0:00:19 > 0:00:23Good morning. Here at the Scottish Parliament it is questions to the
0:00:23 > 0:00:27First Minister as ever. SNPs can ask everything and anything. I suspect
0:00:27 > 0:00:32some may want to ask about today's Audit Scotland report on the NHS.
0:00:32 > 0:00:37The opposition SNPs will want to talk about report findings on missed
0:00:37 > 0:00:40targets, on improvement stalled, on the improvements for the health
0:00:40 > 0:00:44service. The First Minister will want to reply by talking about
0:00:44 > 0:00:47patient satisfaction. That may come up. Other things may come up. Only
0:00:47 > 0:00:55one way to find out. Let's cross to the chamber.
0:00:55 > 0:00:59Ministers will wish to join me in thanking coming to the gallery the
0:00:59 > 0:01:09High Commissioner.
0:01:10 > 0:01:15Question number one.This morning's Audit Scotland report said reform of
0:01:15 > 0:01:20the NHS is progressing, but major challenges still lie ahead. Nobody
0:01:20 > 0:01:25underestimates the work needed to see services improve year on year
0:01:25 > 0:01:30within our health service. The bottom line is seven out of eight
0:01:30 > 0:01:33key performance standards have been missed this year. Can I ask the
0:01:33 > 0:01:36First Minister to confirm how many of these performance standards have
0:01:36 > 0:01:41seen any improvements over the last five years?Of course, in England,
0:01:41 > 0:01:46under the Conservatives, it is eight out of eight.
0:01:46 > 0:01:57Let me address... Let me address directly the Audit Scotland report.
0:01:57 > 0:02:01Firstly, for completeness, let me point out some of the audit Scotland
0:02:01 > 0:02:06findings, I suspect we will not hear from the opposition today. Firstly,
0:02:06 > 0:02:10NHS staff are maintaining and improving the quality of care.
0:02:10 > 0:02:12Secondly, there is a strong culture of continuous improvement in the
0:02:12 > 0:02:19NHS. There is a continued focus on safety and improvement. It levels
0:02:19 > 0:02:23the patient satisfaction at an all time high in the NHS and there are
0:02:23 > 0:02:29signs that reforms are having a positive impact. The report points
0:02:29 > 0:02:36out that since 2008 there has been an 8.2% above inflation increase in
0:02:36 > 0:02:39spending in the National Health Service and that health today
0:02:39 > 0:02:43accounts for a higher proportion of the Scottish Government budget than
0:02:43 > 0:02:49in 2008. As we know, in every health service across the developed world,
0:02:49 > 0:02:52changing population patterns means there are rises demands on our
0:02:52 > 0:02:57health service. However, in meeting these challenges in Scotland and
0:02:57 > 0:03:03they are big challenges, I think against many measures, we are seeing
0:03:03 > 0:03:07the NHS in Scotland perform better than the NHS in any other part of
0:03:07 > 0:03:13the UK. That is because of the actions we are taking. Increased
0:03:13 > 0:03:16investment, reform, integration of health and social care. The focus on
0:03:16 > 0:03:20realistic medicine and the work we have done in A&E are doing in
0:03:20 > 0:03:25elective care more generally. This is tough stuff. Nobody denies that.
0:03:25 > 0:03:29We will continue to focus on delivering the investment and reform
0:03:29 > 0:03:35the NHS needs and patients across the country deserve.
0:03:42 > 0:03:47The answer according to Audit Scotland was one. There has been any
0:03:47 > 0:03:50improvement at all in the last five years. The reason they say is
0:03:50 > 0:03:53because this Scottish Government is still struggling to do the basics.
0:03:53 > 0:03:58One of the big thuns is staffing. Audit Scotland warned two years ago
0:03:58 > 0:04:05that we needed a new national approach to workforce planning. The
0:04:05 > 0:04:09Scottish Government promised to deliver by 2017. That grew to three,
0:04:09 > 0:04:14two of which we are waiting on. And the only one published according to
0:04:14 > 0:04:18Audit Scotland isn't a plan at all. And what's more, the auditor makes
0:04:18 > 0:04:22clear there's no likelihood of the Government being able to produce a
0:04:22 > 0:04:26proper plan because it still doesn't have the data to do so. Audit
0:04:26 > 0:04:29Scotland has been warning about this for years. Why is there no proper
0:04:29 > 0:04:35plan in place and why isn't there the data to allow one to be written?
0:04:35 > 0:04:39Actually, one of the things the Audit Scotland report points to is
0:04:39 > 0:04:44the improving data we have, not just in the acute service but across
0:04:44 > 0:04:48primary care that allows us not just to monitor trends in the NHS but
0:04:48 > 0:04:52drive improvement. Specifically one of the things the Audit Scotland
0:04:52 > 0:04:58report points to as a sign of positive improvement. I make this
0:04:58 > 0:05:02point seriously because I accept the challenges in the health Serhal vis
0:05:02 > 0:05:05and I accept the responsibility of this Government, the Government that
0:05:05 > 0:05:11I lead to face up to and address these challenges in Scotland. Ruth
0:05:11 > 0:05:18difs son seems to want to say the challenges in Scotland's NHS are you
0:05:18 > 0:05:22-- Davis son seems to want to suggest it is down to Scotland's
0:05:22 > 0:05:26NHS. She has to explain why under the Conservatives in England why no
0:05:26 > 0:05:29NHS targets are being met. It is a serious question for the
0:05:29 > 0:05:39Conservatives. Now on the specific issue of staffing, as Ruth Davidson
0:05:39 > 0:05:43is aware there has been a plan looking at NHS staff, one of the
0:05:43 > 0:05:51pieces of legislation we will take forward in the coming Parliament is
0:05:51 > 0:05:55built enshrined safe staffing levels in law. But increasingly and anybody
0:05:55 > 0:05:59who knows anything about how health services are delivered these days
0:05:59 > 0:06:03knows you cannot look at the NHS in isolation. So the second and third
0:06:03 > 0:06:07part of the NHS and health more generally workforce plan will look
0:06:07 > 0:06:12at social care and local authority staffing as well. So that we bring
0:06:12 > 0:06:15together an integrated plan, mapping out the staffing needs for the NHS,
0:06:15 > 0:06:19not just now, but in the years to come. That's the right way to do
0:06:19 > 0:06:24this. And that is what we will continue to take forward. The final
0:06:24 > 0:06:28point on staffing, it is a point I have made before, Presiding Officer,
0:06:28 > 0:06:33and will continue to make it. One of the biggest risks we face in
0:06:33 > 0:06:37Scotland, generally, and in the NHS in particular, is a growing
0:06:37 > 0:06:42inability to recruit people into our public services. And why is that?
0:06:42 > 0:06:45Because the Conservatives want to stop or restrict our ability to
0:06:45 > 0:06:49recruit the best and brightest from other countries. That's one of the
0:06:49 > 0:06:54biggest risks we face to recruitment. Ruth Davidson should be
0:06:54 > 0:07:02ashamed of herself for supporting that.
0:07:02 > 0:07:08Presiding Officer, if I can talk a little bit at length to what the
0:07:08 > 0:07:11auditor general says on this matter the First Minister has tried to
0:07:11 > 0:07:16sweep under the carpet." It is not a plan to address mediate issues. The
0:07:16 > 0:07:19Scottish Government is likely to find it challenging to find any more
0:07:19 > 0:07:24detail in the next two plans, due to a lack of national data on the
0:07:24 > 0:07:26primary care and social care workforces." The data isn't there
0:07:26 > 0:07:31and the plan isn't there. Let's talk about one area where that lack of
0:07:31 > 0:07:35planning is having a real and immediate effect. That is in primary
0:07:35 > 0:07:40care. GPs are central to the changes we all agree, all of us agree are
0:07:40 > 0:07:45needed to improve health care. This has been hindered by the continuing
0:07:45 > 0:07:50difficulties in recruiting and retaining family doctors. And the
0:07:50 > 0:07:56Royal College of GPs make it clear, they have said the SNP has cut the
0:07:56 > 0:08:01share of spending going to GPs over the last decade and they ask, how
0:08:01 > 0:08:05can hospital targets possibly be met when people feel they have to attend
0:08:05 > 0:08:09A&E because they cannot secure an pointment closer to home? Does the
0:08:09 > 0:08:15First Minister have an answer for the Royal College of GPs?Firstly,
0:08:15 > 0:08:19in terms of staffing, it is precisely because we need to make
0:08:19 > 0:08:25sure that there is an integrated plan across not just the acute
0:08:25 > 0:08:27health service but primary and social care, that we are developing
0:08:27 > 0:08:31the workforce plan in the way we are doing it in the way that I think
0:08:31 > 0:08:34Audit Scotland would advice us to do. That is why we will continue to
0:08:34 > 0:08:40take forward that work. Now, in terms of GPs, again, we Scotland is
0:08:40 > 0:08:44not the only country that is experienced in challenges in
0:08:44 > 0:08:49recruiting GPs. That is why we have taken forward a range of different
0:08:49 > 0:08:53actions from increasing the number of medical training places in our
0:08:53 > 0:08:58universities to establishing a new graduate entry programme, which will
0:08:58 > 0:09:01focus specifically on general practise and of course rural and
0:09:01 > 0:09:07remote working. We've seen this year an increase of year one trainees,
0:09:07 > 0:09:11compared to last year, at the same toint point last year, it was 65%.
0:09:11 > 0:09:17It is up to 74% this year. And we have of course have a commitment to
0:09:17 > 0:09:23increase the proportion of the total health budget going to primary care
0:09:23 > 0:09:29by 500 million over this Parliament, taking it to 11% of the total NHS
0:09:29 > 0:09:33budget, with which I think is a greater commitment made by any
0:09:33 > 0:09:36Government anywhere else across these islands. So these are big
0:09:36 > 0:09:42challenges. Anybody can stand up here, Ruth Davidson can point to the
0:09:42 > 0:09:46challenges. I accept the challenges. This Government is putting in place
0:09:46 > 0:09:49the actions to address those challenges and that is what we will
0:09:49 > 0:09:57continue to do.I am standing up here calling on the First Minister
0:09:57 > 0:10:02to honour the promise that she made to GPs a year ago. I am standing up
0:10:02 > 0:10:06for GPs for saying she's gone back on her words. And it's not being
0:10:06 > 0:10:11delivered. Now, today, we've had a report from the nation's auditor
0:10:11 > 0:10:15saying that health in Scotland is not improving and huge inequalities
0:10:15 > 0:10:21remain. There's been a 99% rise in the number of patients we think more
0:10:21 > 0:10:25than 12 weeks in the last year alone. The SNP set their own target,
0:10:25 > 0:10:29but they have improved only one in the last five years. We know there's
0:10:29 > 0:10:32no long-term plan, even though one was promised for the start of this
0:10:32 > 0:10:39year, that GPs are being underfunded and that we spent £171 million
0:10:39 > 0:10:44hiring in agency staff to plug the gaps. Yesterday I met a group of
0:10:44 > 0:10:48fantastic trainees at the Edinburgh medical school. What assurances can
0:10:48 > 0:10:54the First Minister give to them that after ten years of Audit Scotland
0:10:54 > 0:10:58reporting the same failings over r over health she'll actually take
0:10:58 > 0:11:02some action to turn it around? Actually, a number of points to take
0:11:02 > 0:11:06on there. The agency spend in the first year is down. Something which
0:11:06 > 0:11:09is recognised in the Audit Scotland report. We are taking the range of
0:11:09 > 0:11:13actions to make sure we've got the right people coming into medical
0:11:13 > 0:11:18training and making sure we can get them into the NHS, delivering the
0:11:18 > 0:11:22excellent care that the NHS delivers for patients across the country.
0:11:22 > 0:11:24Again a reminder that the Audit Scotland report points to the fact
0:11:24 > 0:11:28that NHS staff are not just maintaining, but improving the
0:11:28 > 0:11:34quality of care across our NHS. Ruth Davidson I don't know if she
0:11:34 > 0:11:38understands the commitment we have made to primary care. She says we
0:11:38 > 0:11:44have not kept the commitment we made last year. . Over the life of this
0:11:44 > 0:11:49Parliament we will increase spending on primary care by £500 million.
0:11:49 > 0:11:51£250 million of that will be specifically in general practise.
0:11:51 > 0:11:55The reason not all of it is in general practise is that in order to
0:11:55 > 0:11:59take pressure off our GPs we need to build wider primary care teams.
0:11:59 > 0:12:04That's the commitment. That will take the proportion of NHS spending
0:12:04 > 0:12:07in primary care to 11%. That is the commitment we will deliver over the
0:12:07 > 0:12:11life of this Parliament. And I would say again, that is not a commitment
0:12:11 > 0:12:15that's repeated by any other Government across these islands. You
0:12:15 > 0:12:19know, we come back to the point here, the central point that we so
0:12:19 > 0:12:23often come back to, when we are discussing public services in this
0:12:23 > 0:12:26Parliament. This Government, the Government that I lead since we came
0:12:26 > 0:12:32to office have increased the health service budget by £3 billion. Again
0:12:32 > 0:12:36recognised in the Audit Scotland report. Ruth Davidson stands up week
0:12:36 > 0:12:41after week calling for action in health, for education, in a range of
0:12:41 > 0:12:44public services, but this is the same person who would reduce the
0:12:44 > 0:12:50amounted of money we have available for public services by giving tax
0:12:50 > 0:12:55cuts to the richest people in our society.
0:12:55 > 0:13:00Presiding Officer, it doesn't add up. Ruth Davidson cannot offer tax
0:13:00 > 0:13:04cuts to the richest whilst calling for more investment in our public
0:13:04 > 0:13:09services. The Tory policies and the Tory approach has no credibility at
0:13:09 > 0:13:14all. So we will continue to deliver the investment. We will continue to
0:13:14 > 0:13:19deliver the reform. Actually the most important finding in this Audit
0:13:19 > 0:13:23Scotland report today is the one that says these reforms that this
0:13:23 > 0:13:25Government is introducing are starting to show the positive
0:13:25 > 0:13:29effects they are designed to do. We will continue with that focus,
0:13:29 > 0:13:35delivering for people across the country.
0:13:40 > 0:13:42Presiding Officer, it is worth remembering that there was the
0:13:42 > 0:13:48report published a few weeks ago that showed that spending per head
0:13:48 > 0:13:52of population in Scotland compared to England had fallen as a result of
0:13:52 > 0:13:56the, direct result of decisions made by this Government.
0:13:56 > 0:14:02But I would say Presiding Officer that anyone reading this report from
0:14:02 > 0:14:06the auditor general this morning on the NHS in Scotland cannot be
0:14:06 > 0:14:10anything but concerned. Concerned about the budgets and the financial
0:14:10 > 0:14:15management of the health and social care in Scotland.
0:14:15 > 0:14:19Concerned about the shortages of staff at every level and concerned
0:14:19 > 0:14:25for the impact of all of this on patients. The report clearly states
0:14:25 > 0:14:30that the patient experience will get poorer, unless the pace and scale of
0:14:30 > 0:14:35necessary change is actioned and actioned now. When are we going to
0:14:35 > 0:14:39see that level of change being actioned?
0:14:39 > 0:14:44As any reading of the Audit Scotland report would tell you, we are seeing
0:14:44 > 0:14:49that change happen in the NHS. It is one of the key findings of the Audit
0:14:49 > 0:14:53Scotland report. One of the key points that is made in the Audit
0:14:53 > 0:14:58Scotland report that we are now starting to see, the reforms
0:14:58 > 0:15:03introduced, it looks specifically integration authorities and says
0:15:03 > 0:15:05these reforms are now starting to deliver the change that we need to
0:15:05 > 0:15:10see. In terms of spending, of course, spending per head of
0:15:10 > 0:15:16population on the health service in Scotland is 6.5% higher than it is
0:15:16 > 0:15:22in the UK as a whole. £143 higher for every person in Scotland,
0:15:22 > 0:15:28compared to the rest of the UK. And again, this is a point I make
0:15:28 > 0:15:32frequently. All parties have to be accountable for what they put
0:15:32 > 0:15:35forward. Labour went into the last Scottish election promising less
0:15:35 > 0:15:41money for the health service than any other party, even the Tories,
0:15:41 > 0:15:44for goodness' sake represented in this Parliament. The fact of the
0:15:44 > 0:15:49matter is, there is record funding going into our health service, there
0:15:49 > 0:15:52are record numbers of people working in our health service. But as Audit
0:15:52 > 0:15:56Scotland expressly says in this report, it is no longer enough just
0:15:56 > 0:15:59to put extra money into the health service because of the rising
0:15:59 > 0:16:04demand. We need to deliver reforms and those are the reforms that we
0:16:04 > 0:16:07are delivering, the reforms, according to Audit Scotland are
0:16:07 > 0:16:11starting to show real benefits to patients across the country.
0:16:15 > 0:16:21If we stick to the facts, we have health boards, across Scotland, not
0:16:21 > 0:16:27able to make the cuts to balance their budgets. Those same boards
0:16:27 > 0:16:31borrow money from the Government to balance the books, store and got
0:16:31 > 0:16:37debt for the future. Prescribing costs are increasing at a level that
0:16:37 > 0:16:43is not sustainable. Indeed, we now have council tax funding being used
0:16:43 > 0:16:50to be able to pay for prescriptions through the integrated joint boards.
0:16:50 > 0:16:54The lack of workforce planning is driving up costs and we are having
0:16:54 > 0:17:01to use more and more agency staff and locums. The entire thing is
0:17:01 > 0:17:07spiralling out of control. The Royal College of Nursing, Presiding
0:17:07 > 0:17:11Officer, are today calling for clarity on how more care will be
0:17:11 > 0:17:16delivered in the community, and they want to know how staff and the
0:17:16 > 0:17:20public will be engaged in the development of services, community
0:17:20 > 0:17:27services, moving forward. Can the First Minister answer that question?
0:17:27 > 0:17:34I am not quite sure which question he wants me to answer first. Alex
0:17:34 > 0:17:41says prescribing costs are rising. Prescribing costs are rising in
0:17:41 > 0:17:44every health service across the developed world, probably across the
0:17:44 > 0:17:49entire world. It is a feature of the ageing population and it is exactly
0:17:49 > 0:17:53the challenge health services here and elsewhere are dealing with, that
0:17:53 > 0:17:57is why we have got to reform how care is delivered. He asked about
0:17:57 > 0:18:02how we deliver more care in the community. As I am sure Alec Rowl
0:18:02 > 0:18:06knows, for the less two budgets, and again it is narrated in the Audit
0:18:06 > 0:18:13Scotland report, we have taken the very difficult step of transferring
0:18:13 > 0:18:16money from the NHS in the integration authorities, so that we
0:18:16 > 0:18:21bring together Health and Social Care Act not just in theory, but in
0:18:21 > 0:18:27practice, because we know, and Audit Scotland talks about the reduction
0:18:27 > 0:18:29in delayed discharges this integrated approach is now
0:18:29 > 0:18:36delivering. If we do that to build social care, we take the pressure
0:18:36 > 0:18:40off the acute services. To all the parties in Parliament, this is not
0:18:40 > 0:18:44easy stuff it is not easy in Scotland, England, Wales, Northern
0:18:44 > 0:18:48Ireland, any part of the world. But in Scotland, we are doing some of
0:18:48 > 0:18:52the necessary stuff still being dodged in most other parts of the
0:18:52 > 0:18:58UK. We are doing the reforms, integrating Health and Social Care
0:18:58 > 0:19:02Act, transferring the budgets, taking the steps around workforce to
0:19:02 > 0:19:05insure the NHS can deliver in the face of the rising demand basis, and
0:19:05 > 0:19:09that is why well everything the Audit Scotland report says is
0:19:09 > 0:19:13important and has to be addressed, the key finding of the Audit
0:19:13 > 0:19:17Scotland report in my view as First Minister with risk once ability but
0:19:17 > 0:19:22these reforms, the key finding is these reforms are starting to show
0:19:22 > 0:19:26positive signs. That says to me we stick with what we are doing because
0:19:26 > 0:19:32we are on the right track and that is why we keep that focus.
0:19:32 > 0:19:37Alec Rowley. I accept totally that this is not
0:19:37 > 0:19:43easy. And I think what the Audit Scotland report says today is we are
0:19:43 > 0:19:50not doing enough and not moving fast enough. As, however, important for
0:19:50 > 0:19:58us to remember that behind all the statistics is real people. So today,
0:19:58 > 0:20:03we should remember it is about people trapped in hospital because
0:20:03 > 0:20:08they cannot get the care packages that they need in the community. It
0:20:08 > 0:20:11is also about those people in communities across Scotland who
0:20:11 > 0:20:15cannot get the support from Health and Social Care Act that they need.
0:20:15 > 0:20:21And it is for all those people on the waiting list. And it is the
0:20:21 > 0:20:25dedicated staff in our hospitals and health centres and community care
0:20:25 > 0:20:31centres that are run off their feet, that is why we need action. Labour
0:20:31 > 0:20:36will use the debate in this Parliament next week to discuss this
0:20:36 > 0:20:41report further. I believe we do need a more detailed discussion on the
0:20:41 > 0:20:47findings of this report. After ten years in government, the First
0:20:47 > 0:20:49Minister has a choice, she can continue to do more of the same or
0:20:49 > 0:20:55will she publish a response to this report that will tell the people of
0:20:55 > 0:21:01Scotland how her government intends to tackle these big issues facing
0:21:01 > 0:21:06health and social care services in Scotland?
0:21:06 > 0:21:11Well, firstly, I welcome the fact we will debate the report, I warmly
0:21:11 > 0:21:15welcome that and maybe in that debate if Labour's position as the
0:21:15 > 0:21:18Government is not doing enough, maybe Labour will bring forward
0:21:18 > 0:21:22ideas as well, rather than simply talk about the problems. The second
0:21:22 > 0:21:28point is this, the point here which any Reading of the Audit Scotland
0:21:28 > 0:21:33report will tell you, is that we are not just doing more of the same, we
0:21:33 > 0:21:36are doing things differently and it is those reforms that are starting
0:21:36 > 0:21:40to have a positive impact the Audit Scotland report talks about. Alec
0:21:40 > 0:21:47Rowley says we should do it faster, well, I am absolutely open to doing
0:21:47 > 0:21:50this faster, but often when we bring forward proposals for change, what
0:21:50 > 0:21:55we find the impediments to those change sitting on the opposition
0:21:55 > 0:22:04benches. Because they never want to do... Then never want to do that
0:22:04 > 0:22:10stuff, they just want to get up here. It is the easiest thing in the
0:22:10 > 0:22:15world to diagnose the problems. Our job and what we are doing is coming
0:22:15 > 0:22:23up with solutions. And we will not do daft and wrong-headed things that
0:22:23 > 0:22:27we are seeing South of the border. Because of the action we are taking
0:22:27 > 0:22:30in Scotland, delayed discharges are coming down because of sensible
0:22:30 > 0:22:41change. In England, we see proposals to use Airbnb to get people out of
0:22:41 > 0:22:44hospital. We will continue to do the sensible evidence-based things that
0:22:44 > 0:22:48deliver the improvements in the NHS that we are determined to continue
0:22:48 > 0:22:57to deliver. A couple of constituency questions.
0:22:57 > 0:23:05The a 77 was closed for 24 hours because of severe flooding. The
0:23:05 > 0:23:09Director says, and I quote, it is quite clear from this and other
0:23:09 > 0:23:16incidents at the current A77 and a 75 do not fit the requirements. So
0:23:16 > 0:23:20major destruction and loss of trade could be major disruptions until
0:23:20 > 0:23:24they commit the necessary resources to evict these recurring problems.
0:23:24 > 0:23:29Will the Scottish Government make this long overdue commitment to the
0:23:29 > 0:23:36people of the South West of Scotland, and dual the roads?We
0:23:36 > 0:23:39have a range of improvements for the roads in the South of Scotland and
0:23:39 > 0:23:43all parts of Scotland. I'm sure all members will appreciate there are
0:23:43 > 0:23:48times when issues like putting will result in a road being closed and
0:23:48 > 0:23:51that is deeply regrettable but sometimes unavoidable. I will ask
0:23:51 > 0:23:55the Transport Minister to contact the member about this issue in more
0:23:55 > 0:23:59detail, but anybody looking at the record of this Government, and the
0:23:59 > 0:24:03Greens often criticise us for that, the investment we have made
0:24:03 > 0:24:06improving our roads over the past ten years is good and we will
0:24:06 > 0:24:10continue to do more including in the south-west and the area in
0:24:10 > 0:24:16particular the member talks about. The First Minister may be aware that
0:24:16 > 0:24:22the conclusions of the Government's review of free ferry fares due out
0:24:22 > 0:24:27at the end of the summer have not been published. In the Northern
0:24:27 > 0:24:31Isles, we were told freight fares would be frozen and we later receive
0:24:31 > 0:24:35notice they would rise by 2.9% next year. How does she just by this
0:24:35 > 0:24:43decision and houses square of government objectives for lowering
0:24:43 > 0:24:46the costs for those living on islands? And does she think it is
0:24:46 > 0:24:51right freight fares on West Coast routes remain largely unchanged
0:24:51 > 0:24:57since 2010 but have increasing evidently for hauliers serving
0:24:57 > 0:25:02Orkney and Shetland?We have invested over £1 billion in the
0:25:02 > 0:25:05ferry services in 2007 and have talked about a particular Audit
0:25:05 > 0:25:10Scotland report this morning and there was a report last week that's
0:25:10 > 0:25:17it investment in very services has doubled over the last decade. We
0:25:17 > 0:25:23have introduced new routes and cut the costs for Calmac customers and
0:25:23 > 0:25:28will do the same for Orkney and Shetland, so we have tackled
0:25:28 > 0:25:32underinvestment that had been the case for a long time and we will
0:25:32 > 0:25:37continue to do so. And the terms of the ferry fares review will be
0:25:37 > 0:25:44published as soon as possible. The First Minister will be aware of
0:25:44 > 0:25:48it gas explosion in a derelict building in Lanarkshire which
0:25:48 > 0:25:53resulted in the right -- tragic death of a worker from Coatbridge.
0:25:53 > 0:25:59How will she be supporting the investigation and what steps is she
0:25:59 > 0:26:04taking to enhance safety and work regulations in Scotland?I want to
0:26:04 > 0:26:12take this opportunity to express my condolences for the family of the
0:26:12 > 0:26:18man who died. The investigation under the health and safety division
0:26:18 > 0:26:22is ongoing and the family will of course be updated in relation to any
0:26:22 > 0:26:26developments. It would be inappropriate to comment further
0:26:26 > 0:26:33while those investigations are under way. This issue is reserved to the
0:26:33 > 0:26:36UK Government, the Health And Safety Executive is responsible for drawing
0:26:36 > 0:26:39conclusions as to whether the relevant regulations remain fit for
0:26:39 > 0:26:43purpose and I'm sure they will do so once they have completed their
0:26:43 > 0:26:46investigation into this particular incident. But the thoughts in the
0:26:46 > 0:26:51meantime of her body in the chamber with a family and friends of the
0:26:51 > 0:26:57individual who lost their life in this incident.
0:26:57 > 0:27:00Looking at today's report into the challenges facing the NHS, I don't
0:27:00 > 0:27:04think anyone should attend that there is a simple, quick fix that
0:27:04 > 0:27:11would solve every problem, but is it not clear that challenges like
0:27:11 > 0:27:15recruitment, retention and staff morale will be made worse, not
0:27:15 > 0:27:21better, if we fail to provide if there a settlement for the dedicated
0:27:21 > 0:27:24professionals providing these essential services who have seen a
0:27:24 > 0:27:31real pay cut of 14% over the last five years?
0:27:31 > 0:27:35Yes, that is why this Government is committed to ensuring we do see
0:27:35 > 0:27:40their pay settlements for public sector workers, not just in the NHS,
0:27:40 > 0:27:44but right across our public sector. Again, I would say I think we are
0:27:44 > 0:27:48still the only government anywhere in the UK that is giving the
0:27:48 > 0:27:54unequivocal commitment to lift the 1% public sector pay cap.
0:27:54 > 0:27:59The commitment has been given to lift the 1% pay cap, but no
0:27:59 > 0:28:03commitment has yet been given to an inflation -based increase, a real
0:28:03 > 0:28:08terms increase, restoring the lost value in people's pay that they
0:28:08 > 0:28:15suffered over recent years. We have heard yes MP's Kate Forbes, the PLO
0:28:15 > 0:28:18to the Finance Secretary who works with the Finance Secretary closely,
0:28:18 > 0:28:23saying on television this week pay settlement for the public sector
0:28:23 > 0:28:28should be at least inflation, if not above inflation. And we have also
0:28:28 > 0:28:34heard a wider range of voices from multiple political parties accepting
0:28:34 > 0:28:39the basic green proposition that their rates and balance of taxation
0:28:39 > 0:28:44can raise adequate revenue to fund our public services, without
0:28:44 > 0:28:48resulting in cuts elsewhere and without cutting the pay of public
0:28:48 > 0:28:51service workers. I don't expect the First Minister to publish her budget
0:28:51 > 0:28:56today, but does she agree with that basic point of principle that we can
0:28:56 > 0:29:00provide an inflation -based increase without hitting low earners through
0:29:00 > 0:29:07Beragh taxation? Firstly, we have given the
0:29:07 > 0:29:10commitment to lift the public sector pay cap, we have not made that
0:29:10 > 0:29:15dependent on actions being taken by the UK Government in the budget,
0:29:15 > 0:29:21unlike the Welsh Government which has done exactly that. We have said,
0:29:21 > 0:29:26and I have said personally, that we must look for pay settlements that
0:29:26 > 0:29:31of fair and of course they must be affordable, but they must also
0:29:31 > 0:29:35reflect the real-life circumstances public sector workers are facing and
0:29:35 > 0:29:40that includes the rising cost of living. We will of course, in the
0:29:40 > 0:29:44normal course of events, confirmed the detail of our public sector pay
0:29:44 > 0:29:48policy when we publish the budget because we require to know the
0:29:48 > 0:29:53overall budget we have available before we do that. That is the
0:29:53 > 0:29:57normal way we do things and we will continue to set out policy in that
0:29:57 > 0:30:04way. In terms of the part of Patrick Harvie's question focusing on tax, I
0:30:04 > 0:30:08have the game said openly that notwithstanding the different
0:30:08 > 0:30:11manifesto commitments we are required to come to a consensus
0:30:11 > 0:30:17position on tax in order to pass a budget. I think given the
0:30:17 > 0:30:20continuation of austerity and the implications of Brexit that are
0:30:20 > 0:30:25becoming clearer by the day, we need to ask ourselves as a Parliament how
0:30:25 > 0:30:30we use our still limited tax powers in order to protect our public
0:30:30 > 0:30:32services and provide the infrastructure businesses need to
0:30:32 > 0:30:37thrive. Next week, we will publish a discussion paper setting out some of
0:30:37 > 0:30:40the options and the principles to guide that's decision and that
0:30:40 > 0:30:45discussion paper will form the basis of the discussions across as
0:30:45 > 0:30:49Parliament in the lead-up to the budget. I suppose that is a long way
0:30:49 > 0:30:56of saying, I do agree with much of the sentiment behind Patrick
0:30:56 > 0:31:00Harvie's question, but we have to take proper decisions in line with
0:31:00 > 0:31:04the proper process of budgeting because unlike the opposition
0:31:04 > 0:31:08parties, the governing party in any Parliament has the responsibility of
0:31:08 > 0:31:13making sure we campaign for the commitments that we make. -- we can
0:31:13 > 0:31:18pay.
0:31:18 > 0:31:21The Government's policy of prioritising full-time college
0:31:21 > 0:31:26courses has result nds a cut of 150,000 part-time places. It has
0:31:26 > 0:31:29deprived thousands the education they want and need, particularly
0:31:29 > 0:31:34women and older people. Last week, the Education Minister sent a
0:31:34 > 0:31:39guidance letter to colleges with an apparent change in policy that had
0:31:39 > 0:31:42never been announced publicly before. Can the First Minister tell
0:31:42 > 0:31:48me, has the policy changed? If so, when did it change?Of course, I
0:31:48 > 0:31:52think most recent figures show the majority of college courses are
0:31:52 > 0:31:57still part-time courses. We and this was a commitment we set out in a
0:31:57 > 0:32:02manifesto. Given the rate of youth unemployment we faced at the time we
0:32:02 > 0:32:07made a deliberate decision and it was the right decision to try and
0:32:07 > 0:32:10increase full-time places at colleges in order to increase the
0:32:10 > 0:32:13likelihood of people going through our colleges, getting into work at
0:32:13 > 0:32:19the end of that and do you know what - the proof of the pudding is in the
0:32:19 > 0:32:24eating because youth unemployment in Scotland today is half the rate it
0:32:24 > 0:32:27was ten years ago when we took office. We have one of the lowest
0:32:27 > 0:32:31rates not just in the UK but anywhere across the European Union.
0:32:31 > 0:32:36The policy we will ask our colleges to pursue will depend on the needs
0:32:36 > 0:32:41of the economy at any given time and that is the basis for the guidance
0:32:41 > 0:32:45that the minister put forward that Willie Rennie has referred to.
0:32:45 > 0:32:50I think we see the evidence of that in some of the economic data I have
0:32:50 > 0:32:56talked about.So nothing is changed, but everything's changed? It is a
0:32:56 > 0:33:00bizarre answer. Has the policy changed or hasn't it changed? If
0:33:00 > 0:33:06this was such a success story, why did her minister sneak it out in a
0:33:06 > 0:33:12paragraph seven of a letter on a wet Wednesday afternoon? If it was a
0:33:12 > 0:33:15success she'd be parading knit this Parliament. Everyone knows, everyone
0:33:15 > 0:33:22knows if the birth rate at the turn of the century is more responsible
0:33:22 > 0:33:26for the drop in youth unemployment than any policy of this Government.
0:33:26 > 0:33:31The truth is it's taken six years for this Government to realise the
0:33:31 > 0:33:37economic value of part-time learner over the age of 24.
0:33:37 > 0:33:41This is a crashing U-turn and the First Minister should be big enough
0:33:41 > 0:33:48to admit. Six years of narrowing the focus has left us shot. That is six
0:33:48 > 0:33:53years of missed economic opportunity. Six years of abusing
0:33:53 > 0:34:02those in this chamber, who dared to question the policy. Will the First
0:34:02 > 0:34:06Minister now apologise to the generation of women and older people
0:34:06 > 0:34:12who have lost out because of this Government?
0:34:23 > 0:34:29Order please! Order please!
0:34:29 > 0:34:33I'd appreciate if members would list on the the question and listen to
0:34:33 > 0:34:36the answer. Thank you. First Minister?
0:34:38 > 0:34:42Probably the fact his pals on the opposition benches needed to give
0:34:42 > 0:34:46him so much help there, suggest they know how fundamentally wrong Willie
0:34:46 > 0:34:51Rennie is. I will not apologise for the fact we have youth unemployment
0:34:51 > 0:34:56at half the rate today than it was when this Government took office.
0:34:56 > 0:35:02Normally I apollise for the fact that we fought on a manifesto to
0:35:02 > 0:35:06maintain full-time numbers in our colleges. We exceeded that manifesto
0:35:06 > 0:35:12commitment. So these are solid achievements. But you know, the real
0:35:12 > 0:35:16flaw, the real flaw in Willie Rennie's question here is, in spite
0:35:16 > 0:35:20of delivering that commitment to increase full-time students at
0:35:20 > 0:35:24colleges in order to get more young people into work, the majority at
0:35:24 > 0:35:27our colleges tend to be part-time courses, open to the people that
0:35:27 > 0:35:31Willie Rennie is talking about. We will continue in colleges and every
0:35:31 > 0:35:35other aspect of Government policy to take forward the policies which are
0:35:35 > 0:35:37right for this needs oh this country. That is what we have done
0:35:37 > 0:35:42and we will continue to do.
0:35:48 > 0:35:53Thank you, Presiding Officer. Today's record has figures showing a
0:35:53 > 0:35:59quarter of Scottish councils are already spending almost £9 million
0:35:59 > 0:36:02mitigating the impact of Universal Credit. Does the First Minister
0:36:02 > 0:36:08agree with me that the impact on people left in dire financial states
0:36:08 > 0:36:14because of Universal Credit is morally unacceptable? And the idea
0:36:14 > 0:36:18that local authorities, or the Scottish Government should have to
0:36:18 > 0:36:31pay the price for failed Westminster austerity is a disgrace?
0:36:32 > 0:36:38Well, the fact that the UK Government is refusing to pause the
0:36:38 > 0:36:42implementation of Universal Credit knowing that they are pushing people
0:36:42 > 0:36:46into debt, into rent arrears, making it difficult for parents to put food
0:36:46 > 0:36:52on the take to feed their children is not just morally unacceptable, it
0:36:52 > 0:36:54is morally repugnant. Every Conservative should be deeply
0:36:54 > 0:36:58ashamed of this. The fact of the matter is that Universal Credit is
0:36:58 > 0:37:05not working. It is demonstrated in the pilot areas. I went to
0:37:05 > 0:37:08Inverness, talking directly to people who found themselves in these
0:37:08 > 0:37:13situations. We need to see a pause to Universal Credit and now before
0:37:13 > 0:37:19any other person has to suffer the indignities and anxieties so many
0:37:19 > 0:37:28have suffered. Again we come back to this issue about mitigation. As
0:37:28 > 0:37:34people across the chamber now we should mitigate where we can. On
0:37:34 > 0:37:37health, colleges, mitigating welfare cuts, implemented and imposed by a
0:37:37 > 0:37:41Conservative Government at Westminster. The sooner we get all
0:37:41 > 0:37:48the welfare powers into the hand of this Parliament, the better.
0:37:56 > 0:38:00Do you believe that cutting yet more firefighter posts and closing fire
0:38:00 > 0:38:06stations will, a. Make our communities safer or B, put more
0:38:06 > 0:38:19lives at risk? If you don't know the answer, have a guess.
0:38:20 > 0:38:27Firstly, let me... Sometimes you only have to listen to the tone to
0:38:27 > 0:38:34know the dire straits they are in. It is bad. Firstly, let me take the
0:38:34 > 0:38:37opportunity for thanking our firemen and women across the country for the
0:38:37 > 0:38:40vital work they do. It is the importance of that work that has
0:38:40 > 0:38:42meant that the Scottish Government this year has increased the
0:38:42 > 0:38:49operational budget of the Fire Service. There's been, since reform,
0:38:49 > 0:38:52no compulsory redundancies, no fire station closures. Over the last year
0:38:52 > 0:38:57we have seen the recutdment of 100 new -- recruitment of 100 new
0:38:57 > 0:39:02firefighters. They cannot standstill when circumstances are changing.
0:39:02 > 0:39:05There are changing risks, changing patterns of demand, changing
0:39:05 > 0:39:11technology. It is right the Fire Service look closely at how they
0:39:11 > 0:39:15deal with that. The priority of them and this Government is not just
0:39:15 > 0:39:19protecting the front line, but enabling our firefighters to do a
0:39:19 > 0:39:25better service for the people of Scotland in the future.
0:39:25 > 0:39:30Could I ask the First Minister what progress has been made with the
0:39:30 > 0:39:33reaching 100 programme, for those who did not receive support from
0:39:33 > 0:39:39previous programmes for access to super fast broadbandsThe digital
0:39:39 > 0:39:43programme Scotland programme has been a huge success so far. It has
0:39:43 > 0:39:48enabled fibre broadband to be delivered to over 800,000 premises
0:39:48 > 0:39:53in Scotland and we are on track to meet 95% of premises with broadband
0:39:53 > 0:39:56by the end of this year. However, we recognise that many areas still
0:39:56 > 0:40:02don't have access. That's why the reaching 100 programme will focus on
0:40:02 > 0:40:05extending super fast access to those premises that will not be reached in
0:40:05 > 0:40:10the current programme. We've completed an open market review and
0:40:10 > 0:40:14public consultation to formally agree an intervention area and
0:40:14 > 0:40:18undertaken engagement to maximum competition. We will set out a
0:40:18 > 0:40:22delivery approach in greater detail shortly ahead of the launch of the
0:40:22 > 0:40:26procurement exercise later in the year.
0:40:26 > 0:40:33I congratulate the Scottish Government on its success on rolling
0:40:33 > 0:40:38out super fast broadband. Tens of thousands of military stations have
0:40:38 > 0:40:41benefitted from the programme. I wonder if the First Minister would
0:40:41 > 0:40:45recognise the one side effect of the success is the gap between the haves
0:40:45 > 0:40:49and the have-nots. They have got bigger and many rural communities
0:40:49 > 0:40:54have not benefitted or received any form of public support. Whilst we
0:40:54 > 0:40:58await the next programme, the roll out of 100, can the ministers
0:40:58 > 0:41:01consider any other short-term measures, perhaps working the
0:41:01 > 0:41:05private sector to connect such communities who in this day and age
0:41:05 > 0:41:13see it as a utility, not a luxury. Can they press UK ministers for
0:41:13 > 0:41:16regulation like introducing universal onably thegations and the
0:41:16 > 0:41:22like -- obligations and the likes of BT who are charging the same amounts
0:41:22 > 0:41:26for widening levels of service?I am very acutely aware that some
0:41:26 > 0:41:32premises, particularly in the rurl parts of the country don't yet have
0:41:32 > 0:41:41fibre broadband access, that is why the Reaching 100 Programme will seek
0:41:41 > 0:41:47this. While it offers residents the premises with broadband speeds of
0:41:47 > 0:41:52less than two megabits a second. The costs of alternative solutions. I am
0:41:52 > 0:41:59sure all members will want to make their constituents aware of that. As
0:41:59 > 0:42:02Richard Lockhead knows it is a reserved function. There are a range
0:42:02 > 0:42:07of issues which need to be addressed. We are working to ensure
0:42:07 > 0:42:10that Scotland's particular challenges are considered and indeed
0:42:10 > 0:42:20will be calling for a more regional approach. The problem with that of
0:42:20 > 0:42:24course is it's not delivering broadband at super fast speeds. But
0:42:24 > 0:42:27we will continue to deliver in our own programme and continue to press
0:42:27 > 0:42:30the UK Government to take action that they need to take in order to
0:42:30 > 0:42:34deliver the same. Question number six.
0:42:34 > 0:42:39Thank you Presiding Officer. To ask the First Minister what actions the
0:42:39 > 0:42:44Scottish Government is taking to hold to account NHS boards that do
0:42:44 > 0:42:51not meet the waiting time targets? We work with and support NHS boards
0:42:51 > 0:42:55to deliver targets. In May we announced £50 million would be made
0:42:55 > 0:42:58available to improve waiting times between now and the end of March
0:42:58 > 0:43:02next year. In August we announced the setting up of an expert group to
0:43:02 > 0:43:05improve the way elected care services are managed across all
0:43:05 > 0:43:10boards. Derek Bell of the academy of Royal Colleges who will lead that
0:43:10 > 0:43:15work was the same person what did similar work which led to the
0:43:15 > 0:43:20improvement of A&E waiting times. We are investing in the diagnostic
0:43:20 > 0:43:23centres over the period of this Parliament.
0:43:23 > 0:43:28I thank the First Minister for that answer. I'd like to just put out
0:43:28 > 0:43:33some things hooer to help the First Minister so she does vptd to address
0:43:33 > 0:43:39them in her answer.Staff in NHS Scotland are dedicated and hard
0:43:39 > 0:43:44working. We appreciate what they do. Failing to reach seven out of ten
0:43:44 > 0:43:48targets is OK because other places in the UK are worse, it doesn't help
0:43:48 > 0:43:51people who are waiting for treatment. Making targets easier is
0:43:51 > 0:43:56not acceptable table. Just increasing spending on the NHS won't
0:43:56 > 0:44:01solve the problem. Therefore, turning to the Audit Scotland
0:44:01 > 0:44:05report, it says previous approaches, such as providing more funding to
0:44:05 > 0:44:09increase activity, or focussing on specific parts of the system, is no
0:44:09 > 0:44:13longer sufficient. There is no doubt the situation is getting worse. And
0:44:13 > 0:44:17the Health Secretary was unable to say this morning on Radio Scotland
0:44:17 > 0:44:25when it would get better. What is the First Minister going to do to
0:44:25 > 0:44:29ensure our NHS has the leadership that it desperately needs, but clear
0:44:29 > 0:44:41lilacs?We certainly -- clearly Lacss. - lacks.
0:44:41 > 0:44:45There was so much in that, I was going to say, it wasn't really a
0:44:45 > 0:44:49question. There's so much in there that's making targets easier. One of
0:44:49 > 0:44:55the things we've done over the past ten years is make many of the NHS
0:44:55 > 0:44:59targets tougher. That is one of the challenges we face. While many of
0:44:59 > 0:45:04them, and I have not said it is OK we are not meeting them. We are
0:45:04 > 0:45:07performing better against tougher targets than used to be the case
0:45:07 > 0:45:10against targets that were weaker. We are toughening up many of these
0:45:10 > 0:45:17targets. In other words, stretching our expectations of what the NHS
0:45:17 > 0:45:21delivers, at the same time as demand on the NHS is increasing. We will
0:45:21 > 0:45:24continue to take the action I have set out here several times already
0:45:24 > 0:45:30today. Investing record sums. Making sure record number of peoples are
0:45:30 > 0:45:34working in our NHS but also taking forward the difficult, but necessary
0:45:34 > 0:45:38reforms that will equip our NHS to deal with rising demand now and in
0:45:38 > 0:45:39the years to come.
0:45:44 > 0:45:49What is this Government -- what is the Scottish Goodman put that
0:45:49 > 0:45:53position on whether public sector workers should be given a real terms
0:45:53 > 0:46:01pay increase in 2018-2019.As I made clear today, the 1% public sector
0:46:01 > 0:46:08pay cap ends in 2019. Enter stand the impact cuts are having on
0:46:08 > 0:46:15working households and we will set out our plans on December 14 and
0:46:15 > 0:46:19develop a pay policy that is affordable and that recognises
0:46:19 > 0:46:22real-life circumstances like the cost of living and supporting those
0:46:22 > 0:46:27on the lowest incomes. Public sector workers in Scotland and across the
0:46:27 > 0:46:32UK deserve a fair deal and the UK Government should follow our lead
0:46:32 > 0:46:35lifting the pay cap and ensuring there is proper investment in our
0:46:35 > 0:46:44vital public services.In recent years, the policy of a public sector
0:46:44 > 0:46:48pay cap followed by the Scottish Government has resulted in 156,000
0:46:48 > 0:46:53health service and police staff being worse off in real terms. This
0:46:53 > 0:46:58is unacceptable and the budget is the opportunity to address that.
0:46:58 > 0:47:03This issue was raised previously by Patrick Harvie and we got two
0:47:03 > 0:47:10minutes of offal by the First Minister, so let me give the First
0:47:10 > 0:47:18Minister a chance to answer the question. Does she support the
0:47:18 > 0:47:21position that the pay rate should be set to at least inflation and will
0:47:21 > 0:47:25the Government bring forward the consequential tax changes required
0:47:25 > 0:47:32to give public sector workers the pay rise they deserve?We will bring
0:47:32 > 0:47:36forward the detail of our spending plans and our tax plans in the
0:47:36 > 0:47:42budget that will be published on December 14, but the Aprot receipt
0:47:42 > 0:47:47of Labour on this issue is quite frankly staggering because we set --
0:47:47 > 0:47:52we said the pay cap will be lifted and have not made that dependent on
0:47:52 > 0:47:54actions taken elsewhere and that is completely different to the position
0:47:54 > 0:48:00taken by Labour. I have a letter here. I will not want to hear this!
0:48:00 > 0:48:07They will not want to hear this! I have a letter here from the Health
0:48:07 > 0:48:11Secretary, the Labour Health Secretary in Wales, the Jeremy Hunt,
0:48:11 > 0:48:16the UK Health Secretary. It says this, I quote, without a commitment
0:48:16 > 0:48:18from the UK Government to give the Welsh Government more money, the
0:48:18 > 0:48:25public sector pay cap will remain. That is what Labour in Wales say. So
0:48:25 > 0:48:31here is what we have got. Labour called for the cap to be lifted in
0:48:31 > 0:48:36Scotland, they called for the cap to be lifted in Westminster, but in
0:48:36 > 0:48:39Wales, the only part of the UK where they have got the power not just a
0:48:39 > 0:48:42call for things to be done, but actually to do things, Labour
0:48:42 > 0:48:47refused to give a commitment to raising the public sector pay cap.
0:48:47 > 0:48:53What does that tell us about labour? This is what it tells us about
0:48:53 > 0:49:04Labour, Labour poll mouth and no action! -- Labour is all mouth.
0:49:04 > 0:49:10There we have it, ending on the subject of pay linked to taxation.
0:49:10 > 0:49:15The primary questions on health and we will get to that in a moment.
0:49:15 > 0:49:18I'm joined now by journalists Libby Brooks and Robbie Dinwoodie.
0:49:18 > 0:49:23The issue of pay Commission was saying to end the 1% cap and it was
0:49:23 > 0:49:28unique in Scotland to offer that. But not committing to a particular
0:49:28 > 0:49:32level of pay for public services. Patrick Harvie was trying to push
0:49:32 > 0:49:40her to give an indication of how much of 1%.James Kellie said, no
0:49:40 > 0:49:44more waffle.Which brought the response in Wales that Labour are in
0:49:44 > 0:49:50control and they said there will be no change in the pay cap. Nicola
0:49:50 > 0:49:54Sturgeon's argument is regardless of what comes in the Westminster
0:49:54 > 0:49:57settlement, there will be a lifting of the pay cap, but how much, she is
0:49:57 > 0:50:04not giving away.It is linked to this issue of taxation and we learnt
0:50:04 > 0:50:09the document to assess what the opposition parties are proposing on
0:50:09 > 0:50:15tax will be published next week as part of the Scottish budget in
0:50:15 > 0:50:17December.Yes, Nicola Sturgeon is not going to pre-empt the budget,
0:50:17 > 0:50:23but Patrick Harvie was pushing very hard to get Turk just to commit to
0:50:23 > 0:50:32Beragh taxation and she revealed the discussion paper would be launched
0:50:32 > 0:50:35next week to set out the different positions of the parties on
0:50:35 > 0:50:39taxation, with the aim of reaching a consensus, which means the budget
0:50:39 > 0:50:45can be passed.Is it a U-turn on colleges or not regarding part-time
0:50:45 > 0:50:49payments? A crashing U-turn according to William Rennie.We
0:50:49 > 0:50:56don't know. The letter suggested it would focus on part-time courses.
0:50:56 > 0:51:00And the argument of the Liberal Democrats and critics more widely is
0:51:00 > 0:51:05the overwhelming focus on full-time courses has been costed for women
0:51:05 > 0:51:11and older students. But as Nicola Sturgeon pointed out, the majority
0:51:11 > 0:51:17of college courses remain and ways have been part-time. So I am not
0:51:17 > 0:51:22that clear.Almost adapting the circumstances. Stay with me for a
0:51:22 > 0:51:30second. Behind me, this is health-related and celebrating the
0:51:30 > 0:51:37fact there has been an almost complete eradication of polio. And
0:51:37 > 0:51:44we had that Audit Scotland report which is critical, but it also says
0:51:44 > 0:51:48there is satisfaction among patients with the NHS. I discussed that with
0:51:48 > 0:51:54two MSPs, Miles Brick the Tory MP first, the point about users of the
0:51:54 > 0:51:59health service being satisfied.In terms of the public and politicians,
0:51:59 > 0:52:04there is huge support for the NHS, of course. But the's Audit Scotland
0:52:04 > 0:52:07in what was shocking and this is even worse and that is a real
0:52:07 > 0:52:10wake-up call for the Government. What the Audit Scotland report
0:52:10 > 0:52:16outlines is how is our health service not working for the public?
0:52:16 > 0:52:20That is something we have to find solutions in this Parliament about.
0:52:20 > 0:52:25Waiting times have gone up, improvements appear to have stalled.
0:52:25 > 0:52:31This report is very critical of the NHS.There is challenges the NHS in
0:52:31 > 0:52:35Scotland face and they are not unique, they are faced by NHS and
0:52:35 > 0:52:39health services across the world as the population ages.I take your
0:52:39 > 0:52:45point, but your ministers responsible for the position in
0:52:45 > 0:52:48Scotland.There are lots of positives in this report about
0:52:48 > 0:52:53patient satisfaction, about the increased investment in the NHS.
0:52:53 > 0:52:59Increased staffing levels. Do you accept that are positives in this
0:52:59 > 0:53:01report as well, patient satisfaction is high and the NHS is making
0:53:01 > 0:53:07improvements?In terms of the health service, the Government have eight
0:53:07 > 0:53:10priority areas and they failed to meet all but one last year and this
0:53:10 > 0:53:14year they have failed to meet all but one, why is that not being
0:53:14 > 0:53:19progressed if these are the Government's priority areas, which
0:53:19 > 0:53:21they consistently failing?They are targets you have set yourself and
0:53:21 > 0:53:25you have not met them.We are looking at improving waiting times
0:53:25 > 0:53:29and have recently announced an expert group to look at waiting
0:53:29 > 0:53:34times and how they improved the patient experience.I hear what you
0:53:34 > 0:53:37say about improvements but the findings are that things are not
0:53:37 > 0:53:42getting better. The report is highly critical.We have looked at the
0:53:42 > 0:53:45biggest changes in Health and Social Care Act over the last year's and we
0:53:45 > 0:53:49are starting to see improvements in our health care through the
0:53:49 > 0:53:55integrated authorities.Starting to see improvements? I support the NHS
0:53:55 > 0:53:58staff 100% but meeting them on a day-to-day basis, they are not
0:53:58 > 0:54:04seeing these changes, they are seeing crisis after crisis and we
0:54:04 > 0:54:07launched a save our surgeries campaign because it is clear general
0:54:07 > 0:54:12practices on the edge. Recruitment is in crisis throughout the service
0:54:12 > 0:54:16and people are handing back their keys. The gateway to our health
0:54:16 > 0:54:19service is DUP is and if we cannot get that right in Scotland, the rest
0:54:19 > 0:54:28of the service will continue to decline -- the gateway to our health
0:54:28 > 0:54:31service is GPs.Millions is being invested. Increasing GPs and
0:54:31 > 0:54:38training. Advanced nurse practitioners. Investment in
0:54:38 > 0:54:44community pharmacy, two EV eight pressure off GPs.Scotland's health
0:54:44 > 0:54:47is not improving and the NHS is facing significant challenges. You
0:54:47 > 0:54:53say there is progress, not according to this report which is an
0:54:53 > 0:54:55independent study.This government is putting lots of money and
0:54:55 > 0:55:00investment and programmes into improving Scotland's health and the
0:55:00 > 0:55:08NHS is not the sole arbiter. It is not working. We are putting money
0:55:08 > 0:55:12into baby boxes, free school meals, increasing exercise and active
0:55:12 > 0:55:17travel to improve the nation's help. They have tried to get a GP
0:55:17 > 0:55:21appointment and they have been told weeks to wait, that is not
0:55:21 > 0:55:24acceptable. We need urgent action and politicians working on this
0:55:24 > 0:55:32together.Politicians across parties need to work together, absolutely.
0:55:32 > 0:55:37We are seeing improvements in our NHS. That is due to the improvements
0:55:37 > 0:55:44this Government is driving.Thank you both very much.
0:55:44 > 0:55:46Two members of the health committee discussing that the Audit Scotland
0:55:46 > 0:55:52report and two journalists joining me now. Let's talk about how it went
0:55:52 > 0:55:56down in the chamber, Nicola Sturgeon robust and fighting back criticism
0:55:56 > 0:56:00from the Conservatives and Labour. She has it easier with the
0:56:00 > 0:56:02Conservatives on this because she can simply point the finger back to
0:56:02 > 0:56:07Westminster. Later, there was a question about Universal Credit and
0:56:07 > 0:56:14she said, if we did not have the spend our money mitigating this
0:56:14 > 0:56:18failed Westminster Mass, more of that could go to help on colleges.
0:56:18 > 0:56:23So pointing out the failings of the English system and this daft idea
0:56:23 > 0:56:26that people with spare bedrooms might be encouraged to take on
0:56:26 > 0:56:30patients, but at the end of the day, it goes back to the act that she is
0:56:30 > 0:56:38in charge here. This report does not make British Reading.In terms of
0:56:38 > 0:56:40the politics in the chamber, the attack was vigorous from Ruth
0:56:40 > 0:56:47Davidson and Alex Rowley, but a vigorous bottle as well.Nicola
0:56:47 > 0:56:50Sturgeon is a former Health Secretary and it is hard to rattle
0:56:50 > 0:56:54her on this territory and she kept coming back to the fact that Audit
0:56:54 > 0:57:01Scotland did say that her reforms were bearing fruit.The report does
0:57:01 > 0:57:07say that indeed. And yet she was under the individual items of
0:57:07 > 0:57:12workplace learning for example, they were pursued by her colleagues.By
0:57:12 > 0:57:16the same token, she was pointing to the very specific nature of
0:57:16 > 0:57:21Scotland's needs in terms of an ageing population and the
0:57:21 > 0:57:29difficulties of getting staff in rural and remote areas. And that the
0:57:29 > 0:57:32reforms are specifically tailored to Scotland and that they are beginning
0:57:32 > 0:57:37to come through.I was struck by something in the report mentioned by
0:57:37 > 0:57:42the First Minister, she said the report says it is not about money
0:57:42 > 0:57:45primarily any more. It is about money of course, but perhaps
0:57:45 > 0:57:54different ways of doing things.That is absolutely true. As Ruth Davidson
0:57:54 > 0:57:56said, you are not changing fast enough. There is some evidence for
0:57:56 > 0:58:02that. There is evidence that the changes being made are also
0:58:02 > 0:58:08beginning to bear fruit. It is not easy. The NHS is like a giant
0:58:08 > 0:58:13supertanker. It is very slow and hard to make it turn. I think any
0:58:13 > 0:58:17sign they are beginning to get things on the right track to cope
0:58:17 > 0:58:21with increasing demands of the day quite encouraging, but it is taking
0:58:21 > 0:58:26a long time to come through. Population projections say
0:58:26 > 0:58:30Scotland's population will increase and it will also age is a balance to
0:58:30 > 0:58:36add to the pressure on the NHS. Absolutely. One of the key issues
0:58:36 > 0:58:45raised in the chamber was that the front line pressure on GPs and
0:58:45 > 0:58:47recruitment being...Recruitment falling on that level. Thank you
0:58:47 > 0:58:53both very much indeed. Discussion on the NHS and the question of tax
0:58:53 > 0:58:58which will be a big decision for the Scottish Government to make in the
0:58:58 > 0:59:02aftermath of the UK budget. The UK budget details first in November and
0:59:02 > 0:59:08then the details of the Scottish budget in December. I am away to
0:59:08 > 0:59:12cover more on that health service issue, and also to find out whether
0:59:12 > 0:59:17Dundee United have managed to get a manager during this programme. You
0:59:17 > 0:59:21can see the pain and the anguish! From me, Brian Taylor, goodbye.