The final item of business is a members’ business debate on motion S6M-17011, in the name of Douglas Lumsden, on addressing waiting times in NHS Grampian. The debate will be concluded without any question being put, and I invite members who wish to speak in the debate to please press their request-to-speak buttons.
Motion debated,
That the Parliament notes the reported concerns regarding challenges that NHS Grampian is facing in relation to staffing shortages and resource limitations, which it understands has contributed to delays in patient care and increased pressure on existing medical personnel; acknowledges that, in September 2024, NHS Grampian reported that over 3,000 patients were waiting over two years for hospital treatment, which it believes was the highest number among Scottish NHS boards; understands that, in November 2024, NHS Grampian declared a board level critical incident, which led to the diversion of ambulance patients to hospitals outside the region due in part to sustained pressures at Aberdeen Royal Infirmary; notes that, in late November 2024, NHS Grampian experienced a significant rise in delayed discharges, with 199 cases, which according to the NHS board accounted for 13% of all beds in the region; believes that hospitals in the area are using outdated medical equipment, including an MRI scanner and an X-ray machine that are 15 and 27 years old, respectively, and notes the calls for the Scottish Government to develop an urgent plan to tackle what it regards as the ongoing issues within NHS Grampian that are impacting on patient care and service delivery.
18:00
In the interest of transparency, I declare that I was a board member of NHS Grampian between 2017 and 2021.
I thank members from other parties who signed my motion, which has allowed the debate to take place. By bringing this debate, in no way am I criticising staff in our national health service, who work tirelessly to care for our constituents. However, given the level of correspondence that I receive from constituents, I felt that I had to try to do something to highlight the issues that are faced at present.
You will be surprised, Presiding Officer, that I do not want tonight’s debate to be a political knockabout with the Scottish Government. I have genuine concerns and would like to hear what the Government can and cannot do to improve the situation that patients in the north-east currently face.
Data so far this year shows that NHS Grampian is failing to keep pace with other health boards across Scotland. The majority of patients within the board’s area of responsibility are waiting longer than the 12-week target, with thousands facing waits of more than a year and some of even two years. Accident and emergency performance is among the worst in Scotland.
I have seen the consequences of that at first hand—not just through the many constituents whom I have met and who have explained how they have been let down, but within my own family. They have faced long, agonising waits in the back of ambulances outside an A and E department that is bursting at the seams, and they now face more long waits for much-needed surgery with no news or updates and no end in sight.
The board has explained that, due to what it calls its “extremely challenging” financial position, it must reduce spending. That is despite £92 million in Scottish Government bailouts and the Scottish National Party claiming to have increased funding for NHS boards. That will not give my constituents confidence in the healthcare system or that they will get the treatment that they need, when they need it, nor will it give them confidence in the leadership of NHS Grampian. How on earth will it get waiting times down when it is forced to make cuts to critical services? That will surely mean more waiting, more delays and more uncertainty.
Compared to other Scottish health boards, NHS Grampian stands out for all the wrong reasons. It has the worst performance against the 12-week treatment target and the greatest number of extremely long waits for treatment, and is near worst in relation to unscheduled care.
I am concerned that it is our elderly constituents who are being disproportionately affected by those waiting times, who are suffering the most and who are having their quality of life impacted. In audiology, there is more than a two-year wait for a hearing aid. In relation to cataracts, there is a 60-week wait for the first appointment and who knows how long for the operation. In orthopaedics, Scotland Versus Arthritis has analysed the waiting times in NHS Grampian and the waiting lists for trauma and orthopaedic treatment have increased by 25 per cent in the past two years, with orthopaedics currently making up 38 per cent of NHS Grampian’s total waiting list.
The financial situation, bed capacity issues, limited staffing and growing demand are all contributing to NHS Grampian’s floundering position. The new Baird family hospital is already five years late, with no opening date set. The board’s reliance on Government bailouts underscores the seriousness of the situation, which simply cannot continue.
The time has come for a robust and meaningful response. The Scottish Government must take steps to put patients and staff first and place NHS Grampian in special measures. Putting NHS Grampian into further enhanced measures would be the first step, but not the last. We need a clear recovery plan, leadership changes where necessary, independent oversight and emergency investment in the services that are under the most pressure. The Scottish Government must make this a priority, not just for the sake of the north-east but as a signal to every patient in Scotland that they matter.
When Douglas Lumsden talks about patients in the north-east, does he recognise that NHS Grampian serves the island constituencies as well? I have a constituent who is waiting for a hip replacement and who was told that the waiting list for elective surgery at Woodend hospital in Aberdeen was more than 3,000 people and that it would be impossible to predict when he would be seen.
I completely agree with Beatrice Wishart—the problem that she describes is the one that most people face. They are on a waiting list but they have no visibility as to how long the wait is going to be. A lot of people will therefore go private if they can afford it. There needs to be a change.
During the recess, I spoke with residents in Turriff, where constituents have repeatedly raised the continuing lack of services in the local hospital. Those services were reduced during the pandemic and have never returned to full strength. This is not the first time that I have raised the situation in Turriff in the chamber. In January, I highlighted how many rural communities across North East Scotland were being let down by the huge reduction in local services, forcing them to travel to hospitals such as Aberdeen royal infirmary, which simply cannot cope. It is a hospital that is severely under pressure—so much so that staff were forced to declare a major incident and turn patients away, with a winter plan that had unravelled by November.
This all matters because, at the end of the day, it affects people—the people whom we were all elected to this place to serve.
I will conclude, therefore, with a story of someone who contacted me last week. My constituent has been diagnosed with basal cell carcinomas on a number of occasions. Normally, those were dealt with by the general practitioner performing minor surgery at a nearby minor surgery centre, but that does not seem to be an option now.
My constituent was instead referred to the dermatology department at the ARI. It took nearly two years for the carcinoma to be removed, and he was warned that there was a strong likelihood of the cancer returning. It has returned, and he has been referred to the dermatology department again; however, he has been warned that it may be over two years before he gets an appointment. He is rightly worried. We often hear about early intervention. In that case, I am sure that early intervention would have led to a better patient outcome and would most probably have been more cost-effective for our NHS.
I am normally a strong believer in local devolution, and I admit that I would be the first to complain if the Scottish Government were undermining local decision making. However, I feel that, with NHS Grampian, we have reached a point at which the Scottish Government needs to be bold. It needs to step in, steady the ship and provide a service that the people of the north-east deserve.
Let us make no mistake about it: these failings are not down to the thousands of dedicated doctors, nurses and surgeons, nor to the many other front-line staff; they are a direct result of mismanagement.
I therefore ask the cabinet secretary, considering the growing waiting lists, the financial interventions and the failure of enhanced monitoring, to turn the ship around. Does he have confidence that he will find the right candidate for the role of chief executive, considering that the interim chief executive has had enough and is going before a replacement has been found? Does he have confidence in the board of NHS Grampian to do its job, to deliver the leadership that staff need and to ensure that patient care is put back on track? If not, what plans does he have to step in and assist the people of the north-east, who are being so badly let down?
18:08
I welcome the tone of Douglas Lumsden’s speech; I have to say that there is much in there with which I agree. I put on record my thanks to all the staff in NHS Grampian, from consultants to cleaners, because they do an exceptional job. However, I am not convinced that they are listened to when they should be by senior management, and that is part of the problem. There also seem to be excessive bureaucracies in NHS Grampian that do not seem to exist elsewhere; I will come to that before I finish my speech.
I disagree with Mr Lumsden on some points with regard to some of the difficulties and the resourcing. If we had followed Tory spending plans, there would have been even less to spend. However, I am not entirely convinced that spending is being utilised in the right manner. Let us look, therefore, at the record ÂŁ2 billion increase in front-line NHS spending, which takes overall health and social care investment to ÂŁ21 billion.
In a meeting that we had on Friday, delayed discharge was highlighted as a problem. However, delayed discharge is not a problem in the city of Aberdeen to the same extent as it is in Aberdeenshire and Moray. I say to the cabinet secretary that I have asked the following question before, and I will continue to ask it: why have the lessons learned by the city of Aberdeen not been exported to Aberdeenshire and Moray? That would make a great difference and would keep people out of hospital.
In Aberdeen city, the Granite Care Consortium has given its front-line staff the ability to increase care or, on a few occasions, to decrease care, when they have seen patients or potential patients suffering, which often prevents them from going into hospital. Let us keep folk out of hospital if we possibly can. Those lessons need to be exported from the city of Aberdeen to Aberdeenshire and Moray to reduce the pressures.
I recognise the disparities in delayed discharge performance, not just in the NHS Grampian area but in other parts of Scotland.
Mr Stewart’s ask of me is to ensure that lessons are learned from the better performing areas. At the weekly collaborative response and assurance group, which is chaired by me or Maree Todd, we ensure that exactly what he asked for is conveyed across Scotland.
The cabinet secretary is well aware of questions that I have asked about NHS Grampian, and I have relayed to him some of the situations that exist with the Baird family hospital and ANCHOR, which is the Aberdeen and north centre for haematology, oncology and radiotherapy. Even on Friday, NHS Grampian could not give us opening dates. That is unacceptable. It says that there are not enough acute beds, but if it opened those units, there would be no difficulty at all. We have yet to get clear answers on those issues. I again ask the cabinet secretary to approach NHS Grampian about that, so that we can have that family hospital to deal with maternity, gynaecology, neonatal and breast services as well as reproductive medicine, and the ANCHOR unit, which will bring together oncology, haematology and radiotherapy, with a capacity to see 65,000 out-patients each year. That would make a real difference.
My other ask of the cabinet secretary is simple. It is about recruitment, including internal processes for staff changing jobs. I have been told that NHS Grampian’s processes are far more bureaucratic than those anywhere else. I will give an example. A nurse told me that she wanted to move ward. It was not a promotion or anything, and it was a similar discipline, but she was told that she would have to be interviewed for that job. What is the point?
Mr Stewart, you are over your time. Could you please conclude?
I will finish.
I have heard the same from cleaners who have had to be interviewed to move wards. None of that makes any sense whatsoever. That bureaucracy, in my opinion, should not be there and needs to be investigated. There are other issues around bed counts, but I will write to the cabinet secretary on that point.
18:14
I congratulate Douglas Lumsden on lodging the motion for debate and for the way in which he has led the debate.
Kevin Stewart and I knew each other before either of us was elected to the Parliament. We fought like cat and dog on Grampian joint police board. However, perhaps uniquely during the time in which we have known each other, today I agreed with almost everything that he said. I have seen from my own case load that there is too much bureaucracy in NHS Grampian.
I echo the point that there are outstanding staff at every level of the organisation dealing with patients on the front line but they are not being listened to by the decision makers and senior managers. I hope that the cabinet secretary will take that on board. He is hearing that not just from Opposition members but from his Government colleagues.
I hope that this is a wake-up call to NHS Grampian and those at the higher echelons of the board, because, day in and day out, we are seeing what our constituents are having to put up with. So far, managers and senior managers have been getting away with allowing the care for our constituents to be sub-par—that is the most polite way that I can put it.
In the short time that I have, I will discuss a couple of issues. One is a case that I wrote to the cabinet secretary about. I received a response from him, and I wrote to NHS Grampian and received a response on behalf of the interim chief executive. It is such a shocking case that it highlights what, sadly, too many patients in Moray, which is part of NHS Grampian, are facing.
Linda Fraser from Forres agreed to allow me to mention her case in the chamber today. She came into my office in Forres and outlined what she had gone through. On 3 October last year, Linda had a neck dissection to remove a lump. She was in Aberdeen royal infirmary for six days and, at the end of that time, she was told that tests proved that she had an aggressive form of melanoma. On 5 November, she saw her surgeon, who went through the next steps for her, which included oncology and physio. Because it was an aggressive melanoma, she expected—as her surgeon did—that she would immediately or very quickly get further information about her next steps. However, nothing came, and she became worried and frustrated. She kept on contacting NHS Grampian to find out more.
Let us remember that Linda’s operation was on 3 October and that she met her surgeon on 5 November. She waited and waited and waited. She contacted the health board repeatedly—that was all done by the patient rather than the health board coming to her. Eventually, her condition got so bad that her neck and cheek started to swell again and she was struggling to swallow.
Linda went to see her local GP, who was so worried that he got her booked in for an appointment at ARI on 23 December. To get to ARI from Forres, she has to get a bus from Moray to Aberdeen, because she does not drive. With a swollen neck and cheek and with difficulty swallowing, and with her GP’s concerns, she got on the bus and went through to ARI. She waited all day for a CT scan on 24 December. She was told at 4 o’clock in the afternoon that it was not going to be possible for her CT scan to be done that day, and she was asked whether she could come back after Christmas, on 27 December. She was sent home on the bus, and then she had to come back through on the bus on 27 December. There seemed to be little care or compassion for this woman, who was clearly suffering and just wanted to get a resolution for her issue.
This has been going on for some time now. When I wrote to the cabinet secretary and the health board, the situation still had not been resolved. Linda has an appointment for an MRI scan on Saturday morning. After an operation in October, she finally has an appointment for an MRI at the end of April. Because it is a morning appointment and she is a Moray patient, she has to get the 10 past 6 bus to that appointment.
When she came into my office, Linda said that she is devastated, that she feels that she is treated as if she is a number and that no care or compassion is shown. That is just one of many cases that I could raise with the cabinet secretary that highlight shocking waiting times and the board’s lack of courtesy and respect for patients.
I will quickly raise another issue. Moray has one of the highest rates of Huntington’s disease anywhere in the UK. In Grampian, new research indicates that the north of Scotland has the highest rate of Huntington’s disease on earth, at a rate that is five times the global average. People with Huntington’s have such complex needs that they need specialist support.
The cabinet secretary will be aware of Aberdeenshire health and social care partnership’s potential decision to remove the funding for specialist Huntington’s support. I am grateful that it is reconsidering that, but will the cabinet secretary apply as much pressure as possible to state that, given the prevalence of Huntington’s disease in the north of Scotland and particularly in the Grampian area, that would be the wrong choice for Aberdeenshire health and social care partnership? We need to maintain that specialist support.
18:19
I, too, thank Douglas Lumsden for securing the debate. I echo his and other members’ tributes to the staff of Grampian health board and their work to support constituents in the region.
The declaration of a critical incident at Aberdeen royal infirmary in November 2024 crystallised what was already known to many people across the north-east—that NHS services in Grampian are just one bad night away from collapse. Any increase in demand can send hospitals into crisis, with ambulances diverted across the region in wintry weather. All of that is happening while the health board plunges further into financial difficulties, as Mr Lumsden set out.
Earlier this month, it was reported that the Scottish Government will lend a further ÂŁ67 million to NHS Grampian, on top of an existing loan for 2023-24, which takes the total loan to ÂŁ92.2 million. The loan was required despite the health board having made ÂŁ46.2 million of savings in the year to February 2025. The board appears to be burning through money just to stand still.
Although the loan is required to keep the lights on, the Scottish Government must work with NHS Grampian to determine what is going wrong and to urgently set out a plan to make things better. That seems to be the consensus across the chamber today. It is the SNP’s refusal to interrogate, innovate and introduce any real and meaningful reform that leaves Scotland’s NHS lagging behind and NHS Grampian using X-ray machines and MRI scanners that are decades old and prone to breaking down.
The crisis in social care in the north-east has been touched on. It means that patients are kept in hospital for far too long. That will only be exacerbated by the series of cuts to social care and community services as health and social care partnerships grapple with financial difficulties and budget cuts.
There is innovation but, unfortunately, that innovation is often not exported. The problem with delayed discharge, for example, is that the innovation that is taking place in Aberdeen is not being exported to Aberdeenshire and Moray. Doing that would make sense and stop suffering.
Mr Stewart makes a fair point, which I was going to come to. I think that Mr Ross also agreed that there is a question about what is being shared between city and shire. The cabinet secretary has recognised that and has set out that there are mechanisms by which such learning can take place, but we need to see evidence of it happening.
We have heard about some of the challenges as a result of the cuts to the health and social care partnership, particularly in Aberdeenshire. I have received an awful lot of communication from constituents on that. I share Mr Ross’s concerns about the Huntington’s situation and the acute need of people in the area, given the higher levels of need among people in the region. It would be good if that issue could be revisited, and I would like to hear from the cabinet secretary in closing about what he is doing to support those calls.
I say to Mr Stewart that it is not a case of just reacting now. In some places, things are happening, but we know that a large part of the issue relates to the region’s ageing population. There has been a 9 per cent increase in the number of over-65s in the NHS Grampian region in the past five years, and acute and social care need come with that.
However, Scotland’s ageing population is not news. It has not happened overnight; indeed, it has been long modelled and predicted for many years. A serious approach from the SNP Government would have been to change the services and prepare for it but, over 18 years, the Government has simply not done so.
While I have time, I will come on to another area of the health and social care partnership’s work. I have been contacted by constituents who were informed that the adult autism and attention deficit hyperactivity disorder assessment service, which is run by the partnership, was closed on 31 March. I was contacted today about that, and there have been comments about it in the chamber previously.
The First Minister has been very critical of the situation in NHS Tayside, where the child and adolescent mental health service for diagnosis of autism and ADHD has been stopped. The situation in Grampian is very similar. Does the cabinet secretary share the First Minister’s concerns about how such changes are being made? Services are being closed entirely, so it looks as though people who have already been on waiting lists for a long time will be on waiting lists in perpetuity.
It is abundantly clear that the situation in NHS Grampian is neither safe nor sustainable, but it serves as a microcosm of what is happening in Scotland’s NHS on the SNP’s watch. One in six Scots are on waiting lists, and there is chaos in A and E, with 1,040 patients waiting for more than 12 hours in the past week alone. The scandal of delayed discharge is costing Scotland nearly £1.7 billion. People are remortgaging their house or taking out loans to pay for private cataract, hip and knee operations and even for chemotherapy. That is the record of this Government. Can we hear some solutions to the Grampian situation tonight?
18:24
I thank Douglas Lumsden for bringing this debate to Parliament, and I quickly remind members that my wife is a GP in the NHS Grampian region.
Pretty much every speaker so far has commented on the value of the staff that we have in NHS Grampian and all NHS boards in Scotland, and that is touching to hear. My wife would be pleased to know that they have political support, because they are out there every day doing amazing things for the patients who can get through the door. That is not to take anything away from the problems that we have heard about, but we do value the staff who are on the ground.
Other members have mentioned points that I whole-heartedly agree with. NHS Grampian reports that more than 3,000 patients were waiting for more than two years for hospital treatment, which is the highest number among Scottish NHS boards. Michael Marra pointed out that, in November 2024, NHS Grampian declared a board-level critical incident, which led to the diversion of ambulance patients to hospitals outside the region. The board is using outdated medical equipment, including a 15-year-old MRI scanner and a 27-year-old X-ray machine. There are too few acute hospital beds and too few staff in some key service areas to cope with demand.
I am not intervening to have an argument. We need to look at the counting of acute beds. I understand that what Public Health Scotland counts is acute beds in acute hospitals, but NHS Grampian has a number of acute beds in hospitals that are not acute hospitals. I have a simple question—why are they not counted and what are they being used for? How are they being utilised for the benefit of patients?
That is a good question that it would be great to have an answer to. All that I know is that NHS Grampian has pointed out that it has the lowest number of acute hospital beds of boards in Scotland. I take Mr Stewart’s point about what that means, but NHS Grampian is saying that it is the second-lowest-funded board per head of population. To put that into numbers, NHS Grampian has 1.4 beds per 1,000 people, while NHS Greater Glasgow and Clyde has 3.6 and NHS Tayside has 2.8. If we are talking about delayed discharge in our hospitals, we also have the problem that we simply do not have enough beds for patients, which causes all the problems for constituents that we have heard about today.
I cannot miss the opportunity to mention Dr Gray’s hospital, which is in my region. It is a vital hospital for local people but, all too often now, I hear locals speaking about deep worries about staffing levels, reduced service levels and long waits. To my mind, that is not acceptable. We must all work together to alleviate the woes of rural depopulation and at least provide appropriate delivery in our rural hospitals, which truly are vitally important.
Today, as Douglas Ross, Douglas Lumsden and Michael Marra did, I will highlight the human impact of waiting times. One of my constituents, who contacted me in January, has been in pain with gallstones since July 2024. She is regularly in A and E with crippling, indescribable pain. She has been given different concoctions of intravenous painkillers, but she is not getting the surgery that would quickly fix the problem. For months, my constituent waited, growing more and more jaundiced, in pain and having been on four types of antibiotics due to inflammation.
After
“six months of hell with no end”,
a family member stepped in—this is not a rich family—to pay nearly £9,000 for private treatment. That should not have happened, and it should not have had to happen. My constituent commends the hard work of their GP but is utterly shocked by the waits in secondary care.
Let me share a different case—that of a care worker, whose work we desperately need in our society. For more than a year, she has been waiting for a cataract operation. My constituent’s eyesight is deteriorating so rapidly that she is no longer able to drive. With the desire and passion to continue to serve those in her care, my constituent now walks 5km a day to the person she cares for, so that she can be with them, and walks 5km back. The situation has got so bad that a family member has had to reduce their working hours to provide support and care for that care worker. That family member sent me this quote:
“The impact has been huge, she has lost independence, self value and had a detrimental effect on her mental health. It has put enormous pressure on myself having to care, she even finds cooking difficult as she cannot see that temperature on her oven or safely use the cooker. Waiting times really need highlighting more!”
How can it be right that, in modern Scotland, either of those cases is crossing my desk? I know that there are complexities, but my message really is simple—whatever it is that is required needs to happen now. My constituents need action that truly delivers.
I call Carol Mochan, who joins us remotely.
18:29
Today’s debate is of critical importance, and it is right that we use our time in the chamber to debate topics that match the Scottish people’s priorities.
The SNP Government might want to hide from its responsibilities and its record when it comes to the NHS, but Opposition members have a responsibility to hold the Government to account on behalf of patients and staff, who have been let down for far too long. I therefore thank Douglas Lumsden for bringing the debate to the chamber, and I share his concern for his constituents. As the motion states, more than 3,000 patients in NHS Grampian have waited more than two years for treatment. That is unacceptable.
The Government’s record is also appalling in my South Scotland region. The issue of waiting times for NHS treatment is perhaps the one that I hear most about from my constituents, and I also hear from overstretched staff members in the areas that I cover. Constituents say to me that waiting times are too high, that there is unclear information on what is happening and that the Scottish Government has no real plan to address the issue. Staff tell me that thousands of registered nursing staff are missing from health and care services, that the number of nurses leaving the register within their first 10 years is increasing and that the number of students applying to study for a nursing degree is falling. The SNP has no credible plan to rectify that, as NHS staff can see.
We are hearing in the chamber tonight that, whether someone lives in a rural area or an urban area, whether they are young or old or whether they have a long-term condition or are seeking new advice, worries about NHS waiting times are a constant.
So far, I have raised the concerns of constituents and staff who have reached out to me. In the few minutes that I have left, I want to raise the voices of women living in Scotland. Recent reporting suggests that women across Scotland are suffering “structural neglect” by the NHS, with hundreds being left to languish on waiting lists for years. Weekend papers highlighted the extreme waiting times that are being experienced specifically by women for female-only medical interventions.
Currently, almost 1,500 women in Scotland have been waiting for more than two years for vital gynaecological surgery. My research shows that women in three health board areas—NHS Grampian, NHS Tayside and NHS Lanarkshire—have been waiting for more than four years, often in agony, for laparoscopies. The response to a Scottish Labour freedom of information request shows how many women are being badly failed by the SNP when it comes to hysterectomies. We revealed a wait of almost six years in NHS Grampian, and in NHS Borders, in my South Scotland region, the longest wait in 2024-25 was 10 times longer than in 2019-20. That is absolutely scandalous. I could go on. Waits for a colposcopy—a test that can help to identify cervical cancer—are unacceptably high. In Ayrshire, the average wait time is continually increasing, with the longest wait at the time being a shocking 238 days.
Bringing down waiting lists must be an absolute priority. We must have a plan that actually delivers for patients and staff. Under the Scottish Government, our tremendous NHS staff have been pushed to the limit, services are at breaking point and patients suffer on endless lists. For patients and staff, this is a Government without a plan, and that must change.
18:33
I, too, thank Douglas Lumsden for securing time for this important debate on NHS Grampian.
Healthcare in the north-east is in crisis as a result of years of chronic underfunding of NHS Grampian by the SNP Government. The health board is financially crippled. The situation is so desperate that it has had to take out a £67.5 million loan from the Scottish Government, bringing the total debt that it owes to £92.2 million. There are huge questions about how that debt will be serviced, given that the health board is already trying to make eye-watering savings. It is almost impossible—how can it pay a debt when it cannot make ends meet?
The reality is that NHS Grampian has been short-changed by more than £260 million—a quarter of a billion pounds—since the SNP got into power. The SNP Government’s parity formula is not worth the paper that it is written on.
That underfunding has resulted in the erosion of community hospitals, closed in-patient facilities and the end of night-time minor injuries units. It also means that NHS Grampian has the lowest bed base in Scotland.
All that has created substantial pressures on hospitals, GPs and the Scottish Ambulance Service, with crews queuing for hours just to get in the door of Aberdeen royal infirmary—a symptom of a system that is stretched beyond its limits.
That is why a critical incident was declared at ARI last November, when patients were diverted from the hospital because the capacity simply was not there. On that day, a dedicated ambulance crew saved the lives of a couple. The crew decided that, if they went to NHS Grampian, the couple probably would not have had their lives saved. The ambulance was diverted—it was blue-lighted all the way through to Dundee and NHS Tayside, double or triple the distance.
Upwards of 3,000 patients in the NHS Grampian area have been languishing on waiting lists for more than two years. The health board’s cancer waiting times are the worst in Scotland, with more than 40 per cent of patients waiting longer than two months to receive their first treatment after being referred. That means lives not just put on hold but put at risk, because we know the pivotal importance of early intervention. It is a ticking time bomb.
Despite the brilliant efforts of NHS staff, NHS Grampian received red ratings for nearly two thirds of its key targets between October and December 2024.
I rarely agree with Kevin Stewart, but, as my colleagues have said, he was spot on when he rightly pointed out that the national treatment centre for Grampian is on ice. The Baird family hospital and the ANCHOR projects have been beset by problems, delays and design issues. What is the SNP Government’s response? To carry out a patchwork of short-term fixes and make empty promises. It is no wonder that Audit Scotland has highlighted the lack of a strategic vision, and that NHS workers are sounding the alarm.
The SNP has failed the north-east. It has failed our NHS. Today, Neil Gray must apologise for the harsh financial conditions that his Government have created for NHS Grampian. My constituents, and the constituents of other łÉČËżěĘÖ who are speaking on their behalf, deserve better than this.
18:37
I thank Mr Lumsden for securing the debate, for bringing it to the chamber and for the way in which he introduced it. Like him, I have family members who reside in the Grampian area, and I, too, thank the staff for the work that they do day in, day out, and for serving my family members, as they do his.
I recognise the significant pressures that NHS Grampian has been experiencing over recent months, which have specifically impacted on delays at the front door of its emergency departments and Scottish Ambulance Service turnaround times. That is largely due to capacity issues in the community as well as in the acute hospital—Kevin Stewart raised some of those issues incredibly well—and the availability of appropriate beds for patients who are ready to be discharged.
I am not going to stand before you, Presiding Officer, and suggest that the delays to patient care that have been raised by Mr Ross, Mr Marra and Mr Eagle and the increased pressure are at all acceptable. They are absolutely not. However, we are committed to supporting NHS Grampian to turn the position around.
Earlier this month, Ms Minto and I met Mr Lumsden, and we discussed audiology services. We are aiming to move more of those services from secondary care into primary care. Mr Lumsden raised minor injuries units, which I explained are specifically for non-urgent interventions. They can provide services by appointment or otherwise for injuries that do not require accident and emergency attendance, thereby reducing pressures on emergency services. Local communication with the public is key so that people know what services are available to them and where.
During the meeting, reference was also made to leadership and the process for the appointment of a new chief executive, which Mr Lumsden has raised again today. When the new chief executive is in post, we will continue to work with them to ensure that NHS Grampian moves into a more sustainable financial position and to being a more resilient service. As I communicated to Mr Lumsden, I can say to Mr Ross, Mr Stewart and others that we also keep the escalation framework under review.
In February, I visited Elmbank medical practice in Aberdeen and the Aberdeen royal infirmary, where I met—
Will the cabinet secretary take an intervention?
Of course.
The cabinet secretary mentioned the escalation procedure. Has he considered moving NHS Grampian to a higher level of escalation? There are a lot of problems that are not unique to NHS Grampian, but they seem to be worse there.
As I said, we keep the escalation framework under review. A recruitment process for a new chief executive is under way and we are sensitive to ensuring that support is provided to NHS Grampian and its leadership to ensure that it can navigate through the situation that it is currently in. However, we do keep the escalation framework under review.
Will the cabinet secretary give way?
Briefly, yes.
One of the challenges for the new chief executive will be funding and finances. Will the cabinet secretary explain the ÂŁ67 million bridging loan? How can an organisation that is having to ask for so much money from the Scottish Government possibly continue to deliver for patients while having to look to pay that money back?
We have been clear in the support that we provide to NHS Grampian that the way in which it delivers its services should not impact on front-line services, in spite of its financial difficulties. The repayment of that money can come only when NHS Grampian is on a more sustainable financial footing. We are not going to be requesting repayment to the detriment of front-line services. I hope that that will reassure Mr Ross and others.
Some of the key improvement works that we expect to be done include optimising and enhancing pathways that streamline patients away from the emergency department to be seen more quickly and in more appropriate areas, such as the rapid ambulatory assessment centre—
Will the cabinet secretary take an intervention?
I am really sorry, but I have to make progress.
That work includes the expansion of acute medical initial assessment, increased respiratory and frailty capacity, and the enhancement of the call before convey service, which provides clinical advice to Ambulance Service crews to enable other pathways to be utilised to reduce the number of conveyances to hospital. On that point, 79.2 per cent of ambulances currently do not convey to the ARI emergency department, and that is the best conversion rate in Scotland. The central aim is to improve patient flow through the system, including from the Ambulance Service to NHS Grampian’s acute sites as well as back into the community as soon as patients are fit for discharge.
Will the cabinet secretary give way?
I will give way briefly.
I welcome what the cabinet secretary has said, but the ambulance staff and hospital staff often feel that they are not listened to when they suggest improvements. Through his officials, will he ensure that folk start listening to those front-line staff and their good ideas?
I heard Mr Stewart’s point, and I was going to come it and to the points that other members have made about staff feeling listened to or otherwise. Clear routes are available to staff to ensure that their voices are heard, but I will take the point away and make sure that it is raised with the board.
Further support that has been provided includes the centre for sustainable delivery providing bespoke clinical support to NHS Grampian. It has identified some opportunities that will support improvements, including for the women’s services that Carol Mochan raised. That support also includes a focus on reducing hospital occupancy to improve flow and reduce turnaround times for the Ambulance Service. There is also the potential to build on the current model of flow navigation, and we will work with the board to develop that in the coming year.
I will approach NHS Grampian again regarding the Baird and ANCHOR, and I will provide Mr Stewart with an update on his point about ensuring that facilities open so that capacity can be built. I will also look at the points that he raised about recruitment.
I will look at Mr Ross’s point about Huntington’s disease. He will understand that that is a local decision, but I will follow up in writing with more detail on the reasons for the decisions that have been taken.
Let me be clear. Addressing the pressures on NHS Grampian is a priority for the Government and for the new chief executive. However, I also want to recognise, as Mr Lumsden did in his opening speech, the hard work and dedication of the staff in Grampian, who go above and beyond to deliver the best quality of care to their patients. I know that there is more to do, but we must not overlook some of the progress that has been delivered by those staff in the past year.
By accessing extra funding from an additional ÂŁ30 million national investment in planned care, NHS Grampian was able to deliver more than 23,000 additional appointments and procedures last year. We will support NHS Grampian to build on that work in 2025-26 through further investment as part of the ÂŁ200 million to reduce waiting lists and support the reduction of delayed discharge.
In the motion and during the debate, Douglas Lumsden and Michael Marra also raised the issue of ageing equipment, including scanners and X-ray machines. From the additional ÂŁ200 million investment this year, we are providing an additional ÂŁ3.3 million to NHS Grampian for two mobile MRI scanners and one mobile CT scanner, which will deliver more than 19,000 additional scans in the coming year.
Finally, not only do my officials work closely with NHS Grampian on a regular basis, but I meet the regional chief executives on a monthly basis. My next meeting with the north, including NHS Grampian and—I say this for Beatrice Wishart’s benefit—NHS Orkney and NHS Shetland, is this Thursday, when we will discuss the issues that have been raised by colleagues today to ensure that we deliver for the people of Grampian and beyond.
Meeting closed at 18:46.Previous
Decision Time