First Minister Nicola Sturgeon, Labour leader Anas Sarwar and Deputy FM John Swinney.

By Bill Heaney

What’s happening in Ireland that is more important than the crisis facing Scotland with the nurses strike and now a threat by teachers to walk out of their classrooms later this month?

Whatever it is, First Minister Nicola Sturgeon, just off the plane from Egypt after attending the COP27 climate change conference, decided to body swerve her weekly Question Time in the Scottish Parliament and diverted to Blackpool for the Irish talks.

She ducked out of the flood of criticism that was bound to fly her way at Holyrood.

And was missing when the Labour leader Anas Sarwar told her deputy, John Swinney: “For the first time in its history, the Royal College of Nursing has voted for strike action.

“The strike is not just about pay; nurses have been underpaid, undervalued and under-resourced since long before the pandemic.

“These are the words of Julie Lamberth, the chair of RCN Scotland. She said: ‘The Scottish Government needs to face up to the reality that their failure to focus on workforce planning and to properly value those … in health and social care over the last decade is the root cause of the staffing crisis we face. The result of our strike ballot is a wake-up call that must not be ignored’.

“Does the Deputy First Minister agree with Julie Lamberth and thousands of nurses across the country?”

It was obvious that the Deputy First Minister and Cabinet Secretary for Covid Recovery John Swinney had been given a hospital pass by Ms Sturgeon.

He replied: “In relation to the situation in the NHS and the comments that he [Mr Sarwar] recounted from the Royal College of Nursing, I make it absolutely clear that the Government remains committed to, and willing to engage in, dialogue and negotiation with the Royal College of Nursing and the other affected and interested trade unions, as we have been doing for some considerable time.

“Notwithstanding the decisions that have been made by members of the RCN, we will continue that dialogue, and I commit the Government to that today.

“In relation to workforce planning, we have record staffing levels in the national health service. Those staffing levels have been the product of sustained investment by the Government, despite the climate of austerity in which we have been operating for some considerable time. The Government will continue to sustain that investment to ensure that we have adequate staffing levels.

“The Government is firmly restricted in what it can do by the financial context in which we are operating and by the pressures on the public finances. However, I assure Mr Sarwar and the Parliament that the Government will do everything in our power to properly support the health service workforce and ensure that we have adequate numbers of staff in our national health service.”

Anas Sarwar replied: “I agree that we are in the midst of an economic and inflation crisis that has been created by a rotten Tory Government at Westminster. It should pay the price for that, and it will pay the price come the general election.

“However, the Deputy First Minister missed the point of what Julie Lamberth was saying—there has been a decade of failure and a decade of not supporting, long before the past seven weeks of economic crisis, before the pandemic and even before Brexit.

“This Government gives the same old platitude about more numbers when we have record vacancies in the NHS under its watch.

“The action is as much for patients as it is for nurses. For years, nurses have been warning that staff shortages risk patient safety. Let us look at just one health board—NHS Greater Glasgow and Clyde. In just one year, it reported 216 investigations into significant adverse events. Those are events that ‘could have contributed or did result in, harm to people or groups of people’

Among the top reasons for why they happened are workload, staffing levels and delays in referral and treatment. The same report reveals that six people died due to those unintended incidents.

“Nurses are saying that a lack of resources is putting patients at risk. Lives are being lost and health boards are reporting the consequences, but the Government’s failure to workforce plan means that there are 6,000 nursing and midwifery vacancies. Why has the Government let it come to this?”

On workforce planning, Mr Swinney said: “Today, we find ourselves with record levels of staffing in our national health service. That is a product of workforce planning, which has been designed to boost recruitment levels.

“Over the past 10 years, we have seen an increase in nursing and midwifery admissions as a consequence of the investment that the Government has made. There has also been an increase in the number of consultants who are operating in the NHS, and we have 8.3 qualified nurses and midwives per 1,000 of population in Scotland compared with 6 per 1,000 of population in England. All of that comparative data shows Scotland to be in a better and stronger position.

“What I do not think helps the situation are the comments that were made at the weekend by the leader of the United Kingdom Labour Party, who said: ‘I think we are recruiting too many people from overseas in, for example, the health service’.

“I listened to those comments with incredulity. What is hampering us in the national health service is the Brexit that was inflicted on us by the Conservatives, which ended the free movement of individuals and resulted in members of staff being lost from our national health service.

“We need to reverse that; we need an approach that is open to migration so that we can boost recruitment into our national health service. The comments from Keir Starmer are a disastrous signal to send to hard-working members of staff.”

But Anas Sarwar told him:  “I have led a cross-party campaign in the Parliament against racial and religious prejudice, so no one should mischaracterise my position or the position of my party. [Interruption.] Members might want to heckle, but they should listen.

“Migrants are an invaluable part of our NHS—they always have been and they always would be. I also say that people who come to work in our NHS are not migrants; they are equal Scots, just like the rest of us. However, that should not prevent us from having a credible workforce plan that means that we train more doctors and nurses here.

“In the past few days, the First Minister has rightly been calling for more action on loss and damage in relation to climate change, so we should not pretend that taking doctors and nurses from developing countries does not cause loss and damage to healthcare systems in those countries. Let us not create a climate of fear, let us not play on that rhetoric and let us talk about what is happening here right now on the Scottish National Party’s watch.

“I listened to the answer that the Deputy First Minister gave. His head is in the sand. If it is so good and so rosy, why are nurses taking strike action for the first time in the RCN’s history? For years—since long before the pandemic—nurses have been crying out about the problems. Let us not forget that it was those staff who kept going even when their lives were at risk from a deadly virus. They are now being forced into action to try to save their patients’ lives.

“Week after week, tragic stories come to the Parliament and, week after week, we get the same old excuses. This health secretary and this Government are clearly out of their depth.

“After 15 years in government, with 750,000 Scots on an NHS waiting list, the worst-ever waits at accident and emergency departments and now the Royal College of Nursing going on strike for the first time in its history, does the Deputy First Minister accept that our NHS has not faced a crisis like this in its history, that this is the worst that it has ever been and that it is all happening on the SNP’s watch?”

John Swinney demurred: “First of all, I think that I touched a very raw nerve with my comments about Keir Starmer. Anyone who looks at my track record, throughout all my public service, will find that I have always—always—been on the side of openness and welcoming people from other countries into our society.

“The point that I am making to Anas Sarwar is that our ability to recruit staff and provide the necessary means for people to work in our national health service has been totally undermined by Brexit and the Conservative Government.

“Keir Starmer, through his comments at the weekend and his hostility to addressing any migration issues, is simply taking the same line as the Tories, and that is an absolute disgrace.

“Any international recruitment that is undertaken by the Scottish Government is done through an ethical route. We do not actively recruit staff from any of the World Health Organization’s red list countries.

“I have acknowledged that there are huge pressures on the national health service, because we have had a pandemic. We are recovering from that pandemic and are experiencing enormous strain in the process of so doing. In that sense, I accept the points that Mr Sarwar raises about the seriousness of the situation that we face.

“However, let me tell Mr Sarwar that the Scottish Government is absolutely focused on giving the necessary leadership and resources to address those circumstances, and we will continue to do so. The reactions and support that we have received from people in Scotland over successive elections show that they are supportive of the work that we undertake.”

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