National Health Service (Urgent Care)

First Minister’s Question Time – in the Scottish Parliament at on 13 June 2024.

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Photo of Douglas Ross Douglas Ross Conservative

I begin by wishing Scotland’s men’s team the very best of luck as they open the Euro 2024 tournament tomorrow night against Germany. The tartan army has travelled in huge numbers to support Steve Clarke and the team, and I know that we will all be cheering them on to success. [ Applause .]

This week, during the election debate in Glasgow, Anna McLintock asked John Swinney what he would do to improve Scotland’s health service. She spoke about her 93-year-old mother, who needed urgent care but had to wait six hours for an ambulance to arrive and then another two hours outside the hospital before she was admitted. John Swinney did not have answers for Anna on Tuesday, so what does he say to her now, and to so many other people across Scotland who have found themselves in the same situation?

Photo of John Swinney John Swinney Scottish National Party

Before I address the substantive question that Douglas Ross has put to me, I, too, put on record my good wishes to Scotland’s men’s team, which will play hosts Germany in the opening match of Euro 2024. If I can say so to the Parliament, it is great to see Scotland back in Europe, where we rightly belong.

As First Minister, I wish Steve Clarke’s team the best of luck, and I wish the huge numbers of Scotland supporters who are making the journey a safe and memorable trip. I know that the tartan army will be an absolute credit to Scotland, and I know that the team will be a credit to Scotland, because it has inspired so many of us by its success in getting to Euro 2024. I look forward very much to being present to encourage the Scotland team on Friday evening, to ensure their success on Friday night.

Mr Ross has raised a significant issue. In the television debate the other evening, I apologised to Anna McLintock for the experience that her mother had had.

One of the challenges that we face is the volume of demand for health service utilisation in Scotland. There is also a challenge because of the level of delayed discharges from hospitals, which means that our hospitals are operating at very high levels of occupancy.

What we are doing about that is to try to work with local authorities to tackle the issue of delayed discharge. We have had extensive discussions. I, personally, have had discussions with the leadership of the Convention of Scottish Local Authorities, and the Cabinet Secretary for Health and Social Care has followed that up to work to reduce delayed discharges and congestion in our hospitals.

In addition, we are investing in our health service to the extent that we now have record levels of staffing to ensure that we can meet the needs and demands of the population in Scotland.

Although I acknowledge that not everybody is getting the treatment that they require as quickly as they require it, a very focused effort is being undertaken within the Government and our health boards to make sure that that can be delivered in all localities in Scotland.

Photo of Douglas Ross Douglas Ross Conservative

The First Minister has apologised again to Anna McLintock, but many more people like her are concerned about the safety and wellbeing of their parents and grandparents. Anna asked the First Minister and other party leaders, “Is our NHS broken?” That is the concern of people up and down Scotland, who cannot get a general practitioner or dentist appointment; who are waiting too long for ambulances or to get into accident and emergency departments; and who need urgent care but cannot get it when they need it. All that those people seem to get from John Swinney and the Scottish National Party are excuses. Do they not deserve to hear the solutions?

Photo of John Swinney John Swinney Scottish National Party

I have set out the solutions in my earlier answer to Mr Ross. The Government is very focused on ensuring that the national health service meets the needs of individuals. We all want the NHS to be able to deliver what people require when they require it.

The Government has taken the hard decisions to increase the resources that are available to the NHS. If we had, for example, just passed on the consequentials to the health service that were allocated through United Kingdom funding formulas, we would have passed on a lower amount of money than we have actually invested in the national health service. This Government has taken hard decisions about increasing tax on higher earners so that we can allocate more resources to the national health service.

I accept that, even having undertaken that allocation of increased resources, there remain significant strains on the national health service. The point that I made on Tuesday evening—in the discussion in which Mr Ross and I were involved—is that we cannot have, as an outcome of this election, a continuation of the Conservative Government’s austerity, because that would be disastrous for the national health service.

Photo of Douglas Ross Douglas Ross Conservative

The national health service in Scotland has been under the remit of the SNP and John Swinney for 17 years. Another audience member said to Mr Swinney on Tuesday that he should not put the blame elsewhere but should take responsibility. Again, we are getting the same from John Swinney—he is taking no responsibility for Scotland’s NHS. He said that the NHS should meet the needs of individuals, but it is not doing so. It is clear to all of us that it is not meeting the needs of individuals.

Elderly people are routinely left waiting for care in our national health service for far longer than they should be. We have a response to a freedom of information request that shows just how stark the situation is. Patients who are aged over 100 are some of the most vulnerable in our communities. In just over a year, hundreds of them have been made to wait beyond the target treatment time in A and E departments. In more than 100 cases, people aged over 100 have been waiting more than 12 hours for emergency treatment. People who are over 100 are waiting for more than half a day to get emergency treatment in Scotland’s NHS. Those are only the figures for people aged over 100—many more elderly people are waiting in agony, too. John Swinney must surely agree that that is appalling and unacceptable. What is he going to do to fix it?

Photo of John Swinney John Swinney Scottish National Party

As I always indicate to Parliament when I am responding to questions, I take responsibility for the actions of my Government and the public services delivered on its behalf—that is my duty as First Minister on all occasions.

I suspect that the situation that Mr Ross recounted is addressed by the fact that our hospitals are operating at such a level of congestion that individuals are not able to be transferred from accident and emergency into wider hospital care for the simple reason that those hospitals are congested because of delayed discharge. That is the explanation of the problem.

The solution to the problem is, as I said in my first answer, to work with local authorities to expand the provision of social care in the community to ensure that we address the delayed discharge issue.

Ultimately, it comes back to the resources that are available to the national health service. I have set out that this Government has taken responsibility for that, because we have been prepared to take the hard decision to increase tax and ensure that more resources have been allocated to the national health service.

Mr Ross would be in a stronger position if he had not argued for me to follow the budget of Liz Truss. That was what Douglas Ross wanted me to do. He wanted me to follow—[ Interruption .]

Photo of John Swinney John Swinney Scottish National Party

He wanted me to follow the tax-cutting agenda of Liz Truss. If I had done that, it would have been catastrophic for the country and the national health service, and I am really glad that I did not do it.

Photo of Douglas Ross Douglas Ross Conservative

I would quite like John Swinney to focus on Scotland’s NHS and our elderly patients, who are waiting far too long to get the treatment that they deserve. He mentions delayed discharge. The cabinet secretary to his left—Shona Robison—promised to eradicate it seven years ago. Seven years ago, the SNP was going to get rid of delayed discharge altogether, but it is still having a huge impact on our NHS now.

Our FOI query only shows the problems in A and E departments and in ambulance waiting times. However, as we have raised with the SNP many times, there is a crisis at every single level of Scotland’s NHS. The number of GP appointments has fallen by 146,000 in the past three years. Over the past 10 years, the number of GP practices has reduced in every single health board across the country. In rural areas, they are shutting at twice the rate of those in urban areas. People across Scotland do not have access to the healthcare that they need and deserve, and that has to change.

We already know what will be line 1 of the SNP’s manifesto. How far down John Swinney’s list of priorities will Scotland’s NHS be?

Photo of John Swinney John Swinney Scottish National Party

The NHS is at the top of my list of priorities—[ Interruption .]

Photo of John Swinney John Swinney Scottish National Party

That is why Scotland has an accident and emergency system that is the best performing in the United Kingdom and has been so for the past nine years—[ Interruption .]

Photo of John Swinney John Swinney Scottish National Party

That is why the NHS is at the top of my list of priorities. On general practitioners, we have more GPs per head of population in Scotland than any other part of the United Kingdom, which are able to provide care to people in various parts of our country.

On priorities, I say to Douglas Ross that we can tell how Governments act by the resources that they allocate. This Government has taken the tough decision to increase tax on higher earners so that we can invest more in the NHS than was proposed by the Conservative Government in the consequentials. That tells us that the Scottish Government is giving the necessary priority to the national health service.

Mr Ross asked me about the question of independence, and I will answer his question very directly. Scotland would be in a stronger position to take greater decisions about investment in the NHS if we had the full powers of independence to use the resources of our country to create the best future for our country. I am proud to represent that position.