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What are you going to spend the £200 million on? That is a big number, and it is welcome, but I do not quite understand how that translates into getting waiting times down.

Let us look at some of the detail on that. In orthopaedics in particular, there are huge numbers of people waiting for treatment—many for more than 18 months. Let us cut to the chase: those people are in pain. You will be aware that there are various models for treating people. In England, there is a more flexible approach, which includes the use of private care funded through the NHS. If a patient is waiting on a new hip or knee, do they really care where they get it, as long as they get it sooner? If they have the choice of getting it in three months or in three years, which would they choose? How open are you to new ways of delivering service to people more quickly?

Is that because accident and emergency departments are chock-a-block? Ambulances are queuing outside with people in the back of them. What sort of experience is that? If someone is sitting in the back of an ambulance for hours, or even being treated in an ambulance because there is no space elsewhere, that ambulance cannot be freed up to go out to someone else and it is not a good experience for the patient. It is a lose-lose scenario. What are you doing at the other end to unblock that?

You keep saying that, but how are we going to fix it?

Thank you very much for that.

I am not talking down nurses.

Let us do a reality check. You agree with the First Minister that the NHS is “resilient” and “robust”, but not a single NHS board in Scotland is meeting its 12-week out-patient target or their in-patient target—not a single NHS board in Scotland is meeting its 18-week planned care target. One in six Scots is sitting on an NHS waiting list—that is nearly 900,000 people, of whom nearly 10,000 have been on a waiting list for over two years. To top it all off, Scotland has one of the lowest life expectancies in western Europe. Does that sound like a “resilient” and “robust” health service that is fit for purpose and that is delivering for the public?

The target for A and E treatment is that 95 per cent of people are dealt with within four hours. That can mean that someone is admitted to hospital, if that is considered necessary, then discharged, or treated then discharged. The current average performance is 69 per cent, which exactly marries up with what you have just said—far too many people in A and E are not being treated, moved on or moved out of that environment, which has a knock-on effect on ambulances.

What is the issue in A and E specifically? Are people turning up when they should not? Is it understaffed? What is the problem? What is causing the delay?

The figures are atrocious. I point you to page 48 of the Audit Scotland report, which I flagged at a previous meeting of the Public Audit Committee. What you would normally expect to see on that page—as I am pleased to see in other tables—are little green ticks where targets have been met. However, there is not a single green tick anywhere on that page.

The numbers speak for themselves. The targets are 95 per cent, 100 per cent and 90 per cent for beginning treatment within given timescales. They are ambitious. I get that. I know that the health service is very challenging across the UK, but look at the performance measures on that page. Look at in-patient treatment within 12 weeks of a decision to treat. The poor people in Grampian are sitting at 46 per cent of the 100 per cent target. Fife and Forth Valley are at 47 per cent. For the three targets, Lanarkshire is at 61 per cent, 46 per cent and 60 per cent—nowhere near the targets. There are huge numbers of people waiting for far longer than they should, and £100 million is not going to scratch the surface, is it?

It has already been mentioned, but one of the issues at the other end is delayed discharge. We have talked a lot about the flow of people going into hospital, but getting them out is key. However, I am afraid that the statistics on that are equally atrocious. In 2023, 658,000 bed days were taken up by delayed discharge. Those are days on which beds could have been occupied by all those people who were sitting in A and E waiting to be admitted. We do not have the full statistics yet for 2024, but doing a year-on-year analysis from November to November, there was a 7 per cent increase in delayed discharge days. My fear is that the number for 2024 will not be great, either.

Of course, the Government promised to eliminate delayed discharge completely, but I do not know how on earth it thought that it was going to do that. It was an admirable ambition, but it is clearly not happening. We had a conversation earlier in which you admitted to being the accountable officer for NHS health and social care, but many of the levers that are required to deal with delayed discharge are entirely outside your control. It must be a huge source of frustration that you cannot really fix that problem, can you?