 The final item of business today is the member's business debate on motion number 505 in the name of Jackie Baillie on Save Our Services. This debate will be concluded without any questions being put. Would those members who wish to speak in the debate please press your request to speak buttons as soon as possible? I call on Jackie Baillie to open the debate. Thank you very much, Presiding Officer, and I very much welcome the opportunity to hold a debate on the proposed cuts to health services across Greater Glasgow and Clyde, and specifically those that are proposed at the Vale of Leven hospital. I know that other colleagues will cover the cuts to the children's ward at the Royal Alexandra hospital, the cuts to maternity services in the Clyde, the cuts to inpatient facilities at the Centre for Integrative Care, and, of course, the closure of Lightburn hospital. All of those cuts were highlighted in January this year, and now they are back today with a vengeance. Let me take this opportunity, Presiding Officer, to welcome campaigners from across the country and, indeed, from my local area to the chamber today. I want to single out hospital watch and the Lenox Herald for their consistent campaign on protecting local health services in my area and to welcome Mark McLean as a very lonely figure in the press gallery. Six months ago, we stood in this chamber and debated cuts to our local health services. At that time, the SNP Government said that there was nothing to worry about. We were wrong. The leaked health board paper had no standing. Basically, there was nothing to see here. In the run-up to the election, the attack on us became even more shrill. We were liars. We were simply scaremongering. Promises were made to local communities, including my own, by SNP candidates, the health minister and even the First Minister. Let me read Shona Robison's quote, because I like to keep election leaflets to see what promises were made. That was popped through the door of every household in Dumbarton constituency during the election. Let me read from it. I have been consistently clear—these are the words of Shona Robison—that this Government sees a bright future for the hospital, which plays a crucial role in the local healthcare system. I will not approve any move away from delivery of the vision for the Vale agreement. Let me say that I absolutely support that. She has been abundantly clear, but somehow I do not think that the health board has quite got the message. The suspicion in my community is that there is a deal struck behind the scenes. In 2009, I wholeheartedly welcomed the vision for the Vale. It contained commitments to a whole range of services to be delivered at the local hospital. Although we have seen staff numbers drop and a substantial number of clinics cancelled, the vision still remains an important commitment for local people in my community. So important was the community midwifery unit for the Vale vision. It was actually pictured on the very front page. Again, I like to keep Government documents. You never know when they will become useful. The exact wording was that the community maternity unit will be sustained and promoted. That is the very same maternity unit that is up for closure today. The number of births at the CMU has fallen sharply in the last year, despite the actual birth rate for women remaining steady. Since 2009, the number of births to women resident in Dumbarton, Vale of Leven and Helensburgh has fallen by only 8 per cent, while the number of deliveries taking place at the Vale of Leven CMU has fallen by nearly 70 per cent. The largest decrease occurring between 2014 and 2015. That suggests to me that the health board has not been serious about promoting the CMU to local women, and that takes me on to their marketing activity. The health board's marketing plan promised to promote the CMU with media releases, highlighting the positive achievements, editorial briefings and case studies with volunteer mothers speaking out in support. However, just take a search of the online archives of the Lenox Herald, because that shows that there are only five positive stories about the Vale CMU between 2008 and 2011. That was outnumbered by stories about the health board reducing the opening hours, midwives being redeployed to the RAH and campaigners fighting against threats to local health service. Where were the pictures of the newborn babies that we all like to see in our local papers? We were also promised leaflets, posters and information for GPs across a wide catchment area. Over the summer, I contacted every GP practice in Dumbarton, Vale of Leven, Helensburgh, Lomond, Clydebank, Bezden and Mulgaing. They were asked to respond to a survey on marketing activity for the CMU. Almost half responded, covering every geographical area. Three quarters of the GPs were not even aware of any marketing activity for the CMU. None of the GPs currently have any information leaflets. None of them have posters on the walls of their surgeries to promote the Vale unit. At the Vale hospital reception, not a leaflet to be hard. The health board has completely failed to promote the unit, which was something that we were promised. Along came the new centralised maternity booking service introduced in June 2014, cutting out the GP and diverting newly pregnant women to a call centre based at the southern general hospital. Surprised, that coincided with a 57 per cent drop in the number of babies born at the Vale of Leven hospital, even though, for that year, the total number of births by local mums actually rose by 6 per cent. 77 babies born at the Vale in 2013-14, compared to 33 in 2014-15 and down to a handful now. I accused the Government of closing it by stealth. In May 2010, the CMU was downgraded from a 24-hour service to an 8am-8pm service with midwives on call during the night. The negative publicity generated by the health board's changes further undermined confidence in the unit. Please do not tell me that this is about safety. I have demonstrated that the actions of the health board have contributed to undermining the community maternity unit. I hope that the Government is not really suggesting that CMUs across the country—of which there are many—are unsafe. The health board has not committed to a formal public consultation with service users and the wider public. Instead, we have an engagement strategy that is based on a consultation that was conducted almost a decade ago. It cannot be serious. We need a full three-month consultation with public meetings so that people have a genuine opportunity to make their voice heard. I absolutely want to believe the health secretary and the Government when they say that there will be no cuts at the Vale. I really do want them to fulfil that promise. If the health secretary's commitment is true, then why has not one single SNP MSP signed my motion—not even George Adam, Stuart McMillan, Ivan McKee or Gil Paterson—who have a direct interest in that area? If the health secretary's commitment is true, then why has that not been designated as a major service change? I would be pleased to hear from the minister when she sums up. If it is designated as a major service change, then it must come to ministers for final sign-off. It would simply not be acceptable for the health secretary to say that this is a matter for the health board, as this will certainly sound the death knell for the Vale maternity unit as sure as night follows day. Finally, if the health secretary is saying that there will be no cuts at the Vale, then why on earth are we having a consultation that is both pointless and expensive? There really is only one thing left to say. Save our services, deliver what you promised just six months ago and stop the cuts. I now move to open speeches of around four minutes, please. Stuart McMillan, to be followed by Anna Sarwar. Thank you very much, Presiding Officer. There is no doubt in my mind that the second decade of the 21st century is a pivotal moment for healthcare and healthcare systems, not just in Scotland but around the world. An ageing population in a shift to more multidisciplinary working and rapid advances in research and technology to site just some of the trends that we see present challenges and opportunities that the founders of the NHS could scarcely have imagined. It is the decisions that we take today on research on the organisation of our NHS, on relationships between investments in social, community, primary and secondary care, and on the education and training of the health and social care workforce of the future that will determine how well our health service responds to those challenges and opportunities. People in Scotland should get the care and support they need in the right place, at the right time, which is why we are transforming our health and social care system to make sure that it keeps pace with Scotland's changing needs, but notwithstanding that, Presiding Officer, I support the IRH and the community midwife unit. I have campaigned to save services in the past and I will do so again on social media. I posted a consultation document that Jackie Baillie was alluding to last week to encourage people to get involved. I am meeting with the chief executive and the chair of the health board this week and I will be meeting with the cabinet secretary for health later this month. I have been and I will continue to raise the issue to encourage the electorate to get involved to make their thoughts known. Despite the cuts to the Scottish Government's budget from the UK Government since 2010, the Audit Scotland report, NHS Scotland 2015, found that health resource spending has increased in real terms. Audit Scotland confirms that there has been a real-terms resource increase in every single year from 2008-9 to 2014-15, and capital spending from Westminster has been cut by 25 per cent to the Scottish Government. However, as per the Scottish Government's commitment, resource spending has increased in real terms and Audit Scotland has confirmed that. Scotland has a record-high NHS workforce and continues to advance in diagnosis, treatment and care. Jackie Baillie spoke about the past and the campaign that took place in 2008. That was certainly a campaign that Jackie Baillie, others and myself were successful in maintaining the community midwife units. It is certainly something that I would like to see the community midwife units maintained going forward. We cannot forget that it was under the previous Labour and Liberal Democrat executive that the cuts agenda started. We lost the consultant-led maternity services in 2003, and that is when the issues of the maternity units actually started to happen. In 2008, the review took place. Jackie Baillie, others and myself were successful in campaigning to save the current formulation of the community midwife units. I think that our communities would not forgive us if we simply sought to blame each other for things that happened in the past or, indeed, are currently happening. Will he join together with me to resist those cuts and perhaps explain why he found it so difficult to support my motion? I generally do appreciate the contributions from Jackie Baillie in the chamber, but I have already said in this particular speech and I have said on the record outside of the Parliament that I will be campaigning, and I am campaigning to save the community midwife unit at the Invercloud Royal hospital. I cannot get any clearer than that, Ms Baillie. Certainly, the NHS Greater Glasgow and Clyde health board has a record-high budget of over £2 billion, which has increased by over 27 per cent under this Government. Nevertheless, it has been announced that the board is to press ahead with further scrutiny of the proposals that include the closure of seven inpatient beds at the Centre for Integrative Care, the community midwife units at the IRH and the Vale of Leven in Alexandria. Although it is clear that the antenatal and postnatal services at the ranking in Greenock ball remain, the health board has proposed to cease birthing services at the IRH. There are typically 30 members of Greater Glasgow and Clyde health board, most of which are made up of health and finance professionals. The seven remaining members are Labour councillors. One representative from each local authority in the health board area, but, once again, we have seen evidence that, unfortunately, the week before the health board took the decision, I am including Ms Baillie. The week before the health board put forward the proposals, the representative from Invercloud resigned from the health board, therefore leaving Invercloud with no voice on that particular board and taking that decision. To conclude with that, I will certainly take no lessons from the Labour party on NHS cuts, and I will always stand for services being delivered at local level. I have got that record in the past, and I will continue to have that record going forward. Thank you very much, Deputy Presiding Officer. Can I start by paying tribute to Jackie Baillie for securing this debate today and also thanking her for her commitment to the Vale of Leven? I know local people in Dunbarthon and indeed those campaigners at the Vale appreciate all our efforts in this Parliament and beyond. I also want to take this opportunity to pay tribute to all the campaigners of all those services right across the west of Scotland and beyond who are dedicating so much of their time to protect the local community services. I also want to put on record my thanks to our hardworking and dedicated NHS staff. The pressures and the failures that we see in our NHS are despite our staff rather than because of our staff who are undervalued, underresourced and overworked by this Government. I am quite disappointed after hearing Mr McMillian's speech today that his party has not been in Government for almost 10 years. He thinks that health was not devolved. He thinks that someone else was in control of our NHS. The reality is that the NHS is already independent in Scotland. This Parliament and this Scottish Government sets the NHS's budget, sets its priorities and oversees its delivery. If there is any failure in the NHS, if there is any failure in the services of our NHS, it is failures by this Government, and to try and blame somebody else is simply shameful. Let me just say about those seven Labour councillors on the health board. All seven Labour councillors unanimously oppose the cuts that are coming from the health board, but the reality is that the rest of the health board is appointed by the Scottish Government and it is them that need to up their game. I am happy to take the intervention. Stuart McMillian I thank Annas Sarwar for taking this intervention, but Mr Sarwar will be aware that the week 4 proposal was put forward and was published. One Labour councillor resigned the Labour councillor from Inverclyde council, therefore leaving no Inverclyde voice on that particular committee meeting. Annas Sarwar Mr McMillian says that he is a voice for Inverclyde. Let's hear what that voice said during the election campaign. He called the Labour candidate Siobhan McCreary pretty much a liar for bringing up the cuts that were coming at Inverclyde. I quote, he says that he is playing carelessly with the Inverclyde population by indulging in unfounded information about threats to health services which he has gleaned from informal conversations with friends. Perhaps Mr McMillian should have conversations with friends across Inverclyde who are disappointed in his failure to stand up to his own Government and his failure to protect services at Inverclyde hospital. The reality is that FLY responses from this party have found that we face almost £1 billion of cuts to our NHS over the next four years. But what was his Government's response, not to own up to the fact that we actually do have challenges on our NHS, but instead to say that there are no cuts and to go on and say that anyone that suggests they are is being completely false. That is FLY from health boards right across the country. The reality is that this Government should go and speak to the campaigners of all those hospital services right across the country. To the Vale of Leven, Jackie Baillie was called a liar during the election campaign for saying that the maternity unit Vale of Leven was under threat. She has been proved to be right. The hard-working campaigners in the audience deserve their time with the health minister so that she can explain why they were lied to during the election campaign. I have already mentioned that, in Inverclyde, Siobhan McReady was labelled a liar for talking about the proposed closure on maternity services in Inverclyde hospital. I think that expected mothers in the west of Scotland deserve better than that. Letting people down, the front page in Inverclyde before the election campaign was our First Minister shamelessly saying that there would be no cuts to services at Inverclyde, holding up a newspaper to try and win votes, but what has happened now is that there are proposed cuts and closures at Inverclyde hospital. The Government cannot run away from its failures on that. What about in Paisley? Neil Bibby was accused of being a liar for saying that there is a potential downgrading of periodic services at the Royal Alexander hospital. What has happened now is that we have seen the fact that there are proposals to downgrade that service, and mothers and families deserve better in Paisley too. Same with the Monklands and the CIC Centre. We are patients who deserve better, and our NHS staff deserve better too. Could I ask—please sit down at the moment, Mr Cameron— those in the public gallery not to be clapping or shouting out loud, or not that you have shouted out loud so far, but just in case? Thank you very much. Deputy Presiding Officer, I appreciate the opportunity to speak on this motion presented by Jackie Baillie on an issue that I know is of huge significance, not simply to colleagues who represent constituents in the west of Scotland, but more importantly to the people of the western bartonshire themselves, who have utilised the fantastic services provided by staff at this EMU at the Vale of Leven for many years. Representing the Highlands and Islands, I am also acutely aware that it is a service that has been used by people in my own region, such as in Argyll and Bute. The Vale of Leven has a wider geographic reach than might first be imagined. The Scottish Government's programme for government continually reinforces the point about the need for the NHS to be more community-orientated. In fact, the first of the four priorities for the coming year is to, and I quote, empower a truly community health service and to deliver the reforms needed for successful community health services. With that in mind, it is understandable why so many people will be puzzled that the Scottish Government's idea of delivering more community health services is to sit on its hands as the CMU is likely to be closed and expecting mothers are told to make anywhere between an extra half hour to an hour journey to Paisley or Glasgow instead. That isn't building more community-led services, it's dismantling them, and that is rightly a matter of grave concern. Among some of the reasons that NHS Greater Glasgow and Clyde have presented in favour of closure—I'm sorry, I've only got four minutes—I can give you the extra time if you wish. I'll take the intervention. To clarify from Mr Cameron that under the board's proposals there's no closure of the CMUs, I think that he inaccurately stated that there would be. It is likely to be closed. Among some of the reasons that NHS Greater Glasgow and Clyde have presented in favour of closure is an issue that the Scottish Conservatives have been raising for some time, namely the issue of short staffing, an issue that has been cut across the NHS. In fact, the health board's paper on this matter notes that they are, and I quote, finding it difficult to recruit to the CMUs as you need experienced staff who live close enough to attend when a woman presents in labour. With a 16 per cent rise in the number of nursing and midwifery vacancies across Scotland in the three months leading up to June, it is no wonder that such a vital service will struggle to cope with demand. A staffing crisis that lies at the door of the party that has run the NHS in Scotland for the last nine years. In 2009, the vision for the Vale was published, and it stated very clearly that the CMU facilities at the Vale of Leven would be protected until 2011. Even as recently as June 2016, the First Minister herself stated that we will not approve proposals that run counter to the vision for the Vale. Despite those warm words, not a single SNP MSP has given their support to Jackie Baillie's motion, and there must be questions about the commitments that have been made by this Government to the CMU. Stuart McMillan attempted to contrast the Scottish Government with the UK Government will let me draw my own contrast. It is well known that NHS spending in England has increased by more than it has on the NHS in Scotland. Deputy Presiding Officer, it is clear from the near 2,000 people who have signed the petition to prevent closure that this is a heartfelt issue in the western Bartonshire area, and although the health board has launched a re-engagement process, it needs to ensure that it does not just become a talking shop where the outcome has already been decided. This has to be an open process and truly reflect the feelings of response many of whom will have used this service first hand. If the Scottish Government is truly committed to the vision for the Vale and is truly committed to promoting more community-based services, then it will join me and the SNP will join me, my colleagues and others across the chamber and support Jackie Baillie's motion today, and I commend her for her persistence in pursuing this matter. Before I call Mr Bibby, I have quite a few members who wish to speak in this debate, so I am minded to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes. I now invite Jackie Baillie to move that motion. I am happy to move, Presiding Officer. Thank you very much. Do members agree to extend the debate this evening? All those happy faces. I now call Mr Bibby, pleased to be followed by Gil Paterson. Thank you, Presiding Officer, and to Jackie Baillie for bringing forward this important debate. This morning, I met dozens of parents and grandparents at the RAH in Paisley along with Kezia Dugdale. All those people rely on local NHS services and I can tell the Scottish Government that they echo the thousands of people in Paisley who have already signed petitions to defend the children's ward at the RAH. Once again, the message was loud and clear. The SNP Government needs to stop their cuts to our local NHS. The transferring of inpatient pediatrics from the RAH to Glasgow represents the closing of the children's ward, as we know it, and a closure to thousands of children who need it. We know that there has been uncertainty over the future of the children's ward at the RAH for many months, but the difference between this debate and the previous debate is that we are now not discussing proposals, we are now discussing the official plan. In our sour work, it is quite right before the election, SNP politicians said that Labour was scaremongering for highlighting those proposed cuts. SNP politicians, such as George Adam, who described the threat to the RAH's children's ward as a fantasy and, in January and in March, even told me that I should stop campaigning to protect it alongside the local families in Paisley. Through his actions, he has shown that it is obvious that he has been more interested in saving his own job than in saving the children's ward at the RAH. I hope that, at some point, he will take the opportunity to tell us if he simply could not understand what those proposals meant for the RAH, or if he was deliberately trying to hide the truth from the people of Paisley before the election. It is time for the SNP Government to come off the fence, and it is that time as well and truly over. I reiterate my call to the health secretary once again to come to Paisley and meet with local parents and grandparents. The health secretary should be under no illusion about just how important the RAH's children's ward is to local families. The concern for local NHS services that has been mentioned is not just felt in Renfrewshire and Western Bartonshire, but in Inverclyde as well. I have heard from many people in Inverclyde in recent weeks who are extremely concerned by the centralisation agenda that is affecting local NHS services. We again warned people earlier this year that there was to be a review of maternity services and exposed that it could affect local provision. Again, all we heard from the SNP was accusations that we were scaremongering. Now we see that the birthing unit at Inverclyde royal hospital is also to be axed. As Jackie Baillie has rightly said about the failed birthing unit, Inverclyde should be maintained and it should be supported to provide a service to more mothers and not be closing its doors. I also call on the Scottish Government and the health secretary to intervene now and provide the health board with the resources needed to stop the plans to close the Inverclyde birthing unit. Local families will be amazed that the Government has not already done this, given that last year Nicola Sturgeon was on the front page of the Greenock Telegraph, promising that Inverclyde hospital was safe and saying that, and I quote, that there are no plans to centralise services out of Inverclyde. Again, the reality is that there have been a number of services transferred from Inverclyde royal hospital to Glasgow recently, and the removal of the birthing unit is the latest example of the hospital's downgrading. Those cuts are leaving people with a real fear about the sustainability in the long term of the hospital. Presiding Officer, we have been here before. The Scottish Government wrongly denied our proposals to cut and close hospital services. We are not discussing proposals anymore, they are now official plans. In closing, it may be now past five o'clock, but it is decision time for the SNP Government. It is time for them to stop sitting on their hands, watching as those services are cut back. My message on behalf of my constituents is clear. The future of our local hospitals depends on keeping those key services. Stop saying that you are protecting NHS budgets when you are not. Stop saying that you will keep health services local when you own. Given the health board the necessary resources that they need, give families in Renfrewshire and Inverclyde the guarantees that they want over their local NHS services. Gil Catterson, to be followed by Alex Rowley. Thanks very much, Presiding Officer. For the purposes of the time and my speech, I am going to stay focused on the veil of leaving hospital as part of the motion. Presiding Officer, history does not bode well for Labour when it comes to the NHS and specifically the veil of leaving hospital. In 2009, the vision for the veil ended a decade of damaging uncertainty for the veil of leaving hospital and the erosion of services by the previous Labour-led Scottish Administration, including the A and E services. The then cabinet secretary of health and now the First Minister made a commitment then to protect the veil and just this year in front of 400 people. On camera in Weston-Bartonshire, the First Minister made the same commitment to the veil of leaving hospital. If that is not enough, the cabinet secretary in front of this Parliament, the public and again on camera reiterated the commitment of the Scottish Government to the veil of leaving hospital remaining open. Jackie Baillie I agree that that is all very helpful. I want to agree with the First Minister and the Health Secretary about the veil hospital. I therefore ask Gil Paterson why we have those proposals before us today. Does he support my very specific call that this should be designated a major service change so that it is signed off by the very ministers who have said that they will protect the veil? Gil Paterson I hear that said. If the Government was telling health boards dominated by the Labour Party to do one thing or do another, it is not how it works. The Government will be involved once the process takes place, not at this present time. It would be up in arms, and so would all the other Opposition MSPs if the Government, Willie Nellie, interfered with health boards. That is what their job is. I have answered you, Jackie Baillie. I am giving you the answer, Jackie Baillie. Jackie Baillie Oh, thank you very much for that. Jackie Baillie Would you two stop having a spat? You can take it outside after the debate. Gil Paterson I apologise. It is not like me, Presiding Officer. As it stands, NHS Greater Glasgow and Clyde health board is carrying out a review of services, and I welcome the Scottish Government's view that it would be unacceptable if any proposals were not consistent with the national policy such as the review of maternity services that has been carried out and considers that any proposals must be subject to proper and meaningful engagement with people affected. The motion asks for the cabinet secretary to intervene. However, NHS Greater Glasgow and Clyde board have already initiated a consultation period, and we need to encourage everyone with a vested interest to engage with this process. For me, with the consultation, there is a serious question that arises in regards to the community minute maternity unit at the Vale of Leven hospital. The Vale of Leven hospital and Inver Clyde provide a wide range of maternity care to all women in each locality, seeing 5,000 non-birth contacts each year, which in my view is very positive news indeed. However, the figures in regards to the Vale's baby delivery services are shockingly low. NHS Greater Glasgow and Clyde had a planned figure of 200 births per year, and in 2015 and 2016 the figure stood at just 43, less than one a week, peaking at 112 way back in 2009. It must be reminded that mothers are consistently advised that during the pregnancy by midwives and other medical professionals included what happens when complications arise. There is a concern that with fewer women who meet low-risk criteria, they will have a higher chance of complications, and it would seem that mothers are voting with their feet. You have to close now, Mr Paterson. Come to a close now. Using the Vale for all other maternity services but opting out to have their delivery carried elsewhere, those figures need to be analysed and the question needs to be asked why the vast majority of mothers in the Vale area are not using the unit for delivery. I want to know just not just if there is an MSP but if there is a father and a grandfather. Mr Paterson, however, I will close there first minister. I did take quite a lot of interruptions. Mr Paterson, you are well over time. Can I remind members that they should not be making interventions until they are so directed by the chair, whether that be when they stand up to try and make a formal one or whether it be muttering from their seats? As the lone fifer in the debate, I wanted to very briefly support Jackie Baillie and congratulate her on bringing that motion forward. I think that what we are seeing here is a lesson to people throughout Scotland in the centralisation of services. Across Scotland, we are seeing cuts taking place. That would be my first point that I want to touch on. I think that there needs to be transparency, openness and honesty from the Government in the cuts that are taking place in health services across Scotland. The question that I have when I look at this is what is it that is driving the review? If the review has been driven by cuts, the result will be a centralisation of services to save money. I wanted to quote from the director of finance in Fife, who earlier this year, when the NHS board said that it would have to cut £30.8 million from its budget, and what she said was that the extent of the challenges that were faced was unprecedented both locally and across the NHS in Scotland as a whole. I have not seen the scale of those financial challenges in my whole career, and that was reported in the local press. If that is the case, then there needs to be, as I said, transparency and honesty about the level of cuts that our health service is facing rather than hiding behind reviews and the centralisation of services. The second point that I would like to make that is mentioned in the motion is the extent of public engagement. We need to ensure that where there is engagement taking place, the Scottish Government has standards for engagement, and that engagement needs to start with all the facts being placed on the table. I would make those two points to the minister. We need to know the extent of cuts that are taking place here and elsewhere, so that we can understand what is driving those reviews and we need proper consultation. I want to reiterate that there is record investment in the NHS. We understand that there are challenges, and it is right that NHS boards do review just to make sure that the services that they provide are the right ones. I agree, and I take on board the point that engagement and openness need to be part of the process, but I reiterate that it is ordinary for NHS boards to look and review their services. Does he agree that that is part and parcel of making sure that we have the smooth running of our NHS? Alex Rowley? I agree if it is clear what is driving those reviews. Where the directorate of finance says that I have not seen the scale of those financial challenges in my whole career. There are massive cuts being imposed, and that would be my final point. The Government cannot simply sit behind or hide behind local health boards, because it is the Government that is saying to local health boards that they have to cut their budgets, and that is where we need the openness and transparency. I congratulate Jackie Baillie, and I wish her and all colleagues and all parks of this chamber that are going to fight for those services every success. Maurice Corry, to be followed by Ivan McKee. Thank you, Deputy Presiding Officer, for the opportunity to speak in tonight's debate on this very important issue to many of my constituents in the west of Scotland, covering in particular the western bartender area and Argyll and Bute. It is a testament to the strength of feeling about this issue that I congratulate Jackie Baillie on bringing it to the chamber today and her motion, which we are debating in this chamber. It has the support from right across the political spectrum of this chamber itself, except of course from that of any SNP member of the Parliament. I have to declare an interest in that all four of my children were born, including twins, at the Vale of Leven hospital in the CMU unit in the 90s, and we would receive them as fantastic support there on some cases from difficult circumstances. This issue has also attracted the support of nearly 2,000 people in the west of Scotland who have signed a petition trying to prevent the closure of services at the Vale of Leven hospital and that it is a clear indication of support that exists in the community at large for the services provided at the hospital. Their views must be listened to and considered when making any decision about the future of this hospital. I would ask that the pending increase of the 2,000 role naval personnel at Faslane and their families and their needs for medical support locally are considered seriously by the Scottish Government in their reviews. I believe that the public is making it clear how they feel about the proposals and I welcome the decision to launch a re-engagement process, but only if it is open and fair or if it really wants to hear what the local people think should be the future of the hospital and its wonderful NHS staff. I do not believe that there is any point in pretending to engage with the public if a decision has already been taken behind closed doors and the views of the public are just going to be disregarded. It would be in disingenuous and a complete waste of public resources. This February, the Cabinet Secretary of Health and Sport said that the vision of the Vale remains key for this hospital and making sure that it is delivered. When this June this year, the First Minister promised that her Government would not approve proposals that run counter to the vision for the Vale. I think that the people in western Barton, Argyll and Bute would have rightly assumed that those statements would mean that the Government and the SNP would be against any proposals to close the community maternity unit at the hospital. It once again begs the question of why no SNP member has given their support to this motion. The statements of the First Minister and the Cabinet Secretary for Health and Sport were a promise made to the public who rely on their hospital, a promise made to the people of west of Scotland by this Government, so I truly hope that the Government will decide to honour that promise. Ivan McKee to be followed by James Kelly. This document here is the Greater Glasgow and Clyde health board, paper 1645, that purport to allow the case for the closure of Lightburn hospital. I attended the health board meeting on 16 August when this paper was first presented. I was there along with the Save Lightburn campaign. I met separately with directors of the health board along with representatives in that meeting of Save Lightburn campaign and of Parkinson's UK to review the case that was made in the paper in more detail. In my mind, having looked at it, the paper fails to make a case for the closure of Lightburn. The data in the paper is used more for support than illumination. Will the member accept that it was wrong for the local SNP MP to use parliamentary resources during the election campaign to write to voters in his constituency to say that there were no plans to close Lightburn hospital and to quote, to say that it was a desperate pitch from Paul Martin, who is attempting to stand shoulder to shoulder with locals against closure of a hospital that is not closing. Can he take that back and apologise to local people? I have got in my hand a letter that I put out during that election campaign, which says nothing of the sort. My letter laid out clearly to the constituents the process that has to be gone through before the closure would take place, which is the process that we are going through just now. I said the data in here. I am taking from a one-day sample in end destinations for inpatients and covers all of the hospitals in East End of Glasgow, not just Lightburn, leaving us none the wiser as to their relevance or implications. No data is presented to back up the claim that the plans to move services will deliver improved outcomes for patients, and no data is provided and how often service is not currently provided for at Lightburn required to be accessed by inpatients there, which is a key part of the board's argument for closure. The board plans to move out patient services from Lightburn to a new proposed health hub at Parkhead, despite there being no timescale for its construction and none of the required £32 million in funding in place. All questions asked the board about the proposed hub that directed me to IJB, a case of integration being used as a vehicle to shift responsibility rather than share it. No clarity is given us to what measures will be put in place to cover the period between the proposed closure of Lightburn and the hope for construction of the new facility. The Lightburn site in the meantime has suffered significant under-investment. Recently, part of the site was boarded up, which, apart from being an eyesore, sends a signal at the site, and the patients that it serves are undervalued. Lightburn serves a local community in East End of Glasgow with a high proportion of elderly residents. Recovery rates are better when patients are closer to family and friends who can benefit from frequent visits, yet the plan to relocate rehabilitation in patient services to other end of the city presents often elderly visitors with challenges in transport. We often hear about tackling health inequality, shifting resources to the most deprived communities, yet the plan to close Lightburn by the health hub does precisely the opposite, removing resources from an area that contains three of the four most deprived areas, according to the recent survey of multiple deprivation. The health board paper stresses the importance of the strategic shift from acute services to the community, yet the document proposes a transfer of services away from a hospital located in the heart of the community to a large acute hospital some distance away. The board has also made it clear that the final decision on Lightburn has not been made, and I have stated on several occasions that its proposal is not based on financial considerations but on clinical factors alone. The public engagement on Lightburn's future has now started and the public will have their say on the local service, and I urge all those with interests in local communities to take part in the process. The answer to shifting the focus of service delivery from acute to the community is not to close a hospital in the community and move patients under going rehabilitation to a large acute hospital some distance away. The answer to tackling health inequalities is not to shift resources from the most deprived communities to the centre. The answer to improving outcomes for patients is not to move them away from friends and family, reducing rather improving their outcomes. The answer to improving health service provision for the people of East End of Glasgow is not this paper from the health ward. I move to the last of the open speeches. Thank you very much, Deputy Presiding Officer. Let me congratulate Jackie Baillie on bringing forward this very substantive motion, which has clearly touched on a number of constituencies in regions, given the large number of contributions that we have had to this very important debate. I want to use my contribution to speak up in favour of Lightburn Hospital, as I did in a previous member's debate in 2013. I know from my own family experience how widely used and valued that hospital is. It has a priority for elderly services and there is quite a big elderly population around East End of Glasgow who use the hospital widely. It would be detrimental to that service to move it to the other end of the city, because where it is sighted just now, just off the Edinburgh road, is near to the main bus services. I know that that service is widely used by those who access the hospital. It has a very valued Parkinson's unit and a dedicated Parkinson's resource in that hospital, which is used beyond East End. I know from my previous position as MSP for Rutherglen that it was used by a great number of people in Canvaeslang in Rutherglen. That service is very much needed in East End of Glasgow and beyond, not just the elderly services, but the Parkinson's services, and they must be maintained. I think that the thing that strikes me about this debate and the debate that is taking place, if you like, over the past six months is the absolute brass neck of the SNP. There was a motion that came before the Parliament, before the election, where the SNP told us that it was committed to maintaining and improving safe and effective local services across Scotland, including the REH failure, leaving Lightburn and St John's. Sure enough, what happens is that the election passes by, the cuts roll down and we start to see those proposed closures. Is the member not aware that the proposal comes from the health board and not from the Scottish Government, and there is a process to be gone through? James Kelly. You really got to laugh, haven't you? Who is actually running the NHS in Scotland? When you listen to the debate, you think that with a SNP MSP after MSP stand up and say, it's not really got anything to do with us. We're only in power. Don't ask me to take any responsibility. However, as I say, it is absolutely gone. Going back to Ivan McKee's election, if you look at what Anne McLaughlin said in a letter to constituents on House of Commons note paper, I have been in touch with the Scottish Government and have received an unequivocal assurance that Lightburn hospital is under no threat of closure. So what I want to hear from the minister in the sum and up is what communication took place between Anne McLaughlin, the MP for Glasgow North East and the Scottish Government, and what assurance was Anne McLaughlin given about the closure of Lightburn hospital? I think that it's vital that we know the answers to these questions. In sum and up, Deputy Presiding Officer, Lightburn is absolutely vital to the east end of Glasgow, and I think that it's important that there's a strong campaign to save that. I think that it's also important that the SNP actually start to take responsibility for some of the decisions that they're taking and stand up and be counted on this issue. Let's save Lightburn, let's save our services, Glasgow deserves better. I now call Aileen Campbell to wind up the debate. Thank you, Presiding Officer. It has been a robust debate, and I know that all members will contribute their views to the on-going engagement. Aside from the robust exchanges, I have appreciated the personal connections that members have highlighted to the services that are important to them. What is not in question is the level of priority afforded to the safe stewardship of the NHS by the people of Scotland. There are no public services that are valued higher, and I want to put on record the Government's sincere appreciation for the unstinting professionalism and commitment shown by those who work so tirelessly in our health and social care services. Turning to Jackie Baillie's motion, I think that it would though be helpful to establish some facts. Firstly, contrary to what is stated in the motion, no decisions have been made about the service change proposals that have been mentioned. NHS Greater Glasgow and Clyde. Minister, will you designate that the cut proposed for the CMU as a major service change because it's not up to the health board, it's not up to the Scottish Health Council, it is ultimately a decision for ministers? Will you insist that that final decision is made by the health secretary? As Jackie Baillie knows, there is a process that has to be gone through, and as I'll outline in my closing remarks, I'll elaborate a bit on that. However, the member knows that no decision has been taken and there is a process of engagement on going, and I will elaborate on that as I go through my remarks. NHS Greater Glasgow and Clyde formalised their proposals at their board meeting in August, and as we would expect, they are now in the process of engaging with the affected local communities, staff and other stakeholders so that they can carefully consider their views. I would encourage local people and their representatives to play a full part in that process. That will take the form of three months public engagement on the proposals relating to the Centre for Integrative Care, community maternity units and Lightburn hospital, running from September until November—I'm sorry, I'm making progress—and that will help to inform the health board's on-going work with the independent Scottish Health Council, which includes coming to a view on which of those service changes should be considered major. The world will reconvene following that work, probably at their meeting planned for December, and then will agree the next steps. Should any of the proposals be designated major, then the board must undertake formal public consultation of at least three months, and its final service change proposals will be subject to ministerial approval. In the case of the proposals around transferring paediatric in-patient and day cases from the Royal Alexandra hospital in Paisley to the new Royal hospital for children, the board will discuss the next steps at its meeting in October. The board has already been clear that, should it move to proceed with those paediatric proposals, it would represent major service change. The possibility that some or all of those proposals may change as a result of the public engagement under way and that some or all may ultimately be subject to ministerial approval means that it would be inappropriate for me to discuss the specifics in any detail beyond reiterating that it would be unacceptable if any formal proposals are not consistent with national policy, such as the review of maternity services that is currently on-going—a point that was made well by Gil Paterson and Ivan McKee. I understand what she says about substance. Let's be clear that we already have the REH designated as a major service change. Can you confirm that it is not for the health council to decide the gift of whether this is a major service change or not lies with ministers? As I said in my response previously, there is a process to be gone through that is getting work through between the NHS boards and the Scottish health councils. If it is considered, then there will be a ministerial intervention. However, I have talked through the process very clearly. I am happy to provide that in writing for Ms Bailey if she still does not get it, but I will continue with the remarks that I want to make. However, I want to be clear that this Government remains committed to robust, evidence-based policy making as set out in our national clinical strategy. Underpinning that is our long-term commitment to secure local services where possible and develop specialist services when necessary. That will ensure that our health and social care services are responsive to the many challenges and opportunities that we face from the pressures resulting from demographic change to the continuous advancements in technology. Where change is advocated, we will ensure that the local boards work with all stakeholders to make the case. What we will not counter is change being dictated to local communities as has happened in the past. I think that Alex Rowley made in that open engagement is crucial in those service reviews. I would reiterate that local people can be assured that this Government will always focus our approach on providing as many services as locally as possible. The minister has taken that intervention. Can she confirm that the content of Anne McLaughlin MP's letter used on parliamentary resources says that she was in direct contact with the Scottish Government? Is she aware of that direct contact and what the form of that contact was? I am not aware of that. I would probably need to look at that after this debate. The member is happy to write in contact with the ministerial team. Mr Sarwar, I have already asked you not to be speaking from a sedentary position. Please desist. That, as I said around ensuring that we deliver services as locally as possible, that is our record in Government. It stands in stark contrast to that of the previous administration. I note in Jackie Baillie's motion that she calls on ministers to intervene and pledge to work with local communities to prevent the closure of health services. I think that we should reflect, and Stuart McMillan was right to add that in his remarks. We should reflect on what this Government has done for such services since 2007 and then compare that with what Labour delivered when they were in power. The very first act of Nicola Sturgeon as health secretary in June 2007 was to come to this Parliament and announce that we were overturning the previous Labour-led administration's decision to close the highly valued A&E departments at Monklands and Ayr hospitals. Since our decision to save these units, they have provided much-needed emergency capacity, seeing more than over 830,000 attendances between them. We have not just maintained those services, we have invested them and enhanced them. What of the bail of leaving hospital in Jackie Baillie's constituency? It was this Government that ended a decade of damaging uncertainty by approving the vision for the veil in 2009, while the Labour-led administration that Jackie Baillie served on as a minister presided over the closure of the hospital's A&E department in 2002. Indeed—oh, she may sigh, but that unfortunately is the uncomfortable truth that your administration closed the A&E department. Indeed, the approval for the vision for the veil secured its remaining emergency services. It meant that key local services, which would have been lost under previous proposals, were safeguarded and they were improved. In terms of delivering on the commitment to the vision for the veil, I can confirm that in-patient activity has increased 36 per cent when compared with 2009-10, and day-case activity has increased by 28 per cent. That is an increase of more than 1,000 cases. Emergency attendances have increased by 12 per cent when compared to 2009-10, and we have also invested 21 million in a new primary care centre that opened on the Baill site in 2013. The Government has been consistently clear that we remain committed to the vision for the veil. We continue to see a bright future for the hospital, which plays a crucial role in local healthcare system. Ministers are fully aware of the strength of local feeling in relation to the current proposals about maternity deliveries at the Vale. I received a petition today of around 2,500 signatures from the Lenox Herald this afternoon. I understand and I know that there are people here tonight in the gallery. I would once again encourage all local stakeholders to make their feelings clear during the public engagement work that is now under way. I would also add that the health board's review will include working with the CMO to look at midwifery services across the region. We have been clear that it would be unacceptable if any final proposals are not consistent with national policy, such as the review of maternity services, which is due to be published later this autumn. In closing, I reiterate the Government's commitment to the delivery of high-quality, sustainable health and social care services. Such services are not static, and our clinical strategies underline our approach to change. The evidence supports this and is as informed by meaningful public engagement. I know that Ivan McKee will ensure his constituents' voices in regard to Lightburn hospital will be held during that engagement process. Where there are proposals for major service change in the NHS, they must be subject to formal public consultation and ultimately ministerial approved. Local people can be assured that, in all such cases, ministers take all the available information and representations into account before coming to a final decision. I look forward to ensuring that all members get their chance to ensure that their constituents' voices are heard in those review processes. I thank those in the gallery for their courtesy, and I now close this meeting.