 I remind members of the Covid-related measures that are in place and that face covering should be worn when moving around the chamber and across the Holyrood campus. The next item of business is a debate on motion 2327 in the name of Anas Sarwar on protecting patient safety at the Queen Elizabeth university hospital. I would ask those members who wish to speak in the debate to please press the request to speak buttons now. I call on Anas Sarwar to speak and to move the motion up to six minutes please, Mr Sarwar. Thank you, Deputy Presiding Officer. This morning I met with Kimberly Darick, whose daughter Millie died four years ago, and Louise Lawrence, whose husband died last year. They, like a number of families, are watching this debate today. Two years ago, I stood up in this Parliament and exposed the failures at the Queen Elizabeth university hospital in Glasgow. It has been uncovered in the two years since is a human tragedy on an unimaginable scale. It is beyond doubt the biggest scandal in the lifetime of this Parliament. Where we have reached today is only possible because of the bravery of senior clinicians who are willing to whistle blow. The response on the health board then was the same play book that they are attempting to play now. Cover-up, spin, denial, bullying, silencing and calling it to question the integrity of senior clinicians and families. Let me start with a direct message to the front-line staff at the Queen Elizabeth university hospital. Thank you for everything that you are doing. I have every confidence in you and know that you are working day and night to do your best for your patients. I have no confidence in the leadership of your health board. You deserve a leadership that does not try to silence you, that does not try to bully you and perhaps most of all, as we have seen this week, you deserve a management that does not disgracefully attempt to spread the blame to staff. I know that they are letting you down and this fight is as much for you as it is for the patients and families. I said directly to the health board leadership, listen to the words of Dr Christine Peters. Do not gaslight the entire staff base at the Queen Elizabeth university hospital in order to protect your jobs at the top. Do not underestimate the resolve of the staff, patients and families. They cannot be silenced, they cannot be managed away. I have spoken to them and I have made them a promise. As a representative, but more importantly as a father. I will not stop, I will not go away, I will not rest until I get the answers and the justice you, your families and the staff deserve, because today we are drawing a line in the sand. In the words of Kimberly Darwick and Louise Lawrence, enough is enough. MSPs in this Parliament have a choice, side with patients, families and staff or the failed leadership of this health board. I say to every member in this chamber for the sake of the dedicated NHS staff, the patients at the hospital, the grieving parents and in memory of those who have lost their lives. I implore you please, let's send a message and tell the leadership of the health board that this Parliament has no confidence in them and escalate the board to the highest emergency level without delay. This has been a two-year fight for justice and in that time we have had three water reports ignored, flagging the risk as high, staff bullied in silence, patients getting infections, more patient deaths, in one case a family only finding out because of the bravery of whistleblorts. In another case, a family still do not know how their child died because the health board has not been able to make contact with them. We have had words closed, an independent review, a case note review, a public inquiry and criminal investigations and families still having to fight the system to get the truth. Families still having to tell their tragic stories in newspapers in order to try to get answers from the Government and the health board. People are still dying from the preventable hospital-acquired infections. In that time, not a single person has been held to account. I have some direct questions for the health secretary. How many Hyatt red warnings have you received from the hospital since you became health secretary and when? How many and when? If the answer is none, then why not and what questions have been asked about why not? If the answer is we have received some, how many, when and what action did you take? A crucial question is this. How many more deaths, how many more heartbroken families, how many more tragic stories is it going to take before this Government loses confidence in the leadership of this health board? Today there is a chance for everyone in this Parliament to show that we believe the NHS staff and we stand by them and to show that we support the parents and patients who have lost loved ones and will seek justice for them. Kimberly Danick and Louise Lawrence and many other families, as I said at the start, are watching this debate. They want to know what side those on this Parliament are on. I know what side I am on. The question for every single member in this chamber is what side are you on. I move the motion in my name. I now call on Marie Todd Minister to speak to and to move amendment 2327.2. Up to five minutes, please, minister. Excuse me, could we have less chatting from Ms Edd into position across the benches, please? I have called Minister Marie Todd, who is actually on her feet to speak, so it's a huge discurtersake to her. Minister, please start. Thank you, Presiding Officer. I want to begin by stating that my thoughts and condolences are with all families who have lost a loved one while in the care of the health service. Various claims have been levelled against the health board and throughout we have worked to ensure that these are investigated and where necessary acted upon. Clearly, when we are considering these individual claims, it is vital that specific consent is given on an individual basis before comments can be made. It would be totally inappropriate for me or any other member of this chamber to discuss cases where that consent is not explicit from the families involved. Members may be aware of a letter from clinicians at the board who have stressed this point. Serious claims have been made regarding Asper Gillis in the Queen Elizabeth university hospital. That is why the health secretary has tasked Healthcare Improvement Scotland to undertake a wider independent general review of Asper Gillis in the QEUH to assess and determine if there are any broader concerns requiring action. Any recommendations from this work will be implemented as quickly as practicable. As members will be aware, an independent review of the QEUH was commenced in March 2019 and was followed by the establishment of a statutory independent public inquiry led by Lord Brody QC in September 2019. This public inquiry is now fully under way and I look forward to its conclusions and any recommendations being fully enacted. Members will also be aware that NHS Greater Glasgow and Clyde was elevated to stage 4 of the NHS board performance board framework in November 2019. In order to provide independent scrutiny of the board, a QEUH oversight board was also established at the same time, which was followed by a case note review in January 2019. The investigations and reviews of recent years have led to a substantive programme of recommendations being implemented by the board and the hospital. That has meant that, of the actions for the board, 98 per cent of the independent review recommendations have been completed. 88 per cent of the oversight board's recommendations have been completed. Importantly, none of the small number of outstanding actions relate directly to patient safety, and 100 per cent of the case note review has been completed. An update on outstanding and continuing actions has been requested at the next meeting of the assurance group. We will work with the board to determine how progress against the recommendations can be shared more widely than current reporting mechanisms. Scotland is the only country in the UK with a national reporting system for incidents and outbreaks. Funded by the Scottish Government, the evaluation of cost of noscomial infection project teams' recent study identified Asper Gillis as representing 0.68 per cent under 1 per cent of all healthcare-associated infection. Within Europe, it is estimated that 6.5 per cent of patients treated within an acute care hospital have an HCI at the time of the survey. In Scotland, at the time of that survey in 2016, the overall point prevalence of HCI was 4.5 per cent of acute hospital patients. In NHS Scotland, more generally, the hospital standardised mortality ratio, the HSMR, provides a measure of mortality adjusted to take account of some of the factors known to affect the underlying risk of death. Those latest statistics show that QEUH is below the Scottish average for HSMR and, again, has been observed in the letter from the clinicians. Immense progress has been made in Scotland since the world-leading Scottish patient safety programme was launched in 2008, since SPSP launched its influence on the safety of care in Scotland by delivering reductions in HSMR by 14 per cent, cardiac arrest by 29 per cent, sepsis mortality by 21 per cent, neonatal mortality by 15 per cent, pediatric ventilator-associated pneumonia by 86 per cent, while the focus rightly and reasonably relates to the performance of the board against important recommendations. In lessons continued to be learned, there is a very important factor that appears to be too often omitted from the conversations. I note that senior clinicians, doctors and nurses have publicly expressed their anger when their integrity has been called into question without evidence to back up such serious allegations. In conclusion, Presiding Officer, where there are concerns, they will be investigated and acted upon. However, our NHS staff are working incredibly— Excuse me, Presiding Officer, could you just second your seat? The minister, if you recall, when I called the minister to speak by the clock, there was sedentary chattering going on, and I had to interrupt the minister before she'd even started. So could we just let the minister conclude and move on with the debate? Thank you Presiding Officer. I'll finish by saying that our NHS staff are working incredibly hard, and we will continue to do all that we can to support them to provide the best care possible for the people of Scotland. I press the motion. I now call on Douglas Ross to speak to and to move amendment 2327.1 up to four minutes, please, Mr Ross. Thank you, Deputy Presiding Officer. My thoughts and condolences are with all the families affected by the scandal. I also want to thank the front-line staff at the hospital. Our criticisms are not with them. It is the direction and the leadership that they are receiving from the board that we rightly, I hope, as a Parliament, can agree needs to be addressed. When the Queen Elizabeth University hospital was first opened in July 2015, the First Minister described it as one of the best-designed healthcare facilities in the world. The then health secretary described the hospital as state of the art and said, and I quote, it would transform patient care. When families watch their loved ones going into hospital, they expect them to receive that world-leading healthcare that our NHS is so highly respected for. They don't expect an NHS hospital to be the cause of death of their loved one. It's been two years since whistleblowers first came forward to suggest that children, including 10-year-old Millie Mayne, had died as a result of contaminated water, yet we still don't have a complete picture of the full extent of the avoidable deaths at Queen Elizabeth University hospital or the Royal hospital for children. We are still reliant years later on the bravery of NHS staff coming forward to tell the truth. I want to thank Labour for bringing forward this motion and crucially important debate today. I want to praise Anna Sauer for being a persistent champion for the cause of the families who deserve these answers. They need to know how their loved ones were so tragically let down. The Scottish Conservatives will stand with Labour on their motion today. The health board has utterly failed in its duties and it's right that they are removed as part of the systemic changing of culture across NHS Greater Glasgow and Clyde towards openness and transparency. However, SNP Government ministers must also restore confidence that they are doing everything that they can to treat the scandal of avoidable deaths with the urgency that it deserves. That means escalating the board to stage 5 of the performance escalation framework now. Almost a week later, we have received a letter of apology and correction from the First Minister because she sat there and stood in response to questions last week, saying that the health board was already at the highest level. Jackie Baillie made a point of order at the end of First Minister's questions and I watched the First Minister and she rolled her eyes when Jackie Baillie was trying to say that there was another level to go to. Now, six days later, she has written to Parliament to apologise for that mistake and said that she could still move to level 5. That is what we are demanding here today. The health secretary and his predecessor have to be held accountable for actions that they have taken since they first learned of these appalling deaths. I would like to raise direct questions with them. What action has been taken to get a grip of this situation? What action has been taken to encourage openness and transparency? What action has been taken to ensure that the hospital is a safe environment for patients? It is not good enough to hide behind a public inquiry as an excuse for inaction. It is not good enough to hold professionals accountable and not the politicians elected to oversee the performance of our health service. That is why Scottish Conservatives in our amendment are calling for a further independent inquiry to be held into the ministerial response to the avoidable deaths at Queen Elizabeth University hospital. If Government ministers are confident that they have taken every single possible action to promote transparency and to take emergency action to prevent further deaths, they will have no issue backing our amendment today. This is not an issue of scoring political points. Every single member in this chamber has to understand the anguish and the heartbreak of the families who have lost loved ones in this appalling tragedy. I say this as a husband, a father and a son. Families entrusted their husbands, wives, mothers, fathers, sons, daughters, brothers and sisters into the care of the health service and they were let down. A hospital is a place where patients are supposed to get better. It was instead the cause of their death and may still be causing death now. How can we deny them the simple request of knowing what went wrong? Of why this happened and what has been done to prevent it from ever happening again? In today's debate, we cannot get the family to those answers but we can commit to finding them and holding those responsible to account and I move the amendment in my name. Thank you very much. I rise for the Liberal Democrat and offer our support to the motion in the name of Anna Sarwar. Can I echo the condolences offered to everyone who has been affected by the tragedies at this hospital? It is a rare occasion when this chamber sees the leaders of all opposition parties in attendance to discuss a topic of such public importance with feelings that run so deep into our society that we are all compelled to lead for our parties. It is dismaying then that the First Minister has not found an hour in her diary to attend Parliament to address the problems at this hospital, a hospital that she commissioned, a hospital that serves patients in her own constituency and one that problems have gone unaddressed on her watch. I find that contemptible. Presiding Officer, three years ago we learned about serious safety and cleanliness issues at the QEUH, ranging from grime-damaged facilities and contaminated supplies. At that time, I and others urged for the hospital to be put under the closest of surveillance. Evidently, this did not happen. This hospital was opened in 2015. It cost £842 million in construction alone. It was heralded, as we have heard, as a super hospital built to provide the most excellent and efficient healthcare to those who need it. Ever since its creation, Queen Elizabeth University Hospital has been troubled by problems embedded in the very fabric of the building itself. Similar problems were, of course, to put a stop to the opening of the new sick kids in Edinburgh, while millions of pounds and 18 months were spent putting them right. Those problems were caught just days before the sick kids came into operation. However, the problems at QEUH have only emerged one by one in the years after it opened, and they emerged because they were allowed to have a catastrophic impact on patient health. The failures and standards are shameful. The fact that such failures have led to loss of life is unforgivable. Andrew Slorence, who we have already heard, father of five, and a dedicated public servant, is just ten years old when she passed away in the paediatric hospital. Last week, we learned about two possible other deaths of children linked to infections in that hospital. As a father of three young children myself, my stomach turns just thinking about this. When anybody uses the hospitals in our country, they entrust their own lives and the lives of those people that they care about into the hands of others. No one should expect their life to be endangered or even lost, not by the condition that they were seeking help for, but by the place of treatment itself. Enough is enough. Now is the time for decisive action. That is why Scottish Liberal Democrats are supporting Scottish Labour's motion today. Those who are responsible must be held accountable, and the NHS board must be escalated to stage 5, accompanied with additional oversight and checks to prevent any further risk to life. That is not a criticism of NHS staff. Anyone who says otherwise is gaslighting those same NHS members of staff. As Dr Christine Peters herself said on Twitter last night, the NHS staff working at the Queen Elizabeth university hospital have acted with the utmost compassion, bravery and self-sacrifice, aware that the fabric of the building that they were operating was harming the patients that they were trying to support. They deserve our utmost respect, but they too have been egregiously let down by mismanagement. It is only because of whistleblowers that we have some of the information that we do. As I mentioned, Dr Christine Peters took to social media last night to tell us about the reviews that have gone into whistleblowing that has happened. The so-called independent review did not look at a culture of bullying in that health board. Those are the things that we need to uncover. Those are the things that deserve our attention. We should be very clear as to what has caused the scandal, failure of management and of leadership, both by Greater Glasgow and Clyde health board and an SNP Government that has been complacent in presiding over one of the worst scandals in the history of devolution. Although it will not make up for the grief, disappointment and anguish created, the very least that this Government can do is to prove it cares by supporting this motion and swiftly acting. We now move to the open debate. I begin by saying that the heart of this issue are patients and their families, who have suffered a serious injustice, the likes of which few of us can even fathom. On top of that, we have hardworking NHS staff whose reputations are being damaged by a failure of authorities to address a life-threatening problem that no one has been held accountable for. The focus of everything that I am about to say is concern for the welfare and the professionalism of both of those groups. That is, after all, our primary responsibility as elected representatives of the people, and I hope that that will be central to any reporting surrounding this story. We naturally end up focusing a great deal of time on incompetence and poor governance in this chamber week after week, but, for me, Scottish Labour, the central concern should always be the effects on people's everyday lives. In this case, at the Queen Elizabeth, we can see it as plain as day that the lives of those affected have been a secondary consideration. Waterborne infections at the hospital have been a factor in the deaths of a number of people, including children. The extent of which we should still not fully understand that is a number of families spending Christmas without those closest to them and every Christmas after that. I am concerned that this is not being fully understood by this Government. Those deaths may have been totally avoidable, and yet no one has been properly held to account. That is gross negligence and someone has to answer for it. We are now at a point where senior clinicians are feeling that they have no choice but to speak out. That is despite a culture of bullying that we are hearing about that exists in the health board. Having worked in the NHS, I find that truly shocking. I know for a fact that clinicians would only take this step if they fell all avenues of appeal and justice had been exhausted. I applaud the staff for doing so and encourage this Government to listen to their pleas, not the claims of the health board senior management. There are a few simple questions that have to be answered today. Why are the leadership of the health board still in post? Why are the oversight board still in post? And why have emergency powers not been used to take control of this hospital and get a grip of this situation? Those are basic things that the public demand of a Government and they are not being done for reasons that I cannot grasp. Given the justified scrutiny of all Governments handling of public health during Covid, it seems to me that we cannot, for a second, allow public trust in our NHS to be damaged. Why are Scottish Labour forced to call for a change at the top of greater Glasgow Clyde health board, while the Government sits on its hands? Let us be clear that it gives none of us any pleasure to say that the senior management of NHS Greater Glasgow Clyde has failed and should step down, but it should take responsibility on this situation and immediately step down. However, if it will not do so, it should be removed and we should move to stage 5 of the performance escalation framework without delay. That is what my party is calling for. It is right and it is honest. I think that, in all honesty, it is the very least that should be done. We need to decide whether we are on the side of the families who are righteously furious or the amazing staff who are being kept quiet. Or is it, in fact, that it is the out-of-touch managers in this Government whose primary interest is laundering their own reputations? Those of us who have presided over this mess cannot be allowed to stay in control. That motion must be supported by every member in this chamber today. I now call Paul McLennan, to be followed by Craig Hoy, up to four minutes please, Mr McLennan. I offer open by offering my condolences to all families who have lost. I have the one while in the care of the health service. Like everyone, I want to recognise the work of the front line NHS staff at the Queen Elizabeth university hospital. Of course, the health service during the pandemic and before that. There are two key fundamentals in this debate that I would like to focus on. First, is the staff for health service deserve the assurance that they have concerns about the care of patients that they will be listening to and supporting. It is important to mention in the debate today the letter that 23 clinicians wrote to the FM today. I quote, We have been and remain fully committed to being completely open and transparent in all that we do and are dismayed that the integrity of our staff has been questioned. Do we ever willfully withhold information from them? Absolutely not. Of course, more importantly, the families of those who have been treated at the Queen Elizabeth hospital campus deserve to have answers to their questions and as safe an environment as possible for the care of their children. I know that you have come up next, Mr Hoy, but I have only got four minutes somewhere in the short time of the debate. The Scottish Government has consistently taken action necessary to ensure greater transparency in learning from the issues that have happened at the hospital. The cabinet secretary established an independent review group to look at the building's design, construction, commissioning, handover and on-going maintenance. Obviously, those matters contributed to infection control. As we have heard, the Scottish Government established an oversight board after Greater Glasgow and Clyde health board was escalated to level 4 on the NHS Scotland's performance network. There is the independent public inquiry under way at the Queen Elizabeth and, of course, at the hospital for children and young people in Edinburgh. That is the important point to remember that it is already under way. The independent case note review led by Professor Mike Stevens looked back at the clinical cases and determined whether linked infections associated with the Queen Elizabeth existed. That report was published in 2021. The Scottish Government has consistently listened to expert recommendations and will continue to assess and monitor arrangements with the Greater Glasgow health board moving forward. There is a significant amount of work already under way to address infection in hospitals and reduce the incidence of infection. We heard that from Marie Todd. We talked, obviously, about why the Greater Glasgow hospital was escalated to stage 4. The public inquiry, as I mentioned before, will be looking at those issues fully investigated. We have obviously mentioned about the concerns about Aspergillus infections and, again, the health secretary has asked Health Care Improvement Scotland to look out and carry a wider review. Obviously, any necessary action will be undertaken as a result of those strands of work. That comes back to the crux of the matter, I think, in the regard and in talking about, obviously, the public inquiry. It has been chaired by Lord Brody, as we know. It is entirely independent and its conduct procedures and lines of inquiry are a matter for the chair, not the Government for the chair. I think that that is really important. The inquiry is critical next step in seeking to understand issues that both affect the Queen Elizabeth and the Royal Enigma as well. It is terms of reference or comprehensive—I am sorry, I have only got one minute left—it is terms of reference or comprehensive, including concerning the physical, emotional and other effects of issues identified on patients and their families. It would be wrong, wrong to pre-empt the outcomes of the public inquiry and it is incumbent on all of this to allow that public work to do its work. That is not playing down anything that is being raised there, but the public inquiry is there for that very reason. Presiding Officer, in conclusion, the balanced proportionate approach addresses the two main points raised at the start of the speech. The staff of our healthcare service deserve the assurance that they should have the concerns about the care of patients that we have listened to and supported. The families of those who have been treated at the Queen Elizabeth campus deserve to have answers to their questions and as safe as environment as possible for the care of their children. I now call Craig Hoy to be followed by Bob Doris, up to four minutes, please, Mr Hoy. The issues that we are debating today could not be more serious. They are matters of life and death, life and death within our NHS, an institution in which people should feel safe and secure, an institution in which people rightly expect to have their lives saved, not their lives wasted, where they should expect the highest level of clinical care, where they should expect the highest standards of hygiene, cleanliness and infection control, but instead we are debating a hospital that failed, a health board that failed and a Government that has failed. It is more than two years since we first learned that contaminated water led to the death of Millie Main, and yet tragic new cases are still only now being made public. Families of those infected reveal a culture of secrecy and cover-up among senior hospital staff. I am in no doubt that the board of NHS Greater Glasgow and Clyde should be held accountable and responsible, but let us not overlook the simple fact that the buck stops beyond. The SNP planned, delivered and ran this hospital. It is this Government which must take full responsibility for this situation. That is why my colleague Douglas Ross is right to call today for a second independent public inquiry into the actions of this SNP Government. Yes, the board should go, but the ultimate responsibility rests with SNP ministers, with their repeated failures, to get to grips with this tragic situation. This Parliament and this country needs to fully understand what action ministers have taken since they first became aware of those issues. Deputy Presiding Officer, while we support the Labour motion before us and we propose our own amendment, we should be careful what we wish for. Escalating this hospital and this health board to stage 5 would mean transferring the operational control of the board to Scottish ministers. On the basis of past, present and, frankly, today's performance, that will not inspire confidence among patients. However, that debate goes far wider than the tragic deaths and illness that are experienced at the Queen Elizabeth University hospital. It is sadly about the culture of this Government. It is moral code. It is moral compass. We know that there are fish rots from the head down. We know how this Government operates when it comes to transparency. We know how this culture has permeated some public institutions, a corrosive culture of secrecy, questions unanswered, seats left unfilled, like the First Minister's today. Responsibility dodged, diversion, distraction. It was me, look the other way, nothing to see here. Deputy Presiding Officer, for the families of those who died—I will press on them in my final minute—for the relatives of Andrew Sorens, for Millie Main, for Gail Armstrong and for the others who died or contracted serious infections, we need answers. People died, children died, parents are grieving, families are asking why. By voting the right way tonight, we will move closer to getting them the answers and, ultimately, the justice that they deserve to hold those who are responsible to account. The minister, the Government and those SNP members can give their voice to transparency, to accountability. They can say that they have no confidence in the board of NHS Glasgow and Clyde, or that they can run the risk—the very real risk—that this country loses confidence in those ministers and that Government. Thank you. I now call Bob Doris to be followed by Gillian Mackay up to four minutes. Thank you very much, Presiding Officer. Others have done that by giving my condolences to the family and loved ones who have lost children and relatives to many of them over the past few years at the Situants Hospital, Landy Queen Elizabeth hospital. I cannot agree with the conclusions of Anna Sarwar here this afternoon. He is right to make Government and Health boards feel uncomfortable given what has happened over the past few years, not with that on the record as well. At the core of the debate this afternoon is a very clear suggestion made by the Opposition that is to escalate NHS Glasgow and Clyde to stage five of the performance escalation framework immediately and in effect of direct ministerial control. The suggestion that I do not think acknowledges the complexity of the situation or the on-going work that is taking place, I think that perhaps unintentionally I am sure suggests that this would be a solution to the most serious issues that have been faced by the Queen Elizabeth hospital and the Royal hospital for children. At this stage, it is unclear to me as to how doing so would make a substantial difference at this moment in time. I would also ignore substantial progress that appears to have been made. Politicians are not experts on healthcare, none of us, and robust independent expert review of the most serious concerns is required. Clear recommendations need to be made, and those have to be implemented as speedily and fully as possible. It is my understanding that that is precisely what is happening. Therefore, it is important that the cabinet secretary has confirmed today that following the work of the Queen Elizabeth University hospital independent review of the oversight board report and the independent case notes review that NHS Glasgow and Clyde board has completed 91 per cent of the 108 recommendations that have been made. I think that that is highly relevant when determining whether escalation processes should be raised to stage 5. Had such progress not been made, the arguments of some in this place would absolutely be far stronger. However, that said, Presiding Officer, it would be helpful if the cabinet secretary in his closing remarks could address how elected representatives in this place can follow the progress that is made by NHS Glasgow and Clyde on those recommendations on an on-going basis. How will NHS Glasgow and Clyde report on its compliance with the many and varied recommendations that have been made in a way that members of this Parliament and others can take a material view on how substantial that progress actually is? What on-going monitoring and reassurance work is in place to ensure that recommendations that are complied with are embedded into practice and complied with for the long term. We must ensure that vital improvements are sustained. A couple more comments, Presiding Officer, in my closing remarks. I listened with interest the response when there was some uncertainty about using hospital standardised mortality ratios to suggest whether or not there is an on-going significant problem at the Queen Elizabeth hospital. It is factual to say that, at the moment, it is below that average, which should give us some confidence. However, I think that it would be helpful, cabinet secretary, if members in this place had a clearer understanding of how hospital standardised mortality ratios work to see if that reassurance could be extended across this place. It is also important that we acknowledge that some senior clinicians have raised concerns about the nature of the political debate in relation to that. What I have also said in closing is that all parties in this place, we have to change the relationship with each other and how we debate those issues, because that can be corrosive. We have to find ways—maybe not this afternoon, Mr Sarwar—to come together on healthcare on those most serious issues. My thoughts are with everyone who has been affected by infection outbreaks at the Queen Elizabeth university hospital and with anyone who has lost a loved one. I cannot imagine the pain experience by the families of people who have caught infections in a place where they were supposed to be safe and cared for. They deserve answers, which is why it is right that a public inquiry has been established and is under way. It is, of course, essential that we do not wait for the findings of the inquiry to be published and that action is taken now to prevent further infection outbreaks. As we have heard, healthcare improvement Scotland is carrying out a wider review into Aspergillusive infections at Queen Elizabeth university hospital and the board is implementing the recommendations of the independent review, the oversight board report and the independent case note review. That essential work must continue at pace, and I am sure that we will all be monitoring progress closely. It is also important that any findings and decisions are communicated on an on-going basis to patient, families and staff, and I would be grateful if the cabinet secretary could confirm that they are being kept up-to-date. The independent review found, and I quote, "...patients, staff and visitors who are vulnerable to immunosuppression or who are in proximity to patients with certain highly infectious communicable diseases have been exposed to risk that could have been lower if the correct design, build and commissioning had taken place." It is of deep concern that we cannot seem to get the basics right when constructing new state-of-the-art hospitals in Scotland. We have seen that at both the Queen Elizabeth university hospital and the Royal Hospital for Children and Young People in Edinburgh, and I sincerely hope that the public inquiry will clearly set out the steps that we need to take to avoid such failures in the future. There has been a devastating human cost behind those failures, and we have a responsibility when debating those sensitive matters to get the tone right. We risk causing more harm than good if we are not careful about the language that we use. Senior clinicians at NHS Greater Glasgow and Clyde have raised concerns about the way those issues have been portrayed. They feel that their integrity is being questioned and that it is undermining patients' confidence in them and the services that they provide. As I have said, those responsible for failures must be held to account, but the attacks on clinicians will not help us to do that. I am concerned about the damage patient trust and lower staff morale at a time when they are under severe stress. We need to establish what has gone wrong and how it can be prevented in the future, while also rebuilding trust between clinicians and patients whose faith in services will understandably have been shaken. Practical steps are being taken to improve patient safety, but we cannot ignore the emotional toll and mental health support that must be made available to patients, families and staff who have been affected. I welcome any comments from the cabinet secretary about what support is being provided. Excuse me just one second, could we not have chatting across benches, please, and let the speaker who is on the floor make their contribution? I would like to close by focusing on concerns that have been raised around confidentiality. The greater Glasgow and Clyde clinicians have also expressed their disappointment at individual patients being discussed in Parliament without the knowledge of the family's concern. That will no doubt add distress to family members who have already experienced a devastating loss and I would urge anyone raising cases in Parliament to ensure proper consent has been sought. We talk about transparency and the need to have open communication with patients and their families, and that applies to us as MSPs, too. No one should have to hear details about their loved ones' case broadcast in Parliament, and I hope that members will reflect on that. The gravity of this debate cannot be ignored, and it is shocking that we have reached this point and that Scottish Labour has had to bring this motion today, because we surely must all agree across this chamber that no family should have to experience a battle to know what happens to their loved ones when they died in one of our hospitals. No family should have to fight for the answers, and no family should have to have their loss relived every day by a lack of closure and a lack of accountability. We must also agree that nobody working in our NHS should ever feel like they cannot speak out and be heard on issues as serious as this. Yet, after years of secrecy, denial and cover-up, not a single person has been held accountable for the catastrophic errors and infection scandal at the Queen Elizabeth University hospital. Since 2015, the issues have been raised time and time again. Contaminated water reports, deadly flaws in the building's fabric, serious patient infections and death, the bullying of staff, the silencing of whistleblowers, but no one in senior management or board leadership held to account. I might have been absolutely clear once again that this is not about doctors, nurses and care assistants working day in and day out in the hospital treating sick patients. They have worked tirelessly, especially throughout the pandemic, and they rightly deserve our deep gratitude. That is about those in positions of leadership. We stand with the courageous staff and whistleblowers who have revealed the scale of infections at the hospital in the face of denial and intimidation from leadership. We stand with the families who have described their ordeal and are feeling that nobody in power is listening to them. Two weeks ago, at First Minister's questions, I raised the case of the Smith family from Greenock. Theresa and Matthew Smith's baby daughter, Sophia, directed just 12 days old of an infection contracted at the Queen Elizabeth, despite initially responding well to treatment for breathing problems. I spoke to Theresa today. Her child is not just a statistic. She spoke to me about the unimaginable pain of being unable to find any closure, to be able to properly grieve the loss of her child because she does not know why she died. She said to me, how can you accept what you do not know? Theresa asked me to speak of Sophia today, to say her name in this place, to say that she was a life worth a world to those who loved her for those short 12 days and who still love her today. The family want all of us in positions of power in this place to listen, to listen when they tell us about the torturous journey to try and get answers, to the fact that for four years they have felt locked in a battle with phone calls, emails and letters stonewalled when all they want to do is find some peace, to the fact that they feel constrained and silenced in the public inquiry, an inquiry regularly cited by the Government in response to calls for action on the issue. Last week, Theresa's evidence was ruled too contentious to be made public after legal applications by the Government and the health board, but legal experts have said that such orders should only be used as a very last resort or it risks public confidence in the inquiry. The First Minister told all of us in this place that she will not tolerate cover-ups or secrecy from health boards, but in this case, her own officials acted to ensure that evidence was heard in secret. That cannot be how the inquiry is to be conducted, given how families have been treated. It is clear, Presiding Officer, that trust for families like the Smith is completely broken. They have little faith in the process, so we must act. This is about leadership, it is about confidence in leadership, but crucially it is about the trust of grieving families and the basic decency of ensuring that they can grieve in some peace. To begin to even think about a process of restoring trust, we must support the motion. I now call Sue Webber to be followed by Julian Martin up to four minutes, please, Ms Webber. Thank you, Deputy Presiding Officer. I stand to speak in support of the amendment today from Douglas Ross, but before I do so may I draw the chamber's attention to my register of interests. I would like to reaffirm my support for the principles outlined in the labour motion today. However, issues with patient safety in the Queen Elizabeth University hospital go beyond some of the heartbreaking tragedies outlined by the Labour members this afternoon. I want to speak further about the burden's front-lines line staff face, burdens that may contribute significantly to the on-going problems with the UK's second-largest acute hospital. Often behind-the-scene pressures, unnecessary pressures, I should add, are placed on staff. No one, Ms Mackay, is blaming clinicians in this chamber today. I want to talk about the staff that are directly involved in delivering patient care in a fast-paced clinical environment. Staff who, through unyielding, arduous management during controls and processes, or unbalanced procurement and budget control processes, find themselves in distressing situations, distracting their attention from delivering safe patient care. Those processes see staff too often being challenged by frustrated senior colleagues, as equipment is not available for them to use. The outcome of that may be that that patient's procedure is cancelled. Why? Because of loan paperwork not being completed days in advance of the planned procedure. Why? Because the one and only device in the department had been opened, sometimes in error, for a previous planned procedure. Procedures have been scheduled at clash when there is only one piece of equipment for the entire department, or it is yet to return from sterile services due to tight turnaround from the cases the day before. Perioperative staff and those in theatre are at the very front line and face these hellish, yet completely unavoidable challenges daily, sometimes even multiple times a day. I can assure you that the frustration felt by the entire multi-disciplinary team is palpable when that happens. I also know that that is not unique to NHS Greater Glasgow and Clyde. Staff should not have to face those issues, especially when they are balanced, sensible, cost-economic solutions available to the managers to approve. We say with one breath and in one debate that we want to support staff's health and wellbeing, and then go on to thank them profusely from this chamber for their heroic efforts. However, as I have said before, we need to do more than offer them our thanks and gratitude. Why do not we look to remove some of the completely unnecessary pressures in their day-to-day jobs? Allow them to focus on their patients. We are calling for a second independent public inquiry into the ministerial response to avoidable deaths at the Queen Elizabeth University hospital. A comprehensive, independent inquiry will identify all the areas that are causing risks to patients in the hospital and will accelerate the implementation of preventative and mitigating actions. The SNP planned, delivered and ran the hospital, and today we have heard that percentages are more important to them than patients, and they must take full responsibility for this disgraceful situation. Thank you, Presiding Officer. Debates like this are always very difficult. Most of us are parents, mothers and husbands. It is painful to talk about loss, and it is painful to hear about your loss being discussed in public with people watching. I have no doubt. The people served by NHS Greater Glasgow and Clyde deserve to have confidence in their health board and in their hospitals. I guess that I am speaking today as my role as convener of health committee is relevant to the scrutiny of the operations of our hospitals. The cases that have been mentioned in this chamber are heartbreaking, and any allegations of some staff and families must be taken extremely seriously and investigated fully. Answers must be given, and I think that we are all in agreement on that. We know that NHS Greater Glasgow and Clyde is currently at the highest level of escalation, and it will remain there while all the issues are thoroughly investigated. We know that the independent statutory public inquiry is under way, and inquiry calls for a moment. I do not have time, and we are afraid, Mr Gilhane. That must be allowed to conclude and report. Of course, further concerns about Aspergillus infections in the Queen Elizabeth hospital have been highlighted recently. Some of them are in the press and some of them in this chamber. Last week, accusations were made of the Government hiding behind process by members of some benches when they called for the board to be sacked wholesale and without delay. As I said, those cases are extremely upsetting, and the emotion is warranted and understandable. When it comes to people who have been held to account, everyone here knows how important robust investigating processes are. They are crucial in three regards, to get to the truth of what has happened, to identify what has to be done as a consequence, and to, where necessary, to provide any evidence on failure on the part of individuals. If we throw those processes out, or if we curtail them, we are lost. I agree with Bob Doris on that point. One of the things that I am most concerned about is the political rhetoric when it comes to the death of anyone. We all have a duty to be very careful on what we say and how we say it in this chamber. People who lost their lives have been mentioned in this chamber over weeks and months. I really do hope that every family has given their consent to this. Families are watching. They are all in agreement that their loved ones' cases should be mentioned in public is something that everyone must remember to do. I am also concerned about high-profile political exchanges that can do to patient trust. It has already been mentioned as reports this morning about a letter to the First Minister and the Cabinet Secretary for Senior Clinicians at Queen Elizabeth. She said that she is writing to express her disappointment and frustration about the way that her hospital colleagues and the treatment that patients have been portrayed in the press and the Scottish Parliament. Unfortunately, some of the rhetoric today, particularly from the Conservative benches, such as the SNP running the hospital, the rotting of it does not do us any favours using that type of language when we are talking about people's loved ones. Only with robust investigation will we get answers to what has happened and, crucially, the right pathway to making sure that any problems discovered get resolved for the future. We must allow that to happen for the sake of the patients and the families and the staff of Queen Elizabeth hospital and, indeed, any hospital where issues are reported, with, similarly, robust systems in place for staff and patients to report without fear or favour. Thank you. We now move to the closing speeches. I call on Sandish Gohani to wind up for the Conservatives up to four minutes, please, Dr Gohani. Thank you. Though colleagues are aware, I would like to point to my declaration of interest as a practicing NHS doctor. Glasgow's Queen Elizabeth University hospital is at the heart of arguably the greatest disgrace, not just of the SNP timing government, but of Scotland's entire devolution era. Marred by scandals since the opening in 2015, hospital management has failed in its duty on a number of fronts, particularly on transparency. A damning investigation into the water supply found widespread contamination. Children died after being infected with bacteria. This tragedy is now subject to a criminal investigation, so no wonder we have little faith right now in the leadership of NHS Greater Glasgow and Clyde. I stress the word leadership. We also understand why Scottish Labour is calling for special measures to move the health board from stage 4, not the highest level, as said by Gillian Martin and the First Minister, to stage 5, which is the highest level. Bob Doris asked what this would achieve, and the answer is accountability, stopping the bullying, secrecy and cover-up culture, unless he feels that this Government would not be able to achieve this. While there are grave concerns over the management of this institution, I believe that patients in their family can trust the front-line clinical staff that deal with them. It is important that we also understand that the continued criticism of the hospital impacts the mental health of doctors and nurses and the morale of all staff. That is another reason why we must act now and deal with this crisis. Let us not have more of the same, more defensive posturing and dithering from an SNP Government, which is now in its sixth year of presiding over the Queen Elizabeth University hospital scandal as staff morale plummets. We need to consider carefully what the people we represent want, what the patients and their families expect. First and foremost, they want assurance that if they or their children need to be admitted to the SNP's flagship hospital, that they will be safe. We need to prioritise this. We need to see an independent specialist infection control assessment of this hospital. Given the history, we need to conduct it every year for at least the next five years. The Queen Elizabeth scandal is like a cancer. We need to treat it and monitor it and make sure that we do that carefully until it is in complete remission. That brings us to accountability. There is no sign of accountability from anyone, including the SNP Green Government. Special measures without delay are a must, but in tandem we are calling for a full inquiry to ascertain not what caused patients to fall ill and die, but who has been responsible for making the decisions during this crisis. The public demands transparency, not cover-up. The accountability trail is important wherever that leads justice must be done. Sue Weber is telling us about frontline staff who face hellish yet avoidable challenges daily. Douglas Ross calls for an independent inquiry to be held into the ministerial response, and that is important because responsibility and accountability cannot escape anyone, including those at the very top. I echo Carol Mocken in saying that we clinicians would only ever speak out like this when there is no other choice. Bullying is unacceptable, so why is it allowed under the SNP Green Watch? NHS clinicians' integrity has never been called into question by anyone in opposition, as I said by Marie Todd, Gillian Macai. I stand in commending the frontline staff that are saving lives day in, day out, despite being let down by senior management day in, day out. For the Scottish Conservatives, our thrust in today's debate is quite straightforward. We are simply addressing two fundamental questions that so many Scottish families ask. First, is my hospital now safe? Second, who is responsible? Our motion is measured and reasonable. We should be able to count on the support of the Government—that is, if it puts patients first. Can I, first of all, like everybody else, extend my condolences to the loved ones of those who have been affected by the issues that have been raised by members right across the chamber? Let me say from the absolute offset that I don't, for a second, begrudge, be it Anna Sauer, be it Paul O'Kane, be it any other member that has raised their cases of constituents or indeed members of the public that have come to them. Nobody in Government begrudges them for raising those cases. In fact, it's incumbent upon you to raise those cases where, obviously, consent has been acquired. I take exception to the line about who's side are you on, because each and every single one of my colleagues and my backbench colleagues—or, indeed, my colleagues in Government and, of course, I include myself in this—I suspect that we are all on the same side. The same side is Douglas Ross, the same side is Anna Sauer and the same side is Alex Cole-Hamilton. Each and every single one of us wants the best, most safe patient experience for members of the public. We are all on the same side. Where we have disagreements, they should absolutely be debated, but I wouldn't question the intention of being at anybody, any member of this Parliament, regardless of which party they belong to, when they raise—I won't because I only have four minutes, so I won't question the intention. Let me move on to another couple of issues. Members can heckle me from the sidelines if they want, but it's really, really impulsive for them. Excuse me, cabinet secretary. Members can't heckle from the sidelines. That's a matter for me. I'm the ref. Could we just listen to the cabinet secretary, please? Because what I want to do is also draw attention to what has been derided in this chamber is some of the concerns that clinicians have raised. That is what clinicians have to say. I'll just read a couple of excerpts from the letter that they have sent to me and to the First Minister, not Jane Grant, the chief executive of the health board, not John Brown, the chair of the health board, but 23 clinicians, doctors, nurses who we applauded for, who we called heroes, who we demanded a pay rise for, and we granted a pay rise too, of course. Those are the men and the women who are heroes, and they are the ones who have written, not again, management, not politicians, not Government ministers. They have said, and I will quote directly, so I'm not accused of misquoting. We have been and remain fully committed to being completely open and transparent in all that we do, and we are dismayed that the integrity of our staff has repeatedly been called into question. In the further excerpt, the unfounded criticism of our clinical teams and staff, as well as the safety of our hospitals, is hugely detrimental to staff morale at a time when so much is being asked of them. They go on to say that sustained criticism of our staff is undoubtedly causing them distress and worry. They are not my words. They are the words of the doctors and nurses. Let's please not dismiss them. Let's please not dismiss the concerns that they have. The second point that I have is one about consent. I don't begrudge Anasawa for raising the cases of Millie Mayne, as he has done, I think exceptionally effectively in this chamber, nor the case of Louise Slorence, which he is doing and continues to do with great effect. We have a responsibility to answer those questions, and what I would say in the case of Andrew Slorence, who was somebody that I knew well in various different ministerial roles. What we have done is ensured that there is not just a case review taking place, but an external review of that. NHS Lothian will provide that as an external assurance. Seven clinicians involved in that. On top of that, on the wider issue of Aspergillus in Queen Elizabeth university hospital, I have instructed his, our national improvement agency, to look at that. On the question that Anasawa asked, I will write to him in detail about that, and I will put that in spice. I do know how many red notices there have been. My understanding is that there have been three red notices, but I will write to him in detail with a number of the questions that he has asked, and also the detail of what we have done nationally. What I will do to end my remarks is to say that we have taken action. There have been seven different reviews. Those recommendations have not sat on a shelf. 98 per cent of those recommendations have been implemented and 88 per cent of the oversight board recommendations have also been completed. I end by saying that, of course, improvements where they can be made must be made. Huge improvements have been made. I would ask members to seriously consider our raising cases in this chamber that it is done with the consent of those families involved. I guarantee to you that, whenever cases are raised, they will not be dismissed, they will be taken seriously by the Government, and I ask members to back my amendment to this motion. I now call on Jackie Baillie to wind up for Labour up to five minutes. Thank you very much, Presiding Officer. For the families watching the Parliament today, this debate will have been a deeply upsetting experience. It will have brought back memories of loved ones, but it will have brought back anger towards those who covered up the truth from them. We owe those families answers, and we owe them action. It is incumbent on all of us in this place to demonstrate that this Parliament will not stand by when NHS staff are being bullied and blamed, and we will not stand by when patients are being failed and lied to. Far too often, during my time in this Parliament, I have had to raise the heart-breaking impact of infection outbreaks in our hospitals on the families and friends left behind. From the deaths following the SEDIF outbreak at the Vale of Leven, to the tragedy continuing to this day at the Queen Elizabeth University Hospital, and each one of those deaths are avoidable. Whilst we cannot bring back those taken too soon, we can help to deliver some justice for their families, and we can try to stop it from happening again. That is our responsibility today. Today, tell the health board leadership, a greater Glasgow implied, that this Parliament has no confidence in them and that enough is enough. Tell them that we will not tolerate their bullying, their cover-ups, their disgusting attempts to blame courageous NHS staff and, yes, their lies. The clinicians and nurses at the hospital are heroes. They have been working in absolutely impossible conditions in a not fit for purpose building. Please do not forget that it was clinicians who exposed the scandal at the Queen Elizabeth Hospital in the first place. They are the ones, along with their patients, that are being failed by health board senior managers. How dare the health board and the Scottish Government use those hard-working staff as a human shield for their failures? The cabinet secretary quotes the letter. These clinicians are senior managers. They are appointed by the chief executive. They are not the clinicians who are saying that there is something terribly wrong. Why do not you listen to those clinicians who are saying that there is a problem? It is beyond doubt that the hospital leadership has failed, but this is a question of leadership for the Government too. For every SNP and green MSP in the chamber today, for the health minister who so recently expressed his confidence in the board and to the First Minister herself, you have a choice to make today. You can choose to side with NHS staff and patients or you can choose to continue the culture of cover-up and secrecy at the very top of Greater Glasgow and Clyde health board. From start to finish, this scandal has happened under Nicola Sturgeon's watch. She was health secretary when the hospital was commissioned. She was First Minister when it was opened. All the warnings about water contamination were ignored. She was First Minister when anasawa first told this Parliament about the infections at the hospital two years ago. She was the First Minister when it emerged that a family hadn't been contacted following the death of their child who had contacted an infection. She was the First Minister when Louise Lawrence pleaded with her to prevent what happened to Andrew happening to others. She is the First Minister today when we have the opportunity to take immediate action by using the Government's emergency powers to escalate the NHS board to the highest level of the performance framework. No more hiding behind process, no more blaming of staff, no more waiting for the findings of a public inquiry at least three years down the line. Families can't wait that long, the country can't wait that long, there are still patients dying in the hospital after contracting infections, so for the sake of the staff working tirelessly to save lives, for the sake of the families who have lost loved ones and for the sake of patients in Glasgow and across Scotland and for public confidence in our NHS, we can and we must take action today. Support the motion. That concludes the debate on protecting patient safety at the Queen Elizabeth University hospital, and it is now time to move on to the next item of business. I remind members of the Covid-related measures that are in place and that face covering should be worn when moving around the chamber and across the Holyrood campus. I will allow a short pause to allow front bench teams to safely change their seats. Thank you.