First Minister’s Questions (BSL) – 1 June 2022`
I start in the way that we are now more regularly starting these proceedings—by wishing Steve Clarke and the team all the very best tonight. It is a major game, as the Scottish national men’s team is now just two matches away from potentially qualifying for the world cup for the first time since 1998. I know that the whole Parliament will wish them well—the players on the pitch, the manager and the team around them, and of course the outstanding tartan army, who will be roaring them on to victory tonight.
We wish them all the very best. In the middle of a cost of living crisis, with so many families struggling, why is the First Minister’s Government allocating another £20 million for an independence referendum? I, too, begin by taking the opportunity to wish Steve Clarke and the team every success at Hampden this evening. I will be there, cheering on Scotland. We all want Scotland to win and to qualify for the first world cup that we would be at in a long, long time. That said, I think that I can speak for everybody at Hampden this evening when I say that, no matter how strongly we will be supporting Scotland, a bit of all our hearts will be with Ukraine, as we continue to stand in solidarity with them in this hour of need. Just as the tartan army this evening will, as it always does, belt out “Flower of Scotland”, I hope that we will also stand and show a real passion for Ukraine’s national anthem.
Good luck to Steve and the team. I thank Douglas Ross warmly for allowing me to set out exactly why giving the people of Scotland an opportunity to choose a better future is so important at this particular moment in time. In many ways, the resource spending review that Kate Forbes set out yesterday sets out the very heavy price that people across Scotland are paying right now for continued Westminster decision-making. As a result of United Kingdom Government decisions, our budget this year has been cut by more than 5 percent in real terms, and growth in our budget over the next four years will be constrained to 2 percent, while inflation is close to 10 percent. Of course, thanks to the folly of Brexit, inflation is higher in the UK than it is in any other G7 country. Every year, the Scottish Government is having to invest more than £700 million to mitigate the impact of Westminster policies that Scotland did not vote for, such as the bedroom tax, the rape clause, and the removal of universal credit, which has plunged more people into poverty. Yes, I think that spending £20 million—0.05 percent, or one-half of one-tenth of 1 percent, of the entire Scottish Government budget—to give the people of this country the opportunity to choose a better future is and will be, a really good investment.
In her answer, the First Minister never once mentioned the cost of living crisis that Scots are facing right now. She never once even attempted to address that issue. She gets very excited and animated when speaking about independence and dividing our country all over again, but there was not a single word for people who are struggling right now and who do not understand why her Government is prioritizing another independence referendum. Spending £20 million on a divisive referendum in the middle of a cost-of-living crisis is shameful. Nicola Sturgeon’s eye is off the ball all over again. I ask members to resist the urge to heckle from a sedentary position.
The First Minister is obsessing about independence when people across Scotland overwhelmingly want the focus to be on the issues that matter to them. Let us look at the £20 million. It could pay for more police officers, more teachers, and more nurses. It could pay for more support for people facing rising energy bills and higher costs at the supermarket. Charging ahead with a plan to divide us is the wrong priority when, now more than ever, we need to pull together, using the strength and security that we get as part of the United Kingdom to see us through the cost of living crisis, just as that saw us through the Covid pandemic. Just how much worse does the cost of living crisis have to get for individuals right across Scotland before the First Minister diverts money away from an independence referendum? Douglas Ross stood up and said that I did not mention the cost of living crisis. I suggest that he might want to consider what is causing the cost of living crisis. It is soaring inflation. As I said, thanks in large part to the utter folly of Brexit, which was imposed on Scotland by Tory Governments, inflation is higher in the UK than it is in any other G7 country.
That is part of the price of the Westminster government. It is a Tory-created cost of living-crisis. How much worse does it have to get before the Conservatives take it seriously and provide real, proper help to people across this country? Douglas Ross stands here and asks me about spending £20 million—which is, as I said, one-half of one-tenth of 1 percent of the entire Scottish budget—to give the people of this country the option of a better future.
He never stands here and apologizes, as he should, for the fact that this Government is required every year to invest more than £700 million to mitigate the effect of Tory policies that we in Scotland do not vote for. That money is spent to mitigate the awful rape clause, which was imposed on Scotland by the Tories; the awful bedroom tax, which was imposed on Scotland by the Tories; and the poverty that Tory policies are plunging so many people into. It is also being spent to mitigate austerity, which research from the Glasgow Centre for Population Health has said has caused a “stalling” in improved life expectancy in Scotland and across the UK. Yes, I think that £20 million to give Scotland the choice of a better future—a Tory-free future—is a good investment. If we look at the opinion polls, I suspect that Scotland is well on the way back to being Tory-free anyway.
Let us remind ourselves that, thanks to this Government, we have more police officers and more primary school teachers than at any time since 1980, so I will get on with the job of delivering for Scotland and, I hope, of freeing Scotland from the continued Westminster Tory Government. The First Minister now just makes it up as she goes along. She is saying that the UK Government is doing nothing to help people. What about the £37 billion investment in this country to help people who are struggling? Eight million people—including the lowest earners across Scotland—will get at least £1,200 in additional support, as announced by the Chancellor of the Exchequer just last week. Despite what the First Minister tried to say in her first answer, we know that her Government has received from the UK Government the biggest block grant ever, which the Scottish Government has squandered.
The spending review shows the real cost of the SNP’s failures for the Scottish public, such as the fortune that has been wasted on ferries, Burntisland Fabrications, and Prestwick airport, and the failures at Queen Elizabeth university hospital—the list goes on and on. The consequences of those failures for our country are devastating. The Institute for Fiscal Studies says that the next two years will mean “really big cuts in planned spending on public services”. Because of the failures of Nicola Sturgeon’s Government, we are facing severe cuts to budgets for the police, prisons, schools, councils, rural affairs, enterprise, tourism, and higher education. Scotland is paying the price for Nicola Sturgeon’s mistakes. The spending review was damning. Does that not show that we are facing the worst financial outlook from a Scottish Government since devolution? Let us look at those issues, in turn, Presiding Officer. First, let us look at the help that the chancellor announced last week—I will say in passing that it is deeply regrettable that it took the party gate crisis, from which Boris Johnson wanted to divert attention, for the chancellor to lift a single finger.
The £400 in universal support, welcome though it is, is a fraction of the projected increase in energy costs that families across the country are facing. The support for the lowest-income families is, again, very welcome, but it does not even come close to putting back the £1,000 that was taken out of the pockets of the lowest-income families in the clawback of the £20 a week of universal credit. Much more needs to be done by the UK Government.
Secondly, on the Scottish Government’s block grant, would it not be better if we had responsibility for raising our revenue rather than having to rely on a block grant from someone else? Douglas Ross says that it is the biggest-ever block grant. This year, because of Westminster Tory decisions, Scotland’s budget is reduced in real terms by 5.2 percent. If that is the biggest grant ever, I am not sure that that is much for the Tories to crow about. Next, Douglas Ross says that money that has been spent to save BiFab, Ferguson’s, and Prestwick airport is wasted money. I think that that says everything that we need to know about the Tories’ approach to jobs—they do not care about people’s jobs. Finally, yesterday, Kate Forbes set out ambitious plans that back our priorities of tackling child poverty, protecting public services, moving to net zero, and supporting the economy. Do I wish that we had more money to allocate? Yes, I do.
However, the Government’s budget is largely determined by decisions that the Tories are taking. Therefore, everything that Douglas Ross has just said does not detract from but makes the argument for this Parliament and this country to become independent. First Minister, stop running from your failures and start to own them. Blaming the Westminster bogeyman does not cut it with the public, who are struggling because the First Minister’s decisions are devastating for the people of Scotland. The Scottish National Party and the Scottish Government are running our finances into the ground, and all that we have heard from the First Minister today is that she has cash for another referendum but cuts for Scotland’s public services.
The most damaging cuts will affect Scotland’s young people. The First Minister used to grandstand, saying that she would close the attainment gap between rich and poor. How is that going? She promised to make education her number 1 priority. How is that going? The Scottish public was told to judge her on education, but she has failed and now she has given up trying.
The education budget is being slashed to the bone. The First Minister likes to talk about Scotland’s future. We want money to be invested in Scotland’s future, but in schools, not in separation. Why put £20 million behind the push for another referendum when it could be spent on delivering opportunities for our young people across Scotland? It is of course just a fact that the size of the Scottish Parliament’s budget is largely decided by decisions made at Westminster. If Douglas Ross does not like the outcome of that, perhaps he should have a word with his bosses at Westminster, or better still, support this Parliament and this country having full financial responsibility. Douglas Ross asked me how the work that is being done to close the attainment gap in education is going. I will be delighted to give him a progress report on that today, and he does not have to take my word for it—I will quote the commissioner for fair access who, just yesterday, talked about progress in closing the attainment gap in access to university. The commissioner said that the work of the Scottish Government has been “an unambiguous success”, and Scotland is now leading the UK.
There is the progress report on education. We know the real reason for all of Douglas Ross’s bluster today. Before I go on to that, let me reiterate— First Minister, let me stop you for a moment. I have already asked members to resist the urge to contribute when it is not their turn to speak. I would be grateful if they could bear that in mind.
For the avoidance of doubt, I reiterate that, if spending £20 million wins this country a better future in which we do not have to spend £700 million on mitigating Tory policies, then yes, that is a good investment. The reason for Douglas Ross’s bluster today is, of course, that we know that the Tories and Douglas Ross are not very popular among the Scottish people. However, as of this week, we also know that Douglas Ross has never been less popular with Conservative voters. For the first time, he has got negative approval ratings and is in the unenviable position where the only Tory who is less popular among Conservative voters is his boss, Boris Johnson. No wonder he is in a bit of a state today. Tonight, almost everyone in the world will be supporting Ukraine—if they were playing any other country in the world, I would probably be supporting them, too.
As they are playing us, I will be cheering on Scotland and the tartan army. I wish Steve Clarke, Andy Robertson, and the entire Scotland men’s football team all the very best for tonight. I hope that they can take us to the world cup. Can the First Minister tell members how many people were on national health service waiting lists a year into the Scottish National Party Government, before the pandemic in March 2020, and how many Scots are on waiting lists now? I will provide the member with the precise figures, but I do not have them to hand.
I do know that more people are on NHS waiting lists now, post-pandemic, than will have been the case at many points in recent years. That is not only the case in Scotland; it is the case across the United Kingdom and much of the world because of the pressures of Covid. I also know that, before the pandemic, significant progress was being made in reducing waiting times. For example, before the pandemic, the number of people who were waiting for a first out-patient appointment had reduced by 21.3 percent. Over the same period, the number of people who had to wait more than 12 weeks for an out-patient appointment had fallen by more than 30 percent, more appointments had been carried out under the in-patient treatment time guarantee and the number of people who had to wait more than six weeks for one of the eight diagnostic tests was down by 25 percent.
That is the progress that was being made. That has been set back by the pandemic, which is why our recovery plan and the significant additional investment that is going into the national health service are so important. The First Minister does not need to send me the stats—I have them right here. The answer that the First Minister was looking for is that a year into the Scottish National Party Government, there were more than 260,000 people on an NHS waiting list. That number had risen to almost 420,000 before the pandemic, in March 2020. Today, that figure stands at more than 708,000 people—one in eight Scots are on an NHS waiting list. The First Minister referenced the recovery or catch-up plan. Surely the term “catch-up” means that the number of people who are waiting would go down, instead of going up, but there are nearly 60,000 more people on an NHS waiting list than there were when the Government announced the catch-up plan back in August. Let me try another question. How many people had to wait more than a year for in-patient treatment when the First Minister took office, and how many are having to wait more than a year today? More people are waiting more than a year today, and I think that most people understand that that is because of the impact of the pandemic.
The latest quarterly figures show an increase in the number of people who have been seen, whether as in-patients, out-patients, or for diagnostic procedures, compared with the previous quarter. That shows the impact of the improvement and catch-up work that is being done. Although we are in a much better position, we are, of course, still in a pandemic. Since the recovery plan was published, we have had another wave of the pandemic. I think that people understand the impact that that is having on our NHS, but they can also see that an increased number of people are working in our NHS and that increased investment is going into our NHS, and they will start to see an increase in the number of patients who are seen and an impact on waiting times.
Regardless of which party is in government across the United Kingdom—the SNP in Scotland, the Tories in England, or Labour in Wales—the NHS is facing the same challenges, but on many measures, the NHS in Scotland is doing better than the NHS in the other UK nations. I have already referenced the fact that the waiting list figures have gone up, not down, since the catch-up plan was announced. As is typical when the First Minister is struggling, she wants to talk about Wales. I remind her that she is paid to care about the people of Scotland because she is Scotland’s First Minister. Here is the answer that the First Minister could not give or does not want to give—and let us remember that there is a legal guarantee that treatment will be provided within 12 weeks.
When Nicola Sturgeon took office, the number of people who had to wait more than a year was 21. As of today, that number is more than 30,000. That is not the number who are having to wait more than the legal period of 12 weeks; it is the number of our fellow Scots who are having to wait more than a year for in-patient treatment, such as a hip replacement, a knee replacement, or a heart operation. Let us look at Nicola Sturgeon’s record on the NHS. She has broken her treatment time law 490,000 times, she has cut more than 4,000 beds out of our NHS and, on her watch, we now have record vacancies for nurses and midwives.
We are 6,000 nurses and midwives short. It is a litany of failures. There is a black hole in our public finances, and we have railways that do not run, ferries that do not sail, and soaring waiting lists in our NHS. Which one is Nicola Sturgeon most ashamed of? I am proud of the work that the Scottish Government does to support the NHS, I am proud of the fact that thousands more people are working in our NHS and I am proud of the fact that the NHS budget has increased by about 90 percent in cash terms since we took office. Anas Sarwar must be the only person in the country, and perhaps the only person on the planet, who does not understand, or is not willing to understand, the impact of a global pandemic on health services in Scotland and around the world. Significant improvements were being made before the pandemic.
The pandemic—during which we had to pause surgery and other treatments in the NHS—has set that back. Now, we are investing and introducing initiatives to catch up on that progress. Anas Sarwar also mentioned beds. I know that he does not like comparisons with Wales when they do not suit him, but the Royal College of Emergency Medicine, which said important things about bed numbers this week, pointed out that Scotland has a higher number of beds per head of population than Wales and England do. Members! Yes, we have lots of work to do, but we have a better foundation to build on than is the case where Labour is in government elsewhere in the UK. We move to the constituency and general supplementary questions. I ask the First Minister for her response to the research that was published yesterday by the University of Glasgow and the Glasgow Centre for Population Health, which she referenced earlier, which suggests that people across the United Kingdom are dying younger as a result of UK Government austerity.
It is appalling and it displays and gives evidence for what many of us have suspected has been the case for some time. The researchers at the Glasgow Centre for Population Health found that “Austerity is highly likely to be the most substantial causal contributor to the stalled mortality trends seen in Scotland and across the UK”. That is down to Tory austerity which, we should remember, was kicked off by Labour under the last Labour Government. We now see the impact of that on people across the country— Members! That is another reason for wanting to get a better future for Scotland. There is inequality across my region when it comes to supporting children with complex needs during the summer. Rob Holland from the National Autistic Society Scotland said: “The lack of services heaps further pressure on families and risks pushing them to breaking point. The availability of short break services should not be wholly reliant on where autistic children live.” What action is the Scottish Government taking to rectify the postcode lottery that autistic children have to endure? I agree that children with autism should have access to good services, regardless of where they live in Scotland, and we would expect local authorities to ensure that they do.
Our duty, which we take seriously, is to support local authorities financially and in other ways. I am happy to ask the education secretary to look at the situation in the region that the member represents and write to him in greater detail. I hope that all local authorities take very seriously their responsibility to support children to catch up on their education. This morning, we learned that the number of people suffering from long Covid has risen to 155,000, which is almost one in 30 Scots.
Last weekend, Dr. Kevin Deans told BBC Scotland that the need for long Covid clinics was absolute and urgent. He said: “We can’t do this”. His intervention destroys the baffling argument from Scottish National Party and Green members that clinics would somehow get in the way of support. The First Minister is devoting twice as much money to her referendum as she is to this awful condition. What does she have to say to the 155,000 sufferers, many of whom are children? Will she revisit long Covid today? The first thing that I will say is that Alex Cole-Hamilton should not misrepresent my position. I have not said that clinics “get in the way” of other support. The argument that I have made and will continue to make is that health boards need to put in place a range of support. Long Covid clinics may well be part of that, and that is for health boards to consider. We will continue to provide funding and support for health boards, including research support to enable clinicians and others to continue to develop their understanding of long Covid and its impact.
Long Covid is something that we take seriously and will continue to take seriously, given, as Alex Cole-Hamilton is right to point out, the significant numbers of people who are living with long Covid and are likely to continue to do so. Last May, the Scottish National Party Government pledged to put in place a replacement for the Erasmus scheme to ensure that, every year, more than 15,000 students from across Scotland have the chance to experience life, learning, and culture abroad. The First Minister has described the removal of the scheme as “cultural vandalism”. The Welsh Labour replacement scheme starts this September. The spending review yesterday was confirmed— Can we hear from Mr. Marra, please? The spending review yesterday confirmed that the Scottish National Party’s scheme will not open until 2026, five years after the promise was made.
How can the First Minister justify that astonishing delay to the 75,000 Scots who will miss out forever? I am not sure whether that was a leadership bid that Michael Marra was launching there or an entirely inadvertent attempt to undermine his leader, who just told me that we should never talk about Wales in this chamber. Perhaps Michael Marra will clarify that in the future. I can say unashamedly that we have looked at the example in Wales and will continue to do so. We remain committed to an alternative to Erasmus and we will set out further details of that in due course. I will tell members what else I am committed to: I am committed to seeing Scotland rejoin the European Union as an independent nation, so that we do not have to have a second-best alternative to Erasmus and can be back in the actual Erasmus scheme, benefiting young people for generations to come. There are eight higher and further education institutions—nine, including the Open University—in my constituency, Glasgow Kelvin.
I am a former teacher, so access to higher education and increasing opportunities are causes that are close to my heart. As schools and colleges finish this year’s national qualifications exam diet, will the First Minister give her response to the report that the commissioner for fair access published yesterday? I very much welcome the report that the commissioner for fair access published yesterday. It is, of course, this Government’s ambition that every child who is growing up in Scotland, regardless of their background, should have an equal chance of going to university, so I very much welcome Sir Peter Scott’s recognition of the excellent progress that has been made. Indeed, I appreciate his role in delivering that outcome. This was his final report, so let me acknowledge and thank him for his commitment, during his time as commissioner, to progressing access to higher education for people from the most deprived areas. The number of entrants on full-time first-year courses from the 20 percent of most deprived communities has increased by 39 percent since Sir Peter Scott took on his role.
The Scottish Government will consider all of Sir Peter’s recommendations carefully and respond in due course. Universities Scotland has warned that eight of Scotland’s universities are set to receive cuts to research funding this year, with four high-performing research institutions facing decreases of greater than £1 million from August. Given that 85 percent of Scottish research is rated world-leading or internationally excellent, why is the First Minister’s Government cutting funding for that vital work? We will continue to support our universities, we will continue to support fair access to our universities and of course, we will continue to support the world-leading research that happens in our universities. It is a bit galling to hear a Conservative member talk about the threats to university research when the biggest threat and the reality for universities are that Brexit has damaged their research potential. Perhaps the Conservatives will want to look to themselves before they raise questions for others on university research. I recently raised with the First Minister the case of a constituent who waited seven months to be diagnosed with an aggressive form of cancer.
We now hear from the international cancer benchmarking partnership and Cancer Research UK that almost two-fifths of cancers in Scotland are being diagnosed in accident and emergency units. This week, I heard from Myeloma UK that in the case of myeloma the proportion is up to a third. How can the Scottish Government reassure my constituents that they will not be made to wait a dangerously long time for a cancer diagnosis? We are already investing in early diagnostic centers for cancers, and we have been investing in the detect cancer early program for some time and continue to invest in that program.
I agree with the member that early diagnosis is vital, for all cancers, and that we must do everything to support that. We also need to encourage people who have symptoms that could be indicative of cancer to come forward to see a doctor as quickly as possible. We will continue to do everything possible to support that early access, because we know that the earlier somebody is diagnosed, the better their chances of survival and recovery. The First Minister will be aware of the long-running campaign to prevent the Yorkshire theme park operator Flamingo Land from developing what it describes as a luxury tourist resort on the banks of Loch Lomond at Balloch.
Our successful campaign to defeat its first application saw a record 60,000 objections lodged, citing damage to ancient woodland, the risk to protected species, the strain on local roads, the impact on access for residents, and a range of other concerns. Sadly, however, Flamingo Land is back, having just lodged a new application. Does the First Minister agree that our national parks are for all of us and that it would be unacceptable for one of the most accessible locations on Loch Lomond to be closed off to all but the select few who will pay to stay in that resort? The Loch Lomond and the Trossachs National Park Authority are responsible for considering planning applications in the national park, so it would not be appropriate, nor indeed would it be helpful, for me to comment on the specifics of any planning application. However, I note that any development must comply with Scottish planning policy and with the local development plan for the national park and that it must also be in keeping with the park authority’s statutory aims.
It is for the park authority to fully consider the application and assess the balance between the impact of the proposed development on the environment and any potential benefits. To ask the First Minister what the Scottish Government’s response is, regarding the impact on Scotland, of the energy profits levy, commonly referred to as a windfall tax, on the oil and gas sector to help support families struggling with the cost of living crisis. After months of delay, the United Kingdom Government belatedly conceded the need for a windfall tax to help those who are struggling to make ends meet—an action that the Scottish Government had been urging it to take. However, we have also made the point that oil and gas companies are not alone in profiting from recent global events and that a windfall tax should apply to all companies that are posting significantly higher profits. The Chancellor of the Exchequer’s failure to implement the levy fairly now means that Scottish industry is carrying a disproportionate burden of funding what is a UK-wide response.
It also means that the available support is still far too limited. By widening out and using the fiscal headroom that is available, the chancellor could have gone beyond one-off measures and introduced long-term strategies, such as introducing an equivalent of the Scottish child payment. Does the First Minister agree that the limited actions taken last week by The Sunday Times rich list chancellor Rishi Sunak do not, although they are welcome, go anywhere near far enough? The Tory cost of living crisis is real for millions across these islands. Food prices are going up, as the Office for National Statistics reported this week; energy costs are going up and are expected to rise again in the autumn; and, at the same time, the UK Government’s Department for Work and Pensions has underpaid claimants by almost £3 billion. Does the First Minister agree that the one thing that the windfall tax shows is the strength of the Scottish economy, as 90 percent of the revenue that is raised from the levy will be drawn from profits that are made in Scotland? That means that, not for the first time, Scotland’s resources are bankrolling the rest of the UK and demonstrating how much stronger a position we would be in as an independent country.
I may go so far as to say that the broad shoulders of Scotland are helping all of the UK at this time. Stuart McMillan is right. First, he is right—this is extremely serious—to say that the help that the chancellor announced, welcome though it was, does not go nearly far enough, given the inflationary cost of living pressures that people are facing right now. I hope that, very quickly, we see and hear further action from the chancellor. Stuart McMillan is also right to say that Scotland’s economy, industry, and resources are bearing a disproportionate burden to prop up the UK Government’s policies.
We called for a windfall tax, but it would be better to see one that was fair and that applied to all companies that are benefiting from excess profits, current global events, or the pandemic. The chancellor has missed a trick with this watered-down levy and has left Scottish industry to foot the bill—not for the first time—for the whole of the UK. The energy profits levy will also encourage investment in, and the development of, new fields such as Cambo. Does the First Minister agree that a growing and prosperous North Sea oil and gas sector is just what we need to support tens of thousands of jobs and fund the types of intervention to cut energy bills that she has just welcomed? My position on Cambo is well known.
What we need to see is greater investment in renewables. Scotland’s potential for oil and gas over the past five decades is now matched by our potential for renewable energy, not least offshore wind. The Scottish Government is investing in that area, and it would be far better if the UK Government followed suit. To ask the First Minister how the Scottish Government plans to address the reported potential spending gap of £3.5 billion in its budget by 2026-27. The spending review is balanced each year, so it is simply not true to claim that there is a £3.5 billion gap in our spending plans.
What the spending review shows, however, is that, in the face of rising inflation, our spending power will be significantly smaller in real terms than what was forecast just a few months ago. What makes matters significantly worse is that the Tory Government is denying Scotland both the powers and the resources to properly address that. The finance secretary confirmed yesterday that the Scottish Government’s budget is today around £7 billion higher than what was forecast just four years ago. That is £7 billion extra from the United Kingdom Treasury that this Scottish Government was not expecting just four years ago. At the same time, both the Scottish Parliament information center and the Institute for Fiscal Studies are telling us that we will see real-term cuts thanks to this Scottish National Party Government’s choices—real-term cuts of 8 percent and more in the years ahead to education, to policing, to justice, to enterprise, to universities, to tourism, to trade promotion and to local government. How on earth did this SNP Government manage to turn an extra £7 billion from Westminster into such savage cuts? Murdo Fraser should probably think twice before quoting the IFS since the IFS had to take to Twitter this week to correct things that he was saying on social media.
The facts are deeply uncomfortable and inconvenient for the Conservatives, but they continue to be the facts. This year—I believe that these are Scottish Fiscal Commission figures—the Scottish budget, in real terms, is 5.2 percent less than it was last year— We will hear from the First Minister. The budget is projected to grow by 2 percent in real terms at a time when inflation is hitting 10 percent. That is the reality. It is also the reality—and a fact—that the size of the Scottish Government’s budget is determined largely by decisions that are taken at Westminster. If the member wants the Scottish Government to have a bigger budget, I will say the same to him as I said to Douglas Ross—either have a word with your bosses at Westminster or, better still, back this Parliament having full fiscal and financial control over our budgets. To ask the First Minister what her position is on whether Scotland’s census 2022 has been a credible exercise. Yes, it has. National Records of Scotland is confident that the national return rate and the coverage across the country, coupled with the normal planned post-collection quality control and assurance work, will provide credible high-quality outputs.
As I have said previously, NRS is working with several statisticians and experts in the census and administrative data to help to steer the work over the next few months. The support and advice from the steering group will help NRS to produce a high-quality census data set—one that will, ultimately, provide us with the right statistical outputs that are needed to inform future service planning. When I asked the First Minister last month about the problems with this year’s census, she said that questions would need to be asked, including about the credibility of the census. We now need answers about the timing of the census, how it was conducted and resourced, and its accessibility. However, now that we know the response rate, does the First Minister agree with my concerns that people on lower incomes will be doubly hit, given the importance of census data in targeting resources to invest in communities and to tackle inequalities, and given the lower rates of return in disadvantaged communities across Scotland? Also, what action will she take to ensure that people will not miss out? Of course, we will review the experience and ensure that any lessons that require to be learned are learned.
I think that it is important to repeat that. However, it is also the case that there is normal planned work, which always follows the census, to assure the credibility of the exercise. NRS is now focused on that planned post-collection quality control and assurance work, which includes the census coverage survey—the second-largest social research exercise in Scotland, after the census. That will include door-to-door interviews with a sample of about 1.5 percent of the Scottish population—about 50,000 households.
Alongside the use of other data, that survey builds on the census returns so that the census outputs are representative of the whole of Scotland’s population. That addresses the concern about people in our more deprived communities. An expert steering group has been established by the registrar general to help in that work. It is important that it now gets on with that. The latest NRS numbers show that well over 1.5 million census field force address visits took place across Scotland in the lead-up to the deadline, which demonstrates vast mobilization and an incredible effort on the doorsteps. I met some census field force staff last Friday morning in Ayr and spent some time knocking on doors and discussing the challenges that they have faced in recent weeks.
Will the First Minister join me in expressing immense gratitude for the field staff who ensured that the return rate was as high and the data as sound as possible? I am glad to hear that Siobhan Brown took up the registrar general’s offer to meet the very hard-working census field force staff. More than 1.66 million field force address visits took place, including multiple visits, on which field staff provided advice and support, left calling cards, provided paper forms to householders, and supported doorstep data capture.
I add to the member’s thanks my thanks to the hundreds of field force staff who have worked tirelessly over the past few months, and who have mobilized across the country and provided invaluable support to the people of Scotland. I also take the opportunity to thank the nearly 2.3 million households that have completed the census. To ask the First Minister what the Scottish Government’s response is to the finding of the Royal College of Emergency Medicine’s report, “Beds in the NHS”, that, since 2010, 4,227 hospital beds have been taken out of active service in the national health service in Scotland. We are committed to ensuring that the NHS has the right number of beds and staff to meet the needs of people across Scotland. We will continue to work with the Royal College of Emergency Medicine and other front-line staff to reduce unnecessarily lengthy hospital stays and avoid unnecessary admissions, to help to increase capacity in hospitals for people who require it.
The royal college acknowledges that bed numbers before the pandemic reduced—I quote— “largely because of shortened hospital stays and the very real need to reduce the length of time that people stay in hospital and provide care for them in as homely or at home an environment as possible.” The report examines bed reductions not only in Scotland but across England, Wales, and Northern Ireland. The report finds that Scotland has a higher number of beds per head of population, with 3.6 beds per 1,000 population. There are just 3.3 beds per 1,000 in Wales and just 2.2 in England. Staffing pressure is one of the biggest issues facing hospitals, and Brexit has worsened matters. Dr. John-Paul Loughrey, who is vice-chair of the Royal College of Emergency Medicine said yesterday that “across the whole acute system, lost staff members who would have come to work in the UK, or who have had to leave the UK, because of the situation with Brexit.” Does the First Minister agree that this has been a time when the NHS has faced and continues to face, unprecedented pressure and that Brexit, which Scotland overwhelmingly rejected, has made the pressures so much worse? Can she outline how the Scottish Government and NHS Scotland are working together to address the situation? Yes—I very much agree with that.
Before I address the matter of staff shortages, I will complete my answer on bed numbers. It is important, and it is a big responsibility of the Government, working with health boards, to ensure that we have an appropriate number of beds in the national health service. Gillian Mackay is right to say that one of the biggest challenges facing health and social care is staff shortages. Indeed, Dr. Loughrey described the situation as “a real problem and a real challenge.” We should be in no doubt that Brexit has put unnecessary and harmful obstacles in the way of potential new members of staff from the European Union joining the NHS, particularly in social care roles. We are working with NHS boards to support international recruitment to try to overcome the barriers that Brexit has put in our way. We are also investing £11 million in international recruitment over the current session of Parliament. That investment has already delivered 191 internationally recruited nurses in the past year, with a pipeline of many more due to join the NHS. The average number of available staffed hospital beds in NHS Scotland is at its lowest level in a decade; it has decreased by 10 percent.
In NHS Grampian, the number of available staffed beds has fallen by nearly 30 percent, which is a shocking figure. What urgent steps will the Government take to restore beds in our NHS and to boost capacity for patients in North East Scotland? As the Royal College of Emergency Medicine said, the reduction in bed numbers is “largely because of shortened hospital stays”. The average length of stay for a hip replacement has fallen from just under 14 days to six and a half days; the average length of stay for a knee replacement has fallen from 12.2 days to 5.7 days; and cataracts, which used to require a hospital stay, are now done on a day-case basis. We must ensure that there is an appropriate number of beds in our NHS. We will continue to do that, but—as I have said—the RCEM also pointed out that Scotland has more beds per head of population than do Wales or England, where the member’s party is, of course, in government. There are big challenges in Scotland, but the numbers suggest that this Government is getting to grips with the challenges better than Governments elsewhere are.
As the First Minister knows, delayed discharge rates are soaring. With an increase of 8 percent in March this year, that means 1 in 10 beds is occupied by a person who is ready to be discharged. That is a result of the continued failure of the Government to properly fund social care in Scotland and to support the workforce. Does the First Minister accept that if her Government was serious about freeing up bed capacity in our NHS it would properly fund social care and show that it values social care workers and unpaid carers by committing to a proper workforce plan, decent terms and conditions, and a wage of at least £15 per hour? I agree with much of the sentiment behind that question.
We must have a good-quality system of social care. Not only is that right for its own sake, but it helps to reduce pressure on our national health service, which is crucial to getting delayed discharge numbers down. We are investing significantly in trying to reduce delayed discharges. We are also investing in the hospital-at-home program, for example. We owe an enormous debt of gratitude to the social care workforce.
There have been two pay increases for the social care workforce during the past year and—of course—we all want to see further increases. However, as I said in response to Gillian Mackay, there are also underlying staff shortages that have been deeply exacerbated by Brexit, so we need to focus on how we can overcome that problem as well as the other challenges on which we continue to focus. That concludes First Minister’s question time.
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