 Rwyf i yn gineit i gael i fynd yw Pwyllgor �aneddwr, Llyfridogaeth nifer, pan gennyn nhw Rwth DAfford Dysiwyd yng ngheilfawr ein rhaglenu ym MhD Aberdd, a hynny llwyddiadau iawn yn cael ei gynwylliannol. Fy wydd hynny, bod ni yw teimlo'r ffluen nhw'n rherau i ei gwn ffluen nhw i fynd yn y gweithio hwnnw a rhaid i'ch gynhyrch yn fwy du, ond y pwyllgor sefydliadau iawn ar nurwch cyd-rhyw Oedon yng Ngheilfawr Cymru yn Felly, yw'r dod i ni gael y cyfan hynny, dwi'n pikeknas ei ddiweddau y mynd yn annes i neud y bydd y mlynygol yn 5 annes ar liio? Rwy'n gwiriddoch yn Y Llywodraeth a Ddeudlasach, rydym ni'n gwnaeth gwahau rydym ni'n gwahau ddeudasach. Rwyf yn gwahau y rhai adres, yn gwahau bod yr Audit Sgrotlund yn gweithio. Rwyf yn gwahau, ond mae i'n gwahau i'n gwahau uchhell oedd yr Audit Sgrotlund ddiweddau I suspect that we won't hear from the opposition today. Firstly, NHS staff are maintaining and improving the quality of care. Secondly, there is a strong culture of continuous improvement in the NHS. There is a continued focus on safety and improvement. Levels of patient satisfaction are at an all-time high in the NHS. There are signs that reforms are having a positive impact. The report also points out that, since 2008, there has been an 8.2 per cent above inflation increase in spending in the national health service, and that health today accounts for a higher proportion of the Scottish Government budget than it did in 2008. As we know, in every health service across the developed world, changing population patterns means that there are rising demands on our health service. However, in meeting those challenges in Scotland—and they are big challenges, I think, against many measures—we are seeing the NHS in Scotland perform better than the NHS in any other part of the UK. That is because of the actions we are taking. Increased investment in the NHS, reform, integration of health and social care, for example, the focus on realistic medicine and the work that we have done on A&E, and we are now doing in elective care more generally. That is tough stuff—nobody denies that—but we will continue to focus on delivering the investment and reform that the NHS needs and that patients across the country deserve. Ruth Davidson. The answer, according to Audit Scotland, was one. In one of the eight key performance indicators, there has been any improvement at all in the last five years. The reason they say is because this Scottish Government is still struggling to do the basics, and one of the big ones is staffing. Audit Scotland warned two years ago that we needed a new national approach to worse work floors planning, and the Scottish Government promised to deliver one by early 2017. That one then grew to three, two of which we are still waiting on, and the only one that has been published, according to Audit Scotland, is not a plan at all. What is more, the Auditor makes clear that there is no likelihood of the Government being able to produce a proper plan, because it still does not have the data to do so. Audit Scotland has been warning about this for years, so why is there no proper plan in place and why is not there the data to allow one to be written? One of the things that the Audit Scotland report points to is the improving data that we now have not just in the acute service but across primary care that allows us not just to monitor trends in the NHS but also to drive improvements. It is specifically one of the things that the Audit Scotland report points to as a sign of positive improvement. I make this point seriously, because I accept the challenges in the health service and I absolutely accept the responsibility of this Government, the Government that I lead, to face up to and address these challenges in Scotland. Ruth Davidson seems to want to say that the challenges in Scotland's NHS are unique to Scotland and are somehow uniquely down to this Government. If that is the case, she has to explain why, under the Conservatives in England, no NHS targets are being met. It is a serious question for the Conservatives. On the specific issue of staffing, as Ruth Davidson is aware, there has been a plan published looking specifically at NHS staff. One of the pieces of legislation that we will take forward in the coming session of Parliament is, of course, a bill to enshrine safe staffing levels in law, something that no other part of the UK is doing. Increasingly, anybody who knows anything about how health services are delivered these days knows that you cannot look at the NHS in isolation. The second and third part of the NHS and health more generally workforce plan will look at social care and local authority staffing so that we bring together an integrated plan mapping out the staffing needs for the NHS, not just now but in the years to come. That is the right way to do this, and that is what we will continue to take forward. The final point that I would make on staffing is a point that I have made before, Presiding Officer, and I will continue to make it. One of the biggest risks that we face in Scotland generally, and in the NHS in particular, is a growing inability to recruit people into our public services. Why is that? Because the Conservatives want to stop or restrict our ability to recruit the best and brightest from other countries. That is one of the biggest risks that we face to recruitment, and Ruth Davidson should be ashamed of herself for supporting that. Ruth Davidson. Presiding Officer, if I can just quote a little bit at length of what the Auditor General says specifically on the issue that the First Minister has tried to sweep under the carpet, the quote is this, it is not a detailed plan to address immediate and future issues. The Scottish Government is likely to find it challenging to provide any more detail in the next two plans. This is due to a lack of national data on the primary care and social care workforces. The data isn't there and the plan isn't there. Let's talk about one area where that lack of work force planning is having a real and immediate effect. That is in primary care, or that Scotland makes clear that GPs are central to the changes that we all agree, all of us agree, are needed to improve healthcare, but that has been hindered by the continuing difficulties in recruiting and retaining family doctors. The Royal College of GPs make it clear today. They have written that the SNP Government has consistently cut the percentage share of health spending going directly to GPs over the last decade. They ask, how can hospital targets possibly be met when people feel that they have to attend A and E because they can't secure an appointment closer to home? Does the First Minister have an answer for the Royal College of GPs? In terms of staffing, it is precisely because we need to make sure that there is an integrated plan across not just the acute health service but primary care and social care as well that we are developing the workforce plan in the way that we are doing it in the way that I think Audit Scotland would advise us to do. That is why we will continue to take forward that work. In terms of GPs, Scotland is not the only country that is experienced in challenges in recruiting GPs. That is why we are taking forward a range of different actions from increasing the number of medical training places in our universities to establishing a new graduate entry programme that will focus specifically on general practice and rural and remote working. We have seen this year an increase in the fill rate of year 1 trainees compared to last year. At the same point last year it was 65 per cent, it is up to 74 per cent this year. We, of course, have a commitment to increase the proportion of the total health budget going to primary care by £500 million over this Parliament, taking it to 11 per cent of the total NHS budget. Again, that is a greater commitment that has been made by any Government anywhere else across the islands. Those are big challenges. Anybody can stand up here, as Ruth Davidson has done, and point to the challenges. I accept the challenges, but this Government is putting in place the actions to address those challenges, and that is what we will continue to do. Ruth Davidson I am standing up here calling on the First Minister to honour the promise that she made to GPs a year ago. I am standing up for GPs who are saying that she has gone back on her words and that it is not being delivered. Today, we have had a report from the nation's auditor saying that health in Scotland is not improving and that huge inequalities remain, that there has been a 99 per cent rise in the number of outpatients waiting more than 12 weeks in the last year alone. The SNP set its own targets to make things better, but they have improved in only one in the last five years. We know that there is no long-term plan, even though one was promised for the start of this year, that GPs are being underfunded and that we spent £171 million hiring in agency staff to plug the gaps. Yesterday, I met a group of fantastic trainees at the Edinburgh Medical School. What reassurances can the First Minister give to them that, after 10 years of Audit Scotland reporting the same failings over health by her Government, she will actually have taken some action to turn it around? The number of points to take on there—firstly, agency spending in the last year is down, something that is recognised in the Audit Scotland report. We are taking the range of actions to make sure that we have the right people coming into medical training and making sure that we can get them into the NHS, delivering the excellent care that the NHS delivers for patients across the country. Again, a reminder that the Audit Scotland report points to the fact that NHS staff are not just maintaining but improving the quality of care across our NHS. Ruth Davidson understands the detail of the commitment that we have made to primary care. She said that we have not kept the commitment that we made last year. Let me tell her what the commitment is. Over the life of this Parliament, we will increase spending on primary care by £500 million, £250 million of that will be specifically in general practice. The reason not all of it is in general practice is that, in order to take pressure off our GPs, we need to build wider primary care teams. That is the commitment. That will take the proportion of NHS spending in primary care to 11 per cent. That is the commitment that we will deliver over the life of this Parliament. I would say again that that is not a commitment that is repeated by any other Government across the islands. The central point that we so often come back to when we are discussing public services in this Parliament is that the Government that I lead since we came to office has increased the health service budget by £3 billion, again recognised in the Audit Scotland report. Ruth Davidson stands up week after week calling for action and health or education across the range of our public services. However, that is the same Ruth Davidson who would reduce the amount of money that we have available for public services by giving tax cuts to the richest people in our society. It does not add up. Ruth Davidson cannot offer tax cuts to the richest while calling for more investment in our public services. The Tory policies and the Tory approach have no credibility at all, so we will continue to deliver the investment. We will continue to deliver the reform. Actually, the most important finding in this Audit Scotland report today is the one that says that those reforms that this Government is introducing are starting to show the positive effects that they are designed to do, so we will continue with that focus, delivering for people across the country. It is worth remembering that there was a report published a few weeks ago by Professor Jim Gallacher that showed that spending per heady population in Scotland compared to England had fallen as a direct result of decisions made by this Government. However, I would say that anyone reading the report from the Auditor General this morning on our NHS in Scotland cannot beat anything but concerned. Concerned about the budgets and the financial management of the health and social care in Scotland. Concerned about the shortages of staff at every level and concerned for the impact of all of that on patients. The report clearly states that the patient experience will get poorer unless the pace and scale of necessary change is actioned and actioned now. When are we going to see that level of change being actioned? As any reading of the Audit Scotland report would tell you, we are seeing that change happen in the NHS. It is one of the key findings of the Audit Scotland report, one of the key points that is made in the Audit Scotland report that we are now starting to see the reforms that have been introduced. It looks specifically at integration authorities and says that those reforms are now starting to deliver the change that we need to see. Of course, spending per head of population on the health service in Scotland is 6.5 per cent higher than it is in the UK as a whole—143 pounds higher for every person in Scotland compared to the rest of the UK. Again, this is a point that I make frequently, but my party is Government, but all parties have to be accountable for what they put forward. Labour went into the last Scottish election promising less money for the health service than any other party, even the Tories for goodness sake, represented in this Parliament. The fact of the matter is that there is record funding going into our health service. There are record numbers of people working in our health service, but, as Audit Scotland expressly says in this report, it is no longer enough just to put extra money into the health service because of the rising demand, we need to deliver reforms. Those are the reforms that we are delivering, the reforms that, according to Audit Scotland, are now starting to show real benefits to patients across the country. Alex Rowley But if we stick to the facts, the facts are that we have health boards across Scotland not able to make the cuts to balance their budgets. Those same boards are then borrowing money from the Government to balance the books, storing up debt for the future. Prescribing costs are increasing at a level that is not sustainable. Indeed, we now have council tax funding being used to be able to pay for prescriptions through the integrated joint boards. The lack of workforce planning is driving up costs, and we are having to use more and more agency staff in locums. The whole thing is spiralling out of control. The Royal College of Nursing is calling for clarity on how more care will be delivered in the community and they want to know how staff and the public will be engaged in the development of services, community services, moving forward. Can the First Minister answer that question? The First Minister I am not quite sure which one of those questions Alex Rowley wants me to answer. Alex Rowley says that prescribing costs are rising in every health service across the developed world, probably across the entire world. It is a feature of the ageing population. It is exactly the challenge that health services here and elsewhere are dealing with. That is why we have to reform how care is delivered. He asks about how we deliver more care in the community, as I am sure Alex Rowley knows, for the last two budgets. Again, it is narrated in the Audit Scotland report for the last two budgets. We have taken the very difficult step of transferring money from the NHS into integration authorities so that we bring together health and social care, not just in theory but in practice, because we know—again, the Audit Scotland talks about the reduction in delayed discharges that the integrated approach is now delivering, because if we do that to build up social care, we take the pressure off the acute services. All the parties in Pyrton are not easy stuff. It is not easy in Scotland, in England, Wales, Northern Ireland or any part of the world. In Scotland, we are doing some of the necessary stuff that is still being dodged in most other parts of the UK. We are doing the reforms, we are integrating health and social care, we are transferring the budgets, we are taking the steps around workforce that will ensure that our NHS can deliver in the face of the rising demand that it faces. That is why, while everything that the Audit Scotland report says is important and has to be addressed, the key finding of the Audit Scotland report, in my view, is First Minister with responsibility for those reforms. The key finding is that the reage reforms are starting to show positive signs. That says to me that we stick with what we are doing because we are on the right track, and that is why we keep that focus. Presiding Officer, I accept totally that this is not easy. I think that what the Audit Scotland report says today is that we are not doing enough and we are not moving fast enough. It is, however, important for us to remember that behind all those statistics, behind all those statistics, are real people. Today, we should remember that it is about people who are trapped in hospital because they cannot get the care packages that they need in the community. It is also about those people in communities up and down Scotland who cannot get the support from health and social care that they need. It is for all those people who are on the waiting list. It is the dedicated staff in our hospitals, health centres and community care centres that are run off their feet. That is why we need action. Labour will use our debate in this Parliament next week to discuss the report further. I believe that we need a more detailed discussion on the findings of the report. After 10 years in government, the First Minister has a choice. She can continue to do more of the same, or will she publish a response to the report that will tell the people of Scotland how her Government intends to tackle those big issues facing our health and social care services in Scotland? First, I welcome the fact that we will debate the report. I warmly welcome that, maybe in that debate. If Labour's position is that the Government is not doing enough, maybe Labour will bring forward some ideas as well rather than simply talk about the problems. The second point is this. The whole point here, which again any reading of the Audit Scotland report will tell you, is that we are not just doing more of the same. We are doing things differently, and it is those reforms that are starting to have the positive impact that the Audit Scotland report talks about. Alex Rowley says that we should do it faster. I am absolutely open to doing this faster, but often when we bring forward proposals for change, what we find are the impediments to those changes that sit on the Opposition benches, because they never want to do it. They just want to get up here, and it is the easiest thing in the world to get and diagnose the problems, our job and what we are doing is coming up with the solutions. I tell you what, we will not do. We will not do daft and wrong-headed things that we are seeing south of the border. Because of the action that we are taking in Scotland, delayed discharges are coming down because of sensible change. In England, we see proposals to use air B and B to rent accommodation from local residents to get all people out of hospitals. We will continue to do the sensible evidence-based things that deliver the improvements in our NHS that we are determined to continue to deliver. We have a couple of constituency questions, the first one is from Brian Whittle. The A77 was closed for 24 hours over the weekend due to severe flooding. Paul Grant, Stenolines Trade Director says, and I quote that it is quite clear from this and other incidents that the current A77 and A75 do not reflect the requirements fitting of a major UK island and freight hub. I am afraid that major disruptions and loss of trade could be a feature of life in this region until those responsible commit the necessary resources to alleviate those recurring problems. I can simply ask the First Minister, will the Scottish Government make this long overdue commitment to the people of the south-west of Scotland, and to the A75 and A77? We have a range of improvement plans for our roads in the south of Scotland, as in all parts of Scotland. I am sure that all members will appreciate that there will be times when issues such as flooding will result in a road being closed. That is deeply regrettable, but sometimes unavoidable. I will ask the transport minister to write to the member about the specific issue that he has raised in more detail. I think that anybody looking at the record of this Government—in fact, the Greens often criticise for it—would say that the investment that we have made in our roads, improving our roads over the past 10 years, is a good one, and we will continue to do more, including in the south-west and the area in particular that the member talks about. Liam McArthur The First Minister may be aware that the conclusions of the Government's review of freight ferry fares due out by the end of the summer have still not been published. Pending the outcome of that review, hauliers in the Northern Isles were told last month that freight fares would be frozen. A week later, they received notice that fares would indeed rise by 2.9 per cent next year. How does she justify that decision? How does it square with Government objectives of bearing down on the cost of living for islanders or, indeed, support for Scotland's food and drink sector? Does she believe that it is right, as Audit Scotland has highlighted, that freight fares paid by hauliers on west coast routes remain largely unchanged since 2010 but have increased significantly for hauliers serving businesses and residents in Orkney and Shetland? Of course, we have invested over £1 billion in our ferry services since 2007. In fact, we have been talking about a particular Audit Scotland report this morning. There was an Audit Scotland report out last week that said that investment in ferry services had doubled over the last decade. We have introduced new routes as part of that investment. We have also already cut fares for CalMac customers and we will shortly be doing the same for Orkney and Shetland, which I know the member will welcome. We have tackled under investment that had been the case for a long time and we will continue to do so. In terms of the ferry fares review, that will be published as soon as possible. The First Minister will be aware of the gas explosion at a derelict building in Lanarkshire recently that resulted in the tragic death of worker Pavel Erbansky, who was from Coatbridge. Can the First Minister outline how she will be supporting the investigation and what steps she is taking to enhance health and safety at work regulations in Scotland? First Minister, I want to take this opportunity to express my deepest sympathies to those affected by what was a very tragic incident, particularly for the family of Pavel Erbansky. The investigation into the death under the direction of the health and safety division of the Crown Office and Procurator Fiscal Service is on-going and, of course, the family will be kept updated in relation to any development. It would be inappropriate to comment further while those investigations are under way. The regulation of workplace health and safety is, of course, an issue reserved to the United Kingdom Government. The health and safety executives are responsible for drawing conclusions from health and safety incidents as to whether relevant regulations remain fit for purpose. I am sure that the HSE will do so once they have completed their investigation into that particular incident. I am sure that the thoughts in the meantime of everybody in the chamber are with the family and friends of the individual who lost their life in that incident. Looking at today's report into the challenges that the NHS faces, I do not think that anyone should pretend that there is a simple, quick fix that would solve every problem at a stroke, but is it not clear that challenges such as recruitment, retention and staff morale will be made worse not better if we fail to provide a fair pay settlement for the dedicated professionals providing those essential services, who have seen a real pay cut of some 14 per cent over the last five years? Yes, that is why this Government is committed to ensuring that we do see fair pay settlements for public sector workers not just in the NHS but right across our public sector. Again, I think that we are still the only Government anywhere in the UK that has given the unequivocal commitment to lift the 1 per cent public sector pay cap. The commitment has been given to lift the 1 per cent pay cap, but no commitment has yet been given to an inflation-based increase, a real-terms increase restoring the lost value in people's pay that they suffered over recent years. We have heard the SNP's Kate Forbes, the PLO to the finance secretary, someone who works with the finance secretary very closely, saying on television this week that the pay settlement for the public sector should be at least inflation if not above inflation. We have also heard a wider range of voices from multiple political parties accepting the basic green proposition that fairer rates and bands of taxation can raise adequate revenue to fund our public services without resulting in cuts elsewhere and without cutting the pay of public service workers. I do not expect the First Minister to publish our budget today, but does she agree with that basic point of principle that we can provide an inflation-based increase above inflation increase without hitting low earners through fairer taxation? First, we have given the commitment to lift the public sector pay cap. We have not made that dependent on actions that the UK Government has taken in the budget, unlike the Welsh Government, which has done exactly that. I have said personally that we must seek to pay settlements that are fair. Of course they must be affordable, but they must also reflect the real life circumstances that public sector workers are facing. Of course that includes the rising cost of living. We will, of course—this is in the normal course of events—confirm the detail of our public sector pay policy when we publish the budget because we require to know the overall budget that we have available to us before we do that. That is in the normal way that we do things and we will continue to set out policy in that way. On the part of Patrick Harvie's question that is focused on tax, I have again said openly that notwithstanding the party's different manifesto commitments, we require as a Parliament to come to a consensus position on tax in order to pass a budget. Given the continuation of austerity, given the implications of Brexit that are becoming clearer by the day, we need to ask ourselves as a Parliament how we use our still limited tax powers in order to protect our public services and provide the infrastructure that businesses need to thrive. Next week we will publish a discussion paper setting out some of the options, some of the principles that should guide that decision, and that discussion paper will then form the basis of the discussions that we have across this Parliament in the lead-up to the budget. That is a long way of saying that I agree with much of the sentiment behind Patrick Harvie's question, but we have to take proper decisions in line with the proper process of budgeting because, unlike the Opposition parties, the governing party in any Parliament has the responsibility of making sure that we can pay for the commitments that we make. The Government's policy of prioritising full-time college courses has resulted in a cut of 150,000 part-time places. It has deprived thousands of people of the education that they want and need, particularly women and older people. Last week, the education minister sent a guidance letter to colleges with an apparent change in policy that had never been announced publicly before. Can the First Minister tell me, has the policy changed and, if so, when exactly did it change? The most recent figures show that the majority of college courses were still part-time courses, but this was a commitment that we set out in a manifesto. Given the rate of youth unemployment that we faced at the time, we made a deliberate decision—and it was the right decision—to try to increase full-time places at colleges in order to increase the likelihood of people going through our colleges and getting into work at the end of that. Do you know what? The proof of the pudding is in the eating, because youth unemployment today in Scotland is half the rate that it was 10 years ago when we took office. In fact, we have one of the lowest rates of youth unemployment, not just in the UK but anywhere across the European Union. The policy that we will ask our colleges to pursue will depend on the needs of the economy at any given time, and that is the basis for the guidance that the minister put forward that Willie Rennie has referred to. However, we have taken the right decisions in our colleges, and I think that we see the evidence of that in some of the economic data that I have talked about. Willie Rennie. Nothing has changed but everything has changed. Is a bizarre answer. Has the policy changed or hasn't it changed? If this was such a success story, why did her minister sneak it out in a paragraph 7 of a letter on a wet Wednesday afternoon? Surely, if it was a success, she would be parading it in this Parliament. Everyone knows that the birth rate at the turn of the century is more responsible for the drop in youth unemployment than any policy of this Government. The truth is that it has taken six years for this Government to realise the economic value of part-time learners over the age of 24. This is a crashing U-turn, and the First Minister should be big enough to admit it. Six years of narrowing the focus has left us short. That is six years of missed economic opportunity. Six years of abusing those in this chamber who dare to question the policy. Will the First Minister now apologise to the generation of women and older people who have lost out because of this Government? First Minister, Members, I would appreciate if Members would listen to the question and then listen to the answer. Probably the fact that his pals on the Opposition benches felt that they needed to give them so much help suggests that they know how fundamentally wrong Willie Rennie is. I will not apologise for the fact that we have youth unemployment at half the rate today than it was when this Government took office. Nor will I apologise for the fact that we fought an election on a manifesto commitment to maintain full-time equivalent numbers in our colleges, and we did not just meet that manifesto commitment, but we exceeded that manifesto commitment. Those are solid achievements, but the real flaw in Willie Rennie's question is that, in spite of delivering that commitment to increase full-time students at colleges in order to get more young people into work, the majority of courses at our colleges continue to be part-time courses, open to the very people that Willie Rennie is talking about. We will continue in colleges and in every other aspect of Government policy to take forward the policies that are right for the needs of this country. That is what we have done, and that is what we will continue to do. We have got to have a couple of supplementaries. Marie Todd. Thank you, Presiding Officer. Today's daily record has figures showing that a quarter of Scottish councils are already spending almost £9 million mitigating the impact of universal credit. Does the First Minister agree with me that the impact on people left in dire financial straits, because of universal credit, is morally unacceptable and the idea that local authorities or the Scottish Government should have to pay the price for failed Westminster austerity is a disgrace? The fact that the UK Government is refusing to pause the implementation of universal credit knowing that it is pushing already vulnerable people into debt, into rent arrears, making it difficult for parents to put food on the table to feed their children, is not just morally unacceptable, it is morally repugnant, and I think that every Conservative should be deeply ashamed of this. The fact of the matter is that universal credit is not working, and that is being demonstrated in the pilot areas that I have spoken before about a visit that I made to Inverness, talking directly to people who have found themselves in these unacceptable situations. We need to see a pause to universal credit, and we need to see that happen now before any other person has to suffer the indignities and the anxieties that so many have already suffered. Again, we come back to this issue about mitigation. As people across the chamber know, we should mitigate where we can, but we should not have to spend money that should be getting spent on education or health or colleges mitigating welfare cuts that are implemented and imposed by a Conservative Government at Westminster. The sooner we get all of welfare powers into the hands of this Parliament, the better. Do you believe that cutting yet more firefighter posts and closing fire stations will, A, make our communities safer, or B, put more lives at risk? If you do not know the answer, have a guess. Sometimes you only have to listen to Neil Findlay's tone to understand why Labour is in the dire straits that they are in. It is shockingly bad. First, let me take the opportunity to thank our firemen and women right across the country for the essential and vital work that they do. It is the important presence of that work that has meant that the Scottish Government this year has increased the operational budget of the fire service. There has been since reform, no compulsory redundancies, no fire station closures. In fact, over the last year, we have seen the recruitment of 100 new firefighters. The fire service, just like any other public sector, cannot stand still when circumstances are changing. There are changing risks, changing patterns of demand, changing technology. It is right that the fire service looks closely at how they deal with that, but as they do, the priority of them and of this Government is not just in protecting the front line, but in enabling our firefighters to do an even better service for the people of Scotland in the future. Can I ask the First Minister what progress has been made with the reaching 100 programme to connect premises that have not received support from the previous programmes for access to superfast broadband? The Digital Scotland Superfast Broadband programme has been a huge success so far. It has already enabled fibre broadband to be delivered to over 800,000 premises in Scotland, and we are on track to meet our target of 95 per cent of premises with broadband access by the end of this year. However, we recognise that many areas still do not have access. That is why the reaching 100 programme will focus on extending superfast access to those premises that will not be reached in the current programme. We have completed an open market review and public consultation to formally agree an intervention area and undertake an extensive supplier engagement to maximise competition. We will set out our delivery approach in greater detail shortly ahead of the launch of a procurement exercise later in the year. I congratulate the Scottish Government on its success in rolling out superfast broadband and accelerating the policy given the slowness of previous UK Governments. Tens of thousands of my constituents have certainly benefited from the programme. However, I wonder if the First Minister has recognised that the one side effect of the success is the gap between the haves and the haves not. I have just got bigger, and many rural communities have not benefited or received any form of public support. Although we will await the next programme and the roll-out of R100, can ministers consider any other further short-term measures, perhaps working with the private sector, to connect such communities who, in this day and age, see connection as a utility and not a luxury? Can Scottish ministers also press UK ministers to introduce appropriate regulation, such as introducing universal obligations and dealing with the likes of BT, who are charging customers similar amounts every month for widening, varying levels of service? I am very acutely aware that some premises, particularly in the rural parts of the country, do not yet have fibre broadband access. That is why the reaching 100 programme will seek to prioritise those communities through the initial procurement exercise. In the meantime, the better broadband scheme already offers residents of premises with broadband speeds of less than 2 megabits per second, a voucher code that subsidises the cost associated with alternative broadband solutions. I am sure that all members will want to make their constituents aware of that. As Richard Lochhead knows, telecoms is a wholly reserved function. There are a range of issues that I think need to address, and we are working closely with OFCOM to ensure that Scotland's particular challenges are considered and indeed calling for a more regional approach. I think that issues such as universal service obligation are important ones, although with the current discussion around a USO being taken forward by the UK Government, the problem with that, of course, is that it is not delivering broadband at super-fast speeds. However, we will continue to deliver on our own programme and continue to press the UK Government to take action that it needs to take in order to deliver the same. Thank you, Presiding Officer. To ask the First Minister what action the Scottish Government is taking to hold to account NHS boards that do not meet their waiting times targets. First Minister. We work with and support NHS boards to improve delivery of waiting times targets. In May, we, for example, announced that £50 million had been made available to improve waiting times between now and the end of March next year. In August, we also announced the setting up of an expert group to improve the way elective care services are managed across all boards. Derek Bell of the Academy of Royal Colleges, who will lead that work, was the same person who did similar work that led to the improvement of A and E waiting times. Of course, we are investing £200 million in a network of five new elective and diagnostic centres over the period of this Parliament. Edward Mountain. I thank the First Minister for that answer, and I would like to put out a few things here to help the First Minister so that she does not have to address them in her answer. We accept hard-pressed staff in NHS Scotland who are committed, dedicated and hard-working, and we do appreciate what they do. Saying that failing to reach seven out of 10 targets is okay because other places in the UK are worse, it does not help people who are waiting for treatment. Making targets easier is not acceptable, and just increasing spending on the NHS won't be solved the problem. Therefore, I turn to the Audit Scotland report. It says that previous approaches such as providing more funding to increase activity or focusing on specific parts of the system is no longer sufficient. There is no doubt that the situation is getting worse, and the Health Secretary was unable to say this morning on Radio Scotland when it would get better. We need transformational and inspirational leadership. What is the First Minister going to do to ensure that our NHS has the leadership that it desperately needs, but clearly lacks? We certainly will not do what other Governments are doing, and that is to privatise the NHS, something that the member will know a lot about. There was so much in that—I was going to say question, but it was not really a question, but there was so much in there that it is just wrong. Making targets easier. One of the things that we have done over the past 10 years is to make many of the NHS targets tougher. That is part of the challenge that we face, and many of them, while, yes—and I have never said that it is okay that we are not meeting them—we are performing better against tougher targets than used to be the case against targets that were weaker. We are toughening up many of those targets, in other words, stretching our expectations of what the NHS delivers, at the same time as demand on the NHS is increasing. We will continue to take the action that I have already set out here several times today, investing record sums in our NHS, making sure that there are record numbers of people working in our NHS, but also taking forward the difficult but necessary reforms that will equip our NHS to deal with rising demand now and in the years to come. To ask the First Minister what the Scottish Government's position is and whether public sector workers should be given a real-terms pay increase in 2018-19. As I have already made clear today, the 1 per cent public sector pay cap will end in 2018-19. I fully understand the impact that increasing living costs and social security cuts are having on working households and we will set out our plans fully in the draft budget on 14 December. We will develop a pay policy that is affordable but also one that recognises real-life circumstances such as the cost of living while continuing to support those on the lowest incomes. Public sector workers, both in Scotland and across the UK, deserve a fair deal and the UK Government should follow our lead in lifting the pay cap, of course, ensuring that there is then proper investment in our vital public services. James Kelly Thank the First Minister for that answer. In recent years, the policy of a public sector pay cap followed by the Scottish Government has resulted in 156,000 health service and police staff being worse off in real terms. That is unacceptable and the budget is the opportunity to address that. When the issue was raised previously by Patrick Harvie in this session, we get two minutes of waffle from the First Minister on it. Let me give the First Minister another chance to answer the question. Does the First Minister accept the position that was set out by Kate Forbes in Scotland tonight that the pay rise should be set at least inflation? Will the Government bring forward the consequential tax changes that are required to give public sector workers the pay rise that they deserve? The First Minister We will bring forward the detail of our spending plans and our tax plans in the budget that will be published in 14 December. However, the hypocrisy of Labour on this issue is quite frankly staggering, because we have said that the pay cap will be lifted. We have not made that dependent on actions taken elsewhere, and that is completely different to the position taken by Labour in the Welsh—I have a letter here. No, they will not want to hear this. I have a letter here, written by the Labour Health Secretary in Wales to Jeremy Hunt, the UK Health Secretary. It says this, and I am quoting, without a commitment from the UK Government to give the Welsh Government more money, the public sector pay cap will remain. That is what Labour in Wales saved. Here is what we have got. Labour calls for the cap to be lifted in Scotland. It calls for the cap to be lifted in Westminster. In Wales, the only part of the UK where it has the power not just to call for things to be done, but to do things, Labour refuses to give a commitment to raising the public sector pay cap. What does that tell us about Labour? This is what it tells us about Labour. Labour are all mouth and no action. The First Minister's question time is over. We now move to members' business and the name of Jeremy Balfour. We will just take a few moments for members to change seats.