Meeting of the Parliament 04 February 2015
I welcome the opportunity to participate in this afternoon’s stage 3 debate.
Labour approached the budget this year with three very clearly defined asks: a front-line fund of £100 million for our NHS, in addition to the money that is already being put in; a resilience fund of £10 million to mitigate the large-scale job losses; and a Scottish office for budget responsibility, at a cost of less than £1 million, to ensure trust and transparency by providing independent financial scrutiny and economic forecasting.
We also asked that the cabinet secretary sit down with local government to look at the huge cuts that were having to be made to councils’ budgets, most notably in education. Despite that request being greeted with much laughter from Scottish National Party members a fortnight ago, that is exactly what the cabinet secretary has done in relation to teacher numbers—but more of that later.
Our budget requests are based on what we believe is in the interests of the country and what is needed immediately. This is no shopping list—we have made a series of measured requests that are all fully costed. Mr Swinney has substantial resources available from the Barnett consequentials arising from the autumn statement, and they can fund in full all our budget requests.
I will start with the front-line fund for our NHS. I listened very carefully to what the cabinet secretary had to say: not one penny more is being allocated to health. The cabinet secretary simply announced what he would do with the remaining £127 million of consequentials that have already been allocated to health. No one can be in any doubt about the pressure that our hospitals and accident and emergency departments are under. Despite the very best efforts of our NHS staff, there is a limit to what they can do without the back-up of adequate resources.
Every week, newspaper headlines highlight the crisis in A and E services. There are stories of older people lying on trolleys waiting for beds for as long as 21 hours. In a case that I know of, a woman who was suffering from acute chronic obstructive pulmonary disease was discharged from hospital in the morning, readmitted to A and E in the afternoon and then spent more than 12 hours on a trolley waiting for a bed. It was clear that she was not fit to be discharged, but such was the pressure on beds that she was sent home far too early, only to end up back in on the same day. That is inefficient use of NHS resources. Such has been the pressure that we have also witnessed portakabins that had been mothballed for years being pressed into use.
If anyone needs any more convincing, they need only look at the A and E statistics that were published yesterday; the target for waiting times at A and E has not been met. Some health boards managed only 85 per cent against a target of 95 per cent—although, of course, the target that the Scottish Government really wants to drop quietly is the 98 per cent target. The stats are for the last quarter of 2014, before there was significant additional pressure on our NHS. Clinicians tell me that there is no longer such a thing as winter pressure and that such pressure is now the norm all year round.
In January, we saw hospital after hospital under strain. Some, including the Western infirmary in Glasgow and the Royal Alexandra hospital in Paisley, closed their doors to new admissions. I fear that things will get worse before they get better.
We have been subjected daily to stories about the state of the NHS in England, too. The other night, I watched a documentary that exposed the extent of the problem in accident and emergency services. That was bad enough, but it turns out that the situation in Scotland is worse than that in England—and we do not have to contend with the reforms that David Cameron has inflicted on the NHS in England.
The cabinet secretary talked about a budget of more than £12 billion, but what he will not talk about is the Institute for Fiscal Studies report that suggested that there is a real-terms reduction in health spending in Scotland. I seem to recall that the excuse at the time was that account had not been taken of the Commonwealth games, which was in the health budget; today I understand that the excuse is the efficient way in which the cabinet secretary deals with capital. I look forward to the next excuse appearing over the horizon, but I suggest that consistent excuses might be desirable.
I point out to the cabinet secretary that in the period 2007 to 2010, when there was a Labour Government in the United Kingdom, the NHS was given inflation-busting increases, which the SNP failed to pass on fully to our NHS in Scotland. Perhaps if the SNP had done that we would not be in the position that we are in.
Our NHS front-line fund would help to move hospitals to some evening and weekend working, so that elective procedures could be carried out at weekends and diagnostics could take place in the evenings. That would make best use of our hospitals and ease the pressure on A and E.
I am told that the Scottish Government will review the position, but the truth is that we have had reviews and even pilots—at least four in different health boards in 2013—but since then there has been silence. The need is self-evident. The time for review is past; the time for action is now. However, the cabinet secretary has not allocated one new penny today.
I have highlighted the very tight financial settlement for local government and the particular impact that that is having on delivery of education. I am pleased that the cabinet secretary has engaged in discussion with COSLA about maintaining teacher numbers, but it is clear that no agreement has been reached and so he has imposed a deal. I think that that is a first. The concordat to which the cabinet secretary signed up lies in tatters.
The terms of Mr Swinney’s offer are curious. I think that the original letter said £8 million, but I heard him say £10 million today, which I take as an improvement, but one local authority said that that was not enough—[Interruption.] It was not a Labour-controlled authority. It said that the amount that it would receive would not even cover its advertising bill for new teachers. [Interruption.]