As we head into winter, our NHS is already in disarray.

Despite the ongoing and extraordinary commitment and dedication of NHS staff, political leadership at the top is sorely lacking and Health Secretary Michael Matheson is too busy trying to keep his own job.

Our NHS, its staff and patients urgently need fresh leadership that will focus on record long waiting lists, driving down delayed discharge, fixing social care, and protecting the service throughout the winter.

The litany of failings goes from bad to worse, and exposes the ongoing and dangerous pressures services are under.

Across Scotland, A&E performance is declining. In NHS Ayrshire and Arran the latest figures show that only 68.8 per cent of patients presenting at A&E were seen within the Scottish Government’s own target of four hours. And 184 people waited over 12 hours. That is simply unacceptable.

One of the key drivers behind this ongoing A&E crisis is the lack of hospital capacity linked to rising levels of delayed discharge.

In October, a staggering 56,762 bed days were lost to delayed discharge across the country, and 5,662 in NHS Ayrshire and Arran alone. That piles pressure on other services, and undermines patient wellbeing.

What is more, the number of scheduled operations continues to lag well below pre-pandemic levels; and operations cancelled the day before or day of surgery for non-clinical or capacity reasons is on the rise.

One in seven Scots is stuck on a waiting list, with waiting times at record levels. More than one in four cancer patients wait longer than 62 days between urgent referral and treatment. Around 27,000 Scots are on waiting lists for mental health care, while the failings in child and young person mental health care remains scandalous, with one in four waiting over 18 weeks between referral and treatment.

None of this is the fault of our wonderful NHS staff. They do an incredible job in extremely difficult circumstances.

But due to serious systemic failings and a lack of political leadership from this Scottish Government and this Health Secretary, they do so with one hand behind their back.

It is little wonder that many are, frankly, voting with their feet. Latest NHS workforce statistics show vacancies remain rampant across services, with close to 7,000 posts currently unfilled across Scotland, above all in nursing and midwifery.

Which brings us to embattled Michael Matheson and his infamous iPad bill. It is frankly extraordinary that he remains in post, and that the First Minister thinks his Health Secretary can keep his job after deceiving the public and media over his actions.

There may be further investigations within the Scottish Parliament itself, but the reality is that he has to go.

If someone working for NHS Ayrshire and Arran had wrongly tried to claim £11,000 in expenses – not to mention then trying to cover it up – they surely would have been sacked on the spot. It can’t be one rule for NHS staff and another rule for the Health Secretary.

Staff deserve better, patients deserve better, Scotland deserves better. It’s past time for this distracted and discredited Health Secretary to go. There must be a renewed focus urgently on the multiple crises in our NHS.