I join others in wishing manager Steve Clarke, captain Andy Robertson, vice-captain John McGinn and the entire Scotland men’s team all the very best for the Euros. I also wish the tartan army a safe and enjoyable visit to Germany.

Before I was elected, I worked in our national health service as a dentist. Dentistry is just one part of our NHS that is currently in crisis. Earlier this week, I visited a practice in Fife. Much to the frustration of the staff there, the practice cannot take any more NHS patients. In fact, four out of five practices across the country are not accepting new NHS patients, and more and more people are being forced to go private and pay.

The issue does not exist just in dentistry; it is all across our health service, and the problem is growing. The number of people who are being forced to pay for their own care has gone up 86 per cent since 2019 and is at the highest level ever. Labour created our NHS to be free at the point of need. Why does that principle not apply under the Scottish National Party?

I recognise the challenges that exist in dental practice, but I point out that Scotland has 57 dentists per 100,000 of the population, compared with 42 per 100,000 in England and 46 per 100,000 in Wales. The investment that the Government has made in the national health service, and particularly in dentistry, has been an important contribution to establishing and achieving that position. That would not have happened had the Government not given that area priority since we came to office in 2007.

The Government has also undertaken a significant intervention through the introduction of a root-and-branch reform of the NHS dental payment system in November last year. We are in the early days of the implementation of that reform package.

Through the combination of the investment in the workforce and the investment in that reform package, the Government is supporting dentistry in Scotland to achieve the necessary delivery of service to people around the country.

I note that the First Minister did not respond to the fact that there is an 86 per cent increase in people having to go for self-payment because of a lack of access to our NHS. Also, the stats that John Swinney quoted will be zero comfort to people who cannot access NHS dentistry and are being forced to go private. I think that he needs to get his head out of the sand.

Labour founded our NHS to be free at the point of need and open to everyone, regardless of the ability to pay. Under the SNP, people again and again are forced to pay because they cannot get treatment in time. Last year, more than 1,500 people in Scotland were forced to pay for knee replacements, at a cost of nearly £16,000 each. There were 8,000 private operations for cataracts, at more than £2,800 each, and almost 3,000 hip replacements, at a cost of more than £14,000 each. In the middle of a cost of living crisis, when mortgages, energy bills and food prices have all gone up, how much have people had to dig into their own savings or borrow from friends and family in order to pay for their own treatment?

I regret the fact that people have felt the need to take recourse to private treatment. I have made it clear in my answers over several weeks that, particularly as a consequence of the increase in case loads because of the cancellation of procedures during the Covid pandemic, the presentation of demand on the national health service has increased. We are working to reduce waiting times and waiting lists to ensure that people get treatment at an earlier time than is the case just now.

I have to say to Anas Sarwar that he is on very thin ground when he challenges me on the question of private involvement in the national health service. I remind him of the comments of Labour’s shadow health secretary, Wes Streeting, who said that a United Kingdom Labour Government would

“hold the door wide open”

for the private sector in the national health service. He also said:

“We will go further than New Labour ever did. I want the NHS to form partnerships with the private sector that goes beyond just hospitals.”

What we have here is a classic example of what Anas Sarwar gets up to in public debate. He comes here and says one thing in Scotland, and in England his bosses are doing a completely different thing, which will have an effect on our budget here in Scotland. Anas Sarwar has already been caught out on that this week. It is not good enough for him to say one thing in Scotland and be contradicted by his bosses in London.

That is, frankly, an embarrassing response to the fact that 3,000 people in Scotland—[ Interruption .]

Let us hear Mr Sarwar.

—have had to pay £14,000 for a hip replacement. Mr Swinney wants to do quotes, so I will quote two simple sentences from the UK Labour manifesto, which was published today, as they are a direct response:

“We have saved the NHS before, and the next Labour Government will do so again. With Labour, it will always be publicly owned and publicly funded.”

There will not be more people going private, as under the SNP. I will quote another sentence:

“There will be no return to austerity”,

so stop the scaremongering, stop the misinformation and be truthful with the people across Scotland—[ Interruption .]

Members!

I asked John Swinney how much people have had to find from their savings or to borrow from friends in order to pay for private treatment, and John Swinney very deliberately failed to answer the question. Let me tell him. Just for hip, knee and cataract surgeries in Scotland last year, people had to pay more than £83 million. That is what families had to find in the middle of a cost of living crisis, because of SNP incompetence. The SNP’s mismanagement of our NHS is so bad that it is those who are in pain, sick and injured who are forced to literally pay the price.

Perhaps most horrifyingly of all, there are people who are forced to go private and pay for their cancer treatment. To all the hecklers at the back, I say that that is the reality under the SNP Government. Cancer, Scotland’s biggest killer, is something that touches us all—

I must have a question, Mr Sarwar.

Every second that is wasted in the fight against cancer decreases the chances of survival—[ Interruption .]

Heckling cancer patients who must pay private fees—is that the height of the SNP’s ambition?

Mr Sarwar, I would be grateful if you could please put a question to the First Minister.

I am coming right now to the question, Presiding Officer.

Last year, more than 1,000 rounds—

Mr Sarwar, I will allow one further opportunity—

This is my question.

I certainly hope that it is.

Last year, more than 1,000 rounds of chemotherapy were paid for privately. Why does the First Minister believe that people in Scotland should have to pay for their life-saving cancer treatment—1,000 rounds—because of his party’s failure and incompetence?

I do not want anybody to have to pay for cancer treatment, but I have to face up to the reality of the challenges that our national health service faces.

Let me just give Mr Sarwar a statistic. The rate of people self-funding for private healthcare in England is 66 per cent higher than it is in Scotland—[ Interruption .] Oh, Jackie Baillie says, “But it is the Tories.” Well, we will give Labour-run Wales as a comparison: the rate is 13 per cent higher in Labour-run Wales than it is in SNP-run Scotland, so I say to Jackie Baillie that it is perhaps not a good idea to heckle me when I am in mid-flow.

What that all comes down to is the financial envelope that is available for the national health service. The Government is taking the hard decisions to increase tax in order to improve the amount of money that is invested in the national health service.

There was a day when the Labour Party supported us on that, but now it has deserted the pitch and run away. On orders from London, the Labour Party in Scotland is now voting against higher taxes on higher earners, because its bosses in London have told it to do exactly that. That will undermine the investment in our national health service, which is why Anas Sarwar has not a scrap of credibility when he tells me that there will be “no return to austerity” under a Labour Government. A Labour Government will have to make £20 billion-worth of spending cuts to pick up where the Tories have left off, so it will be continued austerity from Labour, and Scotland should vote against it.

Before I move to the next question, I point out that the length of time that we have taken to reach this point in this item of business is disadvantaging back benchers who wish to put questions to the First Minister. I would be grateful if members could reflect on that.