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On a point of order, Presiding Officer. I am not sure whether my vote was recorded. I would have voted yes.

To ask the Scottish Government whether it plans to publish winter updates to its NHS recovery plan and winter resilience overview. (S6O-02599)

Similar to the previous health secretary, it is quite clear that this cabinet secretary is simply not doing enough to prepare health boards for the winter. During a recent visit to Borders general hospital, dedicated staff told me that they were already at capacity and were facing a crisis this winter across the hospital. On the day that I visited, 80 out of 310 beds were blocked as a result of delayed discharges, and there was simply no further capacity to flex. Despite what the cabinet secretary says, is it not time that the distracted and divided Scottish National Party Government focused on delivering a real and meaningful NHS recovery plan and a real strategy to deliver resilience this winter?

Gillian Mackay referred to policies that are unenforceable and unworkable. What does she think about the ban on alcohol on Scottish National Party-run ScotRail, which started off as a ban on match days but has been permanently extended to a 24-hour ban? As well as banning the consumption of alcohol on trains at any time of day, it extends to the carrying of alcohol in an unopened bottle, unless it is in a bag that is not see-through. Is that not also unenforceable and unworkable? Should the SNP Government not reconsider the ban on alcohol on our trains?

Does the member agree that the Government is wilfully ignoring the very real fears of those operating in the short-term lets sector? Is he aware of the case of my constituent Linda, who went to discuss her plight with Paul McLennan, her constituency MSP and the minister responsible for the policy? When Linda told him that she stood to lose her source of income, her entire business and possibly the roof over her head as a result of his short-term lets policy, Mr McLennan’s response was that she ought to start “looking for another job”.

Does the member agree that that shows utter and complete contempt on the part of this minister and this Government towards those who live and work in our short-term let and bed-and-breakfast sectors? Given the chaos and harm that the policy will inflict, should it not be Mr McLennan, rather than Linda, who is looking for another job?

In March 2022, ministers were made aware of RAAC guidance from the Institution of Structural Engineers, as the minister has said. In July 2022, learning directorate heads first flagged the risks from RAAC, and, in May 2023, East Lothian Council took action to close parts of a local school. However, it took until 14 August for the Scottish Government to convene a cross-public-sector working group on RAAC. If the safety of occupants of buildings, including children, is of the utmost importance to the Government, why was there an 18-month delay in taking action here, in Scotland?

I thank Christine Grahame for securing this important debate, which recognises the work of NHS Borders paediatric ambulatory care unit, following its 20th anniversary in May, and I join her in celebrating its achievements.

As Christine Grahame has said, over the past 20 years, the care unit, with its specialist team of nurses, has provided blood tests, medical assessments and allergy tests and has supported thousands of children in the comfort of an out-patient setting. That approach means that fewer children are admitted into hospital for treatment or have to travel to be treated in other parts of the country. For children and their families, the reassurance that is provided by being in that familiar setting results in less stress.

The unit has also helped to free up bed space at the BGH across local services, offering peace of mind for children and their parents, and the paediatric nurses there have developed skills including the delivery of specialist immunisations and the use of medical devices. As Christine Grahame alluded to, they have also offered psychological support to children and parents across the Scottish Borders. The staff deserve our praise, recognition and thanks for their work—I thank them hugely.

I also want to take this opportunity to address some of the pressures that health services in the Borders are presently facing. Having visited the BGH last week, it is clear that the present Scottish National Party-Green Government has not yet delivered a meaningful national health service recovery plan. During the visit, I learned about the severe pressures that are being felt across the service, and there is simply no capacity to flex as this winter approaches. Problems are being seen in the accident and emergency department, through the wards and into the step-down Borders view interim care facility.

I thank Christine Grahame for her suitable chastisement. I am sure that we will continue to clash on “Representing Border”. However, I want to take this opportunity to address some concerns that were raised with me directly by senior NHS managers, including the chair of the health board, when I visited the hospital last week. The problems that I said had been seen in A and E, through the wards and into the Borders view interim care facility reflect the real pressures that our local health service is facing, particularly in social care and care at home. Many hospital patients who are ready to be discharged are being forced to wait several weeks and sometimes months for care packages to be arranged so that they can be discharged from hospital. At the time of my visit, 80 out of 310 beds were occupied by patients who were ready to be discharged, which was creating bottlenecks throughout the hospital. Despite the huge efforts of staff—I say to Ms Grahame that I celebrate those efforts—the issue is still resulting in elective surgery appointments being cancelled.

Alongside the board chair, Karen Hamilton, I visited the medical assessment unit. That unit is supposed to signpost patients to a ward or another setting within 72 hours. However, last week there were five patients receiving end-of-life care in the unit. As one member of staff said:

“This is a busy place. This is not a good place for people to die.”

Those patients deserve better.

I recently met general practitioners from Earlston medical practice, who, increasingly, are being asked to deliver secondary care in a primary care setting, through no fault of national health service staff whatsoever but simply because of the capacity in the system. Innovations such as the paediatric ambulatory ward and the health board’s hospital at home pilot, which I had the privilege and honour to see in action, are very much to be welcomed, as is the commitment that is shown by staff.

However, as we prepare for winter, NHS Borders wards and facilities are already above capacity, and there is no room to flex. The hard-working workforce is operating at full capacity, so I hope that the minister will listen to patients and clinicians and will properly resource our NHS and social care sector in rural areas. I commend staff at NHS Borders for their efforts in paediatrics, wards, operating theatres, specialist mental health services and other services. As winter approaches, I urge ministers to give them the tools and the resources to do the job.

In Preston Lodge high school in Prestonpans, 20 classrooms are closed and secondary 1 pupils are being taught off-campus. East Lothian Council has already spent more than £300,000 to maintain education standards—a sum that has not been budgeted for at a time of extreme financial pressure for the council. Will the cabinet secretary therefore commit to reimbursing councils and health boards that have incurred significant non-construction and inspection-related costs due to the discovery of RAAC?

I ask the minister to look again at hospital at home and the home first programme, which is especially important in rural areas. Will she consider providing additional funding for rural council and health board areas, given that the cost of delivering such services in those areas is significantly higher?