The key flashpoints at First Minister's Questions as John Swinney comes under pressure over the NHS

The First Minister was quizzed by opposition leaders in Holyrood

The shadow of the general election loomed large over First Minister’s Questions (FMQs) in Holyrood on Thursday.

Both the Conservatives and Labour challenged John Swinney over the state of the NHS, while the Greens raised oil and gas.

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Health is devolved, but speak to any political candidate and they will tell you it is still a big issue on the doorstep. People up and down the country have real concerns over crumbling public services.

John Swinney. Picture: Jane Barlow/PA WireJohn Swinney. Picture: Jane Barlow/PA Wire
John Swinney. Picture: Jane Barlow/PA Wire

Douglas Ross – NHS waiting times

Mr Ross, the Scottish Tory leader, focused on waiting times in hospitals and A&E departments. He started by raising comments made by an audience member during a BBC debate earlier this week.

The woman told Scotland’s party leaders her 93-year-old mother had been forced to wait six hours for an ambulance, followed by another two hours outside a hospital.

Mr Swinney apologised during the debate, and did so again at FMQs. He said the volume of demand in the NHS was creating challenges. Hospitals are operating “at very high levels of occupancy”, he said, pointing to delayed discharges.

Mr Ross said people are concerned the NHS is “broken”. They only seem to hear excuses, he said, adding: “Don’t they deserve to hear the solutions?”

Mr Swinney said the Government has taken hard decisions, such as increasing tax on higher earners to boost the NHS. However, he acknowledged “significant strains” remain.

The First Minister said continued austerity under a UK Tory government would be “disastrous” for the NHS.

Mr Ross urged the SNP leader to take responsibility, and said a Freedom of Information request showed that since the start of 2023, people aged over 100 had waited more than 12 hours to receive emergency treatment in the NHS in more than 100 cases.

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Mr Swinney said hospitals are congested due to delayed discharge, and the solution is to work with local authorities to expand the provision of social care. However, he said it ultimately comes back to the resources available to the NHS. He said the health service is top of his list of priorities. Scotland’s A&E system is the best-performing in the UK, he said, while Scotland has more GPs per head of population “than any other part of the UK”.

Anas Sarwar – Scots forced to turn to private healthcare

Mr Sarwar, a former dentist, put the First Minister under pressure over the number of people forced to turn to private healthcare.

He said four out of five dental practices are not accepting new NHS patients. Across the health service, he said, more people are having to pay for treatment. The number of patients forced to pay for their own care has gone up by 86 per cent since 2019, the Scottish Labour leader said.

He said Scots paid out more than £83 million for hip, knee and cataracts surgeries last year. “That’s what families had to find in the middle of a cost-of-living crisis because of SNP incompetence,” he said.

Perhaps most horrifying of all, Mr Sarwar said, “there are people who are being forced to go private and pay for their cancer treatment in Scotland”.

Mr Swinney said he did not want anybody to have to pay for cancer treatment, but he had to “face up to the reality of the challenges” in the NHS.

The First Minister said the rate of people self-funding for private healthcare in England is 66 per cent higher than in Scotland. In Wales, he said, it is 13 per cent higher.

Mr Swinney said it all comes down to the “financial envelope” that is available for the NHS. He said Labour was against raising taxes for higher earners in Scotland, which he said would undermine investment in the NHS.

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Lorna Slater – oil and gas

Ms Slater, the co-leader of the Scottish Greens, asked the First Minister how any new oil and gas projects in the North Sea could possibly pass a climate compatibility test.

The First Minister has argued new licences must be considered “on a case-by-case basis, based on their compatibility with our objectives on climate”.

Speaking during FMQs, Mr Swinney said this had been the position of the Scottish Government “for some considerable time”. He said the Government recognises the “absolute necessity” of the journey to net zero.

Ms Slater said: “Our position on the energy transition needs to be evidence-based. That evidence doesn’t change on a case-by-case basis. The Scottish Government’s position is like a 40-a-day smoker being told by the doctor, ‘stop smoking, you’re killing yourself’, and the smoker replies, ‘ah, I’ll treat each cigarette on a case-by-case basis’.”

Mr Swinney was not impressed with this line, saying he was not sure the analogy “worked particularly well”. He said the Government would act “in an evidence-based” fashion. The First Minister also pointed out decisions over oil and gas licences are reserved to the UK government.

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