 Yr Unig i'r cyddiad socio-redu Rogue Wars 6.47 yn oeddo i Jacci Bailey i fod yn ddaf i gandd y NHS, i'n ffordd o ffaith gennymau i ddod i yn ceisio cycheg, i ddylch i'r ddiwethaf cyddiad sydd yn gweithdoch i'r gweithio gennych am melywyr cyffredinol ystod o'i gwyllwch, i ddigonwch chi i wneud, a dweud jonwch i ddylanu'r ffodus ym môl yn ddalio, drwy gwrs teimlo ffaith gan hon sylweddol. Dw i adroddol. Efallai gweld i'r e-mail ar 8.00 p.m. Diolch yn f vomitig hon, fyddwch wedi'i braedd y maeddol yma i'r Llyfr�egwyr ysbryd ddechrau i Gw warnings.肉d ddweud i'r blynyddu oes o'rfunnwg aeth yn rhan i gyd-gweithio i wneud i'r mwynhau. mae'r gweithio ar y 8-hwyf o'r angen i'r hyn yn i'n gwneud. Mae'n 14 angen i'r angen i'r hyn yn i'r proces. Fyredu i'r angen i ymweld, mae'n clywed i'r cyfrannu gyda'r GP yn ni'n fawr. Mae'r SNP yn y cwrin i neud yn ei ddweud yn byw'r cyfrannu hefyd a'r myfyrdd yn ei ddweud. Mae hyn yn ei ddweud yn ddweud, maen nhw'n hyn, ond mae'n gweithio ar y angen i'r hyn. Mae'n ddweud yn éu ddweud ar y incendu, ydych chi'n gweithio y peth yn i gynnydd ym 8 oes aeth y bydd yn gyntaf ysgolion. Daeth gennyn nhw, mae'r dyluniau yn ei gweithio'r gweithio'n gweithio'r gweithio'r gweithio. Y rhaicolygiad y Hwbg ddiwedd y meddwl, mae'r dyluniau yn aeon i'r gweithio'r gweithio'i cyfnog a'i gweithio'r gweithio'i gweithio'r gweithio. Mae NHS rydw i'n gwneud o'r cychwynhau hynny. Mae'r hred falch gwrthi gyda'r berthynas iawn, a ydym e, mae'n arlethwm iawn, gyda'r hiad a'r profi bwysig. Maen nhw i'r chefnol i'r llun yw dd 160 mae gynnwys ei gyd, a chyddol y gallai gynnodd i'r ffwrdd honno. Felly, a fyddai'n ziwethaf i'r dangos i ni, i'r hyn o gwybod gyda'r bwysig. Rydw i'r llun yn hyn i ddiogel i'r PMA, rwy'n ei gyd yw, maen nhw i'r gwyrdd gwiaith gyfrein—glwch â blynyddoedd yn cael ajw mwy y bydd ei wneud am hyn a gydweithio, am ei wneud i cadwoddau ei fod yn ei greu. A finally mortgage will be added anginnwys o tynnu o'r syniad ar gyfer ymlaen i gael ei wneud i'w enw'i'r interests. Dychydig y cymdeithasol yn y SNP yma yng nghylch ar gyfer y pryddysgfaenol sy'n i gyfnodd yn llwytoedd y gyflym yn ei wneud. So, what about the Royal College of Emergency Medicine? They've said that many of the components of the SNP's winter resilience plan, I quote, will not be in place to prevent further harm to patients and staff this winter. Or how about the view from the Royal College of Physicians of Edinburgh who tell us that the solution lies in not properly funding social care to tackle delayed discharge and, therefore, free up hospital beds? Again the Health Secretary is deaf to the solutions because he knows better than the health experts. His winter resilience plan has no new resources. That's right. Not a single penny extra. All the money has been pre-announced, some of it over eleven months ago. Social care, we know, has been underfunded by more than a decade and the health secretaries are repackaged, a cyd-fyniadau yma, yn pengyrch iawn i gynllunio pachio idd不能wr. Felly, mae'n gwaith rydyn ni'n rhai'r byw pwysig o gws a g wastio ymlawniol a gwasanaethau oherwydd mae'n byw pwysig o'r newid. reliable forbidden work, but it's it doesn't take it all that it's... Cosler told me that, despite asking, the healthcare secretary has provided no detailed plan about what needs to be done in social care to help with the impending winter crisis, not one single IOTA of detail and winter is here. Presiding Officer, I have been in Parliament for 23 years and I can say without fear of that Humza Yousaf is absolutely the worst health secretary since devolution. Let's prove this. Let's look at his predecessors. Nicola Sturgeon, 95.9 per cent of people seen within four hours at A&E in October 2011. Alex Neil, 93.9 per cent in October 2013. No, no, I'm praising your ministers, you might want to listen. Shona Robison, 91 per cent in October 2015. Jeane Freeman, 89.6 per cent in October 2020. Let me remind you, that's eight months into the same pandemic that this health secretary blames all his failings on and our missing in action health secretary presides over record lows of 64 per cent, but the waits of over eight hours and 12 hours are now at record highs. Literally thousands of patients, more than 3,000 waiting over three hours and 1,300 waiting over 12 hours in the last week alone. That means that as many as 37 people could have lost their lives because of the delays in that week. Patients waiting on trolleys, getting intravenous drugs administered in corridors which is not safe, sleeping in chairs overnight, this is the new normal in accident and emergency and it was of course a fraction of the current figure back in October 2020 when no more than 350 people in any week during the month waited over eight hours to be seen. That's the difference. Finally, I want to turn to talking about the doctors and nurses and other NHS workers who are the backbone of our NHS. The health secretary is very fond of telling us that the NHS has record levels of staff. What he fails to tell us is that they're coping with record levels of demand and they are doing so with record levels of vacancies. Almost 7,000 nursing vacancies are loaned, a critical shortage of GPs and other allied professionals, patient safety being compromised on a regular basis and successive years of failure to workforce plan. The latest pay offer helps the lowest paid the most, but for many skilled and experienced nurses the pay offer is less than the 5 per cent previously promised. Nurses pay has declined by 17 per cent in real terms. Inflation is now at 10 per cent, this is not a fair pay deal and now nurses in Scotland are being ballasted on strike action. Let me finish with this, our NHS is on its knees. The health secretary has a choice because doing nothing is not a choice. He needs to stop people needlessly dying this winter, so his choice is to set out a clear plan to end waiting times of more than eight hours because this is about saving lives and if he can't do that, frankly, he must resign. I move the motion in my name. I am eager to respond to this debate and outline our continuing NHS recovery from the Covid-19 pandemic. There is nobody in this Government, not I nor my colleagues in the seats behind me, who deny that the NHS is under significant pressure, of course it is. However, for Labour to bring forward a motion about NHS pressures and not to include one single word, not a solitary mention about Covid and the pandemic demonstrates just how it is Jackie Baillie and her party who have their fingers in their ears and not this Government. The pandemic is the biggest shock our NHS has ever faced in its 74-year existence. I have no doubt that, of course, the NHS had challenges pre-pandemic—I will not, you will have your moment, I am sure—I have no doubt that the NHS had challenges pre-pandemic, but for Labour not to recognise that Covid has been the biggest shock it has faced is, frankly, burying the head in the sand. Let us remember that there are 800 people in our hospitals now who, as we speak, are suffering the effects of the virus. There are still people dying, families grieving due to the loss of Covid. Any realistic, pragmatic discussion on the NHS in Scotland cannot simply cast aside the impact of the pandemic, it is central to those challenges that we face. That is why central to our recovery is that successful vaccination programme, Covid and flu vaccination programme, and I want to thank our staff who are involved. The NHS will not recover in weeks as Jackie Baillie is demanding it does, or even months. It will take years—that is why the £1 billion recovery plan is predicated on five years of substantial investment and reform. I am certainly committed to that recovery, and one central plank to that recovery is taking care of our workforce. I have offered, as Jackie Baillie has referenced in the past week, our NHS staff a record pay rise, £2,200, an average 7 per cent uplift to help to tackle the cost of living crisis. It means the lowest paid, seeing a rise of more than 11 per cent and qualified nursing staff, because she mentioned nursing staff, a qualified nursing staff receiving up to 8.45 per cent. If agreed, the uplift will amount to almost £0.5 billion. The largest single-year pay offer if ever given to a gender for change staff is better paid. If it is accepted, that means that our NHS staff is better paid than staff in England, Wales and Northern Ireland. I want to give them my thanks once again, of course. Jackie Baillie Can he maybe explain why NHS nurses are actually balancing for strike action if he's been so generous? There are still unions meeting to discuss the latest pay deal, so I'll let those unions have those discussions, and my door will be open to try to stop industrial action from taking place. I hope that NHS members, when they see the detail of this deal, will accept it. In terms of waiting times, it is untrue to say that there has been no progress in the NHS in terms of its recovery, even while we are in the midst of this pandemic. If I give you one example in terms of long waits, since I announced the planned care waiting times targets this summer, the latest figures in Public Health Scotland show that 76 per cent, 31 out of 41, outpatient specialties have no or fewer than 10 patients waiting more than 10 years. While 60 per cent of inpatient day cases specialties have fewer than 10 patients waiting more than two years, that is demonstrable progress. My thanks to our brilliant NHS staff for it. There's no doubt that delayed discharges are too high. We know that they are real challenges in social care. That's why one of the first things I did coming into this role was to ensure not just one but two pay-up lifts for our adult social care staff. However, we know that there are challenges in the social care sector. We know that our care homes have been hit by a triple whammy of Brexit, the pandemic and high inflation and energy costs. Two out of three of those factors are as a result of the Conservatives putting ideology above the very interests of the country. It's clear that our social care sector is the one paying the price. I met on Tuesday again with chief executives of local authorities, health boards, chief officers of health and social care partnerships and we will do everything that we can to support them. In terms of A and E, of course, those pressures are being driven by those pressures that I've mentioned and delayed discharges. However, we have put £50 million towards our urgent and unscheduled care collaborative programme. While, of course, the level of performance is not where I would want it to be, and I agree entirely with the RCM and the Jackie Baillie's assessment that long waits do harm to patients, we will do everything that we can to take a whole systems approach to reduce those pressures in A and E. However, to end, we must be frank that we face a very difficult winter ahead—the accumulative pressures of the pandemic, the pressures of the flu, the usual winter pressures of slips, trips and falls. Therefore, my focus and that of the Governments will be to spend every single waking moment supporting our NHS and the staff that work within it. We have in Scotland the best-paid staff, we have in Scotland more GPs per head than in England, more dentists per head, more NHS front-line staff per head under this Government. Yes, challenges do persist, but there are shoots of recovery. Let me finish by acknowledging that, while this winter will be one of the most difficult our NHS has ever dealt with, I want to praise our NHS and social care staff for the incredible, compassionate care they provide the people of Scotland day in and day out and give them an absolute promise that we will honour them, not just with words, but through our deeds. Thank you very much indeed. Can I remind the Chamber we do not have any time in hand and therefore Members are going to have to stick to their allocated time limits. With that, I call Sandish Gullhane to speak to and move amendment 6437.2 for up to four minutes. People are dying. People are dying avoidable deaths and it will get worse over winter. Across the country, the Scottish Government continues to fail our Scottish National Health Service and fail our patients. To be clear, this is not the fault of our hard-working clinical and support staff who have and always will go beyond the call of duty, but these heroes really are at breaking point. The Cabinet Secretary should know this, and he would know this if he had bothered to face the front line when he is on one of his well-documented PR drop-ins to one of our hospitals. Cabinet Secretary, you just thanked and praised our staff, but you avoided Dr Moye in A&E when you went. The debate is about responsibility and accountability, so let's consider the facts. Under the SNP, waiting times for A&E and cancer treatment are at their worst ever levels. In the second quarter of this year, more than one in 10 patients waited longer than 84 days to begin treatment, with one in 20 waiting 116 days. We even had one patient left 322 days until treatment began, and we're talking about cancer. As for routine treatments, over 7,000 people are languishing on inpatient waiting lists for more than two years, with the SNP breaking its promise to eradicate waiting lists longer than 24 months by September. While we're on the subject of broken promises, a near-record number of patients are having their discharge from hospital delayed because there's no follow-on social care package in place or space in residential care, yet the SNP promised to solve the problem of delayed discharge by the end of 2015. The Cabinet Secretary is also failing our most vulnerable children. Over a quarter of young people referred to mental health services are not being seen within 18 weeks, yet the Government's own target is 90%. I could go on, but I will run out of time. But it's fair to say that there is a catalogue of failures under the SNP's watch, and as I underscored in the Scottish Conservatives NHS debate last month, we have a record breaking Cabinet Secretary. Trouble is, he's breaking the wrong kind of records. Now, the First Minister and a Cabinet Secretary will come to this chamber and make announcements usually in the form of new spending plans, and yes, they are great at spending taxpayers' money, but they cannot actually deliver results or even a squeaky clean Bill of Health under the auditors. Let's take September 2021, the announcement of £10 million for long Covid. Well, what happened? Come May this year, we found that £10 million was actually £3 million over three years, and we still don't actually know where this money is being spent, and let's not forget that. During this time, the number of Scots with long Covid has risen from around 90,000 to 200,000. That's more than a population of Aberdeen. It's just about headlines for this Cabinet Secretary. Winter is now fast approaching, and it's plain to see that the SNP green government is ill-prepared, and its NHS recovery and winter plan is inadequate. Any waiting time alone are spiralling out of control. We're calling on the Cabinet Secretary to go back to the drawing board and set out a clear plan to get our health services and patients through the next six months, and we want to see more spending announcements that actually have a clear target that can be audited. Patients, taxpayers have a right to know how this Government is spending their money. It's a declaration of interest. I am practising NHS Doctor, and I move the amendment in my name. Thank you very much indeed, Dr Gilhane. I now call on Alex Cole-Hamilton for up to four minutes, Mr Gilhane Hamilton. Thank you very much indeed, Deputy Presiding Officer. I'm grateful very much to my friend Jackie Baillie for securing time for this important debate in the Chamber. Presiding Officer, it is a timely debate. I cannot remember a time when our NHS was in such a state, or when our valiant doctors, nurses and healthcare professionals were under so much strain. Had the Cabinet Secretary taken my intervention, I would have reminded him that this is not solely the impact of our pandemic—the pandemic that we have just been through. In fact, former chief executive of NHS Scotland Paul Gray reminds us that this was a crisis years in the making, Covid just hastened its arrival. It is wrong for him to say otherwise, and it is offensive to the people who are carrying the cost for this Government's negligence day in, day out. I must say, as grateful as I am that we are having this debate, I cannot help but feel a depressing sense of deja vu. It feels as though we are part of Groundhog Day here. Each time we come here and, as Opposition parties, with the latest round of disastrous health and social care statistics, and each time the Government responds with reference to the pandemic and vague promises to make things better, or often they just try to blame something on everyone else. Small wonder, then, that the SNP and the Green Government do not make time for this in their own parliamentary time. It is impossible to overstate the crisis that is engulfing our health service. Everyone knows somebody who is on a waiting list, whether that be a partner arriving—they know somebody who is suffering—whether that is a partner arriving home late after another brutal ward shift, or an elderly parent forced to wait hours on a hospital gurney or weeks just to speak to their GP on the phone. The Cabinet Secretary's NHS recovery and winter plan falls woefully short. They are already missing their interim waiting targets, and there is nothing that will make a material difference ahead of the inevitable strain of winter. The first frosts have not yet arrived. Presiding Officer, the stakes here are literally life and death. For more than a year, waiting times in A and E have steadily risen, tragically resulting in hundreds of avoidable deaths this year alone. Last month, the SNP and the Green Government voted down my party's proposal to hold an inquiry to look at those avoidable emergency care deaths. That is reprehensible. The more apparent the cost of this Government incompetence becomes, the more they will try to distract attention away from their failures and instead the mythical vagaries of Scottish independence, which is, I think, the root cause of ministerial disinterest here. During her keynote speech, I remind the chamber that, at the recent SNP conference, the First Minister mentioned the NHS just 11 times. That is compared to 58 mentions of breaking up the United Kingdom. She had nothing to say on social care. Don't get me started on long Covid. I associate my remarks with those of Dr Gilhane. We now see over 200,000 sufferers of this debilitating condition. It is perhaps the biggest mass-disabling event since the First World War, and we are nowhere. We are spending twice as much money on an independence referendum as we are on assisting those people. It is the same old story that does nothing to help the league of nurses, doctors, patients left abandoned in our A and E departments. The impact of Government failure is felt right across the health and social care story. The devastating story that we heard this afternoon from Jackie Baillie at the top of her remarks is a story told the country over. Ambulances are not getting to people in time, because they cannot discharge patients into emergency wards when they arrive. A and E is full to rafters with patients unable to be admitted into the wider hospital due to lack of beds. On any given night, more than 1,000 people are languishing in Scottish hospitals well enough to go home, but two failed to do so without a social care package. Even when the care packages are arranged too often, those in need are still being let down. The blame does not lie with staff. For years now, they have worked tirelessly, diligently, under enormous physical and emotional strain, and their reward is unfair pay and unimaginable working conditions. With Liberal Democrats in government, we would support staff immediately with a burnout prevention strategy and a NHS staff assembly to set national standards to get rid of the postcode lottery that currently exists in social care. This Government loves to talk about a far-off distant land where everything will be better, where they have neither the design nor the confidence to make things better today. I say to the Government of the Cabinet Secretary either get it sorted or step out, step out of the way to make room for someone who can. Thank you very much. We now move to the open debate. I call first Carl Mawchen to be followed by Zillian Martin for up to four minutes. It has been a busy week for bad news across the UK, so understandably, I think that the Scottish Government is hoping for its own failings to drift under the radar. With winter approaching, we need to get serious and do so quickly about the significant problems that the Government's management of our NHS is putting lives at risk. There is a crisis in A and E across Scotland, and quite frankly, the Cabinet Secretary has been missing in action for a great deal of it. He and a number of his predecessors have overseen years of poor workforce planning, cutting of hospital beds in many areas, and a consistent failure to recognise the approaching dangers of underfunding and under-resourcing social care. Beyond A and E, the situation is desperately concerning, too. I have been helping one constituent who has been waiting over 80 weeks for arthroscopy surgery. 80 weeks, Cabinet Secretary, in serious pain. Advising things are deteriorating by the day and depending on medication just to get through the day. I have written to the Cabinet Secretary about this case and he is unable to give this woman, this family, any idea, any date of when this vital operation may be able to take place. I am going to say it again, 80 weeks this constituent has been waiting. It is whole families who suffer, whilst living with considerable pain, she struggles to support her daughter, often relying on her husband to do things that she would love to do, love to be involved with. But it is worse than this constant pain. Imagine how this family feel that for 80 weeks they cannot do the things that they would wish with their own daughter. The physical pain and the mental distress, I think we can all think about that. Yet the chances of improving her situation seem to be dwindling with every passing day as she waits for an appointment that seems as if it will never come. As I have said, the Cabinet Secretary himself is unable to offer anything to this woman. These are the human stories behind the statistics, stories that do not even want a headline anymore because they are now just so common. If the health secretary thinks this is acceptable and on top of that cannot seem to do anything about any waiting times, at over eight hours going into winter, with some as high as 12 hours, it is reasonable to ask why, why is he still in this job? We have seen lots of politicians lose and then miraculously regain their jobs down in London this week, yet the bar here seems to be so high that it does not matter how consistently a minister fails, they are actually kept in post. I tried to think what would happen to ordinary workers in this country if they had made as many mistakes as this administration had made. Waiting times are a massive concern for so many of my constituents. Month after month, year after year, people are living with anxiety and concern about how they will get the treatment that they need. Remember those personal stories, and also that hard-working hostile staff are under huge pressure every day and it causes stress and anxiety to them as well. Yet it seems to be one of those things that people in this Government just appear to accept. As a force of nature, nothing serious is ever done to address the problem. No actions are actually taken and it just comes back round to the next year. People truly value it. You can shout all you like. It is true. Those are true stories that the members across this chamber are bringing here to have serious discussion with the cabinet secretary about how we move these forward. People truly value our NHS. This is just not good enough. One in seven Scots are now stuck on NHS waiting lists. Sort it out or pass the responsibility to someone who can. Thank you, Deputy Secretary. Gillian Martin to be followed by Tess White again for up to four minutes. Despite being the best performing A&E departments in UK, Scottish Accident and Emergency Departments are facing capacity issues and not just in winter. I would like to put forward suggestions and thoughts based on conversations that I have had with clinicians. Staff vacancies are the north-east's biggest issue and we have a worrying situation in GP services. In my constituency, where a number of surgeries are struggling to treat patients because they have so many unfilled posts. One of the impacts of that is that patients who would otherwise receive GP care resorts turning up at A&E put in even more pressure on that service. That is one of the reasons why I would like to see the ScotGEM programme expanded to include Grampian. I note that a pay offer has been made to nurses by the cabinet secretary. I really hope that it is accepted but there are pressures on other parts of our staff as well. A wide range of people in the NHS have advised me that they have concerns that too many GPs and consultants are retiring far too early. Just today I spoke to a consultant in the NHS Grampian who is concerned that because of tax and pensions implications consultants even from the age of 40 are reducing their hours. A reduction in consultant capacity obviously impacts A&E. I am concerned though that that might also impact any measures that the Government is putting in place to give scheduled urgent appointments and hot clinics that are designed to relieve pressure in A&E. If pensions arrangements are making it less attractive to stay on that is going to impact on capacity and our budgets are stretched and finite but we need to address any seemingly illogical contractual disincentives to work in full time and to retirement age. After all we have invested in training these consultants. On to training I recently hosted an event at the Royal College of Emergency Medicine and heard from an advanced clinical practitioner who pointed to the roll out of more ACPs being a vital to support emergency rooms. I am asking the cabinet secretary what can we do within the work of the urgent care and unscheduled care collaborative to facilitate this. I really do welcome the £50 million funding that has been used to put in place ways to reduce A&E waiting times including offering alternative to hospital based treatment but we do need to accept that there will always be a need for hospital based treatment. In addition to more ACPs we need to look at increasing postgraduate training places and target them at the areas where we have the biggest recruitment challenges. I have been told that these are respiratory acute medicine and geriatrics. Now Labour have this debate about winter planning and I realise that my contribution so far has pointed to long-term strategies but what I have outlined won't just get us through this winter but all subsequent winters. Labour also aid the recovery of the toughest period our NHS has ever known that cannot be ignored. Covid, not just Covid though, a very tough recruitment environment with Brexit which is the elephant in the room here. My NHS board colleagues in Grampian have consistently pointed to the damage that loss of freedom of movement has done to our NHS and social care systems. The Labour motion doesn't mention that because it's to their endless embarrassment that their leader doesn't care about taking us back into the EU common travel arrangements and until they do Labour have zero credibility when it comes to workforce issues affecting our NHS. Now I've spoken before about how Labour always come to this chamber with a list of demands but no costed solutions and to date nearly £2.68 billion of social care demands that Labour have made and don't have the first clue how to fund. I've got them here but today Jackie Baillie hasn't even come forward with any ideas for the A&E departments. Uncosted are not, not one single idea from Jackie Baillie or Carol Mocken and one final point Presiding Officer, frankly the last two words for the Labour motion and Jackie Baillie's speech are a disgrace. Every health secretary and every Government is dealing with the same issues. Grubby personal attacks like this are the worst thing about this place and it undermines the very idea of politics as a public service. Before we proceed a further reminder that time is tight you do need to stick to your speaking allocation and we will not have shouting across the chamber from a sedentary position from particularly the front benches but that goes for the back benches too I call Tess. I want to be followed by Alec Riley for up to four minutes please. Presiding Officer it feels like Groundhog Day. Nicola Sturgeon told this chamber in September that she wanted to see immediate improvement in A&E waiting times but for the third week in a row more than 3,000 patients waited longer than eight hours to be seen in A&E. 1,350 patients waited in pain and distress for more than 12 hours not in hospital beds but in waiting rooms and corridors. These are shocking figures not least because the Royal College of Emergency Medicine has repeatedly warned that waits like these can lead to hundreds of avoidable deaths each one a tragedy and the current chaos is just the tip of the iceberg because the situation will only get worse as winter arrives. In September well before the winter months NHS Grampian in my region asked people to only attend emergency departments in life-threatening situations ambulances have been stacked outside ARI with paramedics treating patients parked outside A&E doors for hours meaning they can't be dispatched elsewhere but the reality is that A&E waiting times are the symptom of a wider malaise that the SNP have presided over for years poor workforce planning and a failure to get a grip on delayed discharge means there are simply aren't enough staff and beds to care for patients you can only stretch an elastic band so far and we have reached breaking point. It's abundantly clear that we need more social care staff now to help prevent bed blocking but the SNP is instead diverting hundreds of millions even billions it seems that the Scottish government isn't quite sure whether it's millions or billions of pounds into the creation of a national care service which won't be up and running for another four years. Meanwhile cancer treatment waiting times are at their worst level on record waiting times for routine treatment are continuing to mount more than a quarter of children and young people are still not being seen by mental health services within 18 weeks and people are having to wait hours not minutes for ambulances to arrive. With Humza Yousaf at the helm our NHS is on its knees NHS staff are working heroically with the resources they have to provide safe patient care but those in the front line are telling us over and over again that the system simply isn't sustainable just last month nurses tried to share their concerns with the health secretary about their increasing workloads their pay situation and patient safety. Humza Yousaf shamefully told them not to patronise him my blood boiled when i heard that my sister is a nurse another is a midwife i speak to front line staff every day and this was just disgraceful but for Humza Yousaf it was just another photo op before retreating to the self congratulation and platitudes of the SMP party conference at the crisis as the crisis facing our NHS has gone from bad to worse the scottish conservatives have called many times for the health secretary to completely rethink his NHS recovery plan we've urged him to go back to the drawing board on his NHS winter resilience plan enough of the distraction and deflection humza Yousaf needs to step up people's lives are at stake thank you thank you very much i now call alec Riley to be followed by jillian mckay for up to four minutes mr Riley thank you president officer i'll have a few points to make in the short time that i have firstly can i say that i welcome the fact that discussions are ongoing there's an our pay offer on the table and whether it's this offer or a future one i hope we can reach an agreement and get an agreement because the last thing we need in our health services industrial action so i really i really hope that happens but i would make the point to the health secretary that i have met with frontline workers and health and social care i've met the local trade unions and nationally and they all stress to me it's not just about money it's about the massive pressure upon which all these staff are currently working and being expected to work and we have to address that to move forward now i would acknowledge the impact to covid i would acknowledge that whoever was going to be in power these are really difficult times i would also acknowledge the impact of a disastrous brexit so there are major difficulties within the NHS that we all face but i think the key issue is we've got to have the confidence that the government have actually got a grip on the issues and do have plans that will actually operate to tackle the problems and that's the problem i have i don't see the evidence that these plans are in place indeed when it comes to social care i'm not convinced this government's got a handle at all on what needs to happen and that is the problem i'll come to more of that but the first point i would want to make is to the Tory party the Scottish Tories because the reality is that right now we have a crisis in this country that has been created in Downing Street an economic crisis that is going to play very badly the daily record the daily record reported last week that we now have 216 official heat banks haven't been opened in addition to the fact that we have 244 food banks now if we're going to go through this winter with people cold people freezing people not able to feed themselves that is going to put massive pressure on our health service and the the really the really difficult thing for me is the Tories have tanked the economy but they have the nerve please don't they stand there and say yes something to say i've already told you they have the nerve to stand up and look into cameras with a straight face and say we're going to have to cut public services i would hope this parliament could unite to say that there should be no austerity on public services and that we will all join together and fight that austerity but back to back to the the scottish government and where there are firstly in terms of care homes care homes are in crisis we've saw that we saw robert colgauer on the news last night talking about the massive pressures that they're under that has gone you have to be addressed but i want quickly to say it cannot be addressed by simply fleecing self funders those who over 18 and a half thousand pound a year are having to pay for their own care because right now they're the only income source for those care homes and sadly their their charges are increasing and there is no protection for it so that must be addressed in terms of social care itself the inequality within social care between those working in the private sector and those working in the public sector must be addressed you cannot continue to ignore that and i have to say the national care service proposal that you've brought forward is basically a national procurement service that is not going to tackle the issues that we face right now and i just looked this morning at the responses to the consultation everyone in that sector all the professional bodies people are using the sector are warning you that so you have to listen that's the problem in conclusion people don't believe you have your handle on this or you have a grip on it you need to do that thank you mr royley and i'll call jillie mckay to be followed by david turns for up to four minutes mr thank you deputy presiding officer this will once again be one of the most difficult winters in the history of our nhs an already tired workforce rising covid related admissions and a backlog of delayed and more complex treatment as well as a battle to reduce a and e waiting times as always some health boards are doing better than others fourth valley in my region is one that is continually at the top of the table in terms of long waits and we need to understand better why in this particular health board this is as support a sustained incremental difference in wait times rather than what we are seeing at the moment bad statistics one week a marked improvement the following week only for the cycle to continue to repeat itself this isn't delivering for patients and gives me great concern for the pressure clinical teams are being put under in these health boards to achieve lower waiting times when they are already stretched and tired keeping people out of acute settings in the first place should always be the primary goal i attended amari cwri roundtable discussion at the start of this week with experience from unpaid carers and their organisations we discussed the current issues faced for those who are caring for a loved one at home an issue that was raised related to nhs 24 and access to that for people with a terminal diagnosis often carers or patients themselves are looking for guidance on whether the issue they currently have needs acute care or not but because of waits for triaging they often end up phoning an ambulance or taking their loved one to any i believe some health boards is part of anticipatory care planning provides specific pathways for those with a terminal diagnosis to get the information they need given the number of people now wanting to die at home i hope the cabinet secretary may look into this as one way to prevent people ending up at any unnecessarily i've previously raised staffing about of ours gp services this is a hugely valuable service that again diverts people away from any and provides timely care we need to make this an attractive option for gps to work in in their briefing rcgp highlighted that they believe people are unaware of how to effectively navigate health and social care services many things have changed over the pandemic some services are not delivered in the same way and pathways may have changed i hope that some effort can be put into ensuring especially over winter that patients know where and when they can access the most appropriate care pharmacy first model for example will be able to help with some minor ailments over the winter again reducing the potential impact on gps we should also acknowledge those in different parts of community care that are working extremely hard to make sure their patients remain well district nurses doing home visits changing bandages and monitoring people's conditions school nurses dealing with a vast range of issues across multiple schools health visitors providing advice and guidance for new parents they are all contributing to the system as well as the brilliant allied health professionals and support staff without whom the nhs simply wouldn't work we need to make sure that staff can take their breaks that they have time for peer support and can access wellbeing measures that help to relieve the physical and mental toll the experience pay is very important but having spoken to nurses from the rcn outside the building before recess their working conditions and terms and conditions are really important too and i will continue to work with rcn members on this to conclude presiding officer we need to ensure this winter that we reduce waiting times as far as possible without putting more undue pressure on a tired workforce and we need to ensure that all avenues for access to care are well advertised and communicated thank you miss mcaiah and i'll call david thorns to be followed by edwin mounting up to four minutes mr thorns thank you presiding officer before i begin i would like to pay tribute to our outstanding health and social care workers across scotland the last few years i've seen an immense strain put on their healthcare system and its workers but despite these stresses and in the face of unprecedented and unimaginable challenges we have continued to provide an exceptional service as we look ahead into this winter the challenges that we will bring no one in this chamber is under any illusions but with difficulty is going to be we all know that extremely tough times lie ahead this winter it will take a combined efforts of national and local government working alongside all our healthcare partners to tackle the challenges that lie ahead but make no mistake while labors stand here today and criticise despite what we would like us to believe isn't just here in scotland that healthcare staff and services are under strain the NHS in every part of the united kingdom is facing significant pressures but to mind similarities end there why what separates us from other parts of uk we have a scottish government that cares a government has a strong and steady leadership a government with plans and the health secretary recognises the challenges that lie ahead and is totally committed to improving performance and delivering positive change put that into contrast for english counterparts and i know who i would trust to safeguard the health and well-being of my family friends and loved ones labour have highlighted their concerns about their A&E departments what you won't hear in the knowledge is that their accident and emergency departments are performing better than those in england wales and northern island the scotland staff and levels of NHS have grown for 10 consecutive years and while staffing and funding is already at historical high levels as we approach a winter period this scottish government will continue to look to modernise and enhance whatever possible no thank you you know why i want to take an intervention when you went in a coalition with the tories and the council through the chair mr torrens through the chair is recognised by his government that a current level of the performance is not acceptable no one here will deny that that is why earlier this month the health secretary outlined in this winter resilience overview several actions for the coming winter months all backed by more than 600 million of funding by april this year more than 1000 additional healthcare support staff and almost 200 registered nurses have been recruited to help address the challenges of our services staffing levels have increased by more than 2800 per cent whole-time equivalent roles in the past year the scottish government is also investing a further recruitment in taking action through the 50 million urgent and unsettled care collaborative i've listened today with interest and some disbelief as my labour colleague speak of thousands of beds the delays lost due to delayed discharge i get a censor in their desire to criticise and condemn the scottish government when we are lacking some self-awareness we can be no doubt that the impact of brexit and the introduction of our new UK immigration procedures have had a profoundly damaging effect on social care and yet a labour party continued to eagerly embrace the tories extreme brexit and all of its overwhelmed negative impacts EU workers have a hugely positive contribution in the care sector for many years and represent a vital component of our country's social care workforce but brexit and the yearning of the Tory parties to take back control of the UK has created a shortfall on care services which in turn has severe knock-on effects on emergency and urgent care the whole system comes blocked when there are not enough care workers to support themselves leave those leaving hospital leading to gridlock and a backlog through entire system when people can't leave possible with due to lack of social care patients are stuck in the NE while they're waiting in a possible bed and why those needing ambulance are then left waiting because they're waiting on transfers of patients yet only this week we all heard care stammers determined the short-sighted answer of it's a straight no when asked about rejoining EU shown that Labour and the Tories are increasingly just two sides of the same coin both completely unwilling to stand up and do what is best for the people of Scotland just imagine what our NHS could do with a seven hundred and seventy million a year that has currently spent mitigating Tory policies you need to conclude you need to conclude our NHS has suffered the biggest shock of its 74 year existence and will not recover overnight as has been acknowledged by his government thank you mr Torrin and I call Edward Mountain to be followed by Emma Harper for up to four minutes mr mountain thank you very much for his deciding officer and first of all I'd like to pay tribute to all our frontline staff in the NHS retail or emergency treatment they never falter last year my personal contact with the NHS allowed me to see how hard they work but what is clear to me is that our frontline staff do not have the resources they need that means there are too many patients that struggle to get seen to get diagnosed and we're still to get from treatment over work gps are often can't see the person in person carrying out a diagnosis on a computer is a risky business gps need to see patients and whilst near me and other online portals might work let me tell you being told you have cancer on a telephone in your parliamentary office sucks as does waiting 10 days for a full up appointment as the NHS comes under increased pressure and face crisis management there is a real danger that the first thing that is sacrificed is human care it is that personal approach that bedside manner that patients not any need but staff so want to deliver that suffers not providing the resources to allow staff to deliver that care is in itself a dereliction of duty your duty cabinet secretary now we all recognise the pressures of covid but the health service was under extreme pressure before covid every winter we face the inevitable and predictable rise in patients every year this government gullid around trying to find solutions every year they said they were listening and learning the trouble is whilst they might have been listening listening they certainly didn't hear and they certainly were never learning now cabinet secretary you will say your winter plan will result in the recruitment of a thousand extra staff and provide 120 million pounds extra to provide help at home where exactly are you going to get those through the tear please mr mountain sorry where exactly will the cabinet secretary get those staff from and how will the additional funds be judged providing the care at home that is so desperately needed turning to delayed discharges another perennial problem and one that this government has failed to address this government promised to eradicate them in 2015 but successive health secretaries including the current health secretary have failed miserably to address them numbers remain at almost a record high in nhs highland alone there has been a 32 increase in delayed discharges in this year alone one word covers this failure this government's failure every treated patient in hospital waiting for a social care package is stopping another patient on the waiting list from getting treatment longer waits delayed treatment results without doubt in less optimal outcomes cabinet secretary your government's failure on delayed discharges is now very much your failure presiding officer across scotland waiting times in a and e are going up cancer waiting times are going up nurse vacancies are going up they're all going in the wrong direction up so the real question is when will the cabinet secretary for health stop dragging our nhs down which seems to be the only thing that he's capable of doing thank you thank you mr mountain i now call Emma Harper the final speaker in the open debate for up to four minutes miss harper thank you presiding officer well here we are again another politically opportunistic motion from the Labour party politicising our health service here in scotland contrary to the motion the health secretary and the team are focused on ensuring scotland's nhs is as well equipped as possible to tackle the huge challenges we face and i know there are challenges you know taking care of people the processes the pathways the prevention of acute admissions the work in primary care the work that my former colleagues undertake every day it's so complex and the systems are challenging i was an nhs scotland england and a nurse in the usa for 30 years before coming here so i think i know a wee bit about what's going on in our national health service and sometimes when i'm reading these motions i wonder if the the opposition can jiddly quackwa about what is actually going on so i know that over the last two years the nhs has suffered the biggest shock in its 74 years of existence and i want to thank the work and the care and the compassion and the commitment of all the people at work in the nhs and what they do every day the scotland's recovery plan is backed by over a billion pounds of investment and it sets out plans for health and care over the next five years so it's no just for this winter the plan will support inpatient day case and outpatient activity and the implementation of sustainable improvements and new models of care through investing in a network of national treatment centres this will increase capacity for additional specialties including diagnosis general surgery orthopedics and ophthalmology the plan also supports the mental health and wellbeing of the health and care workforce and we have heard so much about that in the last couple of years as well and so to look at ways to support people using digital opportunities like nhs near me is something that we should actually get right behind it is welcome and crucial that we need to help equip our nhs for the winter pressures but again it's beyond the winter that we need to be thinking about as well and on specific a and e challenges i hear what has been said you know in common with other health services across the uk and globally any departments are working under significant pressure and the pandemic does continue to affect services mind that word it's called covid we do need to remember the impact that the covid pandemic has had and is still having on our national health service and i know the scottish government has taken action to improve any weights and the 50 million pounds urgent and unscheduled care collaborative will help implement a range of measures to drive down the a and a waiting times this work includes offering alternatives to hospital such as hospital at home directing people to urgent care settings and scheduling urgent appointments to avoid long waits in any i know about the long waits in any i hear it directly from former colleagues and folk working in there in 12 hours shifts it is hugely challenging you know in august scotland's cori annes were 8.1 points better than england and 10.3 percentage points better than wales so in labour controlled wales a and e waiting times for the same period of scotland were worse so i wonder if jackie balie or anybody in the labour benches can clarify when they're closing if they will call in the Welsh Labour secretary to resign also you know labour's performance in wales does not inspire confidence for them doing any better here in scotland presiding officer i am conscious of time but i note what jillian martin has said about potential solutions and i welcome the steps the scottish government are taking to support our nhs i want our health secretary to listen to the clinicians directly for their ideas and suggestions to help improve the systems but we do need to get right behind our staff and our nhs workforce and support them in any way we can help in the future thank you very much indeed miss harper we now move to the closing speeches i called think hoy for up to four minutes mr hoy thank you deputy presiding officer scotland's nhs faces its worst winter on record and it faces this because of the snp government it faces this because of the wrong choices made by this health secretary choices which have led to the worst cancer waiting times ever the worst ambulance waiting times ever and a workforce that is demoralised and unappreciated where nurses are threatening to strike for the first time in history this government has chosen the path of poor terms and low pay deputy presiding officer critically ill patients in the most severe category are being forced to wait hours for an ambulance tens of thousands no i won't tens of thousands of people waited over four hours to be seen at any waiting units last month and hundreds of cancer patients have waited over two months to begin urgent treatment according to the royal college of emergency medicine the ways in scotland's a&e departments last month meant that 40 people died who need not have died cumulatively our nhs isn't just facing a crisis this winter it is facing a catastrophe week after week the snp and greens continue to waste millions of pounds of public money millions of pounds put at risk on the wrong no millions of pounds put at risk on the wrong choice for social care millions wasted on a campaign for scolish independence millions wasted on fake foreign embassies and overseas junkets millions wasted millions wasted by the snp on botched ferries wrongly contracted against the advice of civil servants this didn't come about by chance this came about by choice the snp's choice the wrong choice is welcoming the wrong choices nationally in south scotland i will give away minister if mr hoi would add to his list and look at some of the things that have happened recently south of the border because of the incompetence of the torey party like 65 billion pounds having to be spent to prop up mr hoi mr hoi trustonomics why not focus on the 41 billion pounds that you have here in scotland to make our public service is better perhaps you mr stewart you've had an intervention be quiet the the minister's not in anabody nightclub now you should behave the uh the the wrong choices are being made time and time again wrong choices like the closure of beds in the minor injuries clinic at edicton cottage hospital in north berwick they make the wrong choices for residents time and time again and the calamity of all calamities is coming in the form of the national care service the snp are choosing a national care service over local care and all because they choose centralisation at every turn don't take my word for it let's look at what cosla and unison say for the sake of those individuals and families who need our support waiting four or five years for the establishment of the national care service is not an option we cannot and should not break up the local government workforce particularly at this critical time in our recovery from the pandemic deputy presiding officer independent researchers from the scottish parliament estimate that the snp's proposal to create a national care service will cost up to 1.3 billion pounds over the next five years and even the nodding dogs on the snp's back benches conceded this yesterday in the finance committee the minister knows only too well that he is on the wrong path scotland needs a well-funded high quality health service mr holley the point of order jillian martin they're not incumbent on msps to treat other msps with respect ms martin i'm not sure that is a point of order but it is absolutely the case that members should be treating each other with respect and that goes for absolutely everyone mr holly continue and conclude thank you deputy presiding officer scotland needs a well-funded high quality health service where care is delivered closer to patients where staff feel rewarded and valued and where patients are treated quickly and safely in short an nhs where big choices are driven by patient care not the independence obsession of this incompetent snp government and this incompetent health secretary thank you i now call the cabinet secretary for up to four minutes cabinet secretary thank you uh presiding officer i'm not going to respond to some of those personal attacks because it's a shame that a debate of such importance such seriousness has seen such pathetic grubby personal attacks not just on me but on members right across this chamber and it's a shame because it does no service whatsoever to a hardworking nhs staff who are working under incredible pressure let me tackle some of the issues that have been raised that are very very important to all of us right across this chamber on cancer of course statistics continues to show that notwithstanding the huge impacts of the pandemic that we're still continuing to meet those 31 day targets we are not meeting the 62 day targets they still remain absolutely challenging and that's why our focus my focus has been on the detecting cancer early program it's why we invested and i announced 10 million pounds to improve cancer waiting times that's on top of the 114.5 million in the national cancer plan that's why i announced three rapid cancer diagnostic services and two more have just been approved so we'll continue that relentless focus on ensuring cancer detected early because we know if it is then it leads to better outcomes and survivability for people oh winter funding i was astonished by what jackie bailey had to say she complained that there's no new money she complained that i announced all of the money last year of course it was jackie bailey who demanded last year that money be recurring that winter pressure money was recurring for this winter and now she's standing up complaining that that same money has been recurring you can't have it both way i'll give away to jackie bailey i mean everybody including yourself is saying that this is going to be the worst winter ever surely this is the point at which to put additional resources in to cope with that so patients don't suffer cabinet secretary that's why this financial year we have a record 18 billion pounds being spent on the health service and what i say to jackie bailey is you don't just wake up one day and say oh it's going to be a bad winter you plan for it the year before that's exactly why we ensure we had recurring money at 1000 additional staff recruiting recruited over the course of this winter Edward Mountain is supposed to be on his phone asked might want to listen because he asked where does that money come from where did those staff come from of course those 1000 staff 750 of them will be recruited from overseas and that is because boards tell us they have the capacity to bring people over from overseas and 250 of them will be domestically recruited i want to touch on Alex Rowley's contribution i thought it was a very fair contribution actually and actually showed that there's a willingness from some in the Labour party to get into to come forward with actual ideas and solutions potentially for the social care sector and the national care service what i will say to Alex Rowley there's no silver bullet if there was i promise him we would have deployed it by now but our relentless focus is on workforce workforce workforce because that is the challenge but i cannot disassociate those workforce challenges from the folly of brexit we know and Kevin Stewart was reminding me of the fact that one care home provider telling him that 40% of his staff had to leave largely down to brexit and he lost them due to brexit so our focus will be on the social care sector and pay will be a part of that that's why i cannot give way i virtually have to finish in less than a minute what i will say is that we will have a relentless focus on pay terms and conditions whether it's in the NHS or social care and i'll conclude my remarks shortly but i cannot let the conservatives get away with talking about social care and talking about our public finance how dare how dare they come to this chamber and utter one syllable or one word about the challenges our public finances serve face through their incompetence to their economic mismanagement through their economic vandalism my health budget is worth 650 million pounds less than when it was set in december last year so why don't they grow a backboard and instead of waiting for the next number 10 incumbent to tickle their tummy why don't they try standing up for scotland and stand up for our public services i will end here thank you cabinet secretary i now call on paul o'r cane to conclude wind up the week for up to five minutes mr okayne thank you Presiding Officer our NHS is facing a humanitarian crisis this winter and let's be frank the responsibility lies at the door of this Government and this cabinet secretary and yet again today we have heard the scale of the crisis in our NHS we have heard from Jackie Baillie about the personal cost behind each and every one of those numbers each a person with a family their own story cared for by our amazing staff in our NHS who are at breaking point i think today's debate has been characterised by the cabinet secretary's i have to say thin skin you know he complains that he's been personally attacked the reality is all jackie baillie and this side did was point out his failures in comparison to his predecessors in the health secretary's job including gene freeman who led the country through the beginning of the pandemic alex Cole-Hamilton did similar in his remarks when he pointed out what paul gray has had to say about the head of steam that has built the perfect storm that's been created it isn't all about covid i'd like to make some progress i'm just coming to the point the reality is what we've heard from the SNP this afternoon from the back benches is that they've accused us of political attacks but let's be honest what we've heard is desperate stuff from them the accusers of political attacks and all we've had from the back benches is howls of red story as carol mocking made her contribution nonsense comparisons with wales and england and attacks in cair starmer so scared of the of a UK Labour government so we are not going to take lectures from a party who have spent this debate indulging in what about today refusing to acknowledge their responsibility for every single person who is lying on a trolley in any this winter the cabinet secretary said in his remarks that he prepares for winter in advance so can he tell us why dr john thompson the vice chair of the royal college of emergency medicine has stated that the measures outlined in his winter resilience plan will and i quote not be in place anytime to prevent further harm to patients and staff this winter yes Presiding officer the experts are clear jillian martin calls for solutions backed by the experts absolutely i went outside and met with the rcn when they protested in front of parliament and you know what they told me they told me that they need more training places filled that they need a fair pace settlement across all bans and they have told me that they need proper breaks and proper rest when they're on shift because they're not getting in the moment and the workforce is on its knees but perhaps we should describe to Emma Harper's attitude and not listen to the hardworking staff and their trade unions i'm quite sure they will make diddly quack of whatever her contribution was supposed to be about let's be honest Presiding officer the issue across our nhs is being exacerbated by the Scottish government's refusal to engage on pay whether it's with nurses or whether it's in social care refusing to back Scottish Labour's pledge to pay social care workers 15 pounds an hour a wage that they can live on not just a wage that they have to survive on and the Scottish government have also failed in wider regards in social care they have failed to implement key recommendations of the fully report and there are serious concerns across their approach to the national care service which have been outlined by trade unions the third sector professional bodies and it's clear as Alec Riley and others outlined that they are currently not listening to what is being said about the serious challenges in social care and all of this begs the question if the government isn't going to listen to the advice of independent experts in the field who are they going to listen to? Presiding officer Humza Yousaf is a record breaker I think that's fair to say week after week we see record breaking accident and emergency waiting times every time Scottish Labour is forced to bring this debate to the chamber we have another record broken by this cabinet secretary it's quite clear that in place of meaningful action to address the crisis in A&E in social care and across our NHS all the cabinet secretary has to offer is hollow words it's increasingly obvious that Humza Yousaf is a man with no plan I'm sure most of the members in the chamber could have preempted the cabinet secretary's response before he got to his feet if you don't like one of his excuses he has others first it was Covid then Brexit then the cost of living then winter weather then staffing the same old script which does a disservice to healthcare staff patients and families of patients who are real concerns over the current crisis in our NHS Presiding officer it is not good enough we need a health secretary who can offer leadership not one who hides behind tired old scripted excuses the first minister is fond of saying that the buck stops with the government although she really does anything other than look at the buck and watch it float by so in the cabinet secretary's own words to hard working nurses let's not patronise one another the buck stops with him and if he is not willing to get on and fix the situation in our NHS then he should resign thank you Presiding Officer thank you mr okay that concludes the debate on supporting the NHS in winter it's time to move on to the next item of business there'll be a brief pause while the front benches change