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Meeting of the Parliament

Meeting date: Thursday, February 23, 2023


Contents


First Minister’s Question Time


Accident and Emergency Departments (Waiting Times)

1. Douglas Ross (Highlands and Islands) (Con)

Tomorrow marks one year since Russia invaded Ukraine, starting a horrific war that has so far cost so many innocent lives. I pay tribute to the people of Ukraine for their courage in standing up against Vladimir Putin, and I know that we will all continue to support the people and the Government of Ukraine in their fight against this evil dictator. [Applause.]

Since we were last in the chamber, the First Minister has announced her resignation, and the front runner to succeed her is Humza Yousaf. During his time as Cabinet Secretary for Health and Social Care, Scotland’s national health service has lurched further and further into crisis. The Scottish Conservatives have received a response to a freedom of information request that has uncovered just how awful things have become at accident and emergency departments in the past few months. This new information, which we will publish today, reveals that a patient in the Borders waited for 49 hours to be treated in accident and emergency. Someone in Lanarkshire waited for 54 hours. A patient in Ayrshire waited for 60 hours at accident and emergency—that is two and a half days at accident and emergency. Surely no one can defend that. Does that not confirm that Humza Yousaf is not even up to the job that he has at the moment?

The First Minister (Nicola Sturgeon)

First, I take the opportunity to mark the first anniversary tomorrow of Russia’s illegal and unprovoked invasion of Ukraine, and to express my solidarity and that of the Scottish Government and, I am sure, of everyone in Scotland with the people of Ukraine as they continue to defend and protect their sovereignty, territorial integrity and independence. This afternoon, the Parliament will debate this issue and, this evening, I will host a reception in Bute house for Ukrainians in Scotland. Our thoughts remain with them at this difficult time for them and their country.

I should say, first, that it is for members of my party to elect a new leader of the Scottish National Party and, in effect, a new First Minister for Scotland, subject to the approval of the Parliament.

First, on the issues of the NHS and the health secretary, he is the only health secretary anywhere in the United Kingdom who has managed to avoid a single day of strikes in the national health service during this last period.

Secondly, notwithstanding the significant challenges in accident and emergency—[Interruption.]

Thank you, members. I would be grateful if we could hear the First Minister.

The First Minister

I understand why the Conservatives are feeling uncomfortable, because the Conservative Government in England has not managed to avoid strikes in the NHS.

The Conservatives also get uncomfortable when they hear me point out again that, despite the significant challenges in our national health service, which I will come on to in a moment, Scotland’s accident and emergency departments remain the best performing anywhere in the UK. If I may say so to the health secretary, that is not down to him—it is down to the hard work of staff across our national health service each and every day.

Our health service faces significant issues, and we see that in the Audit Scotland report that was published today. In that report, however, we also see important context that Douglas Ross always seeks to deny. Let me quote from page 7:

“The Covid-19 pandemic continues to affect the delivery of NHS services.”

If someone was to listen to Douglas Ross and others, they would be forgiven for thinking that the pandemic had not even happened.

The report also states:

“Scotland’s NHS is not alone in facing these issues … Many of the factors contributing to the extremely difficult situation facing the NHS in Scotland are not specific to health services, and many are not within the control of the Scottish Government”.

Notwithstanding that, we continue to support our health service to ensure record funding, record staffing, a record pay deal for agenda for change staff in Scotland and progress in reducing the longest waits in our national health service.

Douglas Ross

Shameful—that is the only way to describe that answer from the First Minister, because she made no mention of a patient in Ayrshire who, at the tail end of last year, waited for two and a half days in accident and emergency. The clue is in the name. They went there for emergency treatment and sat for two and a half days, but the First Minister’s answer to that patient is that Scotland’s health service is the best performing health service anywhere in the United Kingdom. That is little comfort to people who are waiting hours or days for treatment.

The First Minister might not have noticed that, when I sat down after mentioning those shocking statistics, Humza Yousaf smiled and smirked. The health secretary thinks that it is funny that people are waiting for days to be seen in A and E in Scotland.

The First Minister mentioned and quoted from the Audit Scotland report on the NHS. Let us remember that, this morning, the British Medical Association Scotland said that the report is “damning” of the current state of the NHS. The report outlines that Nicola Sturgeon’s chosen successor will not meet NHS job targets and says that

“performance declined further in 2022.”

In addition, the report says that

“The number of people experiencing an extremely long wait ... increased in 2022”

and that performance on cancer waiting times “is getting worse”.

Every part of Scotland’s NHS is in crisis because of Humza Yousaf. Can the First Minister tell us whether the useless health secretary is really the best that the SNP has to offer?

The First Minister

In relation to individual cases, it is always unacceptable if someone waits too long for treatment in the national health service. The

“tail end of last year”—

which was Douglas Ross’s phrase—was during the winter peak of pressure. Since then, although I stress that there is still considerable progress to be made, eight-hour and 12-hour waits in accident and emergency departments have reduced, and we continue to support them to make further progress.

Douglas Ross mentioned recruitment. We have record numbers of staff in our NHS right now. Since this Government took office, we have increased NHS staffing by 28,800 people. We have higher staffing per head of population than in England or other parts of the UK.

Funding has doubled in our national health service. We have higher funding proportionately than anywhere else in the UK—to the tune, proportionately, of about £1.8 billion, which is equivalent to 44,000 nurses in our national health service.

Yes, we have significant work to do to reduce waiting times, but we are focused, first, on the longest waits, and we have seen significant progress in reducing them.

I make the comparison with other parts of the UK because Douglas Ross stands here and asks people to believe that those problems are unique to Scotland and, somehow, down to the health secretary in Scotland. That is where the Audit Scotland report is instructive, because it says that those issues are not unique to Scotland. On page 7, it says that

“Scotland’s NHS is not alone in facing these issues”

and that

“many of the factors”

are outwith

“the control of the Scottish Government”.

We will continue to do our job, working with and supporting the national health service. We will do that despite Douglas Ross’s determination to turn it into a political weapon, which we have just seen all too clearly.

Douglas Ross

Wow! The First Minister thinks that Opposition MSPs raising cases of people waiting two and a half days in A and E in Scotland is somehow using the issue as a political weapon. No, it is not; it is about the reality for people across Scotland just now.

The First Minister loves to make the comparison between Scotland and the rest of the UK, but let us remember that the UK Statistics Authority said that Public Health Scotland’s figures—and the statistics that Nicola Sturgeon uses for comparison—could be misleading for patients.

We know that Humza Yousaf released a recovery plan that everybody could see was just a flimsy pamphlet. The First Minister has now quoted from page 7 of the Audit Scotland report twice. Let us go a bit further; I have gone through the whole report. It says of Humza Yousaf’s recovery plan that it lacked detailed actions. Audit Scotland said that he did not do “detailed and robust modelling” and that he did not

“engage fully with NHS boards”.

It also said that information on key patient aims “is missing”.

Humza Yousaf has made the crisis in Scotland’s health service much worse. First Minister, why should a health secretary who has failed our NHS now get to fail the whole of Scotland?

The First Minister

First, I did not suggest that any MSP who raises patient experience is using it as a political weapon; what I said—and what I will say again—is that anyone who tries to suggest that these issues are unique to Scotland’s NHS is seeking to use our NHS as a political weapon. To use Douglas Ross’s phrase, I think that that is shameful on the part of the Conservatives.

On the recovery plan, it is the case that we have considerable work still to do. However, let us look at the progress on eight-hour and 12-hour A and E waits. Earlier, I said that those have dropped significantly since the peak over the winter period. Eight-hour waits are down by 54.9 per cent, and 12-hour waits are down by 61.6 per cent. That is because of the support that we are giving to the NHS and the work of staff on the front line.

On waiting time targets more generally, the numbers waiting the longest for treatment have reduced by almost a quarter for both in-patient and day-case treatment and also for out-patient treatment. There are significant challenges—more significant than at any point in the history of the NHS—but we are supporting our NHS with record funding, record staffing and the wider support that it needs to address those challenges. That is what this Government will continue to do.

Douglas Ross

Oh dear. Eight years ago, a failed SNP health secretary became First Minister. Now, it looks as though history is repeating itself. Why would anybody risk Scotland’s future by giving a man with Humza Yousaf’s record more power? Let us look at his time in office while the First Minister gets more intel from the Deputy First Minister—I do not know what is coming there.

Humza Yousaf was the transport minister who drove without a licence, delayed the dualling of the A9 and clapped like a seal when Nicola Sturgeon launched a ferry with painted-on windows. He was the justice secretary who did nothing while violent crime rose, who got duped by a hoax video into calling on the police to investigate Rangers players and who damaged free speech with his hate crime act. Now, Humza Yousaf is the worst health secretary since devolution, but it looks like he is going to fail upwards. In any other line of work, Humza Yousaf would have been sacked, not promoted. Forget being SNP leader—why is he even still in the Government?

The First Minister

I do not know about anybody else, but it sounds to me as though Douglas Ross is pretty scared of Humza Yousaf—[Interruption.]—as, I am sure, he will be scared of whoever is elected to succeed me as SNP leader. [Interruption.]

Thank you, members.

The First Minister

Douglas Ross referred to the fact that I was health secretary before becoming First Minister, which I am extremely proud of.

Let me just reflect on this fact: in the eight years that I have been First Minister, the people of Scotland have had no fewer than eight opportunities to cast a verdict on me, my party and my Government. With every single one of those eight opportunities, the people of Scotland have rejected the Conservatives and put their trust in me, my party and my Government. I have every confidence that whoever succeeds me as leader of the SNP will continue that record of success.


National Health Service (Audit Scotland Report)

2. Anas Sarwar (Glasgow) (Lab)

I start by echoing the comments of both Douglas Ross and Nicola Sturgeon on the on-going war in Ukraine, and I send the solidarity of everyone in my party to the people of Ukraine against the tyranny of Vladimir Putin.

Nicola Sturgeon and I disagree on many things. It is fair to say that we have had our fair share of stooshies over the years, and I am sure that we will have many more in the years to come, but it is important to note that she has been at the forefront of politics for 20 years, she has served in government for 15 years, and she has been First Minister for eight years. In that time, she has led our country through a global pandemic—a challenge for any leader, anywhere in the world—and, for that, she deserves our recognition and our respect. [Interruption.]

Thank you, members.

The Audit Scotland report—[Interruption.]

Members, can we please do Mr Sarwar the courtesy of listening? Thank you.

Anas Sarwar

The Audit Scotland report on the national health service that was published today makes grim reading for the Government. It supports what patients and staff have been saying about waiting times, and it concludes:

“Before the Covid-19 pandemic, NHS boards were already struggling to meet waiting times standards for planned care, and performance has deteriorated further since”.

The report confirms that Covid did not cause the problems. They were there before Covid but were, of course, exacerbated by Covid. After nearly 16 years of Scottish National Party Government, what went wrong?

The First Minister (Nicola Sturgeon)

First, I thank Anas Sarwar for his generous comments. I fear that it might be damning him with faint praise to say that he has more grace in his wee finger than all the Tories combined—[Interruption.]—although I am sure that he will balance it out over the course of these exchanges. I am definitely showing my age when I reflect on the fact that, in one of my earlier election contests, I stood against Anas Sarwar’s father. In my most recent electoral contest, of course, I stood against Anas Sarwar himself, and I will spare his blushes by not pointing out the result of that latter one, even though his father beat me fairly and squarely back in the day.

Let me turn to the important matter of the NHS. Our NHS faces the most significant challenges that it has faced at any point in its history. That is largely because of the pandemic, but, as I have reflected before, there were challenges in our health service before the pandemic. Changing demographics and ever-increasing expectations of what health services can deliver are, in themselves, positive trends but ones that nevertheless pose challenges for the health service.

What has changed over the years that we have been in Government? Funding for the national health service has doubled and is higher, proportionately, than in any other part of the United Kingdom. Staffing in our health service has increased significantly. As the Auditor General recognises in this morning’s report, we are also seeing the signs of reform and innovation so that we can equip our health service to cope with the challenges.

I do not deny the challenges. However, what the NHS needs and has is a Government that will continue to support it and focus on addressing those challenges. That is the responsibility of Government, and that is what I believe the people of Scotland deserve and want to see continue.

Anas Sarwar

I should say, lightly, that Nicola Sturgeon does not need to remind me of the difference between the 1997 result and the 2021 result—my dad does that often enough for both of us. [Laughter.]

The truth is that this Government took its eye off the ball when it came to the NHS. It did not prioritise the NHS as it should have done. It was not prepared, and it still has not caught up.

The Cabinet Secretary for Health and Social Care launched his NHS recovery plan in August 2021, but, according to Audit Scotland,

“current activity is running well below NHS Recovery Plan targets”,

“More people are being added to waiting lists than are being removed from them, and people are waiting longer for treatment”,

“performance against cancer waiting times standards is getting worse”,

longer waiting times

“are negatively impacting people’s health”,

and, finally,

“The number of people dying each year is still higher than average”.

Things are getting worse, not better. The report is damning, and it is clear that Humza Yousaf has failed. He published a recovery plan that was more about spin than about substance. As a result, patient outcomes are getting worse, staff are burnt out and the NHS is going backwards.

Does the First Minister finally accept the conclusions in Audit Scotland’s report?

The First Minister

I do accept the conclusions in Audit Scotland’s report. The challenges for our national health service are significant. The recommendations in the report are important, and we will seriously consider each and every one of them.

Staff have been working incredibly hard, and I recognise the description of the burnout that many NHS staff will feel. That is why it has been so important to give them the fairest possible pay increase and to ensure that, unlike the situation in England, Wales and Northern Ireland, NHS staff in Scotland have not had to go on strike to get the decent, set pay offer that has now been made.

As an aside on that issue, to bring pay for NHS agenda for change nurses in England up to the level of pay for those in Scotland, the United Kingdom Government would have to offer them a 14 per cent pay increase. That is the gap that now exists.

In terms of our focus on the national health service, we have doubled funding for the NHS since coming to office; the budget that was passed this week in Parliament increases NHS funding by a further £1 billion; front-line spending in Scotland is 10 per cent higher than in England; and we have more staff, including more staff per head of population, than other parts of the UK.

On waiting times, yes, there is much to do, but we have seen a reduction in the longest waits; we have a number of national treatment centres opening this year, which will see an additional 12,000 procedures able to be undertaken in the NHS; and, although cancer waiting times are challenged, as all waiting times are, we are seeing more patients being treated on the key cancer pathways.

There is much work to do, but this Government has a real focus on supporting our national health service, because that is our responsibility.

Anas Sarwar

It is important that we look at the facts. The number of people who were waiting for more than a year for in-patient treatment when Humza Yousaf became health secretary was 22,000. That number was already too high, but, according to Audit Scotland, it now stands at more than 35,000 people. When he took charge of the NHS, 84.1 per cent of people were seen within the 62-day cancer standard; now, the figure is just 74.7 per cent. More than one in four cancer patients are not being seen in time. In the week that Humza Yousaf was appointed health secretary, 3,448 people waited for more than four hours in accident and emergency; this week, the number is 7,572—it has more than doubled, even though fewer people are going to A and E.

On every single measure, this health secretary has failed to get the NHS back on track. In fact, this is the worst it has ever been. Does the First Minister really believe that the man responsible for failing Scotland’s NHS should be responsible for our country?

The First Minister

That is a decision for members in my party.

Since Humza Yousaf became health secretary—this is what Anas Sarwar never wants to mention—there have been, I think, three further waves of a global pandemic that have affected health services all across the UK, Europe and the world. That is not something that can just be ignored. We, in common with other countries, have also just come through one of the most challenging winters that any of us can remember. That is the context for the challenges in our national health service—a context that is recognised and, indeed, pointed out by the Audit Scotland report today, which—I repeat—says:

“The ... pandemic continues to affect the delivery of NHS services. ... Scotland’s NHS is not alone in facing these issues.”

It also says:

“Many of the factors ... are not within the control of the Scottish Government”.

We continue to support the NHS in the ways that I have set out: record funding, record staffing, a record pay rise for agenda for change staff, reform and innovation to change how patients go through the national health service, and action to reduce waiting times. It is going to take time to properly recover the NHS from the pandemic. That is true in Scotland and in other countries, but the focus of this Government will not waver. It never will waver in supporting our national health service and all those who depend upon it.


Emissions Reduction (Climate Change Committee Report)

To ask the First Minister whether the Scottish Government will provide an update on how it is responding to the Climate Change Committee’s report on progress in reducing emissions in Scotland. (S6F-01844)

The First Minister (Nicola Sturgeon)

Scotland is taking action to secure a net zero and climate-resilient future, and we are doing so in a way that is fair and just for everyone. Our focus remains very firmly on delivering the updated climate change plan, delivering on our adaptation outcomes through the 2019 adaptation programme, and planning for a just transition across the economy. We are also carefully considering the Climate Change Committee’s latest advice, and we plan to respond in the spring.

Gillian Mackay

In recent years, Scotland has shown real climate leadership on the global stage. I am proud that the Scottish Government is currently consulting on a position that would see a presumption against exploration for yet more oil and gas in the North Sea while taking real action to build more solar, wind and marine renewables. That action must add up to a plan that delivers on our climate commitments and delivers a just transition for our communities. Does the First Minister agree that Scotland’s new climate plan will be one of the most important plans that this Government will ever produce, and will she join me in calling on all parties to rise to the challenge, come together and take the climate emergency seriously?

The First Minister

Yes, I agree. Addressing the climate emergency, for the sake of this generation but also generations to come, is a massive obligation. I think that it is a moral obligation for all of us, and I hope that everybody across the chamber will have the same conviction in tackling climate change as I do and the Government does.

Gillian Mackay is right to point out the need for all countries to accelerate the move away from fossil fuels. There is an added reason to do so in Scotland, which is the maturity of the North Sea basin. Even if there was not a climate emergency—which there is—we would need to make that just transition.

Investing in that transition and in alternative sources of energy is really important. In Scotland, we are blessed to have an abundance of those alternative sources of energy, which is why ScotWind and our green hydrogen ambitions are so important. They allow us to make the transition for energy needs in a way that is just and fair and that supports those people who currently work in oil and gas into alternative employment.

That just transition is one of the most important obligations of Government, and the updated climate change plan will be one of the most important documents to be published over the period ahead.

Maurice Golden (North East Scotland) (Con)

Creating a circular economy is a key component in reducing emissions. A series of reports by Circle Economy assessed the circularity metric of different countries: the Netherlands scored almost 25 per cent and Northern Ireland scored almost 8 per cent. After 16 years of Scottish National Party rule, Scotland came last, scoring just 1.3 per cent—why?

The First Minister

We are taking many initiatives to make our economy more circular and to reduce waste, and it is important that we continue with them. There is much more to do, which is why we are committed to a circular economy bill.

The Conservatives would be more credible on these issues if they did not oppose, in a knee-jerk way, everything that we bring forward in trying to improve performance around the circular economy, such as the deposit return scheme. Let us focus on what we need to do better, but let us try to find a bit of consensus so that the country can do exactly that and live up to the obligation that we all have.


Women in Entrepreneurship

4. Fiona Hyslop (Linlithgow) (SNP)

To ask the First Minister what the Scottish Government’s position is on the future role of women in driving entrepreneurial activity and economic growth, in light of the publication of the report, “Pathways: A New Approach for Women in Entrepreneurship. (S6F-01832)

The First Minister (Nicola Sturgeon)

On Monday, I had the pleasure of visiting the Roslin innovation centre, where I was able to welcome Ana Stewart and Mark Logan’s outstanding report. The report sets out a range of detailed and ambitious recommendations that consider how to close the gender gap for women in enterprise across Government, the education system, enterprise support networks and wider society.

First and foremost, it is an issue of fairness—women face clear barriers in realising their business ambitions, including in getting access to start-up and growth finance—but it is also important for our economy. If women started businesses at anything like the rate at which men do, it would deliver a significant boost to our economy.

The report is an important piece of work and I look forward to seeing its recommendations implemented.

Fiona Hyslop

I thank the First Minister for the strong leadership that she has shown to women throughout her tenure.

The report is an important milestone for women in business. It notes that

“only 2% of institutional investment”

goes to women-led companies in Scotland. Does the First Minister agree that we must increase the support for women entrepreneurs, as tapping into that latent pool of talent is not only the right thing to do but has the potential to significantly boost Scotland’s economic activity and growth?

The First Minister

I completely agree and thank Fiona Hyslop for that question. Supporting women into enterprise and closing the gender gap is, as I said in my initial answer, more than an issue of fairness, important though that is; it is one of economic necessity.

Women are slightly more than half the population, but only around one in five businesses in Scotland are led by women—we need to change that. The recommendations in the report, which span a whole range of factors, from some of the cultural barriers that women face, to systemic barriers, to things such as access to finance, will all be important in helping us do so. From a different place to the one that I am standing in now, I look forward to continuing to support the full implementation of the recommendations in Parliament.

Again, I thank Ana Stewart and Mark Logan for all the work that they have done to produce the report.


General Practices

5. Tess White (North East Scotland) (Con)

To ask the First Minister what the Scottish Government’s response is to research by the Royal College of General Practitioners reportedly showing that a third of Scotland’s GP staff who were surveyed said their practice was at risk of closing in the next few months. (S6F-01828)

The First Minister (Nicola Sturgeon)

I well understand the difficulties that general practice is facing right now, particularly during what has been—and, in some respects, continues to be—a challenging winter period. I put on record my thanks to general practitioners and their teams across the country.

A record number of GPs are working in Scotland. We have also recruited more than 3,000 healthcare professionals since 2018 as part of wider primary care multidisciplinary teams.

I very much value the work of the Royal College of General Practitioners, which is a very important partner. The survey is important, albeit that I should point out that the survey sample size is relatively small, as there were just 181 Scottish respondents from the many thousands of general practice staff who work here. Nevertheless, we pay close attention to the findings of the survey. We must encourage more trainee doctors and healthcare professionals to work in general practice, and we will keep working with the RCGP and others to ensure that that is an attractive proposition.

Tess White

This week, GPs in the north-east have sounded the alarm that general practice will become an extinct profession. They point the finger at a

“blatant and shameful lack of support”

from the Scottish Government—that is a direct quote. In the north-east, Friockheim medical centre, Invergowrie medical centre, Wallacetown health centre, Burghead and Hopeman GP surgeries and Fyvie Oldmeldrum Medical Group either have closed, will close or have handed back their contract.

Audit Scotland has warned again today that the key target to increase the GP workforce by 2027 is “not on track”. Can the First Minister explain why the action that her Government is taking to address GP recruitment and retention is failing miserably? It is putting patient safety at risk.

The First Minister

General practice is an important part of primary care, and primary care is an increasingly important part of our entire national health service, so we will continue to support general practices as part of wider teams. As I said earlier, since 2018, we have recruited more than 3,000 healthcare professionals to work in wider multidisciplinary teams, and we will continue to do that.

We are on track to meet the GP recruitment target for 2027, although, as Audit Scotland rightly says, that will be challenging. We will continue to focus on that so that we meet the target, and we will continue to ensure that we are making general practice an attractive proposition for people who wish to pursue medical careers.

These are extremely important issues, and these are challenging times for all parts of our national health service. However, the hypocrisy of Conservative members in the chamber is breathtaking at times. I will end my answer with this statistic: in Scotland, where the Scottish National Party is in office, the number of GPs per 100,000 of population is 95, but, in England, where the Conservatives are in office, the number is not 95 but just 78. These are challenging times, but this Government can evidence how we show support for general practice and the NHS as a whole.

Jackie Baillie (Dumbarton) (Lab)

I am afraid that the First Minister’s Government is not on track, and Audit Scotland has said that the Government will miss the target of increasing GP head count by 800. However, it is worse than that, because whole-time equivalent GP numbers have decreased by 200 since 2013, which poses a serious threat to the recovery of primary care. At the same time, the number of patients who are registered with GPs has risen by more than 300,000, yet the SNP has cut £75 million from primary care and GP budgets this year. Does the First Minister not agree that, by slashing funding and failing to increase the number of GPs, the SNP is compounding the crisis in primary care and, ultimately, failing GPs and their patients?

The First Minister

I do not agree with that. I agree that these are extremely challenging times for GPs and everybody who works in our national health service. The target for GP recruitment is for 2027, and we will of course have to focus and work to meet that. I say, with the greatest respect to Audit Scotland—I take everything that it says very seriously—that I am not sure that anybody can look to 2027 and predict what is going to happen. It rightly points out that meeting the target will be challenging, but it is important that we remain on track.

The GP head count has already increased by 277, and the head count among the wider multidisciplinary teams has increased by more than 3,000. Of course, that is increasingly important, because GPs rely on other health professionals to help them to do the excellent job that they do.

To come back to the final point that I made in response to the previous question, we have more GPs, proportionately, than other parts of the UK do. Earlier, I mentioned England; we also have more GPs per head of population than Labour-run Wales does and more than Northern Ireland does. Therefore, there is much work to do in Scotland, but we do it from a position of relative strength.


The Promise

To ask the First Minister what recent action the Scottish Government has been taking to keep the Promise to young people in care. (S6F-01829)

The First Minister (Nicola Sturgeon)

It is the ambition of this Government that every child in Scotland grows up loved, safe and respected so that they have the opportunity to reach their full potential, regardless of the circumstances in which they are born. As well as being a commitment of the Scottish Government, that is a personal commitment of mine, which I will take with me as I leave the Government over the next few weeks.

The budget that was passed on Tuesday commits almost £80 million to the Promise and £50 million to the whole family wellbeing fund. Back in December, we introduced the Children (Care and Justice) (Scotland) Bill, which seeks to put an end to under-18s spending time in young offenders institutions and to ensure that children who come into contact with the care and justice system are treated with trauma-informed and age-appropriate support.

Last Friday, I was delighted to visit East Renfrewshire to celebrate care day. I always value the opportunity to hear what matters directly from children and young people across Scotland as we work together to keep the Promise, which, as I said, is a commitment that I hold personally, as well as—for the time being—as First Minister.

Martin Whitfield

I am very grateful for that answer, but as the First Minister demits office, many in the care sector are deeply concerned about whether the Government will follow through with its pledge to uphold the Promise. I absolutely welcome the First Minister’s personal assurance that, for her, that will be a lifelong commitment.

Nearly two years after the launch, and with only three years to go, there are serious questions about progress. Does the First Minister agree that any failure to deliver the Promise would be nothing less than an abject betrayal of some of the most vulnerable children in our society? Would it be her or her successor as First Minister who would be held responsible for that?

The First Minister

I will always feel responsibility for the Promise, whether I am in government, in this Parliament, or wherever I happen to be in future stages of my life.

I have absolute confidence that whoever succeeds me as First Minister will share my commitment to keeping the Promise and delivering on that, but let me make this promise of my own: if, at any point, I think that the current Government or any future Government is not doing that, there will be somebody on the back benches being very loud and very vocal about it. Mr Whitfield can hold me to that.

Kaukab Stewart (Glasgow Kelvin) (SNP)

I welcome the Scottish Government’s on-going commitment to keeping the Promise to our care-experienced young people. How will the allocation in next year’s budget of £50 million to the whole family wellbeing fund, which the First Minister mentioned, support families who are in need?

The First Minister

The whole family wellbeing fund is really important, and I am extremely committed to it and will want it to continue to be delivered.

We talk about young people in care. It is really important that any young person in care is loved and supported, and that they are safe and secure and nurtured. However, one of our biggest responsibilities is to try to prevent the need for young people to go into care, by supporting families and keeping families together, where we can. That is the purpose and the objective of the whole family wellbeing fund. We want to transform services so that families can access the support that they need when they need it and in the way that they need to do so. When I was in East Renfrewshire on Friday, one mother in particular told me about the importance of that early intervention approach in ensuring that her daughter was able to stay with her and did not have to go into care.

The fund will focus on the system changes that are required to shift investment towards early intervention and prevention, which is a critical part of how we keep the Promise in practice. The £58 million investment in this year’s budget includes the provision of £32 million directly to children’s services planning partnerships to support work at a local level. Further details of the programme proposals will be confirmed in due course.

Many things have been important to me during my years as First Minister; I am sure that I will get the opportunity to speak about some of them in the next few weeks. Few, if any, of those things have been more important to me than the Promise to care-experienced young people. Our society should be judged on how we care for and love the most vulnerable children that we have and I think that this Parliament as a whole—not just this Government—should be committed to ensuring that every young person is loved and nurtured. If we do that, we will have something to be genuinely and really proud of.

Roz McCall (Mid Scotland and Fife) (Con)

I note the First Minister’s personal commitment.

Fiona McLean of The Promise Scotland said:

“For so many care-experienced children, young people and care-experienced adults, their lives won’t have improved over the last two years and things will have been really, really hard and may even have got worse.

That’s heartbreaking and shameful, and it shouldn’t be the case.”

Does the First Minister agree that, two years into the Promise, it is simply unacceptable that the lives of care-experienced people are still no better?

The First Minister

I thank the member for her question. Forgive me if I am getting this wrong—I am not sure if she was referring to Fiona Duncan of The Promise. Fiona has said many things and has done fantastic work with the care review and with The Promise. I know that she is someone who seeks to hold all policy makers and Government ministers to account.

Of course there is much to do. The experience of the pandemic has been tough for everyone, but it has been particularly tough for those who were already vulnerable and marginalised. There will be many respects in which that has been the experience of the past two years for young people in care.

We talk about the Promise—we have been talking about it and I have been talking about it today—in the abstract. We have already done so many things to improve the experience of young people in care. When I speak to young people, those are often the things that they cite to me. The care-experienced bursary is one example. I have spoken to many care-experienced young people who have had the opportunity to go to university only because of the bursary that we introduced. We have taken away some of the other costs, whether those are dental charges or the burden of council tax. Those practical measures are important because they are about levelling the playing field and giving opportunity.

Do we have more to do? We absolutely have more to do. We will absolutely have to rise to the challenge of keeping the Promise. I hope that everyone across the chamber is as committed to that as I am. I will continue to be a very loud and, I hope, powerful advocate for care-experienced young people as we, collectively and as a society, keep the Promise. It came much later than it should have done and we now all have a responsibility to deliver it in full.

We move to general and constituency supplementary questions.


Cancer Strategy (Place-based Research)

Rona Mackay (Strathkelvin and Bearsden) (SNP)

We know about the Scottish Government’s commitment to the excellent research and science in universities across Scotland and the impact that that has on the patients and communities most in need. Given the decision by Cancer Research UK to withdraw funding from the administrative base of Scotland’s only clinical trial unit, the Beatson Institute for Cancer Research in my constituency, will the First Minister say whether the new cancer strategy will reflect the importance of place-based research in addressing regional inequality in cancer in Scotland, particularly in the west of Scotland?

The First Minister (Nicola Sturgeon)

The cancer strategy will be published in the spring and will set out our 10-year vision for cancer in Scotland, which will include building on Scotland’s significant strengths in research. We have recently published an independent report on improving equity of access to cancer clinical trials and will be working with the cancer research community to prioritise the recommendations in that report and to take forward as many as is feasible.

I take the opportunity to absolutely recognise the very high quality of research in the west of Scotland and the collaboration between the Beatson institute, the University of Glasgow and the national health service. To support that, we have recently increased our contribution to Glasgow’s Experimental Cancer Medicine Centre, which will receive more than £2.25 million this year. We are also committed to supporting the NHS Research Scotland cancer research network in running innovative, high-quality research studies across Scotland.


Paediatric Audiology Services (NHS Lothian)

Sue Webber (Lothian) (Con)

There are well-documented issues with paediatric audiology services in NHS Lothian. Constituents of mine have a four-year-old daughter who suffers from progressive hearing loss and has been waiting for more than 20 weeks for an assessment at the paediatric audiology service at Edinburgh’s Royal Hospital for Children and Young People. To my dismay, the family have now been told that they must wait a further 11 months for any assessment for their daughter, who is currently 778th on the waiting list. I hope that that is not too uncomfortable for either the First Minister or the health secretary to hear.

With progressive hearing loss, a quicker assessment can mean a much better outcome and life for Annika and other children like her. What will the First Minister say to Annika and her family while they wait—and wait—for what would be almost a quarter of Annika’s life?

The First Minister (Nicola Sturgeon)

In relation to Annika’s case, I would of course be very willing to look into the particular circumstances. I do not want to see any child wait that length of time for access to care and treatment. The member is right to say that that is so important to their quality of life.

More generally, and as has been alluded to, there have been issues with the service in Lothian, and the vast majority of the recommendations that came out about some of those issues have already been accepted and the work has been completed. We will continue to work with NHS Lothian to ensure that the quality of the service that everybody relies on is as they have a right to expect it to be.

On the individual case, I will of course be willing to look into the matter if the details can be provided to my office.


Edinburgh Eye Pavilion

Sarah Boyack (Lothian) (Lab)

The First Minister will be aware of reports that the projected costs of the new Edinburgh eye pavilion have jumped by £10.5 million to £123 million. Given her Government’s shaky commitment to this vital project in the past, can she reassure patients across the Lothians and south-east Scotland that the new eye pavilion will be a priority for the Scottish Government, and that it will be delivered by 2027?

The First Minister (Nicola Sturgeon)

I gave that commitment during the most recent Scottish election campaign, I think, and I am happy to repeat it today. The commitment of this Government is not “shaky”; it is rock solid.

The construction costs and the business case will obviously be interrogated, as is normal for all business cases. There is inflation in the costs of construction right now, which is impacting on the cost of many capital projects. However, we have a strong capital programme in the NHS and more generally, and we are committed to delivering it.


Highlands and Islands Airports Ltd (Industrial Action)

Beatrice Wishart (Shetland Islands) (LD)

Strike action across the Highlands and Islands network has resulted in airports including Sumburgh being closed since Tuesday. Shetland patients with hospital appointments on the Scottish mainland this week have had to have them rearranged, resulting in delays to treatment and using up precious time and resource within the NHS. Highlands and Islands Airports Ltd is wholly owned by Scottish ministers, so what is the First Minister going to do to secure a resolution and end the disruption to what are lifeline air services?

The First Minister (Nicola Sturgeon)

I will answer that question in two parts. First, in relation to patients whose treatment has been delayed because of the industrial action, health boards will be working to ensure that any delays are minimised. Secondly, there is on-going dialogue to resolve the underlying issue, and I would expect HIAL to do everything possible to reach a resolution to ensure that any further disruption is completely avoided, or certainly minimised.

That concludes First Minister’s questions.

12:48 Meeting suspended.  

12:49 On resuming—