10/05/2017 Scottish Parliament

I would hope that there would be very few if any within this chamber

who would disagree with that principle. The resource is a big

shift of resource towards primary care. I thought that would be

something that would be welcomed across this chamber. I do welcome

the new investment into primary care and also welcome what the Cabinet

said about nursing rules in primary care particularly as we work towards

-- head towards being many GP short. Can now see Cabinet secretary what

role other health care professionals will have on the GP contract process

and secondly when she will be publishing a detailed workforce

plan. The workforce plan is on schedule to be published as I said

in late spring, so imminently, in the next few weeks. Of course, that

has been a big undertaking with masses of consultation across many

sectors and staffing groups. The GP contracts is a contracts negotiated

between the Scottish Government and the British Medical Association,

that it out the contract is the goatee is said -- the contract is

negotiated. The details of that will be released, but it would be

inappropriate while those negotiations are ongoing for us to

do that before the negotiations are concluded. Once they are, I will

make sure that Parliament is informed on the outcome of that. To

us this godless Government what steps it is taking in light of

reports that 65% of adults in Scotland are overweight or obese? We

remain committed to addressing Scotland's excess weight and in line

with the evidence we are maintaining activity across society for people

to be eating less and exercising. We have put a range of programmes to

encourage healthy eating. We are encouraging councils for free school

meals. We have exceeded our target of 150 community sports hubs across

local authorities by 2016. Sport Scotland has also invested to make a

total of 200 clubs by 2020. Thank you. We would ask to consider the

impact of price promotions on obesity as Cancer Research UK assert

that 40% all calorie Dub ought on price promotions. -- are bought.

Salt and sugar and fat content is seriously damaging the health of

people in Scotland in many different ways. Can she tell us how she might

address these concerns, particularly about very high calorie intake as a

result of price promotions. Price promotions certainly is an issue

that Cancer Research UK have pointed out as an area in which we need to

take action on and there will be an opportunity to delve deeply into the

tissues and a whole range of other issues as we develop the obesity

strategy. Certainly we will continue to engage with Cancer Research UK on

this, it is ready helpful that some of this will allow us to identify

just how big an issue this is for Scotland to deal with the challenges

that we face. The prize promotion and affordability of high-fat, sugar

and salt foods is one that we need to look at. There should be nothing

of the table as we approach the new strategy and I look forward to

working with you as we move it forward. Can I ask whether the

minister shares my disappointment that the UK Government didn't take

the opportunity to introduce further restrictions on junk food

advertising in the action plan on childhood obesity? Absolutely. I

would share the member's disappointment on the UK

Government's decision not to include restrictions on junk food

advertising. That does align itself with the disappointment that Cancer

UK expressed in relation to the point is that John Scott raised. We

have long argued that a ban up to the 9pm watershed would greatly

reduce children's exposure to the marketing of healthy, unhealthy

foods. This is backed up by recommendations by many people and

has the backing of the Welsh and Northern Ireland governments. It has

a huge amount of support across our third sector. Strong arguments that

Cancer research UK have on this. Perhaps there will be a change of

heart. As well as two thirds of adults being obese, many children

are. The current prevention of obesity route map isn't working and

as we have heard that the published work by the UK Government is

working, will you accept and recognise that the causes and

consequences of obesity is not born evenly across Scotland's people, it

we need to tackle wealth and equality in Scotland. Absolutely I

recognise that there is disproportionate impact felt on the

communities that are the most vulnerable. They stand to gain the

most if we take action to tackle the issues of the beta T. That is why we

are taking forward a new strategy starting with a consultation

starting very soon. The member who has taken a keen interest and also

our partners to make sure that we have a talented we need to face. It

costs money, but it is also costing content of the impact it has on

people's lives. That impact is the most vulnerable people in the

communities. We need to bring communities with this because price

promotions admitted that forward might have an impact on those with

the least money to spare. Nothing can be off the table with the

consultation and we will need to work together to make sure there is

a downward trend on obesity levels in the country. Thank you. To ask

the Scottish Government what action it has taken to address health

inequalities. Reducing health inequalities is one of the biggest

challenges that we face. It is a symptom of wider income inequalities

and is she said Eric Sass abated by posterity. We are taking attitudes,

supporting fair wages and in proving our social environments. The

Minister note that health inequalities are firmly linked to

income inequalities. Can the Minister give an analysis of the

potential knock-on affect on the NHS that predicted a 10% increase on

child poverty as a result of the UK Government's to child policy will

have. I will reiterate that the UK Government's welfare cuts are unfair

and having a hugely disproportionate impact on women. By 2021, many

houses in Scotland will be affected by the child cap, so while the

Conservatives do come here very often asking us to do more on a

number of different issues, perhaps they also need to be asking the UK

Government colleagues to stop with this gross unfairness. The ISS

estimates that a three child family will lose an average 2500 a year,

while others will lose 7000 and 4 million families across the UK will

see entitlement for. It will push people further into poverty and puts

pressure on other public services. 4 million families impact from the

Tory's cuts, that is 4 million reasons why we should not be voting

Tory in June. Has the Minister studied the new report study this

week by the mental health foundation surviving thriving which highlights

severe health inequalities within mental ill health in Scotland. What

specific action Ayew taking to reduce health inequalities among

people suffering from mental health challenges? I do think that while he

does talk about inequalities quite often in this chamber, he should be

making these points also to his UK Government colleagues who are the

source of some of this inequality and have the power within themselves

to try and reverse that inequality. My colleague Maureen Watts set

forward a 10-year mental health strategy which does address this and

will help reduce inequality and that impact that as the detrimental

impact on mental health. It takes a bit of a brass neck for the

Conservatives to come here and keep talking about inequalities when they

have been the cause of much of that inequality in society in the

country. Does the Minister agree that income and equality is at the

heart of health inequality and one of the key ways to address that is

the tax system? Why won't the Government introduce a progressive

tax system? Within empowers that we have to make sure that we can reduce

inequalities, we are taking forward a number of measures around living

wage, we are bringing forward and have brought forward plans around

taxes and the system, as well. We continually mitigate against the

worst factors of welfare reform. We are doing the best we can within the

powers we have any budget we have been given to make sure that we have

got the best and can create the fairest society that we can seek. It

seems a pity that Neal Finlay ignores those measures and cups from

the To ask the Scottish Government what

it is doing to encourage participation in sport. Active

Scotland's jap outcomes framework sets out plans for a more active

Scotland. We want to ensure people from all ages, across Scotland, from

all ages, have the opportunity to participate in sport and physical

activity much that's creptived in programmes such as active schools to

provide more opportunities FORCEDWHITE OK. Young people and

also invest ins fa its, including community sports hub of which there

are 157 across Scotland, increasing to 200 by 2020. I am delighted

following a at the timal investment ?12 million the superb facilities at

the UK's fist ever Prar Sport centre at Inverclyde are now open. I thank

them inster for that response, despite increasing levels of child

anded a ultimate obesity the budget for sports has been cut

significantly over the past two years even after taking into

account, the funding mentioned by the minister. Can the minister

explain how cutting the budgets for sports, including budgets for

grassroots sports clubs will help tackle the increasing health

problems associated with obesity and related challenges. I announced in

April adational ?2 million in sport governing bodies which will be

distributed by Sports Scotland to help offset the reduced income from

the national Lottery I have written to the UK Government around the

issues that continually present themselves from the Bishop us of

reducing National Lottery. So I'll ask the colleague to get his support

to face the nag alottery reduction problems our bodies are faces. We've

had increases in our infrastructure. We have some of the best

infrastructure across the country in terms of sports and invested heavily

in making sure young people get opportunities and restructured the

way PE is being taken forward around our schools, seeing us reaching

around 98% of our children reaching the two-hour PE. I hear again people

from the sidelines, this is significant investment this

Government is taking forward to improve the infrastructure of our

sporting arenas across the country. We have increased fundamentally the

number of children taking part in two hours or more of PE in every

school. I have just opened a new Para sports centre in Inverclyde now

open and hosted one of the best-ever chop wealth games in Glasgow. Our

commitment is very strong to sport and given all of our young people

the opportunity they deserve, again, though, this is exacerbated,

children's opportunity ape life chances are exacerbated by

inequalities. Again I would reiterate. The Conservatives need to

look closer to home around inequalities and where that is being

manifested. APPLAUSE

Question five not lodged. Question six, Alison Harris. So ask the

Scottish Government what health guidance is given to operators of

sports and leisure facilities that are close to the Grangemouth

chemical complex? There are strict arrangements in place to ensure that

the Grangemouth chemical complex operates safely and that that if

something does go wrong the health and safety of the public is

protected. They include a community warning system in the convenient of

an incident at the complex which enables people living and working in

nearby areas to be alerted quickly. The communtiy warning system is

tested twice a year. The council provides regular local guidance on

what people should do when the community warning system is

triggered. That advice, which applies to sports and leisure fas

silts to go in, stay in and tune in, that is to go indoors, close the

doors and windows and wait fourth instructions.

I thank the minute sister for that response, however, during the recent

incident in Grangemouth, provision was made at prime rain secondary

schools to be kept indoors, however users of the outdoor sports pitches

continued to use the facilities, so in view of the numbers of people who

use these facilities, will the Scottish Government undertake to

review the guidance given to the operators of these facilities? I

think the member raises a very good point. Of course on the 2nd May

there was that incident she described at Grangemouth where a

limited amount of staff were evacuated following a gas leak and

the incident involved the release of gases there at a particular plant.

The local management plan was activated and local road closures

were in place to promote public safety. The point she makes is a

good one, I will have dial oings with and there will be a debrief of

the incident and that we will examine that and make sure any

learning issues are captureded into to refine the plan and arrangements

and I'll keep her updated on the outcome from the debriefing process.

Question number 7. Thank you, to ask the Scottish Government what action

is being taken to improve mental health services in the NHS Forth

Valley, area? Thank you, we have published a new ten-year strategy

for mental health in Scotland. The new strategy contains 40 actions

including those which commit to funding improved provision for

services, to treat child and adolescent mental health problems

and funding work to improve provision of psychological therapy

services and help meet set treatment targets. As part of these actions we

have announced a ?54 million comprehensive package of support to

immroef access to mental health services for both calms and

psychological therapies, within this we've established an improvement

team within health care in improvement Scotland to work on

access to mental health services. Fo. Rth Valley are one of the first

boards to work with the team. Working with the board a new service

model has been introduced by NHS Forth Valley and we've seen awistics

improvements in CAMs waits. Forth Valley are to be congratulated in

obtaining the lowest rate across Scotland at this tripe last year. I

recognise improvement are being made. Can the minister tell me what

the current waiting time is for child and mental health services in

the Forth Valley area. I have constituents who continue to be

concerned about the length of time it is taking to access the services.

Could the minister tell me what specific action has already been

taken and what more can be done to improve be as is sows to CAMs in the

Forth Valley area? The latest published figures for quarter 4 show

Forh Valley's performs an against the standard proved with 94.8% of

people treated within CAM services, were seen within 18 weeks. This

compares to 34% of people receiving treatment within CAMs services with

the 18 week standard in the same time a year ago. In response to your

constituents' concerns, the member might wish to know that I met,

yesterday, with parents from the Forth Valley parents voices, and I

welcomed the opportunity to hear their experiences of CAMs and to

discuss the work we are supporting, through investment and the new

mental health strategy, to improve the standard of care from CAMs,

including the quality and conuity of service. At board level, the new

service model has been introduced within NHS Forth Valuey. The new

model looks to address delays identified in the system, as well as

undertaking staff recruitedment and working on the longer waits. I

understand that the board has established a parents forum, to

increase engagement with local families and this will meet for the

first time at the end of this month and that's precisely what, as the

Government, we wish to see, patient involvement and participation in

designing services. Thank you, Presiding Officer. Ruth

Crawford has raised an important issue. I met with the founder of the

CAMs Fort has Valley parents voices droup and other parents yesterday

after their meeting with the minister and as newspapers have

reported today, they were in absolute tears as they were sharing

their stories. It was heartbreaking to listen to the individual

challenges they have helicopter to face in trying to get the support

they desperately need for their children. I welcome some progress

has been made but it is not simply just about waiting times. The

Scottish Government have committed to look at into this and I look

forward tow hearing more of the detail on this but account minister

provide an update on what her response is to the group's call for

a full audit and review of the CAMs service in the Fort has Valley and

if she will give this consideration? Well, as I have already said, I did

meet with the parents yesterday and listened to their stories, some of

which, most of which are historic, also pre-2007. As a result of what

we have in new mental health strategy and what has been done so

far, we are seeing excellent progress in Fort Valley on waiting

times. So rather than have a fall-blown audit of what is

happening, I would prefer to get on with doing the job and making sure

that what is required is put in place and that's precisely what we

are doing in Forth Valley and with the new mental health strategy

across the country. Thank you, despite the hard work of its

dedicated staff, NHS Forth Valley continues to suffer from lack of

resource, this left over 300 people waiting over four months for

treatment. Can I ask the minister when will Forth Valley NHS be in a

position to meet Government nargts this area? ? Minister? Well, as I

have already mentioned, in my previous answers, Forth Valley NHS

is now meeting its waiting time targets and of course this

Government was the first to introduce waiting times. The NHS

Forth Valley, Scottish Government allocation for building capacity in

Forth Valley was 233,000,409 in two should 16-17 rising to 3769,112 in

2017-18. And this money is being reduced, used to predues pressure on

the core CAMs services. -- 233,009 in 2016 -17.

There is a range of measures to make sure For this, Valley meets its

targets. To ask the Scottish Government to provide an update on

progress in analysis on augmentation and transportation transplantation.

The responses are currently being independently analysed and we expect

to receive that analysis soon. We will carefully consider it before

setting out our next steps in the coming months. I thank the minister.

I helped scrutinise evidence in stage 1 for previous proposals for

on opt out organ donation procedure. And specialist nurses and beds, irre

irrespective of any whether any opt out system was to be introduced. I

voted against it not out of principle but because of the

weakness in legislation before us. Can I ask what consideration has the

Scottish Government given to the recommendations I referred to in

earlier in my question, as well as any weaknesses within the previous

regulation? Since the programme of work to increase donation rates, the

Scottish Government has provided funding to a 07 additional

specialist nurses, as well as organise an donation as well as a

dedicated manager to work full-time in Scotland. There are 22 full-time

equivalent nurses. Appointing more would dilute the expertise in

reaching fwamlies and would not necessarily lead to a rise in

donation rates. Across Scotland, resources have been targeted in

specific areas where it was felt we could make a difference, among

ethnic minority groups and in rural areas.dational resources have been

made to where donation potential is greatest. In terms of intensive care

capacity, the capacity was looked at within the NHS, to achieve it and

was not highlighted as an issue, again, we have a very positive

story, although the stage 1 did not pass, there has been a huge amount

of work and effort gone into ensuring that the effort and

attention placed should increase the rates of do na, we have a good story

to tell, work has been considerable but again I can continue to keep in

touch with Mr Dorris around the next steps following analysis from around

the consultation. Question number 9. Thank you, Presiding Officer. To ask

the Scottish Government what action it is taking to address the affects

of noise pollution on public health. Minister? Through Scotland's

implementation of the European Commission environmental noise

directive, directive 2002, 49 EC noise mapping and associated action

plans have been put in place to help mantleage environmental noise. The

strategic noise maps are currently being updated by Jacobs, experts in

the field and are due for publication this summer. This'll

inform theism amation of the next set of action plans which could

include actions in areas such as traffic and transport policies,

technological and vision and public awhich areness raising.

Thank you for that response. She will be aware that noise is the

second largest cause of ill health after air pollution. UK studies

showed that exposure to noise above recommended levels of meant there

were cases of dementia, stroke and heart attacks amazing all year.

Given this evidence, can I ask why Edinburgh airport has recently been

able to carry out a consultation into new flight path switch will

have local communities subjected to up to 80 decibel is without any

safeguards. The impact that noise can have on health is important.

That is one of the main things in Europe. She will continue to keep

him updated around the mapping, which includes planning exercises

for the four conglomerations which include Edinburgh. That is

multidisciplinary and has local authorities in key partners. Local

authorities will deliver action plans. We will take responsibility

for submitting completed plans. The one he will be particularly

interested in will be the one for Edinburgh which will include

communities surrounding. It is becoming clear that both noise and

air pollution are becoming systemic problems in Scotland. Will you back

the campaign to increase the nub of air quality monitors in Scotland? I

will keep the member updated on how the mapping exercises are

progressing. I will take a good look at the work you can indicate his

colleagues are taking forward. Environmental noise is an important

issue, it does happen impact on health. That is why we need to make

sure we have the right procedures and people in place and make sure

that we have the right resources in place to ensure enforcement and

recognise the impact it can have on a community. That is why the

directive is so important because it is one of the main environmental

problems in Europe and a framework for noise is necessary. We will

continue to maintain and protect enhancing environmental standards,

even though they are an EU requirement we will continue that

post Brexit. To ask the Scottish Government what support it is giving

to general practice. In October 2016, the First Minister made clear

the scale of our ambition and shifting from social care to acute

care. 500 million by 20 21. While the full 500 million investing

primary care, it will reach an additional 250 million per year.

There will be a deer on the increase in investment between now and then.

It has started, investment and direct support of General practice

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

Cabinet Secretary also explain what support will be survived it --

provided to Edinburgh in particular? I am aware the member has a

particular interest in the issues surrounding Inverleith medical

practice are based within his constituency. The retention of the

practice staff team within the NHS is one of the key considerations of

any NHS Lothian 's. I know he has taken out a particular effort to

talk to me about this. Staff have found alternative positions all

within the NHS, something which we have actively promoted. More widely,

the Edinboro health and social care partnership by developing it with

some challenges and some governments. -- Edinburgh. The

Cabinet Secretary will be aware that the GP practices in my constituency

have recently had to resign with the potential of losing five GPs in the

area and another six with imminent retirement. There are another 15

vacant places. What comfort can you give to GPs who have to resign from

the practice? As I've said in this chamber on a number of occasions,

there are sought and medium-term supports that are available through

us to help to address some of the recruitment challenges in the here

and now and the solution that will help to transform the position of

general practice of primary care in Scotland is based around the new

contract and a new model for primary care and that is something that will

benefit GPs within Ayrshire and Arran and elsewhere in Scotland.

Like I say, earlier these were raised, what they are less keen to

talk about and to quote is the RCGP's concerns expressed today that

when they said that of the 226 GPs of -- from other countries were to

leave from Brexit, that could have grave consequences. We don't hear

the Tories talking about that, I wonder why. To ask these gotchas

Government what action it is taking to improve public health through

cycling. We know that cycling has both physical and mental health

benefits and played a big part in health improvement. Over the period

2014 to 17 sport Scotland has invested owners to predict million

in Scottish cycling, the Government body for the sport and Scotland. We

have increased investment by over 83% compared to 2013 14. Or cycling

organisations are working together to find out what more can be done to

get people into cycling at a local and national level. Thank you. Does

the Scottish Government agree with the point set out in the manifesto,

if not, which ones do you not agree with? We certainly will continue to

work with all of our partners to make improvements around the

accessibility, safety of cycling at a local and national level. We do

have and have invested heavily in making sure that there is more

accessibility around cycling, we have invested through legacy

programmes, the one that he may be interested in art bike Park in

Edinburgh which has been given grant funding made available through the

legacy project and allowing people who have not ordinarily had access

to cycling to use a cycle route there for many years to come free of

charge. We have also invested including with our partners a total

investment of 138 millions of cycling facilities and 2007. We have

increased the amount of cycling paths and walking lanes. We will

continue to listen to all calls to let us know what more we can do to

help cycling participation at a local and national level and we will

work to work together to make a difference. What impact will does

the Scottish Government envisage that the European Union -- leaving

the European Union might have? We have promised to match record levels

of investment. Scotland has secured investment of... Low-carbon travel

and transport hubs. In June, transport Scotland will publish

details of projects that have been successful. All the contracts

entered into before the UK leaves the EU will be guaranteed even after

the EU exit point. There is no clarity on what that replacement

scheme will be once the UK has left of the EU. The Scottish Government

will negotiate to make sure that future financial support currently

supported by the youth funds, but I think -- EU funds. I think the mess

that the UK Government has got it in with Brexit, the lack of clarity, it

does impact on many issues in the local community, such as cycling. We

will continue to negotiate and make the case, and ensure that Scotland

gets a fair deal in these negotiations. To ask the Scottish

Government what the policy is in the provision of minor injury units in

communities. The planning and provision of local services is the

responsibility of NHS boards, this planning should take account of

local needs to make sure that the mines are met and patient care is

that delivered in an optimal way. -- demands are met. The west of Glasgow

minor injury union, unit, the Glasgow health board announced that

that service was moving temporarily to the hospital. I'm sure the

minister would agree that minor injury units are a important service

to prevent patients from turning up to accident and emergency. Reducing

pressure. Those who live in the west of Glasgow would like an assurance

that that service will return as before as it was a temporary measure

and it is important that minor injuries unit art local services.

You hold the view that the manager unit should return to them as

promised? I agree that my neck injury units are very important as a

service. They can -- minor injury units. As she will be aware, the

Yorkhill unit was always an interim step as part of the migration of

services in Glasgow in recent years and it is right that the board

should take the time to properly consider where the new west Glasgow

service should be located. She will understand some of the challenges

the Yorkhill site which I think with partly the reason. It was not a site

easy to access. I would think that she would welcome that there would

be an assurance not least from the chairman of the board to meet

rectally that there will be a minor injury -- to me directly. Monetary

unit in the west of Glasgow. I would encourage her to engage with the

board directly, there is no question about whether there should be a west

of Scotland minor injury unit, there will be one. It is about where that

is best located. That concludes portfolio questions. The next item

of business is a debate on motion five 479 to scrap the NHS pay cap.

All members who want is big on this debate press there I want to speak

Basson. -- button. Today the Scottish Parliament has the

opportunity to unite and support NHS staff. We should take that

opportunity. Every single day our amazing NHS staff are performing

miracles. Caring, examinations, diagnosis, treatment, operations,

saving of lives and the delivering of newborns. There are also the

parts that are easily forgotten or not recorded by statistics. Giving

advice, holding hands, sharing tears of grief and joy. Comforting those

that have lost loved ones. Simply put, just being there and caring. We

all have our own personal stories about how the NHS has touched us. We

have our own families or friends who have worked for the greatest

institution in the UK. By coincidence, this debate falls on

the first birthday of my youngest son. This time last year, was the

commendation of probably the biggest emotional roller-coaster that I've

ever been on. Within the space of a week, I had welcomed the birth of my

beautiful needs only for her heart to stop the next day and after days

of battling for us to sadly lose them. The next day, being elected to

this parliament and then a few days later, the birth of my own son. At

joy, but also part guilt for the tragedy that my own brother and

sister sister-in-law were going through. I can honestly say that if

it wasn't for the love and care of the neonatal nurses and the

midwives, my wife and I could not have got through that week. To all

the NHS staff, the porters, the nurses, the midwives, the

consultants, the allied health professionals and all the rest,

thank you. Thank you for caring. Because what we should never forget

is that it is not the buildings, the medicines, the equipment of the

treatments that make our NHS grade, it is the brilliant people that work

for our NHS. Apart -- our thank you is a not enough. They should be

respected and rewarded for the job that they do force of goodwill and

dedication to the NHS and their patients only go so far and that is

why the context of today's debate is so important. A record number of

vacancies, GP vacancies, consultant vacancies, midwife vacancies, Matt

nursing vacancies and more. Just take that last example on nursing

vacancies. More than 2500 nursing staff are missing from our hospitals

across Scotland. Since 2011, the number of vacancies has increased

from 662 2500. Four times the number in only six years. Of those

vacancies, the number going unfulfilled over three months has

increased 300% and now sit at almost 750. Nursing staff reporting they do

not have the thing is required to do the job properly. It showed the

stuffing levels were the biggest concern. Without the right number of

nursing staff, patients do not get the care they need whether it is in

hospital, home wrecker, care centre. -- at home. They are coming up

against the realities. In short, too few nurses do too much work for too

little reward. Under resourced, understaffed and under pressure.

Clearly and are paid. The Scottish Government has the

understand the impact. I met some of understand the impact. I met some of

our nurses this morning. Graham, in service for 32 years, told me this

was the lowest morale amongst staff ever will stop in his words, "Good

will only go so far. Goodwill doesn't pay the bills." Or OLE, a

training nurse, told me about staff in to do shifts and roles they

shouldn't be doing as trainees. Others told me about nurses having

to take second jobs or even, shamefully, having to attend food

banks. NHS staff having to attend food banks! Let me tell you what

posterity means for our nurses and its independent analysis done. Pay

at the starting point of band five has increased by 6% over the period

April 2010 to April 20 17. Over that period, prices have increased by

22%. It means that band five starting point pay has fallen by 13%

in real terms over that period which is the equivalent of a reduction of

?3400. Happy to take an intervention. I thank you. Just

reflecting on the figures. I asked Spice about those figures and I ask

if there was no starting band five on -- in 2010 and through

progression would they be on a reasonable salary. A cash increase

of 37% and a real terms increase of 12%. Does the member recognise those

figures? What I would say to that is that we're talking about starting

salaries and it doesn't take into account progressions. We are

publishing the Spice analyses in order to say that. What I don't

understand is that already the SNP bench are jumping to have and I

commit about numbers and bands, but I have laid out in the own words of

the staff on experiences of them and I don't think they will

appreciate... A point of order. Can I ask you... A collection of the

opportunity as a reference to Anas opportunity as a reference to Anas

Sawar. All members know the rules. It should reflect on how the

intervention reflects on NHS staff who will be watching this debate. Is

it any wonder that we have record levels of vacancies, sickness

absence and a vacancy crisis in the NHS here. On the one hand the

Scottish Government oversees this crisis, on the other hand they paid

hundreds of millions of pounds out every year to private agencies. In

the past year, the rate across the NHS, ?175 million, has been spent on

private agencies. That is cash going to agencies when audit Scotland

report says that agency staff are likely to be more expensive than

bank nurses and pose a greater risk to patient safety and the quality of

care. It makes no sense at all for the Cabinet Secretary to throw money

at Private agencies or starve the NHS of cash to solve the vacancy

crisis. The verdict of the Royal College of Nursing has been damning.

Nursing leaders are clear and I will quote directly. "Budget Shavings

achieved are being used to meet efficiency savings targets for the

NHS". And they go one, NHS staff pay has fallen below that of the cost of

living and many are struggling to survive on their pay packet.

Worryingly they go one that it is negatively impacting on the quality

of care. This is what SNP members should be reflecting on. This is

happening in Scotland. It is happening in 2017. Nurses in

Scotland in the NHS on the watch of the SNP government are struggling to

survive on their paperback it. I want to repeat that. Nurses in

Scotland struggling to survive on their paperback it. The RCN's most

recent survey on members found that almost one in three struggled to pay

gas and electricity bills. They found that one in seven had missed

meals because of their financial difficulties. More than half

reported that they were compelled to work extra hours to increase

earnings and one in three were working shifts at night and weekends

to help pay bills and meet everyday living expenses. The RCN career

service has seen a marked career -- increasing calls with families

seeking advice outside of the nursing profession citing various

issues for progress in their career. The RCN membership survey is aim

membership survey of the RCN in the whole of the UK and not just

Scotland. Would you care to comment on that? I thank the member for that

intervention. I already said that I met nurses in Scotland this morning

who reflected on the same experience that has come across from members

right across the UK. Pay restraint is an impact in Scotland and I would

say to Emma Harper that, having been a nurse, I would expect you to

understand acutely about the struggles and strains of NHS staff

right across the country. I would hope, as a former member of the

union, as a qualified nurse, that she would vote in favour of a pay

increase for our nurses today. This is not the Labour Party reporting

these facts. They are damning facts reported by nurses. Many take second

jobs and some are using food banks to feed their families. This is

happening in Scotland, in 2017. I note that the Scottish Government

amendment calls for an assessment of pay restraint. I say to the Cabinet

Secretary, the RCN, Unison and others already tell us the

consequences of pay restraint. The only people responsible are the

Scottish Government in control of every aspect of Scotland's NHS for a

decade. The First Minister herself is in control and took decisions and

we are reaping the consequences of those. Cutting the number of student

nursing places. By nearly 320 12 to 2013. How did the First Minister

react? I quote directly from the First Minister. A reduction in

intake ford the 2012 academic year is a sensible way forward. How she

must regret those words today. Today this Parliament can unite and send a

message to Scotland's NHS staff and we can tell them loudly and clearly

that they are most valuable asset, you do make the difference and we

recognise how important the work you do is, we respect you and you will

be rewarded will stop that is why our motion is clear, to scrap the

pay cap and give the NHS staff a pay increase they deserve. Not the

alternative, to carry on with more austerities and cuts and that is why

the choice is clear. Focus on a Labour motion that will give the NHS

a pay rise it deserves all focus on the SNP's obsession only with

running another independence I call on Shona Robison.

Thank you. I am happy to move the amendment in my name. As Health

Secretary, I have the fortune to regularly see the excellent work our

health service staff do will stop the men and women of I'd care to

every family in our country, working to ensure that Scotland is as

healthy as popular -- as possible. I'm not alone in this chamber and

agree with Anas Sawar on this point, that they not only have the thanks

of my family the thanks of us all. I want to focus my remarks mainly on

the issue of pay. I will return to the issue of workforce levels which

we have record levels of although there is record demands on our

health service. I will come back to that. The independent pay review

process in the NHS can trace its origins back to the 1980s. It's the

independent NHS pay review bodies which makes recommendations and

advises the four countries on the uplifts to apply. Staff

representatives... We value the process today. We are clear that

they are annual settlements but there is a challenge to the process,

as the UK Treasury has insisted in recent years that the pay restraint

will be maintained until at least 2020. In turn, the UK Government

Department of Health for England adopted this approach and was

supported by Labour run Wales. The Welsh government has agreed that

they also intend to apply the 1% restriction until 2020. Perhaps an

example of Labour saying one thing during an election campaign and

doing an entirely different thing when in government and have the

power to pay nurses. I thank the Cabinet Secretary. Can she confirmed

that her own submission to the independent pay review body

recommended continuing a 1% for NHS staff here. Our pay policy is in

addressing the uplift and of course low pay and will no compulsory

redundancy policy. The RCN also recognise that we are bound by the

Treasury because what it gives in terms of resources to the Department

of Health is what we get in Consett and wills. I will come back to the

pay review body in a second. -- in consequential. The result of our

steady divergences work agenda for steady divergences work agenda for

change staff in Scotland are better changed -- paid them their

counterparts in England, Wales and counterparts in England, Wales

only country to apply the full Northern Ireland because we are the

recommendations in 2014 and the only recommendations in 2014 and the only

country to even request recommendations in 2015. Our staff

and are paid more than their colleagues undertaking the same

duties in other parts of the UK. As the government amendment notes,

nurses in the first pay point now paid ?312 more than their

counterparts in Wales and England. Bank staff in Scotland are paid more

than their counterparts in Wales and England and a band five nurses

started on the first pay point in 2010 and progressed annually will

have started on 20,000 pounds plus but will have advanced to ?29,034

now. Based on Labour's analysis that would be an increase of over 12% or

37% in cash terms. It is not just about pay, it is also about pay

progression and I will come back to that. Of course, there is real job

security that we have brought. This government and with the support of

parliament, has delivered in no compulsory redundancy policy. I know

this commitment is valued highly by NHS Scotland staff and compares

favourably to the likes of the more than 20,000 compulsory redundancies

taking place in the NHS in England since 2010. But the difference with

our approach is more pronounced when you look at the position of the

lowest paid workers in the NHS by delivering a real living wage for a

number of years and ensuring uplifts for the lowest paid above the

recommendations and by working in partnership with unions, like

Unison, to provide upscaling for previously banned one star. We have

entry-level support staff in Scotland being paid over ?1100 more

than their opposite numbers in NHS England. For these hard-working NHS

support staff who helped the delivery of health care here, I know

these amounts can make a real difference.

In a clearly staff where you will about pays their uplift. Staff at

the top of their bands are relatively better off than those in

England and Wales, Dave fails -- they face more challenges. You

highlight that those of the top of the pay band will in real terms be

worse off year on year that we have this pay cap, but we should also

confirm that nurse salary is 3400 worse off then a nurse starting in

2010. Nurses are better off the starting of band five in anywhere

else in the islands including in the Labour run Wales. No one says on .1

of their band. Labour seem to misunderstand you wait pay

progression works. It is about pay and pay progression. Those nurses

starting at the .1 in 2010 will now be seven point ?5,000 -- seven and a

half thousand pounds. We work together and rely on the

inside, advice and necessary challenge that the NHS Scotland

unions and the staff bodies bring. I look forward to meeting with the RCN

Unison and others to discuss pay over the next few weeks and in fact

I met Unison staff earlier today. What was interesting about what one

of the nurses was telling me was that yes, pay and the pay increase

and percentage of pay increases one element out in -- and is important,

it is senior to pay, it is recognition for continued

professional development and training. All of those issues are

equally as important. Those are the issues that I will address in my

meeting with the union. It is a party that has no prospect of

winning, the real action working with the unions in partnership to

address these issues. Our constructive approach to partnership

working was also evident during recent negotiations to effectively

do away with the lowest and one level of NHS Scotland. Not promises

something tomorrow, but something today. Partnership with staff is

always the best way to resolve issues. We will arrange to meet and

discuss and join the commission work to develop an evidence base that

will help us assess impact in the next round to the independent NHS

bodies. I'm in my last minute. One thing I would say to the unions. I

said I will not because I'm in my last minute. In conclusion, there

will be value in the independent pay review process, but we are willing

to explore other approaches if it is in the best interest of NHS staff.

Bearing in mind it was a union, many of whom wanted the independent pay

review process, if they are now saying that they think that that has

run its course and that the unions want to engage with me on looking at

a different set of pay negotiation structures, perhaps Scottish pay

negotiation structures, then I have made clear to the unions on many

occasions that my door is open to that and that has to be with the

staff side agreement. That is something I will put on the table to

discuss with the unions within the NHS, whether or not they want to

maintain the independent payment review body process or whether they

want to move forward in a different way. We will move forward, working

with the NHS staff in partnership to deliver Scottish solutions that work

for the benefit of all of our hard-working NHS staff.

APPLAUSE This debate today is about the

priority and choices for our National Health Service. Do we want

a strong NHS that is able to cope rising demand? Or must we have an

NHS that is unable to handle the heat, with plummeting staff morale,

long awaiting time. Nobody would want the latter. It will lead to the

very issues that we want to avoid. This Government has been in power

for more than ten years now and has had full control of the direction of

the NHS during that time. What is the record? Significant staff

vacancies, nursing in and midwifery. People waiting over the 18 week

target and a failure to meet target in accident and emergency. Only

seven met last year. Most pertinently in this debate... Have

you recently looked of the performance in Scotland is composed

to Tory run England? It is night and day. People were in crisis over the

weekend, not something that has been seen in Scotland. You need to

recognise the A E staff that deliver the best in the UK. We have

been here many times before. This is an SNP Government that runs his

Scottish health service. We should concentrate on their record and not

point the finger at other places. Most pertinent is plummeting staff

morale. Half of NHS staff feeling that they are unable to do their

jobs properly because they are overworked. This is a depressing

record for an SNP Government to regularly like to trumpet that they

are the only party who can deliver for the NHS and it is a record I

would like to come back to an moment. Firstly, Brexit which

appeared in the Government's Amendment and I would like to deal

with it head-on. It is difficult to estimate the number of NHS employees

from non-UK EU countries. We know that in terms of the NHS, it is

approximately 5% to 10%. Undoubtedly, Brexit presents a

challenge in the UK Government has been very clear. By the Government's

top priorities are part of the Brexit negotiations is to secure the

rights of EU Nash used -- Daschle 's right to live in the UK. I've said

before and will say again. Serious issues in NHS staffing did not begin

when the UK voted to leave the EU. GP shortages have been in existence

long before then. SNP cannot use Brexit as cover for the crisis. I

want to carry on. We are going to be many GB short by 2021. Many staff

are close to retirement. Those left, overworked and under immense

pressure. The health force is in crisis due to nearly a decade of SNP

mismanagement. Let's not hear the SNP blame Brexit or use it as a

reason to not take responsibility. Turning to Labour's motion, I have

huge sympathy with the feelings and motivations behind this motion. We

all want our NHS staff to be properly paid, but at this point in

time, these benches cannot support an end to the cap. Partly because of

rising budget Terry pressures, we believe that staff should continue

to receive a 1% pay rise and will be continued to be supported in other

non-financial ways. We should instead be ensuring the short

staffing problems that pervade the health problems are addressed as a

matter of urgency. Surely that extra support shouldn't be food banks.

Surely there needs to be a recognition that there is a direct

correlation between staff vacancies, staff morale, patient outcomes and

staff pay. Surely even the Tories can see that. I accept that

hard-working NHS staff deserve to be paid well as they do skilled and

vital jobs. I will welcome the Government's commitment to the

staff's living wage. Staff in Scotland and the NHS are paid more

than in other UK countries. The NHS is facing rising demands with an

ageing population and conflict health needs. Any decision to

increase pay has to be taken in a wider context. Despite the pay gap,

staff still increased is proximally 6%. If we manage to reform the NHS

in order to continue to deliver good service then we would be able to

invest what we say. Labour have come to this chamber today with an

important issue a very important issue, but they have made no issue

of the cost of what they are proposing. In the NHS, there are

huge vacancy rates. We can't take get -- get people to take up posts.

Yet you arguing a cap of 1%. In this place, there are no vacancies. There

are armies of people outside who would be desperate to take up our

posts. No gaps and yet he will agree to an increase pay level than he is

for nurses there would be paid to him and I. Is that fair? The point

that I would make is that you have given no details of how much this is

going to cost. How is this going to be funded? UK Labour hazards are

mated that every percent extra on pay will cost the NHS. Other figures

think it may be higher. Labour might want to put more figures forward,

but not talk to Diane Abbott. The Labour Party does not address one of

the central issues, we must address staffing issues. Staffing morale is

no and low morale is down to the fact that there is severe shortages

across the NHS. I have taken several interventions, I need to crack on.

The SNP have failed to tackle. The most recent figures show that. Time

and time again, the Government has ignored warnings and having ignored

the warnings and consistent calls from professional bodies that show

that this can't go on. The Royal College of nurses, the doctor who

led the cancer strategy said the NHS Scotland is hurtling over a

precipice with everyone pretending it is going to be all right and it

won't be. We are warning the Scottish Government that over a

recruitment and retention. Everyone is warning the Scottish Government.

It has been coming for years. The question is, when will the SNP

lesson? Do we want another four years under this SNP Government were

targets missed? Do we want another four years work they are crippling

pressures on NHS staff? Can we deal with in action from a Government of

the deludes itself into thinking that they are best placed to deal

with this while ignoring serious concerns? The answer to all those

questions are a resounding no and I move the amendment. Thank you. We

moved to the open debate. I call Monica Lennon. I am supporting

hard-working NHS staff and to vote for a foundation of the -- workers

who are a foundation of the health service. Scottish nurseries will

have received a pay cut of ?3400 under this SNP Government. The Royal

College of Nursing say that there has been a real cut. This is

unsustainable. Nurses are the foundation of our health service,

but they are failing to get the support and resources that we need

from this SNP Government. The facts are clear. Nursing staff are

important. All the while, they are facing their own financial

difficulties. The most recent employment survey which we have

heard about today already, 30% have struggled to pay bills. Over half

have been compelled to work extra and unsocial hours just to make ends

meet. Meanwhile, spending on agency and private nurses under the SNP

have soared. The vacancy crisis with unfilled posts. The SNP formed a

majority Government the number of long-term job losses have rocketed.

Agency spend has also rocketed, now to a on hundreds two ?5 million. Had

that is an area of serving -- savings that the Tories could

consider when they're putting questions over to this side of the

chamber. Nine out of ten nurses say that their work has got worse. In

every aspect, NHS nurses are being overstretched and overworked. MS

nurses across Scotland, they deserve like all our staff a much better

deal than they are currently getting from the SNP.

I've had cause to be in and around hospitals more one at -- more than I

would like recently. My father-in-law was 60 years old and

had a period of illness. The couple of days before he died, couple of

nurses prepared me and my family for what was ahead. His name was Paul

and although I didn't want to hear what he was telling me I was so

pleased to see him because he had cared for my dad in a previous

admission. He cared with such compassion and attentiveness that I

hadn't forgotten him and I doubt I ever will. And then Katie, another

nurse, who looked after my dad and family who looked after us as we

said our goodbyes. When I returned to the hospital just to weeks ago,

this time waiting for my man -- Mum to go to surgery, Katie approached

me. She gave me a hug that leaves you fighting back tears. Last year I

had to be referred to the breast clinic to had -- have cancer tests.

I went alone and I was terrified and emotional. The nursing staff were

simply first-class. They kept me calm as I waited in between

different examinations in a very busy waiting room. I looked around

at dozens of people queueing at the desk, people with children and it

was noisy and stressful. I simply wondered how the staff manage. So,

in the last year I've been in the Scottish Parliament, when I come

here and I hear Scottish Government ministers and SNP backbencher accuse

me and my Scottish Labour colleagues of publishing NHS staff and talking

them down, playing politics, I feel sick to my stomach. When we come

here and when the MSPs come to shine a light on these issues, it is

because we have nothing but admiration and respect for NHS

staff. Nurses are our friends, neighbours and loved ones also. So,

I would ask the Scottish Government when they come here and deflect

criticism of their stewardship, of our beloved NHS onto the staff

stretched to breaking point, is it fair? I know we have a couple of

nurses on the SNP benches and I would really ask them to think about

where their loyalties lie tonight when they come to press their batons

at five o'clock. How can you have been a nurse and served alongside

these people and betrayed them this evening? I just wonder how, as a

counsellor, can she defend what South Lanarkshire did to those

across that authority? Well, I am no longer a counsellor but that is

ridiculous coming from a government minister to bring to the debate

something that has no bearing on this and she knows fine well I

support equal pay for all workers so that is pretty shameful. At five

o'clock... You can smile, but we have had that nurses are going to

food banks. We had a debate last night about food poverty and you

can't sit there and say it's someone else's problem. Tonight we will see

if we will have an SNP government voting with the Tory party to block

a pay rise for nurses. I'm in my final seconds. Thank you for your

generosity. The choice is clear tonight. We either support a pay

rise for NHS staff and believe that pay cap should be scrapped or MSPs

don't. Labour is clear where we stand, on the side of working

people. Others in the chamber should do the same.

Thank you, Presiding Officer. Before I start with what I was going to

say, can I make it clear to members on that side of the chamber and

white across the chamber that they do not have a monopoly on people

having to deal with the health service. They are not the only

people who have had people die in hospital and who care about nurses

and doctors who treated them. Both those contributions suggest that we

don't care about the nurses, we don't care about the hard work they

do and we don't respect the hard work they do, but of course we do.

Every single person in here will have lost someone and I don't think

it is becoming of anyone to try and pretend they have a monopoly on

that. APPLAUSE

The NHS is often described as a jewel in the crown of British

society and with some justification. Despite what they say, it seems that

across the UK it is the Scottish Government who recognises its

importance and prioritises the needs of the NHS whilst trying to balance

reducing money. The Scottish Government has consistently

protected the front line health budget enabling it to be fair on the

point of need. Thank you for taking the intervention. Can I ask what he

would ask the Scottish Government to do to stop nursing staff having to

go to food banks? Scottish nurses are better looked after than any

other nurses across the UK. What you fail to recognise in any debate is

that we work under the same financial restrictions as under the

UK. We made the decision to have non-compulsory redundancies and to

make sure they have a bonus, to make sure they have a wage and a 1%

increase that other nurses across the UK don't get. So don't come here

and tell a Scottish nurses are badly paid in terms of the rest of the UK

because we are doing everything we can hear with the restrictions we

had to make sure Scottish nurses are looked after.

Across the UK, the NHS is under great pressure but no more so than

in Wales. Acronym-macro waiting times are longer and patients there

wait longer than anywhere else in the UK for many routine treatments.

Anas Sawar apparently has all the answers so could he assist his

colleagues in Wales. I could list a load of figures as to how much the

NHS is receiving from the Scottish Government but it's important we

look right across Scotland. We very often get quotes from politicians

criticising the Elizabeth Hospital but there was a peak in the number

who received care and where numbers are high, Scottish Labour seemed to

see this as another opportunity to use the hospital as a stick to beat

the Scottish Government with. The only people they are damaging with

constant carping other hard-working staff across the Queen Elizabeth and

other hospitals. For you to talk about trying to deflect criticism,

we don't. Politicians coming here and criticise health care workers

are not us. They are on those benches there. A recent documentary

was fascinating and shows fraction of dog my cry was a patient and can

vouch for the care that was given there. -- documentary. I know one

family with two kids who are chronically ill and who have to use

the hospital sometimes four or five times a week. If they had to pay

parking charges they would be in an awful state. It would make things

much worse. Until the SNP government came in, this party here made sure

they had to pay for parking. The Labour Party were clear that parking

in hospitals was a justifiable price to pay. I agree that the removal of

parking charges was right but what I don't agree with is taking off

parking charges and having no traffic management system. At St

John's Hospital in Livingston it is chaos with people attending

chemotherapy and other treatments who leave an hour early to drive

around for that hour to try and find somewhere to park. If we remove the

payment system, there has to be a management system. Surely the NHS

can do that. Can I remind members, interesting though charges are, the

debate is not on that and neither is the amendment. Don't talk over me.

Do not sit down, please. I am looking at the amendment and the

main debate. Let us keep to that, please, and not drift into other

areas. Mr Findlay, please sit down. It had better be. I am waiting to

see if it's a point of order. The issue of parking is relevant because

it relates to pay. It is being extended and it is not relevant to

the amendment before me, nor the motion. Let us get back to the

motion in hand. Please continue. Can the Presiding Officer clarify how

far away... I have made my ruling. I want you to get on with your speech.

Do not challenge me, please. Nurses and midwives are one of the most

valuable resources we have. In order to say there a high level of care,

we have committed to free tuition for those wanting to be nurses.

Scotland has worked hard to keep is no compulsory redundancy policy.

Unlike England. Financial restrictions... Figures show that

nurses hereafter paid at a higher rate than across the UK which is

another way of showing how we value the service. There's an election and

people want to grab headlines criticising the government, but I

would ask that with the motion like this, how do we find the extra pay?

Scrap the no compulsory issue or would Scotland take away more bunny

from other front line services? Where, may I ask, where is the ?350

million for the NHS which we were promised after Brexit? Back then,

they did but then they no longer opposed it. It is like a cult, isn't

it? I had the good fortune to see the SNP take control of the Council

on Friday. There I heard that Anas Sawar told someone it was a terrible

day fully SNP and independence and a strong showing for Labour. While he

continues to make fanciful contributions, like last Friday and

today, the Scottish Government would keep to their promise of supporting

our hard-working and much valued nurses. Thank you. No comments about

the length of time from anyone. I gave the time extra to the speaker

because I made a ruling in it. Mr Whittle. Thank you. Can I first

declare an interest in that my daughter is a health care

professional in the NHS. I welcome to speak in this debate and thank

labour for raising the important issue today. Across this chamber, I

am sure there will be agreement that are front line public servants

deserve to be paid appropriately for their work and care and attention.

The question remains is how this can be achieved in a sustainable and

consistent manner beyond political -- political rhetoric? Last week I

witnessed first-hand health care on the front line. Firstly, I spent

some time in A and you will be pleased I was seen well within the

four-hour guideline. I was waiting to be seen and could watch the

station and observe what was going on. Harassed staff only through to

the front desk asking them to stop sending people through because there

was no room and patients complaining they were already sitting there for

half an hour. Nurses feeling guilty even though one nurse was well over

her I was at eight o'clock in the evening. I took the opportunity to

speak with her and what she wanted was to feel valued. For us to

understand the roles she did to have staff numbers and experience to cope

with demand, to have the flexibility in the roster to cope with

fluctuating demand. I met with a GP on Monday night who took it ethical

decision to close the surgery and close the surgery to Crosshouse in

another area. There was anyone tentative enquiries since January to

have the practice taken over. Five GPs potentially taken out of the

system, compounded by the fact that a further six GPs were due for

retirement in the same area. A potential lot of -- loss of 11 GPs

in Kilmarnock. As of two weeks ago, there were already 15 GPs

advertising petition -- positions unfilled in Ayrshire. It is obvious

that this is far from an isolated problem.

Would amend the agree with me that whilst there are difficulties in

recruitment to general practice, they have a report today by the

Royal College of practitioners about the impact of Brexit on the

workforce in Scotland is particularly worrisome and I would

say to your colleagues that it is particularly worrying for those of

us who represent rural areas where up to one of four of the doctors is

an EU national. I will give your time back, that is a long

intervention. It is not just the recruiting staff from around the

world, it is home-grown GPs. Here is the thing. Two weeks before

resigning the practice, asking for help and they are still awaiting

reply. It is all very well having the rhetoric, but it is action that

actually applies and that is paid to be not the case with this

Government. When that GP joined the practice of the partner ten years

ago, it was the eighth one that she applied to. Now the GP can pretty

much choose which practised they want to go to. I was told that the

most dramatic change had happened in the last three years. The practices

that hurt the moat of Rowell ones. that hurt the moat of Rowell ones.

The people that suffer the most ugly ones who lose continuity of care

because it is not GPs -- the most are the role ones. Locals are being

increasingly sought to fill gaps. Three years ago they were paying a

locum, now they are having to pay ?250 for a locum to cover just for

hours. With the pressure that GPs are under, coupled with the demand,

is it no wonder that working at a locum is such an attractive issue?

The issue is not the money that they earn, it is being valued. It is

recognising that the GPs are the gatekeepers, the health care

professionals have built up many years of... The consequence of not

addressing this right now according to this GP is more people ending up

in hospital. The consequences that the next conversation we will have

will be how we deal with the mess and the fallout. It is true for

politicians and GPs, the longer you leave the problem the harder it is

to deal with. The reality is that hospital numbers have risen while

GPs fall. In a bar patient ending up in inevitably rises coming through A

E. Agents that should and could -- patients. It is not just about the

levels of care. An NHS that is sustainable for the long-term quite

frank it will take a radical overhaul in the way we view health

and health care. It requires a culture change in the way that

health professionals are viewed by this place and the public. There are

billions to recoup and reinvest and has to be put in front and centre.

The job that health care professionals do must be made more

attractive and a valued career path and in the words of health care

professionals, but is more about just money. Choosing a career as a

health care professional is not about financial reward. It is a

desire to care. What came across my recent with health care

professionals is concern for patients and what will happen to

them if the NHS are not steered on a more sustainable course. Sustained

continuity of care is needed. If we are serious about recruiting into

the NHS, if we are serious about rewarding our health care

professionals appropriately, throwing more money at the problem

is not the right course of action. We need to stop treating the

symptoms and focus on dealing with long-term. So try to keep the show

on the road and thinking about how we build a sustainable future for

the NHS. Thank you. Thank you very much. We have already heard comments

that the Royal College of Nursing for Scotland briefing and some of

the folk from the Labour benches. I would like to just comment or quote

as well from that particular briefing. The Royal College of

Nursing in Scotland state that pay rewards have been constrained by the

UK Government's policy and public sector pay for subissue be noted

that these got his Government has implemented recommendations even

when the UK Government has not. This means that those terms and

conditions remain roughly equivalent, pay rates for each of

the pay bands vary. That means in Scotland there has been an increase

and a higher level of pay across the bands in Scotland. I want to touch

on a couple of points as well. I will let you in later. Westminster

Government has reduced Scotland's fiscal budget in real terms. In

spite of this, the Scottish Government has committed to

continuing to provide above inflation for the health budget. The

SNP Government has protected the front line health budget increasing

it by 40% from 2006 to 2017. Health funding now stand at record levels.

?13 billion with resource spending being 3.6 billion more than when

this Government took office in 2007. Also Presiding Officer, Her Majesty

Treasury's figures is 7.2% higher than in England. That is an

equivalent of ?152 per person. In terms of the NHS in Scotland, it is

clear that these figures highlight that although there are challenges

in the NHS and I don't think anybody in these benches could indicate that

there aren't any challenges to the NHS, there will always be challenges

to be NHS, irrespective to which party or parties are in power. That

is the case here and in England and Wales. We have heard some examples

of that in this debate this afternoon. Nonetheless, it is clear

that in terms of the Finance and the importance that this Scottish

Government actually places upon the NHS in Scotland, it is paramount

that with the funding that is going into the NHS and with the level of

focus that is going in to make our NHS better and more responsive, then

members from across the chamber have really got to try and understand

that particular level in terms of the funding that is also going in.

Our NHS staff are resilient. We have heard that already today. Our NHS

staff are resilient and they do have a unique set of skills that they

bring to their patients and also to the multidisciplinary teams in which

they operate. Our NHS staff are always there at times of crisis to

treat, care and reassure their parents. -- patients. I have been

very fortunate that I have not had to call upon NHS staff to often.

Suddenly, the constituents that I deal with a regular basis, there

have been challenges there. The one thing that comes back time and time

again is how valued our NHS staff are. I'm sure everybody here

recognises that and appreciate everything that our NHS does for the

country. The Scottish Government's pay policy set aside that flow from

the UK Government spending round. Their cuts are coming to this

Parliament. The cuts are coming to this Government. That means that the

restraints are still required. It is also recognise that maintaining

employment and Scotland's economy remain stronger. The aim of the

policy is to provide a pay increase for all staff come supporting those

on the lowest income and people making their own decisions about

paper aggression. -- pay progression. It is born out of the

fact that there are staff shortages of NHS staff. Speaking on BBC Radio

4, Jonathan Ashworth revealed that as a result of the staff shortages,

Labour would scrap the 1% pay gap. It would reverse bursary to fall

student nurses, midwives and indeed the latest UCAS figures have

revealed the deep damage that Tory Government cuts are having to

nursing. That is after they abolished bursaries. No wonder, that

highlights the fact that nobody wanted to talk about the comparisons

to England. Also the issue of the creeping privatisation of the NHS.

I'm conscious of time, the NHS... And the Scottish Government has been

consistent to offer the right support to students protecting the

bursary, supporting our NHS staff of the future as well as survey. Thank

you. It is time for the pay cap to be scrapped. Years of pay restraint

have eroded living standards for our NHS staff. We can't and I -- deny

staff morale has been affected. The retirement boom on the horizon and

many staff are looking back on years of real term pay cuts and wondering

whether they can afford to keep giving to the NHS. I will support

this motion today because the Scottish Greens believe that we will

restore the value to the NHS staff and the public sector. The pay

impact has an effect on our wider communities. The majority were women

and a below inflation pay cap contributes to the gender pay gap.

Hospitals and health centres are vital anchors in these communities

and holding down pay has implications for them particularly

in promote and roll regions. The Scottish ... I am glad this often

results in better results for NHS Scotland, ensuring an minimum

increase is a positive measure. I do not believe it goes far enough.

Independent pay review body last report is quite clear. Government

sector pay policies set the context for its recommendations. On NHS pay

in England, it says we were told by the health apartment that a 1% pay

award is funded and it is clear that a pay award higher than 1% would

require trade-offs acquire of service levels, investment decisions

and staff numbers. Associated ... If the independent pay review body is

only prepared to make recommendations that are already in

line with Government spending plans and sets the expectations, the NHS

staff should be the cost of trade-offs, ie fail to see where the

independence lies. This one of health's view is that they played a

key role in the budget deficit. It seemed clear to me that the report

makes its recommendations in that fiscal context. That will mean they

play a key role in the budget deficit. The NHS pay should not be

based on economic severity. We are approaching the point where we will

require change. Public sector will not require to shoulder that burden

ten years on or deal with the problem is of the NHS is due to

democratic change. I would be inclined to support a Scottish

system, but if professional bodies and trade unions take a view then it

is vital that the Scottish Government plays a full role in that

process. Delaying submission and inhibiting visa Bisham of other.

The Royal College of Nursing's recent survey found that 30%

struggle to pay gas and electricity bills and many more missed meals

because of financial difficulty. I wonder if you or anyone in the

chamber can provide me with information about how many

respondents were based in Scotland? I was speaking to message -- nurses

yesterday and I can confirm this policy is having an impact on them.

Yesterday I spoke to an experienced nurse who has taken on a part-time

job because she can't make ends meet. While I've heard that pay

progression is still in place, and that is welcome, the fact of the

matter is that someone who who is doing a job can be paid less now for

that job than in 2011 so we have a problem. Nurses shouldn't have to

cope with pressure at home but is financial. 2.6% would be in line

with the retail price index and I believe that's fair. Economic

inequalities are that at the centre of other inequalities cannot be

denied. Use other stress because there's no work and life balance and

you take on extra shifts to keep your head above water. Financial

factors have an incremental effect leading to sickness and time off

work. Staff absence pushes up agency costs and NHS employees feel and

fairness when they see how much is being spent on agency nurses and

locum doctors. In Denmark, hospital nurses are paid about 16% more than

here or over 20% better in Australia. We know this. Nurses

don't go into the profession for the money and nor do midwives or

physiotherapists or other health care workers but patient expect

their dedication and professionalism to go unrewarded because their pay

falls below inflation. The government 's amendment says they

will commission work to develop and evidence -based approach to pay. NHS

staff already know this and they have already made submissions. The

RCN has polled members on action that should be taken on pay

restraint, including the option to balance -- ballot for industrial

action. Can the member wind-up, please. Restoring the balance of NHS

pay will restore the balance and it will have positive effect on the

standard of care we all received. Thank you. I congratulate the Labour

Party in bringing forward this important debate and I can assure

them of the support of these benches tonight. I spent a long time on one

my life. I have met through some of my life. I have met through some of

professionals in our society. People professionals in our society. People

who, in many cases and from an early age, answered and in according to

meet the needs of the most fun rubble and infirm and they have done

so without thought of reward. Just as well because there are very few

roles within the health service which attract financial recompense.

What we are debating today is a cat that has seen it decline in taken

our health service. In the teeth of our health service. In the

a hard Brexit and the devaluation of a hard Brexit and the devaluation of

the pound, we see the value of those pay packets diminish further and

with it, the buying power of hundreds of thousands of employees.

We ask so much of those we look to for treatment and care and yet we

offer so little by way of reward. What we do offer is diminishing. It

is not melodramatic to say that to continue as we have with no prospect

of pay increase in real terms for our NHS or social care workers it

represents an existential threat to the delivery of health and social

care in our society because, at its bedrock, the NHS and the social care

system is nothing without its star. The rhythms of our health service

are constantly interrupted by the stuttering of shortages, inadequate

workforce planning and attrition in pain. Underpinning all of this is

the need for fair and equitable paid to make a career and attractive and

viable life choice. We cannot expect pressures on our hospitals or GP

surgeries to abate while they are so hungry for a new staff cohort that

is not coming up through the ranks or, instead, is looking overseas for

opportunities which attract greater financial incentive. Adequate

investment in our workforce is vital. It is the call we all

received from stakeholders in every speciality in the sector. All too

many junctions in the system, there are buckled in the wake of demand.

Audit Scotland revelations that are health boards missed all but one of

the national targets they are expected to meet. Delays in UWE

offer the starkest insight to the chronic problems we face in our

system -- delays in accident and emergency. My eyes were open to the

reality underpinning the delays in the four-hour target. The accident

and emergency -- department acts as a weather vane. The reality of how

easy it is to clear patients out of accident and emergency into the

wider hospitals so delays mean bed blocking. I have raised many times

one case, an elderly constituent, who had to endure 150 nights in

hospital. I will take an intervention. I perhaps missed the

congratulations from my colleague to the Scottish Government about their

incredible performance on the four-hour waiting times over the

last number of years compared to all other UK countries given that it is

a canary in the mine target. Well, I am delighted to congratulate. On

this point, you miss the trick entirely. The point about those

targets is the fact that we have a colossal problem of bed blocking in

our hospitals and the delay in this case was due to the fact that his

social care package was not available. No night-time check could

be established because there were no staff available to do it. The delay

cost hundreds of thousands of pounds so when the members on the

government benches ask me from where we get the money to pay for such an

uplift, I point to my constituent and his protracted stay in the most

expensive hotel in Edinburgh. The cost of failure in his case is

replicated across every health board. If we were only to

recalibrate the direction of expenditure we could free up

resources to offer financial recompense at every level. It is

because we failed to invest in our social care workforce that cases

like this are so commonly raised here. We expect carers to attend

their charges for sometimes as little as 15 minutes and to receive

a salary they could just as well find stacking shelves in a local

supermarket. Local authorities date with regularity that they commission

social care on grounds of quality over cost but the reality is felt

most keenly by service users on the ground regarding that split. It is

often easier for members of the opposition to ask the moon of

government and to write checks we could never hope to write ourselves

when in government. But to this, the solution is blindingly simple.

Entice people back to the fold, invest in our workforce, given the

future of comfort and security and they will visit it back on the

people in their care tenfold. We have so much to be proud of for the

men and women who deliver care and the very least we can do is ensure

they can do the job they like and love with a measure of dignity and

the proper reward. APPLAUSE

Could I ask Neil Finn delete and others to press the request to

speak. There was a technical glitch. Thank you. Can I refer members to my

register of interests, specifically my member of the GMB and Unite trade

unions. With this motion today, Labour is showing people away out of

a failed economy in which working people are being made to pay the

price for a crisis they did not create. Wages which once rose

gradually are not increasing any more. Housing costs and even the

price of food cannot be afforded any longer and for too many people are

-- people, fuel poverty is going up. We have the poor, the working poor

and the public service working poor as well. People whose wages have

been held down year after year. Nurses experiencing a real terms pay

cut of 30% since 2010 and other people working in full-time jobs in

our national health service still below the poverty line. Still forced

to claim benefits and done in our name. It is not as though we are

living beyond our means but that we are not equitably distributing our

means. All our aims at sacrifice our to the working people. Whilst the

rich are studiously ignored with the result that, in Scotland, the

richest 1% owned more personal wealth in the whole of the poorest

50% altogether. It has other consequences. As one member of the

PCS union told a committee in this Parliament last month. "As Long as

we continue to have pay freezes and pay restraint we will not eradicate

the gender pay gap." In days gone by, incomes policy was part of a

wider programme of action by government through a social contract

to deliver a social wage, it including food price subsidies and

rate subsidies. In places to the state pension -- rent subsidies.

What we have today is a blunt one-way fiat of austerity. The SNP

government makes comparisons with England. Well I'm sure it will be a

comfort to midwives working around the clock in Wishaw, to the nurses

in the Forth Valley Hospital at the top of their pay band, to the

porters toiling... Would you make the same speech to a Labour Party

conference in Wales where nurses are paid less than in Scotland? The last

time I checked I was in a Scottish parliament addressing an SNP

government. What would you say to the porters toiling long hours

working long weekends and to the ambulance crews on call stationed

right across the country, to the hard-working cleaners on ?8 50 per

hour, the lowest paid. I am sure it will be a comfort to them that, if

they lived in England, they would be even worse than subject to even more

restraint. In light of their experience, I am sure they will

greet with some cynicism the suggestion in the amendment that the

best revolution -- resolution will be found in partnership working and

the benevolence of the Scottish Government. When the review body

produced its recommendation it said the scale of efficiency savings that

the NHS is required to make appear to be bigger in Scotland than other

parts of the UK with the Scottish Government telling us that health

boards will be expected to make 3% efficiencies in 2017. So I am

challenging the government today to scrap the cap and allow for free and

responsible collective bargaining. Let me turn to the conservative

amendment because we have a trade union act on the statute book which

is barely a year old. It is a Tory act which I presume the Tory members

here support. It singles out public service workers and puts at the very

top of the list of public service workers, workers in health services.

The very workers we are discussing this afternoon. That is on the face

of the act which they support and it demands a minimum turnout threshold

of 50% and minimum majority thresholds of 40% for legal

industrial action. I am bound to say that if the same rules were applied

to the local government elections last week, which Tory and SNP

ministers... Not a single Tory councillor would have been elected

anywhere in Scotland. Your last minute.

I want to remind the parliament finally of the principles of the

health service set up by Aneurin Bevan. Bevan said that it becomes

more wholesome, more Serena and spiritually healthier if it knows

that its citizens have at the back of its consciousness the knowledge

that not only themselves but all the fellows have the access when ill

that the best the medical skills can provide. If the job is to be done,

the state must accept financial responsibility. These prophetic

words are chosen carefully. It is not medical machinery or

pharmaceutical formulas, but the dedication of the people who work in

the National Health Service and to the SNP let me finish by saying

this, it is no good claiming to be on the side of the workers in the

NHS when you are not prepared to back them up. It is no good claiming

to be investing in the NHS if you are not investing in the people who

deliver the NHS. I would urge all members to look to their conscience,

to accept financial responsibility and accept moral responsibility and

back the Labour motion this afternoon. Before I call the next

member, I say to anyone along the front benches, if you're going to

intervene, intervene properly. Do not heckle from the site. Today's

debate gives us an opportunity to highlight the different approaches

to nurses pay adopted across each part of the UK. I welcome the Labour

Party bringing this debate to the party this week in advance to

international nurses Day which falls this weekend. The debate allows us

to compare and contrast with different administrations. The

Scottish, Welsh and English Government. There is a clear process

in place to determine nurses party Mac page, -- nurses' pay. This tells

us much about what we need to be able to focus on and the commitment

of each administration and the parties that run them. The Tory lead

UK Government of the Labour run Welsh Government have failed to

implement the peer review body. The Scottish Government run by the SNP

in contrast has stood by the body's recommendations and implemented them

in full. While labour talks the talk, we are failing to meet the

recommendations and the Tories look the other way, it is the SNP which

has met its obligations. Funding nurses pay to the review body. The

Royal College of nurses understands this well. It states these got his

Government has implemented recommendations, even when the UK

Government has not. Pay rates that you to the page bands vary. A newly

qualified nurses ?21,999 in England, the same in Wales. In 1693 in

Northern Ireland and ?22,218 in Scotland. A band five nurse earns

more than in England and Wales. It is a clear indication that the

Tories never stop talking about the top 10%. The higher rate taxpayers

can afford to pay a little bit more. Never mind the benefit of the

council tax and the ?400 law in Scotland. When it comes down to it,

the Tory's priorities of targeting constituencies is laid bare for

everyone to see. In the top 10%, UIQ tooth and nail for your percent, if

you happen to be an NHS worker you are not interested in

recommendations on your pay. On the PRB's recommendations, additional

measures have been put in place to assist lower pay in the profession.

A flat rate 400 and lift for those earning 22,000 or less has been

fermented, recognising the particular pressures on low-paid

staff. -- implemented. It ensures nurses are trained to support our

growing health service. Nursing bursaries are still in place in

Scotland and nursing students pay no tuition fees. This is a stark

contrast to policies elsewhere in the UK where both have been

scrapped. As a consequence, the number of English applicants to

nursing courses has plummeted by 23%. Ten times worse than in

Scotland. There is no surprise that England is suffering from a 9% nurse

vacancy rate, more than double that in Scotland, consequence of a

different approach to treatment of staff. A Scottish Government also

understands the need to provide stability and security for our NHS

staff. In contrast, the situations out of the border there have been

many redundancies, NHS: has -- NHS Scotland has had no redundancies.

Entry level support staff in Scotland are paid ?1128 more than

their English counterparts. These measures are underpinned by the

Scottish Government's commitment to support the health service with