Hansard

Thank you, Presiding Officer.

The SNP turns its back on Scotland’s front-line medics and nurses, while we are listening to their concerns and their ideas for rebuilding the NHS. They tell us that the crisis in the NHS cannot be resolved until we tackle the crisis in primary care and social care. Dr Andrew Buist said:

“Our primary care system is the foundation of the NHS in Scotland and desperately needs more, not less, investment. I genuinely fear for practices already struggling to keep pace with spiralling demand. The consequences for the communities deprived of their GP services—or having to cope with a brutally diminished service—are severe.”

What was the SNP’s response? It cut £5 million from GP budgets and £65 million from primary care. It presided over a cut in the number of whole-time equivalent GPs—numbers have gone down by 81 since 2017—at the same time as it promised more. That is a legacy of failure that is now driving up pressure and demand in the NHS.

However, that is not the only broken promise that is piling pressure on the NHS. Eight years ago, the SNP pledged to end the dangerous and costly practice of delayed discharge. It failed. Tackling delayed discharge is vital in supporting our NHS. As Dr Iain Kennedy has said:

“The key to unlocking the front door of our hospitals lies at the back door.”

He went on to say that the exit block

“is the real reason for many of the issues at the front door of our hospitals.”

The SNP failure to tackle delayed discharge is causing huge capacity issues for hospitals, with potentially deadly results. It is not the fault of the people occupying the beds; it is a failure in social care, due to a lack of investment over years. Until there is parity of esteem between health and social care, we will not end the problem. We must support a system that values health and social care equally, is rooted in the community and is about funding prevention and not just crisis. That means support for voluntary sector activities that sustain people in their communities. The Government’s approach of cutting budgets for such things is short-sighted and just plain wrong.

I turn to social care staff. In the chamber, we have all rehearsed the health vacancies numbers and the exodus of staff from the NHS: there are 6,400 nurse vacancies; there is a 14 per cent vacancy rate for consultants in some areas; and there are too few GPs to cope with demand. However, there is little said about the rising number of social care vacancies and the difficulty in recruiting and retaining staff. Of course, the Government does not bother to gather that data. If social care mattered, the staff would be counted. If social care mattered, the Government would pay the predominantly female staff a decent wage.

Time and time again, Labour has called for decent pay for Scotland’s care workers. In two successive budgets, we have called for a wage of £15 an hour. The Government should start immediately by providing £12 an hour and then negotiate a path to the rest.

However, time and time again, this SNP Government has voted with the Tories against Labour’s proposal. The Greens, who made promises about that in their manifesto, have quietly dropped their promise—the price of their ministerial Mondeos is being paid for by social care staff.

Although the SNP and Greens pay lip service to our care workers, they are happy for them to be paid less than supermarket staff. It is little wonder that we now face an exodus of staff.

Earlier today, I welcomed the social care sector, care workers and family carers to the Parliament for a round-table discussion. They could not have been clearer about the change that is needed.

We must not forget the enormous debt that we owe to family carers, who work day in, day out to care for their loved ones. By doing so, they relieve pressure on the NHS and the social care system.

However, they are being failed, too. Care packages have been slashed and respite care has been withdrawn. The SNP has failed to implement key recommendations of the Feeley review, including scrapping non-residential care charges. That alone would make such a difference to the cost of living for those who rely on social care, but the SNP dithers and delays.

There is no doubt that our NHS and social care system is in disarray. Lives are being lost and staff are exhausted. It does not get any more serious than this. No amount of shuffling the deck chairs will end the crisis.

However, the SNP could act now. Let us have a credible recovery plan that is not just about applying short-term sticking plasters but about applying a long-term approach that recognises the immense contribution of primary and social care.

To start, the Government needs to invest in primary care, reverse the planned cuts and put in place a credible workforce plan that will deliver more GPs and more staff.

In social care, the Government needs to scrap non-residential care charges—that could be done overnight—end delayed discharge and give social care workers a decent wage rise.

The SNP’s flagship national care service is in a great deal of trouble. There is a lack of vision, and it is more about structures than about changing culture. It will cost £1.3 billion, not a penny of which will go on providing direct care. The proposal is increasingly being rejected by stakeholders. Let us pause the National Care Service (Scotland) Bill, use the money to fund care packages now and take the time to get it right.

The NHS and social care are standing at the cliff edge of a catastrophe. The situation could not be graver. I do not believe that all hope is lost. Nye Bevan, the founder of the NHS, said that the system would continue to exist

“As long as there are folk left with the faith to fight for it.”

Scottish Labour is ready to fight for it; NHS staff are ready to fight for it; millions of Scots who owe the NHS their lives are ready to fight for it; and Scotland is ready to fight for it. Is this Government ready to fight for it?

If it is, the Government will back Labour’s motion today. That will send a message to thousands of NHS staff that all is not lost. It will send a message that this Parliament is united, across party lines, in defence of our NHS. It will also send a message to thousands of Scots on waiting lists not to give up hope.

I move,

That the Parliament is deeply concerned about the experiences of patients and staff across Scotland’s NHS; notes that in recent weeks A&E has recorded the worst ever performance against the 4-hour target, levels of delayed discharge have reached their highest ever and record numbers of people are waiting for appointments, tests and treatment; considers that this has not been caused by short-term problems, but is the result of 15 years of the Scottish Government failing to tackle systemic issues in Scotland’s health and social care system, and believes that, instead of sticking plaster solutions, Scotland needs an NHS Recovery Plan that is community care-led, focuses on preventative healthcare, properly values social care and delivers £15 per hour for social care staff, and has a fully-funded and sustainable workforce plan for health and care services so that Scotland’s NHS is fit for the 21st century.