Meeting of the Parliament

Meeting date: Thursday, November 3, 2022

Official Report 1151KB pdf

---

First Minister’s Question Time

---

National Health Service (Scans)

I have previously raised examples of patients being sent south of the border for national health service treatment because they cannot get it here from Scotland’s NHS. Now, through a freedom of information request, we have learned that £500,000 of Scottish taxpayers’ money has been spent on sending almost 15,000 patient scans around the world—some as far away as Australia—to be reviewed. Why are Scottish scans being sent to private companies on another continent for analysis?

The NHS will always take steps to ensure the speediest possible diagnosis and treatment of patients. As for what Douglas Ross has narrated, I am happy to look closely at the figures and respond to him in more detail, but that number will represent a tiny fraction of the processing of scans overall in Scotland. Where, for whatever reason, whether it be partly to do with the nature of the condition or, at times, constraints in the service here—I do not know whether it is to do with that in this case—steps have to be taken to speed up test results and the treatment of patients, the NHS will take them.

The fact of the matter is that we are investing record sums and employing record numbers of people in our national health service, but the service is under significant pressure. We will continue to support it to ensure that patients get the services and the treatment that they deserve.

Let me tell the First Minister why thousands of scans are being sent abroad at great cost to Scotland’s NHS. The Royal College of Radiologists has said that Scotland needs 100 more consultant radiologists than it has right now.

However, the problems are not unique to radiology. Across Scotland’s NHS, serious issues are mounting. Health figures this week show that delayed discharge in our NHS has reached its worst ever levels, meaning that patients are unable to get home and are stuck in our hospitals at a cost of hundreds of millions of pounds. Nearly eight years ago, the then Scottish National Party health secretary—who is still sitting on the front bench—promised to “eradicate delayed discharge” within the space of a year. Today, it is worse than ever before. Will the First Minister’s Government ever “eradicate delayed discharge” as it promised?

I remember on many occasions over the past years—when I was health secretary and since I have been First Minister—Conservatives coming to the chamber and criticising this Government for not using the independent sector more to tackle waiting times. It seems that, today, Douglas Ross is doing the exact opposite. I am not sure whether that is another flip-flop from Douglas Ross—that is for him to determine.

With regard to the pressures on our national health service, there has been a global pandemic since the start of 2020, which everybody knows is having an impact on services. However, let us look in more detail at the two particular issues that Douglas Ross raised.

First, with regard to radiology, under this Government, there has been an increase of 62.5 per cent in the number of clinical radiology consultants, as well as an increase in the overall NHS workforce. We have increased the number of radiography staff by 20.5 per cent. We also need to recruit internationally, but there is a global shortage of radiologists, and the challenge of international recruitment is not made easier by the policies of the Conservatives on Brexit and immigration. Nevertheless, we will continue to invest in recruitment and the overall NHS workforce.

Secondly, with regard to delayed discharges, we continue to see significant pressure across the entire health and care system. More people who are coming through hospitals need high levels of care and support in order to be discharged home, and we are investing to address that significant challenge. We are investing more than £100 million to enhance care at home, we have increased the hourly rate of pay for social care workers, and we are investing £40 million to enhance multidisciplinary teams.

However, despite those pressures, the number of average bed days occupied by delay is now similar to pre-Covid levels. The total number of delayed discharges in the most recent year is actually down by 23 per cent on the period immediately pre-Covid.

Those are significant challenges, but the policies, interventions and investment of this Government are intended to address those challenges, and we will continue to take those steps.

The question was about whether the First Minister will promise, as her former health secretary did, to “eradicate delayed discharge”, but she refused to answer. Delayed discharge has got worse, but the First Minister’s excuses are the same.

Serious problems like that are happening throughout our NHS. Today, there are reports of a pensioner in Musselburgh who has been trying to get through to her general practitioner to get treatment for a lung infection. She had to phone the practice 120 times before she got through to anyone. The lady said, “This is the first time in my life I feel like I don’t have proper medical care.” Does the First Minister think that it is acceptable that anyone—let alone an elderly, vulnerable person—has to call a GP more than 100 times before they get through?

I will answer the question about delayed discharges before I come to the issues around GP services.

Of course, it is our intention and policy to eradicate delayed discharges—[Interruption.]

I would be grateful if we could have silence when members are speaking on their feet.

The key piece of information that I gave to Douglas Ross in my previous answer is that we have had a pandemic and, whether he likes to admit it or not, that has had an impact on health and social care services not just in Scotland but across the United Kingdom, Europe and the world.

If we look at the situation in relation to the most recent year for which we have a full year’s figures, we see that there has been a reduction in delayed discharge compared with the period that immediately preceded the Covid pandemic. That is a result of not only the dedication of those who work in health and social care, but the interventions that I referenced in my first answer. We will continue to invest in and support policies that are intended to eradicate delayed discharges.

With regard to GP services, I do not think that the experience that was narrated is acceptable, and I am interested in hearing from the particular GP practice about the reasons for that. GPs are working under considerable stress, strain and pressure, as is the entire NHS, which is why we are committed to further increases in funding for GP services and to recruiting more GPs. We will continue to do the hard work of Government to support our national health service.

My final point is that, if it was down to Douglas Ross, those very difficult circumstances in our national health service would be even worse, because tens of millions of pounds—even more money—would have to be taken out of services to give tax cuts to the wealthiest. It is only six weeks since Douglas Ross demanded that we take money out of public services and give tax cuts to the wealthy. No matter the challenges that the NHS is facing, everybody across Scotland will be breathing a sigh of relief because at least the Conservatives are not in government here, in Scotland.

Whether or not the First Minister wants to admit it, Scotland’s NHS is in crisis at every level. Patient scans are being sent abroad and waiting lists—which were too long before Covid—are now at record levels. The situation at accident and emergency departments is at the most critical level that it has ever been at, and delayed discharge is plaguing our patients and hospitals worse than ever before.

On top of all of that, reports this week say that we could be facing a winter of strikes by staff across our NHS, which could cripple the health service in Scotland. This week, Dr Iain Kennedy, the chairman of the British Medical Association Scotland, said:

“Doctors are terrified about the winter and the year ahead.”

They are right to be terrified, are they not, First Minister?

People are right to be worried about the ability of our national health service to cope with spending constraints and the impact of Tory mismanagement on our economy.

Since we have been in the chamber, we have heard that interest rates have been increased by the Bank of England to 3 per cent, which is the highest rate for 14 years and the biggest single increase since black Wednesday, in 1992. That is the cost to people of Tory economic mismanagement.

On the national health service, in Scotland, we have higher funding per head of population for the NHS than there is in the rest of the UK, and our accident and emergency services, although under significant pressure, are the best performing anywhere in the UK.

In terms of the agenda for change workforce and pay, I wish that we could give them more, because they deserve every penny that we can give them. However, in Scotland, they are being offered an average pay increase of 7 per cent, with more than 11 per cent for the lowest paid. That compares with 4.5 per cent in England, where the Conservatives are in power, and in Wales, where Labour is in power. We are having to fund that increase without any additional resources from the Westminster Government. Instead, on 17 November, we face the prospect of spending cuts—again, to pay for Tory economic mismanagement.

I will continue to take seriously my job of supporting the NHS, and I will take no lessons from the Conservatives, who are making such a mess of the economy, with disastrous impacts for all of our public services.

---

National Health Service (Waiting Times)

This Government has no grip on the national health service crisis. Staff are being asked to do the impossible and patients are being asked to accept the unacceptable.

I will give just one example: 81-year-old Catrina McFarlane has bone cancer, a disease that can cause significant pain and increases the risk of fractures. Last month, she had a fall at home, and she and her husband heard a snapping sound. She was in extreme pain. Due to her condition, she was told that she would need to be transported to hospital in an ambulance. That was at 10.15 in the morning. At 11 o’clock that night—13 hours later—Catrina was still waiting in pain. The emergency operator, who was in tears, said that they could not even guarantee an ambulance by the next morning.

The following day, Catrina’s husband gave up waiting for an ambulance and, in desperation, took her to hospital himself. She was diagnosed with a fractured pelvis. Why did Catrina McFarlane have to wait in pain for nearly 24 hours for an ambulance that never turned up?

I am happy to look into Catrina’s experience. Nobody should wait that length of time for an ambulance, and I will not say otherwise.

As we do with accident and emergency and the NHS overall, this Government continues to focus on supporting our NHS through these difficult times so that it can recover from the impact of the pandemic and get back to delivering the level of service that all patients have a right to expect.

Looking specifically at the Ambulance Service, it, like A and E, is dealing with significant pressures, but its staffing under this Government is up by 67.3 per cent. The number of paramedics is up by almost 40 per cent and ambulance technicians are up by more than 60 per cent. This year, we have allocated additional funding of £45 million over the Ambulance Service’s baseline funding to support workforce growth and service improvement. Our ambulances are saving more critically unwell patients than ever before, and they are diverting cases away from accident and emergency.

Although, of course, an experience like that is not acceptable, and other patients will be having experiences like that right now, the fact is that the vast majority of people who rely on our Ambulance Service, or on any part of the NHS, get an extraordinarily good service from those who work in our national health service. The duty of me and my Government is to ensure, through investment and other interventions, that we are supporting those workers every step of the way. It is not easy. It is not easy for any Government right now, particularly in light of the economic circumstances, but each and every single day we will not shy away from that duty.

Week after week, year after year, the First Minister comes and tells people that it is unacceptable, and then expects people to accept the unacceptable, with devastating consequences across the country. Change the script, First Minister.

Catrina’s experience is not an isolated one. One reason that ambulances are not available is that they are queuing outside A and E, waiting to drop off patients—in some cases for hours. Last week, I highlighted the hidden waits at assessment units; this week, it is patients waiting hours in ambulances just to get through the doors of the hospital. In the past month, more than 2,700 ambulances across Scotland waited at least an hour and 50 minutes to drop off their patients. In just one month at one hospital—the Queen Elizabeth university hospital in Glasgow—218 ambulances waited more than three hours. These are ambulances and paramedics that should be out on the road supporting patients, but are instead forced to wait hours outside A and E.

Last year, I asked the Government to support calls from paramedics and ambulance drivers for a 15-minute turnaround time at A and E, with a maximum wait of 30 minutes. Why is the Government not listening to the paramedics and ambulance drivers? Why are things getting worse, even before we reach the peak winter challenges?

First, I will not stop what this Government is doing to support our national health service. Government, at the best of times—and these are not the best of times—is hard. It is more complicated than simple soundbites or setting targets; we have to do the work in order to achieve them.

That means supporting our national health service and those who work in it with the investment and the wider support that they need. We will continue to take all of those steps. I have narrated the increase in the number of people who are working in our Ambulance Service and the additional investment that we are putting into the Ambulance Service to ensure that we can see that improvement.

Anas Sarwar is right that these issues are all interconnected, so we need to invest in the wider health service in order to improve performance of the Ambulance Service. No, I will not stop saying that we are doing these things, because they are the necessary steps that any Government would need to take to support our NHS in these tough times.

Of course, management of the NHS is our responsibility and nobody else’s. However, our NHS is not immune from wider economic and budgetary decisions that, unfortunately, are outwith the hands of this Government. I wish that we could invest much, much more in our national health service. I agree very much with the Welsh First Minister, Mark Drakeford, who recognises that, although it is his responsibility to manage the health service in Wales, that has been impacted by the decisions of the Tories at Westminster. He can recognise that, so I am left wondering why Anas Sarwar, instead of making sure that people understand the impact of Tory decisions, wants to pretend that it does not exist.

I will never shy away from attacking the Tories for their decisions, but this Government needs to recognise its responsibility for the decisions that it makes and the impact that they have. There is always somebody else to blame; it is always somebody else’s fault. It is the same old soundbites and the same old script from this tired First Minister.

She does not want to listen to me, so maybe she should listen to the words of an ambulance driver:

“Waiting times at the Queen Elizabeth and elsewhere are not a post pandemic issue, we have been raising this for as long as I have been in the service but sadly the times are getting even longer, patients are getting sicker, and it’s happening in all seasons now, not only in the winter months.”

It has got so bad that ambulance workers have voted this week for strike action, not just because of pay but because they feel that they have been undervalued and underresourced for years—but this Government is in denial. There are growing queues for treatment at A and E departments, ambulances off the road for hours while trying to drop off patients and people waiting in pain for help to come.

All of that is before we have even reached the worst of winter. Lives are being lost as a result, and now the Cabinet Secretary for Health and Social Care says that it will take another five years to fix the problem—a problem that has been 15 years in the making. After 15 years of Scottish National Party Government, why should patients in Scotland have to wait a minute longer?

I will always listen to those who work in our NHS, and listen very carefully because they are the experts on the situation. However, I will not insult their intelligence by pretending that the issues are easy to resolve. We will continue to support people on the front line of our national health service, with record investment supporting record recruitment into our national health service and supporting the redesign of our NHS to make sure that patients get the treatment that they need, when and where they need it. That is in the interests of those who work in our national health service, as well.

Of course, we will continue to do everything that we possibly can to reward those who work in the NHS to the fullest possible extent. That is why the pay offer that has been made to agenda for change staff is, in Scotland, an average 7 per cent compared with 4.5 per cent in England and, indeed, in Wales, where Labour is in government. We take those responsibilities extremely seriously, every single day—every minute of every single day—but the fact of the matter is that the pressures on our national health service are not divorced from wider budgetary issues.

The Welsh Labour health minister said recently that the NHS in Wales next year would be “hell on earth” without additional funding from the United Kingdom Government. She said that the Welsh Government faces a “real nightmare” in running the NHS next year unless the UK Government steps up with additional funding. How come it is the case that Labour in Wales can recognise that reality, but Labour in Scotland is clearly so thirled to defending Tories that they are blind to that reality?

We will continue to do everything that we can in terms of the management of our national health service, but the fact of the matter is that we need more funding for our national health service and that can only come from decisions that are taken at Westminster.

We move to general and constituency supplementary questions.

---

Energy Vouchers

We are hearing reports that a large percentage of energy vouchers have not been redeemed by the end of October, and I have had constituents coming in to say that they have not received their vouchers. Can the Scottish Government shed any light on that and put any pressure on the energy companies to sort it out? The energy companies seem to be blaming the postal service.

I am concerned to hear about experiences such as that of John Mason’s constituents. Those echo wider reports this week that a significant proportion of support in the form of prepayment vouchers has so far gone unclaimed. It may be the case that some people are choosing to hold on to the vouchers until the weather turns colder, but it would be deeply worrying for people to be going without because of delays in the system, or for other reasons beyond their control.

I have chaired two meetings with energy suppliers and advice services over the past few weeks. Those have highlighted the need to ensure that the people who are most vulnerable are receiving the support to which they are entitled. I will continue those discussions with energy suppliers and others, but I would encourage energy companies to do everything that they can to ensure that the people who are most vulnerable are getting the maximum possible support and getting it as quickly as possible.

---

NHS Dumfries and Galloway (Patient Complaints)

It is no secret that NHS Dumfries and Galloway is on a crisis footing. A shortage of beds, staff and cash is seeing patients failed. Just when it seemed that things could not get any worse, the health board has now confirmed that it does not even have the capacity to respond to complaints, telling patients that it can no longer give a timescale for investigating their concerns. Does the First Minister think that that is safe or acceptable and will she investigate the case of one of my constituents? She has been waiting since February to get answers as to why her surgery went wrong, and she is losing sleep knowing that the same doctor could be making the same mistake in treating other patients.

First, as I often say in the chamber, I will look into any case that members of Parliament draw to my attention, so if Oliver Mundell wants to send the details of that case, I will of course ensure that it is looked into as quickly as possible.

Secondly, I expect all health boards to deal with complaints appropriately and as quickly as possible, and to communicate with patients as they do so. As I have talked about in earlier exchanges, I absolutely understand the pressures that every part of our national health service is dealing with. As I have already said many times today, I treat with the utmost seriousness the big responsibility on my shoulders and those of the Government to support, and to ensure the good management of, our NHS.

Oliver Mundell mentioned budgets. We are dealing with significant budgetary pressures, which are caused by inflation and the fact—which I do not begrudge at all—that we are trying to pay our NHS staff more. As I have said to Douglas Ross, the reality is that, had we taken the advice of the Scottish Conservatives, there would be even less money to support our NHS, because we would have given tax cuts to the richest. It is to everybody’s relief that we did not follow that call and the example of the United Kingdom Government in that regard.

---

Cancer Care (Inequality)

Reports that were published this past week show that people in Scotland’s most deprived areas are 74 per cent more likely to die of cancer than those in the least deprived areas. Is the First Minister content with that level of disparity in health outcomes between Scotland’s richest and poorest? If not, what will the Scottish Government do about it?

This is an important issue, although it is important to stress that mortality from cancer is reducing overall, which is due to a range of factors, such as better treatments, advances in drugs and technology and, of course, the hard work and dedication of the people who work in our cancer services.

There has been an inequality gap for a considerable time, which we are focused on closing. The factors that drive that are many and varied. Our detect cancer early programme and all the other work that we are doing to promote earlier diagnosis of cancer have a particular focus on inequality; so, too, does all the work that we do to encourage people to adopt behaviours that reduce the risk factors for cancer.

Equality in outcomes is, of course, of driving importance in all this, and that is reflected in all our work on cancer care.

---

Impact of Brexit

This week, the United Kingdom’s own data shows that exports from Scotland to the European Union have slumped by more than £2.2 billion since Brexit. To put it simply, Brexit has made things worse rather than better and made the lives of people throughout Scotland more difficult. Does the First Minister agree that it is time for the Tories to call out Brexit for the act of vandalism that it is, or acknowledge their role as willing accomplices in the havoc that it has wreaked on the lives of people throughout the country?

As Evelyn Tweed was asking a really important question, a member on the Conservative benches, from a sedentary position, asked, “What has this got to do with the Scottish Parliament?” I suggest that the state of the economy, and the fact that Brexit has caused a slump in our exports to the EU and made it so much harder to recruit staff into businesses and our public services, including health and social care, has an awful lot to do with the Scottish Parliament.

Brexit has been an unmitigated disaster—a Tory-imposed disaster. We are seeing its impacts in every walk of life, from exports to the economy and our ability to recruit into essential jobs. It is time that Brexit was reversed, but I do not expect that we will get that from the Tories and, sadly, we no longer hear that commitment from the Labour Party. The only route back into the EU for Scotland now is by becoming an independent country, and the sooner that happens, the better.

---

Ukrainian Refugees (Killin Hotel)

As the First Minister will be aware, refugees staying at the Killin hotel, which is in my region, were originally given four weeks’ notice to quit when the Scottish Government cancelled its contract with the hotel, effective from 18 November. Since then, media interest and coverage of the plight of the refugees has resulted in what has been billed as a U-turn by the Scottish Government, which has said that it will work with the hotel to see whether the refugees can continue to stay while the Government assists them to find long-term, sustainable accommodation. However, despite the Scottish Government’s reprieve, which was announced last week, neither the hotel, the local community council nor the Ukrainians have heard anything further. Many of the Ukrainians are unsure and anxious and have already resigned themselves to relocation. The situation is highly unacceptable and is causing severe distress to the individuals concerned. What action can be put in place to draw a line under the saga and give everybody the resolution that they deserve?

It is our priority to ensure that people who are displaced from Ukraine are looked after and well supported here. Figures that are out just today, I think, show that, since the conflict in Ukraine began, more than 21,500 people, most of whom are sponsored by the Scottish Government, have arrived here. That represents 20.8 per cent of all United Kingdom arrivals, which is testament to our desire and determination to support people from Ukraine as far as possible.

Many of the people staying at the Killin hotel wanted to move to a more central location with easier access to amenities and employment, and, by offering accommodation in Stirling, we seek to provide exactly that. We have of course listened to those Ukrainians who wanted to stay in the Killin area, such as those with employment or children in local schools, and we will help them to do that. We are working with Stirling Council and the local community to ensure that they are supported to find suitable alternative accommodation. We are aware that some of the Ukrainians will be able to stay at the hotel while they continue to be supported to find matched or longer-term accommodation.

We will continue to support everybody who has come here from Ukraine. Part of that is about supporting them out of temporary accommodation and into more settled accommodation as quickly as possible.

---

Industrial Action (University of Dundee)

Unite the union members from the University of Dundee are in their third month of industrial action in defence of their pensions. Today, a delegation of those workers is in the Parliament to provide an update on the dispute, and every MSP has received an invitation to the meeting, which will be held in committee room 2 at 1 o’clock. Can the workers count on the First Minister and her education ministers attending today’s update?

I understand the frustration that people working in our university sector feel at the continued dispute about their pension arrangements. It is of course a matter for universities as the employer; the Scottish Government is not the employer in this case. However, I always encourage employers to get round the table with workers to find resolution to such disputes, and I would call on Universities Scotland to do exactly that.

---

Mental Health Services (Universities)

To ask the First Minister what plans the Scottish Government has to increase and improve the provision of mental health services in Scotland’s universities. (S6F-01479)

We are working closely with universities to ensure that the mental health support that they have in place is responsive to student needs. Over the past three academic years, we have invested more than £11.5 million in providing almost 90 additional counsellors in colleges and universities. That exceeds our programme for government commitment to provide 80 additional counsellors and is on top of what institutions already provided. We are also working with health boards to improve referral pathways to national health service and community-based services for students who are in need of acute support. Finally, in association with stakeholders, we are developing a student mental health plan, which will provide a best practice framework for mental health services in universities and colleges and will be linked to the wider mental health and wellbeing strategy.

The First Minister will know that the Mental Health Foundation, Universities Scotland and the Robertson Trust surveyed more than 15,000 students and found that 74 per cent reported low wellbeing, 45 per cent experienced a serious psychological issue that they felt required professional help and 36 per cent reported experiencing either moderately severe or severe symptoms of depression.

There is a mental health crisis in our universities and colleges, and I am afraid that the actions of the First Minister in cutting the allocated funds for mental health support have made the problem worse. However, she has one chance to deal with the mess that she has created: she must guarantee that the £20 million four-year programme of sector support for student mental health will continue and not be cancelled.

Can I help the First Minister to find that £20 million? [Interruption.] How about the £20 million that she has earmarked for an independence referendum that the majority of Scots do not want? Will she act now to avoid a further crisis?

I do not want to waste too much time giving a basic lesson in financial management to the Conservatives, but money that is due to be allocated in a future financial year cannot be used to fund services in the current financial year. The fact remains that investing a very small sum of money to give the people of Scotland an alternative to Westminster mismanagement is a very good idea indeed.

On mental health, Stephen Kerr is right to point to the figures that he has narrated in the chamber today. Of course, it is, first and foremost, for individual institutions to ensure that they have in place appropriate mental health support for their students, but we are working closely with institutions to support them as they provide such support. As I said earlier, we have invested more than £11.5 million to support 90 additional counsellors in colleges and universities. In fact, we are the only United Kingdom nation to have funded student mental health support in that way, so perhaps Stephen Kerr’s comments would be better directed to his own party in government at Westminster.

As regards yesterday’s statement by the Deputy First Minister, spending on mental health will continue to rise. The vast majority of mental health funding is directed through national health service boards, and that is completely unaffected by anything that the Deputy First Minister announced yesterday.

I come back to the central point. We are in a situation in which we have a budget for this year that was already 2.9 per cent lower in cash terms than it was last year because of Tory Westminster decisions, but within this financial year it has been eroded by £1.7 billion due to inflation. The cost of public sector pay deals so far—I repeat that I do not grudge this—is £700 million more than was budgeted for. Again, that has been driven by inflation.

We have no power to borrow for day-to-day services, we cannot raise tax mid-year and our reserves are fully allocated. Therefore, we have to find ways of providing funding to deal with those pressures from within existing budgets. Of course, we might face even more difficult choices when the Chancellor of the Exchequer announces his budget statement in a couple of weeks.

The fact of the matter is that, if the Conservatives—who, six weeks ago, called on us to cut public service funding to give tax cuts to the richest—want us to invest more in any element of public services, they need to persuade the chancellor to increase the budget of the Scottish Parliament and the Scottish Government. Until they do so, they will continue to have zero credibility on any matters relating to budgets or to public services in Scotland.

---

Living Wage

To ask the First Minister what work the Scottish Government is doing to improve living wage equality. (S6F-01481)

The real living wage accreditation scheme supports employers in lower-paid sectors to become real living wage employers. Recent Office for National Statistics data shows that, in the past year, the proportion of women employees aged over 18 in Scotland who earn the real living wage or more increased by nearly 6 percentage points to 89.7 per cent, compared with 91 per cent of employees overall, and that 10.3 per cent of women in Scotland earn below the real living wage, which is lower than the equivalent United Kingdom figure of 14.3 per cent.

The data confirms that Scottish employers are leading the way in paying the living wage, and we should be proud of the progress that has been made. However, there is still a lot of work to be done to tackle gender and other pay gaps, and we will publish the refreshed fair work action plan later this year. It will address actions to further close those gaps and create more diverse and inclusive workplaces.

I agree that we can be rightly proud of Scotland’s record on wage equality, which means that we have the highest proportion of workers in the UK who are paid above the living wage, as well as the lowest gender pay gap.

However, our progress has been impeded by a broken UK labour market. Does the First Minister agree that we can truly address wage inequality only through Scottish independence, which will provide an opportunity to embed equality principles in our labour laws and to design a system that better meets the needs of Scotland’s workers and employers? [Interruption.]

I know that the Conservatives and Labour do not like hearing this, but it is a very important point that demonstrates a fundamental fact. Independence is not abstract; it is about real issues that impact on the day-to-day lives of people across Scotland.

Take the issue that is being raised here now. Employment law, including the setting of the national minimum wage, is currently reserved entirely to the UK Government. If we had employment powers lying in the hands of those in the Scottish Parliament, which would come with independence, that would enable us to do even more to protect and enhance workers’ rights and to support working people across this country by ensuring that they are paid a living wage. That, in turn, would improve living standards, increase our tax take and boost our economy.

We will continue to call on the UK Government to do more and to devolve crucial powers, but the only way to get those powers—[Interruption.]

Members!

—which have the potential to change the lives of people across Scotland, into the hands of those in this Parliament is by Scotland becoming an independent country. That is not abstract; it is very real, and it becomes more and more obvious with every day that passes.

---

Malnutrition and Food Insecurity

To ask the First Minister what urgent action the Scottish Government is taking to prevent poverty-related malnutrition and food insecurity, in light of reported growing concerns from healthcare workers, school staff and charities about the impact of hunger on people across Scotland. (S6F-01480)

That may be another illustration of the point that I made in my previous answer. I am deeply concerned—as, I know, Monica Lennon and other members will be—about the hardship that people are facing as a result of the cost of living crisis. This Government has allocated almost £3 billion in this financial year to helping households to face that, including £1 billion that is not available anywhere else in the United Kingdom. That includes the Scottish child payment, which will shortly increase to £25 per week, and the Deputy First Minister confirmed yesterday that we will double the December bridging payment for families to £260 and increase the fuel insecurity fund to £20 million.

We must see the UK Government use all the levers at its disposal to tackle the emergency rather than make it worse. That must include increasing benefits in line with inflation and increasing universal credit by £25, and that should also be extended to means-tested legacy benefits. I hope that we will see the UK Government take those steps. However, if those powers lay in the hands of this Parliament, we would not have to look to a UK Government to do those things—we could do those things by our own hand.

The First Minister has set out some important context, but I hope that she agrees that there is more that we can do in this place.

Why has the working group on malnutrition, which was announced by this Government more than a year ago, not met? If it has met this week, it would be good to know about that. I know that there has been some bad publicity.

Free school meals are not yet universally available for young people in Scotland. There was a commitment to make them available for pupils in primaries 6 and 7 in August of this year, but we missed that deadline. We have heard about a pilot scheme for secondary schools. Will the First Minister give a clear timetable for the delivery of the roll-out of free school meals, and will that pilot scheme be published?

Campaigners and front-line workers with both children and older people raise the alarm every day, so I ask whether the four calls to action by the Eat Well Age Well project will be taken on board by the Government.

There is really good work on universal free school meals in Scotland, and I give credit to the Government for doing that, but we all know that we must do more, so I hope that the First Minister will set out those details very soon.

Monica Lennon says that we all know that we can do more here. We will always seek to do more and to do as much as we can, but there is a limit to what we can do within a fixed budget. I do not know whether Monica Lennon listened to John Swinney’s statement yesterday. We are at the limit—probably beyond the limit—of what we can do financially without additional resources from Westminster. I wish it was not like that, because I wish that we were in control of our own finances, but we are not.

I turn to the specific issues that Monica Lennon raised. The date set for an initial meeting of the malnutrition working group was not suitable for some of the key participants, but we intend that the group will meet by the end of this month.

We have an ambitious plan for the roll-out of free school meals, but right now we are already way ahead of any other part of the UK on that. In Scotland, during term time, free school meals are already universally available to more than 280,000 children in primaries 1 to 5 and in special schools, as well as to eligible pupils in P6 through to secondary 6. In England, universal provision is available only in the first three years. In Wales, where Monica Lennon’s colleagues are in government, free school meal provision is based entirely on eligibility. I think that they have just started work on universal provision for the first year.

We have some way to go, but we are absolutely serious about getting to the end of this journey. However, we have already come much further than anyone else, and we are doing all of it within a budget that is being eroded by inflation and that is essentially fixed. If Monica Lennon wants us to do much more and to do it faster, it is not enough for Scottish Labour to will the end; it must also will the means. That will involve giving the Scottish Parliament and the Scottish Government full control over our own finances instead of leaving us at the mercy of Tory Governments at Westminster.

---

Glasgow Climate Pact

To ask the First Minister how the Scottish Government will be building on the legacy from the Glasgow climate pact by attending the 27th United Nations climate change conference of the parties—COP27—in Egypt. (S6F-01477)

Scotland is determined to continue to play its part in responding to the global climate emergency. If the world is to deliver on the Glasgow climate pact, all nations need to continue to increase their ambition and take credible action to reach net zero emissions.

Over the next few days, I will attend COP27 to do what I can to further collaboration between Scotland and other countries, to build on the agreements that were reached in Glasgow and to continue Scotland’s leadership not least on the issue of loss and damage funding. Although we are not yet a member state of the United Nations or party to the Paris agreement, Scotland will play its part by sharing our own experiences of delivering against a net zero target at home, as part of our just transition, and by helping to amplify the voices of people who are being most impacted by climate change, who are often also excluded from the debate. They include people from the countries of the global south, women and young people.

I am pleased that, unlike the Prime Minister, the First Minister did not have to be shamed into attending COP27.

COP26 in Glasgow showed us that, when small nations work together, they can lead the world on climate justice. Alongside Scotland’s leadership on loss and damage funding, which the First Minister mentioned, Denmark helped to launch the Beyond Oil & Gas Alliance and was joined by a flotilla of countries that are planning for a fair and fast phasing out of fossil fuels.

Now that the Scottish Government has a clearer position on ending new coal extraction, is it ready to join that alliance and show the global leadership that is desperately needed on a just oil and gas transition?

At COP26, in Glasgow last year, we had good engagement with those involved in the Beyond Oil & Gas Alliance, including its founder country, Denmark, and we will continue that. Last year, we set out the programme of work that we are undertaking, which will influence and ultimately decide our involvement in the alliance. We are undertaking in-depth analysis to better understand our energy requirements as we transition to net zero, ensuring an approach that supports and protects our energy security and our workforce while meeting our climate obligations. We will publish an energy strategy and our first just transition plan, which will provide a road map for the energy sector’s role in meeting our emissions reduction targets and securing a net zero energy system for Scotland.

Taking all of that into account, we will continue to engage constructively with the Beyond Oil & Gas Alliance as part of the wider programme of analysis and engagement with a range of organisations and stakeholders.

Given the publication at the weekend of three new UN reports stating that there is no clear pathway to the 1.5^oC limit being set, and given the devastating floods in Pakistan that were caused by climate change, will the First Minister set out what more can and should be done at COP27, particularly on loss and damage funding? Does she agree with me that people and countries in the global south must be given due attention and that there must be action by the global north? In welcoming the now planned attendance by the United Kingdom’s Prime Minister, will she urge all global north leaders to act on the issues that are already being faced by countries in the global south?

Yes, I absolutely agree with that. Countries in the global north have a moral obligation and owe that to those in the global south, including action on the issue of loss and damage. Good progress was made in Glasgow last year to put the issue of loss and damage firmly on the agenda. I think that we all wish that we could have gone further, but it is vital that this year’s COP delivers implementation of the Glasgow pact. That includes delivering, in particular, the finance that is needed to enable global south nations to adapt to the impacts of climate change.

However, that is not enough. We need further action on loss and damage. I think that we can be very proud of the commitment and leadership that Scotland showed on the issue last year, which was followed by commitments from Denmark, Wallonia and the Children’s Investment Fund Foundation. We hope that, this year, other Governments will follow suit and help us to mobilise funding to address the losses and damages that people and communities in the global south are suffering right now as a result of climate change, which is caused largely by the global north. In my view, that is one of the big tests for COP27, and I hope that it meets that test in full.

I am sure that the First Minister will agree that, if we cannot do the basics of tackling climate change, Scotland will have no chance of achieving net zero. When will the 2013 target of recycling 50 per cent of household waste be met?

Scotland is doing more than the basics of tackling climate change. I will write to the member with an update in response to his specific question.

Scotland is rightly seen by countries around the world as a leader on these issues. We should continue to challenge ourselves at home and ensure that we are delivering against the targets that we have set, and we will always do that. However, we should also take some pride in the fact that other countries look to Scotland for the leadership that we show—[Interruption.]

I am sorry, First Minister. I am sure that we would like to hear a response to the member’s question.

The Tories are always very keen to talk down Scotland’s contribution. I think that, at COP27, we will see countries around the world talking Scotland up, because they see the leadership that this country offers.

That concludes First Minister’s question time.