Seòmar agus comataidhean

Will the minister accept an intervention?

I hope that the minister will give some indication, either now or during the debate, of when that review will take place and when we will have a report on that.

Actually, I did not move it, Presiding Officer.

Obviously, I share the concerns, but Ariane Burgess must consider that the approach by the Parliament must be evidence based and tested by it. I do not want any of that to happen, and I very much agree with the minister that we require, for the sake of all parties, to have evidence. When there is evidence, flexibility is built into the primary legislation. It does not need to be amended.

On a point of order, Presiding Officer. I was unable to vote. I would have voted no.

With reference to the extreme winter pressures, I welcome the announcement of £8 million for interim social care beds to ease pressure on our hospitals. I note that it is to be shared between health and social care partnerships. When will we hear progress about the division of that money between the partnerships, particularly those serving my constituency of Midlothian South, Tweeddale and Lauderdale, which includes both NHS Lothian and NHS Borders?

To ask the Scottish Government what recent discussions it has had with NHS Borders and NHS Lothian. (S6O-01796)

I, too, put on record my gratitude to all who work across our NHS and care sector in whatever capacity.

I now address the Labour motion. It would have more heft if it at least mentioned, if only in passing, the devastating impact of Covid and the years to follow when the NHS throughout the UK and healthcare throughout Europe and the wider world dealt with a raging pandemic and adapted procedures in the face of the virus, which brought what I might term the usual provision of healthcare to a standstill.

The motion also does not recognise that it will take years for recovery. To this day, sanitation is high, mask protection continues and ambulances have to be sanitised after every patient. All that adds to delays, and Covid still stalks hospital corridors. Add to that the pressures of influenza—not mentioned by Labour—which can be very serious and, despite vaccination, is possibly proving more so to some groups of people, including me, because we have reduced resistance after years of wearing masks and sanitising our hands.

Then there is the welcome but extra pressure of the demographic shift, which also went unsaid in the Labour motion. We all live longer, which is a good thing, but age naturally brings additional demands on our health services and care sector. Wherever we look in the UK, the issues remain the same. Indeed, the situation is worse in Wales—where Labour is in government—than it is in England under the Conservatives. I do not say that with even a slight degree of satisfaction—not in the least—but do so simply to put today’s debate into context.

Also for context, I say that, in my 24 years as an MSP—during the Labour-Liberal Democrat coalition and to date—much of the attention has been on firefighting the increased demands on the NHS. Some good progress was made, and I welcome free personal care under the Labour-Liberal Democrats, and, of course, free prescriptions, free school meals for those in primary 1 to primary 5 and the child payment, all of which are interventions made under the SNP Government that are aimed at reducing NHS pressures. In England, it costs more than £9 per item prescribed, and therefore some people who live south of the border are rationing their medication to the endangerment of their lives let alone their health.

The problem is, as it always has been, how to move from the immediate demands, which are exacerbated as I have narrated, to a medium to long-term solution. I therefore welcome this suggestion by the British Medical Association:

“BMA Scotland is calling for a National Conversation with all stakeholders, to take a long-term approach to what we want and expect from our NHS. Only when we fully understand what we need and want from the NHS can proper consideration be given on how we resource it.

The National Conversation, commissioned by but independent of the Scottish Government, would act as a facilitator for a dialogue between the public, health and care stakeholders, Scottish Government and political parties; its purpose is to inform the reform, it must have practical outcomes that are part of a long-term vision for NHS Scotland.

Now is the time to seriously consider what the NHS provides within the resources we provide it with, and ask the difficult questions around what we as a society want from a National Health Service free at the point of need, what we can afford to deliver and how we deliver it. There are no easy answers.”

I agree.

Covid was a wake-up call for all of us to the growing needs of those who receive care at home or in care homes and the varying standard of that care; integrating health and social care; the standardisation of care provision; recruitment and retention; and the expanding use of pharmacies and allied health professional services so that the right treatment is provided at the right time by the right health professional. All of that is not easy, as the BMA stated.

I will come on to resourcing.

During this thoughtful discussion, we should consider the following questions: what is the role of health boards? What should the relationship between GP practices and health board areas be? Should more GPs be directly employed by the NHS rather than in private practice? How much more can technology be used? What should the state provide in the care sector? What kind of workforce do we need and where do we get it when some options are closed because of Brexit? What will be required as our ageing population increases? How does our society afford expensive treatment and drugs? What price do we put on all that, and how do we fund it?

This is the only party-political thing that I will say: as a result of the disastrous and costly funding of public buildings, including in the NHS, using the private finance initiative under Labour, the cost each year to the Scottish Government in repayments to the private sector on NHS buildings alone runs at £250 million, which could have been better spent on services.

It is the job of the Opposition to hold the Government to account, but too often that is with press headlines in mind. Opposition members must offer solutions and, most importantly, credible funding sources from what is virtually a fixed budget, now reduced in value by £1.4 billion due to inflation.

I say to members in the chamber: less heat and more light, please. Turn down the volume on theatrical rhetoric; turn up thoughtful and responsible debate. That is what the Scottish public want.

According to the list on the UK Government website, as of 21 December 2022, there were 41 countries from which the UK does not require medical reports in relation to applications for gender recognition in the UK. I presume that that does not impact on the Equality Act 2010. Can the cabinet secretary advise members why breaching the Equality Act 2010 applies only when the Scottish Parliament, by an overwhelming cross-party majority, merely does what many other countries have done, or will the UK Government’s position result in the UK removing 41 countries from that list?