Meeting of the Parliament

Meeting date: Thursday, January 12, 2023

Official Report 1262KB pdf

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First Minister’s Question Time

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NHS Greater Glasgow and Clyde (Cancellation of Procedures)

Last night, NHS Greater Glasgow and Clyde cancelled thousands of procedures. We know that the Scottish National Party’s flagship Queen Elizabeth university hospital is already the worst performing in the country, and this morning there are reports of nurses at the hospital working 24-hour shifts. It is disgraceful to put national health service staff in that situation and, despite their incredible efforts, it could be harmful to patients.

A whistleblower has said:

“We are struggling to cope. In short, we’re struggling to provide first world care in what feels like a third world environment.”

Given that, how can the First Minister say that the Cabinet Secretary for Health and Social Care has done all that he can to support NHS staff and prepare for this crisis?

First, in relation to reports in the media this morning about staff in NHS Greater Glasgow and Clyde being asked to work 24-hour shifts, as I am assured by NHS Greater Glasgow and Clyde and as the board has said publicly, that is not true. Let me just quote NHS Greater Glasgow and Clyde:

“there is absolutely no truth to these claims. NHS Greater Glasgow and Clyde does not ask nursing staff to work a 24-hour shift, and there was no prospect that any staff member would need to work for 24 hours. To suggest otherwise is inaccurate and misleading”,

and I would not expect any health board to request any member of staff to do that.

Secondly, staff across the national health service in Scotland—and, indeed, staff across the national health services in England, Wales and Northern Ireland—are struggling right now. They are doing an extraordinary and magnificent job, and my heartfelt thanks go to all of them. However, they are struggling in the face of unprecedented pressure on our national health service—pressure from Covid and, even more so, in recent weeks, from flu and other respiratory illnesses. We hope that that pressure will abate in the weeks to come, but in the meantime the Government continues to do everything possible to support NHS boards as they address those pressures.

In relation to the announcement from NHS Greater Glasgow and Clyde last night, as I said on Monday, we have empowered NHS boards to take action that they think is appropriate to protect critical and life-saving care. NHS Greater Glasgow and Clyde has paused non-urgent elective procedures so that it can prioritise urgent treatment and cancer care, and I would expect that to be for a very short period.

Finally, it insults people’s intelligence to suggest that the problems that are being encountered in the NHS in Scotland, which are the same as the problems that are being encountered elsewhere, are somehow down to the health secretary. Is it, for example, the fault of Humza Yousaf that the kind of action that NHS Greater Glasgow and Clyde announced last night has also been taken in health services in south London, Surrey, York, Scarborough, Derby, Leicester, Nottingham, Southampton and Portsmouth? I could probably go on. These are unprecedented pressures, which we continue to support our NHS to address. [Applause.]

How can nationalist MSPs clap such a despicable answer from Scotland’s First Minister, in Scotland’s Parliament, about Scotland’s national health service?

Let us ignore the nationalist MSPs; let us look at what medical professionals are saying. They are damning about this Government’s response to the crisis here in Scotland. On Monday, the First Minister placed some of the blame for the grave situation in A and E departments on, in her own words, “unnecessary attendances”, but Dr Lailah Peel, deputy chair of BMA Scotland, criticised patient-blaming language, saying that it

“shows a lack of understanding of the current crisis.”

We have analysed the figures, and Dr Peel is spot on. There are fewer people in A and E now than there were in the years leading up to the Covid pandemic. The problem is not unnecessary attendances. Fewer people attended A and E in the first week of this year than did in the first weeks of 2020, 2019, 2018 or 2017. Will the First Minister accept that the blame lies with her Government and not the patients?

Nobody, including me—certainly not me—is blaming patients. It is the case—[Interruption.]

Let us hear the First Minister.

Unnecessary visits to accident and emergency units and unnecessary attendances and admissions to hospital are not in the interests of patients. That is why we are working hard to make sure that, where patients can and should be treated elsewhere, that happens.

Let me take Douglas Ross’s points in turn, and let us look in detail at demand, and why the figures that he has quoted are the case. There is absolutely no doubt that demand on our health service right now is higher than it has been for some time. If we look at calls to NHS 24 over the festive period, those showed the highest demand in a decade. If we look at emergency calls to the Scottish Ambulance Service, those were higher in the most recent week than the average of the four weeks before that. The reason that they are not all translating into attendances at accident and emergency units or admissions to hospital is the work that NHS 24 and the Scottish Ambulance Service are doing to avoid that.

NHS 24 now provides advice and, where necessary, treatment to the vast majority of patients during the initial call that they make. Most of the calls to the Ambulance Service are treated through see and treat, so that patients are not taken to hospital. However, because of that, those who do go to hospital tend to be sicker and their length of stay is longer. That is part of the reason why we have pressure on our hospitals.

The waiting times in A and E are a reflection of the fact that occupancy in our hospitals is so high, which is why we have focused on speeding up discharge from hospital, where appropriate.

Finally, we listen very carefully to, engage with and work with health professionals each and every day, and it would be hard for me to find the appropriate words to describe my respect for our health professionals. Elsewhere in the UK this week, we have seen healthcare professionals on strike. They have not been on strike in Scotland, because of the work that this health secretary has done and because of the respect that we have for our healthcare professionals.

I think that those words may come back to haunt the First Minister. Also, if we are judging cabinet secretaries on sectors striking, I would hate to be Shirley-Anne Somerville right now.

We have just heard it: the First Minister is doubling down on her patient-blaming language. The problem is not too many people attending A and E; it is the Government’s handling of the NHS crisis in Scotland. Dr Peel said that

“Exit block is the problem in A&E”,

and the Government has known that to be a huge issue for years.

In her previous answer, the First Minister defended her position by saying that people are getting sicker, but people who are healthy and ready to go home cannot get out of hospital because the First Minister and her Government have not dealt with bed blocking. They were failing to tackle that issue before the Covid pandemic, and now it is worse than ever.

New reports out today state that the number of avoidable deaths occurring in Scotland is now 60 people a week. That is 60 families, across our country, every single week, grieving the loss of a loved one who could have been saved. First Minister, will you confirm those tragic figures?

What I will absolutely confirm is that, when people wait too long for treatment, it has severe consequences, potentially, for patients. That is why we work so hard, and will continue to work so hard, with the health service to reduce long waits for treatment, whether that is at accident and emergency units or for elective care in our national health service.

I was not—to use Douglas Ross’s phrase—“doubling down” on anything. For the avoidance of any doubt, I am certainly not blaming patients for anything. It is in the interest of patients that, where appropriate, they can be treated outside hospital, because it is not in the interest of any patient to end up in an accident and emergency unit or hospital ward just because treatment is not available in the community.

I was trying to explain—because it is obvious from Douglas Ross’s questions that he does not understand this—the flow of patients through our national health service and that the reason why we see longer waits at accident and emergency is overoccupancy in our hospital wards.

Finally, on the exit block, the significant chunk of what I and the health secretary set out on Monday was about tackling delayed discharges. [Interruption.] We understand, from our daily engagement with health boards—

Let us hear from the First Minister, please.

—that the number of delayed discharges has reduced slightly in recent weeks, but there is much more to do. That was the reason for the interventions and the additional funding that I indicated on Monday and that the health secretary set out to the chamber on Tuesday.

We will continue to focus on providing the support and making the interventions that are necessary right now to help the NHS during this period of unprecedented demand. I remind Douglas Ross and other members of the unprecedented demand that is being faced not just in Scotland but all over the UK, and in much of the rest of the world as well.

The First Minister can throw insults at me if she wants to. I was quoting—[Interruption.] I see that she laughs at this. You can laugh at it, First Minister, if you want—

Speak through the chair, please.

—but I was quoting a front-line doctor in Scotland’s NHS who happens to be the deputy chair of BMA Scotland.

The First Minister has effectively confirmed that the tragic figures that we heard this morning are correct. That there are 60 avoidable deaths every single week in Scotland’s NHS is confirmed by Scotland’s First Minister.

Scotland’s health secretary is making the situation worse, not better. Here is just one example of what we are experiencing across Scotland. On Hogmanay, a family visited their 80-year-old uncle. He has had major heart surgery and hip operations, and he often struggles to breathe. When they arrived, they discovered that he had fallen and broken his neck. The family dialled 999 seven times, and it took more than 12 and a half hours for the ambulance to arrive. That was seven emergency calls, over 12 and a half hours, for an 80-year-old who had broken their neck. His niece told us:

“The ambulance crews were brilliant, but we are disgusted at what our uncle has been put through.”

That dire situation confirms, yet again, that the health secretary and the Government are not on top of this crisis. His failures are creating risk to lives across the country. First Minister, surely, for the good of Scotland, it is time to sack Humza Yousaf.

If I raised a smile in response to Douglas Ross, it was not directed at any health professional. I suppose that I was raising a smile—in challenging circumstances for everybody right now—about Douglas Ross accusing anybody else of throwing insults.

Every single day, the health secretary and I will continue to take the actions that are necessary to support our NHS during these very difficult times. I said earlier that I do not take anything for granted, and I do not intend to sound complacent at all about this: it is because we respect those people who work on the front line of our national health service so highly that we are offering them a much higher pay increase for next year than any other Government in the UK is offering. Thus far, we have avoided industrial action in our national health service. We will continue to do everything that we can to ensure that that continues.

We are supporting health boards, too, to address the reasons for long waits in our national health service—whether for an ambulance, in accident and emergency units or to be discharged from hospital—which is why we announced the action that we announced earlier this week. Too many patients are waiting too long for treatment right now, so we will continue to do everything that we can to address that situation while hoping that the pressures that are caused by, in the main, Covid and flu, abate over the weeks to come.

That should not take away from the fact—true in our Ambulance Service, our accident and emergency units, our general practices and across our hospitals and other healthcare settings—that the vast majority of patients in this country, even during these extremely difficult times, get excellent care on our national health service. That is down to the dedication of those people who work in it, which is why they have my grateful thanks every single day.

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National Health Service

Yesterday, Jackie Baillie and I hosted a health summit with front-line national health service staff, representatives of organisations and experts who work across our NHS. They told us that our NHS is broken and that the system is failing; that they are being asked to do the impossible; and that, every day, that crisis puts patient lives at risk. They were united in telling us that the cause of that crisis is not Covid, the flu, Strep A or winter pressures; they said that it is a crisis that has been 10 years in the making. However, the First Minister does not agree. Why does she think that front-line NHS staff are wrong?

I do not think that front-line health service staff are wrong in what they say. I do not know why it took until yesterday for Anas Sarwar and Jackie Baillie to meet with health service professionals; the Cabinet Secretary for Health and Social Care meets with them regularly, and I have engagements with them as well—[Interruption.]

Thank you, members.

What health service professionals say to us—I am sure that they said this to Anas Sarwar yesterday, too—is that challenges existed in our national health service before Covid. We have been taking action to address those challenges. On funding our national health service, front-line health funding has more than doubled under this Government—it is higher per head of population than it is in other parts of the United Kingdom. Almost 30,000 more people work in our NHS today than when this Government took office, and there are more healthcare professionals—doctors, qualified nurses or professionals across a range of groups—per head of population than there are in other parts of the UK. We will continue to work with front-line healthcare professionals to deal with those challenges.

I take issue with Anas Sarwar on his point that it is somehow not the case that Covid and flu are having a significant impact on those pressures. Right now, there are more than 1,200 patients with Covid in our hospitals, and anybody who says that that is not having an impact on what we are dealing with right now is, frankly, not dealing with reality. In the couple of weeks that led up to Christmas and over the Christmas period, 1,000 patients a week were admitted to our hospitals with flu, and anybody who says that that is not a significant factor in what we are dealing with right now is, frankly, not dealing with reality. I direct that comment at Anas Sarwar, not at healthcare professionals, who are dealing with those issues every day.

Whether on NHS pay—

Briefly, First Minister.

—record investment or record staffing numbers, we will continue to support the NHS in these difficult times, as we always have done.

It is clear from that answer who is not dealing with reality, and it is Nicola Sturgeon and her Scottish National Party Government.

Nicola Sturgeon might not want to listen to me, but she should listen to the organisations. The Royal College of Nursing, the Royal College of Midwives, the Royal College of Emergency Medicine, the Royal College of Physicians and Surgeons of Glasgow, the Royal College of Physicians of Edinburgh, the Royal College of Psychiatrists, the Royal College of Surgeons of Edinburgh, the Royal College of General Practitioners, Glasgow Local Medical Committee, the British Medical Association in Scotland, Unison, the GMB and Unite the union are all saying that they have heard the excuses before and do not believe them, and that they think that the First Minister is not doing enough.

The sticking-plaster approach will not solve the problem. We heard directly from staff about the impact that this crisis is having on them. They told us that it is causing them, in their words, “moral injury”—that is, personal distress and trauma, because they cannot provide the care that they know that their patients need. It is causing our NHS staff psychological and mental trauma. One of them said that the conditions that they are working in mean no dignity, no respect and no safety for patients.

The BMA and the Royal College of Emergency Medicine have both said that the crisis is leading to avoidable deaths—they predict that that could be as many as 60 avoidable deaths a week. The experts tell us that what was announced this week will not be enough to address the problem, so why can the First Minister not see that her sticking-plaster approach is not working?

We will continue to take a range of actions. What we announced this week was in addition to the actions that are already being taken and, of course, the record investment that we are putting into our national health service. In the next financial year, supported by the tax decisions that we are taking—asking those who can most afford it to pay a bit more in tax—an additional £1 billion will go into our NHS. We will support investment and, where it is appropriate and in the interest of patients, we will support reform in care and patient pathways in our NHS.

Nothing that Anas Sarwar has said to me has not already been said directly to Government by healthcare professionals, because we engage with them day in and day out. They are dealing with unprecedented pressures right now. Some of that necessitates longer-term reform of our NHS, but some of that is also absolutely being caused by the winter pressures that have been at their peak in recent weeks. I hope that, over the coming weeks—very soon—we will start to see flu levels reduce significantly, and that will start to reduce some of that pressure on our hospitals, although the situation with Covid remains more unpredictable and volatile, given the new variants that are circulating. I hope that we will see some of that pressure abate, but that will still leave a challenging situation in our health service, which is why the investment, the increase in staffing and the reforms continue to be important.

No Government anywhere has a single solution to the issues right now, but this Government remains focused on taking the actions that are necessary, which is why I think that we continue to have the trust of the people of Scotland as we do so.

The First Minister is just not listening, and the approach is not working. This is not just a crisis in winter; it is a year-round crisis. Nicola Sturgeon’s excuses will not wash. The crisis in our NHS is not because of Covid, it is not because of flu, it is not because of Strep A and it is not because of winter pressures; it is a crisis that has been 15 years in the making. The result is that we have the longest-ever NHS waiting lists, with 750,000 Scots waiting; the worst ever accident and emergency waiting times, with 2,000 people a week waiting more than 12 hours; and record levels of delayed discharge, with 58,501 NHS bed days lost a month.

After 15 years of the SNP, our NHS is broken and the system is failing. Staff are being asked to do the impossible, patients are being asked to accept the unacceptable and lives are being lost. Is it not the case that the people who caused the problem cannot be the ones to fix the problem?

On the latter point, it is, of course, up to the people of Scotland to decide who they trust to be in government to lead the country through challenges.

Of course, there were challenges in the NHS before Covid—I have never sought to suggest otherwise—and the actions that we are taking around investment, staffing and reforms to patient pathways are designed to address that. There are record numbers of staff in our health service right now—almost 30,000 more than when this Government took office—and, of course, more staff per head of population than anywhere else in the UK. That is the reality.

People watching at home—including the one in 25 people in the Scottish population who have Covid and the many people suffering from flu and other respiratory illnesses—who hear Anas Sarwar say that the fact that we have 1,200 Covid patients in our hospitals and the fact that, in recent times, 1,000 patients with flu have been admitted to our hospitals every week have nothing to do with the pressures in our NHS will wonder what on earth he is talking about.

We will continue to work with and listen to those on the front line of our national health service as we continue to strive to give them fair pay increases and as we continue to support them to deliver excellent care, which, even during these tough times, they continue to do for the vast majority of patients across our country.

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Cabinet (Meetings)

To ask the First Minister when the Cabinet will next meet. (S6F-01684)

Tuesday.

My Opposition colleagues are quite right to raise the crisis in our national health service. Liberal Democrat research has quantified just how bad things are. Last year, we discovered that one in six people who could not get a general practitioner appointment carried out a medical procedure on themselves or got somebody else to do it.

Maria is 22 years old. She is a Ukrainian refugee who has been living in Scotland since the summer. She suffers from a hormonal thyroid condition that requires regular testing and treatment. However, when she presented to her new GP, she was faced with an unexpected dilemma. The wait was so long that it made more sense for her to risk travelling back to a war zone to see her doctor in Kyiv—so she did so. The air raid sirens, drone strikes and cruise missile attacks in the Ukrainian capital were less daunting to Maria than the wait for treatment in Scotland’s NHS. That is appalling.

Those are the risks that people are taking for the sake of their own health—and all for the want of basic access to primary care. Is the First Minister embarrassed by that?

I do not know the circumstances of that case beyond what Alex Cole-Hamilton has narrated, and it would be wrong for me to comment on an individual case. What I do know that is that we continue to support general practice. There are more GPs per head of population in Scotland than there are anywhere else in the United Kingdom—there are 83 GPs per 100,000 people here, compared with 63 per 100,000 in England, 63 per 100,000 in Wales and 75 per 100,000 in Northern Ireland. We have a target, of course, and right now we are working towards the delivery of increased numbers of GPs. I think that we have recruited more than 3,000 members of the wider multidisciplinary teams in general practice and primary care.

Like access to other parts of the health service right now, access to GPs is challenging—and very challenging for some patients. We continue to work to address that, and we will continue to do that with record investment and record support for recruitment, in partnership with those who are working so hard across our health service.

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Record Temperatures

To ask the First Minister what the implications for Scotland and the Scottish Government are following Met Office reports that temperatures in Scotland and the United Kingdom reached the highest on record in 2022. (S6F-01689)

The Met Office figures underline that we are already experiencing climate change impacts in Scotland. We must adapt to those changes and prepare for further impacts of global climate change, which are, of course, already locked in.

We are currently preparing the third climate change adaptation programme for publication next year to succeed the current programme. Those programmes respond to the United Kingdom climate change risk assessments, which present the best available evidence and climate projections from organisations across the UK, including, of course, the Met Office.

The Climate Change Committee has urged that risks from higher temperatures be prioritised in the upcoming programme. We are working across Government and with public bodies to ensure improved preparedness for a projected increase in hotter years in the future.

The figures are, indeed, alarming. Across the world—[Interruption.]

We will have a brief suspension.

12:28 Meeting suspended.  

12:29 On resuming—  

I call Fiona Hyslop.

The record temperature figures are, indeed, alarming. Across the world, we are seeing more extreme weather experiences, with increased flooding and extreme heat at home. Every Government bears acute responsibilities for tackling the climate emergency. With the Scottish Government’s draft energy strategy that was published this week and the Climate Change Committee’s critical report that was published in December, does the First Minister acknowledge that the Government now needs to accelerate delivery on housing and transport emission reductions and a just transition to renewable energy? Will she ensure that the Government’s budget is sufficient and that public bodies ramp up on delivery, given that, on current trends, we will not meet our ambitious net zero targets?

I absolutely agree with Fiona Hyslop on all those points. It is worth pointing out that the energy strategy that was published this week, with the just transition vision alongside it, is, in part, about how we accelerate the transition away from fossil fuels to renewable and low-carbon sources of energy in a fair and just manner. That is really important.

We must remain 100 per cent focused on delivering our policy programme, which includes transport and the heating of homes, across the whole of society. As I have just said, we have to decarbonise the energy system, and the draft energy strategy goes into detail about how we do that. We must make sure that the climate change plan reflects all of that. A draft of that plan will be published later this year, alongside sectoral just transition plans, to set out a clear path for emissions reductions. Of course, we also need to make sure that investment is in place to back up all of that.

The Government remains focused on the issue. We often talk about it in terms of a challenge, and much of it is challenging, but there are also massive opportunities for Scotland in all of this, which we must seize.

By 2050, there could be well over 100 heat-related deaths a year, according to the UK Climate Change Committee. Adapting buildings for cooling will be key to avoiding a worst-case scenario, and I welcome the joint work with the UK Government on that.

Can the First Minister confirm when an assessment will be ready of the cooling systems that will be required for the current housing stock?

I will come back to the member with a precise answer on when an assessment will be ready, but I absolutely agree with him that that is an important strand of work.

How we decarbonise the heating and cooling of our buildings is incredibly important as part of the overall delivery of our climate change objectives, so we will continue to work in partnership with the UK Government where necessary, because some of the levers and powers lie with the UK Government. I will be seeing the Prime Minister this evening, and I am sure that these issues will be among the many issues that we will touch on.

I am sure that we will debate the detail of all these important issues robustly in the chamber, but I hope that there will be a lot that unites us as we live up to the responsibility on our shoulders to help to combat the climate emergency.

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Islay Ferries

To ask the First Minister for what reason two ferries that will serve Islay are being built in Turkey. (S6F-01680)

In line with relevant procurement legislation, the contract for the ferries that are currently being built for service on the Islay routes was awarded following a full and open tendering process, led by Caledonian Maritime Assets Ltd—CMAL—which is the procuring authority. The bid that was received from that yard represented the best value for money in terms of quality and price.

I thank the First Minister for that answer, but the Climate Change Committee’s report last month was not just critical but devastating in exposing the Government’s failures on the environment and emissions.

Is the First Minister comfortable that the steel for those two ferries is coming not from a Scottish steel mill—there is one about 40 miles from here, for example—but, rather, from China, the world’s largest polluter, whose steel sector is the second largest contributor to its emissions?

First, on the procurement decisions, over recent weeks, the leader of the member’s party has rightly questioned me in the chamber and has seemed to suggest that, somehow, we did not follow proper procurement policies in the award of other ferry contracts. Therefore, it is really important to stress that, in all these matters, we have complied with the relevant procurement legislation.

In relation to steel, that is a matter for the company that has the contract. The contract that has been awarded is a standard international shipbuilding contract, and, as such, decisions regarding materials and equipment lie with the shipyard. I understand that the shipyard might have originally intended to source steel from Ukraine, but, for obvious reasons, it has had to look elsewhere. The shipyard will take those decisions, and I sure that it will apply all necessary objectives to the decisions that it reaches.

The two new ferries will each be able to carry up to 450 passengers and 100 cars or 14 commercial vehicles, which will provide a combined 40 per cent increase in vehicle and freight capacity on the Islay route. That will represent an improvement for islanders and businesses, and it underlines the Scottish Government’s commitment to our island communities and the ferry network.

Does the First Minister share my view that questions such as the one that we have just heard reiterate the fact that the Tories are interested in politicking, and not people, when it comes to the ferry network?

On Jenni Minto’s last point, she is absolutely right. More importantly, people the length and breadth of Scotland, including our island communities, will draw their own conclusions from the approach that the Conservatives take on such issues.

Jenni Minto, who, in the Parliament, represents a number of islands, is right: the award of the contracts is good news for islanders and island communities, which is why it is important that they are progressing well. I understand that there will be an update on steel cutting and keel laying, which we expect in the coming days. We will continue to take decisions that are in the interests of people who live in our island communities, and that includes the decision that we are talking about.

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Bus Fare Capping

To ask the First Minister, in the light of the extension of bus fare caps in England, whether the Scottish Government supports capping bus fares in Scotland for those aged between 22 and 60. (S6F-01697)

First, I point out that Scotland already has the most generous concessionary fare scheme in the United Kingdom. More than 2.3 million people in Scotland are eligible not for capped bus fares, but for free bus travel. We continue to develop and assess options to create a fairer and more transparent system of fares in order to maintain and increase affordability for people who need it, which is why we are progressing the fair fares review. That review is considering the cost and availability of services and the range of discounts and concessionary schemes that are available on all modes of transport, which includes bus, rail and ferry.

The maximum cost of a single bus fare in London is £1.65. In Edinburgh, it is £1.85. In Manchester, Liverpool and West Yorkshire, where Labour mayors have taken control of transport, it is £2. It is £2 in Cardiff, and now it will be £2 in every part of England for the next few months. However, in greater Glasgow, it can be as much as £2.65 for a 2-mile journey. We really do not need a fares fair review to tell us that that is not fair. It is time to cap fares, for greater public control of buses, and for there to be a bit of urgency. In a cost of living crisis, why are people in Scotland paying among the highest bus fares in the UK?

Neil Bibby has omitted to say that people who are over 60 do not pay anything at all for bus travel, which is replicated in other parts of the UK, and that in Scotland, no one who is under the age of 22 pays for bus travel either. Fares are not capped for them; their bus travel is free. Across our country, 2.3 million people are eligible for completely free bus travel.

On the question of capping costs for people who do pay, it is right that we progress any such proposal through the fair fares review so that we properly consider the cost and availability of services and the whole range of discounts and concessionary schemes that are already available. That is exactly what we will continue to do. I will say this yet again, because I think that it is a fantastic statistic: the reality is that 2.3 million people in Scotland do not pay anything at all. They do not pay a single penny to travel by bus in Scotland.

We move to general and constituency supplementary questions.

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Influenza (Vaccination Uptake)

I refer to the exchanges on the pressures that are on the national health service. I understand that some 2 million people have accessed the flu vaccine—90 per cent or so did that when getting their winter Covid booster—but can more be done to ensure access for those who are eligible? Flu is very serious indeed.

Uptake levels for the Covid and flu vaccines are high, which is welcome. We will continue to promote vaccine uptake for those who are eligible but have not yet been vaccinated.

We will, of course, think most carefully about those who are in the most vulnerable groups. Figures for, I think, the first week of January show that almost 90 per cent of older care home residents in Scotland are vaccinated, which is higher than the figures for England and Wales, and that 77 per cent of over-50s in Scotland are vaccinated, which is again higher than figures for other parts of the United Kingdom. We will continue to work hard to encourage everybody who is eligible for a vaccine to take that up.

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NHS Fife (Major Incident Criteria)

The First Minister is more than aware of the crisis that the NHS faces. Last week, a whistleblower from the accident and emergency department at Victoria hospital in Kirkcaldy contacted me to express their concerns that patients were waiting for more than nine hours to be seen and that patient examinations were being conducted in ambulances that were in the hospital’s grounds. Staff in that department believed that the major incident criteria were being met but they were “not allowed” to call or declare the situation as such.

Will the First Minister confirm that no political direction was given to NHS Fife—or any other health board, for that matter—to ensure that a major incident was not called? Will she agree to investigate why staff were “not allowed” to follow standard protocol?

I said on Monday, and the health secretary confirmed in writing to health boards this week, that although health boards can seek advice and guidance from the Government when they think that that is appropriate, it is up to them to take whatever decisions they think might be appropriate to prioritise critical and life-saving care. Douglas Ross started his questioning to me today by criticising the fact that NHS Greater Glasgow and Clyde has, in effect, done that by pausing non-urgent care in Glasgow—[Interruption.]

Excuse me, First Minister. Members must treat one another with courtesy and respect. I would appreciate it if there were no interruptions at the moment. Continue, First Minister.

The point that I am making is that the action that NHS Greater Glasgow and Clyde announced last night demonstrates that health boards have the flexibility to take such action when they feel that it is necessary, which is right and proper.

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Cameron House Hotel (Fatal Accident Inquiry)

The fatal accident inquiry into the tragic fire at Cameron House hotel more than five years ago reported yesterday. I thank the sheriff and the Lord Advocate for their assistance in getting to this point. The report includes a range of recommendations that are designed to prevent such a fire from happening again.

Will the First Minister give a commitment today that all the recommendations will be implemented as a matter of the utmost urgency? Will she also consider whether the fire brigade requires further enforcement powers, given that, before the Cameron House fire and the more recent fire at the New County hotel in Perth, people appear to have been warned of fire risks but to have done nothing about them?

In relation to the FAI report that was published yesterday, I, too, thank the Scottish Courts and Tribunals Service for its work on this extremely important FAI and for publishing the report. I thank again the emergency services for their response on the night of the fire, and I give my condolences again to those who were bereaved in the incident.

Of course, we will thoroughly consider all the sheriff’s recommendations and I expect that, yes, we will accept all the recommendations. However, we must go through a process of considering them properly. We require to respond in due course, and we will do that.

In the light of the Cameron House fire and the more recent incident in Perth—my condolences go to the bereaved in that incident, too—it is right to look at enforcement provisions. Under the Fire (Scotland) Act 2005, the Scottish Fire and Rescue Service is appointed as the enforcing authority for fire and, as part of that, it produces all the relevant enforcement procedures, while applying the principles that are contained in the Scottish regulators’ strategic code of practice. As the enforcing authority, the Scottish Fire and Rescue Service works with duty holders in relevant premises to achieve compliance in fire safety, through providing advice and support and taking enforcement action when necessary.

Those systems are set out very clearly, but, of course, as part of our consideration of the recommendations of the sheriff, we will ensure that all appropriate aspects of that are looked at in an appropriate way.

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Trade Union Legislation

The Tory UK Government continues to show contempt for workers with its proposed anti-trade union legislation. Does the First Minister share my concern about the impact that those plans could have on the rights of people who are working in devolved public services? Will she join me in condemning and opposing that brazen attack on trade union rights?

That is a really important issue. It is important to make the point that the UK Government already has the most anti-trade union laws in western Europe, and the proposed bill threatens to undermine and weaken the rights of workers even further. We strongly oppose any bill that undermines legitimate trade union activity and does not respect fair work principles.

As Governments, we should be working with the public sector and trade unions to reach fair and reasonable settlements that respect the legitimate interests of workers, rather than pouring fuel on fires or taking away workers’ democratic rights. I will make those points very strongly when I see the Prime Minister this evening.

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Gorgie City Farm (Closure)

Gorgie city farm, which gives volunteering opportunities to disadvantaged young people and adults and provides a wonderful green play and learning space in one of the most urban parts of the capital, is due to close on Monday. The First Minister will be aware of the incredible value that that community facility provides, because she has visited the farm, which is one of Scotland’s last urban farms. What emergency support could be made available to help keep the farm going in an interim period? Will ministers also agree to meet me, the council and local campaigners to discuss a way forward to save the farm?

I have visited Gorgie city farm, so I am well aware of the excellent work that it does and its real value to the community and to Scotland as a whole. Of course, if there are any reasonable steps that the Government could take to support a way forward, we would certainly consider doing so. I will ask the relevant minister to meet with Miles Briggs, the council and representatives of the farm, if that would be helpful and appropriate, to consider options for the future. I will ask that that be taken forward with all due haste.

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University of Edinburgh Admissions (Scottish Students)

A mother in my constituency has provided me with data that shows that, this year, for many courses at the University of Edinburgh—outside the very welcome widening access places—zero Scots were admitted. For Scottish pupils from ordinary families and an average school, the doors are closed, no matter their mind or endeavour. For 440 years, the University of Edinburgh has admitted among the best and brightest of Scotland, including Walter Scott, Katherine Grainger, Stuart McDonald, Robert Louis Stevenson and Joanna Cherry—all great minds who worked hard and gained entry to study law here, in our capital city. With funding frozen for 13 years and the Scottish National Party’s cap on Scottish students, the historical promise of a Scottish education is broken. After five centuries, how has it come to this?

Forgive me if this is not parliamentary language, but, for reasons that I will come to, I am actually quite gobsmacked that that question has been put in that way by a Labour member of Parliament.

Let me first give these facts: a record number of young people secured places at university in this latest Universities and Colleges Admissions Service cycle, and a record number of 18-year-old Scots have secured a university place. That number has gone up by 20 per cent since 2019, the most recent year when there were exams.

The data provides a really positive story for those who are applying from deprived areas. The number of 18-year-olds from the most deprived areas who secure places has increased by 31 per cent since the 2019 cycle, and acceptances for people of all ages from the most deprived areas are up by 4 per cent.

This is where I take issue with Michael Marra. In my earlier days as First Minister, I used to be regularly criticised for the fact that too few young people from deprived communities were going to university. Now, I appear to be being criticised for the fact that too many of them are going to university.

I do not come from a deprived background. I come from a working-class background and went to a state school, and, when I studied law at Glasgow university, I was very much in the minority. Within a context of a record number of young Scots at university, I think that it is really good news that we are seeing more people from the most deprived areas actually going to our universities.

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St Fittick’s Community Park (Rezoning)

The First Minister will be aware that people from Torry and other Aberdeen campaigners are at the Parliament today. They are angry that they face losing their community’s last remaining green space, St Fittick’s community park. Torry contains the most concentrated area of multiple deprivation in the north of Scotland. Losing St Fittick’s will be detrimental to residents’ health and wellbeing and bad for wider social and environmental justice. Will the First Minister support the calls of Torry residents and others to save the park for current and future generations by using powers under the Town and Country Planning (Scotland) Act 1997 to ensure that St Fittick’s is not rezoned for development?

I know that there is strong feeling on the issue. However, Aberdeen City Council has notified ministers of its intention to adopt the local development plan. Ministers will now consider that and, as part of their scrutiny, will consider previous Scottish Government recommendations and check whether reporters’ modifications have been fully translated into the modified plan. Of course, ministers will set out a decision in due course.

That concludes First Minister’s question time.

On a point of order, Presiding Officer. I note that, when the First Minister spoke about the current delayed hospital discharge situation, she referenced live data. As far as I am aware, that live data is not public. The Office for Statistics Regulation has made it clear that, when information is used to publicly inform Parliament, it should be published in an accessible form. Will you seek from the First Minister a commitment to publish that data as soon as possible?

Thank you, Mr Burnett. That is not a matter for the chair, but your comments are on the record.

There will be a brief suspension before we move on to members’ business.

12:51 Meeting suspended.  

12:53 On resuming—