a high-quality home that meets their needs. We continue to do that by working with stakeholders, our partners, and we will publish a joint delivery plan for housing in Scotland by the end of April 2015, following on from our housing event in November this year. That event was unique in bringing together councils, housing associations, housing lenders, landlords and many others with contributions to make to our shared ambition that everyone in Scotland has access to good-quality affordable housing that meets their needs. The Labour Party has used its slot, not for the first time, to bring forward the debate on housing because of the important issues that are faced in the private rented sector. Because of a shortage in housing supply and a lot of people lacking the finance to be able to afford mortgages, the private rented sector has really grown doubled in size in recent years to £368,000. The two particular problems that have been brought out in Labour's motion and also during the course of the debate are rising rent levels and security of tenure. On rents, it is a fact that rents have been gone up in every region. The average level is £537 a month throughout Scotland. That is a stagger in figure. Mr Johnson makes the point that, in regards to the high rent rises in Aberdeen, there are high earners. I point out to Mr Johnson that, if you look at what is going on in Edinburgh, where, on average, people are having to spend 47 per cent of their income on rent, that shows the issues that people are having to face on the ground. I think that Mr Johnson would be able to take a walk not far from the Parliament to find out about some of the real issues that people in the private rented sector are facing. Except that, across Scotland, there are 16 out of the 18 broad market rental areas that the average increase has been less than inflation. I think that the minister has been listening too much to the letting agents. If you go to postcode areas in Glasgow, in Dundee, in Aberdeen and in Edinburgh, there are staggering levels of rent rises going up to the level of 40 per cent in Aberdeen. That is unacceptable and it is the job of government to intervene and to try and take some action on those rent levels. The other issue that has come up in the debate is obviously security of tenure. People in private rented accommodation tend to only be there for two to three years compared with 10 years in the social housing market. That has a big impact on children. We are one in four that these households have children. It puts people in vulnerable situations because they can be put in a situation in which a landlord ends a tenancy at short notice. As Ken Macintosh noted in his contribution, the people can struggle to find alternative accommodation. They also can be put in a position where rent rises are put up at short notice but they do not have any alternatives. What it really comes down to is a position of power. The power in this situation is with the landlords and the letting agents. I think that more of it needs to be shifted on to giving rights to individual tenants. That is why Labour in the housing bill brought forward practical amendments to address the issue of rising rent levels and security of tenure. We have heard SNP, backbencher and after backbencher talk about the importance of the private rented sector and addressing the issues in that sector. Every one of you, given the opportunity, voted down the Labour proposals. You voted down the opportunity to help your constituents. Everybody can quote statistics back and forward. If you look at the contribution that Siobhan McMahon made in her constituent, the constituent, because of the rent levels that he is paying, could not afford to feed himself and had to go to his parents' house in order to get meals. That shows you the reality of what is happening on the ground. In terms of the Conservative and Government amendments, they need to open their eyes to those issues. On the amendments, I think that it is unfortunate that the green amendment was not selected because that would have given the opportunity to focus on some of the issues that students face in terms of rent levels. There is no doubt that those issues in terms of security of tenure in rent levels hit students very hard indeed. The Tory motion and the Tory-Alex Johnson's contributions during the debate, to me, the lords, the growth of the private rented sector and the benefit that that is to the economy, do not acknowledge issues such as the rising rent levels that people are going to have to contribute and the rising levels of people in the private rented sector in poverty. It is one thing to laud the growth in that sector, but if those poverty levels continue to grow, that is a real problem in communities throughout Scotland. In terms of the SNP amendment, it is one that is staggering in terms of its complacency. The Government and its amendment and the various speakers have told us how they published a strategy in 2013. The amendment tells us how they have made great progress with the strategy because we are now having a consultation. Having a strategy published 18 months ago, we are now having a consultation to talk about the issues that should take the minister. The strategy covered a number of other areas in terms of repair, in terms of tenancy deposits and now we have the regulation of letting agents. We have done a number of things in terms of the private sector and we are now consulting on the tenancy regime and rents. Marissa, you acknowledged in your opening contribution that in 2010 you recognised our issues with the private rented sector. This Government has had two bills, a strategy and a consultation and nothing in last week's legislative programme to address the issues of rent increases or security of tenure. This Government is on go slow in terms of housing. It is time that we saw some action because, if you look at what is happening to people on the ground, they are asking the question, the SNP Government are in power, what are you going to do with that power? If you are in a situation where you cannot pay your bills, you cannot pay your energy bills or you cannot pay for your food or your landlord turns up at short notice and introduces an excessive rent rise, you look at the response of the SNP Government and we want to have a strategy, we want to have a consultation. It is not enough to chat about it. It is time that we had some action, it is time that you stood up on behalf of tenants instead of backing the Tories and their old line agents and landlords. We want action now. Thanks very much. That concludes the debate on private sector rent reform. It is now time to move on to the next item of business, which is a debate on motion number 11766 in the name of Neil Findlay on the state of the NHS. I invite members who wish to speak in their debate to press their request to speak buttons now or as soon as possible. Mr Findlay, when you are ready, I invite you to move the motion in your name at which point you will have 10 minutes. The NHS is without doubt the greatest social policy of any Government. The collective pulling of our taxes to provide healthcare for all free at the point of need was a revolution in healthcare, resulting in a system where we contribute according to the ability to pay and where each citizen of this country can use the system according to need. That is something that we should never take for granted and all of us should work to protect. However, our NHS is under pressure, like never before, from the front door of the GP surgery through the social care sector. The pressures across the system are immense. In primary care in my region alone, 27 GP surgeries have full or restricted waiting lists. Workforce pressures are piling up when a GP is of sick or retires. Finding a replacement or a locum is almost impossible. I recently met managers at two practices, both of whom told me that there were no applicants for their particular vacancy. However, rather than addressing those pressures, the Scottish Government has been cutting GP funding. The budget for general practice has been declining steadily and next year there is a real terms further cut of 2.2 per cent. The Royal College has raised concerns about the dangerous consequences for patients in light of continued underfunding. I wonder if you will recognise the £40 million that was announced by Alex Neil to invest in GP surgeries, particularly in more deprived communities and rural areas. Surely that is something that he would welcome. I always welcome more money, but this is about across the board and this is about across a long period of time where the budget has been declining. We see waiting times for appointments up, consultations getting shorter, weakening the relationship between the doctor and their patient and all contributing to, in the words of the Royal College, a crisis in general practice. This situation is evidence of a Government failing to face up to the pressures of their local doctors and the wider NHS itself. Let us have a look at what Audit Scotland says about the NHS. Its report should have been a wake-up call to the Government. It says that the current level of focus on meeting waiting times targets may not be sustainable when combined with additional pressures of increase in demand and tightening budgets. However, if anyone thinks that targets are there in order to monitor and drive performance, the role of Government is to ensure that the NHS is giving the right level of resources to successfully meet those targets. No, thank you, but, of course, they are failing to meet them, not just their own initial targets, but the lower targets that this Government itself set. Audit Scotland also said that there are signs that NHS boards are facing increasing difficulty meeting their financial targets. Some are doing this in unsustainable ways. Four boards require additional funding from the Scottish Government to break even, and five continue to rely on high levels of non-recurrent savings. Those financial constraints are undoubtedly related to the reduction in real terms to the funds allocated to the Scottish NHS. As recently reported by the Institute for Fiscal Studies, the Scottish Government budget has fallen by more than the NHS in England, so much for the progressive credentials of the Scottish National Party Government and its promise to protect the NHS. We have said very clearly that we are committed to a real-terms increase not just in this Parliament, but next. On the Hustings debate for the leadership elections, Neil Findlay refused to give that commitment. Will he give that commitment now? I will deal with the leadership election out with this chamber. That is a different matter. Let's deal with what we are dealing with in here. The consequences are being felt everywhere. Accident and emergency departments are full and unable to cope with increased demand and expectations. Staff tell me that they are frazzled. There is a recruitment crisis, and junior doctors are under huge pressure looking after up to 100 beds while still working far too long hours. I know through my own family and friends how skilled our NHS workforce is. I also recognise that, when people are admitted to hospital, the vast majority of the time they receive first-class treatment, but the number of complaints is on the rise up 23 per cent. Staff complaints are about bullying and intimidation, while whistleblowing procedures remain wholly inadequate. If it was not for the dedication and commitment of NHS staff, the system would be on its knees. Of course, one of the biggest issues that face the health and social care system is delayed discharges. In 2011, the then Cabinet Secretary took action to reduce delayed discharges when the figure reached 200,000 bed days lost and said that it would be resolved. Now what do we see? 421,000 bed days lost a year. Patients stuck in hospital when they could have been at home, all at a cost of £78 million. That represents an abject failure of the Government's stated policy of shifting the balance of care. Trees are Fife of the RCN said last week that the figures published today on delayed discharges are further evidence that our NHS is under pressure. One of the worrying aspects of the figures published today is that we have not hit the winter munch yet. If this is happening over the summer months, what is it going to be like between December and February, when many more patients, particularly our most elderly and vulnerable, are admitted to hospital? Directly linked to that is social care, where we have one of the greatest scandals of our time. Our elderly and vulnerable friends and relatives being cared for by staff, desperate to care but unable to do so. Council budgets cut by 11 per cent, with authorities shackled unable to raise money. 15-minute care visits norm, a minimum wage sector, with carers only staying in the job long enough until they can find a job elsewhere. I met a young girl recently who got a job in social care. She received four days training in an office. One and a half days shadowed on another carer and was then sent out on her own. On her first day, she had 30 clients to visit the first. Man had a catheter in. She did not know what it was. Never mind how to deal with it. The next person she went to had a personality disorder and was abusive to her. She did not know what to do. Her day went on like that. She was paid until 5 pm, but only finished her day's work at 10 at night. For her rewards, she was given £5.13 anewa. That is what we are doing to our elderly loved ones and to the young carers of the future. What is the Government's response? Last week, the First Minister announced that an extra £5 million would be put in place to deal with delayed discharges, but that councils would have to match fund the Government's contribution. What planet is the First Minister living on? Council budgets are being hammered by the Government, services are closing, jobs are being lost, assets are being sold, so can the cabinet secretary give me and our council some idea of where the money is going to come from? I will give way if she wants to tell us where the money is coming from. Local government has been very constructive, unlike the member, in responding to those challenges. If he remembers, it is a tripartite funding agreement between local government, the health service and the Scottish Government. That is what constructive proposals are. Maybe the member could give us a constructive proposal in the remainder of his speech. We do not know where the money is coming from, but local government has defined it. That is the way in which this Government treats local government. We have similar problems in the care home sector. Star shortages, low pay training budgets, falling standards and every week's stories in the press about neglect and the poor care of residents. Across Scotland, care home places are vacant because councils will not allocate to them because of concern over the quality of care. And yet neither the Government nor the care inspectorate know the extent of the problem as they do not collate the information. That cannot go on. We have to make social care a fairly paid, rewarding career, raising standards to ensure that we do genuinely shift the balance of care. That will never, ever happen with a system based on a race to the bottom, like we have at the moment. Two previous cabinet secretaries for health operated a denial strategy, pretending that everything was okay when reality was staring them in the face. So we now have staffing shortages across many disciplines, GPs, midwives, specialist nurses, pediatricians, psychiatrists, emergency medicine, anaethatists. The list goes on. Vacancies for consultant posts have doubled, spending on locums up by 60 per cent, spending on agency staff up by 106 per cent over the last two years and money continuing to leak out of the system into the private sector. In the last few days, we have had the reportant to the Vale of Leven, the Royal Infirmary in Aberdeen and NHS Grampian. There are serious issues in Fife, Lanarkshire, the Lothians and across Scotland. If there ever was a time to accept our argument for a whole-scale review of our NHS and the establishment of a truly independent health regulator, then that time is now. I hope that the new cabinet secretary will reject the arrogant approach of her predecessors and do exactly that. The NHS is at a fantastic institution. As a new cabinet secretary for health, I am grateful for this opportunity to put on record my appreciation for the effort and dedication of those NHS staff who work tirelessly day in and day out to deliver a high-quality service. It is also my first opportunity to see what a privilege it is to have responsibility for the NHS within the Scottish Government. The NHS must always strive to seek further improvements in the delivery of care, but we should not lose sight of where we have come from and the progress that has been made. We have a clear vision and direction for our health service as part of the 2020 vision for health and social care, which has secured and will secure huge benefits as we move forward with integration over the next few years. The NHS is absolutely our top priority and we are making significant financial investment in our health service. NHS front-line resource budget will be protected and receive an above inflation increase in 2015-16. Indeed, the total health budget will receive a real-terms increase in 2015-16, taking it over to £12 billion for the first time. I actually think that the debate has to shift now about how we better use that resource. It is a significant resource. My job is to make sure that that resource begins to achieve the things that absolutely need to achieve. Neil Findlay could reflect on the social care resource that is available. Of course, that is why we have moved to the integration of health and social care. Within Neil Findlay's opening statement, he called for more money for health and social care. What we need to do is to make sure that the money that is within the system, the £12 billion that is within health and the huge resources that are within social care, and delivering the improvements that need to be made. Of course, that is what I will be focusing on doing. As I said earlier, we have committed to ensuring that real-terms rises for the health resource budget for each and every year of the next Parliament. I note that Neil Findlay did not take the opportunity to make that commitment himself, so I think that that pulls the rug somewhat from under his argument about resources. Under this Government, we have increased the number of NHS staff to record levels yesterday. You saw the workforce statistics showing that there are 7.6 per cent more staff working in the NHS, which translates into more than 9,600 staff, more doctors, dentists, AHSs, nurses and support staff. We are also aware that the NHS is treating more people than ever before. Although, at the same time, reducing how long people have to wait for treatment, the number of inpatient cases has increased by more than 162,000 under this Government, with day cases up by more than 45,500. The latest statistics show that 97 per cent of new inpatient day cases have been seen within 12 weeks. There is more resource, but more people are being treated. John Pentland If you believe that we have progressed, do you then share my concern about the current plans to close A&E departments in Lanarkshire and agree that we need more urgent action to address staff shortages and a full, independent review of future plans to address the many issues that affect and help provision in Lanarkshire? The First Minister could do with a bit of a dose of self-awareness, given where we have been with A&E departments in Lanarkshire. It was this Government that saved A&E departments at Monklands. A recent report by the Nuffield Trust into elective waiting times across the four UK countries found that Scotland had the shortest waits for nine out of the 11 common procedures, including hip replacements and cataract removal. On unscheduled care, it is clear that challenges remain, and it should be noted that performance in Scotland's core accident and emergency departments remains the highest of all the UK countries and significantly above the level that we inherited. We could not deliver that without the dedicated, highly motivated and hard-working staff in the NHS. We have a clear vision for our workforce and, of course, we have committed to ensuring that NHS Scotland staff are rewarded fairly for the work that they do, which is why, unlike England and Wales, we have accepted the recommendations of the independent pay review bodies on pay for 2014-15 and why we have a no compulsory redundancy policy in place. We are ensuring that all NHS staff are paid at least the living wage and that we will ensure that our staff are well motivated and rewarded for the job that they do. However, I am absolutely not complacent. I spoke in this Parliament earlier today about the challenges that I identified in NHS Grampian and last week about the veil of leaving report. The Government will absolutely not shy away, and neither will I from acknowledging and addressing the challenges that are facing the NHS. We know that the service will face pressures this winter. Winter planning is a key part of our unscheduled care programme. We have developed winter plans with the boards and their partners to prepare for the disruptions that winter can bring. NHS boards are also testing and communicating their business continuity plans to ensure that critical services are maintained. To deal with those challenges, I am clear that my focus has to be on the next few months in driving forward the shift in the balance of care, to drive forward health and social care integration, to deal with delayed discharge. In presenting the Government's programme for the year ahead, the First Minister made it clear that addressing delayed discharge is one of our key priorities and one in which I give my own personal commitment very briefly. Thank you for giving way, cabinet secretary. It was yourself in 2008 that said, we have reached Labour's target of zero for delayed discharges in 24 of the last quarters since then. Delayed discharges over six weeks have not been met, and you now have a four-week target with a two-week one coming in in April. Let's have a little bit of realism. By saying that delayed discharge is my top priority, it gives you a sense of realism. Of course, when I dealt with delayed discharge, it was an inherited delayed discharge problem that your previous administration left us, and we did deal with it. Argyffraith, I will deal with it again, and I do not want to leave you under any illusion. Just to finish on this, Labour, in the absence of any other policies, continued to call for a review, a beverage-style review. That beverage-style review took four years. I do not want to put the NHS on pause for four years. I want to get on and solve the problems. We know what the problems are in the NHS. We do not need a review to tell us that. What we need is the action to deal with the problems to make sure that the NHS continually delivers the highlight of service that we expect. I move the amendment in my name. Many thanks. I now call in the net mill and to speak to you in move amendment 11766.2, maximum five minutes. Thank you, Presiding Officer. I would like to begin in the short time, allotted to me, by endorsing the opening statement of Labour's motion and paying tribute to the staff of NHS Scotland. The vast majority of those people work in the NHS because they want to help patients, and they work tirelessly to this end. That applies right across the board, within the community and in our hospitals, from the most senior consultants to the most junior medical staff, from nurses and AHPs to the cooks, cleaners, porters and secretaries who all play their part in running the vast organisation that is NHS Scotland in the 21st century. Compared to many in the private sector, they are not well paid, but by and large they derive immense satisfaction from the work that they do, and they do deserve our gratitude and our support. When I think back over the near half century since I qualified in medicine, the achievements of the present day NHS are incredible and growing due to the many advances in technology and medical research and the development of more and more sophisticated medicines and procedures. In 1965, hip replacements were a dream. Transplants unheard of and cancer unmentionable and virtually incurable. The flip side of this is that more and more people are living much longer and with complex medical conditions. Of course, the NHS is under pressure to provide the expected and, sadly, often taken for granted services. So there has to be new thinking about how demand is to be met and the silo mentality and professional empires that I grew up with are having to change. That is not easy when none of us really like to change our habits and get out of our comfort zones. The pressures are evident in the difficulty in meeting waiting times targets, in increasing attendances at A&E departments, in delayed discharges from hospitals, in maintaining the NHS's state and infrastructure and developing it for future needs, and in attracting sufficient members of staff at all levels to deal with patient demand. Those pressures are not just within the NHS in Scotland, but they are present across all modern systems of healthcare and we have to learn how to cope with them. I think that the pinch points are well known and I think that we all have to work together to address them. That is why I do not particularly like the inflammatory language and Labour's motion about a race to the bottom because the aim of people associated with the NHS is to maintain and improve quality and to do that it is imperative that patient well-being is our focus and that we move forward with this in mind using the increasing though finite resources at our disposal to try and achieve the laudable 2020 vision that is the Scottish Government's target. We are fortunate that the NHS budget has been protected in recent years, not least due to the Barnett consequentials from the UK Government's health policy, which has given Scotland an extra £3 billion since 2010 and with more to come every year following today's autumn statement. However, there will always be a demand for more money and how it is spent is clearly a matter of political choice. For example, Scottish Conservatives would pledge an extra 1,000 nurses and midwives paid for by restoring the prescription charge, except for the young, the pensioner, the pregnant and those on low incomes who would remain exempt, as they always have been. Rather than spend valuable time and money on a wholesale review of the NHS, I believe that new ways need to be found to make the best use of resource moving forward. To do that, our total focus must be on the best outcomes for patients who, where possible, want to live at home or in homely community settings. To this end, we must involve people early in their lives and instill in them the importance of taking responsibility for their own health by making appropriate lifestyle choices to help them to keep well and active for as long as possible, thereby reducing their demands on the NHS. It is also vital that the integration of health and social care moves forward at pace, which will mean more emphasis on primary care, not just doctors. On the integration of health and social care, I am certainly very willing to offer Opposition members a briefing on the plans and the progress that is being made, as well as when to pressures to delay discharge, if that would be something that they would find helpful. Nanette Milne, you are in your last minute. Cabinet Secretary, you have almost stolen the bit of my speech. It is advisable that it moves forward, not just doctors, but also HPs and nurses for all grades, local authorities and third sector organisations that provide much of the care within communities so that patients can experience a relatively seamless transition between levels of care as they progress through life. To make that a reality, all interested parties will have to come together, forget the professional and cultural differences and work towards achieving a long-term effective plan to secure the future of Scotland's NHS. The previous health secretary was keen to progress in this way, particularly to involve politicians from all sides and moving forward. As evidence, for example, by the Scottish Government's welcome investment in the 500 extra health visitors—a group of health professionals whose my party greatly values and seeks even more. I am pleased that the cabinet secretary has indicated that she will perhaps follow in his footsteps in this regard, and if so, she can be assured of our support and our involvement in pursuit of a sustainable and high-quality NHS for Scotland. Thank you very much. I now turn to the open debate. We are very short of time, speeches of four minutes at the moment, but I am afraid that our last two speakers may not get four minutes. Bob Doris, to be followed by Rhoda Grant. Presiding Officer, the labour motion before us today identifies a number of pressures in Scotland's NHS. However, the motion is also one-sided. It is partial, and it gives an incomplete picture and impression of our national health service. I appreciate that it is an oppositions job to oppose, but in Scotland's NHS, even despite that motion, I would hope that we can still garner a good degree of consensus across political parties. That remains my hope. For every statistic which signals pressures on our NHS and there certainly are pressures, there is always another one pointing to progress and improvement in patient care, whether it is on waiting times, where, by June 2014, 97.2 per cent of people were treated within a 12-week waiting guarantee. I am minded that, in March 2007, that number was only 85 per cent and that was an 18-week wait. That is progress. Whether it is patient safety, 14.2 per cent increase improvement in the mortality rate, surely that is progress. On hygiene, for our elderly patients, C. diff has fallen by nearly 82 per cent. Surely that is progress. On staffing, record number of consultants compared to 2007, a 36 per cent increase, surely that is progress. An increase in trade nurses and midwives, surely that is progress. By admitting that progress exists, does not mean that we deny that pressures remain. I think that that is a key aspect of the tone for this debate. You can admit that there is pressures without denying that there has been progress in labour. Signally fail to do that within their motion. Let us look at what a routine branch or a full-scale review could mean. Perhaps it could mean tackling unscheduled care. People turning up action and emergency units. Yes, let us do that. Let us look at preventative action and let us look at patient flow through hospitals. Let us call it an unscheduled care action plan and let us put £50 million towards it. Hang on, Presiding Officer, we are all ready doing it. Perhaps we should look at delayed discharge. Perhaps the Government should put in an additional £10 million. Perhaps we should work with our partners in the NHS and in local authorities to have a £20 million pot and to have a delayed discharge action plan. Hang on, Presiding Officer, we are all ready doing it. Perhaps we have to make sure that health and social care integration works better. Indeed, perhaps we have to legislate to make sure that it happens, because some local authorities are worth doing it. Once again, hang on, that is precisely what we have done. The point that I am trying to make, Presiding Officer, is that the NHS is an institution under constant review. I know that very well as deputy convener of the health and sport committee. I work in partnership across parties to improve the NHS. Whether that is the £40 million new medicines fund where we had a route and branch review of access to medicines in Scotland, we did it by keeping the NHS under constant review. Whether it is tackling the regulation and the care inspection of older people's homes across Scotland to make it that more robust, we already did it as the health and sport committee in partnership with the Government. Perhaps it is looking at targets and working out whether the targets that we collect in the NHS are the appropriate ones in the appropriate place at the important time. Anyone who is following budget scrutiny at the health and sport committee just now will see that we have already taken evidence on that. Presiding Officer, undoubtedly there are pressures on the NHS. I am delighted that the Scottish Government has a real-terms increase. I notice that we will finally not guarantee that, but it is under constant review and, more important, it is under constant, persistent progress and advancement. Thank you, Rhoda Grant, to be followed by Mark McDonald. I want to welcome the cabinet secretary to her post and, indeed, her first health debate today, but it is surely telling that she has already made two statements to this chamber in her two short weeks in her post all dealing with the crisis in the NHS. The Labour motion today talks about the sad state of the NHS in Scotland, and this deterioration has not happened overnight. It has been presided over for a number of years by the Scottish Government. I really wonder how bad things will get before they take her advice and carry out a routine branch review of the NHS in Scotland. Is there reluctance due to their own mismanagement and the fear that the review will highlight that incompetence? In response to questions on the statement earlier, the cabinet secretary said that she wants to know what is on all where the problems within our NHS service are, because the only way of knowing it is only by knowing that we can actually take steps to address it. Perhaps she wants to... Cabinet secretary. Why we have the independent inspectorate that we set up to do that, but I wonder if the member can tell us how long this review would take. Would all the things that we are doing around health and social care integration be put on pause while this review happens? What is its purpose if it is actually not to stop doing the actual changes in the NHS that we are doing? What is its purpose and what will be its outcome? Rhoda Grant. The review would take as long as it needed to take to ensure that we had an NHS fit for the 21st century. Alongside that review you would need and would have to tackle with the problems that are occurring on a weekly basis here and now that you are standing up in the chamber talking about, we need to address not only those problems but we have to look at the NHS to make sure that it is fit for the 21st century. The only way of doing that is having a review to identify the pressures and indeed plot the way forward, otherwise we fail the patients' use in the NHS and indeed the NHS and the staff working within it. It is not good enough to depend on the goodwill of staff to keep it from crumbling altogether. Presiding Officer, in the short time available to me I want to touch on one of the issues impacting on the NHS and that is the inadequacy of health and care in the community. The Scottish Government's cuts to council budgets have led to choices being made between feeding old people or indeed educating young people. That is the choices councils are facing today. They promised to fund the council tax freeze but they didn't, leaving the most vulnerable in our society paying the care tax, leaving them with little or nothing to live on. This is a scandalous care tax that needs to end now. Would the member like to tell us which budgets all this money should come from? It is very interesting that the Scottish Government is looking forward to receiving consequentials from the UK Government. Surely that could go towards ending the care tax and allowing people to live with dignity. I am hearing sensitive comments about the NHS. Surely the NHS happens in our communities as well as in hospitals. That is a number of the issue that this Government believes that the NHS only happens in hospitals. We need to treat people in the community, because, if we do not, what has happened is that people are now going into hospitals. Their policy has taken people in due to unscheduled care because of the inadequate healthcare in the community and leads to bed blocking as well. If people cannot get out into the community without adequate healthcare and community care, they remain in hospital. Hospital is a dangerous place for older people. They get stuck, becoming frailer, losing their strength, their ability to look after themselves. That is all due to inadequate care in the community. I want to be clear that we need to change the NHS, and this Government must take responsibility for that change. We need a beverage-style review. Sooner or later, the Government will be forced to do it. I just hope that we do not go further back before they do it. I am afraid that I do not have any time for interventions. Members must take it in their own time. Mark McDonald is followed by Lewis McDonald. Thank you very much, Presiding Officer. It is very interesting to hear Rhoda Grant calling for consequentials to go to local government when the Government has said that it will put them to health, especially when some of her own backbenchers are in the press and journal calling for consequentials to go directly to NHS Grampian. Labour seems to have a very flexible attitude to how many times it can spend the same pot of money. It is a little wonder that it finds themselves in opposition in the chamber. It is also very interesting to listen to the Labour Party when it is questioned about the review that it wants to set up. It appears to have no terms of reference, no defined timescale and nobody who they have identified who would lead said review. They just want somebody else to do their own work for them because there is an utter policy vacuum in the health brief in the Labour Party. They have not come up with one single proactive or constructive policy initiative since Mr Findlay took on the health brief. If that is the approach that we have to look forward to from Neil Findlay's leadership in the Labour Party, he has my full backing in the leadership contest. After all, the deputy leader candidate who is aligned to Neil Findlay has said today that any other outcome would lead to certain defeat for the Labour Party in 2016. I am sure that he would be endorsing Katie Clark's view that Kezia Dugdale represents certain defeat for the Labour Party in 2016, given that he is aligned with her in this campaign. However, there is undoubtedly—well, Mr Findlay calls again from a standard position—I know that he is an adherent of Marxist principles. I think that today he is a bit more groucho than Carl. Most of us yearn for the day when he is a bit more like Harpo, to be honest with you, Presiding Officer. I say that there has undoubtedly been progress in terms of the national health service in Scotland. For example, if I can quote, we have come a long way. A decade ago, many of us who are sitting around the table were inundated with cases involving people who could not get an operation. They have disappeared in my caseload, so there have been tremendous gains. You may laugh, but that is Duncan MacNeill, the convener of the Health and Sport Committee and a Labour MSP, saying that. You can laugh at Duncan MacNeill's quote, but he clearly recognises that there has been progress with the national health service. However, there are pressures. Undoubtedly, there are pressures. There have always been pressures since the inception of the national health service. The net money, I thought, summed that up very well by talking about the medical advancements that have been made over time, which undoubtedly, while benefiting the population, do increase pressures on the national health service. Those also lead on to the demographic trends that we are now seeing. First of all, the one thing that we need to get beyond, I think, is talking about demographic trends as if they are a problem. They are not a problem. People living longer is a good thing. What we have to ensure is that people are living not just longer lives but healthier lives. That involves some of the early intervention work that this Government has focused on. I think that the work on health and social care integration will assist greatly in that, because for too many people there is a gap between those two particular silos into which people all too often fall. Delayed discharge is a key issue on this. When I was on Aberdeen City Council, we had delayed discharge down to zero. There has been a real difficulty at present in the city in getting appropriate care packages in place for individuals. A large part of that problem is because the City of Aberdeen Council, Labour-led, has decided to hive off social care to an arms-length company, Bonacourt Care, which has zero democratic oversight from local councillors. I am in my last 40 seconds. Zero democratic oversight from local councillors, zero democratic accountability, and that is leading to a real difficulty for my constituents in the City of Aberdeen, many of whom are stuck waiting for appropriate care packages so that they can go home. Finally, on GP surgeries, I accept that there has been a long-term issue. If you take Inverury, the place where I was born, the GP surgery has never been expanded despite the exponential growth in population since the time that I was born. There are too many practices that have failed to benefit as a result of planning gain. That has been a failure by both health boards and local authorities in the past. I have had conversations with the previous cabinet secretary about it. I would be delighted to have further conversations with the new cabinet secretary about how perhaps we could look at using the planning gain system to help alleviate some of the pressures on GP premises, many of which are indeed approaching or at capacity. I am afraid that you must close. Health service under pressure struggling to recruit staff and to meet targets, relying on the dedication of hard-working front-line staff to compensate for its lack of clinical assurance systems and to maintain the quality and safety of patient care. That is the picture of NHS Grampian portrayed in report after report published this week. A service under-funded against the Government's own formula to the tune of £158 million over five years, cutting 400 nursing posts over four years in an effort to balance the books, of course. Can the member tell us what the funding formula led to for NHS Grampian under the previous Labour Administration? The previous Administration put in place the National Resource Allocation Committee, which commissioned a review of funding. The incoming SNP Government accepted the recommendations of that commission. The gap between what it provided and what the National Resource Allocation Committee said that it should provide was £26.6 million in 2010. It is £29.7 million this year. It is little wonder that Ellen Hudson of the Royal College of Nursing said yesterday that the Scottish Government should have recognised the problems in NHS Grampian earlier and take an action to address them. That is not all. In addition to the challenges facing other health boards across Scotland, NHS Grampian has also had to deal with a small group of senior staff who have claimed to be whistle-mores while actively undermining the first principles of public service. Yesterday's reports revealed that a small number of consultants had exhibited and I quote unprofessional, offensive and unacceptable behaviour that they had contributed to an environment where 40 per cent of hospital consultants have not agreed a job plan in spite of a contractual obligation to do so and where many staff believe that in Grampian there are, I quote, no consequences for consultants who behave in an appropriate place. Neil Dixon, the chief executive of the general medical council, said yesterday that they were extremely concerned that large numbers of consultants had no job plans and there was minimal evidence that clinical governance structures were working effectively. That is not just about the failure of NHS Grampian to get to grips with unacceptable behaviour by a handful of senior staff. The Scottish Government also has questions to answer about its role in permitting the situation to develop. Healthcare Improvement Scotland reports that the minutes of the medical staff committee suggest that this group sees itself as an alternative management structure rather than as an advisory body. Managers told his that clinicians would tell managers what to do and threaten escalation to the Scottish Government and, incredibly, the reviewers from his reportant that I quote, we heard remarks by some consultants that confirmed this. The arrogance of repeating such boasts in front of external reviewers answerable to ministers says it all. The member not accept that the fact that we have had his in doing the investigation that all of this has been exposed into the light of day and action has been taken, actually shows that, as soon as we became aware of those issues, we did take action. Lose weight on the last minute. I absolutely welcome that and I welcome the daily of this afternoon, but we need to know why those consultants formed the view that they were untouchable and that they could go direct to government if they did not get their own way. We need to know how often government ministers entertained escalation outwith the proper channels and we need to know which ministers were involved. But above all, we need to know what ministers will now do to support NHS Grampian in addressing the issues raised by those reports, given the potential for patients' care and safety to be further compromised, which they show. The recommendations have been accepted, they now need to be implemented. The recommendations by the Royal College of Surgeons have been published, the conclusions have not, and they should be published as soon as possible. The interim chief executive of NHS Grampian deserves all our full support, but that must include urgent additional resources to address the pressing problems of inadequate nurse staffing levels and recruitment across the board. Urgency, openness, resources and local confidence are all required to allow NHS Grampian to move forward, and that is the challenge for the Scottish Government. Many thanks, Richard Lyle, to be followed by Jim Hulme. Thank you, Presiding Officer. Can I begin now your remarks this afternoon by reflecting on the work that the NHS does? Scotland's national health service is a world leader in healthcare. Public service is absolutely essential to the lives of everyone who lives in our country, no matter young or old. At some point, our lives will be called. We will call on the services of our NHS. Now, with specific reference to Mr Finlay's motion, I note with interest that he calls for a full-scale review of the NHS to address the broad range of pressures being identified in all areas of the NHS. I may interest members to know that the document entitled NHS Board Projected Staff and Post-Changes for 2014-15, produced by the Scottish Government, makes clear that the NHS boards across the country have been asked to develop delivery plans, workforce plans and workforce workload tools in order to assess if services that redesign or changes in the skill mix are required to best meet the needs of the population. Presiding Officer, the people who know best are those who are at the heart of the issue, those who are involved in the delivery of their NHS at a local level. I believe that the roll-out of those local delivery plans and workforce plans are the essential instrument to identify the areas that need to be improved within a particular local service and those areas that are performing well. The motion by Mr Finlay also asks that the Government address the broad range of pressures being identified in all areas in the NHS by staff and patients. I also read with interest the latest NHS Scotland chief executive report. I noted the report that the NHS Scotland, as a component of their 2020 vision route map, has developed the 2020 workforce vision, which concerns all NHS Scotland staff and has implications for staff across health and social care together. The document goes on to say that the vision was informed by 10,000 voices and one of the largest qualitative exercises undertaken in NHS Scotland listened to the views of the staff and those working in healthcare. Therefore, I must say to the Labour Party that this Government has always had a commitment to engage, discuss, listen to staff, patients and those involved in healthcare. I would like to look at those pressures that are raising the motion. There can be no doubt that there are significant financial pressures facing our national health service. However, I am proud that this Government's record of standing out up and protecting our NHS. Our attitude towards the NHS is a stark contrast to that of those in the Government's south of the border. To coin a phrase, a race to the bottom is taking place to privatise the NHS in England, but here in Scotland our Government's commitment to protect the NHS is clear. The draft budget 2015-16, the Government made clear that, despite the UK Government having cut the Scottish Government's resource budget in real terms, we have maintained our commitment that the NHS front-line resource budget will be protected and will increase at least in line with inflation. To conclude, our Government has a track record of protecting the NHS despite cuts enforced by Westminster. The Labour Party would do well to remember that. Our Government is committed to engaging and listening to all involved in healthcare in Scotland. Our Government will always seek to improve where possible. In particular, in NHS Lanarkshire, this has improved cancer rates to 95.7 per cent for cancer patients starting treatment within 62 days of urgently offered situation. That compares with 70.3 per cent in the first quarter of 2007. It is a massive improvement. I thank all involved in our national healthcare service for the outstanding work that they do and continue to do. I am afraid that I can only give you just over three minutes. I am pleased that Labour have used their time to discuss our NHS. Let me at the outset do, as others have done, and say that the people who will make our NHS do extraordinary work. They save lives, but they also improve lives of a veteran friend Chris McDivitt, who just in 14 hours will go under the NHS and I am sure that they will do their utmost to get him mobile again. Our thanks go out to the NHS. We know that the quality of patient care is directly related to having the right people with the right skills in the right place at the right time. Warringly, the 2013 NHS Scotland staff survey showed that only 45 per cent of staff agreed that care of patients was the top priority of their health board. That is down 54 per cent from 2010. Only 32 per cent felt that they could meet all the conflicting demands on their time at work, and under a quarter thought that there were enough staff to do their job properly. In the RCN members' survey of 2013, 64 per cent of those working in NHS hospitals said that they were too busy to provide the level of care that they would like, and 81 per cent recorded an increase in their workload in the last year. The Government's vision, 2020 vision, simply will not be achieved unless we have meaningful change. As I have said before to the previous health secretary, the Government rattling off a list of where they have made investment misses the points. It is not just about one-off injections of cash, it is about ensuring that the skill mixes are right. I have only three minutes. I am sorry, minister. The minister must recognise that the system is at breaking point. Yesterday, figures showed that more NHS posts are lying vacant and for longer than was previously the case. Last week, figures revealed an alarming rise in the number of delayed discharges that fewer patients are being treated within the targeted 18 weeks between referral to first treatment, that 56,252 patients in NHS Scotland were waiting for one of the eight key diagnostic tests and a 19 per cent increase on the 2013 figure. They were waiting longer for them, and that A and E four-hour performances had worsened with 242 patients spending more than 12 hours in A and E. I do not think that a full-scale review is the best course of action at this moment. We know what the problems are and we have a good sense of the pressures. What we need is solutions, so with that in mind perhaps the Labour Party could come up with some suggestions, perhaps three solid policy ideas that would go some way to alleviate the pressures on our NHS and transform it to the service that we all want. A review will in itself not achieve that change. It will put all on hold and will slow down actions that desperately need addressed now. Finally, I call Christian Allag before we turn to closing speeches. Cabinet Secretary could not be clear earlier this afternoon in a statement on NHS Grampian, so work done by FK Improvement Scotland did not identify constituent and widespread concern about patient safety. Aberdeen royal infirmary is not significantly different from the Scottish average. In June 2014, NHS Grampian's performance against a four-hour accident and emergency target was 96.1%. Across Scotland is 93.5%. This is to compare with the 91.3% in April 2006, or we could compare with a Labour administration in Wales where it is at 86.3%. If Neil Finlay is concerned about recent statistics at accident and emergency, he would have to agree that Labour is not the answer to his concerns. Where I agree with Mr Finlay is that NHS staff in Scotland are working tirelessly under pressure to deliver high quality care to patients. This is what the report found out in Grampian. We all know where the pressure comes from funding from Westminster and the ageing population and the increasing challenges of recruiting. I welcome that the NHS budget is protected in Scotland under this Government and that the health workforce is rising to a record high. NHS consultant numbers are at a record level under this Government. I agree with Bob Doris about the tone of the Labour motion. As for, for example, patients' confidence in NHS Scotland, let me paint another picture of our public health service in my contribution today. There is an independent site online about patients' expenses of the health service. This site allows patients, carers, family and friends of patients to tell their own stories. The site is called patient opinion. Every voice matters. I receive regular emails and maybe some of the members receive the same emails. I receive emails regarding what's happening in the health services across the north-east. One of them is from an Arbidin patient. I was in a lot of pain, she said, and went to the Arbidin health village where a lovely woman treated me. She broke the news about my condition very considerably and was a huge support, offering me lots of different treatments and advice. I was scared and upset, but she made me feel so much better about the whole situation. Kindness and sensitivity is a credit to the health service offered in Arbidin, and there are a lot more stories like this across the north-east. We can all be rightly proud of the care NHS Scotland staff delivered day in and day out. This is why NHS staff have public support. The reason why this Government has public support is because the Government has a vision for our nation's public services, protecting funding for the NHS, stopping privatisation and integrating health and social care services. There is no support for a full-scale labour review in this chamber, just like there is no support for the Labour Party outside it. It is fair to say that this has been an interesting and probably a worthwhile debate, if at times focusing on the negative rather than the positive. Of course, there are problems within the NHS. We just need to look at recent reports on the Vale of Leven and NHS Grampian to realise that, but there always have been and I am sure there always will be. Nonetheless, the fact that our NHS has evolved and grown in the 66 years of its existence into the vast and complex organisation that we know today is testament to the many generations of staff and politicians who have been committed to it, as all of us are who are here in the chamber today. The current pressures on the NHS are indeed proof of its success, which has resulted in our burgeoning elderly population living with multiple and complex long-term conditions and the health consequences of old age, such as dementia and many of the cancers that stretch its resource to the limit. One of the last things that I heard Alex Neil say in this chamber in his role as health secretary was that the first person who will reach the age of 150 has already been born. Quite a thought and a clear indication that pressures on the NHS will continue well into the future. There are huge problems facing us today, in staffing levels, both in health and social care, in the management and maintenance of the NHS estate and not least in dealing with the health inequalities, which are still a blight on many lives in Scotland. Moreover, the NHS and councils will have to deal with many more people, as life expectancy increases further. Neil Findlay was his usual fiery self, always pessimistic and always on the attack. I look forward to seeing his optimistic side, should he become leader of the Scottish Party in Scotland later this month. The cabinet secretary made a fair representation of her Government's position, and I wish her well in her new and undoubtedly challenging role. She must know that if you are a socialist, you are an optimist. The two things go hand in hand, so I am always optimistic. I have never found that to be the case, I have to say. As I said in my opening speech on this side of the chamber, we are willing to work with her and give her our support whenever we can, and I hope that she will accept her offer in the spirit in which it is intended. The SNP speakers all made predictable speeches in support of Government policy and attacking their number one political enemy. Labour likewise highlighted every problem that could be used to attack the SNP, although Rhoda Grant did emphasise significant issues about the provision of care in the community, which will no doubt be a key concern of the integration bodies at locality level. I personally think that it is wrong to use the NHS as a political football in this way, and it does nothing to help the patients who depend on it. To conclude, Presiding Officer, as I have already acknowledged, there are major problems to deal with in NHS Scotland, but I do not think that we should despair. We are a resilient nation. We have survived and defeated adversity over many centuries, and we have evolved into a country that we can all be proud of, with appropriate leadership from Government of whatever political persuasion. By working together in the interests of patients, I am confident that we can overcome our current problems and achieve a Scottish health service that will be sustainable far into the future, no doubt facing and overcoming even more challenges that are not yet on the horizon. However, please, let us indeed work together to improve the health and wellbeing of our fellow Scots and cut out the political points coding that makes us so unpopular with the public that we serve. They put us where we are, and they deserve our support, so let us try to live up to and beyond their expectations. I thank many thanks and I now call on Maureen Watt, six minutes please minister. Thank you very much Presiding Officer. I've listened very closely to this debate, and first of all I would like to start off by picking up a number of points raised. Neil Findlay, Rhoda Grant and Lewis MacDonald would love to have us believe that the NHS is a failing basket case in Scotland and it is not. It does all NHS staff know, it does them a disservice by saying so. You can't on one side praise the staff and then on the other side say it's failing. It can't be both at the same time. The resource budget in real terms is increasing, but where is the extra money that Rhoda Grant and others have asked for coming from? Rhoda Grant, just hold on a minute, said that NHS consequentials would not go to the NHS, and he also said that hospitals are dangerous places. Can I point out that HIE infection is down and cleanliness is up in this Government's watch? Rhoda Grant. A point of clarification, the minister has, like her colleague, misrepresented my position. Health happens within the community, it is underfunded, you need to fund it, and also our concerns are not made up by ourselves. It is the staff that are working in the NHS that are telling us that the NHS has never been like that. That is why the RCN is calling for a routine branch review alongside us. Maureen Watt. I think that the official report will show what Rhoda Grant said about NHS consequentials. I have asked again and again and you have still not said that Rhoda Grant or the Labour benches have still not said where the money is coming from. Also, Neil Findlay mentioned delayed discharge. Can I point out that in October 2006 there were 908 patients delayed for over four weeks? Today, in October 2014, the number of patients delayed was 321, about one-third of what it was in those—no, thank you—I would like—what, when you go? Neil Findlay. 2011, the First Minister said that I have made improved care for the elderly a personal priority. The NHS and local authorities need to work together to ensure that fewer and fewer older people are left languishing in hospital unnecessarily. At that point, 200,000 people were suffering from delayed discharge. Now we have 400,000. Is that as it says to the First Minister? Those figures are not the case, as the member well knows. The up-to-date figures on delayed discharge are, as I said. However, that is why we are integrating health and social care, and the budgets are moving with them. Just yesterday, I had a meeting on community planning partnerships dealing with just this sort of thing. We are not denying that there are challenges facing the NHS, but this Government has a clear sense of vision and direction for our NHS. Working with our NHS boards, we are putting in place a range of actions to support the delivery of our vision. That was highlighted by the constructive contribution that Nanette Mill and others made. Those who are on the health committee know exactly the position on the front line and were constructive enough to point that out. Scotland is also leading the world through our Scottish patient safety programme and the person-centred collaborative, which are improving the quality of care received by patients. We are also focusing our efforts on ensuring that the right people are available to deliver the right care in the right place at the right time. We need to make better use of workforce intelligence to support medical workforce planning within a more integrated healthcare system. The partnership approach that we take with NHS employers and staff can be extended if they would like to opposition members. For example, our plans for health and social care integration will help to address the challenges of delayed discharge. I hope that the opposition will agree to address that in a cross-party way, as Nanette Mill indicated. It is something that we can take forward at future cross-party meetings, as the cabinet secretary said. I am happy to take on ideas from Neil Findlay and others on how we can do things differently and how they can be done within the current financial settlement. However, I have not heard anything about that today, and it is no point in putting the NHS on pause while a review is carried out. We are happy to meet Opposition members to talk about delayed discharge and winter resilience in the coming weeks. We are supporting delivery of high-quality care with significant financial investment. In addition to the investment in the resource budget, we are committed to investment in NHS capital and infrastructure, which will provide the people of Scotland with world-leading hospitals such as the new South Glasgow hospitals project, which will be completed in 2015. We will also deliver on the Royal hospital for sick children in Edinburgh, replacement for Dumfries and Galloway royal hospital and a new maternity hospital and cancer centre in Aberdeen. We are developing much better, much more robust intelligence on medical staff, profiling and career choices to better inform supply. We are working with boards to boost the sustainability of the Scottish workforce. Yes, the NHS faces challenge, but we are meeting and dealing with these challenges on a daily basis. For all those reasons, I urge the chamber to reject the Labour motion and support the amendment in the name of Shona Robison. Thank you very much. I now call in Dr Richard Simpson to wind up the debate. Dr Simpson, you have until 5 p.m. I am pleased to be summing up in this debate. Regrettably, since 2007, there have only been a tiny number of health debates initiated by the Government. I do believe that the short debate that we have been able to have today is wholly inadequate to explore the really major issues that I think the whole chamber agrees health and social care are facing for the future. The SNP came into government in 2007 on a false prospectus. It encouraged the electorate to think at that time, 27, the first time in government. The SNP manifesto committed their Government not to close any acute beds. Of course, the reality is that they have had to close a number of acute beds. The reality is also that the services need to be redesigned, but they encouraged the electorate to think that the best way to do this was to maintain every local service and keep every local hospital open. They rejected the CURD report, and it is clear that, although the Scottish collaborative and co-operative model to which we have all signed up, based on managed care networks, is delivering, but that requires further specialisation. The public sector model, which is, as I say, all five parties, including the Conservatives, are signed up to, is radically different from the path that is being followed by the English NHS. The most recent report of some of the SNP members have said shows that Scotland has, indeed, narrowed the gap in terms of waiting times. Long gone are the years before 1997, when patients could be waiting for years for hip operations and other procedures. Labour will praise and welcome Government initiatives when they do the right thing. For example, as in the case of the proposed major trauma units that have been announced. However, that does come some years after they were introduced and proven to be workable in other jurisdictions. That was also the case with the health environment inspectorate, which we welcomed but came in two years after England had introduced the same inspectorate. I remind Richard Simpson that the announcement on the healthcare environment inspectorate was made a year after we came in post. Does it not beg the question what had happened the previous eight years, Dr Simpson? In the previous eight years, as you praised the help that we set up, the health, the HAI task force, you developed on that, but you were still later by two years in setting it up than in England. This was the case also with the waiting time scandal, where it took nine months for the SNP to take over the matter and institute a national inquiry. This is currently the case in terms of boarding out, where, after pressure from Labour, the Government quite rightly introduced a system where boards are required to monitor boarding out. Yet three years after that started, we're still unable to get information on boarding out from the boards, as in an FOI that we've done recently. Bad boarding out practice is abound, as we've seen this week in the HAI's report. Again, under pressure, the Government agreed finally to set up an expansion scheme with his for the elderly. Excellent, well done, fantastic. However, Scottish Labour has done an FOI that shows that there is absolutely no cross-referencing between boarding out and cognitive impairment, so your systems are dysfunctional. Now, whilst the SNP constantly acknowledged quite rightly and used the word either pressure or challenges, it is true that the NHS has always faced these challenges, but never in my experience has there been a situation in which the chairman of the BMA to which I should declare I belong, Brian Keithley, called it a slow car crash over the last five years and went on to apologise for the fact that he felt that he was looking at a situation where it was simply rearranging the deckchairs on the Titanic. Now the Royal College of Nursing has added their weight to our call for a routine branch review, along with a programme that's been run by the Herald. This is not just Labour, this is many groups are saying, if we're going to have a vision of where we're going to be beyond 2020, then okay, we need to do the same work on we go. We need to do that work, we need to review what's happening now, we need to do service design just now, but we also need to try and come to an agreed decision beyond 2020. We've agreed to the general principles of 2020, but we need to have a consensus around how we're going to shape our health and social care, not simply say it's going to be integrated. I'm sorry, I don't have time to take an intervention. We need an independent inspection agency, but not, we've got one, but not one which can actually go in itself and do inspections, it actually has to be ordered by the Government to go in, as it was in the case of Grampian, quite rightly, praise you for doing it, but nevertheless they had to be authorised and told to do it by the Government. The HIS should be able to inspect every group, every aspect of the health service, independently or dustly, and as you've now finally agreed on HEI, have enforcement powers as they've had in England for seven years, so we need to have that. No, I want to, I don't have time, I'm sorry. Now Jim Hume, I think, made some very valuable points. The Institute for Fiscal Studies showed that Scotland had cut expenditure against an increase in England between 2010 and 2013. No, I'm sorry, I don't have time. But the point is this, let's look at these pressures, when every board is failing on a legal guarantee that you chose to give. This is not just a guarantee that we would like to aspire to, which is fine, and where if you fail, well, that's a pity, but it is not a legal guarantee. There are this year over 10,000 Scots who have been given by your Government a legal guarantee for the 12-week inpatient and day case who are not having that legal guarantee met. I'm really surprised that someone hasn't asked for a judicial review or taken out a case against you in Government. But there are also 125,000 Scots this year that will not have the 18-week referral to treatment guarantee met. It will be breached. That doesn't include a further 100,000 about which we have no information, so the figure could be 250,000. Jim Hume, I know what was going to mention if he had time about CAMHS and the fact that 200 young people every month have not had the 26-week guarantee met, and we've got an 18-week guarantee coming up that's going to have problems. What about the cancer guarantees? There are hundreds of patients who are not getting their cancer guarantee met, and we aren't at the 95 per cent target. Excuse me, Dr Simpson. Excuse me. There's far, far too much noise in the chamber, Dr Simpson. Of course progress has been made. You would expect progress to be made. If it had not been made, we wouldn't have been not criticising you. We would have been criticising you far harder. Everybody would have been criticising you, but you inherited double the money from Labour. We instituted the biggest increases in health budget that had ever been seen by the health service, and you inherited that. You were lucky. Briefly Cabinet Secretary. We've learned today that Labour have refused to give a commitment to a real-terms increase, and indeed refused to pass on the consequentials to health. Can Richard Simpson confirm both of these things? We will see, but you have constantly repeated the lie that we would not have protected health, we would. It was in our manifesto and it was in our manifesto, Mr Swinney, and in addition to that, we have talked repeatedly about the fact that if you do not protect social care, the health service cannot cope, and that is the actual situation. Let's look in the last few seconds about the numbers of things that you've done. You plan to cut the junior doctors by 20 per cent, you plan to cut the senior training grades by 40 per cent, you did cut the nursing student intake by 20 per cent, you did cut the midwifery student intake by 40 per cent, and those will have consequences in future years. You failed to listen to us on the junior doctors' routers until very recently, when Alex Neil announced that he would stop the 100 hours night duty over seven days, but junior doctors are still doing 65 hours over five days, and then our FOI has shown that not a single human relations department, human resources department in the NHS is proactively asking the junior doctors if tiredness is affecting their work and their ability to journey home. There are failings here that need seriously to be addressed. We need a route and branch of review. We need an independent inspection system with enforcement powers that is truly independent and does not need the Government to authorise it to go in. We need change now. Thank you. That concludes the debate on the state of the NHS. We now move to the next site of business, Mr Findlay. On 21 October 2011, the then Cabinet Secretary, Nicola Sturgeon, said that I have made improved care for the elderly a personal priority. The NHS and local authorities need to work together to ensure that fewer and fewer people are left languishing in hospital unnecessarily. During today's debate, I referred to this in the fact that, at that time, 200,000 bed days were lost to delay discharge in the NHS. Today that figure is over 400,000 bed days. When I raised this issue in the debate, Maureen Watt, the minister, accused me of misleading Parliament by saying that figures were wrong. I wonder if you will allow her tomorrow at some point to come back to Parliament to correct the record. Can I say, Mr Findlay, that that is not a point of order? I have said repeatedly in this chamber that what members say in this chamber are a matter for them and them alone. The minister is sitting listening to you. If the minister indicates she wishes to speak tomorrow, then I would give her the time to do so, but she is making no indication that she wishes to. So, we now move to the next site of business, which is consideration of business motion 11769, in the name of Joe Fitzpatrick, on behalf of the Parliamentary Bureau, setting out a business programme. Many members wish to speak against the motion, should press the request to speak but now, and I call on Joe Fitzpatrick to move motion number 11769. Thank you. No members ask to speak against the motion therefore. I now put the question to the chamber. The question is that motion number 11769, in the name of Joe Fitzpatrick, be agreed to or will be agreed. The motion is therefore agreed to. The next site of business is consideration of six Parliamentary Bureau motions. I would ask Joe Fitzpatrick to move motion number 11770211773, on approval of SSIs on block, and motion number 11774, on committee membership, and motion number 11775, on substitution on committees. The mid-questions on these motions will come at decision time to which we now come. There are nine questions to be put as a result of today's business. Can I remind members that, in relation to the debate on private sector rent reform, if the amendment to the name of Margaret Burgess is agreed, the amendment in the name of Alex Johnson falls? The first question then is amendment number 11763.3, in the name of Margaret Burgess, which seeks to amend motion number 11763, in the name of Mary Phee, on private sector rent reform, be agreed to. Are we all agreed? The Parliament's not agreed. We move to vote. Members should cast their votes now. The result of the vote on amendment number 11763.3, in the name of Margaret Burgess, is as follows. Yes, 64. No, 53. There were no abstentions. The amendment is therefore agreed to, and the amendment in the name of Alex Johnson falls. The next question is at motion number 11763, in the name of Mary Phee, as amended, on private sector rent reform, be agreed to. Are we all agreed? The Parliament's not agreed. We move to vote. Members should cast their votes now. The result of the vote on amendment number 11763, in the name of Mary Phee, as amended, is as follows. Yes, 64. No, 53. There were no abstentions. The motion, as amended, is therefore agreed to. Can I remind members that in relation to the debate on the state of the NHS, if the amendment in the name of Shodnar Robison is agreed, the amendment in the name of Nanette Milne falls? The next question, then, is at amendment number 11766.3, in the name of Shodnar Robison, which seeks to amend motion number 11766, in the name of Neil Findlay, on the state of the NHS, be agreed to. Are we all agreed? The Parliament's not agreed. We move to vote. Members should cast their votes now. The result of the vote on amendment number 11766.3, in the name of Shodnar Robison, is as follows. Yes, 65. No, 38. There were 13 abstentions. The amendment is, therefore, agreed to. The amendment in the name of Nanette Milne falls. The next question is at motion number 11766, in the name of Neil Findlay, as amended, on the state of the NHS, be agreed to. Are we all agreed? The Parliament's not agreed. We move to vote. Members should cast their votes now. The result of the vote on motion number 11766, in the name of Neil Findlay, as amended, is as follows. Yes, 67. No, 37. There were 13 abstentions. The motion, as amended, is, therefore, agreed to. I propose to ask a single question on motion number 11770, in 2-11773, on approval of SSIs. If any member objects a single question being put, please say so now. No, the next question is at motion number 11770, 2-11773, in the name of Tulford Spartacon, approval of SSIs, be agreed to. Are we all agreed? The motions are, therefore, agreed to. The next question is at motion number 11774, in the name of Tulford Spartacon, approval of SSIs, be agreed to. Are we all agreed? The motion is, therefore, agreed to. The next question is at motion number 11775, in the name of Tulford Spartacon, substitution on committees, be agreed to. Are we all agreed? The motion is, therefore, agreed to. That concludes decision time. We now move to members' business. Members who are leaving the chamber should do so quickly and quietly.