Meeting of the Parliament [Draft]

Meeting date: Thursday, June 27, 2024

Official Report 988KB pdf

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First Minister’s Question Time

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National Health Service (Delays)

Public Health Scotland figures show that delayed discharge—also known as bedblocking—is at a record high. According to the charity Macmillan, a set of new figures reveals

“devastating delays in cancer treatment”.

Right now, one in seven of our fellow Scots is on a national health service waiting list. Given all that, why does our health service not make it on to the first page of the Scottish National Party’s priorities?

As I have explained to Parliament previously, I accept that the delayed discharge numbers that Douglas Ross raises with me are far too high. The Government is in active dialogue with local authorities and health boards to reduce those numbers. On waiting times for cancer treatment, we are treating more patients, and an increased number of personnel in the health service are working to deliver on cancer care. Across the whole health service, we are allocating more resources to ensure that it is able to meet the rising demand that has occurred in the aftermath of the Covid pandemic. The health service now occupies a much larger proportion of our budget than was the case previously.

There is, of course, a link between the condition of the health service and the question of independence, which is the question of financial control. What worries me—and not only me; this has been expressed by the Institute for Fiscal Studies as well—is that, at this moment, there is a conspiracy of silence between the Conservatives and the Labour Party about the funding of our public services and our health service. The issue is this: we are not confronting the consequences of 14 years of austerity. For Scotland, independence is the way to do that.

I spoke about Macmillan saying that there are devastating delays in cancer treatment, and John Swinney goes for independence. He spoke about delayed discharge and said that he was in “active dialogue” with local authorities. Yes—that active dialogue is telling them that they are having their budgets cut yet again by this SNP Scottish Government.

On the SNP’s watch, Scotland’s NHS waiting times are at some of their worst levels ever. It has made Scotland the drug deaths capital of Europe; alcohol deaths are now at their highest level for 16 years; and life expectancy in Scotland is lower after 17 years of the SNP Government. The SNP is bad for Scotland’s health. We are all sick of hearing about what is on page 1, line 1. Fixing Scotland’s broken NHS is the public’s priority. Why is it not the SNP’s?

I think that the Government’s decisions speak volumes about the priority that we attach to the health service—[Interruption.]

Let us hear the First Minister.

When this Government came to office in 2007, the health service occupied about 33 per cent of the Government’s budget. Today, it is closer to 50 per cent. Those are the decisions that this Government has taken, and that has ensured that there is more funding to deal with the increased demand on the national health service.

Last year, with the allocation of consequential funding from the United Kingdom Government, we faced a choice. Consequentials came to us for business rates support for the hospitality industry. When that money came here, Douglas Ross wanted us to spend it on the hospitality sector, and we chose to spend it on the health service. We are prepared to make the tough choices; Douglas Ross ducks them. [Applause.]

John Swinney wants to get applause from the clapping seals behind him for record drug deaths in Scotland—[Interruption.]

Members!

He wants us to celebrate—[Interruption.]

Members!

Mr Ross, yet again, I must draw your attention to standing orders rule 7.3, which tells us that we must conduct our business

“in a courteous and respectful manner”.

Do continue in that vein. Thank you.

I was just making the point that the SNP members were applauding John Swinney—[Interruption.] SNP members were applauding John Swinney for overseeing record drug deaths in Europe. We are the worst in Europe, and they applaud that. We have bedblocking at its highest ever level, and they applaud that. We have people—840,000 of our fellow Scots—on waiting lists for far longer than they should be, and SNP MSPs applaud that.

It is not just our health service where the SNP has failed. It has not upgraded the key roads that it promised that it would upgrade: the A9, the A90, the A96, the A7, the A75 and the A77. All those promises have been broken by the SNP.

The attainment gap is supposed to close—it has widened. Violent crime is up, and officer numbers are down. Scottish workers pay more in tax than those in the rest of the United Kingdom, and the SNP has abandoned Scotland’s oil and gas industry. From Salmond to Sturgeon to Swinney, all that they have achieved is dividing Scotland. Is it not time to finally draw a line under the independence debate for good?

One of the issues that Douglas Ross put to me was alcohol-related deaths. I want to share a quote with Parliament, because this is the type of evidence that Parliament needs to chew over and consider when we are dealing with the type of rhetoric that we hear from Douglas Ross. Professor Gerry McCartney, who is professor of wellbeing and economy at the University of Glasgow, said:

“You see lagged effects from decades ago of urban planning, policy decisions and the 1980s economic changes and how that translated into people’s alcohol deaths a decade or two decades later. So it is not unprecedented.”

I simply put that evidence to Parliament, because we have to understand the consequences of the devastation that was wreaked on our country by the policies of Margaret Thatcher’s Conservative Government.

Just to prolong—[Interruption.]

Members!

Just to prolong the absurdity of Douglas Ross’s position, he has, this week, set out a manifesto that commits to

“Repairing the Roads ... Ending Long NHS Waits ... Restoring our Schools”

and

“Making Scotland Safer”.

All—[Interruption.]

Let us hear the First Minister.

All those four commitments cost more money, and then there is the fifth one: “Cutting your Tax”. Douglas Ross stands here and demands that we do more and spend less. It is the politics of absurdity, and Douglas Ross is welcome to all of it.

Let us just look at that answer. John Swinney is considerably older than me, but he is blaming the failures in Scotland now on a period before I was even born. Apparently, it has nothing to do with the 17 years for which the SNP has been in charge in Scotland.

We know that, apart from separating Scotland from the rest of the UK, nothing else matters to John Swinney. Independence will always come first, before our NHS, before jobs, before schools and before the economy—before everything. People up and down Scotland want the focus to be on those issues—the things that really matter to them—but we all know what John Swinney wants. If it is not page 1, line 1, it is not a priority for the SNP.

Right now, in 2024, the SNP’s leader from 2004 is trying to take us back to the division of 2014. Scotland is stagnating under the SNP. We have had 17 years of decline and broken promises. Is it not time to finally move on from the division of this SNP Government to focus on the issues that really matter to people?

I do not really think that Douglas Ross is in a position to go on at me about division when his colleagues behind him have told him to get out of office as leader of the Scottish Conservative Party. [Interruption.] Oh! Do they all want him to stay? What I read in the newspapers was that they were all in revolt. They all wanted rid of him. [Interruption.]

Let us hear one another.

I think that my colleagues are pretty happy that I am here just now, believe you me. [Interruption.]

Let us hear one another.

Let me tell Douglas Ross why independence matters. People in this country are suffering because of the—[Interruption.]

We will hear the First Minister.

—consequences of 14 years of Conservative austerity. They are suffering because of the Conservative obsession with Brexit, which is damaging our economy. They are suffering because of the cost of living crisis that was escalated by the ludicrous behaviour of Liz Truss and Kwasi Kwarteng, which Douglas Ross wanted me to emulate. Independence is the solution to austerity, Brexit and the cost of living—and we are going to see the back of Douglas Ross as well.

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National Health Service Treatment

Presiding Officer,

“Long waits are forcing those who can afford it, to go private. A two-tier health service in Scotland is now beyond question. If you can stump up the cash, then you can get the care you need.

But we all value an NHS free at the point of use.

Yet, Scotland is sleepwalking into sacrificing this principle, threatening the very existence of the national health service as we know it.”

Those are not my words; they are the words of the chair of the British Medical Association Scotland, Dr Iain Kennedy, who was talking about the national health service in Scotland right now on the Scottish National Party’s watch. Is Dr Kennedy wrong?

I have the greatest respect for the comments of Dr Kennedy. I listened and I read his comments with great care, and I take them seriously, because Dr Kennedy has given a significant warning to us about what lies ahead.

I have been completely candid—[Interruption.] This will be interesting to see. I do not think that it is any secret that we are going to have a Labour Government in a little while. We will have to see how the dialogue develops here. A week on Friday, the issues that have been raised with me about the health service are going to be the Labour Party’s problem.

This is your problem. Take some responsibility.

I do not need Mr Marra to shout at me about taking responsibility. I take my responsibilities deadly seriously.

I am calling for a serious conversation about what lies ahead. The health service is a product of the investment that we can make through the public finances. As I have just explained in replying to Mr Ross, when we came to office, the health service occupied 33 per cent of our budget, and it now occupies nearly 50 per cent of it. We have taken the hard decisions, including to increase tax on higher earners in order to invest more in the health service, which Mr Marra and Mr Sarwar want us to reverse.

To look ahead, the Labour Party is proposing an extra £134 million of investment in the health service in Scotland as a consequence of its election victory. That is what it is offering. The last spring budget health consequentials that we got from the awful Tories were £237 million. I invite Anas Sarwar to do the maths. We cannot prolong austerity, and that is what the Labour Party is offering. Until the Labour Party offers a sensible way out of austerity, people in Scotland will not take it seriously.

That is, frankly, an embarrassing response. The Scottish National Party has been in charge of the NHS for 17 years, and the chair of the British Medical Association Scotland says that we now have a two-tier health service under an SNP Government. All that John Swinney spoke about was what would happen if we get a Labour Government after 4 July, which I and many in Scotland hope that we will get. What about this Government’s responsibility and what is happening to people right now? The reality of Dr Kennedy’s comments is that many people feel that they have to pay because they have been waiting too long for treatment. There are no answers from John Swinney to those people.

Nothing sums up SNP waiting time failure like cancer. Two weeks ago, I highlighted the scandal of cancer patients having to pay privately for chemotherapy. Think about that for a moment, Mr Swinney, before you give your next answer.

Cancer is Scotland’s biggest killer. It has touched every family in Scotland. On Tuesday, it was confirmed that, under this SNP Government, we have failed to meet the 62-day treatment standard for cancer treatment. In fact, it has not been met for 12 years. In that time, almost 26,000 cancer patients have waited too long—in the past year alone, 5,000 patients have waited too long. How much longer do those cancer patients and their families need to listen to the SNP Government blaming somebody else for its own failure?

Always speak through the chair, please.

Let me go through some of the steps that we have taken to strengthen cancer care in Scotland and demonstrate the increased level of activity that is taking place. In relation to the significant increase in the number of posts that we have in cancer care, I note that we have funded the creation of 15 extra posts in clinical oncology, six in medical oncology, 68 in clinical radiology and 10 in clinical interventional radiology. There has been a 50 per cent increase in the number of consultant oncologists in the past decade, and we have increased the number of consultant radiologists by 34 per cent over the same period.

If we look at the volume of individuals who are being treated, we see that more than 15 per cent more patients were treated on the 62-day urgent suspicion of cancer pathway than in late 2019, before the Covid pandemic, which is 47 per cent more than 10 years ago. Further, 22 per cent more patients were treated on the 31-day pathway compared with 10 years ago.

My answers directly address Mr Sarwar’s point about what we are doing to treat and support more people. We are expanding the number of people delivering specialist care, and we are making sure that more patients are being treated on the 31-day and the 62-day pathways.

Other measures have been taken such as the rapid cancer diagnostic services that are now being delivered in parts of the country. In NHS Fife, for example, the average wait for referral from diagnosis has gone from 77.5 days to 11.4 days. In Dumfries and Galloway, that average wait has gone from 78.7 days to 13.6 days. I put that information on the record to reassure members of the public that the Government is investing, we are treating more people and more people are being treated more quickly.

I accept that there remain challenges in the delivery of healthcare and cancer care, which is why I believe that we have to have an honest conversation about the financial support that is required to support investment in our health service.

There are many members who wish to ask questions, so I would be grateful for more concise questions and responses.

I cannot wait to have that honest conversation in the run-up to the election in 2026 about the performance of the SNP Government when it comes to the NHS—and neither can many people across the country.

Last year, 5,000 patients waited too long to get their cancer treatment. I said at last week’s First Minister’s question time that “long waits cost lives”. We all know that the faster someone gets treatment, the higher their chances of survival from cancer.

Earlier this month, Professor Farhat Din of the Royal College of Surgeons of Edinburgh told the Scottish Parliament’s Health, Social Care and Sport Committee:

“As a cancer surgeon, when patients in my clinic ask me when their operation will be ... that is a very difficult conversation to have ... Each of those people is part of a family, and there is anxiety for them. There is also anxiety for clinicians, because we are trying to deliver care, but we cannot deliver the high standard of care that we have been trained to deliver.”—[Official Report, Health, Social Care and Sport Committee, 4 June 2024; c 3.]

On the SNP’s watch, 26,000 cancer patients and their families have faced that anxiety and waited too long. Can the First Minister explain why to them and to their doctors?

I have set out what we are doing in considerable detail. The Presiding Officer has asked me to keep my remarks limited, so I will not repeat all that I have just put on the record. What I said in my answer is a demonstration of two things: one, the investment that we have made in specialist capacity to enable us to treat cancer patients, and two, that we are prepared to put in the resources to enable that to happen. That has not happened by accident. It has happened because ministers in the Government took a decision to increase taxes for higher earners so that we could spend more on health than was provided by the United Kingdom Government in consequentials. Secondly, it happened because we decided not to pass on a Barnett consequential to the hospitality sector, but to invest it instead in the national health service.

I am contributing to the debate by acknowledging the significant pressures on the national health service as well as the significant burden that has been created by prolonged austerity. What I worry about—and I worry about it deeply—is that I do not hear a willingness from the Labour Party to take a different course of direction and to invest more in our national health service to ensure that we can deliver the care that people require. I want to ensure that that is well understood by people in the course of the next week, so that they are fully informed about the limitations of the position that has been offered by the Labour Party. I want to demonstrate the commitments that we have given to put our money where our mouth is, to put taxes up, to increase investment in the national health service and to deliver for the people of this country.

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Cabinet (Meetings)

To ask the First Minister when the Cabinet will next meet. (S6F-03266)

The Cabinet will next meet in the week commencing 5 August.

It is harder than ever to see a general practitioner. People are phoning hundreds of times when the lines open, only to be given an appointment weeks later. Local surgeries are on their knees, and a lot of the demand that they face is linked to the crisis in mental health—they need dedicated mental health workers working alongside them. In 2021, Nicola Sturgeon agreed with that. She announced that the Scottish National Party Government would hire 1,000 new staff to lessen the load and that every surgery would benefit by 2026. There is not long to go now, but there is just one catch: we have uncovered that, three years later, not a single one of those workers has been recruited—not one.

The Liberal Democrats are dedicated to getting you fast access to your GP. We are dedicated to world-class mental health support, but the SNP has cut mental health budgets time and time again. Is that not yet more evidence that the SNP has been in power for too long and is letting people down?

No, because we have exceeded our commitment to recruit 800 additional mental health workers to accident and emergency departments, GP practices, police station custody suites and prisons. We have also invested in mental health support in our schools and the appointment of mental health counsellors in order try to provide early intervention to reduce the crystallisation of demand for child and adolescent mental health services, so that young people are supported at an earlier stage. The Government has increased expenditure on mental health with a 2 per cent cash increase, representing 8.5 per cent of total national health service expenditure. Expenditure on CAMHS has also increased, and the Government will continue to support essential mental health services to assist in meeting the demands and needs of individuals in our society.

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Child Poverty (Impact of Two-child Limit)

To ask the First Minister, regarding the impact on child poverty levels in Scotland, what assessment the Scottish Government has made of recent research from the Institute for Fiscal Studies on the impact of the two-child benefit cap. (S6F-03277)

The report shows the scale of the impact of the two-child limit. An extra 250,000 children in the United Kingdom will be affected by it next year and an extra 670,000 will be affected by the end of the next session of the UK Parliament. Those households will be an average of £4,300 worse off, which represents 10 per cent of their income. The evidence is overwhelmingly clear that scrapping the Westminster policy will immediately lift children out of poverty. It is frankly breathtaking that the Labour Party has committed to keeping the two-child benefit cap in place, offering no change to the Tories’ austerity agenda.

As the First Minister has outlined, the IFS research indicates that, when it has been fully rolled out, the two-child benefit cap, which is supported by both Labour and the Tories, will affect one in five children and will cost families an average of £4,300 a year. What assessment has the Scottish Government made of what the impact on child poverty levels would be if an incoming UK Government reversed that cruel policy?

Recent analysis by the Government has estimated that reversing the two-child limit and reintroducing the family element of universal credit would lift 10,000 children in Scotland out of poverty. That would be a welcome addition to the effectiveness of the child poverty measures that the Government is already taking, which include the Scottish child payment and other measures, as a consequence of which we are keeping 100,000 children out of poverty.

It would be of assistance to us in achieving the fundamental aspiration of this Government, which is to eradicate child poverty, if we were to have the support of the United Kingdom Government through the lifting of the two-child limit, rather than the prolonging of child poverty as a consequence of the maintenance of that immoral policy.

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A9 Dualling

To ask the First Minister, in light of the reported number of serious and fatal accidents on the A9 trunk road in recent weeks, what progress is being made on the dualling project. (S6F-03264)

We are all aware of the harm, disruption and inconvenience that are caused by road traffic accidents, including the most recent incidents on the A9. I express my sympathies to everyone who has been affected by the loss of a loved one, including the family and friends of the individual who was killed in the accident on the A9 last Sunday, and to anyone who has been injured on our roads.

As I confirmed at the cross-party meeting that I chaired on Tuesday, this Government’s commitment to dualling the A9 is steadfast, and progress has been made on the timetable that was published in December. Since then, we have progressed the purchase of land for four sections in the programme. The procurement process for the Tay crossing to Ballinluig project began in May, and I can advise Parliament today that we are nearing completion of the procurement process and will shortly award the contract for the dualling of the Tomatin to Moy section.

The First Minister is aware that the busy summer tourist season always brings a spate of serious and fatal accidents on the A9. The latest of those, as he has alluded to, was on Sunday at Calvine; it involved the death of a motorcyclist. That is a terrible tragedy for the family of the man who was killed, but there was also massive disruption on what is a major, busy arterial route. The road was closed for seven and a half hours, and motorists and bus passengers were left stranded. I am sure that the First Minister would want to join me in thanking the local residents and businesses in Blair Atholl that stepped in with food, drink and accommodation to help the people who were affected.

However, such tragedies will continue to happen until the A9 is dualled in full, which the Scottish National Party Government promised would happen by 2025. That promise was broken. The First Minister now says that the dualling programme will proceed. Why will it be different this time?

First, I associate myself with Murdo Fraser’s remarks about the assistance that was provided by my constituents in the Blair Atholl area. The community around Blair Atholl in Pitlochry and Dunkeld has had a lot of experience of providing support when previous incidents have occurred, and I express my warm thanks to the individuals who helped. For completeness, I should also say that the settlements north of Calvine, where the accident took place, in Dalwhinnie, Kingussie and Newtonmore, also provided assistance to motorists who were inconvenienced.

The accident in Calvine happened on a part of the road where it was particularly difficult to enable alternative diversion routes to be put in place. Long diversion routes had to be used, which involved significant amounts of disruption. I have asked Transport Scotland and the Cabinet Secretary for Transport to look again at the handling of that incident so that we can be certain that all assistance that can be provided in such circumstances will be provided.

In relation to the latter part of Mr Fraser’s question, the Government has had to address a number of major infrastructure projects that were part of the on-going programme that we inherited when we came into office, as well as some other projects that emerged that had to be addressed. The Government has completed satisfactorily the Borders railway, the Levenmouth railway, the Airdrie to Bathgate railway, the expansion of a number of stations, the Aberdeen western peripheral route, which was promised for 40 years but never delivered, the Queensferry crossing, the M80 completion, the M8 completion and the M74 completion. We have brought forward—

Please answer briefly, First Minister.

I will do so, Presiding Officer.

We brought forward improvements to the A9 at Luncarty to Pass of Birnam, as well as at Kincraig, Dalraddy, Crubenmore and the Ballinluig junction. I hope that that gives Mr Fraser confidence that the Government delivers.

On Tuesday, a cross-party group of MSPs, representing all but one of the parties in the Holyrood chamber, met the First Minister to discuss the acceleration of the timetable for dualling the A9. Can he now confirm to us all and to Scotland that, with officials and industry, he will give the most serious consideration to that plea? In any financial instrument that is deployed, will he also seek to include provision to deliver our promise on the Nairn bypass?

The Government is committed to delivering the Nairn bypass and the dualling of the A9 from Inverness to Perth. As I indicated at the cross-party group meeting on Tuesday, the Government will keep the programme under review to identify whether there is any way that we can move faster. However, we have established a strong programme that enables us to deliver on the commitment that we have made. The Government’s commitment is absolute.

As Mr Ewing well knows from his long experience in government, we have to live within the financial resources that are available to us. We will deploy creativity in trying to expand those resources but, if our capital budget is cut by 10 per cent, that is a significant challenge to any Government of any political colour.

Listing the projects that have been completed instead of the dualling of the A9 simply adds insult to injury for the people of the north, who have waited too long. How much land has been purchased for the A9 and how much remains to be purchased?

I set out the projects that the Government has delivered and put in place simply to establish confidence in the Government’s ability to deliver capital projects. I have not heard from Rhoda Grant an argument for why we should not have done any of those projects. We were encouraged by the Labour Party to do other projects that we did not want to do, and we had to find the funding for all of that. I simply put those projects on the record.

I cannot give Rhoda Grant a definitive figure for the volume of land that has been acquired, but I will write to her with the details after First Minister’s question time.

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Carer Support Payment

To ask the First Minister whether he will provide an update on the Scottish Government’s work to roll out the carer support payment. (S6F-03280)

Our carer support payment is the 14th benefit to be delivered by Social Security Scotland and has been available for new applicants in Dundee city, Perth and Kinross, and the Western Isles since November 2023. From November it will operate nationally, and on Monday we completed the latest phase of the roll-out, opening the payment to new applications in Angus, North Lanarkshire and South Lanarkshire.

The carer support payment, which was co-designed with carers and support organisations, extends entitlement to many carers in full-time education, thereby removing barriers to education for around 1,500 carers a year.

The carer support payment is Scotland’s 14th transformative devolved payment and it benefits many young carers who would simply not, were they elsewhere in the United Kingdom, receive the financial support that they deserve.

Will the First Minister urge the next UK Government to face up to the devastating effects of a decade of austerity on our communities, including on unpaid carers, and match the progressive social security ambitions of the Scottish National Party Scottish Government?

In addition to Emma Harper’s point about the impact of the carer support payment on young people, from Monday we extended eligibility for that payment to 16 to 19-year-olds who are in full-time secondary education and are in exceptional circumstances. I hope that that will help to address some of the issues that the member raises.

The Government is committing a record £6.3 billion to benefits expenditure, which is £1.1 billion more than we receive from the United Kingdom Government for social security through the block grant. That demonstrates our commitment to tackling poverty. The investment will support more than one in five people in Scotland—in particular, disabled people. It will assist them to live full and independent lives and it will enable older people to heat their homes in winter. It recognises unpaid carers’ valuable contribution to our communities around the country.

We move to general and constituency supplementary questions. If we keep questions and responses concise, we will be able to involve more members.

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Scotland-headquartered Companies (Ownership)

Does the First Minister share my concern about the rate at which Scotland-headquartered companies are being taken over by businesses elsewhere—specifically, and most recently in my constituency, civil engineers R J McLeod (Contractors) Ltd?

I understand the concern and anxiety—in particular, for employees of those organisations. There are examples of Scottish companies acquiring businesses in other parts of the United Kingdom and around the world, so acquisition is and can be a two-way process. Part of what the Government wants to do is strengthen the roots of companies in Scotland and their commitment to the Scottish economy. The recent data from the Royal Bank of Scotland purchasing managers index demonstrates that Scotland is an attractive place to do business and is attracting a great deal of interest domestically and internationally.

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General Practices

Presiding Officer,

“If you’re not satisfied with the service you receive, look beyond the practice and instead hold those with the power to improve matters to account. The Scottish Government needs to do more to directly support general practice, the bedrock of the NHS. Please contact your MSP.”

That is the statement that the Fife local medical committee, which represents general practices in Fife, has written to its patients. Our GPs are the front line of our health service so, in the light of that statement, what message do you have for patients in Fife who are being so completely let down by this Government?

I remind members to always address their remarks through the chair.

I greatly value the contribution that general practices make to the nation’s health. I want to make sure that general practices have the support that they need in order to deliver on their commitments. The Government has invested more than £1.2 billion in general medical services in the past financial year, and we work in close concert with general practices to make sure that they meet the needs of their patients.

The health secretary is in regular dialogue with the representatives of general practices through the British Medical Association and other organisations. That will certainly be encouraged by me.

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Tennis

In recent years there has been a significant growth in participation in tennis in Scotland, with more than 270,000 children playing at least once a year, a 29 per cent increase in children playing weekly and record levels of club membership. It is also welcome that half of all schools in Scotland are registered to deliver the Lawn Tennis Association youth schools programme, which is a free offer with resources to deliver tennis in a school setting.

As Sir Andy Murray, one of Scotland’s greatest ever athletes, comes towards the end of his career, how will the Scottish Government work with both Tennis Scotland and the Lawn Tennis Association to capitalise on his success and ensure that every primary-school age child in Scotland has the opportunity to pick up a racket and try tennis?

I associate myself very much with the sentiments behind Mr Bibby’s question. As a consequence of his incredibly successful career, Sir Andy Murray has given exceptional and demonstrable leadership in encouragement of participation in sport. He has been a great ambassador for Scotland and for tennis and sport.

The answer to the question lies in some of the points that Mr Bibby has put to me—it will be through partnership that we make the greatest success. We are already working with Tennis Scotland, the Lawn Tennis Association and sportscotland to support delivery of tennis activity around the country. There is a £15 million transforming Scottish indoor tennis fund, which is a capital investment programme that has been brought together by that partnership to enable greater use of tennis facilities and to encourage greater participation in tennis.

I assure Mr Bibby of the Government’s willing engagement to work with partners to deliver that increased participation.

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Public Spending

A recent study from researchers at the London School of Economics and Political Science has indicated that, between 2010 and 2019, United Kingdom Government austerity spending cuts cost the average person in the UK nearly half a year in life expectancy. Given that the Institute for Fiscal Studies has warned that both Labour and the Tories are planning further substantial austerity cuts, will the First Minister advise what assessment the Scottish Government has made of the impact of those Westminster cuts on public health in Scotland?

It is very clear that the evidence points to the acute difficulties that Elena Whitham puts on the record. If there is a prolonged reduction in public expenditure, it will harm the population. That is what we are wrestling with, and that is why there must be a change of direction in the public finances. We have taken decisions in Scotland to expand public expenditure to enable investment in our public services. We need the fiscal climate of the United Kingdom to catch up with us to enable greater investment in the public services of our country.

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Fertility Preservation Treatment (National Health Service)

I have been contacted by a constituent with a 38-year-old niece in Lanarkshire who has breast cancer. Treating that will ultimately affect her fertility but, because she has passed her 38th birthday, national health service rules say that she must pay £5,000 for fertility preservation treatment. If she were an otherwise healthy woman, she could get in vitro fertilisation on the NHS into her 40s, and rightly so. I do not think that that is a very fair situation for anyone with breast cancer. Will the First Minister agree to look into that situation as a matter of urgency?

I recognise the sensitivity of the point that Mr Simpson puts to me, and I understand the concern about the different approach that is taken in different scenarios. I am happy for the relevant ministers—the Cabinet Secretary for Health and Social Care and the Minister for Public Health and Women’s Health—to engage directly with Mr Simpson on the question. We will explore what is possible. There might be clinical issues with which I am not familiar, but we will explore the matter to see whether there is a way to address Mr Simpson’s points.

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University Hospital Wishaw (Neonatal Intensive Care)

The Scottish Government’s plan to downgrade the neonatal intensive care unit at University hospital Wishaw is dangerous and flawed, and it will fail vulnerable babies and families in Lanarkshire. My constituents deserve better, and that is why they have the full support of Scottish Labour. What about the First Minister? Will he listen to parents, families and healthcare experts and save this United Kingdom-award-winning unit, or will the Scottish National Party Government continue to defend the indefensible?

I understand that this is a significant and sensitive issue in the Lanarkshire area. However, the conclusions have been arrived at after a very detailed and comprehensive process of evidence gathering. They are based on clinical advice that it would be impossible for the Government to ignore. The information that has been gathered points to the changes that are being proposed, and that approach is based on evidence.

The issue involves babies who are at an extreme level of vulnerability. As a logical consequence, and as the evidence points to, there is a need for very sophisticated intervention to maximise the possibility of sustaining life. It would be difficult for ministers to ignore the compelling evidence on that need. I understand the strength of feeling on the question, but ministers need to act with responsibility in relation to the evidence that is put in front of us.

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Edinburgh-Kaohsiung Friendship Arrangement

I declare an interest as the convener of the cross-party group on Taiwan.

On 12 June, the Cabinet Secretary for Constitution, External Affairs and Culture met the Chinese consul general in Edinburgh. The purpose of the meeting is not known, but we do know that, days later, the City of Edinburgh Council pulled out of a friendship agreement with the Taiwanese port city of Kaohsiung. We also know that Chinese officials made public statements about sanctions against academia, aviation and business in the capital city. Is the First Minister comfortable with such threats to our capital city? Will he instruct the cabinet secretary to publish minutes of his meeting with Chinese officials? In doing so, will the cabinet secretary explain why he felt it appropriate to intervene in the matter at all?

First, the decisions of the City of Edinburgh Council are a matter for the City of Edinburgh Council. Ministers do not have any direction-making powers over local authorities on such matters, although there are some issues on which we have—actually, I am not sure whether we have any direction-making powers over local authorities, because they are independent corporate bodies. Therefore, that question just does not arise.

I certainly do not think that it is appropriate for any threats to be issued to public bodies. Public bodies should be free to make their own judgments and come to their conclusions. I do not agree with such threats in any shape or form.

It is not surprising that the cabinet secretary for external affairs should meet the Chinese consul general, because Mr Robertson has an obligation to meet the consular community regularly—indeed, I will meet the American consul general this evening to mark his moving on from his posting in Edinburgh. Such discussions are routine, but any decisions that the City of Edinburgh Council makes are a matter for it.

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Business Activities (Donald Trump)

My colleague Patrick Harvie has written to the First Minister and the Lord Advocate to request confirmation of what action Scottish ministers are taking in the light of the serious concerns that have come to light regarding Donald Trump’s acquisition of property in Scotland. Mr Trump was recently found guilty on 34 counts by the New York state Supreme Court, including on counts of falsifying business records relating to his Scottish properties. Since 2017, Scottish Greens have called on ministers to apply for an unexplained wealth order under the Proceeds of Crime Act 2002 to investigate Trump’s activities in Scotland. Ministers have said for years that they cannot confirm or deny whether Trump is under investigation but, in that same period, an investigation and a court case have taken place in New York.

Faith in Scotland’s justice system is being put at risk by the appearance of inaction in the face of potentially serious criminal activity by a rich and powerful individual, so will the First Minister provide an update on whether an unexplained wealth order will be sought regarding Donald Trump’s Scottish business activities?

I understand Mr Greer’s points. Any decisions arrived at by the Supreme Court in New York are a matter for that court. There is a process that must be undertaken in Scotland for any unexplained wealth order. That process is taken forward by the civil recovery unit, which is responsible to Scottish ministers under the Proceeds of Crime Act 2002, and the matter would be for that unit to consider.

In the light of Mr Greer’s question, I will explore whether anything more can be said about that, and I will write to him if anything can be added to what I have placed on the record today.

That concludes First Minister’s question time.