Health has dominated proceedings once again, with both Scottish Labour and Scottish Tory leaders raising concerns about the "crisis" in the NHS.

That's all from the live page team today.

Poverty-related malnutrition and food insecurity is Monica Lennon's concern.

The Labour MSP asks for a clear timetable on when free school meals will be available for all pupils, after a previous deadline for the universal roll-out in primary schools was missed.

Nicola Sturgeon says there is a limit within a fixed budget to what the Scottish government can do.

She says she has a very ambitious plan for the roll-out of free school meals and says in Scotland we are way ahead of any other part of the UK.

More than 280,000 children in P1-5 and some eligible groups in secondary schools are receiving free meals compared with just P1-3 in England and in Wales, where the system is based on eligibility.

She says if Labour want them to do more, it involves giving the Scottish Parliament full control over its own finances.

Image source, Getty Images

Background

Nicola Sturgeon announced at the end of last week that she would be attending COP27 summit in Egypt, "given the vital importance of governments working together to tackle climate change".

Prime minister Rishi Sunak has also said he will go to the event in Sharm El Sheikh, despite Number 10 initially indicating that he would be too busy with domestic matters to make the journey.

Confirming the decision on Wednesday, Mr Sunak said there was "no long-term prosperity without action on climate change" or energy security without investment in renewables.

"That's why I will attend COP27 next week - to deliver on Glasgow's legacy of building a secure, clean and sustainable future."

World leaders including US President Joe Biden and France's Emmanuel Macron, as well as former prime minister Boris Johnson, are due to attend the UN event.

Read more: How Nicola Sturgeon carved out a role at COP26

Green MSP Mark Ruskell asks how the first minister will build on the legacy of the Glasgow Climate Pact by attending COP27 in Egypt.

The first minister replies Scotland is determined to continue to play its part in responding to the global climate emergency.

"Over the next few days I will attend COP27 to do what I can to further collaboration between Scotland and other countries."

She goes on to point to the programme of work the Scottish government is undertaking as part of the Beyond Oil and Gas Alliance., external

Stephen Kerr raises the issue of the provision of mental health services in Scotland's universities.

The Tory MSP says: "There is a mental health crisis in our universities and colleges and I'm afraid the actions of the first minister in cutting the allocated funds for mental health support has just made this problem worse."

He calls on the first minister to guarantee the £20m four year programme of sector support for student mental health is continued and not cancelled, suggesting the £20m planned for indyref2 could be used.

Image source, Getty Images

The first minister points out the money due to be allocated in a future financial year cannot be used in this financial year.

She says her government is working closely with institutions and has invested more than £11.5m to support 90 additional councillors in colleges and universities.

In order to fund the £400m needed to give NHS staff a new pay deal,£38m was taken from the mental health budget.

Ms Sturgeon insists spending on mental health will continue to rise and she calls on the chancellor to increase the budget for the Scottish Parliament.

Tory MSP for Mid Scotland, Alexander Stewart brings up the plight of Ukrainian refugees living in the Killin Hotel in Perthshire.

Almost 60 refugees were told they have a month to leave last week after the Scottish government cancelled a contract.

He says this was reversed after media coverage but despite the reprieve neither the hotel, the local community council or the Ukrainians have heard anything further. He calls it unacceptable and distressing.

Ms Sturgeon says it is her priority to make sure those displaced are looked after here. She says more than 21,500 Ukrainians with a Scottish sponsor have arrived here, 20.8% of all UK arrivals.

She says some of the Killin residents wanted to move closer to Stirling and that is being accommodated.

Philip Sim
BBC Scotland political correspondent

You can often tell a lot about the Scottish government’s strategy from the questions of SNP backbenchers.

Having one of your own members ask a helpful question is a tactic as old as parliamentary question times.

The SNP usually have one in there about the impact of Brexit, promoting the idea of Scotland running its own affairs instead.

But this week there were several scripted pitches for independence. Ms Sturgeon brought it up repeatedly on her own, even on top of a clash with Tory MSP Stephen Kerr about funding for a referendum.

It hints at how ongoing rows about the economy will play a part in the longer-running political project.

So even while the main questions between party leaders focused on the here-and-now of health service delivery, the constitutional question is never far from the surface – and it’s not going anywhere.

SNP MSP John Mason raises the issue of energy vouchers not being redeemed by the end of October.

Many customers with prepayment meters have not yet redeemed vouchers to help with energy bills, the BBC has learned.

The first minister says she is concerned by this and it may be that some are holding on to these vouchers until the weather gets colder.

She explains she has chaired two meetings with energy suppliers and advice services over the past few weeks.

Ms Sturgeon says: "I would encourage energy companies to do everything they possibly can to ensure that those who are the most vulnerable are getting the maximum possible support and getting it as quickly as possible."

Philip Sim
BBC Scotland political correspondent

Labour’s Anas Sarwar leads on the health services in almost every session of FMQs, and this week was never going to be any different.

He also put a harrowing case study to the first minister of a member of the public who waited hours for an ambulance – again putting a human face on the big story of NHS delays.

And it means that beyond offering sympathy, Ms Sturgeon had little option but to give a more general answer about services as a whole.

Throwing back statistics about overall provision is a difficult sell when put up against a personal story that people can relate to.

What Ms Sturgeon does have going for her is that Labour agree with her about the actions of the Conservative UK government.

So she can quote Labour ministers in Wales who are also calling for UK ministers to do more to help the health services - ultimately putting the problem back at Westminster’s door.

Mr Sarwar asks the first minister to listen to the words of an ambulance driver who says: "Waiting times are not a post-pandemic issue.

"We have been raising this for as long as I have been in the service. Times are getting longer, patients are getting sicker and it is happening in all seasons now, not only in the winter months".

Nicola Sturgeon says she will always listen to those who work in the NHS and will continue to support them with investment and recruitment.

She says the pressures on the NHS are not divorced from wider budgetary issues and quotes the Welsh Labour health minister as saying their NHS will be "hell on earth" next year without additional funding from the UK government.

She asks how Labour in Wales can recognise that reality, but Labour in Scotland are "blind to that reality".

Mr Sarwar asks the first minister to "change the script" and give real answers.

He says ambulances are waiting hours to drop off patients and that 2,700 ambulances waited at least one hour and 50 minutes to drop off patients at Scottish hospitals.

In one month at the Queen Elizabeth University Hospital in Glasgow, 218 ambulances waited more than three hours.

He asks why things are getting worse, even before the peak of winter pressures.

The first minister says it is "more complicated than sound bites".

She says management of the NHS is the Scottish government's responsibility but says it is not immune from wider economic and budgetary decisions which are outwith the hands of the government.

She wishes she could invest much more in the health service and agrees with Welsh First Minister Mark Drakeford who recognises that his management of the health service there has been affected by the decisions of the Tory government.

Next it's the turn of Scottish Labour leader Anas Sarwar and he too brings up the NHS, saying staff are being asked to "do the impossible" and patients are being asked to "accept the unacceptable".

He cites the example of a patient with bone cancer who waited more than 24 hours for an ambulance when she suffered a fractured pelvis.

Ms Sturgeon offers to look into the case, saying no one should wait that long.

She says the government continues to support the NHS. She says ambulance service staffing is up by 67.3% under this government, and they have allocated additional funding.

However she says experiences like that described are not acceptable.

"Of course people are right to be worried about the ability of our National Health Service to cope with spending constraints and the impact of Tory mismanagement on our economy," the first minister hits back.

She tells the chamber she has just heard interest rates have increased to 3%, the highest for 14 years, due to "Tory economic mismanagement".

Ms Sturgeon points to higher funding in the NHS per head of population here in Scotland compared to the rest of the UK

Again she points out Scotland's A&E performance is better than in the rest of the UK.

She says the Agenda for Change NHS workforce are being offered a 7% pay increase in Scotland, compared to 4.5% where the Conservatives are in power.

"Scotland's NHS is in crisis at every level," argues Mr Ross.

The Scottish Tory leader says the situation in A&E is at the most critical level it has ever been.

He warns of a "winter of strikes from staff across our NHS" and he quotes the chairman of BMA Scotland who said doctors were "terrified" of the year ahead.

NHS difficulties taking on more urgency than everpublished at 12:23 Greenwich Mean Time 3 November 2022

12:23 GMT 3 November 2022

Philip Sim
BBC Scotland political correspondent

Health was an obvious topic for questions today, following on from Wednesday’s announcement from Deputy First Minister John Swinney about “reprofiling” £400m of health funding to go towards NHS pay deals.

Linking things to the economy is a slightly sticky subject for Douglas Ross, as Nicola Sturgeon had plenty of comebacks ready about the UK government’s recent fiscal flip-flops.

But there are no shortage of health issues to pick away at, from delayed discharge to waiting times.

And Mr Ross also had a case study to hand – a classic FMQs tactic to put a face on an issue, and have Ms Sturgeon address her answer to a member of the public instead of to a rival politician.

It all added up to some familiar exchanges about the difficulties facing services and the impact of Covid on the NHS.

But amid an economic storm and with winter looming, the issue is taking on more urgency than ever before.

The first minister says of course it is her government's intention to eradicate delayed discharges and she reiterates that the most recent figures shows a reduction in them.

Nicola Sturgeon agrees having to phone 120 times for a GP appointment is not acceptable.

She points out the NHS is under strain, and more cash is being invested into GP services.

The first minister argues everyone will be breathing a sigh of relief that the Conservatives are not in power here in Scotland.

Mr Ross asks if the first minister will promise to eradicate delayed discharge and she refused to answer.

The Scottish Tory leader argues delayed discharge has got worst and he raises the issue of a pensioner in Musselburgh who has been trying to get through to a GP to get treatment for a lung infection.

Mr Ross says: "She had to phone the practice 120 times before she got through to anyone."

He asks if that is acceptable.

The first minister questions whether this attack on the use of the independent sector is "another flip flop" from Douglas Ross.

Ms Sturgeon says the global pandemic is having an impact on NHS services.

In terms of radiology there has been an increase in consultants of 62.5%, she says.

The first minister says there is a global shortage of radiologists and international recruitment is not made easier by Brexit or the Tory approach to migration.

Turning to delayed discharges, Ms Sturgeon says more than £100m is being invested in care at home.

"Despite these pressures though, the average bed days occupied by delay now is similar to the levels pre-Covid."

Mr Ross says the Royal College of Radiologists says Scotland needs 100 additional consultants in radiology and these problems are not unique to radiology.

The Scottish Tory MSP says delayed discharges have reached their worst ever levels.

He points out the SNP government promised to eradicate delayed discharges eight years ago.

"Today it's worse than ever before. First minister, will your government ever eradicate delayed discharge as you promised?" he asks.

The first minister says the NHS will always take steps to ensure the speediest diagnosis possible.

Ms Sturgeon pledges to look closely at the figures Douglas Ross raises.

She explains this could be due to constraints in the service here, however she adds the Scottish government is investing record sums in the NHS.

"The service is under significant pressure," she adds.