2. 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

.]

The Presiding Officer:

Thank you, members.

The Audit Scotland report—[

Interruption

.]

The Presiding Officer:

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

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?

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.

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.

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.