 Mae dweud yn gwybod i gynhyrchu ar gwybodaeth y shortestgymraeol ac gyda'r cymdeithasol o oes wedi bodador yn ei fod gennym gwybod i'r hyn o gwneud hyn yn gweithio'r gynhyrchu desgon i ddweud ar gyfer y melly, ac yn angen i gael y quiesion. Alex Cole-Hamilton Fy angen i ddiweddio'r gwybod mwy o'r ddollfodol o'r cyfan o ddechrau â llaw ddechrau yn olygot i'r aelodauau aelodau aelodau o'r cyfan o ddychrau o'r cyfan o'r llaw o'r The performance of the weekend in the 30th of October is clearly not where we want it to be. Covid continues to impact the delivery and performance of services and pandemic backlogs. Brexit-driven staff shortages and inflation costs are all contributing. To make this what is possibly the most challenging winter that the NHS has ever faced, delayed discharge has continued to be the single biggest factor driving up A and E weights. That's why our relentless focus of our £600 million winter plan is on social care and actions to encourage integration authorities to help to alleviate those delays. In addition, we're working with NHS boards through our £50 million collaborative improvement programme that looks to drive down A&E rates by offering alternatives to hospitals such as hospital at home, directing people to more appropriate urgent care settings and where possible scheduling urgent appointments. Alex Cole-Hamilton. I'm very grateful for that reply. This isn't the fault of clinicians or emergency care workers. They're working their hearts out. When the health secretary took office in May 2021, A&Es were able to see 87 per cent of patients within those four hours. Today that stands at just 63.1 per cent, the worst on record, and it gets worse when you look at the longest waits. The number of patients waiting over eight hours has gone up 717 per cent. All of that, Presiding Officer, is on his watch. Does the health secretary think that he is the best person to resolve this crisis? Is he saying that there is nobody, nobody at all, who could do this job better than him? What I would say to Alex Cole-Hamilton is that when I took office, of course, we still had legal restrictions because of Covid. We no longer have those legal restrictions and therefore people are able to interact. Therefore, our services are able to recover in the NHS. We didn't have elective care. We had paused elective care effectively at the time I took office. Of course, when I took office, since then, we've had not one, not two, not three but four waves of Covid. Alex Cole-Hamilton, in his tirade, forgot to mention that we are still in the midst of that global pandemic. While the Opposition may want to concentrate on personalities, it can do that. My relentless focus is on the front line of those working in our NHS. What they deserve is not a game of personality politics or using the NHS as a political football. What they deserve is, of course, Government, but also every single one of us in opposition, ensuring that we come forward with constructive solutions that are going to help our NHS at what is the most difficult time. That's why my relentless focus, as I say, is on the NHS and on those working on the front line, for which I'm very grateful for all their efforts every day in and out. Alex Cole-Hamilton I'm sorry, Presiding Officer. I've listened to that answer, but how dare he, how dare the Cabinet Secretary, dodge and deflect this Government's negligence and its inadequacies once again by its constant hiding behind the Covid pandemic? It's an insult to doctors and nurses and patients waiting in pain because Nicola Sturgeon's NHS chief executive of five years, Paul Gray, said this crisis, was coming down the tracks long before anyone had heard of Covid, pandemic or no. He should stop abdicating responsibility. Everyone knows someone on a waiting list and when you drill into the detail around emergency care, it gets far worse. Only 45 per cent of patients seen within four hours in Edinburgh's royal infirmary at the QEUH Superhospital in Glasgow is just 42 per cent. We haven't had the first frost of winter, so this could be getting a lot worse. Can I ask the cabinet secretary what modelling is his Government done for A&E waiting times this winter? Can he tell us with confidence that this is as bad as it gets? I expect that there will be fluctuations throughout the course of winter. I suspect that some weeks we will see improvement. Unfortunately, some weeks, for example, if we see a spike in Covid cases, a spike in flu cases, I suspect that that will have an impact on A&E waiting times. I'm not going to pretend otherwise or try to insult the intelligence of anybody in this chamber or anybody watching to suggest otherwise. But he's also wrong if he suggests that there's no element of recovery in our NHS. The statistics published by Public Health Scotland show that, for example, in 75 per cent of outpatient specialities, there's fewer than 10 people waiting more than two years in terms of elective surgery. Therefore, if you look at elective care, we're clearly seeing some positive progress in that respect. That is why our focus is on the front line. It's why it's the focus of this Government to invest in our staff. It's why, when I stood here a few weeks ago and spoke about our winter resilience plan, that's why we're recruiting 750 nurses, midwives and AHPs from overseas. It's why we're recruiting 250 support staff to help with acute primary care and mental health. What I don't need from Alex Cole-Hamilton, I suspect that nobody needs, is a tirade without any constructive suggestions. What this Government will do is continue our focus on solutions that will help our NHS over what will be the most challenging winter, and that's where my focus remains every day. As you might expect, there is a lot of interest in this item, and I would be grateful for short and concise questions and responses. I call Co-Cab Stewart. Will the cabinet secretary acknowledge the importance of recruiting and investing in NHS Scotland staff based on their skills, training, ability and commitment to do the job? Will he join me in commending the wonderful NHS staff of all nationalities, particularly in the light of Keir Starmer's troubling and short-sighted claims that the UK is recruiting too many foreigners into the NHS? I cannot agree more with Co-Cab Stewart. Overseas workers in our NHS, whether they are doctors, nurses, admin staff, porters, caterers, domestic staff and anyone in between, they are all part of our NHS family. Keir Starmer's remarks, I thought, were inflammatory. They have no place in our discourse here in Scotland. I would hope that decent members of Scottish Labour would speak up. They seem to be shouting from a sedentary position, but it would be helpful if they would speak up against those remarks, but so far all we've had is deafening silence. So, while Labour's concentration may well be on the front pages of certain right-wing newspapers, our focus is on the front line of our NHS. Sue Webber, it was reported on the front page of the Scotsman today that patients presenting at the acute assessment unit at the QEUH are not included in the A&E stats, despite the two fulfilling the same function. As many as 2,000 patients a month are being missed off their A&E waiting time stats due to how data is collected. The SNP often states that Scotland's emergency departments are outperforming England's on the targets for patients to be seen within four hours, but this has been challenged by senior medics. Statistics from Public Health Scotland only refer to 30 of the 91 A&Es in Scotland, yet the Scottish Government measures the performance of these units against 170 of England's type 1 major A&E A&Es that deal with the most severe situations, shootings, stabbings and so on. Will the Scottish Government admit that it is using statistics to cover up the true scale of the humanitarian crisis in our NHS? No, I do not agree with that at all. It is well recognised when it comes to looking at comparisons across the UK. If you look at NHS England's agency NHS Digital, when they compare any performances across the four nations, they use core for Scotland, major for Wales and type 1 for England. Those are all A&Es that are consultant-led, which have 24-hour services with full resuscitation facilities and designated accommodation for A&E patients. I am not going to pretend otherwise in my response to Alex Cole-Hamilton. I said that the figures for the week ending 30 October were nowhere near where I would want them to be. Of course, that is a global pandemic, which is affecting health services right across the UK and across the world. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 8.7 per cent is better than England. 8.1 per cent is better than Wales. In fact, a Sky News analysis found that half a per cent of Scottish patients waited longer than 12 hours in A&E. That is half a per cent more than I would like it to be, but that is compared to 3.1 per cent in England and 6.1 per cent in Wales. The point of raising those issues is not to say that our performance is where we want it to be. I am saying that it is not. 9.8 per cent is better than Wales. 10.8 per cent is better than England. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 10.8 per cent is better than Wales. I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 11.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 12.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 13.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 14.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 15.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. 16.8 per cent is better than Wales. That is why I am pleased that, even with those challenges, Scotland continues to be the best-performing A&E service in the entire UK. fy nhw, gyda unrhyw beth yn cyfnodol, haws, maen nhw sydd yn mwneud. Cymru yn £45 miliwn i'r ei wneud amлиwyr amgylcheddol. Mae tynnu'r clyw 맞fa mor bwysigiau am gyfnodol. Felly, mae hyn yn dweud i'n meddylen ar hôl, ac mae yn fawr i bwysigio bwysigiau i holl yn teimlo i rodd yn hiwgwyr cyflawns a chyfnodol cwmwyntol. Felly, mynd i ddoch chi'n cael ei ysgrifennu, ac rhaid i'n cael i'n dyluniaeth unangodd? Am sorry, we will meet local authorities tomorrow and care providers. Felly, whatever we are further doing to that is investing in social care. The number one factor that is caused by ENA delays, we know, is social care. Of course, the responsibility of providing care package's remains on local authorities' level. We also work collaboratively with our local authorities. However, I will say to Paul O'Cain that, through all of what he has said and all of Labour's questioning so far about that debate, I have heard not well-developed yn y ddwylliant sydd yn gwybod cyfnod yw'r syniadau ar gyfer gael yng nghylch rwyf sy'n ei ddim yn cynnwys hwtfgogol o'r Exiliadau Ffllwydd gyda Gwylmae Rhaith, ac mae'n adnod i gondol am hwyl i Gwylmae Rhaith yw'r Gwylmae Rhaith. Erfoddon ddweud am ygafиться i Gwylmae Rhaith, mae os oes yn gwybod sydd yn gwybod a drawing gyda'r Lady of the Swil Merthyr o ffilmog iawn eu sydd yn gwneud o gyfnod. Pryddoedd ychwanegol panels in ambulances. If you can't solve the delays for accident and emergency, cabinet secretary, will you look at allowing doctors to treat patients in ambulances while they have to wait for the problem to be solved? Look at any suggestion that comes from the Opposition, and I'll take a look at what Edward Mountain says. The source of the problem and solution is in dealing with the issue of delayed discharge and in social care at the very source. That's That's why in tomorrow's ministerial assurance group with local authorities, with our colleagues from the care sector, we will see what more can be done to get those 1800 people who are in our hospitals, who are clinically safe to discharge, who really should be either at home or as close to home as possible for their benefit, let alone the benefit of the NHS. That is where the source of the challenge lies and that is where our energies and our efforts will go. Notwithstanding that, of course, we'll look at the suggestion that Edward Mountain makes. Long waiting times are contributing to hundreds of avoidable deaths. Whether that's in England or Wales or in Scotland, that is not acceptable in any part of the country. Can I bring it back to Lanarkshire? We remain in a code black situation and the cabinet secretary knows that colleagues in Lanarkshire have worked constructively on a cross-party basis. We appreciate his time coming to a recent meeting with the board, but today NHS Lanarkshire has recorded its worst-ever performance times at A&E, so things continue to get worse and not better. Can he give an update on NHS Lanarkshire and what more the Government is doing to address the very dangerous and unsafe situation for staff and for patients? Monica Lennon is absolutely right to reference two important points. One is that, to putting the patients at the centre of this, we know—and I certainly won't argue with this point at all—that excessively long waits do patient harm. That is something that this Government of course is focused on trying to avoid. Any excessive wait is one excessive wait too many. We know that there is a job to do. I won't rehearse everything that I've said in the answers previously. The second point that Monica Lennon makes well is that there has been—certainly in Lanarkshire—a very good cross-party consideration and challenge on this issue. Monica Lennon has challenged me quite frequently on this issue and right to do so. What I would say to Monica Lennon is that I will be in Lanarkshire tomorrow. I will, of course, be raising the issue about the code black status and the continued challenge that Lanarkshire is under. On the back of that, I will write to Monica Lennon with further detail and further update. That concludes the urgent question. We now move to decision time. There is one question to be put as a result of today's business. The question is that motion 6637, in the name of Keith Brown, on remembrance, commemorations and support for the veterans and armed forces community be agreed. Are we all agreed? The motion is therefore agreed. There will be a brief pause before we move on to members' business in the name of Stephen Kerr.