Audit Scotland has today published yet another damning report on the Scottish National Party’s mismanagement of our national health service. It is grim reading for John Swinney, but more devastating for patients and staff.

The report found that

“despite more money ... and more staff ... NHS Scotland’s performance has not improved in line with commitments made by the Scottish Government.”

It says that NHS boards are

“struggling to break even, with seven ... requiring ... Government loans”

and it exposes an “implementation gap” between SNP announcements and the reality for patients. Is it not a damning indictment of John Swinney that, despite his promises, long waits persist, and that, in his hands, the NHS is, in Audit Scotland’s words, “unsustainable”?

Anybody who observes these exchanges at First Minister’s Question Time will understand that I am the first to accept that there are challenges in ensuring that the NHS recovers from the disruption of the two years of the Covid pandemic. I accept that that challenge exists, but significant progress is being made. For example, the number of planned and performed operations in Scotland represents the highest level since January 2020, before the pandemic. In the 12 months to October 2025, 297,014 operations were planned, which is a 4.5 per cent increase from the previous 12 months, and 271,328 operations were performed, which is an increase of 4.6 per cent. That demonstrates that, although there are challenges, progress has been made, and the plans that I have put in place to focus on long waits are beginning to take effect.

The NHS needs to recover from John Swinney and the Scottish National Party. That is the problem that we have across the country. His predecessor promised to end waits of more than a year by September 2024—he failed. John Swinney has promised to end waits of more than a year by March 2026, but, right now, more than 11,000 patients have been waiting for more than two years. What is the result? Figures published this week show that a record number of patients are being forced to go private, with 13,455 private admissions between April and June this year. People in pain are being forced to remortgage their homes and spend life savings to get the treatment that they need.

The founding principles of our NHS—that it is free and available at the point of need—are being destroyed by the SNP. Why is John Swinney doing what even Margaret Thatcher failed to do, which is to privatise healthcare in Scotland?

It is interesting that Mr Sarwar has shifted the ground of his argument on private treatment. Some months ago, Mr Sarwar put to me a figure that was a much more significant accusation on the amount of private treatment that was under way. I cannot remember the exact proportion, but it was of the order of something like one in six of the population, which was absolutely a ludicrously nonsensical figure. Mr Sarwar has changed his ground.

Let me give Mr Sarwar some reassurance about what is happening about long waits. Between April and October this year—[ Interruption .]

Let us hear one another.

Between April and October this year, new out-patient waits of more than a year reduced by 17.9 per cent—that is just since April. In the same period, the waiting list size for new in-patient and day-case procedures waiting more than 52 weeks has reduced by 26.1 per cent.

I say to Mr Sarwar that I accept that there are challenges in the national health service as a consequence of the Covid pandemic, but this Government is delivering on the progress that I said would be made.

I think, on the basis of that rambling response from the First Minister, that he needs some time off and a wee rest. SNP-run Scotland was the only United Kingdom nation where there was an increase in private admissions during the period that I cited. The truth is that Scots are paying the price for John Swinney’s incompetence. Thousands are forced to go private to get the treatment that they need, remortgaging homes or borrowing money to pay, for example, £15,000 for a knee replacement, more than £14,000 for a hip replacement or £3,000 for cataract surgery. That means that Scots have been forced to pay at least £59 million of their own money, on top of their taxes, for cataracts and hip and knee replacements in the past year alone.

That breaches the founding principles of our NHS that healthcare is free and available at the point of need and that access is not based on the ability to pay. People who cannot raise the money are left to wait in pain and anxiety. Why is John Swinney forcing Scots in need to choose between paying the financial cost and paying the human cost of his incompetence and failure?

I simply remind Mr Sarwar that our national health service was disrupted for a period of two years because of Covid, and there is a backlog in treatment. We are working hard to ensure that we reduce that backlog.

To reassure Mr Sarwar, the amount of hip and knee operations reached an all-time high in 2024. As I have just recounted, we are now performing more operations in the national health service, and we are now back to performing at the pre-pandemic level, which is an indication of the effectiveness of the reforms that I have put in place and of the plans that are being delivered for people in Scotland. On that basis, the Government is absolutely focused on ensuring that the national health service meets the needs of people in Scotland as we recover from Covid and delivers on the expectations of the people of our country.