 Yn gwrs, mae'n gwybod gairion. Rydw i'n gwybod i gael y First Minister i gael gwladau gyda'r cwestiynau unrhyw gyd yn Jackson Carlaw. A fawr i chi fod gyda'r cymdeiligion sydd wedi ei ddefnyddio i gwybod i gael gwladau? Felly ddalech am Stocking Fee Mêl i gael ei cynnig oír gwcffiad—y'r cyhoffordd wedi ddefnyddio i gael ei chartair, rydyn ni'n i'n dweud yn ddarpariaith bach. Felly ddim byddai'n iawn credu yr ysgolwch, ac yn dweud, fel hyn mae'n edrych i deall i siaradum i ddwygiau i SciRWT. Bydd hanfyrdd yn fynd yn ei ddynion, ond rydyn ni'n mynd i gael i siaradum yn ei gael i siaradum i'r holliau i 33 oed oherwydd, yn cael ei ddweud. Rydyn ni wedi wneud o ddweud, wrth hynny, os oedol i gael i dim yn ddwyngosol oedol i gael i liffu cwmiddialanol lleanol. Mae'n ei ddweud i'r ddechrau'r turbodau diwrnod o'i cymryd, ond mae'n hyn yn i'n of character on my part, which my party can scarcely forgive, let alone understand. I actually quite like the First Minister. However, I am sure neither of us will allow this weakness on my part to stand in the way of robust exchange and so to business. First Minister, just how badly let down have the thousands of Scottish women fitted with a mesh device been? First Minister? First Lady, can I begin by welcoming Jackson Carlaw to his temporary place asking those questions? Let me say at the outset that I am very proud to be the last woman standing at First Minister's questions. I am not sure if I am expected to reciprocate all the nice things that Jackson Carlaw said to me at this stage, so I will maybe just gloss over that for the moment. Can I turn to the substance of Jackson Carlaw's question, because it is an important one. I know that it is a subject that he has taken a very close interest in over a period of time. In terms of the women affected, I have deep and very profound sympathy for what they have gone through and for the position that they have found themselves in. I cannot begin to imagine the pain and suffering that many of them have experienced. That is why, of course, the Scottish Government has acted through setting up the review and further work that has flowed from that review. Of course, in her first few weeks as health secretary, Jeane Freeman, announced what is effectively a ban, a temporary halt for all mesh procedures, and that will be lifted only when a new restricted use protocol is put in place. That will ensure that procedures are only carried out in future in the most exceptional circumstances and subject to a robust process of approval and fully informed consent. I was not in the chamber for the health secretary's statement, but I did hear some of it on that occasion. Indeed, I think that I heard Jackson Carlaw welcoming the action that the health secretary has taken, and I hope that he will do so again today. Jackson Carlaw. That has surely been the greatest self-inflicted health scandal since the Llyda Maid in the 1960s, and across the chamber sits MSPs who have led with determination to expose it as such, in particular Alec Neill, Neil Findlay, Rona Mackay, Angus MacDonald and Joanne Lamont. In the gallery today are women who many regard as outstanding examples of leadership and courage, Elaine Holmes, who led the public petitions process and mesh, Marion Scott, the journalist who led so successfully and campaigned in the issue, and many other mesh survivors who are watching today's exchanges at home. To me, they are heroes, recognised as such across Scotland, the UK and internationally, for all they have achieved, and they deserve the congratulations and the appreciation of every one of us for everything that they have done. First Minister, during our October recess, the Australian Government issued a full and formal apology to all those whose lives have been compromised by mesh. Here is part of what that apology said. On behalf of the Australian Government, I say sorry to all those women with the historic agony and pain that has come from mesh implementation, which have led to horrific outcomes. Will the First Minister now follow suit and, on behalf of the Scottish Government, today match that apology to all the women in Scotland who have suffered? Firstly, I have expressed apology previously to the women who have suffered. I know that the previous health secretary Shona Robison has done so and Jeane Freeman has also done so, but for the avoidance of any doubt and without any equivocation, let me say today on behalf of the Scottish Government, I apologise unreservedly to any woman who has suffered because of mesh procedures. The Scottish Government has acted here. I know that Jackson Carlaw, because of his interest in this, is aware that medical devices across the UK are regulated by the Medicines and Healthcare Products Regulatory Agency. That is a reserved body. The Scottish Government therefore cannot totally ban mesh. However, the actions that we have taken, for example, the suspension of the use of mesh in 2014 led to a significant reduction in the use of mesh implants and the further action that Jeane Freeman announced some weeks ago to temporary halt procedures until we put in place a new restricted use protocol is the right action. Again, I hope that members who have campaigned on this across the chamber will welcome that today. Thank you for that. On the MHRE, I have indicated that Scottish Conservatives will support a representation to the UK Government on that issue, because this is not really a question of whether a process is devolved or reserved. It is about a process that has failed and we have to ensure that such an incident does not happen again in the future. Exposing mesh has not been a party political initiative. That said, the singular serious misstep in the Scottish Government's record on the issue was its response to the now widely discredited review into mesh regarding women-affected and key clinicians such as Wail Agar as a whitewash. Indeed, nearly 100 MSPs signed a charter to that effect in Parliament. At the time, the First Minister and Health Secretary invited Professor Alison Britton to report on the process, but not the findings of that review that they said would stand. In the event, as the First Minister indicated, the new health secretary abandoned that position with a robust and welcome intervention last month. Professor Britton's report is now complete. There is no first nor second draft amended by any self-interested third party. There is just her unvarnished report. It is now or will imminently be in the hands of ministers. Will the First Minister agree to date both to publish Professor Britton's report without delay and also to say now that she expects, at least, to accept its findings and implement the recommendations made in it in full? The First Minister and I will come to all of them. In terms of the MHRA, I welcome Jackson Carlaw's offer to help to put pressure on the MHRA. The Scottish Government has already raised those concerns. I certainly look forward to hearing what the Scottish Conservatives are going to do to add their voice to the calls that we have already made. I agree with Jackson Carlaw that what is most important here is that this is a procedure that has failed. Of course, it is relevant whether it is a devolved or reserved matter in terms of what the Scottish Government is able to do. That is why I think that it is legitimate to point to the fact that the MHRA is a reserved body. In terms of the review, it is important firstly to say that the review findings were similar to those in recent reviews that were carried out in Northern Ireland, Wales, England and in some countries across the European Union. However, Professor Alison Britton was asked to review the process of the independent review. I understand that ministers have only just received that report and it is our intention to publish that report and, of course, to accept and implement the recommendations or where we think that they are not appropriate to set out very clearly to Parliament why that is the case and allow Parliament to form its own conclusions on that. We are determined to do everything that we can to recognise the suffering that has been experienced by women but, more importantly, to ensure that that suffering is not repeated by other women in the future. It has been a cross-party campaign and I hope that it will continue in that vein. Jackson Carlaw I thank the First Minister for everything that she has said there. For the women concerned, an apology and the First Minister has offered one is a necessary cathartic act. However, small and practical actions can also make a significant change to their lives now. For example, responsibility for the blue badge scheme rests with the Scottish Government. However, many of the women whose mobility has been impaired by mesh are currently simply not eligible. To them, access to the blue badge scheme, those in wheelchairs and on crutches, would be a hugely welcome and practical advantage. Now, this may not be the biggest political ask of the day but it is an important issue to the women involved and we could resolve to do something about it now. Will the First Minister agree today to instruct ministers and officials to review access to the blue badge scheme, to offer those who have seen their mobility severely impaired by mesh the singular and practical improvement to their future lives and wellbeing? I have a lot of sympathy with the points that Jackson Carlaw has made there. I will ask the Cabinet Secretary for Social Security to work with her officials to look at what action can be taken. Although I do not want to at this stage give Parliament assurances that I do not know whether we can deliver on quickly, I would think that this is not necessarily a particularly complicated issue. Local authorities, of course, when it comes to blue badges, will be relevant in these discussions as well. I am sure that the Social Security Cabinet Secretary would be happy to talk to Jackson Carlaw about how we can take this forward once we have had an opportunity to have officials look at it in more detail. 2. Richard Leonard Thank you, Presiding Officer. Today's Audit Scotland report is a damning indictment of this Government's mismanagement of our national health service. It says, and I quote, that the NHS in Scotland is not in a financially sustainable position and performance against national targets is declining. It is not the only report that has raised alarming concerns about Scottish Government health spending. A paper by Professor John McLaren of Glasgow University points to a future £400 million gap between what the Scottish Government plans to spend on the NHS each year and what it actually needs to spend on the NHS each year. First Minister, are the Auditor General and Professor John McLaren wrong? First Minister. Let me come on to John McLaren later. I will deal with Audit Scotland and I will take each of Richard Leonard's points in turn. The Audit Scotland report published this morning is rightly blunt. It sets out the challenges that the NHS is facing. In that sense, of course, it does not tell us what we do not already know or are not already working to address. The challenges that our national health service is facing are the same challenges as the national health service is facing in England, Wales and Northern Ireland, and indeed, the same challenges that health services are facing across much of the world. The Auditor General herself recognises that those challenges come from demands on the service from the ageing population growing. Of course, the task for us is not just to describe the challenge, the task for us is to come up with the solutions, and that is exactly what the Scottish Government is doing. We have plans in place, both for the investment that the health service needs and for the reform that the health service needs. In terms of the comment about financial sustainability, the Audit Scotland report itself recognises that this is not a criticism of Audit Scotland because, of course, the medium-term financial—perhaps the Labour members would like to listen to this, it is important—the medium-term financial plan that the health secretary published in this chamber just before the October recess—is not taking account of in the Audit Scotland report. Of course, that plan sets out a proposal to see the health budget increase by £3.3 billion over the period until 2023. That would be annual growth of 2.9 per cent in real terms. As Audit Scotland report says, the Fraser Vallander Institute predicts that the health resource budget is likely to have to increase by around 2 per cent per year to stand still. We are providing resources over and above that, and I think that that significantly changes the comment about financial sustainability. My last point on that is that the Auditor General in the report is clear that its current models of delivery that are not sustainable—that is why the reforms that we are carrying out are so important as well. Finally, and briefly, let me turn to the John McLaren comments from last week. There are two criticisms made there. On both of them, we would dispute the basis on which they are made. The first is that our estimate of the increased demand for health services is too low. Actually, our estimate is in line with many of the independent estimates. We estimate total rising demand of 4 per cent. That is in line with Fraser Vallander. In fact, it is slightly higher than what Fraser Vallander has recommended. Also, the Institute for Fiscal Studies and, indeed, the Kings fund the Nuffield Trust and the Health Foundation in a letter to the Prime Minister. I would take issue with that. Secondly, John McLaren suggests that our estimate for savings that the health service can make is too high. Actually, they are consistent with past performance and are lower than the savings requirements that are being expected in England. Those are my views on the John McLaren report, but, in summary, our health service does face challenges, but we are the only administration anywhere in the UK that has clear and robust plans in place to address and overcome those challenges. Richard Leonard The NHS in Scotland is not in a financially sustainable position that is in today's audit commission report. The First Minister can talk about her Government's budget choices, but her budget choices force health boards across Scotland to make £449 million worth of cuts in the last financial year alone. The Government calls those efficiency savings, but let's be clear. Those are cuts, and those cuts have increased year on year since Nicola Sturgeon became First Minister. Can the First Minister tell the chamber how much local health boards have had to cut since she took office? Health boards are not facing cuts. Health spending has increased year on year. If Richard Leonard wants to talk, as he is right to do, about the Audit Scotland report, he has to recognise that the Audit Scotland report today says that, over the past 10 years, the health budget has increased in real terms over and above inflation by 7.7 per cent. That is not cuts. That is rising health budgets. Secondly, in terms of the point about financial sustainability, I know that Audit Scotland has corrected its online version of the report this morning, but more substantively—I think that this is just a statement of fact—the report, due to the recent publication of the medium-term financial plan, is not taking account of in the plan. That sets out plans to increase health spending by £3.3 billion between now and 2023, which is over and above what the Fraser of Allander Institute has commented on by Audit Scotland says is needed to deal with the inflationary pressure. We have put in place plans to build on current record funding in the health service to make sure that it is financially sustainable in the future. If we had followed Labour's spending plans from the last Scottish election, if we had followed what they said in their manifesto, the NHS today would be—and Labour perhaps should listen to this—if we had followed those plans, our NHS today would be £360 million worse off than it is. That is the equivalent of the NHS losing 9,000 nurses. We have got the plans to ensure that our NHS is fit for the future, and we will get on with delivering them. The answer to the question that I put to the First Minister, which she refused to give, because she either did not know it or did not want to admit it, is £1.1 billion. That is £1.1 billion worth of cuts that health boards have had to make since Nicola Sturgeon became First Minister. Today's Audit Scotland report exposes the mismanagement of the NHS under the SNP, too many staff under too much pressure, too many patients waiting far too long, too many health boards having to make swinging cuts. Presiding Officer, the SNP has been in office for 11 years, and the Auditor General has today concluded that the NHS in Scotland is not financially sustainable. That represents nothing less than an abject failure of Government, does it not? Richard Leonard, in his first question to me, asked me if I thought Audit Scotland was wrong. I do not think that Audit Scotland was wrong. I have made the point that it does not take full account of our latest financial plan, which was published just before the October recess, but I think that I could equally posit that question to Richard Leonard. Let me read from page 10 of the Audit Scotland report that there has been a 7.7 per cent real terms increase in total health spending in the last decade. If Richard Leonard is coming here to say that that is not true and that there has been cuts to the health budget, is he saying that Audit Scotland is wrong? Frankly, he must be, so he should try and have a bit of consistency in his questioning. Let me set out the record of this Government. Yes, the NHS is under pressure, rising demand is putting pressure on waiting times. The vast majority of people, though, are seen within the waiting times targets. The health secretary set out a plan just earlier this week, showing how we will deliver significant improvements to performance in waiting times. Interestingly, if we look at the number of people waiting more than 12 weeks for treatment in the last full year that we have got figures for, which is too high a hasten to add of just over 80,000, if we go back to the last year before we came into power when Labour were in office, there were 104,867 waiting more than 12 weeks for treatment. We have the plans in place to protect our health service, record numbers of staff, record funding and even more funding planned, because we have the solutions, while Richard Leonard only wants to talk about the problems. A lot of interest in asking supplementaries at this stage. The First Minister is already aware of the horrific situation that my constituents David and Karen Connolly find themselves in with Mrs Connolly's application to become a British citizen rejected by the Home Office despite her husband of 32 years being a British citizen. The couple moved from Zimbabwe via Botswana to be with their son Marcus, a British citizen living for 10 years in Invernoory. Mrs Connolly is also the carer of her engineer husband, who is quadriplegic and requires 20 for their care. I have written in support of their case ahead of their appeal tribunal and to the First Minister. Can I ask the First Minister what more can we do to support the family and make the case for Mrs Connolly being allowed to remain in Scotland with her family? I thank Gillian Martin for raising this case. I have read the details about Mr Mrs Connolly's case in the daily record this morning, and I want to commend Gillian Martin for taking up this case and arguing it so strongly. My heart goes out to Mr Mrs Connolly, and I hope that she gets the opportunity to stay here as a family in Scotland. I have complete sympathy for anybody attempting to navigate the increasingly complex and restrictive UK immigration system. The one-size-fits-all approach imposed by Westminster is arbitrary and it is very often inhuman, particularly in cases that threaten to rip families apart. Literally every day just now we hear more and more stories of lives being disrupted across the country by those disastrous policies. We want to welcome people to come and live here and to contribute to our communities and not to threaten to force them to leave once they settle. If there is more that the Scottish Government can do to help Gillian Martin to argue this case, I am more than happy to look at that and see that we do it, but I want to take the opportunity to wish Mr and Mrs Connolly well and give them the message that the vast majority of people in Scotland welcome them here and want them to stay in our country. Peter Chapman To ask the First Minister how many patients NHS Grampian discharge before a necessary care plan is put in place. I am happy to have the health secretary right to the member with the detail that he is looking for. I do not have that detail to hand. Nobody should be discharged before it is safe for them to be discharged and where the necessary care plans are in place. I know that all health boards and, of course, integrated joint boards work very hard to make sure that that is the case. As we have seen over the past few years, overall, the number of delayed discharges is coming down and we have health services and social care services working more closely together to make sure that people have the care plans that they need. On the specific detail, I will make sure that that is provided to the member. Daniel Johnson Thank you, Presiding Officer. In recent days, the use of recreational firearms has been in the press from the shooting of goats through to my constituency where there is concern about the opening of a gun shop, a mere matter of yards from South Morningside primary school. Having been in touch with the police, they can take no action because their locus is over who can be a firearms dealer, not where those businesses locate. The council has no locus because it is the police that regulate firearms and, indeed, on that basis they would have more interest if someone was seeking to open a fast food joint rather than a gun shop. Can I ask the First Minister this? Does she believe that a gun shop is just another shop? Does she believe, as I do, that this apparent loophole should be closed whereby we should have regulation of not just who can operate those businesses but where they operate? Finally, does she believe that it is right to have a gun shop next to a primary school? I know that I do not. The First Minister I thank the member for raising the issue. I do not know the particular details of the shop that he is raising today, but in general terms I would agree with him that that is not something that I would feel instinctively comfortable with so that I can understand his concerns. I also agree with him that we should not see gun shops as just the same as all other shops for very obvious reasons. As the member is aware, most firearms legislation with the exception of air weapons is reserved to Westminster, although we are the only part of Great Britain to licence air weapons. Firearms licences are issued by Police Scotland. I am more than happy to look into the particular case that Daniel Johnson is raising and to come back to him if there is more action that the Scottish Government or any of our agencies should be taking. However, I would also encourage him to raise his concerns if he has not already done so with Police Scotland. I am more than happy to come back to him because I absolutely understand the reasons for what he has described today, causing deep disquiet, and I am sure that many people will too. The First Minister will be aware that eastern airways recently cancelled their Stornway to Aberdeen service with effect from tomorrow. What more can the Scottish Government and its agencies do to ensure the economic viability of air services to and from the Western Isles, particularly for those of my constituents who work in the oil and gas sectors? I can understand Alasdair Allan's concerns about this. We have to make sure that the connectivity between all our islands, including Alasdair Allan's constituency in the mainland, are encouraging economic sustainability and sustainability in a range of other ways. I am happy to ask the transport secretary to engage with him, to engage with the airline and to look to see whether there is more that the Scottish Government can and should be doing to address that particular concern. In Glasgow on Saturday, thousands of teachers will be taking to the streets to make clear their demand for fair pay settlement. They have already told the Government that they will not have their members divided against one another with some given a decent rise and others left behind. The loss of 3,500 teachers since 2007 and the reliance on temporary contracts for so many newly recruited teachers is having a direct impact on the quality of education. It means more stress in classrooms and staff rooms, more teachers who do not have the permits that let them build a strong relationship with their pupils, music lessons, acts and children going out without additional needs being identified or met. Will the First Minister promise the teachers who will march on Saturday that the Government will give them the fair pay rise that is due so that we can attract and retain the teachers that our children need? We are committed to fair pay rises for all our public sector workers, where we have already agreed deals. We have demonstrated that both for agenda for change workers in our national health service, where we have awarded the best pay rise of any country in the UK, as far as I am aware, and also for our police officers, where the pay rise for our police officers goes beyond that being offered south of the border. In terms of teachers, yes, the teaching unions have formally rejected the latest offer from COSLA, but we are all committed to continuing discussions. The Scottish Government, of course, is actively involved in these negotiations and would urge everyone around the table to take a constructive approach. We had worked with COSLA to put in place a fair pay offer for 2018-19, which would see the Scottish Government contributing an additional £35 million of funding for teachers pay. That would result in all teachers on the main grade scale receiving at least a 5 per cent increase, with some teachers receiving up to 11 per cent in one year. I do believe that that is a generous and fair offer and hope that it will be considered in such a way, but we are committed to continuing negotiations in good faith. In terms of parity, I absolutely understand and sympathise with that point. We value the whole education workforce and recognise the aspiration for parity between teachers and non-teachers. I simply point out that those involve two different negotiating arrangements. The Scottish Government is party to the teachers pay negotiating mechanisms, whereas pay for non-teachers is negotiated between COSLA and the trade unions, and we are not part of that process. Those are two different mechanisms, but that does not take away from the fact that we have sympathy with the overall point that we made. We want to have pay and other arrangements in place that attract people into teaching and give them a rewarding career when they are in it. Patrick Harvie Parity, even within the teaching workforce, does not yet seem to be acknowledged. The teachers who will be marching on Saturday are saying that all teachers deserve that 10 per cent rise. It is necessary in order to make up for the years of below-inflation real-terms pay cuts. The consequence of getting that wrong will not just be unhappy teachers, perhaps even forced to the point of industrial action. Holding back teachers' pay and squeezing the budgets of our local councils will prevent the educational improvements that I believe the First Minister wants to see. It is not only our teachers and schools. The councils that fund them need the resources to do the job properly and to do everything else that we expect of them, from social care to environmental services. If we want the excellent public services that this country deserves, we need to make the resources available. When will this Government finally give councils both the funding and the powers that they need and deserve? Of course, in our last budget, we agreed with the Green Party a deal for councils that delivered real-terms increases in the budget that they have to spend. Of course, we were also the first Government anywhere in the UK to lift the 1 per cent public sector pay cap. In terms of that point about parity within the teaching profession—I am not going to comment specifically on teachers on this because the negotiations are on-going—but generally, within our public sector pay policy—and I think that this has been backed by the Greens and others, we have recognised the need to give bigger pay increases to those at the lower end of the scale than those at the higher end of the scale. I believe in that progressive principle, and it is one that I thought Patrick Harvie agreed with. In terms of pay deals, we absolutely recognise that public sector workers have taken a lot of pain through pay restraint in recent years. We are committed—I have made this very clear, as has the finance secretary—to redressing that as quickly as we can. We have got to do that in a way that is fair, but it stands to reason that we have also got to do that in a way that is affordable. I think that we have demonstrated our commitment to this. The 9 per cent over three years that has been agreed for nurses and other agenda for change workers—the 6.5 per cent over the 30 months for our police officers—strikes a balance between fairness and recognising that we have ground to make up for public sector workers, but also recognising that we have to have deals that are affordable. I hope that we can reach the same fair outcome for teachers, because we all want to see teachers properly rewarded for the excellent job that they do for their sake, but also so that we can continue to attract new people into the profession in the years to come. I take the First Minister back to the NHS. She talked earlier about her plan to meet waiting times targets that she has failed to meet so far. On page 4 of that plan, it says that performance will continue to decline. The next quarters figures will be worse than the last quarter, and those were worse than the ones before that and the ones before that, too. Why is it in year 12 of an SNP Government that we still have to expect waiting times to get worse before there is any sign of them getting better? The answer to that is pretty well known to Willie Rennie and others. Let me repeat what I said to Richard Leonard. The vast majority of patients are seen within our waiting times targets. One of the observations that is made in the Audit Scotland report today is that 90 per cent of patients rate their care as good or excellent. That is a tribute to the NHS and all the staff across the country who work in it. However, demand on our NHS is rising. That is largely because of the ageing profile of our population, and that is putting enormous pressure on waiting times. What the health secretary did this week was to be utterly transparent about those challenges, the impact that they are having right now and what the funding plans are that we have in place to address those challenges and to substantially and sustainably reduce waiting times. I think that that is the right way to go. Although it gives Willie Rennie the opportunity to come and ask those questions today, I think that it is important and right for us to be fully frank, honest and transparent with Parliament about the nature and scale of the challenge that we are facing so that Parliament can then hold us to account as we work through this plan in the years ahead. I will continue working with the health secretary to make sure that we have the funding in place, to make sure that we are putting the staff resources in place and to make sure that we have the reform plans in place to ensure that our NHS is fit for the future. That is my responsibility and it is one that I will continue to live up to. Willie Rennie The law states that patients will be guaranteed NHS treatment within 12 weeks. That is the First Minister's law from when she was health secretary. It was an SNP flagship law that helped them to take power in 2007. It is a law that the SNP Government has broken over 100,000 times. On Tuesday, the Government said that it would keep on breaking the law for another three years. If a member of the public was to break the law this many times, they would serve time in Barlinny. Why is it that when the SNP Government breaks the law, they think that they can get away scot-free? Can the First Minister tell the people of Scotland what exactly are the penalties for breaking the law that she has flouted so many times? He always manages to let himself down on these serious issues, but I can return to the serious point. I am trying to answer it. The 12-week treatment guarantee—yes, it has not been adhered to more than 100,000 times, but 1.6 million patients have been treated within that. Patients that might have waited over 12 weeks without that guarantee. As I just said, there are now fewer people waiting more than 12 weeks for treatment than was the case when this Government came to office. The sanctions and the steps that are taken when health boards do not meet the treatment guarantee are laid down in the law, so Willie Rennie can go like anybody else and look at what they are. The health secretary engages with health boards. Health boards have obligations to advise and inform patients of what they will do to deliver their treatment as quickly as possible. Health boards are monitored on that by the health secretary. I stand here today and do not shy away from the challenges that our health service and common health services across the UK and further afield are facing, but we are putting in place the plans—we have put in place the plans—both around investment and around reform to make sure that we meet those targets and to make sure that the quality of care is as patients expect. The final point is again going back to the Audit Scotland report. The Audit Scotland report, a point repeated by the Auditor General on radio this morning, is very clear about the high quality of care that is delivered by staff in our NHS. That is something that we should thank them for. Mark Ruskell will take a number of questions. Thank you. The science is clear. We have just 12 years and three parliamentary sessions left to avoid dangerous climate breakdown. This week, our Environment, Climate Change and Land Reform Committee heard directly from the IPCC that all climate targets need to be reconsidered. Can the First Minister explain why the Scottish Government has—alongside the UK Tory Government—asked her advisers to only look at whether changes are required to the long-term climate target and not the need to increase ambition between now and 2032? We have specifically asked them for the shorter term as well. In that respect, I am being told by the Environment Secretary that I will be corrected if I am getting that wrong. That is the case. We, of course, in terms of the shorter term targets, if we look at 2020 and 2030, the targets set out in the bill that is currently before Parliament are already the most stretching targets anywhere in the world. In terms of the IPCC report, which we take extremely seriously, the central recommendation in the IPCC report is that the world should reach carbon neutrality by 2050. The bill that is currently before Parliament delivers that for Scotland. We have already passed well-passed PQ emissions, which is the other point that the IPCC report makes about the world needing to get to PQ emissions imminently. The bill does that in terms of the aspiration that many have that I share to go to net zero for all emissions as quickly as possible. We have asked the committee on climate change to give us updated advice, because its existing advice says that the 90 per cent by 2050 in the bill is already at the limit of feasibility. Of course, the bill puts obligations on ministers to review those targets to get to net zero as quickly as possible. We are recognised internationally as a world leader, and my determination is that we stay at the leading edge of world action to tackle climate change for the benefit of this and perhaps even more importantly future generations. Tom Arthur Can I ask the First Minister for her response to comments made in this chamber yesterday that people reliant upon social security, including those receiving in-work benefits, have no right to have more than two children? I think that the comments that were made by Michelle Ballantyne in this chamber yesterday were both appalling and ignorant of the reality facing many families. Appalling because the idea that being poor should be a barrier to having a family is Dickensian and shows the Scottish Conservatives in their true colours. The comments were also ignorant because the rape clause will not just apply when children are first born. From next year it will apply to children of any age should their family circumstances change so that they need to claim benefits. To defend the rape clause, it misses the point that any of us can have our circumstances change at any time and what Michelle Ballantyne seems to be suggesting is that if that happens to a family who perhaps had three children while they were all in work, suddenly fall into different circumstances, those children should be penalised as a result. It is absolutely shameful that the social security safety net is there for all of us should we need it in times of distress or times of change circumstances and, frankly, shame on the Conservatives that they are dismantling that social security safety net. The First Minister will be aware that there are workers hard to build the flagship £2.6 billion Beatrice offshore wind farm that has included migrants without immigration documents paid a fraction of the minimum wage, some under £5 an hour. The Scottish Government believes that green energy is a priority. Will the First Minister act to ensure that green jobs are not exploited jobs and stop that from happening to major infrastructure projects in Scotland? I would unreservedly condemn any employer that was exploiting workers in that way. I am happy to ask the economy secretary and the infrastructure secretary to look into this specific case and to give Jackie Baillie the findings of that when they have had the chance to do so. However, the expectation of me as First Minister and the expectation of this Scottish Government is that employers have fair work policies. In fact, we announced over the course of the recess plans to toughen up our approach to fair work, both in terms of our expectations when Government grants are granted or in the public procurement system. Of course, we will set out more details of that to Parliament in due course. Despite receiving an influenza vaccine, one of my constituents developed pneumonia, requiring a full-day admission to the Board of General Hospital. The First Minister will be aware that, in Scotland, the new flu jab is only available to over 75s. Last year, influenza and pneumonia deaths hit an 18-year high. With a cold snap predicted, is the First Minister confident that under 75s are properly protected and the NHS has the correct resources that it needs to prevent further deaths? Yes, I am confident in our vaccination programme. All of us as responsible members of this Parliament should encourage the public to be confident in that vaccination programme as well. The supply of the vaccine is already available to GPs and the programme is already under way. There are a number of different vaccines in use in Scotland for different groups of people. In terms of the over 75s, it was the recommendation of the JCVI that, if there had to be a prioritisation of that vaccine, it should be over 75s that were in the priority group. That is what the Scottish Government has ensured. Of course, it has been supply issues beyond our control that has meant that, in this year, we cannot extend that to over 65s, but we will do that in future years. However, the other vaccine, the vaccine that is being used for the over 65s, is an effective vaccine. Let me take this opportunity to encourage all those who have not yet taken up the vaccine and are eligible to do so, to do so as quickly as possible. It not only protects them, it helps to protect the population as a whole. To ask the First Minister what the Scottish Government's position is on the use of daylight saving time. I am aware of the European Commission's proposal to end current daylight saving arrangements. The Scottish Government does not believe that there is a substantive economic or social case for any change to those arrangements. The rural economy secretary has, this week, written to the UK Government to stress that the effect of the proposal, if implemented, would be more pronounced than Scotland, given greater extremes in the extent of our daylight hours. The impact would likely be particularly felt by the farming community and other outdoor workers. We are currently engaging with stakeholders to better understand the potential impact of this proposal, and we will ensure that any concerns raised are reflected in our on-going discussions with the UK Government. Christine Grahame Thank you, Presiding Officer. I thank the First Minister for her answer and Scottish Government's support for putting the clocks back one hour this weekend, which I must remember to do as I did not do it one year. I welcome the letter of the cabinet secretary for rural economy to the UK Government, which sometimes being located so far south fails to recognise how long our winter mornings can be. However, if the cabinet secretary for transport will also contact the UK Government on the issue of road traffic accidents and they need the effect of these dark mornings on the safety of our school children, walking to school, particularly in rural areas with no pavements and no street lighting, such as in my constituency of the Borders in Midlothian. The First Minister I am tempted to say that the fact that Christine Grahame, due to a lapse of memory these years ago, one hour out of sync with the rest of his might explain an awful lot, but I am sure that I will pay dearly for that comment in the weeks and months to come. This is a serious issue. We will be happy to make the letter from the rural economy secretary available to Parliament and, of course, likewise with any response that we receive. As I said in my answer, we are currently gathering views on what the impact of the proposed change would be and that will include the impact on transport and other areas highlighted by Christine Grahame. The commission has stated in its own proposals that the evidence is currently inconclusive in terms of road safety, so we will continue to liaise with the UK Government. This is a reserved matter with the transport sector and rural communities on this important issue. If there are issues that the transport secretary requires also to raise, he will certainly do so. The First Minister I apologise for going over time, but question 6. Thank you, Presiding Officer. To ask the First Minister what the Scottish Government's position is on the report from Chest Heart and Stroke Scotland, which suggests that one in five patients are not receiving the support that they require. We welcome Chest Heart and Stroke Scotland's report and will continue to work alongside them to support people living with and affected by those conditions. Our plans to improve rehabilitation are set out in our stroke and heart disease improvement plans. We are working in partnership with NHS boards, the voluntary sector and a range of providers across health and social care to help to ensure that people who have heart disease or have had a stroke get access to the care and support they need to help them to return to independent living. A strategy for tackling strokes and heart disease is delivering improvements with mortality rates, which is reducing by around 40 per cent for both stroke and coronary heart disease over the past 10 years. Pulmonary rehabilitation is already a key recommendation in our national clinical guidelines. Alexander Stewart I thank the First Minister for that response. What assurances can the Scottish Government give that it will do all it can to end existing variations in access to NHS rehabilitation services, as well as provide allied health professionals when pulmonary rehabilitation is already within clinical guidelines, yet an estimated 60,000 people are not currently receiving it? The First Minister First, I say again that we welcome the report by Chest, Heart and Stroke Scotland. I want to take the opportunity today to commend them for the work that they do. The health secretary recently met them to begin discussions with them on their campaign. She has given them a commitment—I will repeat that commitment today—to continue those discussions to see how we can move towards the right to rehab end result that the NHS is looking for. We, as I said, already have plans to improve rehabilitation in place through the stroke and heart disease improvement plans. Those include priorities on rehab, transition to the community and supported self-management to support people living longer, healthier lives in their own communities. Our stroke improvement team and the cardiac rehabilitation champion are working across health and social care with the third sector to help us to deliver on those priorities. We will continue to take forward our existing proposals and any enhanced proposals that are required as a result of our discussions with Chest, Heart and Stroke Scotland. Thank you very much. That concludes First Minister's questions. We are now going to move on to members' business in the name of Jamie Halcro Johnston, but before we do, we are going to have a short suspension simply to allow the public gallery to clear and our guests for the next debate to arrive. A short suspension.