Hansard

As I was saying, in 2008, Audit Scotland said that despite the Government’s policy of shifting the balance of care closer to home, there was

“no evidence available to show changes in the balance of expenditure”

had occurred. In its 2009 report, it said the same thing—that

“significant changes in the balance of care from acute to more community-based services have yet to become evident”.

In 2014, the same thing was said. Last year, in its 2015 report, Audit Scotland was scathing about the Government when it said:

“the Scottish Government has not made sufficient progress towards achieving its 2020 Vision of changing the balance of care to more homely and community-based settings”.

We know what the 2016 report says: exactly the same thing—no progress, no shift in the balance of healthcare, and much more action required.

Year after year, the warnings have been ignored and we are now at breaking point. Despite the long wait, I welcome some of points that were made in the cabinet secretary’s statement earlier. I welcome the fact that the Government intends to accelerate the shift from acute care to primary, community and social care. I welcome the fact that the Government is committing to shifting 50 per cent of front-line NHS funding to outwith the acute hospital sector. However, the fact remains that that should have happened years ago, when Audit Scotland first raised the issue.

That said, as I read the cabinet secretary’s amendment I was encouraged. I thought, “At last—a genuine attempt to set out a list of actions, some of which we could support.” I should have known better. The final line of the amendment refers to UK Government welfare policy. How depressing that, at the last, the cabinet secretary chose to include a partisan red herring at the end of her amendment to try to shift the blame on to someone else. As far as I have been able to see, the Audit Scotland report makes no mention whatever of the effects of welfare policy. Reverting to type is an attribute of the Government.

Let us rise above that. It is clear that a fundamental change in direction is required. To carp from the sidelines is futile and, as a strong Opposition, we do not intend to do that. I have said it before and I say it again—blanket opposition to change in the NHS is irresponsible. The NHS can never be static and we accept that tough decisions have to be taken. The current political debate is failing the NHS because saving the health service now and for the future is more important than the politics of anyone in Parliament.

We want to contribute positively to that endeavour, which is why the Scottish Conservatives are setting out 15 things that we say can be done now and over the next few years to take our NHS through this difficult period, thereby showing that there is a middle course between underaction and overemotion. We are setting out several proposals that we feel can help our NHS to grow, to meet the challenges ahead and, crucially, to ensure that many of the recommendations that Audit Scotland has routinely made can be met.

For example, we are calling on the Government to consider the following: to give immediate clarity on which services will change and which will not; in the next six months, to evaluate the impact of splitting elective and acute care; to expand mental health services into primary, emergency and community settings; and to publish a national workforce plan and commit to six-monthly updates to this Parliament. Those are just a few examples; they are just sensible, straightforward and pragmatic suggestions that should be being implemented but are not. They should be being implemented because in order to solve the problems that exist, new ideas are required.

To sum up, if the SNP truly cares about the future of our health service and wants to provide better government for Scotland instead of endless constitutional navel-gazing, it must deliver an NHS that is fit for not just the next five years, but for the next 25 years and beyond.

I hope that the Audit Scotland report goes down in Scottish political history as a seminal moment in the story of our health service. I hope that the report really does mark a turning point, because we are truly at the stage of make or break.

I move,

That the Parliament welcomes the publication of the Audit Scotland report, NHS in Scotland 2016; believes that the report paints a picture of a health service in crisis; notes that the NHS in Scotland has failed to meet seven of its eight key targets, that NHS boards are facing unprecedented levels of savings and that the health service as a whole is experiencing widespread problems in recruiting and retaining staff; believes that, after almost 10 years in power, the SNP administration must take responsibility for the clear and significant failures in the NHS, and, as a matter of urgency, calls on the Scottish Government to set out its response to all of the recommendations made in the Audit Scotland report.