Seòmar agus comataidhean

I declare an interest as a practising NHS general practitioner.

I was contacted by John, who had already waited 40 weeks for orthopaedic surgery. He had had no updates from the health board. He looked himself and found that his wait had increased—it had been 52 weeks in September and is now 67 weeks. The uncertainty is a major source of frustration and pain.

After the First Minister has just read out what is not happening, and at a time when we can track our online shopping orders to the minute, why is there no transparency about waiting times for hospital appointments?

I declare an interest as a practising NHS general practitioner and a former chair of the BMA GP trainees committee.

In my experience in my GP surgery, I see not statistics, but real-life stories that tell me that our workforce is stretched to breaking point. Behind every delayed scan or missed appointment is a patient who has been left in pain or desperately worried, and a clinician who has been left exhausted. Let us call that what it is: a workforce crisis that has been created in Bute house and presided over by a revolving door of Scottish National Party health secretaries who have failed to plan, failed to lead and failed Scotland’s patients.

As a consequence of those failures, junior doctors are finishing years of training only to find that there are no jobs. GPs who are being trained here are forced to leave Scotland to work; the SNP is training doctors for Australia. Newly qualified nurses and paramedics are joining the ranks of the unemployed, all at a time when patients are struggling to get appointments. That is happening right now outside the chamber in the real world.

The Royal College of Radiologists has laid bare the scale of the crisis. Scotland faces a 25 per cent shortfall in radiologists and a 19 per cent shortfall in clinical oncologists, which is the highest figure in the UK. By 2029, those shortfalls are projected to grow to 35 per cent and 31 per cent respectively. What does that mean for everyone out there and for our patients? It means that there will be longer wait times for cancer diagnosis, delayed treatments and worsening outcomes. In some parts of Scotland, the gaps are even more severe, which will deepen regional inequality. That is truly scary. The Scottish Government needs to get a grip and stop trotting out the kind of platitudes that are in the SNP’s amendment.

The problem extends beyond cancer care. In cardiology, more than 6,000 patients have been waiting more than a year for an echocardiogram. That is a vital test for heart disease, but not according to the SNP. Shockingly, the Scottish Government does not consider that to be one of its key diagnostic tests. It is omitted from workforce planning, routine reporting and serious political attention. After 18 years in Government, the SNP still has not got its head around the basics.

The waiting list for that test is more than double the combined total for the eight key tests that the Government tracks. Clearly, patients with suspected heart disease are having to wait for that test. There is a lack of trained cardiac physiologists. The only degree programme in Scotland for that specialty is ending and no replacement is in place for 2025. That profession, which is crucial to saving lives, is being allowed to wither from neglect. That is the SNP in a nutshell.

I turn to GPs. What I witness there is not isolated strain but the visible symptom of a deeper workforce crisis that the SNP has long ignored. Poor planning, a lack of vision and political complacency have left our NHS hollowed out even as demand continues to soar. There is what has been announced and then there is reality. The SNP promised 800 more GPs by 2027 but, lo and behold, GP numbers instead fell from 4,514 in 2022 to 4,438 last year. The BMA and the Royal College of General Practitioners have warned that general practice is in danger of collapse. However, under the slick management of the SNP, we find ourselves in the absurd position in which doctors are underemployed yet demand is soaring.

It is time for change and leadership rather than slogans and excuses. Our NHS staff and patients deserve better.

I move amendment S6M-17869.1, to insert after “vacancies,”:

“acknowledges that Scotland is experiencing a paradox of underemployed GPs who remain unable to find sufficient work despite widespread demand, as well as unemployed paramedics graduating from universities and paediatric nurses unable to secure roles; highlights that the Scottish National Party administration promised to increase GP numbers by 800 by 2027, but that this target is unlikely to be met as GP numbers are declining and junior doctors are struggling to find jobs; acknowledges that the Royal College of Nursing has claimed that current nursing staffing levels are inadequate, noting that, while the number of nurses employed by NHS Scotland has increased, levels of staff absence and agency use remain unsustainably high; references the report, The Nursing Workforce in Scotland 2025, which shows demand outstripping supply, and calls for better data to enable sustainable workforce planning; recognises that the Royal College of General Practitioners has criticised the Scottish Government’s plan to provide 100,000 extra GP appointments, as Scotland’s NHS currently does not have the workforce capacity to deliver this plan;”.

Does Paul Sweeney agree that those pressures create moral injury, which affects our staff, who feel burnt out then just leave?

How many newly qualified paediatric nurses have found vacancies that enable them to take up a job?

I declare an interest as a practising NHS general practitioner.

The Scottish Conservatives will support the Care Reform (Scotland) Bill, which we are here to debate, but let us not pretend that we have arrived at this moment by design. We are here because of yet another Scottish National Party policy that promised the world and delivered a fiasco. The now defunct National Care Service (Scotland) Bill was once hailed as the most significant reform to health and social care since the creation of the NHS. In reality, it was a half-baked plan that was dreamt up by ministers in an ivory tower and clearly dead in the water before the ink had dried on the first draft.

What has been the price? Nearly £30 million has been spent on a policy that nobody wanted—not the unions, not COSLA and not care professionals.

The care service is not the only SNP debacle in the Parliament. When responding to Brian Whittle, the minister said that we can ask the Scottish Government questions about spending any time. Okay—£200 million has been spent on ferries that are still not finished; £180 million was spent on a deposit return scheme that was scrapped before it was launched; more than £600,000 was spent on failed Supreme Court adventures, from defining a woman to indyref2; and £140 million was spent on a Scotland-only census that flopped. Get out that abacus. Approaching £1 billion of public money has been torched in this parliamentary session alone on vanity projects that never delivered, all paid for by the Scottish taxpayer—and for what? There are big promises and bigger budgets, but zilch delivery.

The SNP now presents the Care Reform (Scotland) Bill—a more modest and workable approach that includes Anne’s law, which guarantees care home residents the right to see loved ones. We support the bill due to Anne’s law. In fact, we would have supported it years ago without the eye-watering price tag of the national care service experiment.

SNP ministers love bold commitments. They rail against Westminster one day but send their constituents the invoice the next. Their convictions are as reliable as the CalMac ferry timetable. Their principles are stirring in speeches but missing in action.

At least the new bill is stripped back and serious about protecting the rights of residents and empowering carers. There is no grandstanding or runaway spending, just practical reform—finally.

However, let us not forget how we got here. The Parliament has been a hall of shame for SNP governance—a flagship bill in ruins, two ferries that are still incomplete, a bungled census and legal stunts that never stood a chance. There has been £1 billion of broken promises and missed targets, with public services left in a worse state than before. Think about what that money could have done for classrooms, GP surgeries or community care.

We support the bill and we back Anne’s law, which should have been on the statute book a very long time ago, but let this be the last car crash in SNP policy making—enough with headlines, enough with hubris and enough with the costs. Scotland does not need another slick soundbite. It needs serious leadership with a plan, a purpose and a price tag that does not leave the public short-changed. The SNP loves to talk about conviction, but, when it comes to commitments, it costs the country a fortune and too often leaves our people stranded. It is time to stop paying premiums for pipe dreams. Scotland deserves better.

The reason for the amendment is the social work profession, so let me read directly from what the professional association for social work and social workers says about amendment 67:

“This is the most important amendment in the Bill from the perspective of the social work profession and its place in Scotland’s public services. Unless the legislation includes some high-level description of the functions of the National Chief Social Work Adviser, their role and purpose remain at the discretion of Scottish Ministers. Enshrining these functions and purpose in legislation ensures that the Adviser and the Agency have a clear statutory purpose in upholding the values and ethics of the social work profession within Government.”

I urge Parliament to support the very people who we are looking to empower—social workers—and vote for amendment 67.

I move amendment 67.

I declare an interest as a practising NHS GP.

Amendment 56, in my name, seeks to ensure that there is a clear process of recourse in Anne’s law for those who are affected. It is essential that there is an explicit route of recourse that creates clear accountability for complaints and a clear process for dispute resolution. Stakeholders have been clear that they want proportionate oversight for Anne’s law. The minister has argued that a framework is already in place for social care complaints. However, it is clear that outlining in the code a specific process for Anne’s law would provide clarity and transparency for all who are involved. Anne’s law is a key element of what is left of the bill, and we must take the opportunity to strengthen it as far as we can in order to protect care home residents, their families and care supporters. Amendment 56 is fully supported by the British Association of Social Workers

Amendment 61, in my name, would ensure transparent reporting on the suspension of care home visits. It would establish a duty on the Care Inspectorate to share that data and analysis and to make recommendations on changes to the code. Such monitoring would ensure that any suspensions to care home visits would be applied proportionately. The minister surely agrees that denying care home residents access to visits has significant consequences. Regular reporting would allow any disproportionate use of the power to become evident, which would enable changes to the code to be made when they are needed. As I mentioned, it is vital that we do all that we can to ensure that Anne’s law is as robust as it can be for those affected. Amendment 61 is also fully supported by the British Association of Social Workers.

Manuscript amendment 61A, in my name, is a technical amendment.

We will support all the amendments in the group. Given that the biggest part of the bill is Anne’s law, we need to make it as robust and effective as possible, especially as it has taken us three years to get here.

I seek to withdraw amendment 65.

Amendment 65, by agreement, withdrawn.

The intention behind amendment 65 was to expand the enforcement powers of the Care Inspectorate with a view to improving standards of care, ensuring resources are available for increased use of inspection volunteers. However, after further discussions, I will not press amendment 65.

Amendment 65 moved—[Sandesh Gulhane].

We have heard what the minister had to say, but I urge Parliament to listen to social workers, who want the amendment and have asked for it. I press amendment 67.