 Rwyf yn rydyn ni'n gweithio i ddarparu cyfrefiynau cyfroedd gyfanolol mewn ffordd cyfrail ar y swylo'r cyfieiniadau ac yn yr Olygriniedd Cymru. The final item of business is a member's business debate on motion 1136 in the name of Jaime Halcro Johnstone on Ambulance Services across Scotland. This debate will be concluded without any questions being put and with those members fawr o'r dd crankwys a'r ffwg i'r cymhwyllteidliadau, mae niferwyr cymaint iawn o'r ddikeu i gael i'r ffaleisio ei fod yn oeddem anhygoel a'i gyflaen, oedd yn eenfos gan gyflaen gwrs i ein bwrth i'r ddigonion i gael i gael i'r dd 스�ysg, I appreciate the opportunity to bring forward this debate today, and I thank all those who have supported my motion and made this evening's debate possible. There's been a great deal of coverage in recent weeks of the challenges that are currently facing our ambulance service, and that isn't a problem that just impacts the most rural parts of Scotland, like the Highlands and Islands. The case of Gerard Brown in Glasgow shocked people across the country. A 40-hour wait for an ambulance, despite the efforts of his GP and family, has rightly been recognised as appalling. His subsequent death is a tragedy. He was one of hundreds of people over the last year who were assessed as requiring emergency response, yet were forced to wait more than 12 hours for an ambulance. His GP called the situation Third World Medicine, and yet many more disturbing cases have come to light since. I hope that today's debate can recognise the experiences of people across Scotland, but I also acknowledge that there are problems that need to be addressed more than just short-term fixes. One thing is clear. Those underlying problems stretch back much further than just the recent months or even the onset of the pandemic, and without credible work on long-term improvements, they will last longer than just this winter. Last week in this chamber, Jackie Baillie quoted one paramedic who noted, I'm fed up reading and hearing in the news that the pandemic is causing the problems with delays. It's true that this is a contributing factor, but this has been a disaster in the making for many years. Another told me, it frustrates me that Covid is the excuse used to carpet over issues that were already there. A constituent wrote to me about his experience a few years ago when his mother severed an artery in her wrist. Bleeding to a point of almost unconsciousness, it took an ambulance 30 minutes to arrive. This was not in some remote village, but in the city of Inverness, where the ambulance dispatched to Inverness from Dingwall. Another spoke of their experience when, despite being referred by an out-of-hours GP, they were told that an ambulance might be available in four and a half hours' time, but there was no guarantee of this. In heavy rain and winds, his wife was forced to drive him, and I quote him, writhing in agony from Aviemore to Inverness, where he had emergency surgery and remained in hospital for nine days. He praised the care that he received from the out-of-hours GP and the staff at Regmore. The only weakness, he said, was the ambulance provision. Please let me be clear that Scottish ambulance crews are remarkable. Their job is to save lives and to protect the public, and I'm proud to have family and friends who work in the service. Unlike many public services, they come to people's homes, streets and workplaces. They are the most front-line of front-line staff and certainly among the most key of key workers. We owe our ambulance crews and support staff a huge debt of gratitude and our thanks. This is all the more reason why in this Parliament and those in the Scottish Government must make sure that they have the proper tools to do their job. Paramedics and other staff are under real pressure. Many have been unable to work in rest breaks over long shifts. Unions have pointed to low staff morale and enduring fatigue, and we risk a growing mental health crisis within our ambulance service. Scotland has always by necessity led the way in public medicine. The Highlands and Islands Medical Service is often cited as a forerunner of a UK-wide national health service. Our lower population density and relative remoteness has often been cited as a justification, at least in part, for the additional devolved funding that Scotland enjoys relative to other parts of the United Kingdom. However, the reality is quite different. Increases in funding in England have not led to similar increases in funding in Scotland. There has been a trend under this Government and before to emerging of healthcare spending between Scotland and England. In April, the Institute for Fiscal Studies pointed out that the start of devolution, healthcare spending in Scotland was 22 per cent higher than in England. Today, it is only 3 per cent. That is a tightening of funding by successive administrations in Edinburgh, which fails entirely to recognise the cost of delivering public services in this part of the United Kingdom. There have always been unique challenges in providing ambulance cover in our rural and island communities. If you are on the mainland of Orkney, there is likely to be only one ambulance active at any given time. How long it will take a crew to reach you is then simply a question of who is in front of you, in the queue and where on the islands the call-outs are. One elderly constituent in Orkney having fallen was forced to wait two and a half hours with a bleeding head wound for an ambulance to arrive. Even in other places, there is also real difficulties. From the west of Skye to the nearest major hospitals in Fort William and Inverness is well over three hours by road, and yet we continue to see threats to local health facilities in more rural areas. I have spoken many times in this chamber about Dr Gray's hospital in Elgin and the downgrading of its maternity services. The alternatives for many prospective mothers will be either in Inverness or Aberdeen. But extensive travel to access services not only places huge strain on patients and delays in emergency treatment, but it also redirects valuable ambulance resources into patient transport. When the health secretary presented his eagerly awaited NHS recovery plan in August, there were only two mentions of the ambulance service. We had to wait until last week to see something approaching a recovery plan for that service. Again, the service was not seen as a priority by SNP ministers. The plan was forced to them by the growing crisis. Thankfully, in Scotland, we benefit from an additional safety net. We now have the British Army and a number of other bodies called in to assist. As the Scotland on Sunday reported at the weekend, over 3,000 calls were diverted from Scotland to control routes in England in the first half of this year alone under mutual aid provisions. Those and the additional funding that has been mentioned are welcome in the short term, but they will not bring transformational change or greater resilience to the service for the future. Deputy Presiding Officer, we have seen pressures not only directly on our ambulance service but on call centres in our A&E departments within our general practice with local NHS services. While some of the current crisis is symptomatic of wider failings and circumstances brought on by the pandemic, ministers have been slow to accept that these have been largely exacerbated rather than created the problems. We must recognise that simply pulling back from the current crisis is not good enough. It is welcome that the First Minister has finally and belatedly been forced to accept that there is a crisis in the ambulance provision in Scotland. It is welcome that the cabinet secretary is here today and recognising the seriousness of the situation. It is present to listen to some of the concerns being raised this evening. I hope that he will take them seriously and recognise the feeling felt by MSPs and the concerns of our constituents. This evening, we have heard, or we will hear, the voices of patients and the voices of ambulance staff. Voices that for too long have not been heard by this Government. It is unfortunate that it has taken issues of this magnitude for those voices to be amplified, and I just hope that ministers are at last really listening. Thank you. I now call on Christine Grahame to be followed by Edward Mountain. Up to four minutes, please, Ms Grahame. Thank you, Presiding Officer. I see the clocks now operational. I congratulate Jamie Halcro Johnston on bringing this important member's debate to the chamber, and this follows question and answer session with the cabinet secretary for health, a debate and questions to the First Minister on the performance of the ambulance service. I also know that we all agree that any issues arising, particularly during this extended and continuing pandemic, in no way reflect on the men and women of the Scottish ambulance service. Since those questions and debates have been taken by the Scottish Government, 20 million to include the assistance were more than 100 military personnel, 88 drivers and 15 support staff. Around 100 second-year paramedic students to help in ambulance control rooms—I will come to that later—more hospital ambulance liaison officers at the busiest A&E, increasing from 11 to 20, helping to ensure a timely admission of patients at A&E because of the knock-on effect on ambulances arriving. Additional help from the Scottish Fire and Rescue Service in the form of volunteer drivers, as well as the British Red Cross and private transport companies were clinically appropriate. Again, back to the call centre, additional senior clinical input in ambulance control rooms to assist and speed up decision making on mental health, addictions, falls, breathing difficulties, high-intensity users and trauma. During the recent statement, we learned that, in August this year, only 21 per cent of calls were actually emergencies. So, ambulance personnel are being called out for one-mic call and term lower-level medical issues, social issues included, for example, someone sleeping rough or passing out drug or through drugs. That can take up a great deal of the cruise time as they either take the person to A&E or try to find somewhere and someone to look after them while they are in that state, because both the police and the ambulance services were duty of care to that person and cannot leave them somewhere unattended. Sometimes that can take up hours of a cruise time, so it is a complex mixture and puts the service under pressure at any time, but more so during Covid. However, I understand that staff are frustrated wasting time at call-outs that they should not have been. That is why I raised the issue of the IT triaging system with the cabinet secretary, which in my view needs refreshed to match the current circumstances. I understand that it was designed a couple of years ago and is highly automated. Call-hangers are not at fault. They run through questions and the system tells them what to do next based on the response. We need to revisit that if only 21 per cent of those call-outs are emergencies. Arriving at A&E also because of Covid processing of patients must take longer, tying up ambulance time as the ambulance is cleaned, and case notes have to be documented at that time and transferred into the system. There will be regional variations—I cannot speak for the Highlands and Islands—and I have to say that I have not had any emails from cases in my constituency in Midlothian South, Tweeddale and Lauderdale to date. It may change after this debate, but I have not had that. In conclusion, the pandemic makes the Government and the public we must look afresh at what we require of a modern ambulance service. There is a duty on the public to behave responsibly. Of course, we must call an ambulance without hesitation in an emergency, and those are defined by the Scottish Ambulance Services as loss of consciousness, cardiac arrest, heart attack, stroke, acute, confused state, chest pains, breathing difficulties, severe bleeding that cannot be stopped, severe allergic reactions, severe burns or scalds, major trauma such as a road traffic accident or fall from height. You can check that out if and doubt on the SES website, but there might be other medical evidence that you should be seeking first, such as your GP, the pharmacist, the optometrist and so on. I thank Jamie Halcro Johnston for raising this important issue with it again, and I would add much of what I'm saying came also from a paramedic. I now call Edward Mountain, who will be joining us remotely to be followed by Carol Mocken. Thank you, Deputy Presiding Officer. First, I'd like to thank my colleague Jamie Halcro Johnston for securing this debate on a subject that's so important to the Highlands, especially in the Highlands and Islands. We all know that every minute counts when it comes to attending a life threatening situation, even more so in the Highlands and Islands where rural communities face long journey times to A&E. It can take over two hours just to get to A&E, whereas in some of the more remote areas. Therefore, the ambulance cruise ability to respond quickly is more often than not of what makes a difference between life and death. During the pandemic, we relied heavily on our hard-working ambulance cruise like never before. As we face a worse pandemic in the health emergency in generations, it rose like all the other front-line staff for the challenge and faced it with true grit and determination. However, that challenge that it faced has been made so much harder by this SNP Government, who has presided over an ambulance waiting time crisis. It is always convenient for the SNP ventures to blame all their failures on either Brexit or the pandemic, but that simply is not true. Those without selective amnesia will remember the shortage of ambulance provision in the Highlands and Islands region that I highlighted back in 2017. At that stage, there were insufficient ambulance cover not only to cover sky but also locava and cave nest. Shortages were addressed with sticking-pasta solutions like single-crewing ambulances. It was until 2018 when the GMB Union threatened to take industrial action due to the lack of emergency ambulance cover in cave nest that this Government almost woke up. That shortage of emergency ambulances had a knock-on effect. During the same period, I had to assist care homes who were having to organise their own patient transport due to the lack of ambulance cover to take patients to hospital. Our ambulance service has been overstretched for far too long, and the situation has reached breaking point with the average waiting time for ambulance crews up now to six hours. That is shocking. Let's put that into context and see what it means in an individual's case. I quoted constituents who contacted me. They collapsed at home, having a mini-streg. They called for an ambulance and were told to wait for a call back. When that call eventually came, they were told to make their own way to accident and emergency because there were no ambulances available. We wondered what they were expected to do. Pop outside, weighed down a taxi or perhaps even jumped on a bus. Hopefully, that wasn't needed because a friend was called and they jumped to and took them to the hospital. That's not where we should be at. Insufficient ambulances are not enough staff and there is nowhere for this Government to hide. No one should have blain but themselves because the crisis started well before the pandemic and well before Brexit. I believe that the crisis is putting people's lives at risk, especially those in the Highlands where there are much greater areas to travel. I am pleased that steps have been taken following the call by the Scottish Conservatives to bring in the Army and the Fire Service to alleviate cruise shortages. However, what we need in the Highlands and the Highland Ambulance Service need is a long-term plan. That takes leadership and vision and, sadly, both those seem to have evaded the SNP Government over the past 14 years. I thank the member for bringing this debate to the chamber. Those who work in our ambulance service deserve our admiration and gratitude for the work that they do every day to respond in emergency situations. However, even more so for what they have done over the past 18 months of a global pandemic where they have experienced pressure like never before. They have worked throughout lockdowns, putting others before themselves and their contribution to our efforts to get through this pandemic cannot be overstated. However, our thanks are nowhere near enough and do little to address the fundamental failings of this Government to properly provide health and emergency services. The problem that we see today in our ambulance services is not down to our workers but down to Governments and ministers who lack the political will to intervene, invest and put focus on issues that impact people's daily lives. This evening's debate will rightly consider the positive contribution of our ambulance service workers. However, the situation that the ambulance service finds itself in just now is a serious one that predates the pandemic and reflects the inability of the Scottish Government to address issues with the purpose and protect the services that thousands of people rely on every day. Indeed, Jamie Halcro Johnston notes in his motion the importance of a well-connected ambulance service that serves rural communities like his in the Highlands. However, that is true also of the south of Scotland, my own region, where ambulance waiting times can be lengthy, particularly for our rural communities. Again, that adds further to the existing problems that our ambulance services face in other areas. As I mentioned in a speech on ambulance services last week, expectation management should not be the priority of this Government nor should it be improving media coverage. Nearer of those are acceptable for the women from air who waited four hours for an ambulance last month or for the families who have felt powerless as loved ones have waited as long as 40 hours. Those are personal stories here, individual tragedies such as Rebecca Stephenson from Prasley, who aged 85 sadly died after waiting eight hours for an ambulance. It should not have taken this much for the Scottish Government to actually sit up and listen. People are not asking much, they are asking their Government to focus on the matters at hand, to address the fundamental issues in our health and emergency services, and to deliver ambulance services that support incredibly hard-working staff and ensure that there is confidence across our communities that they will be served in case of an emergency. I will support the Scottish Government and its efforts to resolve the issues that we face on our ambulance services. What I will not do is sit back and accept commitments of investment that will take years to make any changes. That is by no means an issue that can be rapidly sorted. Indeed, several years of mismanagement have ensured that, but it is one where the political will, the correct investment, focus and urgency can be turned around. Underfunding, understaffing and lack of resources have led our ambulance service to the difficult position that it finds itself in. Our workers have gone way beyond expectations during the pandemic, and the strain on them has been significant. It did not have to be this way and it must not be this way again. This evening, we are correctly here to highlight the importance of our ambulance service and its incredible workers, but that does the service. It is workers and our communities little good if we do not hold to account the people responsible for serious issues facing the Scottish Ambulance Service. I say to the Scottish Government that I will support them in their efforts to deliver change, but there can be no more time wasted. This is urgent and urgent action is needed to make sure that, because lives depend on it. Presiding Officer, I congratulate Jamie Halcro Johnston on securing this debate. Indeed, I recall holding a very similar debate about a year ago. On that occasion, my aim was to build cross-party support for a campaign to pay student paramedics during the course of their studies. While sympathetic, the minister at the time, I recall, was not for budging. Earlier this month, however, those starting their paramedic course will have received a grant for the first time. I would encourage Mr Halcro Johnston not to take whatever the cabinet secretary has to say shortly as the Government's final word on the matter. The current crisis facing our ambulance service has rightly been the subject of much debate over recent weeks in this Parliament. That is understandable, especially when we see the army and firefighters being brought in to help. However, the case around capacity is one that I have been making in relation to Orkney for some time. The single ambulance to cover the entire mainland and linked south Isles is simply not enough. It lacks resilience. From figures that I obtained from the Ambulance Service in 2019, the Orkney mainland was twice left with no ambulance cover at all due to a lack of staffing. That is on top of the 168 occasions when the ambulance was called out and therefore unavailable to respond to other incidents. The lack of resilience and sometimes cover has many consequences. It puts additional stress on hard-working ambulance crews doing their best to keep their communities safe but denied the tools that they need. It puts doctors in an invidious position feeling that they need to respond out of hours, often to incidents for which they are not properly trained. Ultimately, it puts the public in Orkney at greater risk. Since I first started raising the issue, I have been told repeatedly of the need to await the outcome of the demand and capacity review. Scottish Liberal Democrats recently secured that document through freedom of information, and it makes for worrying reading. In response to publication of the review's findings, ministers have insisted that they are committed to recruiting around 450 more ambulance staff. Whether that is indeed new staff and additional money remains unclear, but what is clear is that in its long past time Orkney had the staff to operate two ambulances, not just for a few hours a week, not just on the basis of existing staff volunteering to work overtime, but all of the time. Like so many of the issues that are facing our health and care services right now, the lack of ambulance capacity in Orkney predates the pandemic. However, there now is a perfect opportunity to address that long-standing need. Whether or not ministers choose to do so will be the true measure of the Government's commitment to rebuilding and the priority it attaches to recovery post-pandemic. I thank Jamie Halcro Johnston again, and I give the cabinet secretary fair warning that, as with the funding for student paramedics, this is not an issue on which I intend to take no for an answer. Thank you, Deputy Presiding Officer, and I thank my colleague Jamie Halcro Johnston for securing this important debate. The problems in our ambulance service have struck a chord with a nation following the 40-hour wait that led to the tragic and unnecessary death of Gerald Brown in Glasgow. As usual, for those of us that represent rural constituencies in the northeast and highlands, it takes a tragedy in the central belt before anyone sits up and takes notice. This shocking story has been an all-too familiar tale for too long, for too many of us, and there are too many failures to list here. There are also many who have suffered in silence or whose accounts are languishing in a ministerial inbox. Bill Ritchie waited an hour whilst having a heart attack before a single crewed ambulance arrived just to have to call another unit with two crew members to take him to hospital. He survived, but others have not. Susan Donald's 81-year-old father waited seven hours in agony after falling and breaking his hip. He died three days later in hospital. Pam Anderson, a care home manager, got an ambulance, but, again, there was only one employee in the vehicle. A two-crew team drove 30 miles from Tommin Tool to take her, but Pam died on the way to Aberdeen. The ambulance in Braymar was removed in 2007, and the community is still waiting 14 years later for a satisfactory replacement. That's 14 years of SNP government failure. The local SNP councillors resigned from the party and discussed, and I credit Giva Blackit for her principled stand and lead on the issue locally. Emergency vehicles should not be dispatched with single crew members. NHS Grampian and the Scottish Ambulance Service work around the clock to keep the north-east safe, but they have been failed by the lack of rural ambulance provision in D-side and elsewhere. If two people have the same urgent care needs, the person in a rural area will not get the same level of service as someone in an urban area. That is unacceptable. Ambulance delays are the worst on record, but the delays have underlined causes. Whilst others raised the issue of patient flow through A&E and admissions to hospital, our rural emergency provision has far more fundamental flaws that need addressing. We are now fortunate in the north-east to have Helimet 79, the second of Scotland's charity air ambulances, but charity seems the only route left for rural communities. Other solutions put forward include piloting a joint protocol similar to Victoria Australia that enables better use of the fire service and upskills its co-responders, fund-raising for a helicopter emergency landing pad, making sure that co-responders are properly booked under the Scottish Ambulance Service system, fund-raising for a four-by-four ambulance to replace the existing co-responder van and basing an advanced practitioner in Bremar to support primary care and to respond to emergency calls. I hope that, after the tragedy and continuing failures, the cabinet secretary will finally do the community the courtesy of looking into these options given. However, I am still awaiting a response to my letter from February. To see the health secretary grinning front and centre at a photo opportunity, where he has had to call in the British Army to cover his incompetence, insults those families whose tragic stories have been recounted today. It is plain to everyone here and the families of those who have died or seen their lives irrevocably changed that solving this crisis is not the health secretary's priority. Those heartbreaking stories are people dying and suffering in agony while waiting for an ambulance must be a wake-up call to the SNP Government. However, the truth is that they remain asleep at the wheel. Deputy Presiding Officer, I also put on record my thanks to Jamie Halcro Johnston for bringing this really important issue to the chamber of the Scottish Parliament. I think that we have heard from the south of Scotland to the Highlands and Islands, which I represent alongside him and Edward Mountain to the Northern Isles up in Orkney, just a range of issues that are affecting constituencies and regions right across Scotland. I have raised those issues at a national level in First Minister's Questions, but I want to use the opportunity today to raise some of the concerns that I have received from Murray constituents. I say to Christine Grahame that she is extremely fortunate to not have had a single email or piece of casework about delays for constituents. I say with all sincerity that she is extremely fortunate because some of the emails and some of the contact that I have had from constituents has been harrowing. I will go over just one case in a moment, but Jamie Halcro Johnston was also right to highlight the issue with transfers. I would not be doing my job as a representative of the Highlands and Islands, including the Murray area, if I did not take another opportunity to mention the downgrading of the maternity unit at Dr Gray's. The report by Ralph Roberts, which has now been delayed until November, will the cabinet secretary give a firm commitment that, as soon as it hits his desk, he and his ministers will meet with local campaigners and local representatives about that because we need the full consultant-led maternity unit at Dr Gray's reintroduced? Jamie Halcro Johnston mentioned transfers. I was in that situation earlier on this year. I had to wait in Dr Gray's with my wife, who had just been told that they could not treat her and take her through the stages of labour locally in Dr Gray's. They were already to transfer her to Aberdeen, and we just had to sit and wait and wait as her labour progressed, as she got more and more uncomfortable, as she needed more and more support. However, we could not even leave the hospital because the ambulance was not available. Ultimately, it did come several hours after it was first called for, and she had a very difficult journey through to Aberdeen because her labour had progressed all the time that she was waiting. One of the cases that I briefly want to mention tonight is another Murray family. They have asked not to be named but to explain the details of their case, and just to show how difficult the whole situation is. To give some information, this was a woman who was 31 weeks pregnant and tested positive for Covid. She was able to remain at home for some time, but her symptoms got worse, so she had to go to hospital originally to Dr Gray's and then through to Aberdeen maternity unit, where they looked after her because she had Covid and she was 31 weeks into her pregnancy. Now there was delays getting her from Dr Gray's to Aberdeen, and indeed the ward of Aberdeen expected her far sooner. It took four and a half hours before they arrived to able to take her through, but the most troubling aspect of her case, and this is one of the examples that I would say to Christine Grahame that I've been unable to get my head around, was she required a scan at one point during her stay at Aberdeen maternity unit, and she had to go from the maternity unit to Aberdeen royal infirmary. Because she was Covid positive, she had to get an ambulance. I know that Covid complicates things, but that journey from the maternity unit at Aberdeen to Aberdeen royal infirmary is on Google Maps a four minute journey. After she had received her scan and she wasn't able to eat in advance of the scan, she had a five and a half hour wait for an ambulance to take a 31-week pregnant woman from Aberdeen royal infirmary back to Aberdeen maternity unit, which is a four minute drive. That is unacceptable. Pauline Howey from the Scottish Ambulance Service replied to me last week agreeing that it was not acceptable. Cabinet Secretary, none of these examples are acceptable. We've heard from across Scotland so many experiences. Sorry, I am just in my final minute. So many experiences are people who are not getting service they deserve and I hope from the Cabinet Secretary tonight we can hear the resolution to many of these issues that we're seeing right across Scotland. Thank you. Thank you. I now call on the Cabinet Secretary Hamza Yousaf to respond to the debate up to seven minutes. Presiding Officer, I'm going to thank, as is customary, Mr Halcro Johnston for this evening's debate. I think it is important that this Parliament, although we've had discussions, we've had statements, we've had debates, we've had questions to the First Minister, I do think it's important to keep reiterating the issues that our NHS faces and that our ambulance service faces. It'd be fair to say, although there has been a fair bit of debate and discussion over the past couple of weeks in particular around the ambulance services, the particular issues that a number of members have raised and we've just heard around particular issues in relation to rural communities, remote communities and island communities perhaps haven't got quite the airing or the focus over the last few weeks. It's really helpful that Jamie Halcro Johnston has lodged this motion, although I don't agree with all of it, but I will come into that in a second. There is much in there that he focuses on for those remote rural and island communities. That is, of course, of great importance. Let me just address some of the points that have been made by members right across the chamber. In terms of the issues specifically that affect remote and rural communities, there are specific issues that have been raised. We've just heard from Douglas Ross in relation to the issues around Dr Gray. I'm not surprised that he raised it. I know that he raises it quite rightly every opportunity that he manages to get. I also know that it's a good cross-party campaign as well, so he does have my assurance that when that report does land on my desk from Ralph Roberts that, of course, I will be looking to meet with community campaigners and meet with cross-party MSPs, MPs and, indeed, any other elected members that have an interest in that. In terms of the issues raised by Liam McArthur, I thought that the lesson that he was going to give to Jamie Halcro Johnston was that he should always trust the Scottish Government. I'm afraid that I didn't pass quite his lips, but I'm pleased that we worked not just with him but with the fantastic campaign for parametric bursaries to be able to launch that scheme earlier this year. I think that it will make a big difference in terms of recruitment to the course but also retention to the course as well. In terms of the specific issues in and around Orkney, I do speak to the chair of NHS Orkney fairly regularly. We just spoke a few days ago at the end of last week that I will continue to raise those issues. Of course, I'll take an intervention. Liam McArthur. I would certainly echo his comments in relation to the student parametric campaign. In those conversations with the chair of NHS Orkney, I'm sure that, if they touched on the subject, she would have reinforced with him the importance that NHS Orkney attached to increasing the staffing and the ambulance service, because, at the moment, that demand is falling on out of our GPs, who, as I said in my own remarks, are finding themselves dealing with situations for which they are not trained. Yes, right. Meghan McEwen has raised those issues with me, and I promise to take a look again at the issues that he's raised. Equally, I'm happy to look at the issues raised by Alexander Burnett and around Bremar and the other local issues that have been mentioned by MSPs at this debate. On what we have done, I reject the assertion that the ambulance service was not performing well pre-pandemic. Of course, there were issues. I don't doubt that. For a second, of course, there were cases when members would have raised to this Parliament to my predecessor about where the ambulance waits were too long, but to suggest that there wasn't a good service being provided by the ambulance service pre-pandemic, I'm afraid, is not an assertion that I can agree with, and I can give lots of figures and stats. I won't, because I've got lots of points to make, but I can give lots of detail. Yes, of course. I thank the cabinet secretary for taking the intervention. Are his targets to return the ambulance service to the standards that it was at pre-pandemic, or are we looking for larger improvements in that, given the concerns that have been raised by constituents, people at work within the sector and other organisations about the performance pre-pandemic? The latter we want to do better than we were previously, but I think that it's just a point to make that to suggest that the ambulance service was performing poorly pre-pandemic is not an assertion that I agree with. I do think that there were challenges, but not an assertion that I agree with. I also don't agree with the assertion made by a number of members that we weren't and haven't funded the ambulance service over the course of this Government. In fact, over the course of this Government, staffing has greatly increased. In fact, investment has also greatly increased for the Scottish Ambulance Service under this Government since 2006. We've had a 62 per cent increase in staffing, so if Carol Mawkins says that that is chronic under staffing, then of course that is the position that we inherited, and we have improved upon that over the course of this Government. Not only that, paramedic staffing is up by 26 per cent, ambulance technician is up by 48 per cent and the spend in the ambulance service, even before the current challenges, we've invested an additional 20 million to help us to recruit 300 additional staff. That is additional staff, not just Lee McArthur who asked the question, not just to replace staff turnover. That is not for me to say, and there is no suggestion of that, that the current challenges that members rightly raise do not serve immediate action. They absolutely do, and that is why the Government set out, and I set out, significant measures that we have brought forward. Christine Grahame gave detail of those measures, not just the excellent service that has been provided by the Army, and I thank them again for being so responsive so quickly, not just the excellent service and additional support that is being provided by the Scottish Fire and Rescue Service, but also by volunteers, by the British Red Cross, by private taxi companies, but also by increasing investment and recruitment into our control centres, clinical leads into our control centres, and also hospital ambulance laser officers. I was just about to come to your point about IT, so I'm happy to take the interview. It really is to develop this. It must be of concern to all of us, those dreadful cases that we are hearing about. We must also be concerned that 79 per cent of calls in August were not emergencies, so paramedics are turning up to places where they shouldn't be, and they should be dealing with some of the cases that have been described here. Can we have more detail about how this operates across the various regions? Why were those crews sent out to those when they were not emergencies? Another issue that we have to consider carefully is that 79 per cent were not emergencies. I'm happy to provide members with any detail that they wish in terms of the various different categories of call-outs. Of course, they are judged by what level of acuity they have—high acuity—right the way through to lower acuity. When I talk about the pandemic, exacerbating challenges—that's always the phrase I tend to use—I don't say that those challenges simply emerge because of the pandemic, but they are exacerbated by the pandemic. What I mean by that is that we know that people who haven't presented to their GPs or hospitals are now coming through the front door to ambulances first, sicker, with more complex needs, taking up more hospital beds. I think that that is the point that I wanted to end on, which is that, of course, there is rightly a concentration in today's debate about the ambulance service, but there has to be an understanding. I think that it is by all members that this is a whole systems issue, and that is why this Government is investing whether it is from primary care at the front door, or whether it is into solving and trying to do our best to mitigate the problems around delayed discharge at the back door and making sure that we invest in social care as well. On closing, I will reiterate the point that I have made several times over the past two weeks to thank our hard-working ambulance staff for all that they have done, and to give them an absolute assurance that this Government will continue to invest and continue to ensure that the ambulance service is well staffed for the challenges ahead. Thank you, cabinet secretary, and that concludes the debate, and I close this meeting.