 Thank you. That concludes general questions. First Minister's questions. At question number one, I call Douglas Ross. Thank you. This week's health figures revealed that more people are waiting longer than ever for emergency treatment. Across Scotland, over the past week, nearly 10,000 people waited more than the target four hours at accident and emergency departments. That's the worst Llewbeth yn ddigonwyd? Felly oedd anodd yn clyweddyn ni i gyd? Rydyn ni'n gweithio, nhw'n ddigonwyd gan gweithio a'r dyfu yn gorffodol wedi gweithio a'i gilydd bryddoedd mewn uchwyn o accomplid. Rydyn ni'n gweithio am brydddoedd yn ddigonwyd o'r ddigonwyd yng Nghymru o'r agen nhw'n gweithun sy'n addysg y bydd yn amser o'r iawn i'r ysgolwnd. Y Llywodraeth Cymru wasboliodd flwyddyn nhw'n gweithio am y cyfrifor SNP, Mae ydych chi'n gwybodaethau ar gyfathorol yn eich gweithio hynny yn fagor neson. Rwy'n ddigon i gyd o'r need na termsyn. Mae ydych chi'n gwybodaethau sy'n cyffredinwyd i'n gweithio i gael gwirionedd, i gael gwirionedd mewn cyfathorol a'r mwyaf oedd yn gweithio i gael gwirionedd, a oedd yn gweithio i'n gweithio i'r amser wglaeddau, ond mae'r cysylltu i'r blaenau. Rwyf am rhan o'r ddim yn credu ff Igliad mewn gwahonyn y cyfaint ac yn ôl i'r cysylltu i fynd i gyfaint o'r reviewaidd. Felly, oedd aeth gyfryd eich cyfaint, i gael â'r cyfaint, yn yr urchynedig gynhyrchu cyngrofi aeth chi'n ei wneud i ddyn nhw'r crinhau, wrthur ymgyrch gyflym eich cyfeiri. recruitment, overseas recruitment included, and we're taking action through the £50 million urgent and unscheduled care collaborative. That work includes a range of different strands offering alternatives to hospital where that's appropriate, such as hospital at home, directing people where appropriate to better urgent care settings, and scheduling some urgent appointments to avoid long waits in accident and emergency. The chief operating officer of the NHS also wrote to health boards this week with five additional specific actions that we are expecting health boards to take, so we do expect to see improvement and we want to see that improvement starting to be visible immediately. Final point, I would make, for the sake of those working so hard on our national health service, to put this into context. Our NHS is facing these significant pressures, but the NHS in every part of the UK is doing so as well, and while performance needs to improve here in Scotland, our accident and emergency departments are performing better than those in England, Wales and Northern Ireland. For context, because it is important to put it in context, if we look at the last complete month where we have figures, performance against the four-hour target in Scotland was 66.5 per cent, not good enough and it needs to improve, but that compares to 57 per cent in England, 55.2 per cent in Wales and 45.7 per cent in Northern Ireland. Those pressures exist everywhere. This Government is focused on making sure that we support those in our health service to tackle them. Context may be important for the First Minister and her members behind her, but for people waiting hours and days for A&E treatment, they are hollow words. We are now more than a year into the health secretary's recovery plan, but the situation is getting worse, not better. The First Minister spoke about A&E consultants, but here is what doctors on the front line are saying. The deputy chair of BMA Scotland said this week, as an A&E doctor, I often tell people that A&E is a safe space. You can come here if you're in pain, if you're sore, if you don't know where to go. But Dr Pio continued, our A&E departments are no longer safe, and what's really concerning is our Government just aren't acting, and they're turning a blind eye to this. A new information that we've uncovered shows just how horrendous waiting times are in Scottish hospitals just now. An FUI response has revealed that one patient at a hospital in Ayrshire had to wait 84 hours for treatment. That's three and a half days, the equivalent of turning up for emergency treatment right now and not being seen until next week in the early hours of Monday morning. First Minister, is that really what anyone in Scotland should go through in 2022? No, that is clearly an unacceptable situation, but also an exceptional situation. I'm certainly more than willing to look into the particular circumstances around that. I've been very clear, firstly, that the current performance is not acceptable. I would not and do not shy away from saying that. Secondly, I've been very clear about the action that the Government is taking to support those on the front line to ensure that there is much speedier access to accident and emergency and to health care services more generally, and also to make the important contextual points, because that is part of giving confidence to people that we are taking action to address that. In terms of performance against the four-hour waiting time target, not good enough but better than in counterpart parts of the United Kingdom. Again, in terms of long waits, 12-hour waits are 50 times more in England than they are in Scotland, four times higher in Wales than in Scotland. That does not mean that performance in Scotland is good enough, but Douglas Ross and others often come to this chamber and somehow pretend or suggest that those issues are unique to Scotland. They are not unique to Scotland, they are pressures that all health services are facing, and I am setting out rightly the action that we are taking to support the health service in tackling those. In terms of recruitment, in terms of investment, in terms of changing the pathways of care to make sure that people not only get speedier access but access the right part of the health service at the right time, we are taking action across all of those strands, and we will continue to do so. Douglas Ross Unbelievably, the First Minister just said there that 84 hours is not good enough, but it is better than other parts of the United Kingdom. How does that person, how does a person who was waiting for 84 hours feel when they hear that, their friends and family, and while that was the most extreme example that we found, it is not the only time that someone has waited four days at A&E. Our FOI responses reveal that another patient waited 79 hours earlier this year, another 66 hours and another 53 hours. There are thousands waiting each week for longer than the Government's target time. A constituent wrote to us about their grandmother and this is what they said. My Nana took a turn for the worst last week and could not stop vomiting. Due to her type 2 diabetes and blood pressure, this is a very serious condition indeed. She was admitted to hospital after a lengthy wait and then sent home. This happened several times over a number of days. Finally, she had to be rushed to A&E and her grandson told us this. What I was faced with was utter chaos. I felt so sorry for the doctors and the nurses and helpers. They were literally at breaking point. There were beds and people everywhere. I wish I had taken a picture but the image is etched in my memory forever. The beds were wall to wall and my Nana had to stay in her mobility chair as there was nowhere for her to go. First Minister, this can't go on any longer and it certainly can't go on through the winter. When will people in Scotland get access to emergency treatment that they deserve when they need it? As I said earlier on, we expect to see and we are supporting what it will take to deliver immediate improvements in accident and emergency waiting times. Those are really serious issues. As the case that Douglas Ross has narrated today illustrates, I would not say otherwise, but it doesn't do anybody any service at all to deliberately twist and indeed misrepresent what I said in my previous answer. I did not say—and it's really important to be clear here—that the 84 hours was not good enough but better than anywhere else in the UK. I said our four-hour performance was not good enough but better than other parts of the UK. I said that our longer wait performance was too. What I said about 84 hours was that that is clearly unacceptable, but cases like that are also exceptional. It's important that, where cases like that do occur, they are properly looked into. In terms of our performance against the 12-hour target, in the most recent week, it is very challenging—the lowest four-hour performance on record, and it's important to be clear about that—but more than 9 out of 10, 95.4 per cent of patients were seen within that 12-hour target. Clearly exceptional cases shouldn't happen and, when they do, lessons should be learned, but it is important not to misrepresent the situation or to misrepresent what I said. In terms of the action that we are taking—that is what obviously matters—I have referred to support for recruitment. It is important to point out to the 263 per cent increase in A&E consultants. We are also investing £11 million to support further domestic and international recruitment. Of course, international recruitment has been made significantly harder because of Brexit, and I will just put that on record. It also includes 1,000 healthcare support workers that were brought in over last winter. The £50 million investment that I have already referenced is looking at alternatives to accident emergency, where that is more appropriate for patients. We will continue to focus on improving that performance. To end this answer where I started, we expect to see the performance improve immediately. We have been told this before that there is going to be immediate improvements. People are waiting 84, 79, 66, 59 hours, and the First Minister says that these are exceptional cases, so let me give her another one, because there are just so many. We spoke to another patient who attended Monklands hospital. She was stuck at A&E again and again and again waiting for emergency treatment. She went to A&E with severe abdominal pains. She was left waiting, vomiting and extreme pain for nine hours. She was told to come back the next day at 9am. This time she waited a further six hours. Two days later, her condition had worsened to the point that her GP told her to go back to A&E for urgent treatment. On this occasion, she again waited nine hours. That is a total of 24 hours waiting for emergency treatment in just four days, all in extreme pain. So she wants to ask one simple question to the First Minister. How can you allow this to continue? First Minister, we are not allowing this to continue. We are recognising the significant pressures on our national health service. Let me say an experience that that is completely unacceptable, but there are significant pressures on our national health service and significant action being taken to address those pressures. We will continue to take those steps around recruitment, investment and redesigning pathways of care. I do not know whether it is the case in the particular instance that Douglas Ross has just narrated, but there will be many people who end up in accident and emergency departments who would be better seen and treated in other parts of our national health service. That is why I said that I did not know if that was the case in that particular instance, but there are many people who would be better treated in other ways. That is why we are investing in hospital at home, in different urgent care settings, and in scheduling urgent appointments in A&E so that people do not have to have long waits. This work does take time. This work requires that investment in recruitment that I have spoken about, but that is why the health secretary and the Government are focused on making sure that we do it and support those at the front line of our health service as they support patients who need treatment on the national health service. On 25 August 2021, the First Minister announced her NHS catch-up plan. Can she tell the chamber how many people were on NHS waiting lists then and 13 months on how many are on NHS waiting lists now? Waiting lists and waiting times have increased since then. The figures are published, so they are there for people to see. I am sure that Anna Sarwar will quote the published figures at me. Since then, we have also had further waves of Covid, the pressure on our national health service here and in other parts of the country continues. However, we are focused through the recovery plan on treating the most urgent patients and treating the longest waits. Just this morning, information has been published about performance against the target to eradicate in most specialties those waiting two years or more. We are seeing progress, but this is an extremely challenging time for the national health service, which is why it is so important that we continue to focus on the investment and the action that we are taking. Anna Sarwar Catch-up surely means waiting lists come down rather than go up. 6,000 was the number waiting in August 2021, and nearly 750,000 people are on one now, 14 months on after a so-called catch-up plan. The First Minister should stop pretending that this is all down to Covid. When the SNP came to power, there were 260,000 people on NHS waiting lists. Immediately before Covid, there were 420,000 people on NHS waiting lists, now it is three quarters of a million people. That is now one in seven Scots on an NHS waiting list, and that has consequences. Listen to the staff. Dr Laila Peel from the BMA said this week that patients are now presenting at A&E because of complications developed while waiting for treatment and scans. Week after week, this Government has been breaking records for the worst A&E waiting times ever. First Minister, can you tell us how many people have waited over 12 hours for A&E treatment since you launched your so-called NHS recovery plan? I have obviously just covered the situation in accident emergency. Those waiting over 12 hours has increased, but more than 95 per cent of patients are seen in accident emergency within 12 hours. Of course, the target that we want to meet in accident emergency is the four hour waiting time target. In terms of waiting times more generally, yes, waiting times have been increasing. There has been a two year pandemic. That has had a significant impact on waiting times in our national health service. However, in response to a question earlier on, of course, there are other factors that were pre-existing, the changing demographics of the country being one of those. Over the last two months, there has been a focus on treating the longest waits in our national health service and the figures published today show the progress in that. We are also seeing an increase in the number of inpatient and day case patients who have been seen. In the most recent quarter, a 7.6 per cent increase in those seen demonstrates the recovery of the NHS from Covid. Those are difficult challenges. There is absolutely no getting away from that. Almost every country, certainly every country in the UK and most countries across the world, are grappling with those challenges. However, the investment that we see in our national health service and the steps that we are taking to redesign care are what need to continue. Lastly, we do listen to staff. The health secretary meets staff and unions and professional organisations on a regular basis. Of course, there are many more staff working in our national health service today than was the case when this Government took office. I think that more than 20,000 additional staff have been recruited in that period. Anna Sarwar He might listen to staff. He is not hearing what the staff are telling him and taking the necessary action to help people across the country. In terms of the actual question that I asked the First Minister, the answer she was looking for is 38,255 people have waited more than 12 hours in A&E since the recovery plan was published. 38,255. Frankly, people are sick of the same old excuses, and this SNP Government is always looking for someone else or something else to blame. Across Scotland, people are getting the same inadequate answer from this Government. Wait. Wait in fear for a cancer diagnosis, wait in pain for a hip replacement, wait for hours in an ambulance outside A&E, wait anxiously for their child to get mental health treatment. Today we discover that life expectancy has dropped again for a second year running all under Nicola Sturgeon's watch. After 15 years in power, after 15 years of running our NHS, how long will the people of Scotland have to wait for you and your health secretary to do your job? Through the chair, please, Mr Sarwar, First Minister. We will continue to do our jobs. Ultimately, as it always has been, it is for the people of Scotland to decide whether they want us to continue to do our jobs. A two-year pandemic for Scotland for every country has presented real and very significant challenges, and every day we seek to address those challenges and support those in the front line who are doing that. We will continue to do that in our NHS. We will continue to take the action, albeit in this regard, with one hand tied behind our back to tackle poverty in Scotland to have a positive impact on things like life expectancy. Thank you. Unfortunately, Labour still wants us to have one hand tied behind our back on these issues. While I take full responsibility for performance across all of these things in Scotland, I come back to the reality in Scotland in terms of the national health service that whatever the challenges we face, thanks to the dedication of those working in our national health service, it is performing better than its counterpart in England, where the Conservatives are in power, and better than its counterpart in Wales, where Labour is currently in government. We will continue to address those challenges, we will continue to take the steps necessary to do so, and we will continue to ask the Scottish people to put their trust in us to do exactly that. I now move to constituency and general supplementaries, and I call Bill Kidd. Thank you very much, Presiding Officer. September is Blood Cancer Awareness Week, which provides an opportunity to increase awareness of the importance of new people joining the anti-nonolan stem cell register. A simple act of a swab test could lead to the Selfless Act of Saving a Life. Will the First Minister join me in encouraging young people aged 16 to 30, especially young men from ethnic minority backgrounds, to consider joining the stem cell register and thank Anthony Nolan and the Scottish Fire and Rescue Service for their continued efforts in raising this issue in schools up and down the country? First Minister. Yes, I'm very happy to do so, and I'm grateful to Bill Kidd for raising this important issue. I will join him in encouraging all those eligible to consider joining the stem cell register. Anthony Nolan research has shown that the younger the donor, the better the patient's chance of survival, and has been pointed out that those between aged 16 to 30 can join the stem cell register. Additionally, I would like to acknowledge and indeed thank the Scottish Fire and Rescue Service's 13-year partnership with Anthony Nolan for their continued hard work in raising awareness around this issue. Alexander Stewart Thank you, Presiding Officer. First Minister, a recent report by Public Health Scotland has found that suicide amongst young Scots to be the leading cause of death. Ministers have described every suicide as being a tragedy and that suicide prevention is the key priority for the Scottish Government. Therefore, given that priority, what action is being taken to put in place to ensure that youngsters affected by suicide get the access that they require to reduce this appalling situation? First Minister. Every suicide is a tragedy and obviously we want to take and support steps to reduce the number of suicides in Scotland. I would say, though, that not trying to take anything away from the very important issue that has been raised, thankfully the number of suicide deaths by young people has decreased over the past two years. The Public Health Scotland report earlier this week tells us that the average rate from 2011 to 2020 amongst the under-24s was lower than the rate amongst those aged 25 and over, but it is still way too high. So our new suicide prevention youth advisory group will help to shape the approach to suicide prevention for children and young people. Here, of course, the wider work around mental health support for young people is important as well and encouraging those to access support earlier rather than later and making sure that the services are there for them when they do. Thank you, Presiding Officer. Recent UCAS figures shockingly highlight a shortfall of almost 1,000 in the actual number of students currently accepted into nursing and midwifery courses in Scotland compared to the Government's own recommended intake for 2022-23. I saw first hand last week in my south of Scotland region the impact shortages there having on our Ayrshire hospitals and the wellbeing of the staff. What we need is a clear plan for making nursing and midwifery an appealing career for young people to address the figures that the RCN described as extremely worrying for nursing. So I asked the First Minister today when will her Government stop patting itself in the back, realise the scale of this recruitment problem and outline detailed action it will take to address that problem? Again, addressing an important issue, I think it's important that it is not misrepresented and I know the member wouldn't want to do that. So let me address in some detail the issue of nurse and midwifery student numbers. The target intake for this year is 4,837 so far and I stress so far and I'll come back to that point. There have been 3,850 students accepted on to nursing courses and 280 on to midwifery courses so that's 4,120 so it's not a shortfall I don't think it's a shortfall at all for a reason I'll come on to but there are 700 around 700 places yet to be filled not 1,000 but the reason I say so far is because this is a clearing process that has not yet completed. It is still underway and final numbers won't be known until the end of the cycle in December but even so compared to 2019 the figures so far are 5% up in terms of acceptancies for nursing places and 7% up in terms of midwifery places and again for context because I think context is also important the number of nursing acceptancies in Wales over the same period is down by 17% so this cycle is not yet complete but I think there is much to be encouraged about and perhaps one of the reasons is that we have increased the nursing and midwifery student bursary to 10,000 pounds that's higher than it is anywhere else in the UK and we also have more qualified nurses in midwifery per head of population than any other part of the UK as well so challenges yes but clearly and this has just been evidenced action being taken to address those challenges. Alistair Allen Alistair Allen The Tories seem to have conceded that a trade deal with the USA was yet another effort to delude themselves and deceive others on the merits of Brexit. Meanwhile former Scotland Food and Drink chief executive James Withers recently stated that the UK is suffering from an on-going mullies, this is long Brexit and we're all living with it. Does the First Minister support this view and agree that the renormalisation of relations with our European friends is the only way to ensure that Scotland's world-class food and drink industry does not continue to be hamstrung by UK mismanagement? There's no doubt at all that the food and drink sector in Scotland indeed across the UK has borne the brunt of the hard Brexit pursued by the UK Tory government particularly through the loss of free trade and free movement of people. We know that Scotland's food exports to the EU in 2021 were down by 70 million pounds compared to 2019 and that is clearly down to the reckless Brexit that the UK government has pursued. Given that they've had to admit this week that there's no trade deal with the United States on the horizon, I think the least the UK government can now do is to stop threatening a trade war with the European Union in the middle of a cost of living crisis. Brexit was not in the interests of Scotland and further exacerbating trade tensions with the EU would certainly not be in the interests of Scotland or anybody else across the United Kingdom. Miles Briggs. Thank you, Presiding Officer. Campaigners were heartened when the First Minister signalled that the Scottish Government will take forward a formal apology to those affected by forced adoption. Monica Lennon and myself have met with ministers to try to progress this issue but progress has been limited. For many campaigners, time is simply running out. So can I ask the First Minister a very straightforward question? Will she today commit to take forward that national apology before the end of this year? The commitments that we have made, the commitments that I have made I think in this chamber still stand. I understand the importance of this issue and understand the great sensitivity of this issue. It is important though that we properly think through and work through all of the various issues, the legal issues that are inevitably involved in this, but also give careful thought to the framing and the wording of an apology. This is an important issue, so rather than give an update right now, what I will do is ask officials or the relevant minister to write to the member to put this in spice, giving a more detailed update on the work that has been done and the progress that is being made. Colin Smyth Thank you, Presiding Officer. Just last year, Scottish Government funding of £4.8 million was awarded to Dumfriesshire-based Alpha Solway to build a manufacturing plant in Dumfries for PPE, with a promise from ministers of 300 jobs. Today, that firm employs fewer than half that number and has just begun a consultation on further job losses in the firm's words due to NHS orders being stopped. Of course, the overall level of PPE that we need may well have been reduced, but surely one of the lessons of the pandemic is that never again should we rely on import and PPE. It should be manufactured here in Scotland. That presumably was a view of the Government when it awarded this funding. Will the First Minister urgently investigate the Government's approach to the purchase of PPE and the stopping of NHS orders so that we can avoid any further job losses at Alpha Solway and ensure that we have that vital future resilience when it comes to PPE? During the pandemic, we did build a resilient PPE manufacturing sector in Scotland. I think that that is important. I think that it is important that we maintain that to reduce any dependence on imported PPE in the future. It is the case, though. The member has referenced this in his question that demand for PPE has understandably slowed considerably between the peak of the pandemic and current demand, meaning that procurement requirements have reduced. Work is continuing to implement a new approach to pandemic PPE and to learn fully the lessons from Covid. In terms of Alpha Solway, it is one of our partners. We very much appreciate the important contribution that company made during the pandemic. I know that this is a concerning time for the company's staff. The business minister has spoken with the company, though, and offered the full support of the Scottish Government and South of Scotland Enterprise. South of Scotland Enterprise, in particular, is engaging with the company to explore all options and will offer any assistance that might be required. I will ask the business minister to keep the member fully updated on progress. Alex Cole-Hamilton I refer the chamber to my register of interests as a member of the Home to Ukraine scheme. To ask the First Minister when the Scottish Government will announce the outcome of its review into the posing of the supersponsor scheme for Ukrainian refugees coming to Scotland. The First Minister First, Presiding Officer, I report to Parliament that more than 18,000 displaced Ukrainians are currently being accommodated in Scotland. This is almost 20 per cent of the total number in the UK. It includes almost 15,000 under the Scottish Government's supersponsor scheme. That compares to our initial commitment of 3,000. That is something for everyone across Scotland to be very proud of. It is, of course, an important part of our overall contribution to supporting and helping Ukraine in this hour of need. We are currently reviewing the operation of the sponsor programme and the Warm Scottish Welcome to ensure that we can provide appropriate and sustainable longer-term support to those here as well as to those still arriving and those due to travel. I can also confirm today that we are providing a dedicated capital fund of up to £50 million, which will be available for registered social landlords, to help to bring sustainable accommodation into use and boost the housing supply for those fleeing conflict in Ukraine. Alex Cole-Hamilton I'm very grateful for that reply. The First Minister boasting about numbers will be of cold comfort to those who have been living out of suitcases since February or are coming to the end of placements with no idea what happens next. This isn't a new life, this is a new limbo. Furthermore, the mobilisations in Russia that pretend referendums mean no chance of early return for our Ukrainian guests. A memo leaked to the Herald from the Government's own rapid rehousing group has described confusion and increasing desperation. This Government has written goodwill checks that refugees cannot cash. While it closed the scheme in July, it still hasn't acted on my call to re-issue the appeal for homes. Additionally, Presiding Officer, we know that if it's easier to travel, it's easier to find homes and jobs. So can I also ask the First Minister, alongside the renewed call for homes, if she will now extend free bus travel to all refugees? First, those who are being temporarily accommodated right now in Scotland, if they weren't in temporary accommodation in Scotland, wouldn't have refuge. So it is important that we do recognise that Scotland is more than playing our part. Almost 20 per cent now of all displaced Ukrainians in the UK are being accommodated here in Scotland. That is a good thing. It is good for Ukrainians and I think it is good for Scotland to be playing that positive part. We continue to take the steps to ensure, of course, that not just temporary accommodation is available, but that longer-term, more sustainable accommodation is available. In terms of temporary accommodation, we continue to support those who have offered private homes for use and the matching process. We continue to work to speed that up, but it is important that we make longer-term accommodation available, which is why the fund I have referenced today is an important part of that work. So we will continue to take all of those steps to make sure that we are playing our part to continue to support Ukraine at this, what I think is a pivotal moment in the war, one where we are all happy to see Ukraine in the ascendancy but continue to be concerned about Putin and his intentions. Scotland will continue to play our part and I hope that people across the chamber will give the Scottish Government our local authority and third sector partners every support in doing so. I would like to ask the First Minister whether she will provide an update on the Scottish Government's support for the people of Pakistan as they face on-going devastation following severe monsoon flash flooding? We have all been shocked and very concerned by the devastating impacts of monsoon flooding in Pakistan, which includes the destruction of or damage to 1.7 million homes. That is a clear example of the loss in damage caused by climate change and underlines the need for all countries to act on that. In terms of the immediate response, we have made available £500,000 in humanitarian relief funding. The Minister for International Development has also met the Pakistan Consul General to hear first hand the situation on the ground and to offer Scotland support on an on-going basis. I thank the First Minister for that update. Pakistanis across Scotland, including from her constituency in Glasgow Southside and mine in Glasgow Kelvin, will appreciate that update. I have previously welcomed to Parliament on behalf of the Education, Children and Young Peoples Committee a delegation from the regional government of Balochistan, one of the regions that are worst affected by the flooding. This week, the UNICEF Pakistan chief field officer in Balochistan reported that we do not have enough food, shelter, healthcare, roads and bridges have been washed away. The flood is not going anywhere. Will the First Minister commit to considering further support for Pakistan in the coming weeks, given the scale of this catastrophe and the on-going havoc and misery that people are living through? Yes, we will absolutely do that. Cookab Stewart is also right to point to her constituency interests in this. To my own constituency interests, a significant proportion of my constituents in Glasgow Southside are of Pakistani origin and will have relatives affected by the flooding. My constituency is also home to the Pakistan Consulate. Those are issues that concern all of us. The scale of the devastation is truly overwhelming. 22,000 schools estimated to have been damaged disrupting the education of an estimated 3.5 million children, estimated material damage of up to $30 billion, 45 per cent of the country's agricultural land has been destroyed. The World Bank estimates that the floods could push 15 million people into poverty. As the Prime Minister of Pakistan has highlighted, that is a clear case of climate injustice. Today, on the international day of recognition for loss and damage, we also support his plea for urgent additional finance to address loss and damage. However, Scotland will always do whatever we can to play our part in supporting countries affected by disasters such as this. To ask the First Minister what action the Scottish Government is taking to support the transition to net zero heating in rural homes. There are long-standing issues of poorer energy efficiency and higher fuel poverty in rural areas. That is why we provide more whole-house retrofits and a wider range of support for installing zero emissions heating in rural areas. Overall, we have committed £1.8 billion for heat and energy efficiency over this Parliament. That includes £42 million for Home Energy Scotland loans with cash back scheme, £55 million for the warmer homes Scotland scheme and £64 million for area-based schemes. We are committed to spending more per head on energy efficiency in remote rural areas where we know installation and labour costs are higher. The Home Energy Scotland service also provides free and partial advice on zero emissions heating and energy efficiency. It's five regional centres provide location-specific energy advice that takes account of rural circumstances and the varying energy demand of properties across the country. Earlier this year, a cross-party group of MSPs wrote to the Scottish Government highlighting the serious financial challenges facing off-gas grid homeowners seeking to replace their oil heating systems, which are increasingly expensive to run and carbon intensive. Despite Scottish Government's much-vaunted target of a million zero carbon heated homes by 2030, there is still no detailed plan on how it will be delivered. Nor are the existing funding packages sufficient to meet the costs that those homeowners will face to install net zero heat. Does the First Minister recognise that any credible strategy should prioritise support for homes facing the costliest transition away from the most carbon intensive heating systems? Yes, I do. I've set out already some of the schemes and the funding attached to those schemes that are already in place to help us to meet the targets that Brian Whittle has referred to. I've already made clear that we recognise and are responding, of course, to the reality that there are deep issues of poorer energy efficiency and higher fuel poverty in rural areas. We are addressing those issues, but there is a big responsibility on us, as on all Governments, to continue to do so. I was struck by comments made recently by the British Energy Efficiency Federation commenting specifically on Scottish Government policies on energy efficiency. I'll perhaps just quote these to give some background. It said that the Scottish Government has deliberately concentrated such improvements in rural and remote communities, not served by the gas grid, and goes on to say, no such set of activist programmes to stimulate energy efficiency yet exists from the UK Government. My advice to Whitehall is simple, you had best be copying Scotland's initiatives. Communities across the Highlands and Islands are experiencing extreme fuel poverty, and many of those places also generate over 400 per cent of their energy use through renewables. Will the Scottish Government consider extra support for homes in those areas that do not yet have or cannot be fitted with green heating systems and are still using systems such as LPG and oil boilers until they are able to be fitted with lower carbon alternatives, given that those areas can already be considered net zero? Regulation lies with the UK Government, and we have asked the UK Government to use its regulatory levers, but within the powers and resources that we have, as I have already given some indication of, we will seek to do exactly that. We recognise the very particular issues that do exist within rural areas, and as part of our overall approach, it is vital that we address those appropriately. The First Minister will be aware that her Government only fit heat pumps under their central heating assistance scheme, and those are absolutely useless in draft old houses. People who need help to replace and install central heating cannot afford to clad their homes with insulation. Will she therefore urgently amend the scheme to ensure that insulation is fitted in tandem with heat pump central heating schemes to make sure that nobody is freezing this winter? We will certainly look on an on-going basis at any adaptation or amendment to the rules around our existing schemes that might be required. I will ask the relevant minister to look particularly at this point and to write to the member as soon as possible. To ask the First Minister what the Scottish Government's response is to the one-parent family Scotland report living without a lifeline, single-parenting and the cost of living. I welcome the report, although I wish it wasn't necessary, because we are all aware of the hardship felt by many families right now and particularly by single parents. The Scottish Government's very significant actions to tackle child poverty alongside our interventions to mitigate the cost of living crisis are providing direct support. For example, our five family benefits, which will shortly be worth over £10,000 in the early years of a child's life, include the Scottish child payment, which will increase to £25 in November, representing a 150 per cent increase within eight months. All of that, of course, in contrast to the UK Government, which continues to hold most of the key levers here. If it reversed the welfare reforms imposed since 2015, such as the two child limit, the £20 cut to universal credit, the benefit freeze and the benefit cap, that would put £780 million into household budgets and 70,000 people, including 30,000 children, would be lifted out of poverty. Unfortunately, we right now have to rely on a UK Government to exercise these levers. I look forward to the day when these decisions lie within the powers of this Parliament. Pam Duncan-Glancy. I thank the First Minister for that answer and I also thank one parent family Scotland and the parents who contributed to the report. The report is indeed a grim read, and just one parent's response in the report says how bad things are. She says, depression, anxiety, stress. I am responsible for the most amazing children, but I am falling apart. I am terrified of losing my job. The report suggests many ways to tackle child poverty, but including, and crucially, to help people to stay out of poverty employability support. I ask the First Minister whether she will explore the recommendations set out in the report, and will she give reassurances that the cuts to employability support announced by the Deputy First Minister will not impact efforts to help single parents and other priority groups, including disabled people, larger families, families with children under one, mums who are under 25 and people of colour? I am happy to give those assurances and I am happy to engage in more detail on all of that. In terms of the specific questions, yes, we will consider all recommendations in this report. Support for employability is important. In terms of the savings that were announced two weeks ago, the Deputy First Minister set out the rationale for those at a time of very high employment and very low unemployment. Our judgment when our budget is under so much pressure that we need to focus as much as possible in increasing the incomes of people through wage increases, as far as we can support those, and through, for example, increases to the Scottish child payment. Nevertheless, supporting employability for low-end parents and for others that tend to be furthest from the labour market remains extremely important. We will continue to use all levers and maximise the resources that we can bring to bear on tackling poverty, generally, child poverty in particular, and the issues that are experienced by low-end parents. I think that this Government has a good record, but the more powers we hold in our own hands, the more we are going to be able to do. Does the First Minister share my frustration that, while the Scottish Government introduces significant poverty interventions such as the Scottish child payment that she has mentioned, our ambition to tackle poverty is not only unmatched, it is absolutely undermined by Tory policies and that, as long as the UK Government holds the key tax borrowing and welfare powers, we are always going to be constrained in our ability to protect the most vulnerable in our society? I do share her that frustration because, just as we tried to use our powers and deploy our resources to lift people out of poverty, we have a UK Government that is taking actions that are pushing people into poverty. That is not a sustainable or a sensible or a morally defensible position. We face a UK Government now that seems to want to increase the bonuses paid to bankers while further eroding the incomes of those on universal credit. It is utterly indefensible. I think we are showing what we can do with the limited welfare powers that we have. The Scottish child payment is the leading example of that, but for as long as so many of these powers and levers lie with the UK Government acting in the way this one is, then our efforts are going to continue to be undermined, which is why it is so important that we get all of these powers into the hands of this Parliament as soon as possible. Thank you. That concludes First Minister's questions. The next item of business is a member's debate in the name of Ruth Maguire. There will be a short suspension to allow those leaving the chamber and public gallery to do so.