Hansard

No, I am sorry—I have taken enough interventions.

That happened at a time when the birth rate had increased by 10 per cent, the number of complex births had increased, conditions related to drugs and alcohol were being increasingly recognised and there was a shortage of midwives in the United Kingdom. That was a parochial, bad decision.

I welcome the fact that almost all the decisions on cutting student intake numbers have been totally reversed. However, for the Government to reverse its decisions within two years of the announcement of its workforce plan is a disgraceful sign of poor planning. John Pentland will illustrate the consequences of that in Lanarkshire.

We have been calling for an independent, robust and integrated monitoring and inspection system. That should happen now, with an examination of the emergency systems in each board. There should be more thorough inspections, through Healthcare Improvement Scotland’s programme of inspecting elderly care and involving the Healthcare Environment Inspectorate, of boarding out and delayed discharge. As the cabinet secretary said in answer to an oral question earlier this afternoon, the whole integrated system of emergency care must be looked at.

There are problems across the whole NHS community and hospital system. This is about demand: there are inadequate preventative or reablement measures, there is inadequate diversion to keep people out of hospital and there is pressure on accident and emergency. Those are partly due to a lack of a whole-system approach to the NHS, GP out-of-hours services—we heard about the situation in Cumbernauld during oral questions today—and delayed discharge. Rhoda Grant will talk a little bit more about care in the community in relation to the motion.

The problems have never been seen more clearly than over Christmas and the new year when A and E departments were swamped. Patients lay on trolleys for up to 24 hours. Some patients were readmitted, having just been discharged, only to lie on trolleys for 14 hours. Hospitals were closed to new admissions. I can validate the fact that consultants were seriously having to be dissuaded by medical directors from leaving at the door the next patients who arrived in ambulances. We have not seen such a situation since 1997. We have not even had the challenge of a bad winter. The level of flu is subnormal at the moment, although my advisers say that it is about to rise.

In 2008, Shona Robison proudly announced that Labour’s target of zero delayed discharges from hospital of more than six weeks had been met, but her hubris led her to say that not only had the Government achieved that important target but delayed discharges would remain at zero. That was a claim too far. In 23 out of the 27 subsequent reported quarters, that level of zero delayed discharges—promised by Shona Robison, now the cabinet secretary—has not been achieved.

Despite that failure and the damaging and unprecedented squeeze on local authority care budgets, Nicola Sturgeon, in one of her last acts as Cabinet Secretary for Health, Wellbeing and Cities Strategy, set new targets for maximum delay of four weeks from April 2013 and two weeks from April 2015. That is another extraordinary decision for a system that is under huge pressure and in which staff who are serving above and beyond are being required to do even more.

The critical issue is that when beds are blocked, admissions from A and E are delayed, resulting in the trolley waits that I have described. Since 2012, the number of occupied bed days has risen by 25 per from 30,000 to 42,000 a month, excluding code 9 patients. That masks a vast variation. For the over 75s, Renfrewshire has reported a rate of only 308 occupied bed days per 1,000 people, whereas Aberdeen city has reported 2,212 occupied bed days per 1,000 people. That is another example of variation that needs to be properly inspected. Will the cabinet secretary invite HIS and the Care Inspectorate to examine the reasons for that variation? Will she commit to working with local authorities, particularly in the cities of Aberdeen and Edinburgh, which have the bigger problems?

In my remaining 60 seconds, I turn to the UK mansion tax. That is an example of risk sharing and benefit sharing. The tax will be levied by Labour to support the NHS not just in Scotland, but in every area across the UK. It will be paid only by those with residences that are worth more than £2 million, and there are only 895 such residences in Scotland. Our proposal is about the redistribution of wealth that has been accumulated in London. I know that Boris Johnson objects, but we all contribute to that wealth. We all contribute to the development of that megacity, so redistribution from it is entirely appropriate.

I said at the beginning of my speech that it is the duty of an Opposition to be critical, but I acknowledge that, until 2011, the Scottish Government was making good progress. I welcome the Government’s acknowledgement in its amendment of some of the pressures and challenges that exist, which are reflected in the worsening statistics. We share common principles with the Government, but we need to resolve the problems before our hard-working staff burn out.

I move,

That the Parliament believes that the NHS in Scotland is under extreme pressure, with waiting times rising at accident and emergency (A&E) departments across the country, people waiting on trolleys for hours and waiting time targets missed in many hospitals; pays tribute to the hard working staff of the NHS; notes that the NHS staff survey reported that 75% of Scotland’s nurses think that there are not enough of them to do the work; welcomes Scottish Labour’s commitment to fund 1,000 extra nurses in the NHS from a UK-wide mansion tax that will pool and share the resources of the UK for the benefit of Scotland’s health service; notes the impact that these nurses will have on pressure points for the NHS services in mental health, A&E and community nursing; further notes that delayed discharge targets are not being met across Scotland; deplores the Scottish Government’s record in breaking its own law guaranteeing treatment in 12 weeks over 12,500 times across the country, and notes the situation of those patients who have had their legal rights breached by the Scottish Government.