First Minister Nicola Sturgeon has been accused of pretending the problems with the NHS were all caused by the pandemic.
Scottish Labour leader Anas Sarwar reeled off a list of stats which showed how the health service had struggled before covid.
The clash came after a damning report was published on the future of the NHS.
Audit Scotland found that the health service is “not financially sustainable” and needs reform.
The watchdog warned of an “ever-increasing backlog of patients waiting to be seen” and that rising spending on the health service was “unsustainable”.
At Holyrood, Sturgeon was quizzed by Sarwar and Tory counterpart Douglas Ross on the findings.
Sarwar said the report painted a “devastating picture”, detailing “out of control” waiting times and problems with staff burn out.
After reminding Sturgeon that the SNP have been in power for 15 years, he said: “How did it come to this?”
She replied by saying Sarwar is “possibly the only person” who has not noticed the global pandemic.
“I think people across the country understand the reasons for the pressures that Scotland's national health service is facing,” she said.
He accused her of pretending the problems had all been created by covid, adding this was “not true”.
Sturgeon said: “I don't pretend that all of the challenges facing our NHS or other health services are all down to COVID.
“The health service has been facing demographic pressures, it has faced the pressure of a decade of Tory austerity, started actually under the last Labour Government.”
“Anas Sarwar wants to pretend that COVID hasn't had a very significant impact, and he somehow wants to pretend that these challenges are unique to Scotland's national health service.
“These are challenges being faced everywhere across the world. This government is investing more than many other governments in our health service.
Ross earlier raised concerns about the Government’s NHS recovery plan, which is based on cutting treatment backlogs, and called for the blueprint to be rewritten.
She admitted the Audit Scotland report was “very challenging” but denied her plan required a redraft:
“We must ensure that that recovery plan is flexible and adaptable to make sure that it is fit for the very significant challenge that Scotland faces and indeed countries across the world face.”
She also said “record” sums were being invested in the NHS and pointed to the numbers of people working in the service.
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