 Felly, mae teitwys yne 7192 i'r ddwyg deulajor Douglas Ross, ond hefyd o gweithgareddau wifi yng Nghyrgrwsgol. The debate will be concluded without any questions being put, and I will be grateful for those members who wished to speak in the debate were to press their request to speak buttons now. I call on Douglas Ross to open the debate. Thank you very much, Presiding Officer, and best wishes for the festive period to yourself and all the staff of Parliament, as well. I will give a brief background on the situation with the Murray Maternity Services, because it has been debated many times in this chamber before. People will be aware that in 2018 we had a temporary downgrade for one year announced, which continues now as we come to the end of 2022. I asked for this debate and I submitted the motion because just last week NHS Grampian finally produced its plan to deliver model 6, which is a return to consultant-led maternity services. It is important, as the final debate of this session and indeed the final debate of this Parliament this year, that members from across the political spectrum and the Cabinet Secretary are able to articulate their initial thoughts on model 6, raise questions about it and hopefully seek reassurances. I also want to say, as I always do, how much I appreciate as a local representative the work of Keat Mum and Maternity Voices Partnership, who have done incredible work and continue to do outstanding work raising the cases for Murray Mums and families. I also appreciate the fact that this is a cross-party issue. I know Richard Lockhead is a minister and cannot fully contribute today, but he is here again. Rhoda Grant has been a great champion for this issue. My Highlands and Islands colleagues, Jamie Halcro Johnston, Edward Mountain and Donald Cameron, as well. I think that that is welcome that we have this cross-party consensus. I would just briefly, and I do not want to dwell on this point, however, note that when I raised this issue as MP for Murray in the House of Commons last week and I was articulating the concerns of Murray Mums, women and families, I was told diddums by Brenda Nohara, the MP for Argyll and Bute. I am sure that the Cabinet Secretary will want to disassociate himself with the words of his colleague. Model 6 was put forward by NHS Grampian at their board meeting last week. I want to say from the outset that I welcome the fact that we now have a plan to deliver model 6. We all want to see a return to consultant-led maternity services at Dr Gray's. My worry is the timing, because the report states that it could take up to, from 2018 to the reintroduction of the service, a total of nine years. I am also worried about the wording. Page 7 of the report of NHS Grampian states that consultant-led bursts could take place as early as the end of 2026 or early 2027. I worry that the word could is doing a lot of heavy lifting in that report. Let's remember that we were told one year from 2018. We are now in 2022, coming in to 2023, and we are told that it could be the end of 2026 or into 2027. We need the pace to be far quicker than that, Presiding Officer. I will give way to Richard Lochhead. I thank Douglas Ross very much for giving way, and the cross-party spirit of this issue is very, very important. I share the member's concern that this has taken far, far too long to get to the stage of where we are today. Of course, we can't change the past. We have to shape the future. One of the member agrees with me that what we need now is a laser-like focus from NHS Grampian and NHS Education Scotland, with, I hope, support from the Scottish Government on recruitment. I understand from the plan that perhaps not far shorter 30 staff will be required to get full restoration of the service, including many specialists and medical staff. Therefore, the sooner we can recruit, the sooner we can bring that date forward, and that's the absolute key to progress. Douglas Ross, I can give you that time back. I'm grateful that you played, Presiding Officer. I agree wholeheartedly with what Richard Lochhead has said. That laser focus must come from the health board, from NHS Grampian, must and, I hope, will come from the Scottish Government, and all the authorities involved here. I would also say that I've got fears, because Richard Lochhead knows, as well as I do, that we've had campaigns to recruit people to Murray before in education. They have been successful for a period, and then they've dwindled away. When people come to Murray, they never want to leave. It's getting them there in the first place. A concern that I have with the Model 6 report is that there's nothing new. We are speaking about significant numbers of staff that we need to attract there, and I'm not hearing much new from the health board about how they will achieve that, but hopefully that will change going forward. The other area that I want to speak about is C sections. The health secretary said last year that he wanted to see a rapid reintroduction of elective caesarians, yet the report tells us that, under the Model 6 plans, it will be more than two years until those elective C sections will be introduced. Why was the health secretary very, hopefully and very enthusiastically saying that we could see a rapid reintroduction of those elective caesarians over a year ago, but now we're told that it will be several more years to come? The other issue that I really want to focus on is Model 6. It is the ultimate destination. We want to get there very quick, but it is underpinned by NHS Grampian on Model 4. Model 4 is seeing more Murray mums giving birth in Inverness. I think that it's a red herring. I want to totally separate, as my motion says, Model 4 from Model 6. It's fundamentally flawed. It's fraught with patient safety concerns, littered with factual errors and baseless assumptions and should be rejected. The health secretary will note that those are not my words. They are the words of clinicians at Raymore hospital, where Model 4 suggests that more Murray mums should go to give birth. Why are we still on this proposal from NHS Grampian suggesting that Model 6, years down the line, has to be underpinned by Model 4? The senior clinicians are advising that Model 4 should be abandoned, yet it still hangs over Model 6. More shockingly, Deputy Presiding Officer, when this proposal was discussed by the NHS board just a week ago and all of the factors on Model 4 that underpinned their plan for Model 6, the clinicians' concerns were mentioned not once. Not a single reference at the health board meeting to the concerns that are being raised by clinicians. I think that that is shocking. I think that it's unacceptable by the board and I don't know why they're not addressing these issues. I spoke to one of the clinicians at Raymore on Tuesday and he told me that, behind the scenes, no-one is proposing anything that would make Model 4 deliverable in either the short or the medium term. Local campaigners are telling us the exact same. Keep Mum have said that there is no evidence to explain how Model 4 leads to Model 6. I will give way to the cabinet secretary. I'm really grateful to Douglas Ross for giving way and I just wanted to ask him, I'll come to the model for Model 6 part of my own contribution. Even if there wasn't a Model 4, does he agree that, for the sustainability of services, that there should be cross-boundary working for maternity services for the north of Scotland? Of course. I do agree with that. My constituents living in Brody are far closer to Raymore hospital than my constituents living in Cullen, who are closer to Aberdeen Royal Infirmary. At the moment, that's not working. I know when Edward Mountain and Jamie Halcro Johnston will discuss that. There are capacity issues at the moment at Raymore, and clinicians are raising those problems, yet it is not being addressed by NHS Grampian. I know I've taken up a bit of time, so I don't want to skirt with any issues with you, Deputy Presiding Officer, so I'll try to focus on the last couple of remarks that I want to say. My motion is clear. I want us to focus on Model 6. The clinicians are telling us to focus on Model 6, and so are the campaigners. Some of the requests that I've got for the cabinet secretary, if that is possible. First of all, we know that there is little faith in the milestones of Model 4 and Model 6 being delivered if there's not independent oversight. So what is he looking to do to ensure that there is the comfort from campaigners that we will achieve the milestones and that they will be recognised independently? NHS Grampian has continually lit down Murray, and the trust in the health board is at rock bottom, and nothing I've heard so far will improve that, to the extent that Keat Mum was not even involved in the development of Model 6 and the paper that went to the board. They were asked to comment afterwards, why were they not involved in the paper? Will he put in a project management team to ensure that those milestones are met and ensure that the project manager is from outwith NHS Grampian? On staffing that Richard Lochhead raised, what conversations has the cabinet secretary had with NHS Education Scotland to make sure that the 2018 issue of junior doctor shortages is not repeated in the future and the additional recruitment that's required by the report is provided? Why will it take until March next year to develop a strategy to market Murray? I said to Richard Lochhead that there has been cross-party efforts for years to recruit more people to Murray. What new is going to come up and why does that not start immediately? There's a request for additional funding from NHS Grampian. Can the cabinet secretary confirm that request will be met to allow NHS Grampian to go on with their planning as quickly as possible? The last couple of points. Can the cabinet secretary look at the urgent re-establishment and expansion of the UHI midwifery course? Again, that came up with clinicians. That will make a big difference to NHS Highland and what we're trying to do at Dr Gray's. Deputy Presiding Officer, to close, I've always said that the staff and the teams at Dr Gray's do outstanding work. I've been blessed to have one child there and I would like to see more and more Murray mums and Murray families able to have their children there. Model 6 is the right approach, but we should have all the focus, all the attention, all the resources on delivering Model 6 as quickly as possible. Hundreds and hundreds of Murray families can see their children being born locally in the excellent facilities under the excellent care of the staff at Dr Gray's. Thank you. Thank you very much, Mr Ross, in the spirit of the week and the season. I'm happy to give a little extra time. Karen Adam, to be followed by Edward Mountain. Around four minutes, Ms Happ. Thank you, Presiding Officer. When Douglas Ross said there that he was hoping to see more and more, I thought that he was going to say of his children born there. I thought that he was giving us a little insight into the future there. I'm really pleased to be able to speak on this motion for two reasons. Firstly, because, as an elective representative for Banffshire and Buckingham Coast, the mums to be across my constituency clearly deserve safe and accessible maternity services. Obviously, that applies to those in the western end of my constituency, which includes part of Murray. That's why I've publicly welcomed the Scottish Government's commitment to restoring consultant-led maternity services at Dr Gray's in Elgin. What's more, I've met with local campaign groups and the health board to get a better understanding of what it will take to achieve that goal. Secondly, as a mum with six children, I'm speaking from direct experience here when it comes to the importance of maternity services. I know the sense of security that they provide, and although they don't take away all the anxieties about giving birth, as any mother would appreciate, the knowledge that there's medical expertise on hand is always a comfort. More than that, it is essential in times of emergency. I've had experience of that having to travel long distances from a rural location into the city of Aberdeen, and people watching me may know or understand that when your waters break, if there's meconium in that, it's quite a dangerous situation, and you really do need medical assistance instantly, and I've had that experience. I am coming from a place of empathy in that regard. If we all want decent maternity services at Dr Gray's for the benefit of mums to be in Murray, how do we reach that goal? We do it by being realistic about the availability of staff, we do it with properly considered planning and we do it by taking the views of local people on board, and we do it with timescales that make sense. We don't rush in because of political expediency, either. If you go back to 2018, when the provision of maternity services changed, one of the big reasons given was because of workforce availability. That was before I became an MSP, but it certainly rings true given my experience since I was elected last year. Time after time, across Bampshire, Buckingham Coast, Health, Social Care and other sectors, like Douglas Ross mentioned, I hear stories about problems with recruitment. In general, terms of vacancies can be there, but it's hard to attract qualified professionals to come and work in North Aberdeenshire and Murray, and it's a problem across much of rural Scotland. It's something that's subject to on-going work by private companies and public bodies. I don't underestimate what they try to do within their sectors, but it's not least within grampiant and highland health boards as regards to maternity services. I'm glad that this work is happening and I'm certainly willing to collaborate with anyone looking to solve this problem. I'm glad to hear that Mr Ross brought it up in Westminster and I would ask him if he could please push on the subject of freedom of movement for qualified professionals and perhaps near neighbours in Europe, for example, would be appreciated. However, to move on to the detail of the planning around maternity services in Elgin, I have sought assurances around the model 4 plans, which could deliver our networked community maternity unit as part of the journey to model 6. I know that the Scottish Government has asked for further work to be done before they go ahead and approve anything. I have also asked the Scottish Government that the lived experience of women and families in Murray is central to decision making on the issue, and I commend NHS Grampian on its development of the model 6 plans, which will deliver full consultant-led maternity services once again, hopefully by the end of 2026. I echo my colleague who represents Murray, Richard Lochhead MSP, who said that NHS Grampian should approach this with a can-do attitude and a commitment to delivery excuse the pun. From the top, the Cabinet Secretary for Health and Social Care has given his cast iron commitment to those services and we all need to be a part of that commitment. Whether elected representatives from either side of this chamber or healthcare professionals, in conclusion, I would say that full maternity services will come back to Elgin and that will benefit women and families in the local area, including my constituency. However, they must return in a way that is person-centred, sustainable and professionally planned. Only two days ago, I received an email from the campaign group Keat Mum, who has been absolutely incredible, and I quote from them, there must be a dynamic project management team in place with strict external oversight to make sure that milestones are met and I see nothing to disagree with there. Thank you, Presiding Officer. I just say at the outset, Douglas Ross's words and wise words, and they actually come from the heart, not only of his constituents, but also the fact that he's been through this and seen firsthand what effect this is. I have to say at the outset also that I do feel sorry for the cabinet secretary, and it is some pity because it's not his problem. The problem is that he's been left holding the baby because it was his predecessor's problem and her predecessor's problem where this all started. So I know that cabinet secretary's got a lot to deal with, and I think I would also just make the point that we're all after option six for Murray, and it's got to be done as quickly as possible. I'm going to come at this from the other way round, from the Highland Perspective, if I may, and talk about option four and why option four is such a threat to, I believe, to the Highland Service. First of all, we have to remember that Reg Moore recently had to take on all the duties of gynaecology and midwifery from Caithness, and that took on a huge strain, and about an extra 250 mothers a year come down from Caithness now to Reg Moore. I think that there was only eight births in Caithness last year, so not many, most of them are coming down to Reg Moore, and Reg Moore's having to cope with that without one single extra bed. Now, I know that the cabinet secretary's been and looked at the facilities at Reg Moore, but they're 25, 30 years old, pretty rudimentary if I could be so bold as to say that. In fact, if your baby is put into the special care unit there, you cannot even get taken down there on a bed if you've just delivered on the basis that corridors are too narrow. In fact, nurses can't work in the special care baby unit except for to deliver the care because there's no station for making notes, there's no ability for them to work round it. So option 4 is being discussed, and what's happened, I've looked at the plans and, you know, the £5 million that were promised by the cabinet secretary for option 4 to deliver the extra facilities will not deliver one extra bed, not one extra bed, but what Reg Moore is being told is that they may have to take on an extra 500 patients from Murray till option 6 is sorted out. Now, that's a real issue because while those 500 patients are coming to Reg Moore and the facilities are being upgraded, the whole services at Reg Moore will have to relocate, relocate through the rest of the hospital. There aren't the facilities for that. I shouldn't have to remind you, cabinet secretary, there's 3,200 people waiting for orthopedic operations alone in Reg Moore. If you relocate the maternity unit to another unit, another ward in Reg Moore, it means operations will have to suffer, and that's just not good enough. And it also means that you're going to fracture the delivery of the service because you won't be able to concentrate all the midwifery and the services that are provided there in one ward. And they don't have the facilities, they have no way of extracting, for example, the gases that are used during delivery, anaesthetic gases, which means that patients, not only mothers delivering will feel the benefit from it, but those staff that are working around them will also have to deal with it, and that makes it very dangerous for them in extended periods of treatment. Now, I see the clocks ticking down, but, cabinet secretary, you went up there, you met with the clinicians and they've told you option 4 is not safe. Now, if somebody tells you that, you've got to be really careful because what I perceive is going to happen, cabinet secretary, is that if you push on with option 4 and all is just finishing off, Presiding Officer, if you push on with option 4, that what will happen is mums coming down from Caithness will not be able to get in because the beds are all full and their ambulance will be just diverted to the next available hospital, which from Caithness, if you get to Highland and you've spent two hours strapped on a gurney to get to Raigmore, the thought of spending two and a half hours to get to Perth or two and a half hours to get to Aberdeen is just not acceptable. So, I say, as I'm representing the Highlands and talking specifically about Highland mums and Caithness mums in particular, what you're proposing on option 4, you're told it's not safe, is not acceptable, and whilst I always would encourage cross-border and cross-health board working to do so when you're being told it's not safe, is not something that I could ever countenance or support you in doing. To be followed by Finlay Carson around four minutes, Ms Grant. Thank you, Presiding Officer, and I want to congratulate Douglas Ross on securing the debate and indeed to keep mum and the other campaigners who ensure that this issue is not forgotten. And, like Edward Mountain, I also want to highlight the similar plight in Caithness for the community there and hope that they will not be ignored when fighting for similar services. No-one looking at the photos and film footage of the roads in the last week could be anything other than horrified at the prospecting of driving in these conditions, but that is the reality for pregnant women and muddy in Caithness. Imagine having to drive those roads while driving someone in labour trying desperately to get to a suitably equipped hospital. Should not be the case where there are enough births to warrant suitably trained staff that there should be support for complex labour and births. Those of my generation remember the tragic case when a midwife paramedic and baby died when being transferred from Skye to Inverness on icy roads. It can still happen and we cannot have this happen again, especially when we have the ability to provide services much closer to people. Members of the maried community do not have faith that NHS Grampian will implement model 6, which reinstates from maternity services at Dr Gray's hospital in Elgin, and they do not believe that NHS Highland is the resources of the staff to implement the interim model 4, where women can elect to go to Regmore hospital in Inverness, rather than Aberdeen. As Douglas Ross pointed out, those concerns regarding model 4 are shared by clinical staff in Regmore, and I take their intervention very seriously. Keep Mum has asked for an independent oversight of the project to reinstate services to Dr Gray's hospital by somebody outside the Grampian NHS Board, and they would prefer someone from the community who understands the issue, and I believe that that would be helpful when rebuilding trust. However, it might also require oversight from someone with the authority of the Scottish Government who can act on behalf of the Cabinet Secretary. That oversight would give comfort to the community, campaigners and, indeed, politicians such as ourselves, that the reinstatement of services was being pursued with sufficient urgency. Therefore, I ask the Scottish Government and the Cabinet Secretary if they would consider that request and address that today or undertake to come back with their thoughts on how that could happen at a later date. Members of the community also believe that the basic information on which those models are based is not robust. They believe that there will be many more births moved to Aberdeen and to Inverness than is suggested. One of the reasons for originally withdrawing maternity services from Dr Gray's was staffing, and we have heard about that, the lack of junior doctors, and it is an issue in all rural hospitals and communities. Because of that, we miss out on fully trained staff, because we all know where people train, they put down their routes on this day. If junior doctors are not placed in rural health locations, we lose them forever. That concern applies with regard to all health professionals in rural areas, and it will continue until we ensure that rural areas have an adequate supply of trainees and junior staff. I have raised that with NHS education in Scotland, but can I ask and summing up if the Cabinet Secretary would say what steps the Scottish Government is taking to ensure that that happens? The NHS Grampian board report is full of caveats, and I share concerns that they may never reinstate full maternity services without a concerted effort. I am also concerned to learn that NHS Grampian does not normally invite elected representatives for Murray to their regular MSP briefings, and neither do they brief regional MSPs on progress on those issues. Something that I believe is absolutely unacceptable and, sadly, that gives an indication of the importance of place in the community in Murray when they do not believe that they are required to brief their elected representatives, especially at a time like this. I hope that that will change, because it does not give me confidence in NHS Grampian at all. I now call Finlay Carson to be followed by Calmogh in around four minutes. Thank you very much, Presiding Officer, and I pass on my good wishes for the festive season and recognise your generous generosity at this festive time when I give my contribution. From the outset, I wholeheartedly sympathise with my colleague Douglas Ross in the problems that he is facing around the serious lack of maternity services at Dr Gray's hospital in Elgin. While my contribution is not specifically about Dr Gray's, I believe, with your indulgence, Presiding Officer, it will highlight that this is the case, not just in Murray, but in other rural areas where the trust and health boards are at rock bottom. I am sure that it will be of little comfort to Douglas Ross to know that he is not alone in witnessing a serious erosion of health services in his constituency. In Galloway and Western Ffries we are experiencing a similar crisis, also one that needs to be rectified as a matter of urgency. There has been much talk in this debate about option 4 or option 6, but in Galloway we have no option. Mothers to be in Wightonshire are facing the daunting prospect of a 70-mile trip to Dumfries and Galloway royal infirmary, a journey that can often take two hours in order to give birth. I know from experience my wife had to stay for a period prior to giving birth in DGRI because of a condition she had meant that there was too much risk in her possibly taking an hour or more to get to hospital when Labour started. Incredibly, there is a midwife-led community maternity unit in Stranraer, which was once the eighth busiest in Scotland, but bizarrely it is currently closed. What makes this situation all the more galling is the fact that there are four midwives who live in the immediate area but have to travel to Dumfries instead of being employed locally in that unit. I know that there is an independently reviewed formula used to identify funding for health boards, but it is fair to ask whether it is fit for purpose when it comes to areas such as Murray and Galloway. Clearly, it is unacceptable that there are glaring health inequalities when it comes to dealing with pregnant women in my constituency who are having to meet this two-hour car journey or by ambulance. I can also point out that there have been numerous incidents of women giving birth in labies along the E75 as recently as last month. In November, the Minister for Women's Health, Mary Todd, visited the unit at Stranraer to see for herself and the facilities and offer, but sadly it remains closed. The minister was also involved in discussions where one woman was tragically suffered a miscarriage but still had to make the long, long journey from Stranraer to Dumfries. That lady bravely told of her heart-wrenching experience that was wholly exasperated by the fact that she couldn't go to her local maternity unit in Stranraer. That shouldn't be allowed to happen in this day and age. To face such untold stress and anxiety while about to give birth, this is something that should be a joyful and memorable experience, but that's been denied to so many women in Wigtonshire. I know that the cabinet secretary has reiterated that all health services, not just maternity, should be provided as close to home as possible, which is of course a positive step, but I sincerely hope that we stick to that commitment and put sufficient pressure on Dumfries and Galloway health board to deliver on providing maternity services in Stranraer. Of course, it's not just maternity services that are being affected but other health services previously delivered at the likes of our cottage hospitals, which have been largely paused since the outbreak of the pandemic. Again, Dumfries and Galloway health board have refused to instigate a full return of these health services previously provided in Castle Douglas, Cacubria, Newton Stewart and Moffitt, even though that's not in my constituency. There's been enormous strength of local feeling about the importance of delivering a range of health services such as palliative care and step down care in our cottage hospitals. It's abundantly clear that people need to be cared for as close as possible rather than have to undertake journeys that are unreasonable. In conclusion, it's important that the Scottish Government and indeed health boards listen to the people that matter, the public, and that means everywhere in rural and urban areas. They deserve and demand maternity and other health services on the doorsteps where they live. Thank you very much, Mr Carson. I think that you may have tested to destructing the definition of relevance, but at least you didn't dress it up as a point of order, so thank goodness for small mercies. Final speaker on the open debate, Calmwalk. Members will be pleased that some of my contributions have been made, so I will be quite brief, but I wanted to thank Douglas Ross for bringing the debate to the chamber. One of the first speeches that I made in Parliament in June 2021 was a motion brought by Douglas Ross calling for an action to deliver locally-based maternity services for women in Moray. It is a concern, Deputy Presiding Officer. I think that we can all agree that we are here again some 18 months later debating the same topic. Part of my contribution was going to be to speak a bit about what Finlay Carson had been saying in my own south of Scotland region. I know women who are having to travel from Stranraer right across to Dumfries, and it is wholly unacceptable. If you have ever been on that road, you would absolutely accept that point. I hope that the cabinet secretary has something to say on that. A few words to close up. I think that people will know that I have brought to the chamber many times the issue of the women's champion. It is yet another example of, unfortunately, the Scottish Government falling short in terms of marks of women's health. It is clear that a women's health champion is needed to spearhead many women's health-related campaigns and issues, but I think that that gives us a clear indication that we have to get that in place. People will know that I have been asking since June when we could get an appointment made for a women's champion. I say to the minister, please can this be one of the first appointments made in 2023, because we need someone who can push those issues and scrutinise those issues and go back to the Government and also report for us so that we have this information in Parliament. It would benefit the women in Moray, the discussion of this member's debate in my constituency, but I am sure that there will be other examples. It is really important that we get that done. I pay tribute to the campaigners who have consistently stood up for the services that they want to have. It is our responsibility to keep bringing that to the chamber and to push the Government harder and harder on that issue. I will not stop asking for the women's champion to be put in place, because I fully believe that it will help us to address some of those issues. Thank you, Deputy Presiding Officer. I begin as you did and as many others did in wishing everybody all the very best for the festive season, the very merry Christmas indeed and all the best for 2023. I have a secret list of who I think will be getting a lump of coal on Christmas, but it would be uncharantable for me to even suggest who might be on such a list. I thank Douglas Ross for securing the important members' debate. I am pleased that, notwithstanding the exceptionally long nights that we have had over the past couple of nights, engaging in the GRR bill, we were still able to make time for the business bill before this important debate. It is important not just to the members in the chamber, but we know very many people right across Murray, but as Finlay Carson has demonstrated, he is right across Scotland as well. I am pleased to acknowledge that there is an exceptionally good cross-party campaign in this regard. I have met a number of elected members, of course with Douglas Ross and Richard Lochhead, Rhoda Grant and many others right across the various different levels of the political spectrum and across political parties on what I think is an excellent campaign. In my very opening restate to the Government's absolutely cast iron commitment, as Karen Adam asked me to do, cast iron commitment to returning consultant-led maternity services at Dr Gray's. I will go through the background because I think that people are very aware of it and have heard of the background from other members. I will try to address some of the points that have been raised. Let me come to a point that has been made by a number of colleagues across the chamber. Edward Mountain made this point most forcibly in his contribution. It is so important that we listen to clinicians, whether they are in Rhegmore, whether they are clinicians in Dr Gray's. That clinical expertise is exceptionally important. I do not want anybody to leave the chamber thinking that I do not listen and put a lot of stock and weight on the opinion and expertise of clinicians. That is why, when I stood here last talking about Dr Gray's in this chamber, I was not in a position to be able to approve the model 4 plans. Frankly, the concerns raised by clinicians to me were playing heavily on my mind. I will reflect on the question that Douglas Ross has posed and others have posed to me in relation to model 4. The concerns that have been raised by them as elected members, by Keat Mum, by NBP and others as well. I think that model 4 has probably become a distraction. What we are trying to do is to describe an improvement journey with all the elements that are required for effectively that integrated model. When I asked Douglas Ross, do you believe in that cross boundary working, his answer was absolutely, and I think that that is right. If we are going to have a sustainable model with all the recruitment challenges that we know that we have, not just in the north-east of Scotland but in many areas of remote rural and island Scotland, then that cross boundary working is going to be exceptionally important. It is fair to say that there are concerns around model 4, clinical concerns, community concerns, elected representative concerns around model 4. I have to say that in terms of model 6, the plan that we have in front of us, I know that it will not go fast enough for many people, but I would say that it is far more ambitious than, for example, when I was standing in this chamber many months ago and people were saying that it might take 10 years or 7 years or that is what they had heard from others, so we have a more ambitious model 6 plan. With all those things taken into account, I have decided that we will not continue with model 4 as previously outlined. However, I do expect, as I have already said, I expect NHS Highland and the Grampian to continue to work together to ensure the sustainable maternity services for women in the north of Scotland. Of course I will go away. Douglas Ross, I am grateful to the cabinet secretary for giving way and that is a very welcome announcement. That is what I ask for in this motion. It is what campaigners have been asking for. He is saying that he will not continue with model 4 in its current form. We cannot just have a change of name. I am just trying to tease this out. The concerns will remain if it is called something different, if it is just slightly tweaked. What does he mean by we will not continue with model 4 in its current form? On his point about me agreeing with the cross-border opportunities, we know with model 6 that there will still be a need for some months, in some circumstances, to go to Aberdeen. We all accept that, but they should be the exception rather than the rule. I want to see as many as possible of the 1,000 burst average in Murray each year happening at Dr Gray's. I suspect that I am not going to be able to do this issue justice in the time that we have, so I am happy to, as always, pick up with Douglas Ross and other members and maybe even do a briefing for cross-party members to address some of those issues. What I mean is that our laser-like focus should absolutely be on model 6, the end destination, and the full return and restoration of consultant-led contagious services to Dr Gray. We will not be proceeding with model 4, as per Ralph Roberts's report. What I would say is really important, though, is that it is really, for me, vital that, where there are recruitment challenges, there may be cross-boundary working in relation to ensuring that the service is sustainable. Dr Gray's, what I also mean, for example, is that Douglas Ross knows that, in the plan that has been put forward in relation to model 6 by NHS Grampian, it makes the point—and endorsed, of course, by NHS Highland—that we are going to put significant investment into Rhaigmoor, because of all the reasons that have been articulated by Edward Mountain already. It is a need of refurbishment and so on and so forth, and not just refurbishment, I think that there is a need to invest absolutely in the workforce in Rhaigmoor 2. If there is a time period, as per the plan at the moment, where Rhaigmoor has the capacity—clinical—has the infrastructure in place to take more women from Elgin or from Murray more widely, while Dr Gray's is still being fully restored, because there is a gap, there is a time gap between 2025 and the end of 26-27, should women have the choice to go to Rhaigmoor, which is a shorter journey for many of Douglas Ross's constituents, as opposed to go to Aberdeen. I think that that is a conversation that is absolutely worth having. I make no mistake about it. My focus and the focus that I have said now to the health board is that, given the ambitious timescales, in my view, around the return of maternity services to Dr Gray's, the focus must be on model 6. Richard Lochhead, I thank the cabinet secretary for giving way and welcome his announcement, which is something that I was calling for in conveying the views of Keat Mum at a recent meeting a few weeks ago. On the integrated model, I think that there is no one in Murray who would dispute or argue against the idea of staff being recruited on a cross-border basis, because everyone's outcome focused on the fully restored service at Dr Gray's. That integrated model is perfectly acceptable in terms of the views of staff recruitment. If consultants work between Rhaigmoor and Dr Gray's, that will be welcomed if that plugs the gap in terms of the restored service. On the timescales and recruiting consultants, one of the anxieties in Murray is affordability. The plan from NHS Grampian for the full restoration asks for or suggests that what is required is just under £22 million of investment between now and next five years, with £7 million a year thereafter. Is there any comments to the cabinet secretary who could make about the anxiety locally about affordability, which would slow down the timescale if that was to be the reality? I can't give assurance that. Before I do that, can I say that Richard Lochhead really articulated it perfectly, that what we're talking about is that integrated model. Let me be clear that we're not going to proceed with model 4. Model 6 is now the focus. Instead of even calling it model 4 and model 6, let's just say that it's the restoration of consultant-led maternity services at Dr Gray's. That's where we're going to go, but the importance of the integrated model, I think that Richard Lochhead has articulated exceptionally well. It helps with the sustainability of the service, which I think it absolutely will. The short answer to your question is yes. I have committed—the Government has committed—to the full restoration of consultant-led maternity services at Dr Gray's. That means that we have to step up and ensure that it's fully funded as well. We'll do that. There will always be an element of discussion, as you'd imagine, with the health board in that regard. I should say that none of that means that we're not going to continue our investment in Rheigmore. I want to give that absolute assurance. Edward Mountain has raised it with me—a doctor. I'm promoting him, I think—but Fergus Ewing has raised that issue with me. Many MSPs have raised the issue of our investment in Rheigmore with me. I suspect vastly out of time. I don't know if there is some additional time, Presiding Officer. I'm being generous, cabinet secretary. Oh, good. Okay. I'll try not to keep people back. Continue full-time being. Too much, because there were a number of questions that were—so how much time? I can give you another couple of minutes. Okay, another couple of minutes. That would be great, Presiding Officer, much appreciated. I wanted to touch upon the issue of a number of issues that were raised with me direct. I may be better writing to some members because of the time constraints. In relation to the question that was asked to me about external assurance, it was raised by a number of members, and perhaps a perception of distrust in relation to the health board. What I would say is that there are two things. First of all, there is an external assurance panel in place. Members have met, I think, Linda Dacasteker, who's heading that, but she's not the only person who's part of that panel. As the name suggests, there are a number of people who are involved in that external assurance. I'm not minded to put an external project manager into Grampian. I think that Grampian do have to own this. They have to have ownership of it, and I sincerely believe in the discussions that I've had with them that they've got an absolute commitment. I think that their plan, which is, again, far shorter in terms of timescale, than some members had expected when they'd raised 10 years, 7 years with me previously, shows that they are committed to that. In terms of the issue around C sections, I'm always clear to say that I'm going to be always going to take clinical advice in that respect. Why did we come up with a different timescale previously? That was the timescale that was in the Rafe of Roberts report that was presented to me. When that report was rightly interrogated by clinicians, then they have come with a timescale of early 2025 for elective sections being reinstated to Dr Gray's. In terms of Nes, that's been raised by a number of colleagues, both in terms of Grampian but also NHS Highland. I think that a broader issue, maybe even touching upon what Finlay Carson has said, is a really important issue about training and getting more trainees to train in rural Scotland. Nes are fully involved in that very mission. In fact, they've been left in no doubt in relation to Dr Gray's and my expectation of their involvement. I'll probably write to the members, given that I only have a little bit of time left. I thought that I had made an excellent point about the freedom of movement and immigration. Having raised the issue with the UK Government previously, from the health perspective of the fellow health secretary, they certainly understand the need for the Home Office for immigration to work to help us to plug some of the gaps in the workforce. It's not the only... It's not the panacea, but it certainly could help. I'll conclude by perhaps addressing the point that was made by Carol Mocken in relation to the women's health champion. We will update Parliament early in the new year. Carol Mocken is absolutely right. She has every right to push the Government really hard on this appointment and we made a commitment in that respect. It's so so important that we get the right person, because that person, I hope, will stay in post for many, many years to come, push the Government in relation to the women's health plan. I'm absolutely committed to the end, a planning officer. Thank you for your generosity on the end by saying that the Government is absolutely committed to fully restoring and returning consultant-led maternity services to Dr Gray. We'll not proceed with Moral 4. We will proceed to that end destination. Of course, I look forward to keeping members updated. Again, I finish where I started by wishing you all the very best for the festive season. Thank you very much, cabinet secretary. I congratulate everybody on persevering, making it through to the end of what has been a long week and a busy session. Can I add my good wishes for the Christmas season and for the new year? With that, I close this meeting of Parliament.