 The next item of business is a debate on motion 11874, in the name of Jackie Baillie, on ending NHS long waits. I'd be grateful if members wished to speak in the debate, we're to press their request to speak buttons. I call on Jackie Baillie to speak to and move the motion up to six minutes. Thank you, Presiding Officer. Scotland saw in the new year with accident and emergency departments in utter disarray. As thousands of people, the sick and the injured experienced long and dangerous waits. Only yesterday we learned that in the first week of 2024 only 59.4% of patients were seen within four hours. Indeed, in Glasgow's Queen Elizabeth University hospital, the figure was 31.1%. Over 1,200 people waiting longer. It may be a new year but nothing has changed. The crisis in the NHS and social care continues and the SNP's response is nothing to see here. It's business as usual from the SNP and the NHS and its hard-working staff remain at breaking point. Almost one in six Scots are stuck on a waiting list. That's 860,000 people. 80,000 are waiting over a year. We all remember Humza Yousaf's pledge in July 2022 to eliminate completely the longest waits in planned care. Well, let's have a look at how that's going. Two-year waits throughout patients were to be ended by August 2022. Failed. 18 months throughout patients eliminated by December 2022. Failed. One-year waits throughout patients eliminated by March 2023. Failed. Inpatient activity is not much better. Two years for inpatient waits to be eliminated by September 2022. Guess what? They failed. 18 months for inpatients to be eliminated by September 2023. They failed that one, too. One-year waits for inpatients will be ended by September 2024. Well, I have to say, Presiding Officer, on the basis of current delivery, I suspect that that will be a fail, too. I know they don't like hearing it, but the fact's a plane for everybody to see. The SNP promised to end long waits and they failed utterly. I repeat, we have almost one in six Scots waiting for tests and for treatment. That has real consequences. I have a constituent who works in theatre at the Golden Jubilee hospital. She has been on the waiting list for three years, but NHS Greater Glasgow and Clyde won't let her have her operation at the Jubilee. She is actually assisting people who come from other health board areas that have been waiting as much as a year. That's two years less than her, and she is no further forward. Her knee is now bone on bone. Should she take sick leave from the NHS, or will she make sure that she has her operation, cabinet secretary? Successive SNP health secretaries, Nicola Sturgeon, Humza Yousaf and Michael Matheson, have simply failed to tackle workforce pressures, and we have 6,700 medical vacancies in our NHS. We know that the current health secretary is distracted by personal scandals, and he has failed miserably to deliver for the NHS. Take the flagship national treatment centres, the cornerstone of the SNP's NHS recovery plan. Many of those new centres were supposed to clear the waiting list backlog by 2026, but they have been delayed. Some might not even proceed at all. Officials advised Humza Yousaf against citing figures on the additional capacity that national treatment centres would deliver, because, and I quote, projections included in the NHS recovery plan have dropped significantly. The 1,500 additional staff, promised by 2026, is unlikely to be met, and some boards are experiencing recruitment challenges in relation to staffing. A cabinet secretary briefing from 8 March 2023 revealed that there was no, and I quote, no revenue funding source for the national treatment centres that are not yet in construction, whilst, and I quote again, the remaining programme is not affordable on the basis of the current capital spending review. National treatment centres delayed in NHS Grampian, in Tayside, and NHS Lanarkshire and NHS Ayrshire and Arran do not even have the full business case required to get the process started. What about the Edinburgh eye pavilion 2? The SNP will not tell us what will be ditched until March or possibly May, because they do not want scrutiny of the capital programme alongside the budget. The truth is that those centres will not be delivered on time and some might not be delivered at all. The SNP's recovery plan is simply not worth the paper that it is written on. All we have is yet more broken promises from a party that has run out of ideas. The Scottish Government is always keen to blame the pandemic. Of course, the pandemic happened, but the truth is that the NHS was in crisis long before Covid-19. Finally, let me address the SNP's latest promise on extra investment. We heard from the cabinet secretary that they are going to reduce waiting lists by £100,000 in two years' time. Firstly, what happens to the other 700,000 people waiting, but many patients and NHS staff will rightly ask why they should have any faith left in this Government after all its previous broken promises. Secondly, let me tell you how it is being paid for, because the SNP assumes that there will be a Labour Government in Westminster that delivers extra NHS funding to Scotland. That is right. Even the SNP Government knows that we need a UK Labour Government for its plans to come to fruition. The people of Scotland have been left high and dry by an SNP Government, marred in scandal after scandal and more interested in playing fantasy politics than dealing with the crisis in our NHS. Enough is enough that the SNP Government must prioritise tackling the NHS crisis before more lives are lost. As a Government, we remain focused on ensuring that our health service continues to recover from the long-term effects of the pandemic. Scotland is not unique in facing those challenges as services across the UK continue to be challenged. Too many people are waiting too long for treatment and I am committed to delivering sustained improvements and reducing waiting times year on year across our NHS. That is why, in our draft budget, we have provided funding of over £19.5 billion for health and social care, giving our NHS a real-terms uplift, which is in stark contrast to the UK Government's autumn statement that shows a real-terms cut to NHS England. Even in the face of unprecedented pressures, we continue to see progress following the introduction of our long-wait targets. We have seen a substantive reduction in new outpatient waits over two years since the targets were announced, with 85 per cent of specialities having fewer than 10 waits. The number of waits over 78 weeks reduced by 30.1 per cent, as of September last year, and 34 per cent of specialities had fewer than 10 patients waiting over 52 weeks. Wates of over two years for inpatient day-case treatments have also reduced by 26 per cent since the target was introduced. With the thanks of hard-working staff and our NHS boards, we have seen a further increase in activity, with the latest statistic showing activity in inpatient day-cases at the highest level since the start of the pandemic. Isn't it the case that you promised to end those waits, not simply just reduce them, and by your own measure you have failed? The relatives, as I set out, were making substantial progress, but clearly more needs to be done and we are determined to do that. I know that challenges remain, and there are still unacceptable waits for some specialities. That is why we are committed to enhancing regional and national working to develop national solutions to create a sustainable service, to reduce backlogs, and to focus on those specialities where there are significant pressures. That is supported by our national treatment centre programme. We have opened two NTCs last year, one in Fife and the other in NHS Highland, with a further two centres opening in the coming months in Fort Valley and also at the Golden Jubilee hospital. Central to all of this is our £1 billion of recovery NHS recovery plan. Our second annual progress update, published in 6 December, demonstrates the improvements that have been taken forward as a result of our significant investment, delivering targeted reform and also dedicated innovation. For example, since 2021, I need to make progress given a limited time, I am afraid. We have already invested £8.6 million in programmes through the Centre for Sustainable Delivery to help to support transformation and the roll-out of new techniques, innovation and safe, fast and efficient pathways for Scotland's patients. It is crucial that we secure best value wherever we are delivering services in NHS Scotland, allowing us to maximise the impact of our investment and the delivery of quality services to patients. None of that would be possible without a dedicated staff within NHS Scotland. NHS staff levels are historically high under this Government, with more than 24 per cent imposed, and we remain committed to implementing our national strategy. Due to our constructive engagement with trade unions, Scotland is the only part of the UK not experiencing strike action in our NHS. I am surprised that Labour is bringing forward this debate in the very same week when junior doctors are striking in Labour-run Wales, resulting in the cancellation of 6,500 outpatient appointments and some 400 planned operations, which will undoubtedly impact on their own waiting times. Of course, that is devolved by NHS England, where a total of 1.3 million acute inpatient and outpatient appointments have been cancelled due to strike action in England since December 2022. As a Government, we will continue to make progress and I am determined to see continued improvements over the course of the coming year. I am committed to making sure that we take forward the changes to deliver a recovery and also to reform the way in which we deliver services within NHS Scotland to deliver a sustainable healthcare system to continue to deliver high-quality services to the patients of Scotland. I can just ask you to move the amendment. Thank you. I will now call on Sandesh Gulhane to speak to it and move amendment 11874.1 up to four minutes, please. Thank you. I wish to draw members' attention to my register of interests of practicing NHS GP. Well, there you heard it. Everything's fine here. There's no problem. The cabinet secretary says our health service is rosy. Well, in December 2023, only 66% of patients at A&E were seen within four hours. Between July and September 2023, only 72% of cancer patients began treatment within the statutory 62 days of an urgent referral. Another month, another set of dismal data, another quarter, more failure. We're sounding like a broken record, but the SNP just doesn't seem to care. It takes no responsibility, safe in the knowledge that the Scottish Greens have their backs for the price of two ministerial limos. So maybe we should stop talking about stats and percentages and instead highlight what really matters, people's lives. According to the Royal College of Emergency Medicine in 2023, there were 1,400 extra avoidable deaths that were linked to long A&E wait times, 1,400 people, not numbers on a spreadsheet. I want to be crystal clear. Nobody is criticising our front-line staff. They go far and above their call of duty. But this incompetent SNP Government have left healthcare in Scotland on its knees, and Humza Yousaf, Michael Matheson and one health minister after another have offered no solutions. Scotland needs and deserves a fresh approach to deliver a modern, efficient and local NHS, accessible to all. Instead, the SNP has dithered and watched Scotland's GP workforce shrink. Scotland has had enough of the SNP playbook. The First Minister or the Cabinet Secretary comes to a chamber, makes an announcement, fails to deliver and then defends their record by tripping out spin and promising lessons that will be learned. Let's take access to child and adolescent mental health services camps. Humza Yousaf promised to clear camps waiting lists by March 2023, yet by September 2023, over 5,000 children were still waiting to start treatment. One child waiting 37 weeks in Glasgow with some having waited a year in Lothian. This matters because poor mental health robs our kids of their childhood. Young people and young adults have to wait 39 weeks for the first appointment for treatment for CAMHS treatment. I think that the Government should apologise for the appalling lack of support to young people. I couldn't agree more. Our kids are suffering and they are not being looked after by our SNP Government. Let's look at NHS estate. The SNP's manifesto pledged to invest £10 billion over a decade to renew our NHS estate, yet today we hear that all NHS projects have been halted for at least two years, even affecting the SNP's solution to waiting lists for national treatment centres. I would like to close with another SNP failure, the worst drugs-related deaths in Europe. I will leave the matter of hunting down those who profit from the criminal trade in this misery to Police Scotland. Drug dealers are criminals, gangsters, but we can bring the SNP to book for cutting the funding to drug and alcohol recovery services by £19 million. People addicted to drugs and alcohol deserve and desperately need our help. They should have a right to recovery. It is only our front-line NHS workers that are preventing Scotland's health service from keeling over. On this SNP's watch, the same party that has been in charge of health since 2007 has failed to pass on £18 billion in health consequentials in that time, and we see the results. The SNP is responsible. No ifs, no buts. I am very grateful to Jackie Baillie for bringing this motion to Parliament today. Before I begin my remarks, can I congratulate her on her investiture as a dame this afternoon at the palace, getting an honour for politics and up all the right people's noses? Here we are again, Presiding Officer. The facts laid out in the motion for today's debate make grim reading indeed, and they are no stranger to any of us or our casework postbags. Almost one in six people in Scotland are currently on NHS waiting lists for either tests or treatment. 80,000 people are currently waiting over a year—365 days—to be seen. People are dying because they are waiting too long for emergency care. Just yesterday, any waiting times figures were released, and they are equal to the record-breaking figures of last year. Things just aren't getting any better. Whether they are forced to wait hours for an ambulance to be seen in A&E or left abandoned on trolleys or languishing on wards, people are being let down, and it's not. Just on the front line, these problems are manifest, but right across our health service in its entirety. Take diabetes as an example. Currently, only 18 per cent of people living with diabetes in Scotland are receiving the essential health checks, the regular health checks that they need. That's down from 40 per cent, pre-pandemic, which is still well behind where it should have been. I have lost count of the number of times that we've had debates like this in this chamber. We keep having them, unusually just in opposition time. I fear that we've become enured to that. We've got used to our health service languishing and struggling in the way that it has, and we have become dangerously comfortable with crisis. Every time we raise it in this place, ministers refer to the pandemic. Every time they do so, they insult the intelligence of us all here, those people watching, and they seriously test the patience of the hard-working staff on which we rely. The issues in our NHS were there long before anyone had heard of Covid-19, and people are tired of those excuses. They are tired of the ministerial disinterest and mismanagement that have defined this SNP and green administration's approach to health. I want to be crystal clear that none of this is the fault of our hard-working staff. They have worked their fingers to the bone. They have worked miracles and spin gold out of straw. They have worked long hours under the most stressful circumstances imaginable, and they deserve our utmost thanks. However, they are being let down as well. There are currently almost 6,800 NHS workforce vacancies unfilled. That puts enormous untold strain on the staff who are there. The chair of BMA Scotland has said, and I quote, doctors and other healthcare workers are exhausted and facing burnout under these increasing workloads. SNP green government decisions have compounded the pressures on nursing staff, and that problem stretches all the way back to Nicola Sturgeon cutting nursing and midwifery training places and claiming at the time that it was an, I quote, the sensible thing to do. The Health Secretary has shown zero sign of innovative thinking necessary to resolve this issue. When Humza Yousaf was in his position, he repeatedly ignored my party's call for a plan to address staff burnout and to set up a health and social care staff assembly. This government has shown a pig-headed contempt for a strategy that would guarantee annual leave, ensure safe staffing levels and champion the expertise of those who know our health service best. It's little wonder, then, that we are now finding it harder than ever to attract and to retain new staff. On this government's watch, costs for temporary staff have risen to over half a billion pounds in recent years. Rather than making the meaningful investment our health service needs, this government is relying on short-term fixes to plug the gaps. Presiding Officer, to put it plainly, this government is failing. It is failing Scotland's NHS, both the hard-working staff who run it and the patients who depend on it. Both staff and patients are alike and need long-term solutions. They need new hope. The Health Secretary needs to do three things. I'll close with those. He needs urgently drafted his failing recovery plan. Give hard-working staff the fair-paying conditions that they deserve and fix the issues in social care so that people can be treated in the community rather than being left to languish on hospital wards well enough to go home but too frail to do so without a viable care package. Thank you. We move to the open debate, and I call Carol Mocken to be followed by Claire Holly. Thank you, Presiding Officer. This issue is perhaps the one that I hear most about from constituents across south of Scotland, and that's why it is essential that it is given fair hearing here in the chamber today. Whether they live in rural or urban areas, if they are young or old, if they have a long-term condition or seek new advice, worries about NHS waiting times are a constant. Not just waiting but it's described to me as languishing on NHS waiting lists. That's not me describing this. It's patients, constituents and all of our communities. I expect every one of us here has or no someone waiting experiencing this. Put simply, our constituents want to know what can be done to avoid to stop our NHS being under such constant pressure. Although they are sympathetic that waiting times are a reality of any health service, some of the extended waits that people are having to put up with are simply unheard of. 7,000 Scots waiting over two years. I wasn't going to bring that up, but in the cabinet secretary's contribution that he kept referring to other nations, 7,000 Scots over two years and in England it's 227, it's not helpful to continue to go over those figures. People want to know what is happening. In Scotland it really is at the point where it's become commonly accepted that there are certain operations and treatments you will have to wait potentially years for and in some cases that can shorten lives and cause unmanageable stress. Is that really what we came to this place to do? As lawmakers, as elected representatives of our communities, we have to understand that the people telling us this are not just statistics moving from one column to another, they are real people with complex lives that in constant limbo because they simply do not know when they will receive the treatment that they require. Under this SNP Government we've heard 80,000 people and their loved ones are living with anxiety and in many cases pain for over a year waiting for planned care because this Government are not getting it right. Those people view commitments made by the Government as a personal promise and time again they're seeing that it amounts to just words. I do not think that it is acceptable and I implore those with the power to change the trajectory to not treat this in terms of look over there as someone else's fall or we're not as bad as someone else. I don't think that that does justice to our constituents. Do look at the long-term plan, the long-term investment and infrastructure needs of the NHS in Scotland. Be honest about delays on national treatment centres, reset the programme clearly. You only mentioned a couple of the national treatment centres and didn't speak about some of the other projected centres. We also need to acknowledge that we require to ensure that our workforce is secure and that we move away from the damaging and expensive reliance on agency workforce. This has been a thing of this SNP Government and it needs to address it. It's our job here to hold you to account and I ask you to address this. I have sympathy for any Government who has to put up with the constant undercutting of public services led by the Conservative Government and Westminster. However, our job in this place is to deal with what we can do and this Government can do things. On behalf of my constituents, let's be clear about what can be done. This Government has been in power for 17 years, delivering promises made around staffing and national treatment centres. There is a staffing crisis that is making commitments like the national treatment centre impossible to deliver. We must do what we can and I ask the cabinet secretary to take this. This is a genuine request to feedback appropriately on this so that we can feed this into our communities and our constituents. Cabinet Secretary, let's push forward into the new year with a serious plan not yet more empty promises. I refer members to my entry in the register of interests. I hold a bank nurse contract with NHS Greater Glasgow and Clyde. As someone who continues to work proudly in our NHS, I'm under no illusions of the challenges that it currently faces. In the years ahead, those challenges will become more pronounced with demographic changes and the expected increase in disease burden. It's therefore abundantly clear that significant investment in our NHS and indeed reform of the delivery of care is of paramount importance. In the face of Tory austerity, their shameful autumn statement and their mishandling of the economy, which has caused inflation to run rampant, this SNP Scottish Government is taking the necessary decisions to ensure continued investment in health and social care services. In the draft budget, the Deputy First Minister announced an increase of over £550 million to NHS front-line boards, a 4.3 per cent uplift, taking the total investment to over £13.2 billion. Scottish Government funding of the NHS has ensured record high staffing levels. It will drive forward work to increase health service capacity, including through a network of national treatment centres, and it will reduce backlogs, delivering year-on-year reductions in waiting lists. On that last point, yes, of course, too many people have waited too long for treatment. However, I do welcome that we've seen a significant reduction in the longest waits since the targets were announced last July. That includes a 69 per cent reduction in patients waiting over two years for a new outpatient appointment from the end of June 2022. There's also been a 26 per cent reduction in patients waiting longer than two years for inpatient or day-case treatment since the targets were announced. That is well-come progress, but we know there is still more to do. Scottish Labour never wants to talk about the significant and on-going impact that Covid has on our health service, notably in the area of planned care, as well as other external factors. It should listen to the Welsh Government's Minister for Health and Social Services, who said only in the past week that the pressures on the NHS are unrelenting in every part of the UK. Over the past 13 years, the NHS, such as other public services, have had to contend with austerity, the impact of a botched Brexit, the pandemic, record levels of inflation and rising demand. It is not difficult to work out why it is so challenged across the whole of the UK. It is also worth noting that we are sitting in this chamber today while we are here. Junior doctors are currently striking in Wales where labour is in power. The NHS is nothing without its dedicated workforce. I am proud that, due to the value that the SNP Government places on our health staff, Scotland remains the only country in the UK to have been successful in averting NHS strikes. In doing so, we have avoided the knock-on effect that this would have on capacity and on-prespond operations and outpatient appointments. That was looking at Wales where labour is in power, but even looking at Westminster where an opposition is clear, Labour does not have the plans or the ambition to tackle the challenges facing health services across the UK. Labour's shadow health secretary said that a UK Labour Government would hold the door wide open to private sector involvement in the NHS, and also stated that he did not think that it is good enough that the NHS uses every winter crisis and every challenge it faces as an excuse to ask for more money. Hardly supportive of the hard-working staff that we hear faint praise for from across those opposition benches. Labour's only plan for our NHS seems to be opening up to the private sector involvement, starving it of much-needed investment, supporting a Brexit that impacts on recruitment of health and social care staff and undervaluing NHS staff, leading to strikes. This Scottish Government remains committed to driving down waiting times, particularly for those waiting the longest for treatment. We are resilient in doing what we can to support our workforce through record levels of staff, promoting their wellbeing, protecting and providing proper pay increase, and absolutely committed to keeping our NHS publicly owned, privately, but with no private involvement and at the point of need. Thank you. I call Colin Smyth to be followed by Annie Wells. Thank you, Presiding Officer. Once again, it was the pandemic that did it as the sole reason that we have heard from the Cabinet Secretary for the Crisis in Golf and Health and Social Care Services. It is a damning admission that two years on, Humza Yousaf's recovery plan is failing, but it also defies the reality that the seeds for this crisis were sown well before 2020. Pre-pandemic, the Scottish Government received warning after warning, alarm after alarm sounded about the risk to patients, of the systematic underfunding, of the absence of proper workforce planning, of the lack of any clear plan for our health and social care services. Far back in 2017, the British Medical Association warned that the national health service was at breaking point, and the failure to listen to those warnings to act this incompetence has consequences for patients and for staff. A day rarely goes by when constituents don't share heartbreaking stories showing just how broken services are. A year ago in this chamber, I told the story of Pat, who was receiving pallative care after a cancer diagnosis. Pat's wish was to spend what time she had left at home. Her care needs were, of course, increasing, but that wish was not too much to ask. An assessment was made, a care package agreed, but there were no carers to deliver it. Marie Curie did what they could as did the family, but the growing burden on Pat's husband became too much. He was admitted to hospital and, tragically, that's where he remains. There were still no carers to take over, so Pat was also admitted to hospital, even though she was not receiving any medical treatment and could and should have been cared for at home. Pat sadly died in hospital. Since then, things have got worse. I could share more tragic cases from my inbox. Constituents being placed in care homes from hospital to fiddle the delayed discharge figures often for months, often miles from their families, waiting to go home where they should be. Operations routinely cancelled because beds are unnecessarily full due to delayed discharge. Jackie Baillie listed many of the Government's broken promises on health. Here's another one. Nine years ago, the SNP pledged to eradicate delayed discharge within a year. Today, it has spiralled out of control. It's draining £1.2 billion over the last decade from our NHS. In Dumfries and Galloway alone, between 2015 and 2023, that bill was a staggering £40 million. Money that we could have been using to pay carers a proper wage. No service, no constituent in my region has been left untouched by the crisis in gulf and health and social care. Care homes have closed, community hospitals have closed, GP surgeries have closed, dentists have closed. Indeed, more than 20,000 patients in Dumfries and Galloway alone have been deregistered from the NHS recently. You cannot register with a single NHS dentist in that region. There's no waiting list because there is nobody to register with on a waiting list. We've heard increasing concerns that the NHS is unsustainable in its current form. The reality is that it's this Scottish Government's negligence that's unsustainable. Their failure to take responsibility to act decisively is a real threat to the future of our national health service. We need the Government to stop ignoring the warnings, to finally make good on their promise to eradicate delayed discharge. We need a long-term plan to tackle the low level of sheltered houses and the loss of care homes locally. We need the Government to pay our care workers properly. At a time of the national minimum wage, we'll rise to £11.45 per hour from April. The Government's pledge to pay carers just 56p more will make little difference to filling vacancies. However, listening to the calls from unions, listening to the calls from Labour to pay care workers a fair wage with a clear timescale to move towards £15 per hour and proper clear progression would help with the recruitment crisis. It would free up hospital beds and, ultimately, it would reduce the long waits for treatment. That's the least patients in our dedicated hard-working staff deserve. We all admire the dedication and hard work of NHS staff. Whatever help we need to go to incredible lengths to keep us healthy, we owe them our thanks for the work that they do. However, despite the amazing efforts of NHS staff, Scotland's health service is in crisis. Staff have been let down by the lack of support from the SNP Government. Systemic problems in our NHS have driven excellent nurses and doctors to breaking point. No matter how hard they work, they cannot give every patient the care they deserve anymore. That offers a grim reality of Scotland's NHS under the SNP's leadership. There is a crisis at practically every level of the NHS. Years of subpar plans from the SNP, including the use of the Swansea NHS recovery plan, has seen the situation in our NHS spiral out of control. The SNP will blame the pandemic, but the reality is that most of those problems were already apparent before Covid. The pandemic only made them worse. Here's the situation right now in the NHS. Wasting times for A&E have hit the record worst ever levels. The treatment time target for A&E is four hours, but since this session of Parliament began, that target has been missed over a million times. That doesn't just inconvenience people. It costs lives. Last year, the Royal College of Emergency Medicine said that one extra death occurs for every 72 patients that wait over eight hours in A&E. Based on those figures, just to the end of September last year, more than 1,400 people lost their lives because of A&E waiting times. The problems at A&E have sent the ambulance service into crisis too. Ambulances are regularly forced to queue for hours outside hospitals before they can admit a patient and get back out on the road. The consequence is people waiting absurdly long times for ambulances, even up to as much as 15 hours. However, the issues do not end there. People are often leaving treatment until it becomes an emergency and they need to attend A&E or get an ambulance because they have not been able to get a GP appointment. They cannot get an appointment quickly because there are simply not enough GPs. The SNP's poor workforce planning has left GPs struggling to meet demand. The British Medical Association says that we need another 1,000 GPs to plug gaps. The SNP promised to increase GP numbers, but they are going in the wrong direction, and that is not the only broken promise from the SNP and Scotland's NHS. Maybe the most damaging one was their failure to end delayed discharge, which the Deputy First Minister said he would do nine years ago. The consequences of failing to meet that promise have been huge. Almost 2,000 beds are occupied every day due to delayed discharge. Neither is the SNP's failure to recruit more GPs that own the serious workforce issue in Scotland's NHS. Spending on agency staff has quadrupled in two years. There are over 5,000 nursing vacancies in NHS Scotland, and staff turnover is at its highest rate in a decade. I do not have time to get a lot to do in my last minute. The consequences of those systemic problems is that our excellent NHS staff cannot deliver the care that they want to, and patients are left waiting days, weeks, months and sometimes even years for the treatment that they need. One thing is certain, Presiding Officer, that the crisis in our NHS cannot go on like this, and our vision is for a modern, efficient local Scottish health service that is accessible to all. Iver McKee, to be followed by Jamie Greene. Thank you, Presiding Officer. It's a pleasure to speak on this short debate on Scotland's health service. It's important to recognise the challenges that we face, but the successes that have been delivered in the work that is on-going, and the cabinet secretary has outlined a number of those, including the fact that Scotland is the only part of the UK that has avoided strikes in our NHS. Of course, the service faces challenge is not least of an ageing population, health inflation, the impact of Brexit on workforce availability, and many others. It's important to use the short time that we have available, not as the opposition are doing, just to throw out random talking points into the debate, but to have clear proposals that we can take forward to make some specific improvements in addition to the work that is already happening. In the short time that I have available, I just want to focus on a few of those. First, I will round about the adoption of technology, including process improvement, leveraging the great work of Scotland's fabulous life science sector. Some examples will only have 1.5 per cent of operations across Scotland's NHS, delivered by robotics, something where higher quality and increased efficiency can be delivered. I would ask the cabinet secretary to look more thoroughly at that. Use of artificial intelligence and, for example, radiography. Use of sensor technology, for example, in falls, monitoring and prevention. Use of increased digitisation, leaving Scotland's great expertise in that sector and booking systems, digital dentistry and many others. I would like to pay tribute to the work of the accelerated national innovation adoption pathway, and the great work that has been taken forward there, but there is so much more that can be done in that space. Secondly, the roll-out of that technology and best practice right across the health service and all health boards across the country. That one is for Scotland. I know that there is work happening there, but I would ask the Government to do some evaluation of the potential savings and improvements that could be made of best practice in each health board that was adopted across all health boards. Thirdly, in terms of shifting resources, it was good to have a conversation and an evidence session from the cabinet secretary at the health committee on that yesterday. We know that that cure is significantly cheaper than prevention working on the Christy principles, and it would be great to see more happening in that space. We know that there has to be a shift from management layers towards the front line and from high-cost interventions to lower-cost ones. Again, I would ask the Government to take forward some work in detail to help us to understand how we can better measure the resources that apply in each of those areas and get under the skin of the health board budget, so that we know what the potential savings and improvements are by moving towards a more front-line-focused service that is focused more on prevention rather than rather on downstream cure. The next theory is roundabout structures. A big bang solution is time-consuming and expensive, but I do not doubt that there are many opportunities to remove duplication of services between health boards in terms of back-office management and administration and bureaucracy, and to have a closer working-together of health boards. Looking for opportunities for consolidation where that makes sense to be able to take out costs from the back-office and reapply them to the front-line services. I would also ask that the single authority model is given some more serious attention in certain areas of the country. I know that that is very favoured, particularly in smaller local authorities, and it allows for a much more efficient service delivery model. I am looking to join the dots where possible and making it easier. The example of community-link workers in my constituency in Glasgow recently where different parts of the system are unable to agree to continue to fund that very cost-effective intervention until the cabinet secretary stepped in to make that happen. Finally, it is very important to recognise the Government's absolute commitment to the fundamental principles of the health service. Public-provided services are free at the point of use and, of course, to resist all efforts towards privatisation of the service, as has unfortunately happened in other parts of the UK. I congratulate Dame Jackie Baillie on her honours today. I am disappointed that she did not wear that hat to the chamber. I listened to today's debate. When Opposition parties debate those great pillars of devolved government, health and education, as we have done so well today, I think that they generally do so for good reason. Those debates are often backed up with statistics and facts, often informed by stakeholder evidence. They are not talking points, I would say gently to Mr McKee, their facts and their worth debating in this chamber, because the Government's response to those debates is predictable. Little sign of contrition or acceptance of any of the criticism directed towards it, a denial of the scale or extent of the problems that we face and a huge amount of what aboutry, as we have heard from the minister, today's debate is a fine example of that. Labour rightly pointed out today that 80,000 people have waited over a year for planned care. They rightly raised the years of missed targets, the growing workforce problems faced. On our benches, we highlighted the worrying cuts to drug and alcohol services, and we raised the plight of the 1 million people who have waited over four hours at A&E since 2020-21. The Lib Dems raised issues around NHS staff themselves, who, of course, are at the core of those debates. The Greens did not even bother to turn up this afternoon, and that says so much. The Government's feeble amendment, and it is a feeble amendment, immediately, in the first opening line, removes the word alarmed from it, because they clearly are not as alarmed as we are or, indeed, as our constituents are. They go as far as congratulating themselves, because fewer patients are waiting over two years for an appointment to be seen. Their amendment removes all references to the drug and alcohol deaths, removes references to A&E waiting times, to mental health waiting times and, frankly, anything else that seems to embarrass them. In fact, their only defence in their amendment today is that all devolved policy makers seem to be doing a terrible job managing health. It is all relative, I suppose, of mediocrity at its very worst, Presiding Officer. The bad news is far too often buried away. It is not publicly available. For example, in researching this debate, audiology waiting times could not be found, because, apparently, from an FOI response, we learned that this data is not published following an agreement with the Scottish Government. What a surprise. Speech therapy figures were released yesterday, not by the Government, but by the Royal College of Speech and Language Therapists. Again, they had to FOI the data. From that data, we discovered that 6,500 children in Scotland are currently on a waiting list for their first appointment. It is shocking. I have raised this issue because, in my area, they actually closed the waiting list. It was over two years long. It is despicable. What about mental health waiting times? One patient in Ershawn Arran waited 91 weeks for their first CAMHS appointment. Can you imagine that? We only know that because we FOI'd it. We only know that because we asked written questions. We never hear it from the Government and we certainly never hear it in their debates. The amendment from the Government today is just sheer brass neck, I'm afraid, because we've heard repeated parroting today that the NHS in Scotland is free at the point of need. Here's a reality check. If you want to see a dentist this week in Greenock and you pick up the phone, the only appointment you will get, cabinet secretary, is if you offer to pay for one. That's the reality of the NHS in Scotland. The same goes if you want a hearing aid, the same goes if you're desperate for a knee or a hip replacement. You have to borrow the money, cast in your savings, go abroad or go private. That is the reality of the health service today in 2024. With our amendment, the only people the Government are filling are themselves. Fixing the problem requires admittance that there is a problem. It's not creeping privatisation that we need to be worrying about, it's creeping ineptitude in Government. Let me tell you that there's plenty of it going around. I call Bob Dorris, the final speaker in the open debate. With regard to this afternoon's debate on the NHS in Scotland, it's worth observing that the substantive motion before us from the Labour Party offers not a single new idea or initiative for what Labour in Scotland would do differently to improve Scotland's NHS, nor does it identify a single additional penny for Scotland's NHS. I acknowledge the Scottish Government amendment recognising that health services across the UK are dealing with the long-term effects of Covid-19 pandemics on waiting times and further recognises that too many people are waiting too long for treatment. Of course, despite some improvements, that includes right here in Scotland. I readily acknowledge that we all wish to see that those improvements gather pace. The Labour motion mentions long-term waits in particular within NHS. Stephanie Howard, the chief physician to the Welsh Government in September 2023 sought to analyse long-term waits across all UK nations. Ms Howard indicates that for treatment pathways waiting for more than one year in Wales in March 2023, that was 133,000 people. The figure in Scotland was 74,000. For two years in Wales it was 28,000. In Scotland it was 8,000. I also acknowledge that although we know that those figures are not entirely equivalent to each other and should not be directly compared, that is not what I am doing. The methodological differences cannot account for the scale of some of the differences in the numbers waiting longer than one or two years. That suggests more impactful progress in Scotland on this occasion than elsewhere. That will not always be the case, so I can ask the Scottish Government how we share such practices across the UK to share best practice and how we receive it from elsewhere. I commend health and social care workers not only in Scotland but right across the UK. We need to set the challenges facing Scotland and a pan-UK context, even when that is uncomfortable for Labour when it includes NHS performance in Wales. Given the spending plans of the UK Government, we would see only an additional 10 million pounds increased to Scotland's budget and something that we have to acknowledge that the UK Labour Party has not deviated from. I thank heavens that the Scottish Government will increase the spend to our NHS by over half a billion pounds. I acknowledge that vacancy levels in recruitment remain significant challenges. Again, such challenges are faced right across the UK. That is understandable, given that the impact of Brexit has undermined workforce planning right across the UK. Indeed, the Nuffield Trust research indicated that there are 4,000 less European doctors working in the NHS because of Brexit. The NMC estimated in 2022 that there are now up to 58,000 fewer European nurses across the UK compared to pre-Brexit trends. That is a reality. The Labour motion mentioning recruitment challenges makes absolutely no reference of Brexit. It does not have credibility, but, of course, it does not suit its agenda. After all, Labour is a pro-Brexit party, something that does not like to draw attention to here in Scotland. I suspect that what will help Scotland's NHS recruitment challenges, however, is the fact that NHS Work in Scotland is the best paid and best supported than anywhere else in the UK. In my way of various recruitment initiatives, the Scottish Government is taking forward to tackle staff vacancies, because there are real challenges, but can I ask whether that includes attracting unfortunately within the confines of Brexit Britain, many of those EU healthcare professionals that have chosen not to work in Britain as the direct consequence of Brexit? I absolutely acknowledge the significant and enduring challenge of Scotland's NHS, indeed in healthcare systems right across the UK. Unfortunately, Labour set today's terms of reference with this debate and pursued cynical political opportunism, rather than constructive dialogue. I look forward to the next debate. I hope they do much better. Thank you. We move to winding up speeches. I call on Tess White up to four minutes, please. Thank you, Presiding Officer. The complacency of this SNP Government as the NHS spirals is staggering. As we have heard this afternoon from waiting times to workforce planning, the NHS is in crisis. National treatment centres were touted by Humza Yousaf as the cure all for capacity problems, but now the SNP has hit the brakes on NHS capital projects. You just couldn't make it up. Almost 830,000 patients are on NHS waiting lists, a figure that's barely believable. A patient in Tayside waited almost four and a half years for orthopedic surgery, another in Grampian waited three years and 179 days for cataract surgery. The impact on patient treatment and staff morale is profound, and there's no end in sight. The beleaguered health secretary has been distracted and more preoccupied with saving his own job than plugging the gaps in NHS vacancies. Jackie Baillie highlighted promises made by this SNP Green Government such as their promise to eliminate completely longest waits in planned care. She gave them a fail, fail, fail, fail, and she said that Michael Matheson was distracted by personal scandals. Michael Matheson apologised for the unacceptable waits. He gave us more spin about £1 billion NHS recovery, the national strategy. He talked about transformation—their words, not worth the paper they're written on. It's spin, statistical spin yet again, but people see the reality on the ground. Deflection, whether it's Wales, Westminster or the pandemic. Cabinet Secretary, why don't we believe what you say anymore? Sandesh Gilhane described the First Minister or Cabinet Secretary. They come to the chamber, they make an announcement, they fail to deliver, then they defend their record by tripping out spin and promising lessons will be learned. If we just look at Cams, Cams use if promised to deliver, he promised to clear Cams waiting times by March 2023, as Sandesh Gilhane said. And this does matter because poor mental health robs these children of their childhood. Jamie Greene talked about the shocking and despicable lack of action on Cams waiting times, and he described 91 weeks in his constituency for a first appointment. Jamie Greene also said, where are the greens? I've noticed that two greens have miraculously just turned up at near the end of this debate but didn't listen to any of the debate. And Jamie Greene talked about the creeping ineptitude in government. Bob Dorris said, not a single new idea is coming forward from anyone else. You've had 17 years, Bob Dorris. The SNP say they have record staffing levels. The SNP don't like to hear the truth. The reality is that NHS has massive vacancies and high staff turnover. Annie Wells described the failure to recruit more GPs and spending on agency staff has quadrupled in two years. There are over 5,000 nursing vacancies, she said, in NHS Scotland, and staff turnover is at its highest rate in a decade. Scotland deserves a fresh approach to deliver a modern, efficient and local NHS, but the stark reality is that, while winter for the NHS is especially difficult, it is now condition critical for the health service all year round. 17 years of SNP mismanagement means that the system is at breaking point and the buck stops at Bute House and there's no one, no one else to blame. I want to start by thanking those who are at the heart of our NHS for their commitment, their hard work and their dedication. Without them, we would not be able to talk about building on recovery and delivering on our promises. We remain committed to driving down waiting times. We have increased investment in front-line NHS boards by more than £0.5 billion in the draft budget and we will continue to target resources to reduce waiting times, particularly for those waiting longest for treatment through maximising productivity and additional resources. The Centre for Sustainable Delivery is working closely with boards to accelerate implementation of high-impact changes, including active clinical referral treatment and patient initiated review, freeing up additional capacity in the NHS system and providing sustainable solutions for the future. With regard to delayed discharges, the winter plan for the NHS and social care for this year was published jointly between Scottish Government and COSLA, and it sets out a whole system approach to responding to the surge in demand for health and social care services that are experienced in the winter. It includes significant new funding measures to support the health and social security system this winter, including £50 million to recruit 317 additional staff to the Scottish Ambulance Service and an additional funding for hospitals at home. Delays with regard to the Scottish Ambulance Service, I accept that there have been delays, but what we are doing despite those challenges, the Scottish Ambulance Service continues to maintain a fast response to the most critically unwell patients and divert cases away from A and E by safely triaging patients within their community whenever possible. I absolutely recognise that too many people are waiting too long for treatment, and the launch of our waiting well hub gives people more information and tools they need to look after their health and wellbeing to think about what matters to them and what health improvements they could make while they wait. With regard to mental health, which has been raised by a couple of contributors today, I think that it is important to note that 1 in 2 children, that is 50 per cent of children, are seen within 10 weeks. 13 out of 14 of our health board CAMH services have effectively eliminated their long waits. I think that that is really important. I also want to be clear that, under this Scottish Government, Scotland's NHS will always remain in the hands of the public and be free at the point of use. However, make no mistake, privatisation from Westminster Governments poses a real threat to Scotland's NHS. The Tories have always wanted to privatise the NHS, but now we have a Labour Party following suit. Unbelievably, with Labour's Shadow Health Secretary, Wes Streeting, said that a Labour Government would hold the door wide open for the private sector in the NHS. That matters for Scotland's NHS. By ramping up privatisation in England, the UK Government is starving our NHS of investment, and if you need proof of that, look no further than the autumn statement, which shows a real terms cut to NHS England funding for £24.25 and does not provide even a single penny towards the next year's NHS budget to pay for this year's pay deal. Even with the on-going pressures that we have seen, continued progress. In the last three years, there was an 11 per cent increase in the number of planned operations compared with the previous 12 months. That demonstrates the continued post-pandemic recovery of Scotland's NHS. I was very pleased to hear Ivan McKee specifically reference the fantastic research work for AI and Anaya that is going on in Scotland. That innovation will provide us with other ways forward. The progress that we have made comes from our commitment to ensuring that Scotland has a sustainable and appropriately skilled workforce. Work is well under way to ensure that we have sustainable workforce pipelines now and in the future. Let's look at this. Nursing and midwifery staffing is at a record high. We have 8.4 qualified nurses in mid-wise per 1,000 to the population, and allied health professionals are at a record high of 34.1 per cent. Our NHS is our most cherished public. The reason why Labour brought this motion to the Parliament today was because this waiting time scandal is unprecedented, and it is one that comes up daily in our casework, and that is why we brought it here today. You heard from the speeches here—we all did, Presiding Officer—that we all have skin in the game on. If it is not something that is affecting our own families, we will know someone who is languishing on that NHS waiting list, as Mr Smith raised the tragic case. If his constitution is just one horrendous example, I could rehearse several to the chamber today if I had more time. As we know that prevention is much better when we get in early, otherwise families spiral out of control and much greater harm is caused, that is what is compounding the problem facing us, with one in six Scots—over 860,000 of us, technically the biggest city of Scotland worth of people languishing on that NHS waiting list. My friend the member for Don Barton newly invested, as Dame Jackie mentioned earlier today. The warm words from the Scottish Government cut little ice in this side of the chamber, Presiding Officer. The First Minister said in 2022 that the Government would seek to eliminate the longest waits in planned care, but around 80,000 people are still waiting over one year to be seen, and that has consequences. As the member Ms Wells for Glasgow said, 1,600 excess deaths are estimated in A&E alone. That is severe and it is having serious effects on our population. That is why this is a matter for debate here today. With 7,000 Scots waiting over two years for treatment, as opposed to just 227 in England, I think that it has been disingenuous in the extreme for members to come here and claim that Covid is the common denominator behind those matters. Certainly, Covid has had an effect, but it does not account for the extent to which the NHS in Scotland is not performing well enough, and it is completely unacceptable for the Government to not take responsibility for that. It should stand by that record. I have to give way on that point. I thank the member for taking intervention. Could he please clarify a couple of points that I raised in my speech? The Welsh Health Minister said that Covid has an impact on the NHS waiting times. Does he disagree with that? Does Scottish Labour support less waiting in his calls to privatise the NHS? Paul Sweeney? We seem to be in violent agreement, because I accept the point that Covid has had an effect, but it does not account for the extent to which the NHS is in disarray in Scotland. As for privatisation, I think that that is a gross misrepresentation of the Labour Party position. We also want to look at the reality of what our constituents are telling us, because that is why we are here today, after all, not to moan about other parts of the UK, but to represent our constituents here in this place, to hold this Government to account for its actions. I am afraid that having to choose one lateing list to prioritise if they are all more than one, waiting over multiple years for surgery in countless cases of young people waiting over a year for mental health assessments is simply not acceptable. Indeed, some members of the Government benches made constructive points. I refer to the member for Glasgow Provin, who raised the issue of digital spines for patient journeys. Those are huge interventions that we could be making to improve productivity in our NHS, but we are seeing capital budgets cut in efforts to improve efficiencies, constrain GPs, and tell us that they simply do not have the headspace to even look at service reforms. Mental health is, of course, a serious concern that is being raised by members today. The Scottish Government has failed to ever meet its target on waiting times for CAMHS, and the psychological therapies target has never been routinely met. Dr Colhaney from Glasgow mentioned that, as did Mr Greene for West Scotland. I think that those are critical points that have to be continually mentioned to the Government. The Government says that they are taking these weights seriously, but the mental health budget has been frozen and subsequently cut in year for two years running, and they are failing to meet their own target of 10 per cent on NHS spend being allocated to mental health. I think that the Minister of the Cabinet Secretary came to committee only this week and admitted that it is unlikely to be met by the end of this Parliament. It is simply not acceptable when, if that 10 per cent commitment had been fulfilled over the past three years, almost £550 million more would have been invested into mental health services. Instead, we have a recruitment crisis that is costing us £567 million on banking agency staffing. It has the cheek to come here and talk about privatisation when it is plowing £0.5 billion into private recruitment agencies. It is a sham. It is unacceptable. As colleagues have referenced, the waiting times for cancer diagnostic tests is costing lives. People are waiting well on a cancer diagnosis, and we are afraid that they are dying waiting for treatment. That is what is happening in our mid-tier, and it is unacceptable on our watch. That is why we have brought this motion to the chamber today, and that is why we commend it to the chamber, and I hope that all parties will support it for the sake of Scotland's wealth and health, ensuring that we have the best possible outcomes for our constituents. That concludes the debate on ending NHS long waits. It is now time to move on to the next item of business, which is consideration of business motion 11887, in the name of George Adam, on behalf of the parliamentary bureau, setting out a business programme. I call on George Adam to move the motion. Thank you minister. No member has asked to speak on the motion. Therefore, the question is that motion 11887 be agreed. Are we all agreed? The motion is therefore agreed. The next item of business is consideration of business motion 11888, in the name of George Adam, on behalf of the parliamentary bureau, on stage 1 timetabling for a bill. Any member who wishes to speak against the motion should press their request to speak button now, and I call on George Adam to move the motion. Thank you minister. I call on Sandesh Gulhane up to five minutes, Dr Gulhane. Thank you, Presiding Officer. I wish to draw members to my register of interest as a practicing NHS GP. The Scottish Parliament's Health Committee has discussed the SNP's befuddled plan to create a national care service at 21 meetings since June 2022. In May last year, meeting number 15, the perplexed minister, Marie Todd, told us it was hard for her to get her head around the bill. This is the SNP flagship policy, a £2 billion policy, a policy that has been completely changed by Humza Yousaf. The policy is being rewritten as we speak, but the SNP will not let us see the actual wording of the policy before stage 1's vote, almost certainly due to time pressure. We agree the bill needs further delay, but why not decide when the changes to the bill can realistically be completed, then use this to create a realistic timetable, allowing us to vote on a bill that we can read and not guess at? Just as Minister Marie Todd said in May today, nobody can get their head around this bill. Create a realistic timetable and a fair timetable for this Parliament. Thank you. I call on Marie Todd up to five minutes, Minister. I am wondering, are the Conservatives really suggesting that we shouldn't proceed with the change that is so urgently needed in the sector, because we all know that the case for change has been made unequivocally through the independent review of adult social care, through our on-going co-design discussions with people with lived experience, and through almost every exchange I have with those working in and receiving services from the social work and social care sector. The case for change in social care is unassailable and everyone agrees that it is necessary. This is milestone legislation. It is the most ambitious reform of public services in Scotland since devolution. This change is necessary to deliver the consistency and the quality of care and support across Scotland that people deserve. It is also necessary to reinforce our commitment to Scotland's people to take long-term action to change our society and make it a fairer place to live. We remain committed to delivering a national care service to improve quality, fairness and consistency of provision that meets individuals' needs. We know that the social care system in Scotland needs to change and that our partners across the public sector, including local government and the NHS, agree that we are working with people with lived experience and people who work in social care to provide what is needed. That is essential for a task of this magnitude. We revisited our approach last year to do further engagement with people with lived experience and with COSLA and the NHS. We have been working really hard in discussion with numerous stakeholders through numerous regional events and meetings over the second half of 2023, certainly. Jackie Baillie is grateful to the minister for taking an intervention. Given that you are delaying the process, will you seek the opportunity to put in place an external advisory board to help to shape that revised legislation? We have a clear idea of the legislation going forward, and I am more than happy to articulate that case to you right now. We have had weekly engagement between the Scottish Government, COSLA and the NHS since last summer. The weekly talks built upon the shared accountability consensus that was reached on 30 June last year, and I have created a proposal for a revised version of the national care service. Subject to the will of the Scottish Parliament, the Scottish Government proposed to make amendments to the bill at stage 2 in response to evidence taken at stage 1 and on-going feedback from stakeholders. I believe that our proposals for changing the bill at stage 2 are a highly reasonable and balanced proposition. They accommodate, as far as possible, the various stakeholders' positions while ensuring that we can still effect the real change and improvements that people using services today require and deserve. The health committee and the finance committee both asked for further information, which I provided in early December before Christmas, and I provided a substantial and robust package of material, including an updated financial memorandum and an updated business case. We are committed to working with the parliamentary committees. I have already committed to the lead committee to provide information on the Scottish Government's proposed amendments in a timescale that enables them to consider to the level that they are needing. I am just closing. We are providing as much information as we can, as is appropriate in the parliamentary process, and we will continue to do so. The question is that motion 11888 be agreed. Are we all agreed? The motion is therefore agreed. The next item of business is consideration of business motions 11889 on stage 1 timetable for a bill and 11890 on stage 2 timetable for a bill, and I ask any member who wishes to speak against the motions to press their request to speak buttons. I call on George Adam on behalf of Parliamentary Bureau to move the motions. Thank you minister. No member has asked to speak against the motions. Therefore, the question is that motions 11889 and 11890 be agreed. Are we all agreed? The motions are therefore agreed, and there are six questions to be put as a result of today's business. The first is that amendment 11875.2, in the name of Jenny Gilruth, which seeks to amend motion 11875, in the name of Pam Duncan Glancy, on stand-up for quality education, be agreed. Are we all agreed? The Parliament is not agreed to, therefore we will move to vote, and there will be a short suspension to allow members to access digital voting.