10/05/2017

:00:00. > :00:11.I would hope that there would be very few if any within this chamber

:00:12. > :00:14.who would disagree with that principle. The resource is a big

:00:15. > :00:17.shift of resource towards primary care. I thought that would be

:00:18. > :00:24.something that would be welcomed across this chamber. I do welcome

:00:25. > :00:27.the new investment into primary care and also welcome what the Cabinet

:00:28. > :00:37.said about nursing rules in primary care particularly as we work towards

:00:38. > :00:43.-- head towards being many GP short. Can now see Cabinet secretary what

:00:44. > :00:47.role other health care professionals will have on the GP contract process

:00:48. > :00:52.and secondly when she will be publishing a detailed workforce

:00:53. > :00:57.plan. The workforce plan is on schedule to be published as I said

:00:58. > :01:03.in late spring, so imminently, in the next few weeks. Of course, that

:01:04. > :01:15.has been a big undertaking with masses of consultation across many

:01:16. > :01:20.sectors and staffing groups. The GP contracts is a contracts negotiated

:01:21. > :01:23.between the Scottish Government and the British Medical Association,

:01:24. > :01:30.that it out the contract is the goatee is said -- the contract is

:01:31. > :01:35.negotiated. The details of that will be released, but it would be

:01:36. > :01:38.inappropriate while those negotiations are ongoing for us to

:01:39. > :01:41.do that before the negotiations are concluded. Once they are, I will

:01:42. > :01:48.make sure that Parliament is informed on the outcome of that. To

:01:49. > :01:52.us this godless Government what steps it is taking in light of

:01:53. > :02:00.reports that 65% of adults in Scotland are overweight or obese? We

:02:01. > :02:06.remain committed to addressing Scotland's excess weight and in line

:02:07. > :02:11.with the evidence we are maintaining activity across society for people

:02:12. > :02:19.to be eating less and exercising. We have put a range of programmes to

:02:20. > :02:23.encourage healthy eating. We are encouraging councils for free school

:02:24. > :02:29.meals. We have exceeded our target of 150 community sports hubs across

:02:30. > :02:36.local authorities by 2016. Sport Scotland has also invested to make a

:02:37. > :02:41.total of 200 clubs by 2020. Thank you. We would ask to consider the

:02:42. > :02:47.impact of price promotions on obesity as Cancer Research UK assert

:02:48. > :02:54.that 40% all calorie Dub ought on price promotions. -- are bought.

:02:55. > :02:57.Salt and sugar and fat content is seriously damaging the health of

:02:58. > :03:00.people in Scotland in many different ways. Can she tell us how she might

:03:01. > :03:08.address these concerns, particularly about very high calorie intake as a

:03:09. > :03:13.result of price promotions. Price promotions certainly is an issue

:03:14. > :03:19.that Cancer Research UK have pointed out as an area in which we need to

:03:20. > :03:21.take action on and there will be an opportunity to delve deeply into the

:03:22. > :03:31.tissues and a whole range of other issues as we develop the obesity

:03:32. > :03:35.strategy. Certainly we will continue to engage with Cancer Research UK on

:03:36. > :03:42.this, it is ready helpful that some of this will allow us to identify

:03:43. > :03:46.just how big an issue this is for Scotland to deal with the challenges

:03:47. > :03:50.that we face. The prize promotion and affordability of high-fat, sugar

:03:51. > :03:58.and salt foods is one that we need to look at. There should be nothing

:03:59. > :04:02.of the table as we approach the new strategy and I look forward to

:04:03. > :04:13.working with you as we move it forward. Can I ask whether the

:04:14. > :04:17.minister shares my disappointment that the UK Government didn't take

:04:18. > :04:20.the opportunity to introduce further restrictions on junk food

:04:21. > :04:27.advertising in the action plan on childhood obesity? Absolutely. I

:04:28. > :04:33.would share the member's disappointment on the UK

:04:34. > :04:37.Government's decision not to include restrictions on junk food

:04:38. > :04:40.advertising. That does align itself with the disappointment that Cancer

:04:41. > :04:46.UK expressed in relation to the point is that John Scott raised. We

:04:47. > :04:50.have long argued that a ban up to the 9pm watershed would greatly

:04:51. > :04:56.reduce children's exposure to the marketing of healthy, unhealthy

:04:57. > :04:59.foods. This is backed up by recommendations by many people and

:05:00. > :05:03.has the backing of the Welsh and Northern Ireland governments. It has

:05:04. > :05:13.a huge amount of support across our third sector. Strong arguments that

:05:14. > :05:19.Cancer research UK have on this. Perhaps there will be a change of

:05:20. > :05:27.heart. As well as two thirds of adults being obese, many children

:05:28. > :05:37.are. The current prevention of obesity route map isn't working and

:05:38. > :05:40.as we have heard that the published work by the UK Government is

:05:41. > :05:46.working, will you accept and recognise that the causes and

:05:47. > :05:52.consequences of obesity is not born evenly across Scotland's people, it

:05:53. > :05:58.we need to tackle wealth and equality in Scotland. Absolutely I

:05:59. > :06:00.recognise that there is disproportionate impact felt on the

:06:01. > :06:07.communities that are the most vulnerable. They stand to gain the

:06:08. > :06:13.most if we take action to tackle the issues of the beta T. That is why we

:06:14. > :06:20.are taking forward a new strategy starting with a consultation

:06:21. > :06:29.starting very soon. The member who has taken a keen interest and also

:06:30. > :06:34.our partners to make sure that we have a talented we need to face. It

:06:35. > :06:42.costs money, but it is also costing content of the impact it has on

:06:43. > :06:45.people's lives. That impact is the most vulnerable people in the

:06:46. > :06:48.communities. We need to bring communities with this because price

:06:49. > :06:56.promotions admitted that forward might have an impact on those with

:06:57. > :06:59.the least money to spare. Nothing can be off the table with the

:07:00. > :07:05.consultation and we will need to work together to make sure there is

:07:06. > :07:11.a downward trend on obesity levels in the country. Thank you. To ask

:07:12. > :07:16.the Scottish Government what action it has taken to address health

:07:17. > :07:20.inequalities. Reducing health inequalities is one of the biggest

:07:21. > :07:26.challenges that we face. It is a symptom of wider income inequalities

:07:27. > :07:34.and is she said Eric Sass abated by posterity. We are taking attitudes,

:07:35. > :07:40.supporting fair wages and in proving our social environments. The

:07:41. > :07:43.Minister note that health inequalities are firmly linked to

:07:44. > :07:49.income inequalities. Can the Minister give an analysis of the

:07:50. > :07:53.potential knock-on affect on the NHS that predicted a 10% increase on

:07:54. > :08:00.child poverty as a result of the UK Government's to child policy will

:08:01. > :08:05.have. I will reiterate that the UK Government's welfare cuts are unfair

:08:06. > :08:11.and having a hugely disproportionate impact on women. By 2021, many

:08:12. > :08:15.houses in Scotland will be affected by the child cap, so while the

:08:16. > :08:19.Conservatives do come here very often asking us to do more on a

:08:20. > :08:23.number of different issues, perhaps they also need to be asking the UK

:08:24. > :08:27.Government colleagues to stop with this gross unfairness. The ISS

:08:28. > :08:35.estimates that a three child family will lose an average 2500 a year,

:08:36. > :08:44.while others will lose 7000 and 4 million families across the UK will

:08:45. > :08:48.see entitlement for. It will push people further into poverty and puts

:08:49. > :08:55.pressure on other public services. 4 million families impact from the

:08:56. > :09:01.Tory's cuts, that is 4 million reasons why we should not be voting

:09:02. > :09:05.Tory in June. Has the Minister studied the new report study this

:09:06. > :09:08.week by the mental health foundation surviving thriving which highlights

:09:09. > :09:13.severe health inequalities within mental ill health in Scotland. What

:09:14. > :09:20.specific action Ayew taking to reduce health inequalities among

:09:21. > :09:26.people suffering from mental health challenges? I do think that while he

:09:27. > :09:30.does talk about inequalities quite often in this chamber, he should be

:09:31. > :09:33.making these points also to his UK Government colleagues who are the

:09:34. > :09:42.source of some of this inequality and have the power within themselves

:09:43. > :09:46.to try and reverse that inequality. My colleague Maureen Watts set

:09:47. > :09:51.forward a 10-year mental health strategy which does address this and

:09:52. > :09:59.will help reduce inequality and that impact that as the detrimental

:10:00. > :10:02.impact on mental health. It takes a bit of a brass neck for the

:10:03. > :10:06.Conservatives to come here and keep talking about inequalities when they

:10:07. > :10:13.have been the cause of much of that inequality in society in the

:10:14. > :10:18.country. Does the Minister agree that income and equality is at the

:10:19. > :10:23.heart of health inequality and one of the key ways to address that is

:10:24. > :10:29.the tax system? Why won't the Government introduce a progressive

:10:30. > :10:33.tax system? Within empowers that we have to make sure that we can reduce

:10:34. > :10:37.inequalities, we are taking forward a number of measures around living

:10:38. > :10:45.wage, we are bringing forward and have brought forward plans around

:10:46. > :10:50.taxes and the system, as well. We continually mitigate against the

:10:51. > :10:53.worst factors of welfare reform. We are doing the best we can within the

:10:54. > :10:59.powers we have any budget we have been given to make sure that we have

:11:00. > :11:04.got the best and can create the fairest society that we can seek. It

:11:05. > :11:05.seems a pity that Neal Finlay ignores those measures and cups from

:11:06. > :11:14.the To ask the Scottish Government what

:11:15. > :11:21.it is doing to encourage participation in sport. Active

:11:22. > :11:25.Scotland's jap outcomes framework sets out plans for a more active

:11:26. > :11:29.Scotland. We want to ensure people from all ages, across Scotland, from

:11:30. > :11:33.all ages, have the opportunity to participate in sport and physical

:11:34. > :11:36.activity much that's creptived in programmes such as active schools to

:11:37. > :11:40.provide more opportunities FORCEDWHITE OK. Young people and

:11:41. > :11:44.also invest ins fa its, including community sports hub of which there

:11:45. > :11:49.are 157 across Scotland, increasing to 200 by 2020. I am delighted

:11:50. > :11:54.following a at the timal investment ?12 million the superb facilities at

:11:55. > :11:58.the UK's fist ever Prar Sport centre at Inverclyde are now open. I thank

:11:59. > :12:02.them inster for that response, despite increasing levels of child

:12:03. > :12:04.anded a ultimate obesity the budget for sports has been cut

:12:05. > :12:07.significantly over the past two years even after taking into

:12:08. > :12:13.account, the funding mentioned by the minister. Can the minister

:12:14. > :12:18.explain how cutting the budgets for sports, including budgets for

:12:19. > :12:21.grassroots sports clubs will help tackle the increasing health

:12:22. > :12:29.problems associated with obesity and related challenges. I announced in

:12:30. > :12:33.April adational ?2 million in sport governing bodies which will be

:12:34. > :12:36.distributed by Sports Scotland to help offset the reduced income from

:12:37. > :12:43.the national Lottery I have written to the UK Government around the

:12:44. > :12:49.issues that continually present themselves from the Bishop us of

:12:50. > :12:55.reducing National Lottery. So I'll ask the colleague to get his support

:12:56. > :13:00.to face the nag alottery reduction problems our bodies are faces. We've

:13:01. > :13:03.had increases in our infrastructure. We have some of the best

:13:04. > :13:09.infrastructure across the country in terms of sports and invested heavily

:13:10. > :13:13.in making sure young people get opportunities and restructured the

:13:14. > :13:19.way PE is being taken forward around our schools, seeing us reaching

:13:20. > :13:23.around 98% of our children reaching the two-hour PE. I hear again people

:13:24. > :13:26.from the sidelines, this is significant investment this

:13:27. > :13:30.Government is taking forward to improve the infrastructure of our

:13:31. > :13:33.sporting arenas across the country. We have increased fundamentally the

:13:34. > :13:38.number of children taking part in two hours or more of PE in every

:13:39. > :13:42.school. I have just opened a new Para sports centre in Inverclyde now

:13:43. > :13:47.open and hosted one of the best-ever chop wealth games in Glasgow. Our

:13:48. > :13:51.commitment is very strong to sport and given all of our young people

:13:52. > :13:54.the opportunity they deserve, again, though, this is exacerbated,

:13:55. > :13:56.children's opportunity ape life chances are exacerbated by

:13:57. > :14:00.inequalities. Again I would reiterate. The Conservatives need to

:14:01. > :14:02.look closer to home around inequalities and where that is being

:14:03. > :14:09.manifested. APPLAUSE

:14:10. > :14:13.Question five not lodged. Question six, Alison Harris. So ask the

:14:14. > :14:16.Scottish Government what health guidance is given to operators of

:14:17. > :14:19.sports and leisure facilities that are close to the Grangemouth

:14:20. > :14:23.chemical complex? There are strict arrangements in place to ensure that

:14:24. > :14:27.the Grangemouth chemical complex operates safely and that that if

:14:28. > :14:30.something does go wrong the health and safety of the public is

:14:31. > :14:33.protected. They include a community warning system in the convenient of

:14:34. > :14:37.an incident at the complex which enables people living and working in

:14:38. > :14:41.nearby areas to be alerted quickly. The communtiy warning system is

:14:42. > :14:44.tested twice a year. The council provides regular local guidance on

:14:45. > :14:46.what people should do when the community warning system is

:14:47. > :14:50.triggered. That advice, which applies to sports and leisure fas

:14:51. > :14:55.silts to go in, stay in and tune in, that is to go indoors, close the

:14:56. > :14:58.doors and windows and wait fourth instructions.

:14:59. > :15:02.I thank the minute sister for that response, however, during the recent

:15:03. > :15:06.incident in Grangemouth, provision was made at prime rain secondary

:15:07. > :15:10.schools to be kept indoors, however users of the outdoor sports pitches

:15:11. > :15:14.continued to use the facilities, so in view of the numbers of people who

:15:15. > :15:17.use these facilities, will the Scottish Government undertake to

:15:18. > :15:24.review the guidance given to the operators of these facilities? I

:15:25. > :15:28.think the member raises a very good point. Of course on the 2nd May

:15:29. > :15:33.there was that incident she described at Grangemouth where a

:15:34. > :15:37.limited amount of staff were evacuated following a gas leak and

:15:38. > :15:43.the incident involved the release of gases there at a particular plant.

:15:44. > :15:48.The local management plan was activated and local road closures

:15:49. > :15:52.were in place to promote public safety. The point she makes is a

:15:53. > :15:57.good one, I will have dial oings with and there will be a debrief of

:15:58. > :16:02.the incident and that we will examine that and make sure any

:16:03. > :16:11.learning issues are captureded into to refine the plan and arrangements

:16:12. > :16:15.and I'll keep her updated on the outcome from the debriefing process.

:16:16. > :16:20.Question number 7. Thank you, to ask the Scottish Government what action

:16:21. > :16:26.is being taken to improve mental health services in the NHS Forth

:16:27. > :16:31.Valley, area? Thank you, we have published a new ten-year strategy

:16:32. > :16:35.for mental health in Scotland. The new strategy contains 40 actions

:16:36. > :16:39.including those which commit to funding improved provision for

:16:40. > :16:43.services, to treat child and adolescent mental health problems

:16:44. > :16:48.and funding work to improve provision of psychological therapy

:16:49. > :16:52.services and help meet set treatment targets. As part of these actions we

:16:53. > :16:58.have announced a ?54 million comprehensive package of support to

:16:59. > :17:03.immroef access to mental health services for both calms and

:17:04. > :17:08.psychological therapies, within this we've established an improvement

:17:09. > :17:10.team within health care in improvement Scotland to work on

:17:11. > :17:15.access to mental health services. Fo. Rth Valley are one of the first

:17:16. > :17:22.boards to work with the team. Working with the board a new service

:17:23. > :17:29.model has been introduced by NHS Forth Valley and we've seen awistics

:17:30. > :17:35.improvements in CAMs waits. Forth Valley are to be congratulated in

:17:36. > :17:38.obtaining the lowest rate across Scotland at this tripe last year. I

:17:39. > :17:44.recognise improvement are being made. Can the minister tell me what

:17:45. > :17:48.the current waiting time is for child and mental health services in

:17:49. > :17:51.the Forth Valley area. I have constituents who continue to be

:17:52. > :17:55.concerned about the length of time it is taking to access the services.

:17:56. > :17:59.Could the minister tell me what specific action has already been

:18:00. > :18:05.taken and what more can be done to improve be as is sows to CAMs in the

:18:06. > :18:15.Forth Valley area? The latest published figures for quarter 4 show

:18:16. > :18:19.Forh Valley's performs an against the standard proved with 94.8% of

:18:20. > :18:26.people treated within CAM services, were seen within 18 weeks. This

:18:27. > :18:29.compares to 34% of people receiving treatment within CAMs services with

:18:30. > :18:37.the 18 week standard in the same time a year ago. In response to your

:18:38. > :18:45.constituents' concerns, the member might wish to know that I met,

:18:46. > :18:49.yesterday, with parents from the Forth Valley parents voices, and I

:18:50. > :18:52.welcomed the opportunity to hear their experiences of CAMs and to

:18:53. > :18:57.discuss the work we are supporting, through investment and the new

:18:58. > :19:02.mental health strategy, to improve the standard of care from CAMs,

:19:03. > :19:07.including the quality and conuity of service. At board level, the new

:19:08. > :19:11.service model has been introduced within NHS Forth Valuey. The new

:19:12. > :19:16.model looks to address delays identified in the system, as well as

:19:17. > :19:20.undertaking staff recruitedment and working on the longer waits. I

:19:21. > :19:23.understand that the board has established a parents forum, to

:19:24. > :19:28.increase engagement with local families and this will meet for the

:19:29. > :19:33.first time at the end of this month and that's precisely what, as the

:19:34. > :19:36.Government, we wish to see, patient involvement and participation in

:19:37. > :19:40.designing services. Thank you, Presiding Officer. Ruth

:19:41. > :19:47.Crawford has raised an important issue. I met with the founder of the

:19:48. > :19:51.CAMs Fort has Valley parents voices droup and other parents yesterday

:19:52. > :19:54.after their meeting with the minister and as newspapers have

:19:55. > :19:58.reported today, they were in absolute tears as they were sharing

:19:59. > :20:00.their stories. It was heartbreaking to listen to the individual

:20:01. > :20:03.challenges they have helicopter to face in trying to get the support

:20:04. > :20:07.they desperately need for their children. I welcome some progress

:20:08. > :20:11.has been made but it is not simply just about waiting times. The

:20:12. > :20:15.Scottish Government have committed to look at into this and I look

:20:16. > :20:18.forward tow hearing more of the detail on this but account minister

:20:19. > :20:24.provide an update on what her response is to the group's call for

:20:25. > :20:28.a full audit and review of the CAMs service in the Fort has Valley and

:20:29. > :20:33.if she will give this consideration? Well, as I have already said, I did

:20:34. > :20:42.meet with the parents yesterday and listened to their stories, some of

:20:43. > :20:47.which, most of which are historic, also pre-2007. As a result of what

:20:48. > :20:52.we have in new mental health strategy and what has been done so

:20:53. > :20:56.far, we are seeing excellent progress in Fort Valley on waiting

:20:57. > :20:58.times. So rather than have a fall-blown audit of what is

:20:59. > :21:04.happening, I would prefer to get on with doing the job and making sure

:21:05. > :21:09.that what is required is put in place and that's precisely what we

:21:10. > :21:13.are doing in Forth Valley and with the new mental health strategy

:21:14. > :21:17.across the country. Thank you, despite the hard work of its

:21:18. > :21:21.dedicated staff, NHS Forth Valley continues to suffer from lack of

:21:22. > :21:25.resource, this left over 300 people waiting over four months for

:21:26. > :21:29.treatment. Can I ask the minister when will Forth Valley NHS be in a

:21:30. > :21:37.position to meet Government nargts this area? ? Minister? Well, as I

:21:38. > :21:41.have already mentioned, in my previous answers, Forth Valley NHS

:21:42. > :21:45.is now meeting its waiting time targets and of course this

:21:46. > :21:52.Government was the first to introduce waiting times. The NHS

:21:53. > :22:04.Forth Valley, Scottish Government allocation for building capacity in

:22:05. > :22:11.Forth Valley was 233,000,409 in two should 16-17 rising to 3769,112 in

:22:12. > :22:25.2017-18. And this money is being reduced, used to predues pressure on

:22:26. > :22:36.the core CAMs services. -- 233,009 in 2016 -17.

:22:37. > :22:47.There is a range of measures to make sure For this, Valley meets its

:22:48. > :22:54.targets. To ask the Scottish Government to provide an update on

:22:55. > :22:58.progress in analysis on augmentation and transportation transplantation.

:22:59. > :23:03.The responses are currently being independently analysed and we expect

:23:04. > :23:07.to receive that analysis soon. We will carefully consider it before

:23:08. > :23:13.setting out our next steps in the coming months. I thank the minister.

:23:14. > :23:21.I helped scrutinise evidence in stage 1 for previous proposals for

:23:22. > :23:25.on opt out organ donation procedure. And specialist nurses and beds, irre

:23:26. > :23:29.irrespective of any whether any opt out system was to be introduced. I

:23:30. > :23:34.voted against it not out of principle but because of the

:23:35. > :23:38.weakness in legislation before us. Can I ask what consideration has the

:23:39. > :23:42.Scottish Government given to the recommendations I referred to in

:23:43. > :23:49.earlier in my question, as well as any weaknesses within the previous

:23:50. > :23:53.regulation? Since the programme of work to increase donation rates, the

:23:54. > :23:57.Scottish Government has provided funding to a 07 additional

:23:58. > :24:02.specialist nurses, as well as organise an donation as well as a

:24:03. > :24:08.dedicated manager to work full-time in Scotland. There are 22 full-time

:24:09. > :24:12.equivalent nurses. Appointing more would dilute the expertise in

:24:13. > :24:18.reaching fwamlies and would not necessarily lead to a rise in

:24:19. > :24:22.donation rates. Across Scotland, resources have been targeted in

:24:23. > :24:25.specific areas where it was felt we could make a difference, among

:24:26. > :24:28.ethnic minority groups and in rural areas.dational resources have been

:24:29. > :24:38.made to where donation potential is greatest. In terms of intensive care

:24:39. > :24:41.capacity, the capacity was looked at within the NHS, to achieve it and

:24:42. > :24:46.was not highlighted as an issue, again, we have a very positive

:24:47. > :24:52.story, although the stage 1 did not pass, there has been a huge amount

:24:53. > :24:55.of work and effort gone into ensuring that the effort and

:24:56. > :25:00.attention placed should increase the rates of do na, we have a good story

:25:01. > :25:06.to tell, work has been considerable but again I can continue to keep in

:25:07. > :25:09.touch with Mr Dorris around the next steps following analysis from around

:25:10. > :25:11.the consultation. Question number 9. Thank you, Presiding Officer. To ask

:25:12. > :25:16.the Scottish Government what action it is taking to address the affects

:25:17. > :25:23.of noise pollution on public health. Minister? Through Scotland's

:25:24. > :25:26.implementation of the European Commission environmental noise

:25:27. > :25:30.directive, directive 2002, 49 EC noise mapping and associated action

:25:31. > :25:33.plans have been put in place to help mantleage environmental noise. The

:25:34. > :25:37.strategic noise maps are currently being updated by Jacobs, experts in

:25:38. > :25:40.the field and are due for publication this summer. This'll

:25:41. > :25:44.inform theism amation of the next set of action plans which could

:25:45. > :25:46.include actions in areas such as traffic and transport policies,

:25:47. > :25:51.technological and vision and public awhich areness raising.

:25:52. > :25:58.Thank you for that response. She will be aware that noise is the

:25:59. > :26:02.second largest cause of ill health after air pollution. UK studies

:26:03. > :26:13.showed that exposure to noise above recommended levels of meant there

:26:14. > :26:17.were cases of dementia, stroke and heart attacks amazing all year.

:26:18. > :26:21.Given this evidence, can I ask why Edinburgh airport has recently been

:26:22. > :26:28.able to carry out a consultation into new flight path switch will

:26:29. > :26:37.have local communities subjected to up to 80 decibel is without any

:26:38. > :26:43.safeguards. The impact that noise can have on health is important.

:26:44. > :26:51.That is one of the main things in Europe. She will continue to keep

:26:52. > :26:58.him updated around the mapping, which includes planning exercises

:26:59. > :27:01.for the four conglomerations which include Edinburgh. That is

:27:02. > :27:07.multidisciplinary and has local authorities in key partners. Local

:27:08. > :27:11.authorities will deliver action plans. We will take responsibility

:27:12. > :27:16.for submitting completed plans. The one he will be particularly

:27:17. > :27:23.interested in will be the one for Edinburgh which will include

:27:24. > :27:26.communities surrounding. It is becoming clear that both noise and

:27:27. > :27:33.air pollution are becoming systemic problems in Scotland. Will you back

:27:34. > :27:38.the campaign to increase the nub of air quality monitors in Scotland? I

:27:39. > :27:44.will keep the member updated on how the mapping exercises are

:27:45. > :27:49.progressing. I will take a good look at the work you can indicate his

:27:50. > :27:53.colleagues are taking forward. Environmental noise is an important

:27:54. > :27:57.issue, it does happen impact on health. That is why we need to make

:27:58. > :28:02.sure we have the right procedures and people in place and make sure

:28:03. > :28:06.that we have the right resources in place to ensure enforcement and

:28:07. > :28:09.recognise the impact it can have on a community. That is why the

:28:10. > :28:12.directive is so important because it is one of the main environmental

:28:13. > :28:21.problems in Europe and a framework for noise is necessary. We will

:28:22. > :28:24.continue to maintain and protect enhancing environmental standards,

:28:25. > :28:32.even though they are an EU requirement we will continue that

:28:33. > :28:39.post Brexit. To ask the Scottish Government what support it is giving

:28:40. > :28:45.to general practice. In October 2016, the First Minister made clear

:28:46. > :28:54.the scale of our ambition and shifting from social care to acute

:28:55. > :29:04.care. 500 million by 20 21. While the full 500 million investing

:29:05. > :29:07.primary care, it will reach an additional 250 million per year.

:29:08. > :29:14.There will be a deer on the increase in investment between now and then.

:29:15. > :29:17.It has started, investment and direct support of General practice

:29:18. > :29:29.has been ?60 million of this will increase to more. Thank you. Can the

:29:30. > :29:35.Cabinet Secretary also explain what support will be survived it --

:29:36. > :29:42.provided to Edinburgh in particular? I am aware the member has a

:29:43. > :29:46.particular interest in the issues surrounding Inverleith medical

:29:47. > :29:51.practice are based within his constituency. The retention of the

:29:52. > :29:56.practice staff team within the NHS is one of the key considerations of

:29:57. > :30:03.any NHS Lothian 's. I know he has taken out a particular effort to

:30:04. > :30:08.talk to me about this. Staff have found alternative positions all

:30:09. > :30:14.within the NHS, something which we have actively promoted. More widely,

:30:15. > :30:23.the Edinboro health and social care partnership by developing it with

:30:24. > :30:33.some challenges and some governments. -- Edinburgh. The

:30:34. > :30:40.Cabinet Secretary will be aware that the GP practices in my constituency

:30:41. > :30:44.have recently had to resign with the potential of losing five GPs in the

:30:45. > :30:52.area and another six with imminent retirement. There are another 15

:30:53. > :30:58.vacant places. What comfort can you give to GPs who have to resign from

:30:59. > :31:04.the practice? As I've said in this chamber on a number of occasions,

:31:05. > :31:10.there are sought and medium-term supports that are available through

:31:11. > :31:15.us to help to address some of the recruitment challenges in the here

:31:16. > :31:18.and now and the solution that will help to transform the position of

:31:19. > :31:22.general practice of primary care in Scotland is based around the new

:31:23. > :31:27.contract and a new model for primary care and that is something that will

:31:28. > :31:36.benefit GPs within Ayrshire and Arran and elsewhere in Scotland.

:31:37. > :31:40.Like I say, earlier these were raised, what they are less keen to

:31:41. > :31:46.talk about and to quote is the RCGP's concerns expressed today that

:31:47. > :31:55.when they said that of the 226 GPs of -- from other countries were to

:31:56. > :31:57.leave from Brexit, that could have grave consequences. We don't hear

:31:58. > :32:04.the Tories talking about that, I wonder why. To ask these gotchas

:32:05. > :32:09.Government what action it is taking to improve public health through

:32:10. > :32:12.cycling. We know that cycling has both physical and mental health

:32:13. > :32:17.benefits and played a big part in health improvement. Over the period

:32:18. > :32:19.2014 to 17 sport Scotland has invested owners to predict million

:32:20. > :32:26.in Scottish cycling, the Government body for the sport and Scotland. We

:32:27. > :32:34.have increased investment by over 83% compared to 2013 14. Or cycling

:32:35. > :32:40.organisations are working together to find out what more can be done to

:32:41. > :32:49.get people into cycling at a local and national level. Thank you. Does

:32:50. > :32:54.the Scottish Government agree with the point set out in the manifesto,

:32:55. > :32:58.if not, which ones do you not agree with? We certainly will continue to

:32:59. > :33:03.work with all of our partners to make improvements around the

:33:04. > :33:07.accessibility, safety of cycling at a local and national level. We do

:33:08. > :33:11.have and have invested heavily in making sure that there is more

:33:12. > :33:17.accessibility around cycling, we have invested through legacy

:33:18. > :33:22.programmes, the one that he may be interested in art bike Park in

:33:23. > :33:26.Edinburgh which has been given grant funding made available through the

:33:27. > :33:34.legacy project and allowing people who have not ordinarily had access

:33:35. > :33:38.to cycling to use a cycle route there for many years to come free of

:33:39. > :33:43.charge. We have also invested including with our partners a total

:33:44. > :33:50.investment of 138 millions of cycling facilities and 2007. We have

:33:51. > :33:53.increased the amount of cycling paths and walking lanes. We will

:33:54. > :33:58.continue to listen to all calls to let us know what more we can do to

:33:59. > :34:03.help cycling participation at a local and national level and we will

:34:04. > :34:11.work to work together to make a difference. What impact will does

:34:12. > :34:19.the Scottish Government envisage that the European Union -- leaving

:34:20. > :34:30.the European Union might have? We have promised to match record levels

:34:31. > :34:36.of investment. Scotland has secured investment of... Low-carbon travel

:34:37. > :34:42.and transport hubs. In June, transport Scotland will publish

:34:43. > :34:47.details of projects that have been successful. All the contracts

:34:48. > :34:52.entered into before the UK leaves the EU will be guaranteed even after

:34:53. > :34:58.the EU exit point. There is no clarity on what that replacement

:34:59. > :35:01.scheme will be once the UK has left of the EU. The Scottish Government

:35:02. > :35:09.will negotiate to make sure that future financial support currently

:35:10. > :35:15.supported by the youth funds, but I think -- EU funds. I think the mess

:35:16. > :35:21.that the UK Government has got it in with Brexit, the lack of clarity, it

:35:22. > :35:24.does impact on many issues in the local community, such as cycling. We

:35:25. > :35:29.will continue to negotiate and make the case, and ensure that Scotland

:35:30. > :35:38.gets a fair deal in these negotiations. To ask the Scottish

:35:39. > :35:43.Government what the policy is in the provision of minor injury units in

:35:44. > :35:46.communities. The planning and provision of local services is the

:35:47. > :35:49.responsibility of NHS boards, this planning should take account of

:35:50. > :35:55.local needs to make sure that the mines are met and patient care is

:35:56. > :36:05.that delivered in an optimal way. -- demands are met. The west of Glasgow

:36:06. > :36:12.minor injury union, unit, the Glasgow health board announced that

:36:13. > :36:15.that service was moving temporarily to the hospital. I'm sure the

:36:16. > :36:23.minister would agree that minor injury units are a important service

:36:24. > :36:27.to prevent patients from turning up to accident and emergency. Reducing

:36:28. > :36:30.pressure. Those who live in the west of Glasgow would like an assurance

:36:31. > :36:34.that that service will return as before as it was a temporary measure

:36:35. > :36:46.and it is important that minor injuries unit art local services.

:36:47. > :36:50.You hold the view that the manager unit should return to them as

:36:51. > :36:54.promised? I agree that my neck injury units are very important as a

:36:55. > :37:06.service. They can -- minor injury units. As she will be aware, the

:37:07. > :37:11.Yorkhill unit was always an interim step as part of the migration of

:37:12. > :37:14.services in Glasgow in recent years and it is right that the board

:37:15. > :37:19.should take the time to properly consider where the new west Glasgow

:37:20. > :37:23.service should be located. She will understand some of the challenges

:37:24. > :37:30.the Yorkhill site which I think with partly the reason. It was not a site

:37:31. > :37:34.easy to access. I would think that she would welcome that there would

:37:35. > :37:39.be an assurance not least from the chairman of the board to meet

:37:40. > :37:50.rectally that there will be a minor injury -- to me directly. Monetary

:37:51. > :37:54.unit in the west of Glasgow. I would encourage her to engage with the

:37:55. > :37:59.board directly, there is no question about whether there should be a west

:38:00. > :38:05.of Scotland minor injury unit, there will be one. It is about where that

:38:06. > :38:12.is best located. That concludes portfolio questions. The next item

:38:13. > :38:17.of business is a debate on motion five 479 to scrap the NHS pay cap.

:38:18. > :38:26.All members who want is big on this debate press there I want to speak

:38:27. > :38:29.Basson. -- button. Today the Scottish Parliament has the

:38:30. > :38:34.opportunity to unite and support NHS staff. We should take that

:38:35. > :38:38.opportunity. Every single day our amazing NHS staff are performing

:38:39. > :38:45.miracles. Caring, examinations, diagnosis, treatment, operations,

:38:46. > :38:50.saving of lives and the delivering of newborns. There are also the

:38:51. > :38:54.parts that are easily forgotten or not recorded by statistics. Giving

:38:55. > :39:00.advice, holding hands, sharing tears of grief and joy. Comforting those

:39:01. > :39:06.that have lost loved ones. Simply put, just being there and caring. We

:39:07. > :39:11.all have our own personal stories about how the NHS has touched us. We

:39:12. > :39:16.have our own families or friends who have worked for the greatest

:39:17. > :39:20.institution in the UK. By coincidence, this debate falls on

:39:21. > :39:25.the first birthday of my youngest son. This time last year, was the

:39:26. > :39:29.commendation of probably the biggest emotional roller-coaster that I've

:39:30. > :39:36.ever been on. Within the space of a week, I had welcomed the birth of my

:39:37. > :39:42.beautiful needs only for her heart to stop the next day and after days

:39:43. > :39:47.of battling for us to sadly lose them. The next day, being elected to

:39:48. > :39:53.this parliament and then a few days later, the birth of my own son. At

:39:54. > :39:59.joy, but also part guilt for the tragedy that my own brother and

:40:00. > :40:05.sister sister-in-law were going through. I can honestly say that if

:40:06. > :40:11.it wasn't for the love and care of the neonatal nurses and the

:40:12. > :40:16.midwives, my wife and I could not have got through that week. To all

:40:17. > :40:19.the NHS staff, the porters, the nurses, the midwives, the

:40:20. > :40:24.consultants, the allied health professionals and all the rest,

:40:25. > :40:29.thank you. Thank you for caring. Because what we should never forget

:40:30. > :40:34.is that it is not the buildings, the medicines, the equipment of the

:40:35. > :40:42.treatments that make our NHS grade, it is the brilliant people that work

:40:43. > :40:45.for our NHS. Apart -- our thank you is a not enough. They should be

:40:46. > :40:51.respected and rewarded for the job that they do force of goodwill and

:40:52. > :40:57.dedication to the NHS and their patients only go so far and that is

:40:58. > :41:04.why the context of today's debate is so important. A record number of

:41:05. > :41:08.vacancies, GP vacancies, consultant vacancies, midwife vacancies, Matt

:41:09. > :41:14.nursing vacancies and more. Just take that last example on nursing

:41:15. > :41:20.vacancies. More than 2500 nursing staff are missing from our hospitals

:41:21. > :41:28.across Scotland. Since 2011, the number of vacancies has increased

:41:29. > :41:30.from 662 2500. Four times the number in only six years. Of those

:41:31. > :41:37.vacancies, the number going unfulfilled over three months has

:41:38. > :41:48.increased 300% and now sit at almost 750. Nursing staff reporting they do

:41:49. > :41:53.not have the thing is required to do the job properly. It showed the

:41:54. > :42:02.stuffing levels were the biggest concern. Without the right number of

:42:03. > :42:07.nursing staff, patients do not get the care they need whether it is in

:42:08. > :42:18.hospital, home wrecker, care centre. -- at home. They are coming up

:42:19. > :42:23.against the realities. In short, too few nurses do too much work for too

:42:24. > :42:26.little reward. Under resourced, understaffed and under pressure.

:42:27. > :42:43.Clearly and are paid. The Scottish Government has the

:42:44. > :42:52.understand the impact. I met some of understand the impact. I met some of

:42:53. > :42:56.our nurses this morning. Graham, in service for 32 years, told me this

:42:57. > :43:03.was the lowest morale amongst staff ever will stop in his words, "Good

:43:04. > :43:10.will only go so far. Goodwill doesn't pay the bills." Or OLE, a

:43:11. > :43:16.training nurse, told me about staff in to do shifts and roles they

:43:17. > :43:23.shouldn't be doing as trainees. Others told me about nurses having

:43:24. > :43:28.to take second jobs or even, shamefully, having to attend food

:43:29. > :43:36.banks. NHS staff having to attend food banks! Let me tell you what

:43:37. > :43:39.posterity means for our nurses and its independent analysis done. Pay

:43:40. > :43:47.at the starting point of band five has increased by 6% over the period

:43:48. > :43:55.April 2010 to April 20 17. Over that period, prices have increased by

:43:56. > :44:02.22%. It means that band five starting point pay has fallen by 13%

:44:03. > :44:09.in real terms over that period which is the equivalent of a reduction of

:44:10. > :44:16.?3400. Happy to take an intervention. I thank you. Just

:44:17. > :44:24.reflecting on the figures. I asked Spice about those figures and I ask

:44:25. > :44:29.if there was no starting band five on -- in 2010 and through

:44:30. > :44:39.progression would they be on a reasonable salary. A cash increase

:44:40. > :44:44.of 37% and a real terms increase of 12%. Does the member recognise those

:44:45. > :44:48.figures? What I would say to that is that we're talking about starting

:44:49. > :44:54.salaries and it doesn't take into account progressions. We are

:44:55. > :44:59.publishing the Spice analyses in order to say that. What I don't

:45:00. > :45:03.understand is that already the SNP bench are jumping to have and I

:45:04. > :45:09.commit about numbers and bands, but I have laid out in the own words of

:45:10. > :45:17.the staff on experiences of them and I don't think they will

:45:18. > :45:28.appreciate... A point of order. Can I ask you... A collection of the

:45:29. > :45:33.opportunity as a reference to Anas opportunity as a reference to Anas

:45:34. > :45:40.Sawar. All members know the rules. It should reflect on how the

:45:41. > :45:48.intervention reflects on NHS staff who will be watching this debate. Is

:45:49. > :45:52.it any wonder that we have record levels of vacancies, sickness

:45:53. > :45:56.absence and a vacancy crisis in the NHS here. On the one hand the

:45:57. > :46:00.Scottish Government oversees this crisis, on the other hand they paid

:46:01. > :46:10.hundreds of millions of pounds out every year to private agencies. In

:46:11. > :46:14.the past year, the rate across the NHS, ?175 million, has been spent on

:46:15. > :46:20.private agencies. That is cash going to agencies when audit Scotland

:46:21. > :46:26.report says that agency staff are likely to be more expensive than

:46:27. > :46:31.bank nurses and pose a greater risk to patient safety and the quality of

:46:32. > :46:35.care. It makes no sense at all for the Cabinet Secretary to throw money

:46:36. > :46:40.at Private agencies or starve the NHS of cash to solve the vacancy

:46:41. > :46:46.crisis. The verdict of the Royal College of Nursing has been damning.

:46:47. > :46:52.Nursing leaders are clear and I will quote directly. "Budget Shavings

:46:53. > :46:59.achieved are being used to meet efficiency savings targets for the

:47:00. > :47:04.NHS". And they go one, NHS staff pay has fallen below that of the cost of

:47:05. > :47:09.living and many are struggling to survive on their pay packet.

:47:10. > :47:14.Worryingly they go one that it is negatively impacting on the quality

:47:15. > :47:20.of care. This is what SNP members should be reflecting on. This is

:47:21. > :47:25.happening in Scotland. It is happening in 2017. Nurses in

:47:26. > :47:32.Scotland in the NHS on the watch of the SNP government are struggling to

:47:33. > :47:36.survive on their paperback it. I want to repeat that. Nurses in

:47:37. > :47:44.Scotland struggling to survive on their paperback it. The RCN's most

:47:45. > :47:48.recent survey on members found that almost one in three struggled to pay

:47:49. > :47:53.gas and electricity bills. They found that one in seven had missed

:47:54. > :47:57.meals because of their financial difficulties. More than half

:47:58. > :48:02.reported that they were compelled to work extra hours to increase

:48:03. > :48:07.earnings and one in three were working shifts at night and weekends

:48:08. > :48:12.to help pay bills and meet everyday living expenses. The RCN career

:48:13. > :48:18.service has seen a marked career -- increasing calls with families

:48:19. > :48:29.seeking advice outside of the nursing profession citing various

:48:30. > :48:35.issues for progress in their career. The RCN membership survey is aim

:48:36. > :48:38.membership survey of the RCN in the whole of the UK and not just

:48:39. > :48:45.Scotland. Would you care to comment on that? I thank the member for that

:48:46. > :48:50.intervention. I already said that I met nurses in Scotland this morning

:48:51. > :48:54.who reflected on the same experience that has come across from members

:48:55. > :49:00.right across the UK. Pay restraint is an impact in Scotland and I would

:49:01. > :49:05.say to Emma Harper that, having been a nurse, I would expect you to

:49:06. > :49:10.understand acutely about the struggles and strains of NHS staff

:49:11. > :49:15.right across the country. I would hope, as a former member of the

:49:16. > :49:21.union, as a qualified nurse, that she would vote in favour of a pay

:49:22. > :49:27.increase for our nurses today. This is not the Labour Party reporting

:49:28. > :49:32.these facts. They are damning facts reported by nurses. Many take second

:49:33. > :49:38.jobs and some are using food banks to feed their families. This is

:49:39. > :49:43.happening in Scotland, in 2017. I note that the Scottish Government

:49:44. > :49:48.amendment calls for an assessment of pay restraint. I say to the Cabinet

:49:49. > :49:52.Secretary, the RCN, Unison and others already tell us the

:49:53. > :49:57.consequences of pay restraint. The only people responsible are the

:49:58. > :50:03.Scottish Government in control of every aspect of Scotland's NHS for a

:50:04. > :50:07.decade. The First Minister herself is in control and took decisions and

:50:08. > :50:19.we are reaping the consequences of those. Cutting the number of student

:50:20. > :50:24.nursing places. By nearly 320 12 to 2013. How did the First Minister

:50:25. > :50:29.react? I quote directly from the First Minister. A reduction in

:50:30. > :50:34.intake ford the 2012 academic year is a sensible way forward. How she

:50:35. > :50:40.must regret those words today. Today this Parliament can unite and send a

:50:41. > :50:47.message to Scotland's NHS staff and we can tell them loudly and clearly

:50:48. > :50:51.that they are most valuable asset, you do make the difference and we

:50:52. > :50:55.recognise how important the work you do is, we respect you and you will

:50:56. > :51:01.be rewarded will stop that is why our motion is clear, to scrap the

:51:02. > :51:07.pay cap and give the NHS staff a pay increase they deserve. Not the

:51:08. > :51:12.alternative, to carry on with more austerities and cuts and that is why

:51:13. > :51:19.the choice is clear. Focus on a Labour motion that will give the NHS

:51:20. > :51:21.a pay rise it deserves all focus on the SNP's obsession only with

:51:22. > :51:37.running another independence I call on Shona Robison.

:51:38. > :51:41.Thank you. I am happy to move the amendment in my name. As Health

:51:42. > :51:44.Secretary, I have the fortune to regularly see the excellent work our

:51:45. > :51:51.health service staff do will stop the men and women of I'd care to

:51:52. > :51:56.every family in our country, working to ensure that Scotland is as

:51:57. > :52:01.healthy as popular -- as possible. I'm not alone in this chamber and

:52:02. > :52:07.agree with Anas Sawar on this point, that they not only have the thanks

:52:08. > :52:13.of my family the thanks of us all. I want to focus my remarks mainly on

:52:14. > :52:18.the issue of pay. I will return to the issue of workforce levels which

:52:19. > :52:24.we have record levels of although there is record demands on our

:52:25. > :52:31.health service. I will come back to that. The independent pay review

:52:32. > :52:37.process in the NHS can trace its origins back to the 1980s. It's the

:52:38. > :52:43.independent NHS pay review bodies which makes recommendations and

:52:44. > :52:49.advises the four countries on the uplifts to apply. Staff

:52:50. > :52:54.representatives... We value the process today. We are clear that

:52:55. > :52:59.they are annual settlements but there is a challenge to the process,

:53:00. > :53:05.as the UK Treasury has insisted in recent years that the pay restraint

:53:06. > :53:09.will be maintained until at least 2020. In turn, the UK Government

:53:10. > :53:14.Department of Health for England adopted this approach and was

:53:15. > :53:20.supported by Labour run Wales. The Welsh government has agreed that

:53:21. > :53:24.they also intend to apply the 1% restriction until 2020. Perhaps an

:53:25. > :53:28.example of Labour saying one thing during an election campaign and

:53:29. > :53:34.doing an entirely different thing when in government and have the

:53:35. > :53:38.power to pay nurses. I thank the Cabinet Secretary. Can she confirmed

:53:39. > :53:45.that her own submission to the independent pay review body

:53:46. > :53:52.recommended continuing a 1% for NHS staff here. Our pay policy is in

:53:53. > :53:58.addressing the uplift and of course low pay and will no compulsory

:53:59. > :54:03.redundancy policy. The RCN also recognise that we are bound by the

:54:04. > :54:08.Treasury because what it gives in terms of resources to the Department

:54:09. > :54:16.of Health is what we get in Consett and wills. I will come back to the

:54:17. > :54:25.pay review body in a second. -- in consequential. The result of our

:54:26. > :54:38.steady divergences work agenda for steady divergences work agenda for

:54:39. > :54:40.change staff in Scotland are better changed -- paid them their

:54:41. > :54:42.counterparts in England, Wales and counterparts in England, Wales

:54:43. > :54:44.only country to apply the full Northern Ireland because we are the

:54:45. > :54:44.recommendations in 2014 and the only recommendations in 2014 and the only

:54:45. > :54:48.country to even request recommendations in 2015. Our staff

:54:49. > :54:52.and are paid more than their colleagues undertaking the same

:54:53. > :55:00.duties in other parts of the UK. As the government amendment notes,

:55:01. > :55:06.nurses in the first pay point now paid ?312 more than their

:55:07. > :55:11.counterparts in Wales and England. Bank staff in Scotland are paid more

:55:12. > :55:16.than their counterparts in Wales and England and a band five nurses

:55:17. > :55:22.started on the first pay point in 2010 and progressed annually will

:55:23. > :55:28.have started on 20,000 pounds plus but will have advanced to ?29,034

:55:29. > :55:35.now. Based on Labour's analysis that would be an increase of over 12% or

:55:36. > :55:41.37% in cash terms. It is not just about pay, it is also about pay

:55:42. > :55:46.progression and I will come back to that. Of course, there is real job

:55:47. > :55:51.security that we have brought. This government and with the support of

:55:52. > :55:55.parliament, has delivered in no compulsory redundancy policy. I know

:55:56. > :56:01.this commitment is valued highly by NHS Scotland staff and compares

:56:02. > :56:04.favourably to the likes of the more than 20,000 compulsory redundancies

:56:05. > :56:09.taking place in the NHS in England since 2010. But the difference with

:56:10. > :56:13.our approach is more pronounced when you look at the position of the

:56:14. > :56:18.lowest paid workers in the NHS by delivering a real living wage for a

:56:19. > :56:23.number of years and ensuring uplifts for the lowest paid above the

:56:24. > :56:27.recommendations and by working in partnership with unions, like

:56:28. > :56:32.Unison, to provide upscaling for previously banned one star. We have

:56:33. > :56:38.entry-level support staff in Scotland being paid over ?1100 more

:56:39. > :56:44.than their opposite numbers in NHS England. For these hard-working NHS

:56:45. > :56:47.support staff who helped the delivery of health care here, I know

:56:48. > :56:52.these amounts can make a real difference.

:56:53. > :56:59.In a clearly staff where you will about pays their uplift. Staff at

:57:00. > :57:05.the top of their bands are relatively better off than those in

:57:06. > :57:12.England and Wales, Dave fails -- they face more challenges. You

:57:13. > :57:17.highlight that those of the top of the pay band will in real terms be

:57:18. > :57:26.worse off year on year that we have this pay cap, but we should also

:57:27. > :57:34.confirm that nurse salary is 3400 worse off then a nurse starting in

:57:35. > :57:39.2010. Nurses are better off the starting of band five in anywhere

:57:40. > :57:44.else in the islands including in the Labour run Wales. No one says on .1

:57:45. > :57:48.of their band. Labour seem to misunderstand you wait pay

:57:49. > :57:53.progression works. It is about pay and pay progression. Those nurses

:57:54. > :58:00.starting at the .1 in 2010 will now be seven point ?5,000 -- seven and a

:58:01. > :58:13.half thousand pounds. We work together and rely on the

:58:14. > :58:18.inside, advice and necessary challenge that the NHS Scotland

:58:19. > :58:22.unions and the staff bodies bring. I look forward to meeting with the RCN

:58:23. > :58:28.Unison and others to discuss pay over the next few weeks and in fact

:58:29. > :58:32.I met Unison staff earlier today. What was interesting about what one

:58:33. > :58:36.of the nurses was telling me was that yes, pay and the pay increase

:58:37. > :58:45.and percentage of pay increases one element out in -- and is important,

:58:46. > :58:46.it is senior to pay, it is recognition for continued

:58:47. > :58:53.professional development and training. All of those issues are

:58:54. > :58:59.equally as important. Those are the issues that I will address in my

:59:00. > :59:04.meeting with the union. It is a party that has no prospect of

:59:05. > :59:07.winning, the real action working with the unions in partnership to

:59:08. > :59:12.address these issues. Our constructive approach to partnership

:59:13. > :59:16.working was also evident during recent negotiations to effectively

:59:17. > :59:26.do away with the lowest and one level of NHS Scotland. Not promises

:59:27. > :59:29.something tomorrow, but something today. Partnership with staff is

:59:30. > :59:39.always the best way to resolve issues. We will arrange to meet and

:59:40. > :59:45.discuss and join the commission work to develop an evidence base that

:59:46. > :59:51.will help us assess impact in the next round to the independent NHS

:59:52. > :59:58.bodies. I'm in my last minute. One thing I would say to the unions. I

:59:59. > :00:04.said I will not because I'm in my last minute. In conclusion, there

:00:05. > :00:09.will be value in the independent pay review process, but we are willing

:00:10. > :00:15.to explore other approaches if it is in the best interest of NHS staff.

:00:16. > :00:18.Bearing in mind it was a union, many of whom wanted the independent pay

:00:19. > :00:21.review process, if they are now saying that they think that that has

:00:22. > :00:27.run its course and that the unions want to engage with me on looking at

:00:28. > :00:29.a different set of pay negotiation structures, perhaps Scottish pay

:00:30. > :00:33.negotiation structures, then I have made clear to the unions on many

:00:34. > :00:38.occasions that my door is open to that and that has to be with the

:00:39. > :00:42.staff side agreement. That is something I will put on the table to

:00:43. > :00:47.discuss with the unions within the NHS, whether or not they want to

:00:48. > :00:51.maintain the independent payment review body process or whether they

:00:52. > :00:56.want to move forward in a different way. We will move forward, working

:00:57. > :00:59.with the NHS staff in partnership to deliver Scottish solutions that work

:01:00. > :01:00.for the benefit of all of our hard-working NHS staff.

:01:01. > :01:14.APPLAUSE This debate today is about the

:01:15. > :01:20.priority and choices for our National Health Service. Do we want

:01:21. > :01:24.a strong NHS that is able to cope rising demand? Or must we have an

:01:25. > :01:32.NHS that is unable to handle the heat, with plummeting staff morale,

:01:33. > :01:38.long awaiting time. Nobody would want the latter. It will lead to the

:01:39. > :01:41.very issues that we want to avoid. This Government has been in power

:01:42. > :01:47.for more than ten years now and has had full control of the direction of

:01:48. > :01:54.the NHS during that time. What is the record? Significant staff

:01:55. > :02:00.vacancies, nursing in and midwifery. People waiting over the 18 week

:02:01. > :02:05.target and a failure to meet target in accident and emergency. Only

:02:06. > :02:15.seven met last year. Most pertinently in this debate... Have

:02:16. > :02:21.you recently looked of the performance in Scotland is composed

:02:22. > :02:27.to Tory run England? It is night and day. People were in crisis over the

:02:28. > :02:34.weekend, not something that has been seen in Scotland. You need to

:02:35. > :02:41.recognise the A E staff that deliver the best in the UK. We have

:02:42. > :02:45.been here many times before. This is an SNP Government that runs his

:02:46. > :02:48.Scottish health service. We should concentrate on their record and not

:02:49. > :02:54.point the finger at other places. Most pertinent is plummeting staff

:02:55. > :02:58.morale. Half of NHS staff feeling that they are unable to do their

:02:59. > :03:02.jobs properly because they are overworked. This is a depressing

:03:03. > :03:05.record for an SNP Government to regularly like to trumpet that they

:03:06. > :03:09.are the only party who can deliver for the NHS and it is a record I

:03:10. > :03:13.would like to come back to an moment. Firstly, Brexit which

:03:14. > :03:20.appeared in the Government's Amendment and I would like to deal

:03:21. > :03:25.with it head-on. It is difficult to estimate the number of NHS employees

:03:26. > :03:32.from non-UK EU countries. We know that in terms of the NHS, it is

:03:33. > :03:34.approximately 5% to 10%. Undoubtedly, Brexit presents a

:03:35. > :03:39.challenge in the UK Government has been very clear. By the Government's

:03:40. > :03:44.top priorities are part of the Brexit negotiations is to secure the

:03:45. > :03:48.rights of EU Nash used -- Daschle 's right to live in the UK. I've said

:03:49. > :03:59.before and will say again. Serious issues in NHS staffing did not begin

:04:00. > :04:05.when the UK voted to leave the EU. GP shortages have been in existence

:04:06. > :04:11.long before then. SNP cannot use Brexit as cover for the crisis. I

:04:12. > :04:16.want to carry on. We are going to be many GB short by 2021. Many staff

:04:17. > :04:20.are close to retirement. Those left, overworked and under immense

:04:21. > :04:27.pressure. The health force is in crisis due to nearly a decade of SNP

:04:28. > :04:33.mismanagement. Let's not hear the SNP blame Brexit or use it as a

:04:34. > :04:38.reason to not take responsibility. Turning to Labour's motion, I have

:04:39. > :04:41.huge sympathy with the feelings and motivations behind this motion. We

:04:42. > :04:46.all want our NHS staff to be properly paid, but at this point in

:04:47. > :04:50.time, these benches cannot support an end to the cap. Partly because of

:04:51. > :04:58.rising budget Terry pressures, we believe that staff should continue

:04:59. > :05:01.to receive a 1% pay rise and will be continued to be supported in other

:05:02. > :05:05.non-financial ways. We should instead be ensuring the short

:05:06. > :05:13.staffing problems that pervade the health problems are addressed as a

:05:14. > :05:16.matter of urgency. Surely that extra support shouldn't be food banks.

:05:17. > :05:20.Surely there needs to be a recognition that there is a direct

:05:21. > :05:24.correlation between staff vacancies, staff morale, patient outcomes and

:05:25. > :05:30.staff pay. Surely even the Tories can see that. I accept that

:05:31. > :05:35.hard-working NHS staff deserve to be paid well as they do skilled and

:05:36. > :05:43.vital jobs. I will welcome the Government's commitment to the

:05:44. > :05:51.staff's living wage. Staff in Scotland and the NHS are paid more

:05:52. > :05:54.than in other UK countries. The NHS is facing rising demands with an

:05:55. > :05:59.ageing population and conflict health needs. Any decision to

:06:00. > :06:09.increase pay has to be taken in a wider context. Despite the pay gap,

:06:10. > :06:19.staff still increased is proximally 6%. If we manage to reform the NHS

:06:20. > :06:23.in order to continue to deliver good service then we would be able to

:06:24. > :06:27.invest what we say. Labour have come to this chamber today with an

:06:28. > :06:33.important issue a very important issue, but they have made no issue

:06:34. > :06:44.of the cost of what they are proposing. In the NHS, there are

:06:45. > :06:49.huge vacancy rates. We can't take get -- get people to take up posts.

:06:50. > :06:53.Yet you arguing a cap of 1%. In this place, there are no vacancies. There

:06:54. > :06:57.are armies of people outside who would be desperate to take up our

:06:58. > :07:03.posts. No gaps and yet he will agree to an increase pay level than he is

:07:04. > :07:10.for nurses there would be paid to him and I. Is that fair? The point

:07:11. > :07:15.that I would make is that you have given no details of how much this is

:07:16. > :07:19.going to cost. How is this going to be funded? UK Labour hazards are

:07:20. > :07:29.mated that every percent extra on pay will cost the NHS. Other figures

:07:30. > :07:37.think it may be higher. Labour might want to put more figures forward,

:07:38. > :07:42.but not talk to Diane Abbott. The Labour Party does not address one of

:07:43. > :07:47.the central issues, we must address staffing issues. Staffing morale is

:07:48. > :07:53.no and low morale is down to the fact that there is severe shortages

:07:54. > :07:58.across the NHS. I have taken several interventions, I need to crack on.

:07:59. > :08:08.The SNP have failed to tackle. The most recent figures show that. Time

:08:09. > :08:12.and time again, the Government has ignored warnings and having ignored

:08:13. > :08:16.the warnings and consistent calls from professional bodies that show

:08:17. > :08:22.that this can't go on. The Royal College of nurses, the doctor who

:08:23. > :08:24.led the cancer strategy said the NHS Scotland is hurtling over a

:08:25. > :08:28.precipice with everyone pretending it is going to be all right and it

:08:29. > :08:33.won't be. We are warning the Scottish Government that over a

:08:34. > :08:38.recruitment and retention. Everyone is warning the Scottish Government.

:08:39. > :08:42.It has been coming for years. The question is, when will the SNP

:08:43. > :08:45.lesson? Do we want another four years under this SNP Government were

:08:46. > :08:51.targets missed? Do we want another four years work they are crippling

:08:52. > :08:54.pressures on NHS staff? Can we deal with in action from a Government of

:08:55. > :08:59.the deludes itself into thinking that they are best placed to deal

:09:00. > :09:03.with this while ignoring serious concerns? The answer to all those

:09:04. > :09:08.questions are a resounding no and I move the amendment. Thank you. We

:09:09. > :09:24.moved to the open debate. I call Monica Lennon. I am supporting

:09:25. > :09:30.hard-working NHS staff and to vote for a foundation of the -- workers

:09:31. > :09:38.who are a foundation of the health service. Scottish nurseries will

:09:39. > :09:51.have received a pay cut of ?3400 under this SNP Government. The Royal

:09:52. > :09:56.College of Nursing say that there has been a real cut. This is

:09:57. > :09:59.unsustainable. Nurses are the foundation of our health service,

:10:00. > :10:04.but they are failing to get the support and resources that we need

:10:05. > :10:16.from this SNP Government. The facts are clear. Nursing staff are

:10:17. > :10:20.important. All the while, they are facing their own financial

:10:21. > :10:24.difficulties. The most recent employment survey which we have

:10:25. > :10:29.heard about today already, 30% have struggled to pay bills. Over half

:10:30. > :10:35.have been compelled to work extra and unsocial hours just to make ends

:10:36. > :10:45.meet. Meanwhile, spending on agency and private nurses under the SNP

:10:46. > :10:52.have soared. The vacancy crisis with unfilled posts. The SNP formed a

:10:53. > :10:59.majority Government the number of long-term job losses have rocketed.

:11:00. > :11:06.Agency spend has also rocketed, now to a on hundreds two ?5 million. Had

:11:07. > :11:10.that is an area of serving -- savings that the Tories could

:11:11. > :11:16.consider when they're putting questions over to this side of the

:11:17. > :11:22.chamber. Nine out of ten nurses say that their work has got worse. In

:11:23. > :11:32.every aspect, NHS nurses are being overstretched and overworked. MS

:11:33. > :11:37.nurses across Scotland, they deserve like all our staff a much better

:11:38. > :11:46.deal than they are currently getting from the SNP.

:11:47. > :11:55.I've had cause to be in and around hospitals more one at -- more than I

:11:56. > :12:01.would like recently. My father-in-law was 60 years old and

:12:02. > :12:06.had a period of illness. The couple of days before he died, couple of

:12:07. > :12:11.nurses prepared me and my family for what was ahead. His name was Paul

:12:12. > :12:16.and although I didn't want to hear what he was telling me I was so

:12:17. > :12:21.pleased to see him because he had cared for my dad in a previous

:12:22. > :12:26.admission. He cared with such compassion and attentiveness that I

:12:27. > :12:30.hadn't forgotten him and I doubt I ever will. And then Katie, another

:12:31. > :12:36.nurse, who looked after my dad and family who looked after us as we

:12:37. > :12:42.said our goodbyes. When I returned to the hospital just to weeks ago,

:12:43. > :12:52.this time waiting for my man -- Mum to go to surgery, Katie approached

:12:53. > :13:00.me. She gave me a hug that leaves you fighting back tears. Last year I

:13:01. > :13:06.had to be referred to the breast clinic to had -- have cancer tests.

:13:07. > :13:13.I went alone and I was terrified and emotional. The nursing staff were

:13:14. > :13:18.simply first-class. They kept me calm as I waited in between

:13:19. > :13:24.different examinations in a very busy waiting room. I looked around

:13:25. > :13:29.at dozens of people queueing at the desk, people with children and it

:13:30. > :13:35.was noisy and stressful. I simply wondered how the staff manage. So,

:13:36. > :13:39.in the last year I've been in the Scottish Parliament, when I come

:13:40. > :13:44.here and I hear Scottish Government ministers and SNP backbencher accuse

:13:45. > :13:49.me and my Scottish Labour colleagues of publishing NHS staff and talking

:13:50. > :13:57.them down, playing politics, I feel sick to my stomach. When we come

:13:58. > :14:02.here and when the MSPs come to shine a light on these issues, it is

:14:03. > :14:12.because we have nothing but admiration and respect for NHS

:14:13. > :14:18.staff. Nurses are our friends, neighbours and loved ones also. So,

:14:19. > :14:22.I would ask the Scottish Government when they come here and deflect

:14:23. > :14:28.criticism of their stewardship, of our beloved NHS onto the staff

:14:29. > :14:35.stretched to breaking point, is it fair? I know we have a couple of

:14:36. > :14:39.nurses on the SNP benches and I would really ask them to think about

:14:40. > :14:45.where their loyalties lie tonight when they come to press their batons

:14:46. > :14:47.at five o'clock. How can you have been a nurse and served alongside

:14:48. > :15:00.these people and betrayed them this evening? I just wonder how, as a

:15:01. > :15:07.counsellor, can she defend what South Lanarkshire did to those

:15:08. > :15:11.across that authority? Well, I am no longer a counsellor but that is

:15:12. > :15:14.ridiculous coming from a government minister to bring to the debate

:15:15. > :15:18.something that has no bearing on this and she knows fine well I

:15:19. > :15:27.support equal pay for all workers so that is pretty shameful. At five

:15:28. > :15:30.o'clock... You can smile, but we have had that nurses are going to

:15:31. > :15:35.food banks. We had a debate last night about food poverty and you

:15:36. > :15:41.can't sit there and say it's someone else's problem. Tonight we will see

:15:42. > :15:48.if we will have an SNP government voting with the Tory party to block

:15:49. > :15:54.a pay rise for nurses. I'm in my final seconds. Thank you for your

:15:55. > :15:58.generosity. The choice is clear tonight. We either support a pay

:15:59. > :16:04.rise for NHS staff and believe that pay cap should be scrapped or MSPs

:16:05. > :16:09.don't. Labour is clear where we stand, on the side of working

:16:10. > :16:16.people. Others in the chamber should do the same.

:16:17. > :16:22.Thank you, Presiding Officer. Before I start with what I was going to

:16:23. > :16:26.say, can I make it clear to members on that side of the chamber and

:16:27. > :16:30.white across the chamber that they do not have a monopoly on people

:16:31. > :16:35.having to deal with the health service. They are not the only

:16:36. > :16:42.people who have had people die in hospital and who care about nurses

:16:43. > :16:47.and doctors who treated them. Both those contributions suggest that we

:16:48. > :16:51.don't care about the nurses, we don't care about the hard work they

:16:52. > :16:56.do and we don't respect the hard work they do, but of course we do.

:16:57. > :17:02.Every single person in here will have lost someone and I don't think

:17:03. > :17:04.it is becoming of anyone to try and pretend they have a monopoly on

:17:05. > :17:10.that. APPLAUSE

:17:11. > :17:13.The NHS is often described as a jewel in the crown of British

:17:14. > :17:20.society and with some justification. Despite what they say, it seems that

:17:21. > :17:22.across the UK it is the Scottish Government who recognises its

:17:23. > :17:30.importance and prioritises the needs of the NHS whilst trying to balance

:17:31. > :17:33.reducing money. The Scottish Government has consistently

:17:34. > :17:41.protected the front line health budget enabling it to be fair on the

:17:42. > :17:46.point of need. Thank you for taking the intervention. Can I ask what he

:17:47. > :17:52.would ask the Scottish Government to do to stop nursing staff having to

:17:53. > :17:57.go to food banks? Scottish nurses are better looked after than any

:17:58. > :18:03.other nurses across the UK. What you fail to recognise in any debate is

:18:04. > :18:08.that we work under the same financial restrictions as under the

:18:09. > :18:12.UK. We made the decision to have non-compulsory redundancies and to

:18:13. > :18:17.make sure they have a bonus, to make sure they have a wage and a 1%

:18:18. > :18:22.increase that other nurses across the UK don't get. So don't come here

:18:23. > :18:26.and tell a Scottish nurses are badly paid in terms of the rest of the UK

:18:27. > :18:30.because we are doing everything we can hear with the restrictions we

:18:31. > :18:38.had to make sure Scottish nurses are looked after.

:18:39. > :18:45.Across the UK, the NHS is under great pressure but no more so than

:18:46. > :18:49.in Wales. Acronym-macro waiting times are longer and patients there

:18:50. > :18:57.wait longer than anywhere else in the UK for many routine treatments.

:18:58. > :19:00.Anas Sawar apparently has all the answers so could he assist his

:19:01. > :19:05.colleagues in Wales. I could list a load of figures as to how much the

:19:06. > :19:10.NHS is receiving from the Scottish Government but it's important we

:19:11. > :19:16.look right across Scotland. We very often get quotes from politicians

:19:17. > :19:23.criticising the Elizabeth Hospital but there was a peak in the number

:19:24. > :19:27.who received care and where numbers are high, Scottish Labour seemed to

:19:28. > :19:33.see this as another opportunity to use the hospital as a stick to beat

:19:34. > :19:40.the Scottish Government with. The only people they are damaging with

:19:41. > :19:44.constant carping other hard-working staff across the Queen Elizabeth and

:19:45. > :19:50.other hospitals. For you to talk about trying to deflect criticism,

:19:51. > :19:53.we don't. Politicians coming here and criticise health care workers

:19:54. > :20:01.are not us. They are on those benches there. A recent documentary

:20:02. > :20:05.was fascinating and shows fraction of dog my cry was a patient and can

:20:06. > :20:19.vouch for the care that was given there. -- documentary. I know one

:20:20. > :20:23.family with two kids who are chronically ill and who have to use

:20:24. > :20:29.the hospital sometimes four or five times a week. If they had to pay

:20:30. > :20:33.parking charges they would be in an awful state. It would make things

:20:34. > :20:40.much worse. Until the SNP government came in, this party here made sure

:20:41. > :20:44.they had to pay for parking. The Labour Party were clear that parking

:20:45. > :20:52.in hospitals was a justifiable price to pay. I agree that the removal of

:20:53. > :20:57.parking charges was right but what I don't agree with is taking off

:20:58. > :21:01.parking charges and having no traffic management system. At St

:21:02. > :21:05.John's Hospital in Livingston it is chaos with people attending

:21:06. > :21:11.chemotherapy and other treatments who leave an hour early to drive

:21:12. > :21:16.around for that hour to try and find somewhere to park. If we remove the

:21:17. > :21:24.payment system, there has to be a management system. Surely the NHS

:21:25. > :21:29.can do that. Can I remind members, interesting though charges are, the

:21:30. > :21:36.debate is not on that and neither is the amendment. Don't talk over me.

:21:37. > :21:41.Do not sit down, please. I am looking at the amendment and the

:21:42. > :21:47.main debate. Let us keep to that, please, and not drift into other

:21:48. > :21:57.areas. Mr Findlay, please sit down. It had better be. I am waiting to

:21:58. > :22:03.see if it's a point of order. The issue of parking is relevant because

:22:04. > :22:08.it relates to pay. It is being extended and it is not relevant to

:22:09. > :22:14.the amendment before me, nor the motion. Let us get back to the

:22:15. > :22:19.motion in hand. Please continue. Can the Presiding Officer clarify how

:22:20. > :22:25.far away... I have made my ruling. I want you to get on with your speech.

:22:26. > :22:32.Do not challenge me, please. Nurses and midwives are one of the most

:22:33. > :22:36.valuable resources we have. In order to say there a high level of care,

:22:37. > :22:44.we have committed to free tuition for those wanting to be nurses.

:22:45. > :22:53.Scotland has worked hard to keep is no compulsory redundancy policy.

:22:54. > :22:57.Unlike England. Financial restrictions... Figures show that

:22:58. > :23:00.nurses hereafter paid at a higher rate than across the UK which is

:23:01. > :23:07.another way of showing how we value the service. There's an election and

:23:08. > :23:10.people want to grab headlines criticising the government, but I

:23:11. > :23:18.would ask that with the motion like this, how do we find the extra pay?

:23:19. > :23:21.Scrap the no compulsory issue or would Scotland take away more bunny

:23:22. > :23:30.from other front line services? Where, may I ask, where is the ?350

:23:31. > :23:39.million for the NHS which we were promised after Brexit? Back then,

:23:40. > :23:45.they did but then they no longer opposed it. It is like a cult, isn't

:23:46. > :23:51.it? I had the good fortune to see the SNP take control of the Council

:23:52. > :23:56.on Friday. There I heard that Anas Sawar told someone it was a terrible

:23:57. > :24:00.day fully SNP and independence and a strong showing for Labour. While he

:24:01. > :24:04.continues to make fanciful contributions, like last Friday and

:24:05. > :24:09.today, the Scottish Government would keep to their promise of supporting

:24:10. > :24:21.our hard-working and much valued nurses. Thank you. No comments about

:24:22. > :24:25.the length of time from anyone. I gave the time extra to the speaker

:24:26. > :24:35.because I made a ruling in it. Mr Whittle. Thank you. Can I first

:24:36. > :24:38.declare an interest in that my daughter is a health care

:24:39. > :24:42.professional in the NHS. I welcome to speak in this debate and thank

:24:43. > :24:48.labour for raising the important issue today. Across this chamber, I

:24:49. > :24:56.am sure there will be agreement that are front line public servants

:24:57. > :25:00.deserve to be paid appropriately for their work and care and attention.

:25:01. > :25:03.The question remains is how this can be achieved in a sustainable and

:25:04. > :25:10.consistent manner beyond political -- political rhetoric? Last week I

:25:11. > :25:15.witnessed first-hand health care on the front line. Firstly, I spent

:25:16. > :25:19.some time in A and you will be pleased I was seen well within the

:25:20. > :25:24.four-hour guideline. I was waiting to be seen and could watch the

:25:25. > :25:29.station and observe what was going on. Harassed staff only through to

:25:30. > :25:33.the front desk asking them to stop sending people through because there

:25:34. > :25:39.was no room and patients complaining they were already sitting there for

:25:40. > :25:43.half an hour. Nurses feeling guilty even though one nurse was well over

:25:44. > :25:49.her I was at eight o'clock in the evening. I took the opportunity to

:25:50. > :25:52.speak with her and what she wanted was to feel valued. For us to

:25:53. > :25:57.understand the roles she did to have staff numbers and experience to cope

:25:58. > :26:02.with demand, to have the flexibility in the roster to cope with

:26:03. > :26:10.fluctuating demand. I met with a GP on Monday night who took it ethical

:26:11. > :26:16.decision to close the surgery and close the surgery to Crosshouse in

:26:17. > :26:22.another area. There was anyone tentative enquiries since January to

:26:23. > :26:26.have the practice taken over. Five GPs potentially taken out of the

:26:27. > :26:29.system, compounded by the fact that a further six GPs were due for

:26:30. > :26:36.retirement in the same area. A potential lot of -- loss of 11 GPs

:26:37. > :26:42.in Kilmarnock. As of two weeks ago, there were already 15 GPs

:26:43. > :26:47.advertising petition -- positions unfilled in Ayrshire. It is obvious

:26:48. > :26:53.that this is far from an isolated problem.

:26:54. > :27:02.Would amend the agree with me that whilst there are difficulties in

:27:03. > :27:07.recruitment to general practice, they have a report today by the

:27:08. > :27:10.Royal College of practitioners about the impact of Brexit on the

:27:11. > :27:18.workforce in Scotland is particularly worrisome and I would

:27:19. > :27:21.say to your colleagues that it is particularly worrying for those of

:27:22. > :27:29.us who represent rural areas where up to one of four of the doctors is

:27:30. > :27:33.an EU national. I will give your time back, that is a long

:27:34. > :27:38.intervention. It is not just the recruiting staff from around the

:27:39. > :27:47.world, it is home-grown GPs. Here is the thing. Two weeks before

:27:48. > :27:54.resigning the practice, asking for help and they are still awaiting

:27:55. > :27:58.reply. It is all very well having the rhetoric, but it is action that

:27:59. > :28:02.actually applies and that is paid to be not the case with this

:28:03. > :28:05.Government. When that GP joined the practice of the partner ten years

:28:06. > :28:10.ago, it was the eighth one that she applied to. Now the GP can pretty

:28:11. > :28:14.much choose which practised they want to go to. I was told that the

:28:15. > :28:20.most dramatic change had happened in the last three years. The practices

:28:21. > :28:25.that hurt the moat of Rowell ones. that hurt the moat of Rowell ones.

:28:26. > :28:31.The people that suffer the most ugly ones who lose continuity of care

:28:32. > :28:45.because it is not GPs -- the most are the role ones. Locals are being

:28:46. > :28:53.increasingly sought to fill gaps. Three years ago they were paying a

:28:54. > :28:57.locum, now they are having to pay ?250 for a locum to cover just for

:28:58. > :29:04.hours. With the pressure that GPs are under, coupled with the demand,

:29:05. > :29:08.is it no wonder that working at a locum is such an attractive issue?

:29:09. > :29:12.The issue is not the money that they earn, it is being valued. It is

:29:13. > :29:21.recognising that the GPs are the gatekeepers, the health care

:29:22. > :29:26.professionals have built up many years of... The consequence of not

:29:27. > :29:31.addressing this right now according to this GP is more people ending up

:29:32. > :29:35.in hospital. The consequences that the next conversation we will have

:29:36. > :29:43.will be how we deal with the mess and the fallout. It is true for

:29:44. > :29:49.politicians and GPs, the longer you leave the problem the harder it is

:29:50. > :29:53.to deal with. The reality is that hospital numbers have risen while

:29:54. > :30:00.GPs fall. In a bar patient ending up in inevitably rises coming through A

:30:01. > :30:07.E. Agents that should and could -- patients. It is not just about the

:30:08. > :30:12.levels of care. An NHS that is sustainable for the long-term quite

:30:13. > :30:15.frank it will take a radical overhaul in the way we view health

:30:16. > :30:20.and health care. It requires a culture change in the way that

:30:21. > :30:26.health professionals are viewed by this place and the public. There are

:30:27. > :30:33.billions to recoup and reinvest and has to be put in front and centre.

:30:34. > :30:36.The job that health care professionals do must be made more

:30:37. > :30:39.attractive and a valued career path and in the words of health care

:30:40. > :30:46.professionals, but is more about just money. Choosing a career as a

:30:47. > :30:51.health care professional is not about financial reward. It is a

:30:52. > :30:55.desire to care. What came across my recent with health care

:30:56. > :30:59.professionals is concern for patients and what will happen to

:31:00. > :31:07.them if the NHS are not steered on a more sustainable course. Sustained

:31:08. > :31:11.continuity of care is needed. If we are serious about recruiting into

:31:12. > :31:13.the NHS, if we are serious about rewarding our health care

:31:14. > :31:16.professionals appropriately, throwing more money at the problem

:31:17. > :31:20.is not the right course of action. We need to stop treating the

:31:21. > :31:27.symptoms and focus on dealing with long-term. So try to keep the show

:31:28. > :31:33.on the road and thinking about how we build a sustainable future for

:31:34. > :31:41.the NHS. Thank you. Thank you very much. We have already heard comments

:31:42. > :31:46.that the Royal College of Nursing for Scotland briefing and some of

:31:47. > :31:50.the folk from the Labour benches. I would like to just comment or quote

:31:51. > :31:54.as well from that particular briefing. The Royal College of

:31:55. > :32:00.Nursing in Scotland state that pay rewards have been constrained by the

:32:01. > :32:04.UK Government's policy and public sector pay for subissue be noted

:32:05. > :32:07.that these got his Government has implemented recommendations even

:32:08. > :32:13.when the UK Government has not. This means that those terms and

:32:14. > :32:21.conditions remain roughly equivalent, pay rates for each of

:32:22. > :32:24.the pay bands vary. That means in Scotland there has been an increase

:32:25. > :32:30.and a higher level of pay across the bands in Scotland. I want to touch

:32:31. > :32:37.on a couple of points as well. I will let you in later. Westminster

:32:38. > :32:43.Government has reduced Scotland's fiscal budget in real terms. In

:32:44. > :32:48.spite of this, the Scottish Government has committed to

:32:49. > :32:52.continuing to provide above inflation for the health budget. The

:32:53. > :33:00.SNP Government has protected the front line health budget increasing

:33:01. > :33:08.it by 40% from 2006 to 2017. Health funding now stand at record levels.

:33:09. > :33:14.?13 billion with resource spending being 3.6 billion more than when

:33:15. > :33:24.this Government took office in 2007. Also Presiding Officer, Her Majesty

:33:25. > :33:29.Treasury's figures is 7.2% higher than in England. That is an

:33:30. > :33:34.equivalent of ?152 per person. In terms of the NHS in Scotland, it is

:33:35. > :33:37.clear that these figures highlight that although there are challenges

:33:38. > :33:42.in the NHS and I don't think anybody in these benches could indicate that

:33:43. > :33:46.there aren't any challenges to the NHS, there will always be challenges

:33:47. > :33:49.to be NHS, irrespective to which party or parties are in power. That

:33:50. > :33:53.is the case here and in England and Wales. We have heard some examples

:33:54. > :33:59.of that in this debate this afternoon. Nonetheless, it is clear

:34:00. > :34:03.that in terms of the Finance and the importance that this Scottish

:34:04. > :34:08.Government actually places upon the NHS in Scotland, it is paramount

:34:09. > :34:13.that with the funding that is going into the NHS and with the level of

:34:14. > :34:19.focus that is going in to make our NHS better and more responsive, then

:34:20. > :34:22.members from across the chamber have really got to try and understand

:34:23. > :34:26.that particular level in terms of the funding that is also going in.

:34:27. > :34:32.Our NHS staff are resilient. We have heard that already today. Our NHS

:34:33. > :34:36.staff are resilient and they do have a unique set of skills that they

:34:37. > :34:40.bring to their patients and also to the multidisciplinary teams in which

:34:41. > :34:44.they operate. Our NHS staff are always there at times of crisis to

:34:45. > :34:52.treat, care and reassure their parents. -- patients. I have been

:34:53. > :35:00.very fortunate that I have not had to call upon NHS staff to often.

:35:01. > :35:05.Suddenly, the constituents that I deal with a regular basis, there

:35:06. > :35:12.have been challenges there. The one thing that comes back time and time

:35:13. > :35:19.again is how valued our NHS staff are. I'm sure everybody here

:35:20. > :35:23.recognises that and appreciate everything that our NHS does for the

:35:24. > :35:40.country. The Scottish Government's pay policy set aside that flow from

:35:41. > :35:44.the UK Government spending round. Their cuts are coming to this

:35:45. > :35:54.Parliament. The cuts are coming to this Government. That means that the

:35:55. > :36:01.restraints are still required. It is also recognise that maintaining

:36:02. > :36:05.employment and Scotland's economy remain stronger. The aim of the

:36:06. > :36:11.policy is to provide a pay increase for all staff come supporting those

:36:12. > :36:15.on the lowest income and people making their own decisions about

:36:16. > :36:26.paper aggression. -- pay progression. It is born out of the

:36:27. > :36:30.fact that there are staff shortages of NHS staff. Speaking on BBC Radio

:36:31. > :36:39.4, Jonathan Ashworth revealed that as a result of the staff shortages,

:36:40. > :36:46.Labour would scrap the 1% pay gap. It would reverse bursary to fall

:36:47. > :36:49.student nurses, midwives and indeed the latest UCAS figures have

:36:50. > :37:00.revealed the deep damage that Tory Government cuts are having to

:37:01. > :37:06.nursing. That is after they abolished bursaries. No wonder, that

:37:07. > :37:17.highlights the fact that nobody wanted to talk about the comparisons

:37:18. > :37:30.to England. Also the issue of the creeping privatisation of the NHS.

:37:31. > :37:36.I'm conscious of time, the NHS... And the Scottish Government has been

:37:37. > :37:43.consistent to offer the right support to students protecting the

:37:44. > :37:55.bursary, supporting our NHS staff of the future as well as survey. Thank

:37:56. > :38:00.you. It is time for the pay cap to be scrapped. Years of pay restraint

:38:01. > :38:11.have eroded living standards for our NHS staff. We can't and I -- deny

:38:12. > :38:15.staff morale has been affected. The retirement boom on the horizon and

:38:16. > :38:19.many staff are looking back on years of real term pay cuts and wondering

:38:20. > :38:22.whether they can afford to keep giving to the NHS. I will support

:38:23. > :38:29.this motion today because the Scottish Greens believe that we will

:38:30. > :38:34.restore the value to the NHS staff and the public sector. The pay

:38:35. > :38:40.impact has an effect on our wider communities. The majority were women

:38:41. > :38:48.and a below inflation pay cap contributes to the gender pay gap.

:38:49. > :38:53.Hospitals and health centres are vital anchors in these communities

:38:54. > :38:55.and holding down pay has implications for them particularly

:38:56. > :39:09.in promote and roll regions. The Scottish ... I am glad this often

:39:10. > :39:17.results in better results for NHS Scotland, ensuring an minimum

:39:18. > :39:21.increase is a positive measure. I do not believe it goes far enough.

:39:22. > :39:25.Independent pay review body last report is quite clear. Government

:39:26. > :39:30.sector pay policies set the context for its recommendations. On NHS pay

:39:31. > :39:37.in England, it says we were told by the health apartment that a 1% pay

:39:38. > :39:42.award is funded and it is clear that a pay award higher than 1% would

:39:43. > :39:51.require trade-offs acquire of service levels, investment decisions

:39:52. > :39:53.and staff numbers. Associated ... If the independent pay review body is

:39:54. > :39:56.only prepared to make recommendations that are already in

:39:57. > :40:02.line with Government spending plans and sets the expectations, the NHS

:40:03. > :40:09.staff should be the cost of trade-offs, ie fail to see where the

:40:10. > :40:16.independence lies. This one of health's view is that they played a

:40:17. > :40:22.key role in the budget deficit. It seemed clear to me that the report

:40:23. > :40:30.makes its recommendations in that fiscal context. That will mean they

:40:31. > :40:43.play a key role in the budget deficit. The NHS pay should not be

:40:44. > :40:48.based on economic severity. We are approaching the point where we will

:40:49. > :40:57.require change. Public sector will not require to shoulder that burden

:40:58. > :41:02.ten years on or deal with the problem is of the NHS is due to

:41:03. > :41:08.democratic change. I would be inclined to support a Scottish

:41:09. > :41:14.system, but if professional bodies and trade unions take a view then it

:41:15. > :41:27.is vital that the Scottish Government plays a full role in that

:41:28. > :41:48.process. Delaying submission and inhibiting visa Bisham of other.

:41:49. > :41:58.The Royal College of Nursing's recent survey found that 30%

:41:59. > :42:05.struggle to pay gas and electricity bills and many more missed meals

:42:06. > :42:09.because of financial difficulty. I wonder if you or anyone in the

:42:10. > :42:12.chamber can provide me with information about how many

:42:13. > :42:18.respondents were based in Scotland? I was speaking to message -- nurses

:42:19. > :42:24.yesterday and I can confirm this policy is having an impact on them.

:42:25. > :42:28.Yesterday I spoke to an experienced nurse who has taken on a part-time

:42:29. > :42:33.job because she can't make ends meet. While I've heard that pay

:42:34. > :42:36.progression is still in place, and that is welcome, the fact of the

:42:37. > :42:41.matter is that someone who who is doing a job can be paid less now for

:42:42. > :42:47.that job than in 2011 so we have a problem. Nurses shouldn't have to

:42:48. > :42:54.cope with pressure at home but is financial. 2.6% would be in line

:42:55. > :42:58.with the retail price index and I believe that's fair. Economic

:42:59. > :43:06.inequalities are that at the centre of other inequalities cannot be

:43:07. > :43:10.denied. Use other stress because there's no work and life balance and

:43:11. > :43:15.you take on extra shifts to keep your head above water. Financial

:43:16. > :43:21.factors have an incremental effect leading to sickness and time off

:43:22. > :43:25.work. Staff absence pushes up agency costs and NHS employees feel and

:43:26. > :43:31.fairness when they see how much is being spent on agency nurses and

:43:32. > :43:35.locum doctors. In Denmark, hospital nurses are paid about 16% more than

:43:36. > :43:42.here or over 20% better in Australia. We know this. Nurses

:43:43. > :43:47.don't go into the profession for the money and nor do midwives or

:43:48. > :43:51.physiotherapists or other health care workers but patient expect

:43:52. > :43:55.their dedication and professionalism to go unrewarded because their pay

:43:56. > :43:58.falls below inflation. The government 's amendment says they

:43:59. > :44:09.will commission work to develop and evidence -based approach to pay. NHS

:44:10. > :44:16.staff already know this and they have already made submissions. The

:44:17. > :44:20.RCN has polled members on action that should be taken on pay

:44:21. > :44:25.restraint, including the option to balance -- ballot for industrial

:44:26. > :44:32.action. Can the member wind-up, please. Restoring the balance of NHS

:44:33. > :44:37.pay will restore the balance and it will have positive effect on the

:44:38. > :44:43.standard of care we all received. Thank you. I congratulate the Labour

:44:44. > :44:49.Party in bringing forward this important debate and I can assure

:44:50. > :44:59.them of the support of these benches tonight. I spent a long time on one

:45:00. > :45:13.my life. I have met through some of my life. I have met through some of

:45:14. > :45:14.professionals in our society. People professionals in our society. People

:45:15. > :45:17.who, in many cases and from an early age, answered and in according to

:45:18. > :45:23.meet the needs of the most fun rubble and infirm and they have done

:45:24. > :45:28.so without thought of reward. Just as well because there are very few

:45:29. > :45:35.roles within the health service which attract financial recompense.

:45:36. > :45:46.What we are debating today is a cat that has seen it decline in taken

:45:47. > :45:47.our health service. In the teeth of our health service. In the

:45:48. > :45:48.a hard Brexit and the devaluation of a hard Brexit and the devaluation of

:45:49. > :45:53.the pound, we see the value of those pay packets diminish further and

:45:54. > :45:57.with it, the buying power of hundreds of thousands of employees.

:45:58. > :46:02.We ask so much of those we look to for treatment and care and yet we

:46:03. > :46:08.offer so little by way of reward. What we do offer is diminishing. It

:46:09. > :46:13.is not melodramatic to say that to continue as we have with no prospect

:46:14. > :46:18.of pay increase in real terms for our NHS or social care workers it

:46:19. > :46:24.represents an existential threat to the delivery of health and social

:46:25. > :46:28.care in our society because, at its bedrock, the NHS and the social care

:46:29. > :46:34.system is nothing without its star. The rhythms of our health service

:46:35. > :46:38.are constantly interrupted by the stuttering of shortages, inadequate

:46:39. > :46:42.workforce planning and attrition in pain. Underpinning all of this is

:46:43. > :46:49.the need for fair and equitable paid to make a career and attractive and

:46:50. > :46:54.viable life choice. We cannot expect pressures on our hospitals or GP

:46:55. > :46:59.surgeries to abate while they are so hungry for a new staff cohort that

:47:00. > :47:05.is not coming up through the ranks or, instead, is looking overseas for

:47:06. > :47:08.opportunities which attract greater financial incentive. Adequate

:47:09. > :47:16.investment in our workforce is vital. It is the call we all

:47:17. > :47:22.received from stakeholders in every speciality in the sector. All too

:47:23. > :47:27.many junctions in the system, there are buckled in the wake of demand.

:47:28. > :47:32.Audit Scotland revelations that are health boards missed all but one of

:47:33. > :47:36.the national targets they are expected to meet. Delays in UWE

:47:37. > :47:44.offer the starkest insight to the chronic problems we face in our

:47:45. > :47:50.system -- delays in accident and emergency. My eyes were open to the

:47:51. > :47:57.reality underpinning the delays in the four-hour target. The accident

:47:58. > :48:06.and emergency -- department acts as a weather vane. The reality of how

:48:07. > :48:10.easy it is to clear patients out of accident and emergency into the

:48:11. > :48:19.wider hospitals so delays mean bed blocking. I have raised many times

:48:20. > :48:25.one case, an elderly constituent, who had to endure 150 nights in

:48:26. > :48:33.hospital. I will take an intervention. I perhaps missed the

:48:34. > :48:37.congratulations from my colleague to the Scottish Government about their

:48:38. > :48:41.incredible performance on the four-hour waiting times over the

:48:42. > :48:47.last number of years compared to all other UK countries given that it is

:48:48. > :48:58.a canary in the mine target. Well, I am delighted to congratulate. On

:48:59. > :49:03.this point, you miss the trick entirely. The point about those

:49:04. > :49:08.targets is the fact that we have a colossal problem of bed blocking in

:49:09. > :49:14.our hospitals and the delay in this case was due to the fact that his

:49:15. > :49:18.social care package was not available. No night-time check could

:49:19. > :49:23.be established because there were no staff available to do it. The delay

:49:24. > :49:26.cost hundreds of thousands of pounds so when the members on the

:49:27. > :49:32.government benches ask me from where we get the money to pay for such an

:49:33. > :49:37.uplift, I point to my constituent and his protracted stay in the most

:49:38. > :49:40.expensive hotel in Edinburgh. The cost of failure in his case is

:49:41. > :49:45.replicated across every health board. If we were only to

:49:46. > :49:48.recalibrate the direction of expenditure we could free up

:49:49. > :49:52.resources to offer financial recompense at every level. It is

:49:53. > :49:57.because we failed to invest in our social care workforce that cases

:49:58. > :50:02.like this are so commonly raised here. We expect carers to attend

:50:03. > :50:06.their charges for sometimes as little as 15 minutes and to receive

:50:07. > :50:11.a salary they could just as well find stacking shelves in a local

:50:12. > :50:14.supermarket. Local authorities date with regularity that they commission

:50:15. > :50:21.social care on grounds of quality over cost but the reality is felt

:50:22. > :50:24.most keenly by service users on the ground regarding that split. It is

:50:25. > :50:28.often easier for members of the opposition to ask the moon of

:50:29. > :50:34.government and to write checks we could never hope to write ourselves

:50:35. > :50:41.when in government. But to this, the solution is blindingly simple.

:50:42. > :50:44.Entice people back to the fold, invest in our workforce, given the

:50:45. > :50:48.future of comfort and security and they will visit it back on the

:50:49. > :50:53.people in their care tenfold. We have so much to be proud of for the

:50:54. > :50:57.men and women who deliver care and the very least we can do is ensure

:50:58. > :51:00.they can do the job they like and love with a measure of dignity and

:51:01. > :51:07.the proper reward. APPLAUSE

:51:08. > :51:15.Could I ask Neil Finn delete and others to press the request to

:51:16. > :51:22.speak. There was a technical glitch. Thank you. Can I refer members to my

:51:23. > :51:27.register of interests, specifically my member of the GMB and Unite trade

:51:28. > :51:32.unions. With this motion today, Labour is showing people away out of

:51:33. > :51:36.a failed economy in which working people are being made to pay the

:51:37. > :51:42.price for a crisis they did not create. Wages which once rose

:51:43. > :51:46.gradually are not increasing any more. Housing costs and even the

:51:47. > :51:53.price of food cannot be afforded any longer and for too many people are

:51:54. > :51:58.-- people, fuel poverty is going up. We have the poor, the working poor

:51:59. > :52:04.and the public service working poor as well. People whose wages have

:52:05. > :52:10.been held down year after year. Nurses experiencing a real terms pay

:52:11. > :52:15.cut of 30% since 2010 and other people working in full-time jobs in

:52:16. > :52:19.our national health service still below the poverty line. Still forced

:52:20. > :52:28.to claim benefits and done in our name. It is not as though we are

:52:29. > :52:33.living beyond our means but that we are not equitably distributing our

:52:34. > :52:39.means. All our aims at sacrifice our to the working people. Whilst the

:52:40. > :52:44.rich are studiously ignored with the result that, in Scotland, the

:52:45. > :52:48.richest 1% owned more personal wealth in the whole of the poorest

:52:49. > :52:55.50% altogether. It has other consequences. As one member of the

:52:56. > :53:03.PCS union told a committee in this Parliament last month. "As Long as

:53:04. > :53:09.we continue to have pay freezes and pay restraint we will not eradicate

:53:10. > :53:12.the gender pay gap." In days gone by, incomes policy was part of a

:53:13. > :53:17.wider programme of action by government through a social contract

:53:18. > :53:21.to deliver a social wage, it including food price subsidies and

:53:22. > :53:33.rate subsidies. In places to the state pension -- rent subsidies.

:53:34. > :53:39.What we have today is a blunt one-way fiat of austerity. The SNP

:53:40. > :53:44.government makes comparisons with England. Well I'm sure it will be a

:53:45. > :53:49.comfort to midwives working around the clock in Wishaw, to the nurses

:53:50. > :53:55.in the Forth Valley Hospital at the top of their pay band, to the

:53:56. > :53:58.porters toiling... Would you make the same speech to a Labour Party

:53:59. > :54:06.conference in Wales where nurses are paid less than in Scotland? The last

:54:07. > :54:10.time I checked I was in a Scottish parliament addressing an SNP

:54:11. > :54:16.government. What would you say to the porters toiling long hours

:54:17. > :54:21.working long weekends and to the ambulance crews on call stationed

:54:22. > :54:28.right across the country, to the hard-working cleaners on ?8 50 per

:54:29. > :54:33.hour, the lowest paid. I am sure it will be a comfort to them that, if

:54:34. > :54:38.they lived in England, they would be even worse than subject to even more

:54:39. > :54:41.restraint. In light of their experience, I am sure they will

:54:42. > :54:47.greet with some cynicism the suggestion in the amendment that the

:54:48. > :54:50.best revolution -- resolution will be found in partnership working and

:54:51. > :54:54.the benevolence of the Scottish Government. When the review body

:54:55. > :54:58.produced its recommendation it said the scale of efficiency savings that

:54:59. > :55:04.the NHS is required to make appear to be bigger in Scotland than other

:55:05. > :55:09.parts of the UK with the Scottish Government telling us that health

:55:10. > :55:16.boards will be expected to make 3% efficiencies in 2017. So I am

:55:17. > :55:20.challenging the government today to scrap the cap and allow for free and

:55:21. > :55:28.responsible collective bargaining. Let me turn to the conservative

:55:29. > :55:33.amendment because we have a trade union act on the statute book which

:55:34. > :55:40.is barely a year old. It is a Tory act which I presume the Tory members

:55:41. > :55:44.here support. It singles out public service workers and puts at the very

:55:45. > :55:49.top of the list of public service workers, workers in health services.

:55:50. > :55:55.The very workers we are discussing this afternoon. That is on the face

:55:56. > :55:59.of the act which they support and it demands a minimum turnout threshold

:56:00. > :56:05.of 50% and minimum majority thresholds of 40% for legal

:56:06. > :56:10.industrial action. I am bound to say that if the same rules were applied

:56:11. > :56:14.to the local government elections last week, which Tory and SNP

:56:15. > :56:18.ministers... Not a single Tory councillor would have been elected

:56:19. > :56:25.anywhere in Scotland. Your last minute.

:56:26. > :56:30.I want to remind the parliament finally of the principles of the

:56:31. > :56:36.health service set up by Aneurin Bevan. Bevan said that it becomes

:56:37. > :56:41.more wholesome, more Serena and spiritually healthier if it knows

:56:42. > :56:45.that its citizens have at the back of its consciousness the knowledge

:56:46. > :56:49.that not only themselves but all the fellows have the access when ill

:56:50. > :56:54.that the best the medical skills can provide. If the job is to be done,

:56:55. > :57:05.the state must accept financial responsibility. These prophetic

:57:06. > :57:07.words are chosen carefully. It is not medical machinery or

:57:08. > :57:12.pharmaceutical formulas, but the dedication of the people who work in

:57:13. > :57:18.the National Health Service and to the SNP let me finish by saying

:57:19. > :57:22.this, it is no good claiming to be on the side of the workers in the

:57:23. > :57:27.NHS when you are not prepared to back them up. It is no good claiming

:57:28. > :57:31.to be investing in the NHS if you are not investing in the people who

:57:32. > :57:36.deliver the NHS. I would urge all members to look to their conscience,

:57:37. > :57:40.to accept financial responsibility and accept moral responsibility and

:57:41. > :57:47.back the Labour motion this afternoon. Before I call the next

:57:48. > :57:51.member, I say to anyone along the front benches, if you're going to

:57:52. > :58:00.intervene, intervene properly. Do not heckle from the site. Today's

:58:01. > :58:04.debate gives us an opportunity to highlight the different approaches

:58:05. > :58:09.to nurses pay adopted across each part of the UK. I welcome the Labour

:58:10. > :58:13.Party bringing this debate to the party this week in advance to

:58:14. > :58:16.international nurses Day which falls this weekend. The debate allows us

:58:17. > :58:21.to compare and contrast with different administrations. The

:58:22. > :58:29.Scottish, Welsh and English Government. There is a clear process

:58:30. > :58:39.in place to determine nurses party Mac page, -- nurses' pay. This tells

:58:40. > :58:44.us much about what we need to be able to focus on and the commitment

:58:45. > :58:48.of each administration and the parties that run them. The Tory lead

:58:49. > :58:54.UK Government of the Labour run Welsh Government have failed to

:58:55. > :58:58.implement the peer review body. The Scottish Government run by the SNP

:58:59. > :59:02.in contrast has stood by the body's recommendations and implemented them

:59:03. > :59:06.in full. While labour talks the talk, we are failing to meet the

:59:07. > :59:16.recommendations and the Tories look the other way, it is the SNP which

:59:17. > :59:20.has met its obligations. Funding nurses pay to the review body. The

:59:21. > :59:27.Royal College of nurses understands this well. It states these got his

:59:28. > :59:32.Government has implemented recommendations, even when the UK

:59:33. > :59:41.Government has not. Pay rates that you to the page bands vary. A newly

:59:42. > :59:47.qualified nurses ?21,999 in England, the same in Wales. In 1693 in

:59:48. > :59:58.Northern Ireland and ?22,218 in Scotland. A band five nurse earns

:59:59. > :00:01.more than in England and Wales. It is a clear indication that the

:00:02. > :00:07.Tories never stop talking about the top 10%. The higher rate taxpayers

:00:08. > :00:13.can afford to pay a little bit more. Never mind the benefit of the

:00:14. > :00:19.council tax and the ?400 law in Scotland. When it comes down to it,

:00:20. > :00:23.the Tory's priorities of targeting constituencies is laid bare for

:00:24. > :00:28.everyone to see. In the top 10%, UIQ tooth and nail for your percent, if

:00:29. > :00:37.you happen to be an NHS worker you are not interested in

:00:38. > :00:39.recommendations on your pay. On the PRB's recommendations, additional

:00:40. > :00:45.measures have been put in place to assist lower pay in the profession.

:00:46. > :00:49.A flat rate 400 and lift for those earning 22,000 or less has been

:00:50. > :01:00.fermented, recognising the particular pressures on low-paid

:01:01. > :01:04.staff. -- implemented. It ensures nurses are trained to support our

:01:05. > :01:08.growing health service. Nursing bursaries are still in place in

:01:09. > :01:12.Scotland and nursing students pay no tuition fees. This is a stark

:01:13. > :01:17.contrast to policies elsewhere in the UK where both have been

:01:18. > :01:20.scrapped. As a consequence, the number of English applicants to

:01:21. > :01:24.nursing courses has plummeted by 23%. Ten times worse than in

:01:25. > :01:28.Scotland. There is no surprise that England is suffering from a 9% nurse

:01:29. > :01:34.vacancy rate, more than double that in Scotland, consequence of a

:01:35. > :01:37.different approach to treatment of staff. A Scottish Government also

:01:38. > :01:45.understands the need to provide stability and security for our NHS

:01:46. > :01:55.staff. In contrast, the situations out of the border there have been

:01:56. > :02:00.many redundancies, NHS: has -- NHS Scotland has had no redundancies.

:02:01. > :02:13.Entry level support staff in Scotland are paid ?1128 more than

:02:14. > :02:16.their English counterparts. These measures are underpinned by the

:02:17. > :02:31.Scottish Government's commitment to support the health service with

:02:32. > :02:36.money 500 million pounds. Will he agree that for any nurse or any NHS

:02:37. > :02:40.staff member in Scotland to have to turn to a food bank is a scandal and

:02:41. > :02:46.unacceptable? What action does he suggest should be taken, if not

:02:47. > :02:49.giving them a pay rise? If the man had that listing to the last five

:02:50. > :02:56.minutes, he would have understood what I would've said. What has he

:02:57. > :03:02.got to say about that? Viewpoint is that Scottish Government have

:03:03. > :03:05.committed ?500 million more than Scottish Labour have in 2050

:03:06. > :03:17.manifesto that they were elected on. This against the -- 2015. The Tories

:03:18. > :03:23.came to office and not only with funding and support for the staff in

:03:24. > :03:29.NHS Scotland, England and is Labour front Wales. The performances

:03:30. > :03:34.significantly higher across Scotland and the rest of the UK. The Scottish

:03:35. > :03:38.Government has also stood firm against the creeping privatisation

:03:39. > :03:44.of services, a trend that has seen 7% of health service provision down

:03:45. > :03:47.south now in private hands. The contrast between how the SNP

:03:48. > :03:53.Scottish Government runs the health service here and how the Tory UK

:03:54. > :04:01.Government and the Labour run Welsh Government, it could not be clearer.

:04:02. > :04:06.As in so many other aspects of running our NHS, it is this SNP

:04:07. > :04:13.Government that the people of NHS -- people of Scotland contrast. Staff

:04:14. > :04:22.and patients alike. -- can trust. We have no time at all in hand. Strict

:04:23. > :04:27.guidelines. Firstly I thank them for bringing forward this important

:04:28. > :04:32.debate. Extremely interesting and a significant matter I am delighted to

:04:33. > :04:36.contribute to it. Those who work for the NHS and care for us on a daily

:04:37. > :04:40.basis. I would like to focus on securing the long-term future of the

:04:41. > :04:46.NHS in Scotland and how staff should be supported by improving the short

:04:47. > :04:50.staffing crisis. In the ten years that the SNP have been in power in

:04:51. > :04:54.Scotland, the NHS has taken a turn for the worse with a major staffing

:04:55. > :04:58.crisis. The Scottish Government have taken a short-term view on job

:04:59. > :05:01.vacancies within the NHS. Much to the detriment of our NHS in

:05:02. > :05:05.Scotland. We no longer have the numbers of staff that we need to

:05:06. > :05:11.ensure the patients get the best room in possible. The number of

:05:12. > :05:15.nursing vacancies are on the rise. There was a vacancy rate of 4.1%

:05:16. > :05:23.within the nursing and midwifery posts which has risen from 3.6% in

:05:24. > :05:31.2015. These vacancies are putting increasing levels of pressure on

:05:32. > :05:36.overstretched staff. Similarly, GPs, sold the Mac consultants have seen a

:05:37. > :05:41.rise in the number of vacancies. Empty posts put further strain on an

:05:42. > :05:49.exhausted staff. It put undue stress of those working on art services. We

:05:50. > :05:58.solve the problem by getting locum doctors and nurses. We look for

:05:59. > :06:01.temporary solution. Due to this poor workforce planning, the use of

:06:02. > :06:16.agency nurses has decreased by 50% all year. In addition, the Scottish

:06:17. > :06:19.Government is spending more than ?250,000 on locum staff. It is

:06:20. > :06:24.unsustainable and will do nothing to help the long term problem of

:06:25. > :06:27.vacancies in the NHS. I recognise there will always be a need for

:06:28. > :06:31.locum staff, we should not be reliant on this form of staffing as

:06:32. > :06:39.we are at present. We are seeing a sticking plaster approach on this by

:06:40. > :06:45.the Government. Chief Executive of an association called for fewer

:06:46. > :06:49.locum staff to be used. She stated that our health services in a

:06:50. > :06:54.serious state. Really serious. If we want to care when we are old -- if

:06:55. > :07:02.we want to have care when we are old, we have to look after it today.

:07:03. > :07:07.We need to find new ways for health boards to focus on long-term

:07:08. > :07:19.sustainability in services. We can only fill vacant posts. Gaps in NHS

:07:20. > :07:24.Scotland are only predicted to grow. It is particularly prominent among

:07:25. > :07:27.nurses and midwives. That means that 18.2% of the workforce planning to

:07:28. > :07:33.retire in the next ten years which will have a significant impact on

:07:34. > :07:39.NHS staffing Scotland and put even more strain on the staff. We need to

:07:40. > :07:44.make sure there is a sustainable NHS staff in Scotland for the

:07:45. > :07:47.sustainable future and the Scottish Government are turning to retire GPs

:07:48. > :07:53.to fill the gaps. There have been many cases of trust having to

:07:54. > :07:59.recruit from abroad due to the shortage of the staff. This is not

:08:00. > :08:03.the way to secure the future of the service in Scotland. We are seeing

:08:04. > :08:10.the impact of Nicola Sturgeon's cuts from and she was Health Secretary.

:08:11. > :08:13.Training places were slashed by more than a fifth and more than 2000

:08:14. > :08:18.nursing jobs were cut to balance the books. The Royal College of Nursing

:08:19. > :08:25.believes that these cuts are now hitting the NHS. The Royal College

:08:26. > :08:29.of Nursing has summarised the situation as follows, we want that

:08:30. > :08:40.this was short-sighted and would lead to problems. We have increased

:08:41. > :08:47.demand for services and. Therefore, in conclusion, the SNP Government

:08:48. > :08:51.were warned about their actions at the time and now must take

:08:52. > :08:55.responsibility for ultimately bringing these staffing shortages

:08:56. > :08:59.today. We now ask that they start planning the NHS workforce for the

:09:00. > :09:02.future and ensuring that we take measures to improve sustainability

:09:03. > :09:11.of our NHS here in Scotland. I will be supporting the Conservative

:09:12. > :09:21.amendment, thank you. Thank you Presiding Officer. Can I thank this

:09:22. > :09:24.motion for being brought. They are acting now. It would not have been

:09:25. > :09:29.acted if his motion had not been brought forward. My wife and

:09:30. > :09:35.daughter work in the NHS, both of them at the lower end of the NHS pay

:09:36. > :09:42.scale. While so have to declare an interest as a member of the Unite

:09:43. > :09:53.union. My wife and daughters multi-Mac colleagues, videos, OT is

:09:54. > :09:59.an arrest. They've been subjected to years austerity. Years of pay

:10:00. > :10:08.settlements below the rate of inflation. The cost of basic food

:10:09. > :10:13.items like beef, fish, dairy products, gas, electricity, soared

:10:14. > :10:24.well over 20% in the retail price it indexes forecast to grow. This

:10:25. > :10:28.represents a pay cut for a band five nurse. The reality of working in

:10:29. > :10:34.Scotland's NHS is that we have a system under pressure like never

:10:35. > :10:38.before. Staff are run ragged. Is the Mac morale is low and the system is

:10:39. > :10:46.creaking at the seams. All of this overwhelmingly is disproportionately

:10:47. > :10:51.impacting women workers who make up three quarters of the NHS star. So

:10:52. > :11:03.much for addressing gender pay issues. This may be between -- this

:11:04. > :11:06.may be true, but it has been driven by an increase spend and overtime

:11:07. > :11:15.payments to try and plug that staffing gap. NHS spend has doubled

:11:16. > :11:46.in that period. The staff bank and their agencies to try and make up

:11:47. > :11:53.This is driven by an increase in bank spending and agency spending to

:11:54. > :12:04.plug Big Apple and we see staff working more hours. -- plug the gap.

:12:05. > :12:11.Agency staff poses a greater ways to agents -- patient safety. Is it

:12:12. > :12:17.sensible to pay thousands more a year to agencies for one nurse in

:12:18. > :12:28.one year. And that is the reality. Rates are nursing and midwifery

:12:29. > :12:36.staff vacancies, 3.6%. Almost 5% for GPs and 6.5% for consultants.

:12:37. > :12:41.Similar rates across the NHS. For tradesmen it is difficult to

:12:42. > :12:47.recruit. Alec Trish and and other craftsmen... Pay has not kept up

:12:48. > :12:57.with industry rates -- electricians. Agencies. Do not want to be

:12:58. > :13:03.patronised. -- health staff. They won support of management and Anna

:13:04. > :13:08.Breuer who cares and the tools to get on with the job they enjoy.

:13:09. > :13:22.Crucially, they won't pay that recognises all of that. Unison in

:13:23. > :13:29.their UK staff -- UK wide is the -- survey found 34% rely on overtime

:13:30. > :13:35.and half rely on financial support from family and friends. What a

:13:36. > :13:38.state of affairs for our greatest public services! What a state of

:13:39. > :13:46.affairs. Who deliver the care we need when we are sick. Let us be

:13:47. > :13:50.clear, it's overrated contributory factor in people choosing other

:13:51. > :14:02.careers. I went people -- contributory factor.

:14:03. > :14:13.Increasing stress, high agencies and cultured combined with a declining

:14:14. > :14:22.pay is not a recipe for meeting the demands of the system. The Health

:14:23. > :14:26.Secretary has two act or... I want to see other public sector staff

:14:27. > :14:32.paid fairly. The cat has hit people in many areas, including local

:14:33. > :14:37.government. The government can act when it wants to. Let me commend the

:14:38. > :14:42.prison officers Association for securing what was called a one-off

:14:43. > :14:50.?2000 increase for prison officers in 2015. It seems like one off has a

:14:51. > :14:54.flexible meaning just as once in a generation has as far as this

:14:55. > :14:59.government is concerned. That deal has been repeated this year. What

:15:00. > :15:09.about other stuff in the prison service? Not for them. And staff in

:15:10. > :15:16.local government? No 2000 for them. NHS staff? No 2000 for them. These

:15:17. > :15:20.public sector workers deliver services that civilise our society

:15:21. > :15:22.and I support the call for an end to the pay gap and I support the motion

:15:23. > :15:37.-- motion put forward. Thank you. Can I remind the chamber

:15:38. > :15:41.that I am registered with the general pharmaceutical Council. I am

:15:42. > :15:47.pleased to speak because I worked as a hospital pharmacist, one of many

:15:48. > :15:52.staff groups paid under agenda for change. Each year, the pay review

:15:53. > :15:59.body made a recommendation as to how much my salary should rise. Several

:16:00. > :16:03.times in the last few years, being a below inflation settlement, I would

:16:04. > :16:10.agree is incorrect to describe it as arise. The Scottish Government has

:16:11. > :16:14.honoured the advice every year. Something my colleagues here were

:16:15. > :16:19.very thankful for. My colleagues south of the border have not been so

:16:20. > :16:23.lucky. Westminster government has not passed on the increase in

:16:24. > :16:28.several years and this has led to a marked difference in salaries

:16:29. > :16:32.between the two countries with Scottish band five staff being paid

:16:33. > :16:39.up to ?312 more than their English and wealth -- Welsh counterparts.

:16:40. > :16:47.The difference is even more stark in lower bands where the

:16:48. > :16:52.recommendations for lowest paid entry-level NHS support staff are

:16:53. > :16:59.paid more than ?1128 more than their counterparts in England. The reality

:17:00. > :17:02.in the UK is that nurses, junior doctors and care workers or get paid

:17:03. > :17:08.more here than in England. As you might expect, given my background, I

:17:09. > :17:14.believe that NHS staff should be paid more. But I wonder if it is

:17:15. > :17:20.possible given the budget cuts from Westminster. Along with many of my

:17:21. > :17:25.colleagues in the NHS, I know the NHS here is relatively well

:17:26. > :17:31.protected behind a government that is committed to a publicly run

:17:32. > :17:39.service free at the point of care. Of course the us terribly agenda

:17:40. > :17:44.supported by the Tories and their coalition partners, the Lib Dems,

:17:45. > :18:02.cut public spending and that has an impact on the Scottish Government's

:18:03. > :18:08.budget. Excuse me. Thank you. I am grateful for the intervention. Even

:18:09. > :18:12.through her ultra-loyalist prison, I wonder if describing her colleagues

:18:13. > :18:19.as grateful for the miserly increase that she actually lies the

:18:20. > :18:25.statistics from the research from the RCN in this country. As I have

:18:26. > :18:32.said, I suspect that if that survey had been conducted on an individual

:18:33. > :18:37.country case within the UK we would have got very different results. The

:18:38. > :18:41.Institute for Fiscal Studies said that spending growth on the NHS

:18:42. > :18:46.under your coalition government was the lowest five-year average since

:18:47. > :18:52.records began, although that was generous compared with the cuts in

:18:53. > :18:58.spending to other cuts in government apartments. The Scottish Government

:18:59. > :19:03.has to be congratulated for managing to increase pay in Scotland and also

:19:04. > :19:10.they have ensured there have been no compulsory redundancies. They have

:19:11. > :19:15.maintained free nurse student bursaries, free nurse student

:19:16. > :19:19.tuition and not only that, they created the discretionary hardship

:19:20. > :19:26.fund. It has not happened in England so the number of English applicants

:19:27. > :19:31.to nursing courses has plummeted by 23% whilst being substantially

:19:32. > :19:37.maintained in Scott -- Scotland. It may be widely current nurse vacancy

:19:38. > :19:43.rate in England is 9% compared with 4% here where wage increases have

:19:44. > :19:47.been more generous. There has been increasing policy divergence between

:19:48. > :19:51.the NHS here and in England and it makes it much harder to sustain a UK

:19:52. > :19:58.wide perspective. I have already mentioned some areas of the

:19:59. > :20:03.divergence. The Conservative amendment raises another, the level

:20:04. > :20:07.of spent on agency locum staff. My conservative colleagues will no

:20:08. > :20:10.doubt welcome the fact that NHS Scotland has a nationally

:20:11. > :20:14.coordinated programme for the effective management of all

:20:15. > :20:18.temporary staffing. The team works to establish regional and staff

:20:19. > :20:25.banks to allow boards access to high-quality, flexible workforces of

:20:26. > :20:29.experienced and competent -- competent staff who work on NHS

:20:30. > :20:35.contracts and provide better value for money than alternative methods.

:20:36. > :20:39.Conservative colleagues will also be pleased to hear that NHS Scotland

:20:40. > :20:45.spends proportionately a third of what is spent in NHS England on

:20:46. > :20:51.medical and nursing staff. Other areas of divergences ask Scotland

:20:52. > :21:00.outperforms all other UK countries on the four-hour A target, delayed

:21:01. > :21:04.discharges to. An increase of 11% in England because of a lack of

:21:05. > :21:09.investment in social care. In Scotland the figure has decreased by

:21:10. > :21:16.9% because of contrasting policies. Scotland has spent more person --

:21:17. > :21:24.more on health per person since 2010. More doctors, more nurses and

:21:25. > :21:31.more midwives work here thanks to the SNP government's sound

:21:32. > :21:40.management of the NHS. I want to finish with a mention of the members

:21:41. > :21:44.debate secured by Mike colleague, also a nurse. We celebrate later

:21:45. > :21:52.this week International nurses date and, ... You must close. I have

:21:53. > :21:58.worked with some nurses and I am sure they will be plead --

:21:59. > :22:02.pleased... You are finished. Thank you.

:22:03. > :22:14.Thank you. I welcome the opportunity to speak and thank labour for

:22:15. > :22:19.bringing this to the chamber today. The challenge facing the NHS has

:22:20. > :22:25.been described as a perfect storm. Funding, structure and culture.

:22:26. > :22:31.Recently, Scottish Conservatives had a 15 point action plan highlighting

:22:32. > :22:35.areas where there is scope for improvement, even with a demanding

:22:36. > :22:41.and ageing population. It highlighted a problem that faces the

:22:42. > :22:48.NHS. Staffing is the key to managing its funding and this is where huge

:22:49. > :22:55.cracks have appeared. My mother has been a district nurse, midwives and

:22:56. > :23:02.health visitor who gave decades of support to the NHS. Her drive to

:23:03. > :23:07.support patients in dignity from birth to death was exceptional and

:23:08. > :23:13.she gave her working life to caring in the community and I'm very proud

:23:14. > :23:17.of that. Wastage overspending and delays blight the NHS in his

:23:18. > :23:24.day-to-day operations and this is an opera -- an area where we can look

:23:25. > :23:34.at improvements and savings yields. Funding was roughly flat during 2008

:23:35. > :23:38.and 2009 and that has seen a huge impact. Despite moves to

:23:39. > :23:42.integration, the NHS is still broadly based on a traditional model

:23:43. > :23:49.and we acknowledge that. We have social care and reliant on primary

:23:50. > :23:54.and secondary care. I would like to play tribute to all the staff who

:23:55. > :23:58.play a vital role, their dedication, enthusiasm and commitment knows no

:23:59. > :24:08.bounds and our NHS staff are the envy of the world because of their

:24:09. > :24:13.dedication. But staff feel disengaged from reforms. They also

:24:14. > :24:17.look at the work load and if they are not managing that effectively

:24:18. > :24:22.then they feel stressed and overworked. There are still far too

:24:23. > :24:30.many managers and that system is causing unnecessary creation of

:24:31. > :24:37.tears of management. Pay, training and support is vital to ensure staff

:24:38. > :24:42.feel valued within our NHS. If clinicians feel any native from

:24:43. > :24:48.reforms than the pressures they face continued to grow. Staff feeling

:24:49. > :24:56.gauged if they are effective and they see better ways of managing

:24:57. > :24:59.things -- feel engaged. Better outcomes is used for patients and

:25:00. > :25:05.that is what we want to see within our NHS. I believe that is happening

:25:06. > :25:10.the length and breadth of our country because of the dedication of

:25:11. > :25:13.the staff that work within the NHS. We are dealing with an ageing

:25:14. > :25:18.population and we understand the demographics facing us and the bed

:25:19. > :25:23.blocking that takes place. Other aspects that fall into place and

:25:24. > :25:29.show we have issues to manage and we have to manage the finances to

:25:30. > :25:33.ensure budgets work effectively and that individuals can work within

:25:34. > :25:41.these constraints. It is quite complex, but it is not the fact that

:25:42. > :25:49.we have to see that the SNP spend millions on private health plans.

:25:50. > :25:54.Last year alone, 14 health boards spent ?15.6 million on private

:25:55. > :25:55.operations because NHS operations -- hospitals could not cope with

:25:56. > :26:05.demand. The Government is also spending

:26:06. > :26:10.money on agency staff and that has a huge knock on effect as we go

:26:11. > :26:15.forward. For ten years, the SNP has been running the health service in

:26:16. > :26:19.Scotland and staff morale is at its lowest ebb. They are failing their

:26:20. > :26:24.staff, letting them be left behind and left out. This Government has a

:26:25. > :26:32.track record where they are looking at what their staff is achieving and

:26:33. > :26:36.not going forward. We also have do think about what we are doing when

:26:37. > :26:45.it comes to my own region in mid Scotland and Fife. We have had

:26:46. > :26:49.issues with reference to staffing levels in a row and targets that are

:26:50. > :26:53.set by this Government. We have failed to achieve many of them as we

:26:54. > :26:58.have gone forward. Much of this is unsustainable to ensure that we do

:26:59. > :27:01.have a workforce that is fit for purpose and going forward. Even with

:27:02. > :27:08.the systems that they are bringing in, like NHS 24, the IT system, it

:27:09. > :27:13.is 73% over budget and more than four years overdue. We have a lack

:27:14. > :27:16.of staff with any system and the SNP are not tackling the issue, they

:27:17. > :27:20.actually adding to the issue and adding to the complexities that we

:27:21. > :27:23.face within this problem. Technological glitches have been

:27:24. > :27:30.reported by the staff who are struggling to cope in many hospitals

:27:31. > :27:34.across Scotland and some are saying that low morale, staff vacancies,

:27:35. > :27:41.staff sickness and staff stress are adding to and compounding what is

:27:42. > :27:45.taking place within our NHS. NHS requires certainty as it moves

:27:46. > :27:49.forward. The Scottish Conservative Party have recommended that the NHS

:27:50. > :27:52.needs to invest now in dramatic service change that will have a

:27:53. > :27:59.positive knock-on effect and ensure that we have a way of managing our

:28:00. > :28:03.finances. Also the National working planning must be addressed by this

:28:04. > :28:09.Government. You cannot continue to sweep it under the carpet. A quick

:28:10. > :28:15.conclusion please. This will go some way to making the changes that we

:28:16. > :28:19.require. I pay tribute to the NHS staff, but not in the Scottish

:28:20. > :28:30.Government to have looked over this for ten years in decline and decay.

:28:31. > :28:37.I support the amendment. The larger last of the speeches. I am looking

:28:38. > :28:45.forward to speaking in this debate and I do thank you further his

:28:46. > :28:50.opening comments about his own family experience. I'm sure everyone

:28:51. > :28:55.in the chamber as was noted as a direct experience of the NHS and

:28:56. > :29:01.interaction with the NHS. I must remind you that I am a nurse and a

:29:02. > :29:04.member of the Royal College of Nursing and there is one thing that

:29:05. > :29:11.I can agree on across this chamber today. Nurses should be paid more.

:29:12. > :29:16.This evening, I will lead a members debate celebrating International

:29:17. > :29:22.nurses Day because I think we should shout louder about the invaluable

:29:23. > :29:28.work that nurses do here in Scotland and internationally. Often in very

:29:29. > :29:33.difficult circumstances. Of course, I think there should be reflected in

:29:34. > :29:37.the pay and conditions. Do the Labour Party ever ask themselves why

:29:38. > :29:44.we can't pay nurses as well as we would like in Scotland? I have some

:29:45. > :29:48.bad news for the Labour benches. When you don't fully control your

:29:49. > :29:52.own budget, neither do you fully control the pay and conditions of

:29:53. > :29:56.NHS staff. I believe this point has been made to them before. The

:29:57. > :30:03.Scottish Government has managed to maintain record levels of investment

:30:04. > :30:08.in NHS Scotland, while withstanding cuts to the block grant. Funding

:30:09. > :30:17.constraints on the NHS are the direct result of Westminster's

:30:18. > :30:21.austerity agenda. We appear to control our budget enough to pay

:30:22. > :30:32.prison officers more, why can that not apply to nurses? Thank you. The

:30:33. > :30:37.whole understanding of this process, just raising taxes and looking at

:30:38. > :30:44.the whole aspects of how we look at the salary and the banding and the

:30:45. > :30:51.whole NHS, in my experience as a nurse who has worked 33 years the

:30:52. > :30:58.most recent 14 in the NHS, I think I see staff struggle with the workload

:30:59. > :31:06.every day. As a nurse educator, part of my duties were to support

:31:07. > :31:11.efficiently working and recognise people when they are under stress.

:31:12. > :31:16.Like I am right now. And I want to make sure that I get this on the

:31:17. > :31:23.record, I hear what you're saying. My colleagues would love a pay rise.

:31:24. > :31:28.But how can we do that with the constraints that we are being put

:31:29. > :31:36.under? The constant austerity measures of the Tory Government. I

:31:37. > :31:43.am sure that all others this chamber will welcome the fact that whilst

:31:44. > :31:49.many people have expressed concern about staff satisfaction in the NHS,

:31:50. > :31:53.we do have a very high level of patient satisfaction in the NHS and

:31:54. > :31:58.many of our nursing workforce are to be congratulated for that. We have a

:31:59. > :32:03.record high of 90%, the highest ever since record began in terms of

:32:04. > :32:11.inpatient survey satisfaction and we also have in the Scottish social

:32:12. > :32:21.attitudes survey the highest rate of confidence in the NHS in the last

:32:22. > :32:25.ten years. Thank you for that intervention. The Royal College of

:32:26. > :32:29.Nursing actually do state in the briefing that pay awards that the

:32:30. > :32:37.NHS staff has been constrained by the UK Government's policy on public

:32:38. > :32:42.sector. It should be noted that the Scottish Government has implemented

:32:43. > :32:48.recommendations made by the pay review body to date. Every year, as

:32:49. > :32:52.the pay review is processed, the Scottish Government takes on board

:32:53. > :32:57.these recommendations. I would like to appreciate the scrutiny of the

:32:58. > :33:02.Government's policies and I think that that is a role that all the

:33:03. > :33:06.opposition parties need to do. Me included as a backbencher. It is the

:33:07. > :33:12.role of the opposition parties to come to the chamber ready with an

:33:13. > :33:19.approach that might support the NHS in a balanced, fair and level headed

:33:20. > :33:26.manner. The 1% rise in Scotland is further supplemented by the Scottish

:33:27. > :33:35.Government's measure like a ?400 uplift. Is gotten from entry level

:33:36. > :33:39.nursing support or NHS support, they get paid an extra 1120 pounds or

:33:40. > :33:44.more idea than their English counterparts. For me, one of my

:33:45. > :33:49.colleagues was at a recruitment event and said that nurses are

:33:50. > :33:55.leaving NHS England and coming to Dumfries Galloway to get better

:33:56. > :34:00.pay and better work conditions because they see what is happening

:34:01. > :34:04.in NHS England. I welcome those nurses from England. Come and work

:34:05. > :34:12.in Scotland and we will look after you. Thank you. We now move to the

:34:13. > :34:20.closing speeches. Miles breaks, six minutes. Thank you. I'm pleased to

:34:21. > :34:23.close this debate for the Scottish Conservatives. Since being elected,

:34:24. > :34:27.it has been a pleasure to meet with and learn from many of those people

:34:28. > :34:33.who work in our health service day in, day out. Their commitment is

:34:34. > :34:36.what drives us each day. I want to thank them and pay tribute to their

:34:37. > :34:39.dedication as many members have done in today's debate. One message that

:34:40. > :34:45.they have told me directly is that the decline of the performance has

:34:46. > :34:52.not just been a recent thing, it started once the Labour Party was in

:34:53. > :34:58.charge. Over ten years that the Labour Party were in charge in the

:34:59. > :35:02.Scottish Government, waiting times increased and drug-related deaths

:35:03. > :35:11.increased. There was also the highest rate of superbug issues. We

:35:12. > :35:15.have our own personal stories of how the NHS and those who work in it

:35:16. > :35:19.have helped us and given us love and support and the amazing nurses which

:35:20. > :35:23.work through our health service, but what struck me from today's debate

:35:24. > :35:28.was that no Labour Speaker wanted to actually justify what they do when

:35:29. > :35:32.they are in power and certainly their record in Wales. Wales is the

:35:33. > :35:39.only part of the United Kingdom where the Labour Party have been a

:35:40. > :35:46.consistent unbeaten control. Over two decades. I am looking at the NHS

:35:47. > :35:53.in Wales. It is little wonder that Labour MSP 's want to have that

:35:54. > :35:57.record not discussed today. The Welsh Labour Party have not

:35:58. > :36:01.introduced the pay rise which they are proposing today. Your colleagues

:36:02. > :36:04.in power are not doing what you are proposing. Waiting times in Wales

:36:05. > :36:13.are at their highest in patients are having to be sent to England. No

:36:14. > :36:18.thank you. Agents are having to be -- -- patients are having to wait

:36:19. > :36:23.five weeks longer for treatment than they do in England. Labour have

:36:24. > :36:28.imposed record-breaking budget cuts and decided over the poorest aspects

:36:29. > :36:34.of cancer treatment anywhere in the UK, downgrading treatments across

:36:35. > :36:48.Wells. It is a scandal that across Wales they have not met their cancer

:36:49. > :36:52.treatment. May you address what has happened in the room this afternoon?

:36:53. > :36:58.Yes. We're still seeing the impact of this. The private finance

:36:59. > :37:03.initiatives have seen new hospitals built at taxpayer's expense of 7.8

:37:04. > :37:12.billion. Hospitals such as Edinburgh Royal Infirmary which cost a good

:37:13. > :37:18.deal to build, what will... I don't think that's right. James Dornan try

:37:19. > :37:23.to make the point about the cost of NHS staff parking and that is a key

:37:24. > :37:27.issue about the fact that they are facing. It is an ongoing scandal

:37:28. > :37:32.that car parking charges are as high as they are in Edinburgh. I have

:37:33. > :37:43.been pleased to support the campaign alongside staff, visitors. Excuse

:37:44. > :37:47.me, Mr Briggs, I think Presiding Officer earlier made a ruling on car

:37:48. > :37:50.parking and I would ask that you address the debate that has taken

:37:51. > :37:57.place and indeed the motion and amendments that were put forward. It

:37:58. > :38:04.was an important point. These costs impact on people's lives and many

:38:05. > :38:11.nurses have told me it is a significant amount. When that

:38:12. > :38:15.increased... Mr Briggs, I asked you to move on to address the motion

:38:16. > :38:26.but, amendments and the debate that has taken place. I will indeed. We

:38:27. > :38:31.all agree that everyone in our NHS staff deserves to be respected and

:38:32. > :38:36.valued and to be able to work in a safe environment. That is something

:38:37. > :38:40.that has not been the case in the NHS. NHS staff has been bullied and

:38:41. > :38:45.often do not feel they have been listened to. My colleague has laid

:38:46. > :38:54.out the SMP's failure to improve the health service over the last ten

:38:55. > :39:01.years. Scotland's NHS needs major reforms. Hospital closures and

:39:02. > :39:09.redesign, such as the closure of the Edinburgh cleft palate surgery unit.

:39:10. > :39:16.A radical culture change is needed and required, working for NHS must

:39:17. > :39:22.become a attractive and valued career path again, especially in

:39:23. > :39:28.rural areas and in general practice. Staff shortages are widespread with

:39:29. > :39:33.over 2500 vacant nursing and midwifery posts, spending on agency

:39:34. > :39:42.staff has increased dramatically and nearly ?2500 are being spent in

:39:43. > :39:52.Scotland. -- 250,000. Returning to the culture change needed,

:39:53. > :39:57.unnecessary... Only this week, the health and sport committee learned

:39:58. > :40:08.the tree urging work being undertaken to take pressure off A

:40:09. > :40:11.E units. It can make real differences. They are desperate to

:40:12. > :40:15.have these responsibilities. NHS should rightly be an institution to

:40:16. > :40:18.be proud of, rather than one constantly on the brink of crisis.

:40:19. > :40:23.It should be an organisation that values every member of staff and all

:40:24. > :40:30.those who care for us. Enabling our workforce to do our jobs. You must

:40:31. > :40:36.come to a close, please. Today's debate has... Mr Briggs, please come

:40:37. > :40:42.to a close. Mr Briggs, would you please sit down? Thank you. Can I

:40:43. > :40:47.remind members of the chamber there when I asked members to close the

:40:48. > :40:50.debate, there is a reason for that. There are time constraints and I

:40:51. > :40:54.expect that to be complied with. I will now move on to close the

:40:55. > :41:14.debate, up to seven minutes, I want to start on a point of

:41:15. > :41:27.agreement and that is that we all care about the staff. I thought we

:41:28. > :41:35.had powerful contributions regarding support from the NHS. Monica Lennon

:41:36. > :41:40.talked about the high level of care her family received and we would

:41:41. > :41:45.expect nothing less. Similarly, my family have received the same level

:41:46. > :41:50.of care and that every individual nurse and health care worker and

:41:51. > :41:55.Porter and everyone else, I want to thank each and everyone of them from

:41:56. > :42:00.the bottom of my heart, as I am sure everyone in the chamber has done

:42:01. > :42:05.this afternoon. I will try and address as many points as I can that

:42:06. > :42:11.have been raised. On workforce, which a number of members raised.

:42:12. > :42:14.First, I have said time and time again in this chamber, I don't run

:42:15. > :42:24.away from the challenges the health service has. Although we have record

:42:25. > :42:29.levels of staffing at and midwifery staff compared to five years ago,

:42:30. > :42:37.demands continued to rise. Of course, in terms of vacancy levels,

:42:38. > :42:44.yes, they are too high standing at 4.1% in December of last year. That

:42:45. > :42:50.is something we are working very hard to address with boards.

:42:51. > :42:56.Similarly, on agency spend, again, something members mentioned. Agency

:42:57. > :43:03.spend is too high which is why we have a national programme to reduce

:43:04. > :43:07.that. But there is a context. Combined medical and nursing costs

:43:08. > :43:16.represent 2% of the overall staffing spent and agency nursing represents

:43:17. > :43:21.is even -- 0.4% of nursing and midwifery staffing in the NHS. It is

:43:22. > :43:28.too high but we have to see it in context and it is less than when we

:43:29. > :43:32.took power. Indeed, as many members pointed out, we have maintained

:43:33. > :43:38.things like the student nurse bursary which has meant that we've

:43:39. > :43:45.seen a high level of interest in people coming in to our nursing and

:43:46. > :43:50.midwifery courses compared to where the bursary has been removed south

:43:51. > :43:54.of the border where they've seen a 20% D crease in student nurse

:43:55. > :44:01.applications. That is something that will store up a whole heap of

:44:02. > :44:07.difficulties for the NHS South of the border. That has been one of the

:44:08. > :44:12.defining issues this afternoon. Let me say to all members, I have no

:44:13. > :44:20.difficulty with anyone criticising the record of my government in

:44:21. > :44:26.power. That is what you are here to do. However, what is also a little

:44:27. > :44:35.disappointing in these debates is that nowhere was there any

:44:36. > :44:41.recognition that pay rates are indeed higher in Scotland, that the

:44:42. > :44:46.Scottish Government has taken action to address low pay, that we still

:44:47. > :44:52.have nurse student bursaries, that we have a no compulsory redundancy

:44:53. > :44:57.policy. All of these things I would have thought would have meant --

:44:58. > :45:03.merited a mention but not one mention of any of that and that

:45:04. > :45:07.shows a complete lack of balance. I accept criticism, but occasionally

:45:08. > :45:16.it would be good to get recognition of some of the good things that we

:45:17. > :45:25.have brought in. Thank you. I recognise those things. And I will

:45:26. > :45:29.do it now. We are pleased to those things have happened in Scotland.

:45:30. > :45:35.Will she also recognise that in her own submission to the pay review

:45:36. > :45:42.body that we should have a 1% pay cap for NHS staff this year? It was

:45:43. > :45:47.a balanced submission about pay, progression, tackling low pay and

:45:48. > :45:52.many other things that nurses tell me are important. It is not just

:45:53. > :46:00.about pay but all of those other things. We are constrained by the

:46:01. > :46:04.Treasury and all roads lead back to the Treasury effectively in terms of

:46:05. > :46:09.what the independent pay review body can do. There was an important point

:46:10. > :46:13.made. There is a choice to be made because if we are part of the

:46:14. > :46:17.independent pay review body that is the recommendation we will have to

:46:18. > :46:22.implement otherwise why are we part off it? If we have Scottish

:46:23. > :46:28.negotiating machinery all we want that I am happy to talk about it but

:46:29. > :46:32.at the moment they do not agree is the direction of travel we should

:46:33. > :46:36.have. We need to get agreement across all of the unions and staff

:46:37. > :46:40.about that way forward and if that's the way we want to go that is

:46:41. > :46:45.something I will support. I also want to touch on something Richard

:46:46. > :47:00.Leonard said and he said something I thought

:47:01. > :47:03.was quite interesting and suddenly Labour will have to clarify perhaps

:47:04. > :47:09.in the winding up speech. He seemed to indicate that Labour's position

:47:10. > :47:15.on partnership working had changed and they no longer support it. He

:47:16. > :47:23.said usually it -- unions should be free to negotiate although I am

:47:24. > :47:27.paraphrasing. Really? So you don't want employee directives to sit on

:47:28. > :47:30.boards and having an equal voice around the table representing the

:47:31. > :47:37.staff site and you no longer want partnership forums to be at the

:47:38. > :47:39.heart of decision-making? Unions like partnership working because it

:47:40. > :47:46.delivers for them in a way that isn't delivered in the rest of these

:47:47. > :47:49.islands. Unions will be interested to hear your comments on partnership

:47:50. > :47:57.working and perhaps Labour can clarify that. You must close,

:47:58. > :48:00.Cabinet Secretary. Can I say to the rest of the members that I'm sorry I

:48:01. > :48:07.haven't been able to come back on their comments but we have a plan, a

:48:08. > :48:12.comprehensive blueprint for the NHS. We will get through that and work

:48:13. > :48:16.with staff. I will address pay and other concerns staff have raised

:48:17. > :48:29.with unions when I meet them in the next few weeks. I call on the debate

:48:30. > :48:35.to be closed. Thank you next year is the 70th anniversary of them NHS.

:48:36. > :48:39.The founding principle that, no matter your class, race, age or

:48:40. > :48:44.wealth should be entitled to quality health care free at the point of use

:48:45. > :48:51.is as petition -- pressures today as when Nye Bevan established it in

:48:52. > :48:54.1948. Equally pressures is the principle that if we were

:48:55. > :48:59.high-quality health care we need to value the staff who we entrust to

:49:00. > :49:05.deliver it. The foundation stone of the NHS is not formula or equipment

:49:06. > :49:10.but the skill and dedication of the people. Parliament has the

:49:11. > :49:15.opportunity to match the principle and words with actions to show we

:49:16. > :49:19.are on the side of nurses, doctors and allied health care staff who

:49:20. > :49:24.look after our loved ones as if they were their own. Members have taken

:49:25. > :49:28.the opportunity to pay tribute to the commitment and dedication of

:49:29. > :49:37.amazing dedication -- dedicated NHS staff. We know that the best way we

:49:38. > :49:42.can support and repaint the staff is to provide them with adequate

:49:43. > :49:46.investment in our workforce. What staff need is decent pay and

:49:47. > :49:49.conditions and what they want is adequate staffing levels. Speaker

:49:50. > :49:55.after speaker rightly highlighted that we do not have adequate

:49:56. > :49:59.staffing levels. We have recruitment and retention problems across the

:50:00. > :50:05.NHS. One in four of GP practices reports a vacancy. We have a ticking

:50:06. > :50:10.time bomb of GPs queueing up to retire. The Royal College of General

:50:11. > :50:16.practitioners predicted that by 2020 there will be a GP shortfall of 830.

:50:17. > :50:25.That will be back to the level in 2009. There are more than 2500

:50:26. > :50:32.nursing and midwifery vacancies, four times higher than in 2011.

:50:33. > :50:41.Nearly 750 of those poets have been lying vacant for months. -- posts.

:50:42. > :50:47.The clients of high vacancy rates and training posts going unfilled is

:50:48. > :50:52.an increasing the burden on existing staff adding to the burden of

:50:53. > :50:58.unsustainable workloads. But the Scottish Government has continued to

:50:59. > :51:02.employee pay policy that means that someone is worse off than someone

:51:03. > :51:05.entering nursing seven years ago. A cut in the real Thames Valley of

:51:06. > :51:11.their starting salary will make it more difficult to attract staff that

:51:12. > :51:16.we so badly need in our health service. Independent analysis by the

:51:17. > :51:22.Scottish parliament information Centre shows what it means. . If

:51:23. > :51:28.nurses pay had stayed in line with inflation over the past seven years,

:51:29. > :51:39.the band five starting point in April 2017 would be ?25,839 but it

:51:40. > :51:44.is ?22,440. There is far too much background noise going on. Please

:51:45. > :51:51.have some courtesy for Mr Smith. A nest at King 's salary today is

:51:52. > :51:58.?3400 less than a real terms starting salary in April 2010 -- a

:51:59. > :52:02.nurse's starting salary. It is disappointing that listening the two

:52:03. > :52:11.some contributions today, they are in the Nile. The Eichmann seems to

:52:12. > :52:12.be it is better -- their argument seems to be it is better than south

:52:13. > :52:23.of the border. To suddenly shed crocodile tears for

:52:24. > :52:29.nurses in other parts of the UK... The irony is lost on SNP member

:52:30. > :52:37.after member who had more to say about England and Wales than about

:52:38. > :52:42.Scotland. I had to say, if the height of their aim is to be

:52:43. > :52:49.uncaring than Tory health minister then it is time they raised their

:52:50. > :52:55.ambitions. They were only surpassed by Myles Briggs who we thought was

:52:56. > :52:59.trying to walk out of this Parliament but it seems he was

:53:00. > :53:04.making a bid for the Welsh assembly. SNP say that the best resolution

:53:05. > :53:08.will be found by the Scottish Government working in partnership

:53:09. > :53:12.with NHS staff representatives and it calls on the Scottish Government

:53:13. > :53:18.to seek agreement with staff from the representatives of the unions...

:53:19. > :53:24.I will give way. Thank you. I wonder if you could clarify the position of

:53:25. > :53:29.labour on partnership working? Does it support that or not? If we can

:53:30. > :53:37.deliver the pay rise they want to see for all staff right across the

:53:38. > :53:41.UK. That will be in the Labour Party manifesto at the next election. The

:53:42. > :53:44.amendment talks about working jointly with unions and

:53:45. > :53:50.representatives to commission work to develop and evidence raised.

:53:51. > :53:57.Using it as part of a submission for the next pay round of the pay review

:53:58. > :54:03.body. It's a bit rich to talk about joint submissions when their own

:54:04. > :54:10.submission to this year 's pay review body went against those staff

:54:11. > :54:13.and argued for a real terms pay cut. As Alison Johnson pointed out, the

:54:14. > :54:19.pay review body -based recommendations on the pay policy of

:54:20. > :54:26.the government. Evidence is already here to show the impact of pay

:54:27. > :54:30.restraint. The 44 page submission the 2017 states that public sector

:54:31. > :54:35.pay restraint has clearly damaged both the finances and morale. It

:54:36. > :54:40.says that unless action is taken now, minimum wage levels will

:54:41. > :54:46.overtake the agenda for change... It says it can only be avoided by a

:54:47. > :54:56.significant pay increase and that -- if that is not enough for the SNP

:54:57. > :55:01.and the RCN survey found that 40% missed meals because of financial

:55:02. > :55:10.difficulties, 53% compelled to work extra hours to increase endings and

:55:11. > :55:15.lots were working extra shifts. It corresponds with an increase of 30%

:55:16. > :55:20.over the past five years in the number of RCN members having to seek

:55:21. > :55:24.specialist money advice from the welfare service. Many are borrowing

:55:25. > :55:28.to meet essential costs like childcare and some have to use food

:55:29. > :55:35.banks to feed their families. Maybe that is what Donald Cameron meant by

:55:36. > :55:39.supporting nurses in other ways. No wonder nurses here have been

:55:40. > :55:45.balloted on industrial action to try to end the pay cap. Nurses in

:55:46. > :55:49.Scotland, before any SNP member tries to pretend it isn't an issue

:55:50. > :55:53.for nurses here. We don't need to wait to next year to see the

:55:54. > :55:57.evidence of the pay cap as it there before our eyes. The Scottish

:55:58. > :56:01.Government is ignoring it. It has the power to make different

:56:02. > :56:04.decisions as it did with prison officers and has the power to be

:56:05. > :56:09.more progressive than the Tories but it has chosen not to use them and

:56:10. > :56:14.not to support Scotland's health care workforce. The amendment makes

:56:15. > :56:18.one valid point on the impact of Brexit. Our health and social care

:56:19. > :56:21.sector employs 12,000 EU nationals and we know parts of the sector

:56:22. > :56:27.would not function without the contribution. Theresa May and a Tory

:56:28. > :56:33.government will not make the commitment to protect their status.

:56:34. > :56:38.Despite their anti-immigration rhetoric, if you go into hospital

:56:39. > :56:42.you're more likely to come across a migrant caring for us than a migrant

:56:43. > :56:48.lying in the next bed. Not content with misleading us on the back of a

:56:49. > :56:54.bus that the NHS will receive 350 million a week if we left the EU,

:56:55. > :56:55.those supporting Brexit are using them like poker chips in their

:56:56. > :57:05.negotiations. Let's be clear, the staffing crisis

:57:06. > :57:15.is with us here and now. Even before the hard Brexit occurs. It fails to

:57:16. > :57:19.address the crisis. It does not a single penny in the pocket of nurses

:57:20. > :57:22.struggling to pay the bills. It won't contribute to the recruitment

:57:23. > :57:27.of a single new doctor. We have a clear choice when we come to vote

:57:28. > :57:35.shortly. This parliament can choose to say to the Scottish Government

:57:36. > :57:38.that is time to scrap it, a well-deserved pay rise and begin to

:57:39. > :57:46.tackle the recruitment and retention crisis. Or it can choose to vote to

:57:47. > :57:49.continue with austerity, nurses going to food banks being

:57:50. > :57:57.acceptable. We are on the side of the NHS. That concludes our debate

:57:58. > :58:09.on scrap the NHS pay cap. We now move onto the next item of. I would

:58:10. > :58:15.ask... It is on behalf of the Parliamentary bureau. I would ask

:58:16. > :58:23.any member who wishes to speak against the motion to press their

:58:24. > :58:28.Basson now. -- button. No member has asked to speak against the motion.

:58:29. > :58:41.We are agreed. Next item of business is consideration of 5521. There are

:58:42. > :58:48.four questions to be put as a result of today's business. I would remind

:58:49. > :58:55.members that if it is agreed, the amendment in the name of Donald

:58:56. > :59:01.Cameron falls. It seeks to amend motion 5479 in the name of scrapping

:59:02. > :59:05.the NHS pay cap being agreed. Allele agreed? We're not agreed. Members

:59:06. > :59:53.may cast their votes now. The result of the vote on amendment

:59:54. > :59:59.number 5479.3 is yes 62, no 55 and there were no abstentions. The

:00:00. > :00:06.amendment is therefore agreed. It is pre-empted. The next question is the

:00:07. > :00:10.motion 5479 in the name is agreed. We'll agreed? We're not agreed. We

:00:11. > :00:45.will move to division and members will cast their votes now.

:00:46. > :00:59.The result of the vote as amended is yes 62, no 55. There were no

:01:00. > :01:06.abstentions, the motion is therefore agreed. The final question is the

:01:07. > :01:11.motion 5521. We all agreed? Yes. We are agreed. That concludes decision

:01:12. > :01:15.time. We will now move to member's business. Celebrating International

:01:16. > :01:34.nurses day. The 2017 general election is upon

:01:35. > :01:42.us.