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I will give way briefly.

I am really sorry, but I have to make progress.

That work includes the expansion of acute medical initial assessment, increased respiratory and frailty capacity, and the enhancement of the call before convey service, which provides clinical advice to Ambulance Service crews to enable other pathways to be utilised to reduce the number of conveyances to hospital. On that point, 79.2 per cent of ambulances currently do not convey to the ARI emergency department, and that is the best conversion rate in Scotland. The central aim is to improve patient flow through the system, including from the Ambulance Service to NHS Grampian’s acute sites as well as back into the community as soon as patients are fit for discharge.

I heard Mr Stewart’s point, and I was going to come it and to the points that other members have made about staff feeling listened to or otherwise. Clear routes are available to staff to ensure that their voices are heard, but I will take the point away and make sure that it is raised with the board.

Further support that has been provided includes the centre for sustainable delivery providing bespoke clinical support to NHS Grampian. It has identified some opportunities that will support improvements, including for the women’s services that Carol Mochan raised. That support also includes a focus on reducing hospital occupancy to improve flow and reduce turnaround times for the Ambulance Service. There is also the potential to build on the current model of flow navigation, and we will work with the board to develop that in the coming year.

I will approach NHS Grampian again regarding the Baird and ANCHOR, and I will provide Mr Stewart with an update on his point about ensuring that facilities open so that capacity can be built. I will also look at the points that he raised about recruitment.

I will look at Mr Ross’s point about Huntington’s disease. He will understand that that is a local decision, but I will follow up in writing with more detail on the reasons for the decisions that have been taken.

Let me be clear. Addressing the pressures on NHS Grampian is a priority for the Government and for the new chief executive. However, I also want to recognise, as Mr Lumsden did in his opening speech, the hard work and dedication of the staff in Grampian, who go above and beyond to deliver the best quality of care to their patients. I know that there is more to do, but we must not overlook some of the progress that has been delivered by those staff in the past year.

By accessing extra funding from an additional £30 million national investment in planned care, NHS Grampian was able to deliver more than 23,000 additional appointments and procedures last year. We will support NHS Grampian to build on that work in 2025-26 through further investment as part of the £200 million to reduce waiting lists and support the reduction of delayed discharge.

In the motion and during the debate, Douglas Lumsden and Michael Marra also raised the issue of ageing equipment, including scanners and X-ray machines. From the additional £200 million investment this year, we are providing an additional £3.3 million to NHS Grampian for two mobile MRI scanners and one mobile CT scanner, which will deliver more than 19,000 additional scans in the coming year.

Finally, not only do my officials work closely with NHS Grampian on a regular basis, but I meet the regional chief executives on a monthly basis. My next meeting with the north, including NHS Grampian and—I say this for Beatrice Wishart’s benefit—NHS Orkney and NHS Shetland, is this Thursday, when we will discuss the issues that have been raised by colleagues today to ensure that we deliver for the people of Grampian and beyond.

I thank Mr Lumsden for securing the debate, for bringing it to the chamber and for the way in which he introduced it. Like him, I have family members who reside in the Grampian area, and I, too, thank the staff for the work that they do day in, day out, and for serving my family members, as they do his.

I recognise the significant pressures that NHS Grampian has been experiencing over recent months, which have specifically impacted on delays at the front door of its emergency departments and Scottish Ambulance Service turnaround times. That is largely due to capacity issues in the community as well as in the acute hospital—Kevin Stewart raised some of those issues incredibly well—and the availability of appropriate beds for patients who are ready to be discharged.

I am not going to stand before you, Presiding Officer, and suggest that the delays to patient care that have been raised by Mr Ross, Mr Marra and Mr Eagle and the increased pressure are at all acceptable. They are absolutely not. However, we are committed to supporting NHS Grampian to turn the position around.

Earlier this month, Ms Minto and I met Mr Lumsden, and we discussed audiology services. We are aiming to move more of those services from secondary care into primary care. Mr Lumsden raised minor injuries units, which I explained are specifically for non-urgent interventions. They can provide services by appointment or otherwise for injuries that do not require accident and emergency attendance, thereby reducing pressures on emergency services. Local communication with the public is key so that people know what services are available to them and where.

During the meeting, reference was also made to leadership and the process for the appointment of a new chief executive, which Mr Lumsden has raised again today. When the new chief executive is in post, we will continue to work with them to ensure that NHS Grampian moves into a more sustainable financial position and to being a more resilient service. As I communicated to Mr Lumsden, I can say to Mr Ross, Mr Stewart and others that we also keep the escalation framework under review.

In February, I visited Elmbank medical practice in Aberdeen and the Aberdeen royal infirmary, where I met—

As I said, we keep the escalation framework under review. A recruitment process for a new chief executive is under way and we are sensitive to ensuring that support is provided to NHS Grampian and its leadership to ensure that it can navigate through the situation that it is currently in. However, we do keep the escalation framework under review.

Briefly, yes.

General practice community link workers play a critical role in addressing the social determinants of health. Social determinants such as debt, social isolation and housing can have a negative impact on people’s health. In such cases, link workers provide crucial support by linking people with community resources. There is good evidence from local data and evaluations from wider research of the positive impact of community link working.

Our national review of community link workers will look to expand the existing evidence base, including by improving the consistency of the data that health and social care partnerships and link worker services collect.

I, too, have concerns about the planned cuts to link workers in West Dunbartonshire and the impact that they might have on patients, particularly those on low incomes. We know that there are clear and inextricable links between poverty and ill health and between poverty and barriers to accessing healthcare.

I understand that the integration joint board met last week to confirm its 2025-26 budget and that it agreed to reduce the number of link worker posts from nine to five whole-time equivalents. I stress the principle that link worker capacity should be targeted towards the greatest patient need, and my officials will continue to work with local partners to be clear about that principle.

GPs are essential to the delivery of high-quality, sustainable general practice. In November 2024, I published a plan with a suite of 20 actions to improve GP recruitment and retention. Those actions include reshaping the GP retainer scheme to provide GPs with flexible support when it is needed, expanding the Royal College of General Practitioners leadership scheme to support mid-career retention, and establishing early career fellowships to help newly qualified GPs to develop the skills for a career in general practice. In the current financial year, we have invested an additional £13.6 million to support the retention of key general practice staff.

I must challenge Tess White’s characterisation. We have invested an additional £73 million in general practice. The 2025-26 budget includes more than £2.2 billion of investment in primary care, which will take our spending on wider primary care to more than 11 per cent of the total 2025-26 health and social care resource budget. There has been an increase of more than 300 in the head count of general practitioners and we have expanded the wider multidisciplinary team to approaching 5,000 staff. The characterisation that Tess White gives is just not true.

However, I recognise that challenges remain and I recognise the particular challenges in rural and island communities—I understand that especially given my background. As I said in response to Colin Beattie, I will continue to engage with the BMA and the Royal College of General Practitioners to ensure that we can support general practice in all parts of the country.