Neil Gray
Scottish National Party · Scotland
“I welcome the fact that, through the police and the courts, our justice system is ensuring that justice is done. Victims show enormous bravery and trust in our legal system in reporting crime, and I want that to continue.”
“The Scottish Government-funded Caledonian system is a good example of a community-based programme that aims to address the behaviour of men who have been convicted of domestic abuse, alongside providing support to affected women and children.”
“On the day after my appointment as justice secretary, I visited HMP Edinburgh to see the level of pressure that the Scottish Prison Service is facing due to an increasing prison population. It is clear that staff want to focus on rehabilitation and reducing reoffending but that it is increasingly difficult for them to do so.”
“Scotland shows a clear and persistent trend of increasing the length of average custodial sentences, including a 37 per cent rise between 2014-15 and 2023-24.”
“However, although the operational impact that will result from the changes is expected to be minimal, I still advise the Parliament to give legislative consent to the relevant sections of the bill.”
“I note my thanks and appreciation to the Parliament for expediting consideration of this legislative consent motion. It is regrettable that we are having to expedite scrutiny on an LCM, which is due to the UK Government’s timetabling for the National Security (State Threats) Bill.”
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“Improving access to urgent care services is a key priority for the Scottish Government. On 31 March 2025, we published the NHS Scotland operational improvement plan, which sets out how we plan to improve access to treatment, including in urgent care settings. As part of our wider £21.7 billion investment in health and social care services, the plan includes an additional £200 million to reduce waiting times and improve patient flow through hospitals, which will lead to a reduction in ambulance turnaround times and in delayed discharges. We are supporting boards to strengthen facilities such as flow navigation centres, so that they are able to refer patients to more services and avoid their unnecessary conveyance to hospital in ambulances.”
“In England, for instance, the combination of the rate of admissions that are paid for by insurance and the uptake rate of private healthcare accounts for 1,445 admissions per 100,000, compared with 902 per 100,000 in Scotland. Jackie Baillie looks to distance herself from those facts, which relate to her Labour Government’s performance, but they are facts. That reality demonstrates that there are shared challenges across the UK in responding to the situation that arose during Covid. We have a plan to deliver for the people of Scotland and we intend to deliver against it. The Presiding Officer: That concludes general question time. First Minister’s Question Time 12:00 Economic Performance 1.”
“Jackie Baillie: Scots are forking out thousands of pounds—some are having to use personal savings or borrow from family members—to pay for cataract procedures, for hip and knee replacements and even for rounds of chemotherapy. I hear what the cabinet secretary says, but it is a lot of words that cover up the incompetence of the Scottish National Party Government. When will he accept that, after 18 years of the SNP in charge, Scots face the reality of a two-tier health service in Scotland? Neil Gray: I have set out—and have always been candid about—the challenges that our healthcare systems face. Those challenges are not unique to Scotland, but it is unacceptable for anybody to have to wait too long for their healthcare to be provided. However, private healthcare is used much less in Scotland than in other parts of the UK.”
“Although a patient has the right, at any time, to exercise choice and seek private treatment, we recognise that excessively long waits for national health service treatment are not acceptable. That is why we are determined to reduce patient waits in the year ahead. Our investment of £106 million of additional funding will help us to deliver more than 150,000 extra appointments and procedures in 2025-26. This includes £25 million for orthopaedics and more than £12 million for ophthalmology. That funding is just part of our record investment of £21.7 billion in health and social care this year, which will expand capacity and reduce waiting times.”
“Neil Gray: The Cabinet Secretary for Finance and Local Government has repeatedly raised with UK Treasury ministers the increase in employer national insurance contributions and has pressed for the additional cost to public services in Scotland to be fully funded. That increase is having a profound impact across Scottish public services, which are paying for a UK Government tax rise. Our GPs, social care services and voluntary sector partners are all paying for UK Government decisions, so it is incredibly disappointing that, in the recent spending review, the chancellor has yet again failed to fund that additional cost. We will have to consider the implications of that as we continue to deliver services for the people of Scotland. National Resilience Strategy (Discussions with United Kingdom Government) 7.”
“Collette Stevenson: I am proud that Scotland is the only part of the UK where general practitioners and dentists have seen real-terms growth in their wages in recent years. I hope that that will drive recruitment in the sectors as we continue to improve access to healthcare across Scotland. However, the UK Labour Government’s reckless increase to employer national insurance is hitting GP and dental practices hard. What discussions has the Scottish Government had with the UK Government regarding such damaging Westminster policies? Will he outline how the Scottish Government will work with stakeholders to retain and recruit health professionals in Scotland?”
“First, the trade unions for agenda for change staff, including those that represent nurses and midwives, unanimously accepted a two-year pay deal of 4.25 per cent and 3.75 per cent. The independent review body on doctors’ and dentists’ pay has recommended a United Kingdom-wide 4 per cent pay uplift for national health service medical and dental staff, and I intend to accept that recommendation. Resident doctors are excluded from that recommendation, and I will hold direct talks with them in the coming weeks. The pay recommendation will mean, for instance, increases of between £4,286 and £5,695 in consultants’ salaries, and it will mean that, at the top of their scale, a consultant will earn basic pay of more than £148,000.”
“Neil Gray: In our interactions, I have listened to Mr Ewing’s testimony and that of the GPs that he represents and, as a result, I have taken action. I am concerned by Mr Ewing’s narration in the conclusion of his question about the pace at which the matter is moving. I would be more than happy to check in again with the Highland health and social care partnership to ensure that it is working at the necessary pace, and to stress that the effectiveness and safety of the system are paramount.”
“Fergus Ewing: Over the past three or four years, I have raised with the cabinet secretary and his two predecessors that a GP-run service would save millions of pounds a year—a fact that the cabinet secretary appears to ignore. More important, it would be safer because, as the cabinet secretary well knows, we have already lost the life of one infant, because of the negligence of a centralised national health service system. Given the concerns and the fact that the vaccination service will not, even now, be returned to GPs for this winter, will the cabinet secretary intervene and demand that NHS Highland return the service to GPs before any more damage is caused to patients in my constituency in the Highlands?”
“In general, the model of health boards being responsible for delivering vaccinations is working well across Scotland, but I recognise the need for flexibility in some areas, such as those that I have discussed at various junctures with Mr Ewing, in order to account for specific circumstances that might negatively affect vaccine uptake. That is why I have agreed to Highland health and social care partnership putting in place a mixed model. Oversight of how that will be developed and deployed to deliver local and accessible vaccination services in a safe and cost- effective way will ultimately remain the responsibility of Highland HSCP, with input and support from local GPs, practice managers, Public Health Scotland and the Scottish Government.”
“Indeed, the latest statistics indicate that there are historically high levels of nursing and midwifery staff, and that more than 1,000 band 5 nursing and midwifery vacancies across Scotland are open to newly qualified practitioners.”
“Through our on-going work to implement the recommendations of the nursing and midwifery task force, we will take further action that is designed both to attract and retain our nursing workforce, listening to the feedback that we have gleaned directly through conversations with staff on the ground. I note Jackie Baillie’s concern around newly qualified nurses who are unable to secure posts. I am aware that a limited number of newly qualified children’s nurses and midwives had challenges in identifying suitable posts in their local area last year. My understanding is that vacancies are often available across nursing disciplines, and geography can impact fill rates.”
“In this chamber, I have always been candid about the challenges that our NHS faces, and today will be no different. Once again, I put on record my deep appreciation for all the hard-working staff without whom our NHS simply could not function. In the case of our agenda for change staff, I was delighted to be able to recognise their efforts through the recent agreement of a two-year pay deal, which will feed through into pay slips later this month. We continue to invest heavily in our workforce, and the latest NHS Scotland workforce statistics, which were published last week, demonstrate 13 consecutive years of growth. There were other causes for optimism in those statistics, most notably the 62 per cent reduction in nurse agency staffing that was achieved over 2024-25.”
“The Deputy Presiding Officer: I call the cabinet secretary, Neil Gray, to speak to and move amendment S6M-17869.2. 15:00”
“I move, That the Parliament recognises the scale of the crisis in Scotland’s NHS, with almost one in six people in Scotland on NHS waiting lists for tests or treatment, and private hospital admissions in Scotland reaching record levels in 2024, all while patients struggle to access a GP appointment; is concerned, therefore, regarding reports that resident doctors are unable to secure speciality training places in Scotland’s NHS, while newly qualified nurses cannot get jobs despite over 2,600 unfilled whole-time equivalent nursing and midwifery vacancies; regrets that inadequate NHS workforce planning by the Scottish National Party administration is forcing highly skilled clinicians to seek employment elsewhere, and calls on the Scottish Government to expedite its reported Future Medical Workforce project, and to report back to the Parliament by 1 September 2025, and undertake a wider review of workforce planning, with independent modelling and projections, and to report back by 1 December 2025, so that there is the required level of workforce to staff Scotland’s NHS.”
“They said: “My colleagues and patients love me, the feedback I get is great, but the system simply doesn’t care. I am betrayed by the career and country I loved, and the worst part is: I know I’m not alone.” This is Parliament’s chance to speak up for the young, talented, hard-working people who have spent years training to work in our NHS as doctors, nurses and allied health professionals. They cannot get a job, and that is the fault of this Government and nobody else. This is the time for ministers to commit to changing the system, so that qualified doctors and nurses can do the jobs for which they trained.”
“It is another month for Australian headhunters to recruit them and another month that patients have to continue to wait for treatment. That is why the Scottish Government has to act now—not next year, but right now. It needs to provide jobs for those resident doctors this August or risk losing them from the NHS completely. The Scottish Government needs to expedite its future medical workforce project and report back to Parliament by 1 September. It must also undertake a wider review of workforce planning, with independent modelling and projections, to report back by 1 December, because there is an urgent need for a proper workforce plan. Those would be important first steps towards that and, frankly, we cannot afford to wait any longer. I will finish with another quote from a doctor who was surveyed by BMA Scotland.”
“All that must be mind boggling to the patients who are queuing at accident and emergency or just waiting for a test, diagnosis or treatment. It is no wonder that more and more people with means are going private because they can no longer cope with waiting in pain. The SNP Government says that it wants to fix our NHS, but do you know something? After 18 years, if it had any idea of how to do so, we would have seen it by now. We all know that our NHS is nothing without its staff, but, instead of using them as a human shield, as this Government does, the SNP must get its head out of the sand and take action, because every month that the SNP drags its feet is another month when unemployed resident doctors do not know where to find the money for rent.”
“I have today been sent information that shows that the SNP has cut the number of specialty training places for resident doctors in core surgical training, general surgery, neurosurgery, ear, nose and throat, urology, obstetrics and paediatrics. It is not just doctors whose places are being cut. Last year, the Royal College of Nursing Scotland warned that newly qualified nurses could not find jobs, despite more than 2,600 whole-time- equivalent nursing and midwifery vacancies being unfilled. Hundreds of nurses graduated without jobs to go to. One mother, whose daughter is about to graduate this year as a paediatric nurse, contacted me to say that she and her fellow graduates could not find jobs in Scotland, despite working on short-staffed wards during their training. Her daughter is now preparing to move to Leicester.”
“However, the SNP’s failure to come up with a proper workforce plan is also a betrayal of all of us. As Susan, a resident doctor in Hamilton, asked, “Why are we spending money increasing university places for medical students, when there are not enough jobs, or training posts, to continue their career in Scotland?” The Scots who cannot get an appointment should rightly be outraged at the idea that they cannot see a doctor when, somewhere nearby, an unemployed qualified doctor is sitting on their hands. Douglas, a resident doctor, said: “I would love to be an anaesthetist, I would love to help bring down waiting lists but I can’t.” The SNP Government will say all the right things about how important NHS staff are—and they are—but its actions betray it.”
“These are the voices of resident doctors who have trained for years, but, in today’s Scotland, are not able to get jobs: “It feels like a complete dead end … completely soul crushing after seven years of dedication”. “I do not know if I will be able to pay my rent come August and, if I am unable to secure enough work, I will have to move back in with my parents”. “It is literally giving me sleepless nights.” Some are considering moving to England or, indeed, abroad. Others are forced to choose between their family life and a job on the other side of the country, and others still are considering a new career. That is the reality of being a resident doctor in the Scottish National Party’s Scotland. For the individuals concerned, it must be a crushing blow to realise that the stable career that they chose is anything but.”
“Will the member take an intervention? Jackie Baillie: No—I think that you should listen. It costs £300,000 to train a single doctor to the point at which they can land a specialty training place, and we are also training nurses at a cost of £60,000. We are throwing that down the drain— what a waste, not just of taxpayers’ money, but of those people’s futures. Today, the British Medical Association Scotland published a survey of its resident doctors that shows that a staggering 70 per cent of them have concerns about their employment—all that while the vacancy rate for consultants is at 14.4 per cent. To put that into context, that is 1,000 vacant consultant posts, which is enough to fill two large hospitals.”
“Amendment 2B disagreed to. Amendment 2C moved—[Brian Whittle]. The Presiding Officer: The question is, that amendment 2C be agreed to. Are we agreed? Members: No. The Presiding Officer: There will be a division. The vote is closed.”
“For Baillie, Jackie (Dumbarton) (Lab) Baker, Claire (Mid Scotland and Fife) (Lab) Balfour, Jeremy (Lothian) (Con) Boyack, Sarah (Lothian) (Lab) Briggs, Miles (Lothian) (Con) Burnett, Alexander (Aberdeenshire West) (Con) Carlaw, Jackson (Eastwood) (Con) Carson, Finlay (Galloway and West Dumfries) (Con) Choudhury, Foysol (Lothian) (Lab) Clark, Katy (West Scotland) (Lab) Cole-Hamilton, Alex (Edinburgh Western) (LD) Dowey, Sharon (South Scotland) (Con) Duncan-Glancy, Pam (Glasgow) (Lab) Eagle, Tim (Highlands and Islands) (Con) Findlay, Russell (West Scotland) (Con) Fraser, Murdo (Mid Scotland and Fife) (Con) Gallacher, Meghan (Central Scotland) (Con) Golden, Maurice (North East Scotland) (Con) Gosal, Pam (West Scotland) (Con) Grant, Rhoda (Highlands and Islands) (Lab) Greene, Jamie (West Scotland) (LD) Griffin, Mark (Central Scotland) (Lab) Gulhane, Sandesh (Glasgow) (Con) Hamilton, Rachael (Ettrick, Roxburgh and Berwickshire) (Con) Hoy, Craig (South Scotland) (Con) Johnson, Daniel (Edinburgh Southern) (Lab) Kerr, Liam (North East Scotland) (Con) Kerr, Stephen (Central Scotland) (Con) Lumsden, Douglas (North East Scotland) (Con) Marra, Michael (North East Scotland) (Lab) McArthur, Liam (Orkney Islands) (LD) McCall, Roz (Mid Scotland and Fife) (Con) McNeill, Pauline (Glasgow) (Lab) Mochan, Carol (South Scotland) (Lab) Mundell, Oliver (Dumfriesshire) (Con) O’Kane, Paul (West Scotland) (Lab) Rennie, Willie (North East Fife) (LD) Rowley, Alex (Mid Scotland and Fife) (Lab) Russell, Davy (Hamilton, Larkhall and Stonehouse) (Lab) Simpson, Graham (Central Scotland) (Con) Smith, Liz (Mid Scotland and Fife) (Con) Smyth, Colin (South Scotland) (Lab) Stewart, Alexander (Mid Scotland and Fife) (Con) Sweeney, Paul (Glasgow) (Lab) Villalba, Mercedes (North East Scotland) (Lab) Webber, Sue (Lothian) (Con) White, Tess (North East Scotland) (Con) Whitfield, Martin (South Scotland) (Lab) Whittle, Brian (South Scotland) (Con) Wishart, Beatrice (Shetland Islands) (LD) Against Adam, George (Paisley) (SNP) Adam, Karen (Banffshire and Buchan Coast) (SNP) Adamson, Clare (Motherwell and Wishaw) (SNP) Allan, Alasdair (Na h-Eileanan an Iar) (SNP) Arthur, Tom (Renfrewshire South) (SNP) Beattie, Colin (Midlothian North and Musselburgh) (SNP) Brown, Keith (Clackmannanshire and Dunblane) (SNP) Brown, Siobhian (Ayr) (SNP) Burgess, Ariane (Highlands and Islands) (Green) Callaghan, Stephanie (Uddingston and Bellshill) (SNP) Chapman, Maggie (North East Scotland) (Green) Coffey, Willie (Kilmarnock and Irvine Valley) (SNP) Constance, Angela (Almond Valley) (SNP) Dey, Graeme (Angus South) (SNP) Don-Innes, Natalie (Renfrewshire North and West) (SNP) Doris, Bob (Glasgow Maryhill and Springburn) (SNP) Dunbar, Jackie (Aberdeen Donside) (SNP) Ewing, Annabelle (Cowdenbeath) (SNP) Ewing, Fergus (Inverness and Nairn) (SNP) Fairlie, Jim (Perthshire South and Kinross-shire) (SNP) FitzPatrick, Joe (Dundee City West) (SNP) Forbes, Kate (Skye, Lochaber and Badenoch) (SNP) Gibson, Kenneth (Cunninghame North) (SNP) Gougeon, Mairi (Angus North and Mearns) (SNP) Grahame, Christine (Midlothian South, Tweeddale and Lauderdale) (SNP) Gray, Neil (Airdrie and Shotts) (SNP) Greer, Ross (West Scotland) (Green) Harper, Emma (South Scotland) (SNP) Harvie, Patrick (Glasgow) (Green) Haughey, Clare (Rutherglen) (SNP) Hepburn, Jamie (Cumbernauld and Kilsyth) (SNP) Hyslop, Fiona (Linlithgow) (SNP) Kidd, Bill (Glasgow Anniesland) (SNP) Lochhead, Richard (Moray) (SNP) MacDonald, Gordon (Edinburgh Pentlands) (SNP) Mackay, Gillian (Central Scotland) (Green) [Proxy vote cast by Ross Greer] Mackay, Rona (Strathkelvin and Bearsden) (SNP) Macpherson, Ben (Edinburgh Northern and Leith) (SNP) Maguire, Ruth (Cunninghame South) (SNP) [Proxy vote cast by Rona Mackay] Martin, Gillian (Aberdeenshire East) (SNP) Mason, John (Glasgow Shettleston) (Ind) Matheson, Michael (Falkirk West) (SNP) McAllan, Màiri (Clydesdale) (SNP) [Proxy vote cast by Jamie Hepburn] McKee, Ivan (Glasgow Provan) (SNP) McLennan, Paul (East Lothian) (SNP) McMillan, Stuart (Greenock and Inverclyde) (SNP) McNair, Marie (Clydebank and Milngavie) (SNP) Minto, Jenni (Argyll and Bute) (SNP) Nicoll, Audrey (Aberdeen South and North Kincardine) (SNP) Regan, Ash (Edinburgh Eastern) (Alba) Robertson, Angus (Edinburgh Central) (SNP) Robison, Shona (Dundee City East) (SNP) Roddick, Emma (Highlands and Islands) (SNP) Ruskell, Mark (Mid Scotland and Fife) (Green) Slater, Lorna (Lothian) (Green) Somerville, Shirley-Anne (Dunfermline) (SNP) Stevenson, Collette (East Kilbride) (SNP) Stewart, Kaukab (Glasgow Kelvin) (SNP) Stewart, Kevin (Aberdeen Central) (SNP) Swinney, John (Perthshire North) (SNP) Thomson, Michelle (Falkirk East) (SNP) Todd, Maree (Caithness, Sutherland and Ross) (SNP) Torrance, David (Kirkcaldy) (SNP) Tweed, Evelyn (Stirling) (SNP) Whitham, Elena (Carrick, Cumnock and Doon Valley) (SNP) Yousaf, Humza (Glasgow Pollok) (SNP) The Presiding Officer: The result of the division is: For 50, Against 66, Abstentions 0.”
“On a point of order, Presiding Officer. It appears that my vote has been recorded, but I am not certain. Just to be clear, I note that I would have voted no. The Presiding Officer: I confirm that your vote was recorded.”
“That will provide a robust basis for the wider local transformation required over the longer term, under the new board chief executive. Foremost in our considerations of this matter must be the people who are served by NHS Grampian. I know that we are all united in wanting the very best for them. The Deputy Presiding Officer: The cabinet secretary will now take questions on the issues raised in his statement. I intend to allow around 20 minutes, after which we will need to move on to the next item of business. I ask members who wish to ask a question to press their request-to- speak buttons.”
“The Government’s assurance board will look for evidence of that meaningful partnership working around the development and implementation of NHS Grampian’s improvement plan. I hope that this statement assures members that we take the issues very seriously and that I will continue to keep them updated on the next steps, including on the specific actions required as part of the board’s improvement plan and the shape of the on-going support and scrutiny that will be provided by the Government. I reiterate that we remain committed to supporting the new leadership of NHS Grampian to turn the position around. We need to mitigate the immediate risks around the financial and associated operational pressures that the board faces, and to help to stabilise the system.”
“Meaningful partnership working with local staff and their representatives will be necessary for NHS Grampian to successfully develop and implement its improvement plan. We expect all boards, including NHS Grampian, to have robust systems and processes in place for engaging with and involving colleagues in their planning and strategies, in line with our NHS Scotland national staff governance standard. NHS Grampian must work closely with its staff- side, trade union and professional organisation representatives in its area partnership forum to ensure that it listens and responds to concerns raised by staff and that their views help to inform future activity. Similarly, we expect the full engagement of local clinical views, not least through the NHS Grampian area clinical forum.”
“The whole-system diagnostic will help to inform the board’s detailed improvement plan and the tailored package of scrutiny and support that will underpin it. As with other stage 4 escalations in the past, the Government will establish an assurance board, which will report to the director general for health and social care and chief executive of NHS Scotland. That board, which will be chaired by a Scottish Government director, will be tasked with providing oversight of NHS Grampian’s progress against the specific actions in its improvement plan. I also want to recognise the concerns raised in the members’ business debate about local management meaningfully engaging with, and properly listening to, front-line staff—a point that was alighted on in particular by Kevin Stewart, both in that debate and in his more recent topical question.”
“The diagnostic will establish a shared, data-driven understanding of the current operation of the whole system and provide insight into the specific issues that NHS Grampian faces; review the existing service models and relationships with financial management, ensuring that assets are being optimised and care is being delivered effectively in the right place; and identify what further cross-boundary collaboration could take place with other NHS boards, particularly in the north of Scotland, to support NHS Grampian to mitigate its operational risks. I am determined that the scope of the diagnostic and subsequent work will not be limited and that it should extend to all relevant areas of local service delivery and expenditure.”
“One of the key initial elements of the package of enhanced support and scrutiny will be a whole-system diagnostic. KPMG has been appointed to carry out that work, and we expect it to report by the end of June. The overarching goal of the diagnostic is to better understand how the whole system is operating and, in partnership with NHS Grampian, determine which changes the board could realistically effect within its financial envelope.”
“The key focus of the further escalation will be to mitigate immediate concerns about the financial and associated operational pressures and to stabilise the local system. Another concern that we heard during the members’ business debate in late April was about the leadership of the board, with the interim chief executive having announced his intention to retire earlier this year. I am advised that there is a strong shortlist of candidates for the chief executive post, with the final interviews scheduled for early June. As such, we are confident of making a successful appointment in the near future. As I have said, the purpose of the intervention is to stabilise the system and provide a robust basis for the wider local transformation work that is required over the longer term and in support of the new leadership.”
“Indeed, we are providing an additional £3.3 million to NHS Grampian in 2025-26 for two mobile MRI scanners and one mobile CT scanner. Those resources are set to deliver more than 19,000 additional scans over the course of the year. Nonetheless, financial and operational issues persist, and it is right that we now act further. We heard in the recent members’ business debate on NHS Grampian about the long-standing demographic, demand and capacity pressures across the local health and social care system. We understand that those pressures will require a comprehensive local strategy to deliver the fundamental transformation that is required and that that will not happen overnight.”
“By way of an example, I note that the centre for sustainable delivery has provided bespoke clinical support to NHS Grampian and has identified opportunities that will support improvements. That includes a focus on reducing hospital occupancy to improve flow and reducing turnaround times for the ambulance service. There is the potential to build on the current local model of flow navigation, and work is under way with the board to develop that further. I should reiterate that, by accessing extra funding from an additional £30 million national investment in planned care, NHS Grampian was able to deliver more than 23,000 additional appointments and procedures last year. We will continue to support the board in building on that work.”
“The board has since referred to a number of on- going “intolerable risks”, including with regard to its ability to respond effectively to persistent demand and pressures on local unscheduled and planned care. The Government and the national centre for sustainable delivery have been engaging with and supporting the board for some time to help it to assess delivery and target sustained improvements in local unscheduled care performance. Indeed, I want to be clear that this is an escalation in support and scrutiny for NHS Grampian. As such, it will build on the previous support and improvement activity that has been undertaken. The support provided to date has come from a range of providers, including the Government’s financial delivery unit and Healthcare Improvement Scotland.”
“Concerns remain about future financial pressures for NHS Grampian, and there is insufficient confidence that the board’s current plans will arrest the rate of expenditure and deliver the sustainable recovery that is required. We cannot tolerate that position. It is therefore our judgment that further formal escalation is necessary. Along with the additional support and scrutiny that that will provide, we must seek to mitigate the significant financial risks to the local board and, more widely, the overall national health service. Alongside financial management issues, NHS Grampian is being escalated due to rising concerns about local services. That includes the operational pressures that led the board to declare a critical incident for three days last November, diverting some activity to other board areas due to capacity constraints.”
“At that time, I assured the chamber that I would keep the board’s escalation position under close review, and that, if required, I would not hesitate to act further in the best interests of local people. Following careful consideration, the Government announced on 12 May that NHS Grampian’s escalation status had been raised to stage 4 of the framework for finance, leadership and governance. NHS Grampian had the largest financial deficit of any health board in 2024-25. It reported a forecast outturn deficit of £65.1 million. Indeed, despite record funding of more than £1.34 billion in the current financial year, and the tailored support that is already offered under stage 3 of the framework, the board will be in receipt of cumulative brokerage from the Government in excess of £90 million across the past two years.”
“We are determined to do that in a way that is not detrimental to key, front-line services. NHS Grampian has been experiencing significant financial and operational pressures for several months. That prompted the escalation of the health board to stage 3 of the NHS Scotland support and intervention framework for financial management in January this year. Stage 3 is the first formal stage of escalation and, as such, NHS Grampian has been receiving a package of tailored support. However, significant concerns remain about the board’s financial position, plans, leadership and governance, and about any associated impact that they might be having on the delivery of local services. We heard a number of those concerns during the members’ business debate on NHS Grampian that was secured by Douglas Lumsden on 22 April.”
“I wish to update Parliament on our decision to escalate NHS Grampian to stage 4 of the NHS Scotland support and intervention framework. I once again acknowledge that staff in NHS Grampian continue to work tirelessly to deliver the high-quality healthcare that we expect. Our intervention is in no way a reflection on the excellent care and support that they offer local people each and every day, nor should we forget the significant health service innovations and improvements, which I have seen first-hand during visits to Grampian. Indeed, the purpose of the intervention is to enable local staff to go further. We will do so by providing the right balance of scrutiny and support to stabilise the system, ensuring a robust basis for the wider local transformation that is required over the longer term.”
“The Deputy Presiding Officer: We have a number of supplementaries. I will try to get them all in, but I need brevity.”
“Neil Gray: I do not think that that is inevitable. I am still committed to meeting that target. We currently have a record number of GPs in training, and I want to work with both the RCGP and the British Medical Association general practice committee on how we see increased resources going into general practice to support greater employment. We have seen a rise in the head count, but I recognise that the whole-time equivalent position has been more challenging post Covid, as people have—understandably—taken different decisions on work-life balance. I want to see the capacity of, and the provision from, general practice increase. Our vision for the health service has shifted the balance of care into community and primary care and to a more preventative model, and we arrive at that only by having increased services in general practice.”
“I thank the Royal College of General Practitioners Scotland for its report, “Whole person medical care: The value of the General Practitioner”, which highlights the value of GPs and the contribution that they make to the nation’s healthcare. I look forward to discussing the report further with the RCGP at one of our regular meetings. We remain committed to increasing the number of GPs working in Scotland. In November last year, I published a plan setting out 20 measures to improve GP recruitment and retention. Martin Whitfield: The report states categorically: “The Scottish Government’s current target is to increase the number of headcount GPs in Scotland by 800 by 2027.” It goes on to say: “It is the view of Audit Scotland and RCGP Scotland that this target will not be met.” Does the cabinet secretary agree?”
“At the top of my list are the unscheduled care pathways in Grampian, so that the board starts to see improvements, because the current position is unacceptable. “Whole person medical care: The value of the General Practitioner” 7.”
“What, precisely, has the cabinet secretary done since February to reduce ambulance wait times in NHS Grampian, and when does he project that those measures will result in NHS Grampian hitting its targets? Neil Gray: I saw for myself the challenges that NHS Grampian is facing, specifically at the Aberdeen Royal infirmary, from my visit there, to which Liam Kerr referred. I understand the challenges there—I have family members living in Grampian, so I understand the specific issues intensely. We have escalated NHS Grampian on the escalation framework to level 4, both for its performance and delivery and in relation to the financial picture. That escalation provides additional support and scrutiny to ensure that the board is meeting its financial and delivery imperatives.”
“Data on turnaround times for ambulance resources across Scotland by hospital site and by national health service board are shared with the Scottish Government and published weekly, so we are well aware of the challenges that both NHS Grampian and the Scottish Ambulance Service are facing in that regard. We continue to work closely with both organisations to improve turnaround times in the region. Liam Kerr: The cabinet secretary will be aware, because he visited NHS Grampian in February and—along with his usual apology for the Government’s failure—he promised to improve things. Here we are in May, and one in 10 people is waiting four hours or more for an ambulance, with delays steadily rising. That is nearly double the target figure of two and a half hours.”
“Neil Gray: I thank Liz Smith for raising her concerns about her constituent in Forth Valley. I am obviously not aware of the full circumstances, so I cannot comment specifically, but what Liz Smith has narrated to Parliament is deeply concerning. I would appreciate it if she could furnish me with the details of the case so that I can raise it with NHS Forth Valley and get an explanation of what is happening. In general, as I said in my initial answer, I would expect a timeous response. There can be reasons why that can be delayed, but from what Liz Smith tells me, it has gone beyond that point with that complaint.”
“Liz Smith: I am currently representing a constituent who lodged a complaint with NHS Forth Valley back in October 2024. Other than three holding replies that were received up to the beginning of January, my constituent is still waiting. When I approached NHS Forth Valley, I was informed that, because of staff shortages, it was now working only on complaints that were received during August 2024 and that it would be unlikely that my constituent would receive a response until at least October 2025, which is a whole year after the initial complaint was made. Given what the cabinet secretary has just said, I hope that he will agree that that is completely unacceptable and that it is certainly not within the 20 days that it is supposed to be the case for investigation. What action will the cabinet secretary take?”
“Overall responsibility and accountability for the management of NHS complaints lies with individual boards’ chief executives, their executive directors and the appropriate senior management. The boards must ensure that complaints teams are adequately resourced to meet their statutory duties in relation to complaints handling. The Scottish Government has been clear about the importance of a timely and effective response in order to resolve a complaint. However, we are aware that not all investigations will be able to meet the 20-day target. The regulations make provision for timescales of responses to complaints to be extended where appropriate, provided that complainants are informed of the reason for the delay and given a revised timescale for a response.”
“There is a significant amount of work going on to support people in communities to prevent the issues that Carol Mochan has rightly raised as being of concern at the moment. That includes work on our five family payments: the Scottish child payment, best start foods and the three best start grants, which, together, could be worth more than £10,000 by the time an eligible child turns six. We also have healthy start vitamins, which contain vitamin D and are provided free to all pregnant women throughout their pregnancies. We are taking a number of steps to address the poverty-related drivers of poor nutrition and malnutrition that Carol Mochan speaks of, as well as responding with the framework, which will come imminently. Immigration (Care Sector) 6.”
“As well as that being totally unacceptable, it places significant pressures and costs on our healthcare system. Many families, including in my South Scotland region, face high costs, poor food availability and significant inequalities, all of which limit their access to nutritious foods. The cabinet secretary referred to the malnutrition short-life working group. It was commissioned to recommend a framework for the prevention of malnutrition and dehydration more than two years ago, but we have had no detail to date. When will the framework be published? Neil Gray: As I said in response to Carol Mochan’s first question, we will be developing a diet and healthy weight implementation plan, which will be informed by the working group and by the population health framework, which is coming imminently.”