National Health Service

First Minister’s Question Time – in the Scottish Parliament at on 16 May 2024.

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Photo of Anas Sarwar Anas Sarwar Labour

After 17 years of this Scottish National Party Government, the crisis in our national health service is deepening. More than 820,000 Scots are on NHS waiting lists; people who are waiting in pain are using their savings or borrowing money from loved ones to pay for private treatment; people cannot get general practitioner appointments; and 169,000 patients have waited more than four hours for treatment in an accident and emergency department since the start of this year.

Now, because of the Government’s financial mismanagement, the NHS and social care services face a black hole of up to £1.4 billion this year. That has led the finance director of NHS Greater Glasgow and Clyde—Scotland’s biggest health board—to warn that spending on every service would need to be reviewed.

Our NHS faces the biggest crisis in its lifetime, but health boards are being asked to make cuts across the country because of decisions that John Swinney has made. Does the First Minister accept responsibility? What will he do to fix the mess that he has made?

Photo of John Swinney John Swinney Scottish National Party

It is very important that we have a substantial discussion about the public finances and the context in which we are operating. In Scotland, we are operating after 14 years of austerity that have put insufferable pressure on our public services. Within that, the national health service has been the best financially supported of any service in Scotland.

Anas Sarwar could have come here today to ask me about financial pressures on local government—he would have been right to do so, because there are financial pressures on local government—but he is raising with me financial pressures on the national health service, which is the public service that has been best funded by the Government.

I have set the context for Anas Sarwar’s question, because he and his colleagues have to understand that Scotland is now paying an intolerable price for 14 years of Westminster austerity.

Photo of Anas Sarwar Anas Sarwar Labour

John Swinney and I do not disagree on the fact that we need to get rid of a rotten Tory Government that has destroyed the United Kingdom over the past 14 years—there is no disagreement on that. However, after 17 years in government, there is always somebody else to blame. How about taking some responsibility for the decisions that are made here, in Scotland?

The First Minister made no effort to address the scale of the crisis that our NHS is facing. Instead, he went to his get-out-of-jail-free card, which is to blame the UK Tory Government. His financial mismanagement and the £1.4 billion black hole that it has created will impact on the delivery of every service in every part of the country.

Let us look at the past few weeks’ announcements: Inverclyde’s out-of-hours GP service has been permanently closed, with patients now facing a 50-mile round trip to access overnight appointments; in the city of Glasgow alone, more than 150 jobs have been lost in health and social care services; in North Ayrshire, care homes have been reduced and charges for vulnerable people have increased; and, in Edinburgh, unions have warned that social care cuts will mean that, in their words,

“Thousands of hours of support will be cut; hospitals, care homes, prison cells and morgues will fill up as a consequence.”

Stop passing the buck. Stop looking for somebody else to blame. John Swinney has been at the heart of the SNP Government for 17 years. Is that not a damning indictment of his record?

Photo of John Swinney John Swinney Scottish National Party

I will never evade responsibility for my actions as a minister; it is not in my character to do so. However, I will be straight with the Parliament and the public in Scotland.

If anyone wants to look at all the things that I have said on the parliamentary record over the past 17 years, they will find me being straight with people about the financial challenges that we face. I also happen to be a former finance minister who balanced the budget on 10 occasions over the past 17 years. That involved taking difficult decisions to protect our public services, and it resulted in the national health service being the best-funded service among our public services.

We have also had to take some pretty tough decisions, for which I take responsibility, such as increasing tax on higher earners. Mr Sarwar has deserted that territory. Mr Sarwar and Mr Marra no longer believe in that territory. They voted for it once, and they now condemn it.

How does Mr Sarwar believe that we can invest as much as we do in the health service today if we are not prepared to ask people to contribute more in taxation? That gives us £1.5 billion more in revenue at our disposal, because of decisions for which I am absolutely happy to take responsibility. As a consequence of that, we can fund the national health service better than if we had relied simply on the financial settlement from the United Kingdom.

Photo of Anas Sarwar Anas Sarwar Labour

It demonstrates the First Minister’s economic incoherence that he supports higher taxes for nurses but lower taxes for oil and gas giants that are making record profits in the middle of a cost of living crisis.

Our NHS is weaker than ever. Staff are under unbearable pressure and patients are being asked to accept the unacceptable, all because of the decisions that this Government has made.

As Deputy First Minister, John Swinney cut hundreds of millions of pounds from health and social care budgets. He said that he does not want to “evade responsibility” for the decisions that he has made. Let me remind him of just one group of decisions that he made in one year alone.

He cut £70 million from social care while people were stuck in hospital, unable to get a care package. He cut £65 million from primary care services, making it difficult for people to get a GP appointment. He cut £38 million from mental health services, leaving people in crisis waiting for longer to get the help that they need. He raided integration joint board budgets for more than £300 million. Those are the same local services that face funding gaps just now.

I say to John Swinney: do not evade responsibility. Stand up, apologise for the decisions that you have made and recognise why people across Scotland are asking, “How can the man who made the mess now be the one to fix it?”

Photo of Alison Johnstone Alison Johnstone Green

Always speak through the chair, Mr Sarwar.

Photo of John Swinney John Swinney Scottish National Party

It is a bit rich for Anas Sarwar to come to the chamber and criticise me for decisions that I have taken, when he supports a party that wishes to relieve bankers of the obligation to pay into our tax system by lifting the cap on their bonuses. That is a ludicrous position.

This morning, I listened to the contribution from Keir Starmer in which he set out Labour’s policy position. I did not hear Keir Starmer setting out an uplift in public expenditure as a consequence of 14 years of austerity.

Photo of John Swinney John Swinney Scottish National Party

Mr Sarwar has accepted my point that austerity has been a curse on our society. Despite that austerity, however, resource funding for the national health service has more than doubled since this Government came to office in 2007.

We have taken tough decisions to increase tax in order to invest more in the national health service. We have made the national health service the best financially supported service of all public services in Scotland, and we are absolutely committed to delivering for the national health service.

Anas Sarwar cannot come to the chamber and deny that we have been operating in a significantly constrained public expenditure context and that we have delivered the best settlement that we can for the national health service.