The next item of business is a debate on motion number 346 in the name of Shona Robison on taking Scotland forward, delivering a healthier Scotland. May I invite members who wish to speak in the debate to press the request to speak buttons now? I call on Shona Robison to speak to and move the motion. Thank you, Presiding Officer. It's a privilege to be back here in the job that I relish driving forward, a healthier Scotland, and ensuring services are fit for the future. This Government has a mandate to ensure that health and social care remain at the top of our agenda, reflecting our strong record of protecting our NHS from the impact of UK Government's austerity measures continue to protect people from prescription charges, which, of course, are a tax on illness and continue to champion an NHS in public hands with services free at the point of use, continuing to press for an explicit protection for the NHS on the face of the TTIP agreement and continuing record levels of investment to ensure that our NHS remains world-class and recognised for quality and patient safety. That reputation has been won by thousands of dedicated staff who work in our health and social care sector, and we pay tribute to their tireless effort whenever we debate health and social care. I do so again today very briefly. Neil Findlay. Is it only the NHS that the cabinet secretary is concerned about in relation to TTIP? Why should she give an unequivocal opposition to TTIP? Shona Robison. We made it very clear that we want explicit protection for the NHS on the face of the TTIP agreement, and we have been consistent about that. We see that as the key priority within that trade deal and, indeed, for other trade deals as well. We want to go further in this Parliament. We will enshrine, save staffing levels in law and put nursing and midwifery workforce planning tools on to a statutory footing. We will create an additional 1,000 nursing and midwifery training places, retain the nursing and midwifery bursaries and explore ways to support those in greatest need, including a discretionary fund of at least £1 million for nursing and midwifery students facing financial hardship. We will increase the number of GPs, and nurses working in communities will increase GP training and medical school places, including a new graduate medical school, and we will train 500 additional advanced nurse practitioners. We will also train 1,000 paramedics to work in the community. We will improve the recruitment and retention alongside continuing our no compulsory redundancy policy. We will enable the living wage to be paid to social care workers supporting some of the most vulnerable members of our society. Despite the record of success and what I have laid out in our priorities going forward, I do not shy away from some of the difficult issues. There are considerable challenges ahead to improve population health and to tackle health inequalities, to ensure parity between mental and physical health, to shift the balance of care to people's homes and communities, to ensure positive interventions for children and to ensure that health and social care services are seamlessly responsive to local needs. Those things matter to the people of Scotland. They told us so as part of the national conversation on creating a healthier Scotland last year. That conversation reached around 9,000 people through 240 events with over 360,000 website and social media inputs. That fantastic response formed the basis of the report on the key outcomes of the conversation that I published in March, which focused around six key themes. First, preventing illness, the vital importance of mental health and wellbeing, person-centred care, the need for increased awareness of the range of social care services available, the need for more accessible and flexible services and a real recognition of the challenges ahead and the need for clear priorities. What is important here is the interrelationship between our priorities for health and wellbeing and those for raising attainment and sustainable economic growth. In our press conference after her election victory, the First Minister referred to education, health and economic growth as the Government's top priorities. The three are inextricably linked. Improving the population's health and addressing health inequalities cannot be tackled solely as a health issue. It needs and will get cross-portfolio working between health and, for example, education and social security. A healthy population and returning people to health are key to economic prosperity. I am committed to taking forward our health and social care agenda in the context of public sector improvement and against the four pillars of public sector reform in our response to the Christy report. Prevention, integration at a local level, workforce development and a focus on performance with targets being outcomes-based. It is in this context that, as the way in which we deliver health and social care changes, we will ensure that the structure of our NHS and its relationship with local government reflects those changes. That is why we are committed in this Parliament to review the number, the structure and the regulation of health boards and their relationship with local councils with a view to reducing unnecessary backroom duplication and removing impediments to better care. That is a cornerstone of our national clinical strategy, which will be the blueprint for health and social care over the next 15 years. Its foundation is to provide care as locally as possible through a whole team community-based approach, which is vital to the future of the NHS, allowing people to continue to be treated close to home or in their home in the vast majority of cases. When hospital care is needed, I want the best results for patients. Evidence shows that people who need very specialist treatment often get better outcomes by receiving it from teams who are doing complex operations more frequently. The strategy outlines how complex treatments may be delivered in specialist centres with follow-up treatment available locally. It also outlines proposals to support smaller and rural hospitals to deliver for their communities, including having clinicians working across more than one hospital to allow specialist input to be delivered in remote and rural locations. There are good examples of that happening already, which we need to build on to ensure equity of access to expert care for everyone. The key commitments in our manifesto underpin this Government's future focus for health and social care, so that by 2020 we will have secured our vision for people living longer, healthier lives at home or in homely settings and, over the period out to 2030, we will have in place policies, systems and services that support people to begin their life well, live well, age well and die well. Our approach will continue to be underpinned by the quality strategy and the triple aim of better health, better care and better value. It will deliver transformational change in three key areas, shifting from a fix-and-treat approach to prevention and anticipation, shifting from doing things to people to working with them in active partnership and shifting the balance further from hospital to community care. We will drive those changes through four interconnected key initiatives, the reform of public health services and renewed emphasis on population health improvement, renewed focus on getting it right for every child, the implementation of the national clinical strategy and the continued roll-out of health and social care integration. The national clinical strategy and continued integration, driven at local levels, will put clinicians in consultation with the public at the centre of redesigning care to deliver better patient outcomes and they will support the transformational shift from hospital to community based and from unplanned to planned care. The direction of travel reflects the approach and the chief medical officer for Scotland's report on realistic medicine that has been widely welcomed. The key commitments in our manifesto will therefore be the building blocks for transformational change. We will support people to start their lives well through the development of a 10-year child and adolescent health and wellbeing strategy and the continued roll-out and extension of family nurse partnerships to provide support for young first-time mothers. We will support people to live well through the cancer strategy, which enjoyed widespread support in other parties' manifestos supported by £100 million of investment. Through a range of commitments to expand primary care services by, for example, giving GP practices access to enhanced pharmacists and recruiting 250 community link workers, I want GP practices to become more of a community health service involving teams of health professionals and others, working together under the guidance of a GP with people who are seeing the right professional at the right time. We are testing that approach already through new models of care, some based around community hubs, and we will underpin that with the new GP contract in 2017. We are developing a 10-year plan to transform mental health care. Mental health was a key theme from the national conversation in this commitment, and the appointment of Maureen Watt as a dedicated minister for mental health shows that we have listened and acted, and Maureen Watt will say more about mental health later in her closing speech. We will support people to age well through the protection of free nursing and personal care for the elderly, a new three-year dementia strategy, and investing £200 million in five new elective centres and expanding the golden jubilee so that we can meet the increased demands of an ageing population and are better prepared for winter pressures, reduce cancellations, reduce delayed discharge and a reduction in the use of the private sector. I will support people to die well by ensuring that everyone who needs it has access to palliative care, designed with people and their families in mind and ensuring parity between public funding for children and adult hospices. I am also committed to ensuring that our approach to targets will be outcomes-based, to give people the best possible care according to need. Targets have served us well and have driven many demonstrable improvements over the last 10 years, for example lower waiting times and safer environments. Some continue to be and will remain vitally important to patients, such as speedy access to cancer treatment and swift progress through our emergency services in and out of hospital. Of course, a continued sharp focus on tackling delayed discharge. The time is now right to take stock of what we ask from the NHS in conjunction with our partners in social care and to ensure that our approach is consistent with the outcomes-based focus of health and social care integration enshrined in statute and with the new integrated delivery landscape. I am therefore announcing that, over the summer, we will undertake a consultation in conjunction with staff, stakeholders, social care and clinical partners to review our approach to targets, with a view to publishing a document on the way forward in 2016-17. An expert group will be set up to lead that review. It is also important that we have systems in place that will allow us to see how the NHS is performing, regardless of whether there is a specific target in place or not, and to ensure more consistency across Scotland. I will therefore consider, as part of the review, how we monitor performance more generally, including areas where there is no formal target. All parties called for a review of targets during the election campaign, so I hope that that will have cross-party support today. I suggest to Labour that they feed in their views on appropriate cancer targets into that review, rather than through an amendment today, which I think would be premature. Delivering transformational change will involve extensive engagement with the public and professionals alike. People rightly expect to engage with us on health policy and delivery, and I am committed to doing just that. Last year, I announced our voice, a framework to support people to get involved at every level to improve health and social care services. We are recruiting 1,200 members of the public to a national citizens panel, which will consider a range of important questions related to health and social care. We are supporting people to feed back on their day-to-day experiences of healthcare services through the independent website, Patient Opinion, and we are supporting teams across Scotland to build a culture of continuous improvement, founded on asking the people who use services what matters to them. As we move forward in the direction of outline today, we do so from solid foundations. Under this Government, we have a record high health budget of £12.4 billion in 2016-17 and will increase the NHS revenue budget by £500 million above inflation by the end of this Parliament. We have record high levels of staffing, as confirmed in today's official figures. We have high patient satisfaction ratings. 86 per cent of people are fairly or very satisfied with local health services. We have cleaner hospitals with MRSA cases down by 93 per cent between March 2007 and December 2015. We have a 16.5 per cent reduction in hospital standardised mortality ratios since implementation of the Scottish patient safety programme in 2008. That is around 20,000 fewer than expected deaths—an astonishing reflection of the hard work of thousands of dedicated staff. That is a record that everyone working in health and social care can be rightly proud of. However, I am aware that there are huge challenges ahead and difficult choices and priorities to be made. I hope that we can unite across this chamber to rise to those and to continue to build on the consensus that we secured around last year's national conversation. As I did for that conversation, I want to invite again the Opposition spokespeople to meet with me to discuss how best to take that plan forward. I hope that that invitation will be positively responded to. I am very happy to move the motion in my name. I now call on David Cameron to speak to and move amendment 346.4. Sorry, Donald Cameron, how could I? At least it wasn't Donald Trump. I don't think I'll respond to that. Thank you, Mr Cameron. I'll start all over again. I now call Donald Cameron to speak to and move amendment 346.4. You have up to 11 minutes. Thank you, Deputy Presiding Officer. I would like to begin by reiterating my congratulations to Shona Robison on her reappointment as health secretary as well as welcoming the other members of her team. I am both delighted and humbled to have been appointed the shadow cabinet secretary for health and sport. This portfolio comes with a huge responsibility that I and my colleagues in the Scottish Conservative health team take very seriously. We look forward to working with the cabinet secretary towards the healthier Scotland that everyone wants to see. Where we can find common ground with the Scottish Government, we will work together and consensually, and I am happy to accept the invitation that she has just extended to us to come and meet and discuss matters with her. However, we will not shy away from holding this SNP Government to account on all aspects of health, and I will later set out some areas of concern that we say need to be highlighted and addressed as soon as possible. Our priorities are to ensure that our health service has the sustainable funding that it needs, that patients can tailor treatment to their own preferences, and that mental health achieves parity in principle and in practice with physical health. On that last point, we welcome the Scottish Government's commitment to mental health, and in fact we would like to see an extra £300 million specifically committed to it. The urgency of this issue is highlighted by the staggering statistic that one in four Scots suffer from mental health problems at some point in their lives, and as the SAMH has noted, one in three GP appointments have a mental health component rising to one in two in Scotland's most deprived areas—a very real and stark example of true health inequality. Our young people in particular deserve improvement in mental health provision. There is much to do here, and my colleague Miles Briggs will elaborate on some of our plans. In sport, we will continue to advocate for an opening up of access to clubs and facilities that delivers huge benefits in terms of health and opportunity. Preventative health will be a key focus of this parliamentary session, and my colleague Brian Whittle will set out our priorities here later this afternoon. On the key point of funding for our health service, I think that the first thing to do is to repeat my predecessor Jackson Carlaw's clear conviction that the Scottish Conservatives are committed to a publicly funded health service that is free at the point of use. We are also committed to protecting NHS funding, which is why we want to see it protected by a health guarantee whereby funding increases each year by the highest of inflation, barnic consequentials or 2 per cent—a triple lock, as it were. That would mean an extra £1.5 billion of funding by the end of this Parliament, taking the overall budget to £14.5 billion by 2021-22. We stand by the same, and it is welcome that the Scottish Government has committed to increasing the NHS revenue budget by £500 million more than inflation by the end of this Parliament. Will the cabinet secretary set out for the sake of clarity exactly how much the Scottish Government expects the overall budget to reach by the end of the Parliament? Will the cabinet secretary commit the Scottish Government to matching the triple lock in our health guarantee? As we all know, NHS budgets in Scotland did not rise as much as they did in England in the last Parliament. In relation to targets, the Scottish Government must, and now in the light of what has just been announced, recognise that some top-down targets imposed on the NHS may, in some cases, be putting pressure on staff, which will not be in patients' best interests. We therefore believe that now is the time to review the top-down target system to identify those targets that effectively drive improvements for patients and those that do not. That should be the acid test. A full review of NHS targets is needed, so staff are always focusing directly on patients' needs. I am very grateful that the cabinet secretary has announced a consultation. We, in our manifesto, sought such a review of targets, and I would ask her to set out a definitive timetable for when that consultation occurs, when it reports, etc. As well as considering those arrangements, we must focus on the principal challenge that is faced in the NHS, its model of primary care. The advent of GP hubs is welcome, but I am already aware of the huge pressure facing GP surgeries across Scotland, not least in terms of GP's workloads, but with list sizes for practices having grown by 10 per cent since 2005. That is exacerbated by the crisis in GP recruitment and retention. While staffing levels in general across the NHS are seriously concerning, the situation relating to GP's in particular must be urgently addressed. According to the Royal College of General Practitioners, by 2020 Scotland will be 740 GP short of bringing coverage per head back to level scene in 2009. That statistic has been cited already in debates in this chamber in the last few weeks, but it is an important one and bears repeating. Make no mistake, this is a crisis and it is one that the SNP must have seen coming. If they didn't see it coming, then they should have seen it coming, not least because they have been in power since 2007 and yet have singularly failed to prepare for the desperate situation we now find ourselves in. With a third of GP's set to retire within 10 years, we need a lot more than the increase of 7 GP's per year that this Government managed between 2009 and 2013. Can the cabinet secretary say how many more GP's she expects there to be in Scotland by 2020? I sincerely hope that the Scottish Government produces a detailed, meaningful plan to deal with this crisis and I look forward to hearing it. To start with, budget allocations to general practice should increase in absolute and proportionate terms each year. The scope to relieve pressure on hospitals can be further realised by putting pharmacies at the heart of primary care. As set out clearly in the Scottish Conservative manifesto, which the First Minister, or one of her many acolytes, apparently forgot to read before her speech a couple of weeks ago, we too proposed that the minor ailment service should be expanded to benefit primary care. I noticed that the Scottish Government has already made some nods in this direction, but I hope that they will back this up with concrete commitments. Moving on to hospitals and health boards themselves, new elective and diagnostic treatment centres are welcome. However, a point I would like to highlight is that we must not allow these schemes to detract from the many small community hospitals that are so important to the public across Scotland. Representing the Highlands and Islands, I am acutely aware of the need for remote rural areas to have access to the same health services that are available elsewhere. To take one example, someone in Arden and Merkin, who is pregnant and requires a scan, needs to travel to Inverness, a round-trip of approximately eight hours, to get that scan. Or, for example, a parent who lives in Aberfeldy will have to drive to Dundee to access out-of-house services if their child falls ill at the weekend. We Scottish Conservatives are determined to open up access for rural Scotland, and I look forward to working with stakeholders to make this a reality. I would also like to highlight another priority in the Scottish Conservatives' plans for health, which is to put patients in charge of their own treatment and care. If the health service is to be sustainable in the face of demographic challenges and yet to remain responsive to each user's need, it must combine flexibility with personal responsibility and self-management. We believe that the right way to approach this is with a principle of no decision about me without me, so patients are consulted on treatment decisions and can express preferences on aspects such as the location of appointments. We also need to increase the availability of information for the public so that everyone is fully aware of the services available to them without having to navigate a myriad of phone numbers and websites. One idea that is worth considering is for annual statements setting out local health and social services to be sent to the public in their own homes. On the other hand, providing more flexibility should also bring more responsibility for patients themselves. There needs to be an injection of personal responsibility to ensure that the health service can serve everyone to the best of their ability. One thing that is worth looking at is for health boards and GP surgeries to, in certain circumstances, be allowed to find patients who miss appointments three times without a good reason to. A final area that I would like to touch on is the integration of health and social care. We have been and remain supportive of on-going integration and we share the recognition across this chamber of the potential for more effective service delivery. However, we have concerns regarding the resourcing to support this. Is the Scottish Government confident that the allocated budgets are adequate and will they be spent efficiently? I will continue to provide constructive input as those partnerships develop, but we must ensure that we do not end up simply moving bureaucracy from one body to another. There is an overarching need to promote more joint working and information sharing between health and social care and the third sector, so that organisations such as housing associations, pharmacies and voluntary bodies can bring their full weight to bear. The Scottish Conservatives will work with the Scottish Government to secure the best approach to reform of health service, but we are also here to ensure that every decision is made in the best interests of patients and the general public, and that will always be our starting point. We will hold the Scottish Government to account on planned reforms and on daily performance, but the Government also needs to think deeply and to think radically about long-term reform of the NHS. Will it be enough simply to keep the NHS afloat in its present state, patching here and there with short-term solutions? Or will the Scottish Government grasp the chance to make our whole health service sustainable in the long term? In fact, this debate is not just about the next five years, but about the next 25 years. It is about the health service that will exist then meeting the needs of our children and our grandchildren. It is about showing the vision and courage to remodel that service for future generations in the face of huge demographic challenges. That is where the Scottish Conservative team and I have set our sights. I move the amendment in my name. I now call Anna Sarwar to speak to a move amendment. I need my glasses now. My first job was in the NHS, so it is with great pride that I rise to speak in this debate as Labour's shadow cabinet secretary for health. I begin by congratulating Shona Robison on her reappointment as the cabinet secretary. I look forward to working constructively with her and her colleagues in the health team. I do believe that there will be many areas of common ground where Labour and the other parties in this chamber can work together. I believe that we have a majority across this Parliament who want to be bold in how we tackle Scotland's health challenges. The question is whether we have the will. We have an opportunity today to demonstrate consensus and send a message to cancer patients and the wider Scottish public that this Parliament will be bold, will act and help deliver transformative change. I have listened to the comments that the cabinet secretary made about a review, and of course Labour will engage in that process. However, what a review cannot be is a way of avoiding failures with missed targets. Another question that patients will be asking is how long will they have to wait until the outcomes of any such review? Also, if the review was such a fundamental part of today's debate, why was it not included in today's motion? I would suggest that our amendment was in place first and the review came after. I do not think that this review will be of any comfort to a cancer patient waiting to hear about a possible cancer diagnosis, so I hope that the minister will reconsider how they vote on our amendment today, because I do believe that we can find consensus on this issue. I would say that, respectively, if we cannot have a target on cancer, what should we have a NHS target on happy to? We do have targets on cancer—the 62-day and the 31-day target—and we have £100 million investment going forward in a cancer strategy. Wouldn't it be better to engage with clinicians and other stakeholders in looking at what further work needs to be done on getting the right measurements, rather than just do it through an amendment today, which runs counter to the whole direction of travel? I thank you for that intervention. I am happy to engage with stakeholders. We have a 62-day waiting time guarantee. It has not been met since the last quarter of 2013, so we need to have action from this Government, not just reviews and blind promises. However, I do believe that we can find consensus, but there will be times that we will, of course, have to challenge the Government's record and the Government's performance. In only the past two weeks, we have seen extensive media coverage on the chronic failures on waiting times in A and E, on cancer treatment times and on shameful figures on the widening health gap between the richest and poorest in our society. However, let there be no doubt that criticism will never be a reflection on our NHS workforce, who I know from personal experience go above and beyond to care and support Scotland's families. Indeed, many of my criticisms will be because I am defending NHS staff, who are often overworked, overstretched and undervalued. I look forward to getting to meet and learn from the thousands of hard-working and passionate healthcare and social care staff from across our NHS, who every day seek to do their best for their patients. I am sure that this whole Parliament will want to send a clear message of thanks to each and every one of them. The Government has already made clear that its priority in this Parliament is to close the attainment gap. We can only do that if we are serious about closing the inequality gap too. The health inequality statistics make grim reading for all of us. They are shameful. Health inequality is on the rise, Deputy Presiding Officer. Life expectancy mapped out because of your postcode, the circumstances of your parents and your level of education. Health inequality's limited social mobility restrict economic growth and strangle opportunity for far too many of our fellow citizens. The scale of the gap is so wide that I believe that only a bold and ambitious approach to new ways of working in the NHS and genuine collaboration across this chamber will deliver the long-term changes that we all want to see. Indeed, tackling inequality should be our greatest cause. I welcome the Government's commitment in the motion to increase spending in real terms on the NHS, but I must question this Government's commitment to tackling our inequalities with its refusal to use the tax powers of this Parliament to end austerity and provide more money for public services. So make no mistake that over the course of this Parliament we will be looking very closely at health board budgets set by this Government to see if, despite promises of more resources, local services are being cut. Families will be looking closely at decisions on the children's ward at St John's, the children's ward at the Royal Alexandria hospital and maternity services at the Vale of Leven. I am sure that the cabinet secretary recognises that some of her greatest challenges come from the care sector and ever growing older population and budgetary pressures. That has not helped by the £1.4 billion cut imposed on local authorities since 2011. Cuts that do not only cause problems for council services, the backlog of patients waiting for a care package has a knock-on effect on our NHS, with beds blocked, procedures cancelled and resources lost. It is Scotland's shame that 270 Scots died last year waiting for care packages. That is why this Government needs to be bold and speed up the time that it takes to agree a social care package. Time constraints limit what I want to say about mental health. I know that my colleague Monica Lennon will say more, but I want to say this. The time for parity between mental and physical health is long overdue. Its impact on individuals and families is just as great as physical health problems, in many cases, more so. For so many mental health problems, it is with them for long periods of their life, often from childhood and into adulthood. I want to turn to the amendment that I formally move in my name. For cancer patients, the link between the speed of referral, treatment and outcome is well documented. How quickly you are diagnosed and when your treatment starts is vital in ensuring the best possible chances of a positive outcome. Women who are diagnosed at the earliest stage of breast cancer are six times more likely to survive than those who are diagnosed at the latest stage. The evidence could not be clearer. However, more than 3,500 cancer patients have not started treatment within the Scottish Government's own waiting time target. When we know, every day counts. However, in yesterday's cancer patient experience survey, almost one in five patients say that they think that they should have been seen sooner after suspicions arose. That is why we continue to support Government efforts. I am running out of time, so I apologise. Labour's amendment recognises the Government's position on number of areas, but we need to do more. Today, the Parliament has an opportunity to better the experience for cancer patients. We believe that if a GP suspects that a patient has cancer, they should see a specialist and get the results within a fortnight. That is an opportunity for this Parliament to work constructively to set an achievable ambition and improve the experience of cancer patients. Cancer is Scotland's biggest killer. It is time to be bold in how we treat it. I urge the Scottish Government and members across the chamber to support Labour's amendment. Thank you. Thank you, Mr Sarwar. We now move to the open debate. Speech is up to six minutes. Clare Haughtie, to be followed by Brian Whittle. I call Clare Haughtie, please. Thank you, Presiding Officer. You may be aware that this is the first national infant mental health week. As a mental health nurse who has worked with mothers in their infants for the past 12 years, I warmly welcome this initiative. I hope that this will be the first of many such weeks aimed at raising awareness and knowledge of this very important issue. Many in this chamber may wonder what exactly infant mental health is, and the term refers to how well a child develops socially and emotionally from birth until the age of three. It is about a child developing the ability to form secure relationships with adults and their peers, and it is about them being able to manage and to express a full range of emotions and being able to explore their environment and to learn from it. All of these are essential building blocks for developing well-rounded healthy children and adults. When a baby is born, it is pre-programmed to seek out and adapt a relationship with a primary carer or a parent, and babies look for that person and develop a strong bond with them. This is evolution's answer to the prolonged period of helplessness of human child experiences, a way of ensuring survival. It looks to a parent for love, for food, for care and for comfort from distress. This attachment to the caregiver helps to create the basis of a sense of self, of inner confidence and of a place in the world, of a sense of security and certainty that their needs will be met and that they will be looked after.  It provides a window of opportunity to have a huge effect on a child's chances of achievement, of success in life and of their happiness, but genes only provide a blueprint for an infant's brain, an infant's environment and its experiences carry out that construction work. Research on brain development in infants has rewritten the textbooks over recent years. There is strong evidence to suggest that the quality and content of a baby's relationship with their parents may affect the development of their neurobiological structure of their brain, and this is a structure that is harder to alter the longer that goes on for better or for worse. With the first few years of life seeing the most rapid brain growth, producing 700 new neuro connections every second, it is not difficult to realise the importance of getting it right for every child from the start of life. In other words, for a baby's brain, if you don't use it, you lose it, and if a part of the brain doesn't fire, it doesn't wire. The Government, through the national parenting strategy, sets out an aspiration to make Scotland the best place in the world to grow up, providing parents and families the information and the tools that they need to ensure good infant mental health and development, and that's essential. Programmes such as Play, Talk and Read, where public health messages about the importance and benefits of interacting with your baby, are explained and encouraged, continuing to provide families with books, materials, advice and support through Bookbug, not only giving families books to read and share but also in their singing and rhyming sessions, promoting the benefits that those interactions have in developing speech and language and in building confidence in social skills. Midwights in anti-natal education and health visitors also play a key role in promoting good infant mental health. The additional 500 health visitors by 2018, as outlined in the manifesto, will help to enhance this work. However, some parents have more complex needs and for them other services have been developed. That is why I particularly welcome the significant investment that the Scottish Government has made in family nurse partnerships. That is a strong evidence-based programme that was developed in the USA over the past 30 years. Research has shown that it has significantly improved the health and wellbeing of disadvantaged children. Family nurse partnerships are a preventative programme for vulnerable first-time mothers. It offers intensive and structured home visiting, delivered by specially trained nurses. The named individual nurse works with the family from early pregnancy until the child is aged 2. The family nurse partnership has three aims—to improve pregnancy outcomes, to improve child health and to improve parents' economic health sufficiency. Following a pilot in NHS Lothian, it was rolled out to other health boards and has evaluated well in a Scottish context. The family nurse partnerships will continue to be rolled out to provide their targeted support to all eligible teenage mums by the end of 2018. With further investment, initially £4 million, the programme will also be extended to vulnerable first-time mothers aged 20 to 24 who currently do not qualify for the service and to include more children who are at risk of going into care. In addition to those initiatives, the Scottish Government and its election manifesto promised to work with mental health charities, stakeholders and service users to put in place a 10-year plan. That plan will transform mental health services, including those for children and young people. Additional funding for child and adolescent mental health services has already been delivered. The number of child psychologists has doubled, but intimate mental health must be seen as an essential part of any future service development. We need our babies and infants to be healthy, both physically and mentally, so that they can grow into healthy, resilient children and adults and be able to fulfil their potential and succeed in life. Before I start, I declare an interest in that. I am a director of a company developing technology for the healthcare sector and I receive no remuneration for this position. May I say what a privilege it is to be speaking in this chamber for the first time, unexpected though that may have seemed a short few weeks ago. Indeed, my competitor in running for the Comaric and Irvine Valley constituency, Willie Coffey, and I use the term running loosely, suggested in this chamber that I got in via the vagrancies of the voting system. I can assure Mr Coffey that, whether I get in through the back door, front door, side door or skylight, I am here. He has five years to get used to my dulcet tones. I would like to thank those who voted for me nearly doubling our share of the vote in the constituency. I also thank those who voted otherwise but took the time nonetheless to speak to me, sometimes attempting to point out the error of my ways but always courteous and always in good humour. However, that is important because if we only listen to those who agree with us, we get a very polarised view of the world. It has been quite an interesting journey to get to this spot. I was an international athlete for 13 years and those of you who mentioned this, I thank you for remembering. Those of you who said, I do not remember you but my dad said that you were not bad. You have made a happy man very old. Presiding officer and fellow athletes, my passion lies in the firm belief that education is the solution to health and welfare, not only academically but also coaching in sports, the arts and drama or any activity that can engage, enthuse and engender a passion in our youngsters. It has been stated in this chamber that the greatest inequality is the inequality of opportunity and I wholeheartedly agree with that. However, we have not done particularly well in addressing this. Compare state education to private education and we ask what the difference is. It is most certainly not the quality of the teachers, it is quite simply the access to opportunity. Sport and activity is the norm in the private school sector and this was born out by the fact that a third of the 2012 Olympic team was made up by 7 per cent who were privately educated and the Scottish school sports championships is fast becoming the vastian of private education. From the mid-80s where sport and state schools was decimated, there has been a steady decline in the physical literacy of our children and this has a worrying effect on the health of our nation. Our farmers produce the highest quality food in the world and yet with the unhealthiest nation in Europe and the unhealthiest small country in the world. That suggests to me that homegrown produce is not making its way to the Scottish table. Ten per cent of the Scottish NHS budget is now spent on the treatment of type 2 diabetes, a disease that is predominantly linked to inactivity and obesity. One in four A and E cases are drink and drugs related and we all aware how stretched our A and E staff are. Ten per cent increase in child tooth extractions in the last four years. The above examples are preventable yet cost the Scottish NHS billions. We are also focused in financing the NHS. We have missed the fact that there is a serious financial benefit in tackling preventable disease. As a leading Glasgow diabetes consultant said to me, we are sleepwalking into an economic health nightmare. The preventable disease academic is the greatest threat to our most treasured institution in the NHS. Not my words, Presiding Officer, a warning from the front-line healthcare professionals. Nowadays, kids are accused of laziness, always playing in computer games, on phones or on tablets or watching DVDs. I would like to challenge that. Who is giving them those things and what are we offering as an alternative? In my experience, if they get the chance, kids want to participate. We need a progressive physical literacy programme alongside the academic one. Pre-school active play into primary school active games into secondary school sport. We are all agreed that increasing child access to nursery education is a good thing, so can we lay the foundations for an active healthy lifestyle? If a child wants to participate in out-of-school activity, we need to go home first and then go somewhere else. That makes no sense to me because the facilities are in the schools. With a bit of innovation and thought, we can reintroduce extra curricular opportunities across the country, irrespective of background or personal circumstance. To do that, we need agreement and co-operation from across the chamber. It will take a generation—yes, a generation—to do that, which means that it is for this chamber to set the path but for others to reap the rewards of those decisions. However, in the words of Harry Truman, it is amazing what you can accomplish if you do not care who gets the credit. If we choose to open up the choices to our children and allow them the opportunities to find their passion, stoke their enthusiasm, engender self-belief, self-motivation and self-awareness and drive towards achievement, whatever they decide that happens to be, they will seek to make better lifestyle choices. The importance of self-awareness cannot be overstated because if we help them to achieve that, no matter the discipline, it will have a profound effect across all other aspects of their lives and those of society. However, if we choose to ignore that issue, it will continue to deteriorate with increasing health inequality and a whitening of the attainment gap that we so much want to eliminate. I would finish with the words from a great hero of mine whom we sadly lost a few days ago, Muhammad Ali, who said, He who is not courageous enough to take risks will accomplish nothing in life. This chamber must be bold and make the changes required to open up opportunities for our kids and make Scotland a healthier and happier place for them to flourish. I think that you referred to me as a fellow athlete. Anybody who knows me, that is strange news indeed to hear. I call Tom Arthur to be followed by Monica Lennon and Mr Arthur, please. Thank you, Presiding Officer. I would like to begin by congratulating the Cabinet Secretary on her reappointment and also by congratulating both Maureen Watt and Aileen Campbell on their appointments. I welcome the tenor of the Government's motion, acknowledging as it does the multiferous challenges that we face in delivering a healthier Scotland and, importantly, recognising the need for a joined-up and collaborative approach in meeting those challenges. I would also like to welcome the creation of a dedicated position for mental health. I know that this is something for which there is a great deal of cross-party support, and it does, in my opinion, signal the clear intent of this administration to bring a long overdue parity between mental and physical health. Indeed, mental health must be a national priority. Speaking as the son of a retired psychiatric nurse, I am keenly aware of the incredible work that our mental health clinicians and staff perform. I look forward to seeing the development and details and implementation of the proposed mental health strategy, and I welcome the commitment to increase mental health spending to over £1 billion by 2020. I also welcome the commitment to invest £4 million per year in the recruitment of 100 mental health link workers in Scotland's most deprived areas. It is vital that those in need are able to quickly access service providers, such as recovery across mental health, who provide support to many people in my constituency of Renfisher South. Such organisations are invaluable, and we must continue to do all that we can to support them. In this debate, as in many others, we must consider the challenges posed to society by growing inequality. We are all aware of the complexity of the reasons behind health inequalities. My constituency of Renfisher South has been subject to many of the challenges faced by post-industrial communities in the west of Scotland. Compared to the national average, people in Renfisher South are more likely to be admitted to hospital, and there are significantly more alcohol-related hospital stays than the Scottish average. The Government's recognition that health inequalities will require an approach that looks beyond the NHS and that routes activity to address inequalities across Government is to be welcomed. I look forward to seeing how that principle continues to inform proposals on the use of the new social security powers coming to this Parliament. However, it is important that, for too many, inequality begins in the womb. I am delighted that this Government has taken important steps to address this through the rolling out of baby boxes and the recent announcement that, by next spring, all pregnant women will receive free vitamins. The bill is in the work that is already undertaken by this Government to address neonatal inequality such as seeking to overcome the barriers to breastfeeding that too many women face. Here, as with mental health, we must acknowledge the work of the first sector in making Scotland healthier. This weekend, passed at the outstanding Lillys Day event at Cobarkin, I met Melanie and Hazel from the breastfeeding network. The breastfeeding network does outstanding work in communities such as Johnston, Lynwood and Cobarkin in supporting mothers to make informed decisions about breastfeeding and providing access to help when they need it. It is vital that we continue to support organisations such as the breastfeeding network to ensure that they continue to play an active role in making our communities healthier. I would like to conclude by addressing those who would challenge the principle that the NHS should be free at the point of view. In particular, those in the chamber who were elected on a commitment to reintroduce prescription charges. Admittedly, they have been decidedly more coy in this matter since being elected when they campaign. The arguments that are just in support of the proposition, if I may summarise, invabably follow the formula of asking why someone in a high salary should be exempted from paying a nominal fee for medication prescribed by a GP. It is contended that such a charge would provide a welcome source of revenue and would be entirely compatible with the principle of fairness as only those who are capable of forwarding the fee would be required to pay it. One could respond to such an argument by highlighting how the previous system of prescription charges saw many on low incomes, slipped through the net and consequently was subject to paying charges that they struggled to afford. One could also raise the question of how much of that fee would actually reach front-line resource budgets once it had been through the bureaucratic ringer of means testing. However, as important and valid as those technical critiques are, it is my view that the most fundamental objection to prescription charges is that they undermine the universalism that must be a motivating ideal in the delivery of all our public services, especially our NHS. Universalism is not an ideal that is easy to realise, but it serves as a beacon to us. It shows that our minds and thinking are not bounded by the present, that we dare to imagine the kind of truly equal society that we can and will be. Over the coming Parliament and indeed the coming decade, like many countries, Scotland will face great challenges in the delivery of health and care services, but it is clear that this Government recognises those challenges and it is clear that this Government has the ideas and the vision to deliver the healthier Scotland that we all seek. I welcome the opportunity to contribute to this debate on delivering a healthier Scotland. Although Scotland is generally becoming healthier, deep-rooted health inequalities remain. Despite Scotland's health-improving in recent years to our shame, we have the widest health inequalities in Western Europe. That will not be a surprise to returning members for the Scottish Parliament's Health and Sport Committee reported in 2015 that, despite many well-intended initiatives, none have made any significant difference. Indeed, although health is improving, it is doing so less rapidly than in other European countries, and although the latest figures are a little more encouraging, health inequalities remain persistently wide. That was 2015. That is why organisations such as Voluntary Health Scotland this week call for a comprehensive Scottish Government strategy for tackling health inequality. Health inequalities are intrinsically tied to poverty and income inequality. The Scottish Council for Voluntary Organisations is absolutely right when it says that deep-rooted health concerns have to be addressed by improving social conditions, strengthening communities and empowering individuals to fulfil their human rights. Tackling health inequalities requires an approach that looks beyond the NHS to examine inequalities across all parts of Government. Of that, I hope that there is consensus across the chamber. On mental health, I am pleased that there is consensus among all the political parties in the chamber to treat mental health with parity of esteem, but warm words are not enough. The SNP Government knows that it must deliver. Let us take child and adolescent mental health services and psychological therapies waiting times. Today's figures represent an improvement, but on-going mis-targets ultimately mean that too many vulnerable patients are being badly let down. As a mother of a nine-year-old daughter, I hope to never experience the fear and desperation that causes families. However, I have listened to parents and young people in my region, Central Scotland, to share a little of their horror with me as their loved ones wait and wait and wait. Members will recall that now retired MSP Dr Richard Simpson, a psychiatrist with over 20-year experience, has previously pointed out that the longer young people with mental health problems wait for treatment, the worse their condition gets. The waiting is not some sort of inconvenience, there is a genuine argument that it worsens their condition. Just the other week, figures obtained by NUS Scotland under freedom of information show that a 47 per cent increase in students trying to access mental health support services. Further, research reveals that universities and college services are struggling to meet that demand. The commission on health inequalities revealed previously that whole communities have been at breaking point. In Kilwining, for example, a sharp rise in young male suicide led to the community describing this as a crisis. Yet the waiting time for a psychiatric appointment was 18 months in some cases. The local community, no longer able to stand by and watch other young people die, took action in their own hands and a local organisation hired a councillor to treat some of the young people who were waiting for treatment. Just last month, the Courier reported in Dundee that there has been a rise in all ages of people across the city taking their own lives. Horrified by the alarming regularity of incidents, campaigners chose to speak out and call for improvements to be made to mental health care across Tayside and Scotland as a whole. For one ex-assistant chief constable of Tayside police Angela Wilson, who served on the beats in Tayside and dealt with suicide as part of her role, strongly argues that society and the Government have to treat mental and physical health as equals, but she says that the statistics show that they are not putting as much money into mental health issues, particularly young people's mental health. There is not enough money going into research and certainly not enough into treatment. Sophie Pilgrim, who heads children's charity Kindred, said that there are very long waiting times for diagnosis. For example, one in 10 children have a condition, which is a diagnostic label, but there is long delays in getting that information, and if you do not have a diagnosis, you cannot get the right treatment for that condition. The number of patients, but especially children, waiting longer than they should have to for mental health treatment is simply unacceptable. Like the cabinet secretary, I also pay tribute to our dedicated NHS staff. Our health professionals are working as hard as they can, but under staffing and under resourcing is putting their own mental health at risk. We need more mental health professionals throughout our health service from primary care settings to A&E. To deliver a healthier Scotland, we must invest in our future and help our children and young people achieve their potential. Health inequalities are not just about health services and not only about lifestyle and behaviour, but about justice. Although mental health hits all genders, ages and socioeconomic groups, it is three times greater in areas of socioeconomic deprivation. Our mental health service is still too narrowly focused on the acute side of care rather than prevention. We need to make sure that our NHS, established in the 1940s, is fit for the challenges of the 1940s. That means treating mental health every bit as seriously as physical health. It is essential that the mental health strategy is informed by an evaluation of the 2015 strategy, and a transformative approach to mental health requires a long-term vision supported by sustained investment. When thinking of health, our thoughts naturally often turn to the NHS and to medical treatment, and I think that it will rightly be welcomed across this chamber that the Scottish Government health spending will rise to a record high of nearly £13 billion this year. In my area, Edinburgh Eastern, the NHS Lothian budget in 2016-17 will be £1.3 million, and that is up a huge 50 per cent since 2007. Within that, I was very pleased to note the Government's ambitious £100 million new cancer strategy. Although cancer mortality rates have come down significantly by 11 per cent over the last 10 years, that new cancer strategy directs resources towards improving prevention, detection, diagnosis and treatment still further. That topic stands out for me as, like many, I have personal experience of the devastation that cancer that is detected too late can bring. When I was 17, my parents sat me down and told me that my father had cancer. Yes, it was very serious, they said, and no, nothing could be done. He died 10 weeks later, aged just 49. This sort of thing changes you forever. So, for me, our fight against cancer isn't just numbers on a page, it is personal. I believe that I speak for many families when I say that this new cancer strategy is very welcome. I met up with Cancer Research UK just before the election, and I will be meeting with them again this Friday. I was pleased to hear that they were very happy with the SNP Government's cancer strategy. They said that with 50 actions, they see that as a strong plan that will impact on cancer survival in Scotland. Also, the first ever Scottish Cancer Patient Experience Survey results were published this week. 5,000 patients were surveyed, and 94 per cent of them rated their care as highly positive. That is good, but there is still much more to be done. Cancer awareness or educating people to spot the early signs and symptoms of cancer will also help to increase early detection rates. A report compiled by Cancer Research last month confirms what we already know, that there is a link between poverty and cancer. Being brought up in poor housing or with a very low income doesn't just affect the child, it affects the adult that they will go on to become. Health and wellbeing isn't just about the NHS and it isn't always about medicine, it's also about things like poverty, things like lifestyle and nutrition, things like housing, the environment and levels of inclusion. In that spirit, I would like to highlight two fantastic projects in my constituency that promote health in that wider sense of health and wellbeing. Caring in Craig Miller takes referred clients who are elderly, disabled or vulnerable and they attend, they get company, they get some lunch and they also get to do some activities. When I was there recently, I spoke to one of the regulars who was 91 years old and he said that if he didn't come along to this as a widower, he wouldn't speak to anyone from one end of the week to another. Isolation obviously is an enemy of good health and vulnerable members of our society benefit hugely from this type of interaction. Caring in Craig Miller also operate a very simple but highly effective service called phone link. Users can self-appoint themselves to sign up to receive a daily reassuring phone call. For those who feel really isolated, this type of service, this daily chat to someone at the other end of a phone is a lifeline for them. At the other end of the age spectrum is the Venti Centre. This, unfortunately, has recently had its core funding removed by the council. It's one of only three of its type across the whole of Edinburgh and it operates in Craig Miller, which the SIMD reports is in the 15 per cent most deprived areas of Scotland. This service is run by a committed team who start off the morning driving around, collecting referred primary school children and bringing them into the centre. They have to do this in two trips because their mini bus will only take half their kids. Once at the centre, the children receive a healthy breakfast of their choosing. In some cases, that, together with the free school meal that they will receive, will be the only meals that those children will eat. The kids are then walked to school and that ensures that they arrive on time, well fed and, most importantly, ready to learn. Clearly, that service has wider implications for helping to close the attainment gap. Decades of research shows that children who don't get enough to eat, particularly in the morning, have impaired cognitive capacity. Their brains just don't have enough fuel, fuel for attention, for concentration, for learning and even for appropriate types of behaviour. Not eating breakfast can rob those children of their potential. Children from chaotic backgrounds need and deserve our care and clearly going hungry is going to be bad for those children's development. Missing school impacts now and later in life on future wellbeing and possibly on whether that child will stay healthy or suffer from a disease like cancer. Without a new funding source, Benchy will have to close its doors to those kids, so I would welcome any help that the cabinet secretary could suggest to support those types of services for my constituents going forward. Keeping our NHS in public hands and prioritising cancer treatments Can I ask the member to wind up, please? Will help us to work towards a future Scotland with less families suffering like-minded. Sometimes the simplest ideas—a hot breakfast for a small child or a phone call to an elderly person— can achieve great strides for wellbeing. Thank you very much. I call Rachael Hamilton, who is followed by Richard Lyle. Not to be outdone by my colleague Brian Whittle, it seems appropriate on a debate about delivering a healthier Scotland to pay tribute to Muhammad Ali. He was a man that understood the power of sport and how it can change the nation. He not only enriched America but the world. He said, impossible is just a big word thrown around by small men who find it easier to live in the world than to explore the power that they have to change it. Presiding Officer, each and every one of us, including our family and friends, have at some point in our lives used the fantastic services of the NHS. Parliament should recognise the tremendous work that those working in the health sector do. More importantly, this Parliament should ensure that the resources that are needed for a first-class health service are delivered. Scotland is facing huge challenges ahead, an ageing population with multiple long-term health problems, a growing diabetes problem and a general practice that simply cannot meet demand. Rightly, this motion calls for cross-party support across this Parliament to meet the challenges ahead. We have an SNP Government who wants to work together but then attempts to shift the blame to the UK Government. It is time for the Government to stop treating the NHS like a political football. I was pleased to hear Shona Robinson use the words preventing illness, prevention and preventative in her opening statement. Presiding Officer, encouraging a healthy lifestyle is important to establish good habits early on and right throughout childhood and adulthood. We all know the factors of a healthy lifestyle, regular exercise and healthy eating. However, in Scotland, two out of every three adults are overweight or obese. 31 per cent of children are at risk of being overweight and, by 2030, obesity levels of 40 per cent are predicted. Those are the highest rates in the UK and among the highest in the OECD countries. A SPICE report last year estimated that the cost of obesity was £4.6 billion a year to Scotland, a resource that could be directed to hospitals, nurses and general practice. If we work hard to get Scotland active now, we will see a return on this vital investment. In 2014, the Scottish Government reported that physical inactivity contributes to nearly £2,500 deaths and costs the NHS £91 million a year. In order to combat inactivity, we must encourage participation of sports and recreational activities in and out of schools. I currently help to coach Earlston High School's netball team in the borders and see first-hand the benefits that sport, particularly netball, can bring. Indeed, its qualities have been recognised and an initiative set up by Netball Scotland, called Bounce Back to Netball, was recently launched, aimed at 18s and over. A further goal, excuse upon, is to offer netball in more secondary schools throughout Scotland by educating our educators. We must replicate the same example set by Netball Scotland and help tackle health inequalities. Let us take this positive illustration and be constructive, not blaming the UK Government on an obstacle that we have the power to overcome. The Scottish Government has new powers and it is time to be accountable, get to work and offer solutions to Scotland's health problems. In fact, it is with the help of the UK Government's commitments to the NHS that the Scottish Conservatives were able to pledge a health guarantee in the 2016 manifesto. As Donald Cameron said, we want to see the health budget rise annually by whatever is highest out of inflation, 2 per cent or Barnett consequentials. Under current projections, that would mean an additional £1.5 billion for our health service by the end of the Parliament, with the budget reaching £14.5 billion by 2021-22. To make best use of an increased NHS budget, the Scottish Government must show leadership. That is echoed in the Audit Scotland report that states, that the Scottish Government needs to provide stronger leadership and a clear plan for implementing the 2020 vision to enable everyone to live longer, healthier lives at home. The 2020 vision has crossed party consensus, but it will be the Scottish Government's ability to apply the vision that it underpins its success. Indeed, it is the UK Government that has the ambition to be amongst the best in Europe at reducing levels of premature mortality. Premature mortality is something that Scotland is blighted by, affected by numerous factors that are the responsibility of the Government, or the NHS, including diet, climate, personal circumstance and lifestyle choice. The Scottish Government must take more responsibility and accountability. By encouraging physical activity, we can reduce the chance of type 2 diabetes, which is a growing problem in Scotland, by 40 per cent, cardio vascular disease by 35 per cent, breast and colon cancers by 20 per cent and also improve mental health. Clearly, promoting and encouraging an active lifestyle can do so much good. We should prioritise this as much as we do when we warn of the dangers of smoking and drinking. With reference to the motion, I also expect TTIP to bring much good, delivering £10 billion to the UK economy each year. I commend the UK Government for achieving this and recognise that there is no way that TTIP will affect how the NHS decides who will provide the best service. To conclude, Scotland does face significant challenges and we must all work together to make Scotland healthier. I have stated the case here to focus on physical activity as a pre-emptive means to fight future battles with ill health. We really must act now to ensure that Scotland has a healthy future. I remind members that, for every 30 seconds or minute, they go over, someone might get cut off their own speaking list. That is why we have to be rigorous. I call Richard Lyle to be followed by Jackson Carlaw. I congratulate you on your election and wish you all the very best and all that you do. I also congratulate the cabinet secretary and her team on what is doing well. I like at the outset of my remarks to reflect on my predecessor, Michael McMahon, who held the Urringston and Bellsill seat formally known as Hamilton North and Bellsill for some 17 years. Michael worked incredibly hard, having worked as a welder at Terrex and Newhouse to his activities within the trade union movement and his work as a parliamentarian in this place. Although we may have disagreed politically on many occasions, it must be said that we did get on very well. I therefore felt that it was most appropriate to pay tribute to him in place of record my thanks for the work that he did on behalf of his constituents during the time that he represented them. I am sure that the chamber will join with me in wishing him and his family all the very best in the future. When I speak of the representation of constituents that Michael undertook, it is to those constituents that I want to turn next to my remarks. Having first been elected as a local government councillor in Bellsill in 1976, a seat that I held until 2012, then being elected to the Scottish Parliament in 2011 as a list member for Central Scotland, there have been many political high points in my career. However, none have matched the feeling of both elation and responsibility than being elected to serve as the first SNP MSP for Urringston and Bellsill in May. I promise to do all my very best to represent all the people of Urringston and Bellsill and everything that I do in this place and indeed in our community. Turning now to today's important debate of keeping Scotland moving forward with the health care Scotland, during the election I spoke day in, day out with people who wanted to know what we were going to do with the NHS and so many of them outlined to me the sheer importance of the NHS to them and to their families. I reaffirmed each day her commitment to the NHS, a commitment that the cabinet secretary has shared with us again today, a commitment that the SNP stands proud on, that under an SNP government the NHS will be kept free at the point of need and publicly owned. With an increase in the health revenue budget, in real terms of the year, we need to shape a national health service that can meet the needs and challenges of our ageing population. We are now spending more than £13 billion on Scotland's health service, a service that I believe is one of the best in the world, but I know that we have to continue to improve and that is why I have full confidence in this Government's proposals. Those proposals include continuing to protect free personal and nursing care for the elderly, which is benefiting more than 70,000 elderly people in Scotland, and I am sure that it benefits many of my constituents in Urringston and Bellsall. We have been clear that it is not just business as usual and therefore I am pleased to see that the Government will be examining the introduction of the extension of free personal care and nursing care to those under 65 with diagnosis of dementia to continue to deliver for those who need help the most. This is carers week. I want to take time, as I am sure that many in the chamber will do, to thank our carers for the work that they do, day in, day out. I know that the Government will build on the carers act by considering a national or regional approach to supporting carers and care for people. They will equalise the carers allowance with a jobseeker's allowance, benefiting around 64,000 carers per year by around £600 per year. That is an increase from £62.10 to £73.10 per week. It will also increase the carers allowance for those who look after more than one disabled child, which will help approximately 2,000 carers throughout our communities. On primary care reform, I know that the proposal to bring together multidisciplinary teams in GP surgeries and help to deliver a community health service, recruit 500 pharmacists and train 500 advanced nurses and A&Ps for primary care teams. Over 1,000 paramedics have been trained over the next five years to work in community settings. That personnel will continue to deliver a new primary care out of our national delivery plan. We are increasing GP training places from 300 to 400 per year, and I note the increase in GP numbers. It should be noted that, under the SNP, NHS staff is at a record high, at more than 11,400. It is clear that, under the SNP, the NHS will take a different course from that of the NHS and other parts of the United Kingdom. I know that we in the SNP will be working every day to deliver a national health service that is enshrined in its core and founding values, and a national health service that has the support that it needs to continue to deliver to the people of Scotland, a national health service that is owned by the people and is for the people and is truly free at the point of need. I look forward to playing my part in working to deliver for the people of Uningston and Balesill, not only for our vision for the NHS but for Scotland. I congratulate Shona Robison on her reappointment as Cabinet Secretary for Health. I welcome the appointment, as I did before, of Maureen Watt as the Minister for Responsibility for Mental Health. I welcome Aileen Campbell to the health portfolio team. Shona Robison and I, one way or another, have spoken on health for almost nine years, I think, in the Scottish Parliament, with brief interludes chief of the Commonwealth Games, me elsewhere, for a short time. I do want to thank all of the various organisations, professional embodies and others, who have been so helpful in keeping me informed and helping to shape health policy over the last nine years. I now move on elsewhere, but I do so with mixed feelings because health is such a fundamentally important subject, and I think that there is a huge emerging consensus across Parliament that began in the last Parliament, and we will continue in that. I note that not only are all the other front bench spokesmen new to the health portfolio, they are nearly all new to Parliament as well. That is hugely encouraging, because it allows a line to be drawn under some of the battles that I think were fought before. For the consensus that I think is recognised across the chamber, to actually be made real so that we can see the kind of progress that is required during the course of this Parliament. I was slightly disappointed by the motion. It wasn't just as consensual as I'd hoped it might be. There was a slight tone of belligerence at certain points in that, aimed, I think, at this side of the chamber. I think that it is important that that consensus is achieved because the BMA, the RCN, the Royal College of Physicians, the surgeons, the Royal College of Emergency Nursing, all the allied health professionals will be looking to this debate, and the early signs in this chamber about the tone that is going to be taken in the way that the whole debate about health is taken forward in this Parliament. That is the decisive Parliament. I think that we have recognised for some time that the increase in the pressure on our health service is not one that can be remedied by budget alone, albeit that all the parties are committed to considerable increase in spending. There is now a consensus in this Parliament, unlike any of the other Parliaments of the United Kingdom, that we want a publicly-owned, free-at-the-point-of-need and delivery national health service. We therefore have to have a means of taking forward the challenges that exist within health on a cross-party basis. I know that the cabinet secretary is committed to that. I welcome the commitment that she gave in her speech to convening talks with the other parties, but what will be important as well as those talks is a process that everybody understands by which they can contribute to the thinking on health and not just to be asked to agree with whatever decisions the Government may come forward with. The cabinet secretary mentioned the need to look at the structure of the tertiary health boards and others during the course of this Parliament. I welcome that. There is no agenda, there is no determination to drive through structural change, but I think that there is a recognition that the future development of secondary care depends upon an understanding of what that whole health board structure should be. There is a recognition that primary care has to be the focus of major change in investment in the course of this Parliament. There is a recognition that mental health now has to deliver on our having removed the association of stigma with that condition to ensure that we create a parity with physical health and the service that we provide. A 10-year programme, while welcome, I hope will contain a lot of urgent action in the five years of this Parliament and not just seek to achieve ends in the Parliament after this one again. There was less said about the development of new medicines. I know in the last Parliament we agreed on the whole process by which new medicines would be approved, but I was dismayed as Parliament dissolved to discover that the SMC had rejected translamma, the first new drug that has come forward for young men suffering from Duchenne's muscular dystrophy. I do think that we need to look and constantly review it sometimes since the new process was put in place to ensure that in this golden age of new pharmaceutical developments for conditions that have bedeviled generations, as these new treatments are made available, we are able to offer them to patients and to recognise that very often these are for conditions from which very few people suffer, and therefore the net cost of that drug will be expensive. Having found treatments for conditions such as Duchenne's muscular dystrophy, we have to find a process by which we are able to offer those to patients and give them hope. The main thing that I want to conclude on is this discussion on the budget. I did see the cues round the block of evangelical nationalists who were turning up to hear Nicholas Sturgeon deliver her manifesto commitments, and among them, as the tears wept from the glass eyes of government, she said that the Scottish Government would be spending £15 billion on health by the end of this Parliament annually. Almost within 24 hours, I was in a television programme with Jamie Hepburn, who was a minister at the time, who said that it would be £14 billion. Then I heard other figures in between. Today, I see that a commitment to £15 billion is now an aim, just an aim, to increase by £500 million over the rate of inflation between now and the end of the Parliament. What I would very much welcome the Government doing is setting out exactly so that not just people in this chamber but all of those within the wider healthcare community who want to understand the financial envelope within which they will be working, to set out the actual planned programme of health spending over the course of this Parliament so that we can understand what is to be available and when it is to be available. However, if we work together, then there is the prospect in this Parliament the one that I think will determine whether or not we have a sustainable health service going forward in the future of securing that objective, and that is a prize worth us all working together to achieve. I call Marie Todd to be followed by Lewis Macdonald, Ms Todd. Thank you, Presiding Officer. I'm delighted to be part of this Parliament speaking here for the first time today. Like several of my Conservative colleagues, I too feel surprised at having gained entry to this chamber, but for different reasons I'm sure. When I was a wee girl growing up in Ulipol, the Scottish Parliament had not yet reconvened, and politicians were distant and different from me. I was thinking about that the week before the election, when I was travelling from Geirloch for a public meeting and passed the very beautiful Loch Meri, which I was named after. Later, on my way round the coast to Ulipol, I passed the big house at Grignard, where my granny was a servant before she married my granda, who was a joiner. My other granny from Lewis was a herring wifey, and she was fiercely proud until the day that she died that she was never in service. Those were the only two careers open to her. Instead, she followed the fishing all around the coast of Britain and spent long, hard days gutting and silting the silver darlings far from home. Her husband, my granda, was a whaler, and he travelled the world for work. You see, the story of migration to find work is part and parcel of my family history. Indeed, it's part of most families whose history lies in the Highlands and Islands. Families migrated and women worked, normal, not something invented in the 21st century. By the time I finished school, I had a lot more options than both my grannies did. Girls can do anything now. Of course, I still had to move away to study science at university, but my pharmacy degree meant that I could at least come back to the Highlands if not quite back home to Ulipol. Presiding officer, like so many of my colleagues here in this chamber, I am deeply grateful for the educational opportunities that I have had, and I'm proud that here in Scotland, we recognise and nurture talent, regardless of our background, focusing only on the value that educated citizens bring to our nation. It's a huge privilege for me to represent the Highlands and Islands. I have a passion for this part of the world. My constituency is enormous, stretching from Contire in the South to Shetland in the North, from the Western Isles across to Murray. It covers nearly half the landmass of Scotland and is stunningly beautiful, packed with lochs, mountains and islands. Those vast distances in wild terrain can make delivering healthcare a challenge. The fact that our young people leave to study and find work and older people come to retire is another one. All of us living there want fast access to treatment as close to home as possible, but modern healthcare has become more and more specialised, and travelling to centres of excellence can mean exhausting journeys and isolation from families and friends. Technology will be vital to service improvement, but we must make sure that it doesn't just replace face-to-face contact but enhances it. The challenges that we face in the Highlands mean that we need to think clever, deliver in partnership and fully develop and use the whole multidisciplinary team's skills. That will enable us to improve both quality and efficiency. The Highlands and Islands was the first region to integrate health and social care in Scotland, and we are using that advantage to look ahead at new delivery mechanisms. Health, as others have said today, is about so much more than just treating illness. Social care, housing and education are vital to good health. Health inequality is closely related to wealth inequality, but how we deliver health can have an impact on that. There are already examples of new partnerships and collaborations happening that include working with communities and creating employment and training opportunities while improving service delivery. I have worked as a clinical pharmacist in mental health for 20 years, and I am fiercely proud of what the SNP has accomplished since being in charge. The spending commitment in mental health and the long-term planning will help us to achieve parity with physical health. My colleagues in the pharmacy at New Craig's hospital in Inverness have embraced prescription for excellence and are working hard to get their expertise in choosing the right medicine out of the hospital and into the community where most of our patients are. Soon, all of the clinical pharmacists will be prescribers and they are developing a pilot scheme to work part-time with community mental health teams and GP practices to improve the speed of access to specialist care and to improve the quality of prescribing. We need to build on those types of examples and deliver the services that people want where they want them. The job of government is not to micromanage the health service from the centre but to create the circumstances that empower people and communities to find their own solutions. With this Government in power, I know that we can do this. The principle of equal access to healthcare was at the core of the national health service when it was founded in 1948, and it remains central to its purpose today. That principle appeared to be put at risk for patients in the north-east earlier this year when ministers ordered a review of their own decision to have a trauma network with major trauma centres in each of Scotland's four largest cities, a decision that had been taken and announced by SNP ministers in 2014. When clinicians in Aberdeen were invited to meet the Scottish Government advisors who were conducting that review a few weeks ago, they were horrified to find that they were being consulted on only one option with major trauma centres only in Glasgow and Edinburgh. That model was being considered and they were told because it would deliver the best possible trauma care for 75 per cent of the Scottish population. Little wonder that so many surgeons and physicians at Forrester Hill responded to that proposition by calling for ministers to honour their original decision and to support a major trauma centre in Aberdeen. 57 senior clinicians signed an open letter within a few days of those private consultations. The plan for two centres in Edinburgh and Glasgow, they said, would appear to leave 25 per cent of the Scottish population, including the people of Grampian, with a second-class service. We are deeply worried that a solution for the central belt of Scotland will leave the rest of Scotland out in the cold. That critique of the Government's review went right to the heart of the matter, indeed to the heart of the Government's motion before us here today. A second-class service for a quarter of the population would clearly fly in the face of the founding principles of the NHS, which all parties still endorse. I am delighted that the campaign for a major trauma centre won the support of thousands of people across the north-east. It was taken up enthusiastically by NHS unions, staff and Aberdeen Trade Union Council. It was explicitly endorsed in Labour's election manifesto and became a major election issue across the region. By polling day, it had won support from all parties, including the SNP, and I was delighted when Nicola Sturgeon came to Aberdeen on 3 May and revealed that she had always been persuaded of the merits of a major trauma centre in Aberdeen. I was even more pleased when the health secretary told the press and journal last week that four major trauma centres in place this year was once again the policy position of the Scottish Government. It was as if the review of that policy, which she had ordered a few months before, had never been. All is well that ends well. I am sure that Shona Robison will put those commitments on the parliamentary record today in order to allow attention to be focused on the necessary development of capability and capacity at both Aberdeen, Royal and Firmary and Ninewells. If she does that, she will recognise that the outstanding issue for healthcare in Grampian remains a continued shortfall in funding, compared with the Government's own NHS Scotland resource allocation committee formula, or NRAC. I think that it is important to put those numbers on the record today. Independent researchers at SPICE confirmed last week that NHS Grampian's allocation under NRAC for 2016-17 should be £897.4 million. John Swinney told Parliament in November that we remain committed to moving all boards to being no greater than 1 per cent below NRAC parity. That 99 per cent target for Grampian would mean £888.4 million this year. What was then allocated, however, even after an additional uplift, was only £882.3 million, over £6 million short of John Swinney's commitment to 99 per cent of NRAC poverty. I would happily take an intervention from the cabinet secretary. I would say to Lewis MacDonald that the delivery of health service resource funding through the NRAC formula was way in excess of anything that his administration delivered for Grampian. Perhaps he needs to move on from fighting the election battle on to more positive ground for the consensus of this debate. Lewis MacDonald positively seeking commitments from the Government, which have been repeated and repeated in the chamber and elsewhere, that at least 99 per cent of NRAC would be achieved by this year. That has not been achieved, as the health secretary well knows. I simply ask her to be accountable for that and to ask her to make up that difference. Of course, we know that, like other boards, NHS Grampian is struggling to meet the commitments that it has with the funding available. 18.5 million pounds in savings were being discussed at the board meeting last week. We know from the cancer survey that 80 per cent of patients in Grampian received no care plan and 65 per cent were offered no information on financial help or benefits. We also know that alcohol and drugs partnerships in Grampian are facing a 20 per cent cut in this financial year, and all such cuts and deficiencies are ultimately down to the funding decisions ministers make. Under funding of 15.1 million health secretary, savings required of 18.5 million. The shortfall compared with NRAC, the failure to reach even 99 per cent, are not just statistics or yesterday's battles. They have consequences for patient care, and I hope that the Government will do better and meet its 99 per cent target next year, and I encourage them to do that. Decisions are needed also on the consequentials from the soft drinks industry levy, the sugar tax, which will add millions of pounds a year to the Scottish Government's budget from 2018. We have advocated using that money to support after-school sports, because we believe that that would bring direct benefit to young people in terms of health and confidence and reducing inequalities too. The SNP has not yet made such a commitment, but nor did they rule it out. I hope that ministers will tell us today if they agree with our approach and that they will use the sugar tax to give sports for young people the boost that they need and deserve. Time is really tight. I call Alison Johnstone to be followed by Emma Harper. Thank you, Deputy Presiding Officer. I welcome the opportunity to speak in this debate. I would like to thank all those who have sent us their expert views on this afternoon's debate, the Royal College of Nursing, SCVO, Inclusion Scotland, the British Psychological Society, Obesity Action Scotland and Scottish Wildlife Trust. All those organisations have specific acts, and they have a particular focus, but they share common asks, too. For example, that mental health treatment has parity with that of physical health. I welcome the Government's decision to review the targets that we put in place, and I look forward to tomorrow morning's launch at the Royal College of Nursing on their latest work on targets. Targets, it is fair to say, have been the topic of many a heated debate and many a heated parliamentary question, but targets only make sense when they are the right ones. The Royal College of Nursing, with its 40,000 members who provide care to people in a wide range of settings, is asking questions of us. Their views and the views of all those working in health must be heard. We need to know if targets are skewing clinical priorities. We need to know if we are wasting resources and if our focus is on the right things. The RCN manifesto could not have been clearer. It asks that decisions about health are made to shape health for generations to come, rather than a focus on short-term targets. A parliamentary term may currently last five years, but we have to take a longer-term view. The RCN tells us that Scotland is not seeing real change in community-based services and that there has been a focus around acute services in isolation, rather than a whole-service approach. It tells us that, if Scotland is serious about moving care out to the community, then investment must be made in prevention. SCVO2 emphasises the need for a greater focus on prevention, the need to focus on early intervention instead of simply treating symptoms of ill health, and the Scottish Greens firmly support such a focus. However, of course, good health is hugely dependent on many factors outside the NHS—a living wage, secure affordable housing, affordable heat and nutritious food. One in four of us will suffer from mental ill health, yet only 5.8 per cent of UK research funding is spent on mental health research. We know and we have heard that mental ill health is three times greater in areas of socioeconomic deprivation, where access to general healthcare is too often too challenging. A GP in one of Edinburgh's most deprived areas for nearly 20 years recently wrote to me, and he wanted to emphasise that practice in those areas throughout Scotland is still not receiving enough financial support to allow them to respond adequately to the needs of many of their patients who often have a greater variety of medical problems, they are less healthy due to combined effects of higher levels of smoking, sometimes substance and alcohol misuse, low incomes, unemployment and family dysfunction. He was pointing out that this is a reflection of the inverse care law coined by Dr Julian Tudorhart, who worked in the Welsh Valleys many decades ago, which proposes that the more care people need, the less they actually receive. Of course, with political will, this can be overcome, so greater investment in general practice and primary care in the most socially and economically deprived areas is essential and urgently needed. The cabinet secretary will be aware of the work of Professor Graham Watt in Glasgow and his excellent deep-end project over the past 10 to 15 years. There is good evidence that green spaces and closer contact with nature can have a measurable benefit for people's mental health and physical wellbeing, and Scottish Wildlife Trust is right to emphasise that people who are connected with their natural environment are healthier and happier, and I support them in their request that the Government invest more in nature. Research shows that income-related health inequalities are reduced by having easy access to high-quality green space, and presently less than one and a half per cent of Scotland's budget is invested in the natural environment. Scotland is not a healthy nation. One quarter of adults are obese and more than half of overweight, and obesity action Scotland tells us that 30 per cent of our children are obese, the highest rates in the UK and amongst the highest in the OECD, and the Scottish Wildlife Trust highlights the impact of obesity in its briefing, saying that the cost of obesity could cost the NHS at least £3 billion by 2030. We can spend this money on more positive things. It is a multifaceted problem and there isn't one solution, but physical activity, as others have mentioned, has a part to play. For example, Jog Scotland's growth is at a record level. It has had over 5,000 members join in the last 12 months. That is an increase of more than 47 per cent on last year's figure. 303 jog leaders were trained across Scotland in the same period, and they have had a record number of entrants in their events over 5,000 entrants. They are 14 years old and they have never charged for membership. That has contributed to their very inclusive profile. There are just as many jog Scotland groups in poorer areas as there are in affluent ones, so removing that financial barrier to participation is key and no other sports national governing body can report comparable growth figures. Despite those successes, and unless there is a significant change to the Government's policy, it is likely that jog Scotland's funding will cease at the end of the current financial year. I would be grateful if the cabinet secretary could address that point. On another issue, I would also be grateful if the Government could confirm that it has not ruled out the use of prep treatment to prevent HIV and that it is still open to such a treatment. Health is a complex area. I have found that there is a great deal of consensus across the chamber, and I look forward to working with colleagues in this term. Emma Harper is followed by Ross Thomson. Congratulations to the cabinet secretary for your reappointment. I am pleased to be able to speak in the debate today on delivering a healthier Scotland. I declare an interest as I am a member of the RCN, and I have a current licence to practice as a registered nurse, so I would refer people to my formal register of interest, please. As we have heard, delivering a healthier Scotland has a wide scope with many challenges to address. The national health service is Scotland's biggest employer. It is the largest public service for which the Scottish Government is responsible. We have already made great progress in promoting a healthier Scotland. The Scottish Government introduced a smoking ban in 2006. Ten years on, we are seeing fewer admissions to hospital for acute coronary syndrome and stroke, and even bar workers are enjoying improved respiratory health. The smoking ban might also be helping non-smokers, as some studies show a reduction of heart attack and stroke in that group. That improvement in health continues because of the publication of the tobacco-controlled strategy in 2013. The Scottish Government is working hard for a healthier Scotland. However, the austerity agenda that has been pushed by Westminster since 2010 has undermined Scottish Government attempts to make progress on many fronts. For example, drug and alcohol charities have expressed anger at unethical Tory plans to cut the benefits of addicts who refuse state treatment. Is not that just like cutting the benefits for those who smoke and refuse smoking cessation treatment? Westminster is perpetuating a punitive approach to drug use usherd in during the 1980s, and that left a giant chasm of opinion between the policy for care approach and those working on the front line with drug users. Even the Home Office's recent paper says that the punitive approach does not work. The Scottish Government is working to close this gap. The new partnership for action on drugs in Scotland, the PADS group, was officially launched at the beginning of this year. As my south of Scotland colleague Paul Wheelhouse pledged, when he was minister for community and safety, the group will work to find radical and brave solutions to tackle drug misuse. That was one of the words that Brian Whittle used. Brave is what we have to be. Since 2008, the Scottish Government has invested £254 million in front line services. There have been significant success stories. Drug taken amongst adults has fallen. Drug taken among young people is the lowest in a decade, and 93 per cent of patients waiting to receive treatment for a drug-related problem now do so within three weeks of referral. However, we cannot be complacent. We must focus on the real causes of addiction and drug misuse and seek radical and brave solutions. That can be through education. Indeed, education is already being delivered across Dumfries and Galloway to secondary schools, particularly the S4 pupils, as a method of prevention, rather than treatment. Prevention is really important, so could those to Mark Franklin and First Base Agency in Dumfries for this? During my healthcare degree studies, I completed a class on alcohol drugs and addiction, and it changed my preconceived notions about addiction. I gave Professor Ian McPhee for helping me to gain a better knowledge. I give Ian McPhee my credit for understanding some of the research, some by psychologists, Stanton Peale and Bruce Alexander, and the developments for treating people who are experiencing difficulties with drugs, treating them as human beings. Some of the drugs happen to be legal, like alcohol. What I learned is the importance of how the environment has a great impact on the development of addiction. I urge members to search for the Rat Park studies by Bruce Alexander, which look at the environment as a causative agent in developing addiction. We in the Scottish Government are already promoting an environment that raises people out of poverty, provides a living wage, a decent start in life and the ability to choose an education path that suits individual needs. We will give the Scottish people hope, hope over fear, and that will undoubtedly improve their environment and contribute to a healthier Scotland. Some politicians have mentioned previously that the cost to the NHS for supplying syringes and drug works is not a good cost—£12,000 a year in Dumfries and Galloway. Some say that that is facilitating drug addiction instead of trying to beat it. That is a harmful idea. That idea can only come from a stark lack of understanding about addiction. The practice of needle exchange was introduced in Britain at the height of the AIDS epidemic to prevent HIV transmission through the sharing of contaminated needles. In countries without the programme, the rate of HIV conversion among drug users was much higher—60 per cent in Russia, compared with 1 per cent in the UK. Today, other blood-bond viruses such as Hepatitis C are more prevalent than HIV, which is why it is so important that needle exchange programme continues. Without the needle exchange, the number of those suffering hep C would undoubtedly soar, and the cost of treating that is up to £35,000 a year, so compare that to just £12,000 in Galloway. That is why it is misleading to decryde the cost to the NHS of supplying free syringes. I would like some reassurance that the Government and healthcare can address addiction positively and address the stigma that drug users face. We must treat all and any patient with dignity, compassion and respect. Ross Thompson, to be followed by Alex Cole-Hamilton. Thank you, Deputy Presiding Officer. I would first like to declare interest as an Aberdeen City councillor and direct members to my register of interests. It is truly a great privilege to be standing in this chamber today, and I am incredibly grateful to the people of the north-east for sending me here. I cannot begin to describe just how honoured I feel to serve them. That said, I know that I am here because many people across my region voted Scottish Conservative for the first time. Having spoken to hundreds of voters during the campaign, I know that for many this was a real leap of faith. To quote one voter, their heads were scrambled even contemplating it. I want to reassure those voters that I do not take that support for granted. They have given me a job to do, to hold the SNP to account, to oppose higher taxes and crucially to oppose any attempt for a second independence referendum, and that is exactly what I am going to do. I also recognise that there were many who did not vote for me and my party, and to them I give my sincerest commitment to give our communities a strong voice in Parliament, to stand up for our region, to fight for a better deal for our residents and always to work hard on their behalf whenever they need my assistance, regardless of how they voted. The north-east is a diverse and dynamic region. In Dundee, the city of discovery, we have a centre of excellence in gaming innovation and technology that is recognised across the globe. Angus, Scotland's birthplace, lies steeped in history and home to their broth smoky, one of my personal favourites. In Aberdeenshire, one is taken on a journey from the snow-peaked mountains to the sea, a stunningly beautiful and, in my view, unrivaled landscape that produces some of the finest quality food and drink available anywhere. Then there is Aberdeen, the city that I am proud to call home, the silver city with the golden sands, a beauty to behold and Europe's energy capital, the very centre of our crucial oil and gas industry. Beyond that, a city that is more than oil and gas and more than granite, a city with a vibrant and flourishing cultural scene, with venues alive with music and dance. Deputy Presiding Officer, I am definitely not one to give fashion advice, but today I am wearing my Aberdeen Forever tartan tie. I give from the Lord Provost of Aberdeen, George Adam, the black represents oil, blue for the sea, white for the famous silver granite and red and gold for the city's coat of arms. With WiFi in the chamber, you can order yours online right now. I am proud of my home city and the people, and I always will be. However, Aberdeen and the wider North East face many challenges. Aberdeen City Council is the lowest funded in Scotland, ranked 32 out of 32 authorities, despite having some of the most deprived communities in all of Scotland. That has been compounded by an energy industry crisis, which is affecting every part of our city, from our schools to our shops, our hotels to our taxi drivers. The council is fighting to retain business, to secure new business investment for the future and yet is getting a raw financial deal. You can bet your bottom dollar that I will be fighting for a fairer deal for Aberdeen and Aberdeenshire. Turning to health is clear that their birthnote formula again disadvantages Grampiwn, as we lose funding to the central belt that could have been used to invest in our local health services. That means hard choices. Just last week, we saw NHS Grampiwn reach a decision that it needs to cut £18.5 million to sustain itself. That means cuts to agency nurses, locums and the use of independent treatment to meet treatment time targets. That is extremely worrying for people across the North East who are concerned about the effects that that will have on the most vulnerable and those in rural communities. To compound that, the health board has identified a huge £100 million cost facing the service to address the impending impact of a growing population and the demand for primary and community care from new housing developments. On top of all that, we have seen the SNP's tentacles of centralisation grab local services and pull them to the central belt. Vital services such as renal transplants, paediatric intensive care and paediatric cleft surgery, just to name a few, have all gone. Moves that are fundamentally undermining health provision in the North East. In this context, the First Minister's belated announcement confirming a trauma centre for Aberdein is to be given a cautionary welcome. Residents across the region are sadly well used to the SNP making big promises with great fanfare but completely failing to deliver. However, this is a resource that Aberdein needs to rehabilitate patients and to support them in returning to a normal life. The First Minister's words need backed up by action and I will hold the cabinet secretary for health to account to ensure that she follows through on that pledge and that there is no slippage in its delivery. It has also been extraordinary that the NHS in Scotland is in such poor shape after nine years of an SNP government that was led by former health secretary. It is even more astonishing that it is the same SNP who urged us to vote yes in the independence referendum in order to save our NHS that has in fact cut the total NHS budget, with the Government failing to pass on 1.5 billion of Barnett consequentials to the NHS since 2011—a time when significant investment is needed to meet the cost of an ageing infrastructure and medical equipment. Deputy Presiding Officer, to quote William Arthur Ward to sum up my own attempts to serve in this place, do more than belong, participate, do more than care, help, do more than believe, practice, do more than be fair, be kind, do more than forgive, forget, do more than dream, work. Alex Cole-Hamilton to be followed by Graham Day Thank you, Presiding Officer. Can I begin by offering my congratulations to Shona Robison on her reappointment as Cabinet Secretary for Health? As shadow spokesperson for health for the Liberal Democrats, I warmly accept her invitation to meet to discuss taking the health of Scotland forward. I would also like to welcome her ministerial team, Aileen Campbell, who I have done a lot of work with during my time in the children's voluntary sector, and in particular Maureen Watt. I think that it was very generous of the First Minister to recognise the contribution of the Liberal Democrats in the election campaign, calling for a mental health minister. It is high time and she is most welcome. Presiding Officer, the measure of a civilised society is how we educate and bring up our young, but most importantly how we care for our sick and infirm. It is the test to which all administrations will be measured. I think that it is fair today that we have heard some examples of where the SNP are meeting this test, and they are to be warmly congratulated for that. However, there are corollaries to this, and I will come on to that. I think that one of the things that most lept out at me this week was the patient experience survey conducted by Marie Curie in terms of cancer care. Although lots of that was good, I would like to bring to the attention of the cabinet secretary and the ministerial team one particular example, and that is the case of Stephen Hansen. Stephen is a constituent of mine. He is a young father in his 40s, who, a number of years ago, was diagnosed with metastatic bowel cancer. He and his family requested Sertuximab, which is a new cancer drug, and were told that they could have it after he had completed two lines of unsuccessful chemotherapy. On completion of the second line of chemotherapy, Stephen heard the devastating news that the cancer had grown, but was told that the policy had changed, and now Sertuximab would no longer be available to him because it was now only used as a first line treatment. I have written to the cabinet secretary and I look forward to discussing Stephen's case further, because I think that not only should we not be treating patients like that, we should not be treating human beings like that. It is an element of cruelty to that. We cannot support as a party this motion today for the sole reason that, whilst there is much in it, we do agree with. We do not believe that it is ambitious enough, particularly on the two major crises that are currently affecting our health service. Those are indeed the slippage that we have seen in real terms, in percentage health spend on mental health, but also the burgeoning crisis in our GP sector. Yesterday, I visited Ladywell Medical Centre in Cwestorfin. They are a great practice and they are at capacity, but they told me that when the garden city development approved by Edinburgh City Council comes on stream next year, they will be asked to absorb another 4,000 patients. They will be at capacity and they will have to close their lists. As already, East Craig's also in my constituency have had to do. This is because no new health centres have been built in my constituency for the last 45 years, despite a year-on-year population growth. One in four surgeries is still trying to recruit a GP partner who they cannot seem to find. At the end of this decade, as we have heard other benches refer to in this debate, we will have 740 fewer GP's than our primary healthcare requires as a nation. Training places are one thing, and it was great to hear the cabinet secretary announce them, but they are nothing if there are no GP's to fill them. Ask any doctor and they will tell you. One quarter of surgery appointments in our GP surgeries are used by people with underlying mental health needs. They demand far more attention from our doctors than they currently receive from our health board funders. Percentage terms, that funding is actually dropping. Last year, I was walking through the centre of Edinburgh and a man very sadly took his own life and died on the pavement beside me. I was the first responder at the scene and I had an ambulance there 90 seconds later. At a time when his primary care needs were absolutely nil, but had he walked into a GP surgery when he had begun to feel unwell, he could have expected to wait at least nine months for the kind of care. He was 41 years old and very sadly joins the ranks of those men under the age of 50 for whom suicide is the leading cause of death. 700 people in Scotland a year die from taking their own life. That is almost equivalent to those dying of breast cancer. To conclude, investment in mental health will not just help our hard-pressed and overworked GPs. It must be seen as a pan-departmental issue as well. It is an economic issue. 643,000 days lost to work due to depression every year. It is a criminal justice issue with many public acts of disturbance being caused by people again with underlying mental health issues. To finally finish, it is a childhood issue. The fact that six health boards today have announced that they have missed their own targets is a national disgrace. We must double the spending that comes with spending, and that is the challenge before us. I call Graeme Dey to follow by Neil Bibby to follow by Bruce Crawford. Gentlemen, it is up to five minutes each, as we are short for time. I want to focus my contribution on some of the practicalities around delivery of health services on the ground in areas such as I represent. Let me say at the outset that nothing I intend to say is designed to let the Scottish Government off the hook, as it were, ultimately the responsibility for the delivery of health services lies with the Government. However, as Marie Todd said, no Government of any hue can micromanage every aspect of the workings of NHS boards, which impact what is actually happening on the ground in terms of day-to-day delivery, nor can it ensure that councils do their bit in maximising ready access to those services. An overarching policy and ambitions can so readily be undermined by underlying issues and the responsibility for which ultimately lies at that local level. NHS Tayside has a 2020 vision document for the delivery of healthcare across its area, which talks of ensuring that services are readily available in rural settings, but talking the talk has to be followed by walking the walk. To be fair, to some extent, it is doing that in my constituency. Let me acknowledge that we have seen very welcome enhancements of provisions in Angus South. The advent of access to day-patient cancer services in our broth is a welcome step forward. The joined up working with GPs in Angus Council along the coastal strip to better serve dementia patients and their families has been terrific. I look forward to seeing it rolled out in Cary Muir. However, I would be failing in my duty as the constituency MSP not to highlight pinch points around delivery of the kind of services the cabinet secretary and his Government I know want for rural parts. We face a particular demographic challenge in Angus, whereby the working-age population from which the NHS would recruit is going down, while those of an age statistically more likely to require health services is increasing. That is being exacerbated by an apparent difficulty in recruiting staff from outwith the locality to work in such rural or perhaps more accurately semi-rural settings. In part, I am told that this is down to newly trained staff, for example, having done their training in shiny busy modern facilities, finding older traditional service models, which exist in too many rural areas, comparatively unattractive. However, we have to find a means of tackling this issue, otherwise we will see more and more instances of what has just happened with Mntrose and Ffirmraith's maternity unit in my colleague Mary Evans's neighbouring constituency, which has had to close to new births until September, owing to staff shortages. The NHS nationally now boasts almost 60,000 midwives, 4.6 per cent more than in 2006, yet a facility in a significant-sized town is unable, albeit temporarily, to attract staff in sufficient numbers. That tells us that there is a specific problem here at play. Let us be clear that, if it is not addressed, ultimately on safety grounds, we could see a more permanent impact on locally available services, not necessarily in Mntrose, but in a wider sense. You only have to look at events at the nearby Mulberry unit at Stratford hospital to see that. Whatever other reasons there are behind the potential threat to its future, difficulties in recruiting and retaining staff are advanced as a major reason why, under plans to close, one of the three mental health inpatient units in Tayside, Mulberry seems to be favourite to go. Ironically, Mulberry is a modern facility that is popular with service users and their families, and indeed with the staff deployed there. NHS Tayside, albeit with any and all possible Government support, must find a way to overcome that problem around rural recruitment. What are other boards doing? What best practice examples are out there? I want to hear another area of concern this time around primary care and how the benefits of additional funding and jointly agreed initiatives may not yet be being felt on the ground. As the cabinet secretary and those two GP practices in my constituency are keen to be innovative and embrace some of the new measures that the Government has brought forward in conjunction with stakeholders to address the recruitment and retention of staff and patient access issues that they are encountering. However, the initial response that they have had from the health board has not offered the encouragement that they were anticipating. Health boards need to be promoting the new measures and embracing different approaches in support of primary care, particularly around the recruitment issues and the working models. In terms of patient access, we also need a real change in approach around local authority planning. When considering housing developments, councils will seek developer contributions to alleviate any company impact on education provision. However, they have, in my experience up until recently, shown little regard for potential impact on local GP lists, which is having tangible consequences for people seeking appointments. I am partially reassured to be told that, going forward, all new housing developments across Tayside will now be considered as part of the developing primary care premises strategy, but the councils and NHS Tayside really need to get their act together quickly. If the population of an area is to be increased by the sanctioning of a significant new build, then potential impact on access to local health services must be at the heart of the decision-making process. I welcome the opportunity to speak in the first health debate of this new parliamentary session. This is a new session, but today I will again use my contribution to discuss the future of the NHS in my area and stand up for my constituents, specifically the families and staff of the royal Alexandra hospital children's ward in Paisley. Before I do that, I want to put on record my support for the amendment in the name of my colleague Annas Sarwar, which calls for a cut in cancer waiting things. To make the NHS fit to tackle those challenges, there needs to be proper funding in place. I acknowledge and welcome the health secretary today, indicating that she wants to properly resource health services in Scotland. In order for this to be a reality, the health secretary will need to properly resource health boards like NHS Greater Glasgow and Clyde, Scotland's largest health board area. As Shona Robinson knows, the board will soon set its budget and needs to make cuts of £69 million over the coming financial year. That is over £1 million every week. I have said before and I will say again that the Scottish Government cannot say that they are protecting the NHS budget when Scotland's largest health board is having to make such significant cuts. Those cuts are a threat and could decimate local services like the children's ward at the RAH in Paisley. That children's ward provides a vitally important service to local families and the staff provide a very high standard of care. I have said before and I will do so again that the existing ward services should be maintained, they should not be subject to closure or any downgrading. We have been talking about health inequalities today and it will be remised not to remember that the RAH serves the most deprived community in the whole country. If the Scottish Government is serious about this, it will seek to protect and improve health services at the RAH. We know that key decisions on services at the hospital, like other hospitals, were delayed until after the election. Now, we learn from the front page of the Paisley daily express on Saturday that the health board recently told Renfrewshire Council that it is their preferred option to move impatient paediatric services from the RAH to Glasgow. It is now beyond any shadow of a doubt that the children's ward has been and is under threat. The health secretary, before the election, wrongly denied that there were any proposals. The First Minister, as specifically said on national television just days before the election, there were no proposals either. I will not surprise the health secretary that I have a few questions for her and her colleagues on the current situation. Can the health secretary tell us if the position is of the Government that there are no proposals still to close or downgrade the children's ward? Renfrewshire Council have made an effort to contact the health board about the plans for the children's ward. Is the health secretary still saying that she or her officials have had no discussions whatsoever about the future of the ward, like she said in the chamber in March? Also, can she confirm that she still believes that the NHS services, including the children's ward at the RAH in Paisley, are clinically safe, like she did in March? Can she confirm that she will ensure that there will be a full and meaningful consultation on any proposals affecting the RAH should the health board press ahead? However, the formal question that I would like to answer to now is whether the health secretary will give a commitment to come to Paisley to listen to the views of local families that are affected by proposed cuts to the RAH. I am sure that the health secretary would not snub such a meeting. The health secretary should come to Paisley to listen to the views of local families. Surely she would not expect local families and staff to come to Edinburgh to meet her. The on-going uncertainty about the future of the children's ward is deeply disrespectful to and worrying for families and staff. The health secretary should visit Paisley and listen to the views of local parents on the importance of the ward. Listening to local mums, such as Karen Mico, who said, "...I've lost count of the number of times you've been in the RAH. It's certainly been at least once a week since Alex, her son, was born. He suffers from seizures, infections and breathing difficulties in every second counts when it comes to getting him treatment. Getting there quickly is so important." The final question that I have for the health secretary that will need an answer to it is whether or not she will protect ward 15 at the RAH and provide the health board with the necessary resources to do so. The health secretary told the Paisley Express in January that she would have the final say over any proposal. Having wrongly denied the existence of proposals to local families, it would be unforgivable for the health secretary to back any plans to close or to downgrade the children's ward against the wishes of local families. It's time for the Scottish Government to be honest with and listen to local families and RAH staff. It's time for the local health board to be properly funded and it's time for the health secretary to make sure that there is no closure or downgrading whatsoever of the RAH's children's ward. Thank you very much, Mr Bibby. I call Bruce Crawford, who will be the last speaker when we move to the winding-up speeches. Members who have been in the chamber during the debate took part should be in the chamber for the winding-up speeches. Microphone and card, I think, but not necessarily in that order. Probably now we've lost a minute, so forgive me. I'll give you a back deference to your age. Thank you very much. I'll come to age in a moment, but I'm delighted to be able to speak in this first health debate in this new Parliament. Right across the chamber, I think that we've all agreed that our most cherished service is our national health service. Right across the chamber, we've also agreed that it faces significant challenges. I enjoyed the contribution from Jackson Carlaw, who recognised rightly that there's an emerging consensus here, and I think that the way he put it across was very, very effective. I hope that, as we go through the course of the next five years, we can keep that consensus together to help to deliver the challenges, the changes that are going to be needed in the health service. There are a number of challenges, obviously, and I'll touch on a few of them. We know that in the national health service, inflation runs ahead of that in the normal economy because of the price of drugs, etc. We're also aware, as was touched on by Brian Whittle, that we have a real problem with obesity and diabetes, and that's driving up demand in the national health service. Touching on Brian, I say to him, well done in his first speech, as I do to Marie Todd, and I think that it was Ross Thompson's first speech as well, so well done to you all. Obviously, beyond that, we have a demographic problem. People are living longer and we've got complex conditions becoming more and more prevalent. That's why I was pleased to see in the Scottish National Party manifesto commitment the idea of the elective diagnostic and treatment centre to deal with routine problems, particularly problems around cataract operations, hips and knee replacements. I think that this idea and the idea to take this forward is an absolute necessity to take pressure off acute and primary care services in the future. As I become more chronologically challenged myself, perhaps like you, we might need this service ourselves. I think that I tread very carefully. I always tread very carefully around you. But I think that the reality is that the structure must change to reflect a changing Scotland and a huge challenge of the future. We have an architecture and a landscape of health boards with 22 health boards in Scotland, 14 territorial boards and eight special boards. I think that they must be up for some sort of reform cabinet secretary and I welcome you and the rest of your team to your back to your post and the new focus around about you. We need to tackle that scale of that architecture and landscape if we're going to make it fit for the purpose and whose challenges of the future. Can we find a way to remove duplication from those services and administrative costs that we can put into the front line? That's the sort of areas that we're going to have to take tough decisions around to put the national health service on a sound basis and equip it for the next decade and beyond. I'm glad that the cabinet secretary touched