Meeting of the Parliament

Meeting date: Thursday, February 28, 2013

Official Report 655KB pdf

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First Minister’s Question Time

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Engagements

1. To ask the First Minister what engagements he has planned for the rest of the day. (S4F-01206)

I will be looking at the situation in Raasay, because I was asked at First Minister’s question time last week what could be done about the issue of sporting rights on the island. I am happy to inform the Parliament that the Minister for Environment and Climate Change, Paul Wheelhouse, spoke to the crofters of Raasay this morning to inform them that he has been able to extend their lease for sporting rights on the island for another year. The contract that was awarded to South Ayrshire Stalking has been withdrawn by mutual consent—we welcome its positive attitude to resolving the issue. Mr Wheelhouse will meet community representatives on the island tomorrow to discuss the matter and underline the Government’s continued support for furthering the land reform agenda, including the championing of community management and ownership wherever possible.

I thank the First Minister for that information. We will want to know, of course, what will happen in a year’s time. The decision was one of the most astonishing by any minister in this Parliament since 1999. If the First Minister is making a commitment to sort it, then of course we are very grateful to him.

The latest figures on waiting times in accident and emergency units in Scotland show that the guarantee of treatment within four hours is being breached the length and breadth of the country. Does the First Minister agree with Margaret Watt, chair of the Scotland Patients Association, that the latest figures for accident and emergency waiting times are shocking?

There is no doubt that this winter has been a challenging time for accident and emergency units across Scotland. The reasons for that are well known and well understood, being norovirus and the incidence of respiratory infections that have resulted in hospitalisation.

The plan announced by the Cabinet Secretary for Health and Wellbeing to switch £50 million of new investment into accident and emergency departments is a substantial effort to ensure that our accident and emergency units around Scotland are able to cope with extreme pressures. That decision by the health secretary and the welcoming response that it has had across the health service should also be welcomed across the chamber.

We know that when the First Minister abandons his usual bluster for his wee quiet voice and calls for all of us across the Parliament to be concerned, the reality of what the Scottish National Party is presiding over must be absolutely appalling. We know that we have to plan for winter. If £50 million was available, why was it not made available earlier, rather than in response to a crisis?

What the First Minister says is simply not good enough. Members will recall that we were told by Alex Neil that the case of John McGarrity, the 84-year-old man who spent eight hours on a hospital trolley after being rushed to hospital with a chest infection, was not a true reflection of the national health service under the SNP. In one way he was right. It turns out that last December alone more than 300 John McGarritys waited even longer than eight hours. The reason for a four-hour waiting target for A and E treatment was to guarantee quality care to those patients in the greatest need. Can the First Minister tell me, when was the last time that the four-hour target was met for Scotland as a whole?

The monthly figures on accident and emergency have been substantially improving over the period. Of course, meeting the four-hour waiting-time target, in terms of the percentage, has been increasing as part of the general move towards improvement in the health service.

The reason why I respond to issues such as the health service in the way that I do is that they are extremely serious issues. The health service is a subject, particularly in terms of patient care, that should be treated in that manner. There are points to make, of course, about the support that this Government has given to the health service. We have guaranteed the health service—and ring fenced—its resource funding. It was not clear that the Labour Party would do that, either in 2007 or, indeed, in the run-up to the 2011 election. If I remember correctly, the number of consultants in accident and emergency units across Scotland has doubled over the past few years. However, it is quite clear from the winter pressures on the health service over the past few months that the accident and emergency units must be further strengthened to meet such strong conditions, which is exactly what the health secretary has done.

It is significant that that positive action, which I think will mean the recruitment of another 200 staff in accident and emergency units around Scotland, has been broadly welcomed across the country as a serious response to a serious issue. I hope that it can also be welcomed across this chamber, since it affects the constituents of each and every one of us.

There have been six First Minister’s question times since January this year. I can only assume that, on the other four occasions on which the First Minister shouted and bawled in defence of his NHS policy, he was not being serious about the challenges that were put to him.

This is a really serious matter. What do you do in Government when reality confronts you? The last thing that you do—as we have seen again just now—is retreat to debating points rather than focus on what has happened to people. [Interruption.]

Order.

The First Minister is not serious if he continues to contend that the problem is that it is winter and that the miraculous appearance of £50 million will solve the problem. He has not listened to staff and he has not listened to patients.

The First Minister did not answer the question, either. It would appear that he either has not read his own report or does not want to admit the answer in the chamber. The report says that

“the last time compliance was met across Scotland was September 2009.”

That is more than three years of letting patients down at one of the most vulnerable times in their lives.

Yesterday, the Auditor General told us that Nicola Sturgeon ignored warning signs when it came to waiting times. Did she also choose to ignore the warning signs about A and E?

What Johann Lamont forgets is that the target has been increasing throughout the past four to five years as a result of the targets of continuous improvement in the health service. That has to be taken into account when measuring the figures. By any reasonable estimation, the response that the health secretary has made is a substantial response to prepare for winter pressures and to reinforce accident and emergency units across Scotland.

I disagree with Johann Lamont about the evidence of the Auditor General. What I saw the Auditor General say at the Public Audit Committee yesterday was:

“We have not found evidence of manipulation at all.”

[Interruption.] I am quoting the Auditor General. That is in direct contrast to the Labour Party’s claims to the contrary over the past few months. Now, I know that, from the Labour Party point of view, it must be inconvenient that the Auditor General said that at the Public Audit Committee yesterday, but nonetheless she did.

I am sure that Johann Lamont will be the first to acknowledge the range of statistics that were released on Tuesday 26 February, which showed that 90.9 per cent of patients were seen and treated within 18 weeks from initial referral to the start of treatment. Out of 58,070 patients, only seven missed their 12-week treatment time guarantee. That means that 99.99 per cent were treated within the guaranteed time.

Let us have an acknowledgement that the health service, even under the significant pressures on it this winter, is performing extremely well across a range of measures. That does not mean that it is perfect or that it does not make mistakes—it can make mistakes, like any human organisation—but the basis of our treatment of the health service should be that of a public service that is performing extremely well.

Whether the First Minister says it in a quiet voice or a loud voice, the same problem remains: he is entirely in denial about what is happening in the national health service. He may come and say, “Yes, I hear what you say, but actually everything is fantastic”, but that is not the lived reality of people in hospitals the length and breadth of Scotland and it is not what his staff in the NHS are telling him.

Does the First Minister not realise how ridiculous he sounds, protecting his former health secretary and defending his record in this way? Apparently, to be like Nye Bevan, you have to get an amber warning from Audit Scotland, mislead the country on waiting times and ignore the warning signs of failing accident and emergency wards that are struggling to cope.

Does the First Minister not realise that this is about policy, not slogans? It is not about him winning or losing votes but about saving people’s lives. Does he not see that, by denying the truth—

That is not true.

Order.

Does the First Minister not see that, by denying the truth of the scale of the problem, he is denying the sick and the vulnerable the treatment that they so desperately need?

Obviously, if Johann Lamont reads out a pre-prepared question, she cannot take account of the answers that she has been given in response to the previous three questions. Because of the nature of the issue I have tried to deal with it seriously. By any estimation, the health secretary’s response to the pressures on accident and emergency departments is serious indeed.

On the overall position and whether or not the NHS is improving on its treatment of patients, the median—the mid-point, or the average, in that sense—waiting time for all patients, including people who are medically and socially unavailable, has reduced from 40 to 32 days since 2008. The average, or median, across the waiting list has improved—that is a fact from the figures. That indicates a health service that has been responding extremely well.

We also know a number of other things. This Government strives to protect the revenue budget of the health services and it has done so. That is not an uncontroversial political move and it was not supported by the Labour Party in 2007 or in the run-up to the 2011 election. The proof of the pudding is, of course, to look at the only place remaining in these islands where the Labour Party is in administration, which is Wales. In Wales, Labour has not protected the health service’s revenue budget because of the pressures that that Administration has been under as a result of the cuts from London. Therefore, it is instructive to look at the comparisons between Scotland and Wales on the statistics that are being produced. From initial referral, 90.9 per cent of patients in Scotland were treated within 18 weeks. In Wales, under Labour, where there is a 26-week target, 81.3 per cent of patients were treated within that target.

I make the point to the Labour Party that this Government has pledged to protect the revenue budget of the health service. The performance of the health service for all patients has, undoubtedly, been increasing over the past few years. The Labour Party did not come to the recent budget negotiations with any plan to increase the funding of the health service. Indeed, the consequence of its plan on housing—if it can be called a plan—would be to reduce funding for other key public services.

I am entitled to say that this Government has protected, under the most extreme public finance circumstances, the resource provision of the health service. The overall performance of the health service has undoubtedly been improving—the health service is not perfect and makes mistakes, as any human organisation does—and we have a health secretary who has shifted key resources into accident and emergency to deal with the winter crisis. That is an indication of a Government that defends the most crucial public service in Scotland, and defends it to the absolute utmost.

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Prime Minister (Meetings)

2. To ask the First Minister when he will next meet the Prime Minister. (S4F-01198)

No plans in the near future.

The difference between the First Minister’s attitude and manner in relation to waiting lists from last week to this week is astonishing. The reality is that, no matter what tone he takes in the debate, thousands of people across Scotland are waiting far too long for treatment.

Last week, the First Minister’s lame excuses were that the computer system was not up to scratch and that too many people were on holiday to report for treatment. Yesterday, the Auditor General told the Parliament that that was nonsense. If the First Minister wants to quote the Auditor General, then let us quote from the Auditor General. She said:

“the information was available ... it wasn’t acted upon ... it should have rung warning bells”

for the Scottish Government.

What is the First Minister’s excuse now? Is it really that autumn turned to winter?

If we are swapping quotes from the Auditor General, I should have completed the quote that I gave earlier. The Auditor General said:

“We have not found evidence of manipulation at all.”

She also said:

“It was clear that the IT systems needed to improve.”

That was the point—and onus—of Audit Scotland’s report.

The complaint is that 23 per cent of patients on the waiting list related to social and medical unavailability, but we also know from past statistics that that compares with 33 per cent of patients on the waiting list under the Labour Party in 2006.

There are genuine reasons for social unavailability. There are a number of reasons why people may not be available for the treatment that they need: medical reasons and, indeed, social reasons. That was not the issue at stake. The issue at stake was whether other health boards in Scotland had repeated the malpractice in Lothian of wrongly allocating people to social unavailability. That is why it is very important that the Auditor General made it clear yesterday that Audit Scotland did not find evidence of such manipulation throughout Scotland.

Let us have just a little bit of recognition that the new patient-determined system that was introduced last quarter provides a mechanism and method by which we can all be assured that patients have all been attributed to the right codes.

Let us look further at what the Auditor General said, which is that if national health service boards and the Government had been looking at the other information that was available, such as the increasing use of social unavailability codes, that should have raised some warning signs, which would have merited further investigation.

The Government’s complacency about treatment targets relates not just to treatment over the 18 weeks but starts when people first enter accident and emergency.

Only this week, a Scottish Government spokesman insisted that there were no accident and emergency admissions targets at all. However, the Government’s own ISD Scotland documents state clearly that NHS boards are tasked with reducing the attendance rate in emergency departments. That is despite the Royal College of Physicians saying in the Scottish Government’s press release that accident and emergency admissions would soar by 13.5 per cent by 2020.

The First Minister cannot blame the computers or people’s holidays. Now his own spokesman cannot deny what is in his own documents. There are targets and the Government is missing them. Does he or anyone else in the Government know what is going on inside the health service?

Every week, the same question is asked about Ruth Davidson’s questions at First Minister’s questions.

Obviously, there are targets across accident and emergency in Scotland. We have just discussed those targets and the health secretary’s action to ensure that the health service throughout Scotland can respond to the strong pressures.

As I pointed out to Johann Lamont, if we look at what has happened to median waiting times, including social unavailability and medical unavailability—the lot—we see that they have been reducing over the past few years.

There is another aspect that is pretty important: the satisfaction rate among patients—the people who experience the health service—which is running at near record levels in Scotland at the moment.

I will say one last thing to Ruth Davidson—given the tenor of today, I will say it as gently as possible. Given the Conservatives’ record of disaster in the health service—the history of their administration of the Scottish health service when they were, unfortunately, in charge of the Scottish Office, the situation that prevails south of the border, the extraordinary cutbacks and the lack of belief in public service—the last people who should come to proclaim their faith in a public health service are a political party that, over a generation, has done its level best to undermine it.

Is the First Minister aware that Shetland crofters who are owner-occupiers cannot currently decroft their land, which causes immediate legal and financial difficulties? Is he aware that I have raised the matter with ministers and have yet to have an answer? Does he accept that the mess was caused by the Crofting Reform (Scotland) Act 2010 and will he undertake to look into the matter and report immediately back to Parliament? If he can fix Raasay in a week, will he fix the Shetland mess by next Thursday as well?

I am glad that Tavish Scott acknowledged the speed of action on Raasay because, only this morning, he complained in The Scotsman about the lack of it. I assure him that I will apply as much concentration and thought to the genuine constituency issue that he mentions, and we will see whether ministers can provide some satisfaction in resolution of that problem as well. We are here to help. [Laughter.]

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National Health Service (Medical Negligence Claims)

3. To ask the First Minister what action is being taken to reduce the cost of NHS medical negligence claims. (S4F-01213)

The most important thing that is being done is the introduction of the Scottish patient safety programme in all of Scotland’s acute hospitals to reduce adverse incidents, to improve critical care outcomes and to strengthen organisational and leadership attention on improving safety. Murdo Fraser will know that Don Berwick, the former Obama adviser whom the Prime Minister has tasked with improving patient safety in England, has said of the patient safety programme in Scotland:

“The Scottish Patient Safety Programme is without doubt one of the most ambitious patient safety initiatives in the world ... making Scotland the safest nation on earth from the viewpoint of health care.”

I thank the First Minister for his response, but the rising cost of medical negligence claims must be a concern, not least because it means that there is less money to spend on front-line services. The Scottish Government’s proposed no-fault compensation scheme would certainly have benefits, but it could lead to a 50 per cent increase in the cost of claims. At current figures, that would represent an extra £18 million per year, or the equivalent of the salaries of 840 nurses.

In light of that, will the First Minister look seriously at all options for addressing the issue, recognising that many of those who suffer bad treatment at the hands of the NHS simply want an explanation and an apology rather than financial compensation?

We think that no-fault compensation is an important way to progress the issue. Murdo Fraser should acknowledge that the direction that the statistics have been taking in Scotland should give us pause for thought.

Like Murdo Fraser, I read the article in The Herald on Monday with great interest. It made a point that led me to carry out some further investigation. It said:

“As some cases can take years to resolve, some of the payouts may relate to pre-2006 negligence incidents.”

I was particularly interested in the 2010-11 figures, which showed a huge spike in compensation payments to £60 million. It turns out that, in that year, just three claims totalled £18.1 million, but those claims stem back to incidents that occurred in 1989, 1993 and 2004. That tells us two things: first, that we should be very careful about looking at the year in which money is paid out, as opposed to the year in which a claim originated; and, secondly, that—as the extraordinary length of time before settlement tells us—an initiative such as no-fault compensation might well be called for.

I accept that the issue should be a matter of substantial concern, but it should be noted that the sum that was paid out in 2011-12, which amounted to £27.2 million, represents about 0.3 per cent of the resource budget of the NHS in Scotland. The equivalent figure in England is 1.3 per cent, which is some four times higher. We should recognise that the issue requires to be tackled through an initiative, which is what no-fault compensation is designed to do. We should also put the issue in perspective and recognise that it is one that I suspect is being encountered by health services across the western world. The Government’s initiative is a genuine attempt to address the circumstances of the issue.

Does the First Minister recognise the substantial concerns that have been expressed by the legal and the medical professions about the proposals for no-fault compensation, which are about not just the additional cost but the lack of detail on how such a scheme would operate effectively? Will he therefore review the proposals to take on board those concerns and consult again before proceeding further? I am sure that he would agree that it is important that we get this right.

We have taken and are taking substantial care. My previous understanding of Jackie Baillie’s position was that she supported no-fault compensation.

I hope that some of the statistics that I have given and the analysis that I have provided of current claims against the health service will encourage people to agree that there are issues that must be looked at in substantial detail. It is clear that the current situation is a matter of serious concern.

As I have just indicated and as I am sure that Jackie Baillie will want to acknowledge, the figures that we are seeing now relate to claims that date back years—issues that occurred a substantial number of years ago. They tell us that an initiative is necessary to bring the issue under control. They also tell us that perhaps we should look behind the situation before drawing conclusions such as those that Jackie Baillie, unfortunately, tried to draw in the press this week. I am sure that, when it comes to no-fault compensation, Jackie Baillie would be the very last person in the chamber to try to score political points by attributing claims to the current year when they refer to issues that arose a substantial length of time ago.

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Economy (Downgrading of Bond Rating)

4. To ask the First Minister what the impact will be on the Scottish economy of the downgrading of the United Kingdom Government’s bond rating. (S4F-01203)

The decision to downgrade the UK’s credit rating confirms the utter failure of the UK Government’s economic strategy. There were substantial warnings from this Government and from others that the approach that has been taken to austerity could undermine the possibility of growth, and the evidence to support that view has become ever more clear. I hope that the Chancellor of the Exchequer will now heed the warning, and that instead of reinforcing the disastrous policies that he has been pursuing, he will consider the opportunity that next month’s budget provides to boost real investment in the real economy.

Moody’s set out one of the reasons for its downgrade action as being

“further potential austerity measures included in the government’s next Comprehensive Spending Review”.

Does not that demonstrate that Scotland’s remaining part of the UK threatens rather than secures Scotland’s fiscal position, and that those who have argued that we must be part of the UK in order to maintain a AAA rating have been shown to be completely wrong? Surely no one can trust a word that the no campaign says.

Amazingly enough, into my hands has come a no campaign leaflet. It says that

“one reason why we’re better together”

is the UK’s AAA rating. I am sure that the unified ranks of the Liberal Democrats, the Conservative Party and the Labour Party will immediately want to withdraw that misrepresentation from circulation.

The pound appears to have held up against the dollar and the euro, the FTSE has held up and yields on bonds have held up. Is the First Minister disappointed with the market reaction to the downgrade?

What I am “disappointed with” is political spokesmen who first say that AAA is the be-all and end-all when it comes to Scotland, but who now say that it does not matter when it comes to the United Kingdom.

Let me quote an enormous sage and real authority on these matters—someone who, I am sure, Gavin Brown would treat with the utmost respect: Alistair Darling. In commenting on the mistakes and failings of the Conservative Party, which he is now leading in a joint campaign, Alistair said:

“It was very unwise to stake their reputation on maintaining the triple A rating.”

If we come to the conclusion that even the master of disaster, the author of all the misfortunes, the chancellor who led this country into the greatest recession since the 1930s, believes that the Conservative Party is incompetent, the rest of us can only say that we agree, on this occasion, with Alistair Darling.

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Education (New National Qualifications)

5. To ask the First Minister what action the Scottish Government is taking to address concerns expressed by teachers in an Educational Institute of Scotland survey on readiness for the new national qualifications. (S4F-01208)

Hugh Henry and I agree that curriculum for excellence is the most important educational development in a generation. It has been shaped and implemented in partnership with teachers, parents and learners. In response to teachers’ concerns, we are rolling out a package of support, which has been agreed with the Educational Institute of Scotland. It includes an additional £3.5 million and two additional in-service days in 2012-13 for every secondary school, as well as a wide range of support materials.

Teachers will welcome any additional support. If the First Minister has confidence in the actions that have been taken, will he give his personal guarantee that no Scottish pupil will be disadvantaged by the changes?

The changes will be good for Scottish education and therefore, by definition, good for each pupil. Today has seen release of more support materials, including specimen exam papers, which complement the support that has already been provided, which I mentioned. That will be completed with additional materials in March and April. The full package will enable teachers to deliver the new qualifications with confidence; I know that Hugh Henry understands that it contains exactly the material that many teachers have been calling for.

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Economy (North Sea Oil Investment)

6. To ask the First Minister what impact the reported 30-year high in North Sea oil investment will have on the Scottish economy. (S4F-01200)

I think that the survey from Oil & Gas UK that was released on Monday is hugely significant, because it shows oil and gas investment rising to the highest level for more than three decades.

These are exciting times for the industry. There have been a number of substantial recent investments in the North Sea. Dana Petroleum and Statoil have announced major investments, and the latter’s investment in the Mariner field is expected to result in 30 years of production. Furthermore, a substantial new oil discovery was recently announced by TAQA at the Darwin oil field in the northern area of the North Sea.

The Scottish Government will shortly publish the first in a series of analytical bulletins on oil and gas. The new analysis demonstrates the vast potential that remains. Scotland’s share of United Kingdom oil reserves is estimated to be in excess of 90 per cent, which is some 60 per cent of the reserves of the entire European Union.

The oil and gas sector will remain one of Scotland’s outstanding sectors for many years to come. We have vast reserves and wealth remaining. I fully agree with Professor Joseph Stiglitz, who gave evidence to Parliament yesterday, that that wealth must not continue to be squandered by the UK Government.

The oil and gas industry is the economic powerhouse of not only the Scottish economy, but the UK economy. Even George Osborne’s disastrous changes to the tax regime, which have since been reversed, failed to stymie investment. Does the First Minister agree that it is the success of the oil and gas industry that is propping up the Chancellor of the Exchequer’s failures, and that the fruits of our precious resource would be much better spent on creating a fairer, more socially just and independent Scotland?

I agree with that, and I agree that it is a tribute to the strength of the industry that it has managed to withstand even the ministrations of George Osborne.

I was particularly interested to note one of the items in the analysis in the Oil & Gas UK report, on the significance of the £20 billion-worth of investments over the past two years. It stated that production from those investments alone will rapidly rise to half a million barrels of oil a day by 2017 and will pay more than £3 billion additional production tax in that year. Members will be aware, of course, that we expect 2017 to be the first full year of an independent Scotland.

Did the First Minister also see this week the comments by Geoff Holmes of Talisman Sinopec Energy UK? He said that the growing investment in the North Sea needs to be underpinned by skills in order to ensure that that development can continue to be as safe as it has been in the past 25 years. If the First Minister saw that comment, does he agree that the answer is to locate the energy skills academy in Aberdeen without delay, in order to support the oil and gas industry going forward?

Detailed announcements on the oil and gas academy, which I know Lewis Macdonald supports whole-heartedly, will be made in the very near future, and I hope and anticipate that they will be welcomed by him.