Humza Yousaf is facing renewed calls to sack his health secretary after waiting time performances plunged across Scotland’s A&E units last week.

With delayed discharge figures also deteriorating, Scottish Labour said Michael Matheson had “proved time and time again that he is not up to the job”.

The Tories said the situation was "shameful", while the Liberal Democrats said the NHS had entered the New Year in a "perilous position".

Public Health Scotland reported almost two in every five patients had to wait longer than the official four-hour target between Christmas and Hogmanay.

The 60.8% figure for the week to December 31 was down from 65% the previous week and the joint third worst performance of 2023.

However it was better than the equivalent week in 2022, when just 55.5% of A&E patients were seen on time.

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The number of patients enduring extreme waits also rose last week.

The number waiting more than eight hours rose from 2,584 to 3,178 (10.8 to 13.6% of patients), while the number waiting more than 12 hours rose almost a third, from 964 to 1,271 (4 to 5.4% of patients).

The increases were in spite of a fall in attendances, from 23,943 to 23,331.

The target is for 95% of patients to be admitted, transferred or discharged within four hours.

It has not been met nationally since July 2020.

The worst performing health board last week was, as usual, NHS Forth Valley, where 43.5% of patients were seen within four hours, followed by NHS Lanarkshire (48.5%) and NHS Grampian (52.6%). 

Other newly-released health statistics showed delayed discharge levels in November were the worst of 2023, with an average 1,894 beds occupied each day by patients who were medically fit to leave hospital but lacked suitable care and accommodation outside. 

This was 3% up on the figure for October.

In total, 56,811 bed days were lost to delayed discharge in November, despite the SNP promising to eradicate the problem in 2015.

Delayed discharge is a key factor behind long waits in A&E, as it makes it harder to find beds for patients admitted through casualty.

Other data showed 2,277 of 25,922 operations planned in November were cancelled (8.8%), a slight improvement on November 2022. 

Most cancellations were done by the hospital on clinical reasons, although 582, or around a quarter of cancellations, were due to “capacity of non-clinical reasons”.

Scottish Labour Health spokesperson Jackie Baillie said “Health and social care in Scotland is at breaking point, and patients and staff are paying the price. 

“Hundreds of people every month are facing last-minute cancellation of operations that they have been waiting months or even years for.

“Delayed discharge continues to spiral out of control, piling pressure on hospitals and over-stretched A&Es.

“Michael Matheson has proved time and time again that he is not up to the job – not only is he embroiled in scandal, but he has failed miserably to tackle the crisis unfolding in our NHS.

“We need a new Health Secretary and an end to the SNP’s long record of dangerous failure.”

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Tory MSP Dr Sandesh Gulhane added: “It is shamefully predictable that the final A&E waiting time figures for 2023 were utterly disgraceful on the SNP’s watch.

“The discredited and distracted health secretary Michael Matheson spent the year miserably failing to get a grip of the crisis engulfing A&E departments across the country, after inheriting chaos from his predecessor Humza Yousaf.

“It remains the shocking norm that well over a third of patients are waiting longer than four hours to be seen, over 3,000 patients waited over eight hours, while nearly 1,300 suffered waits of over half a day. We know these excess delays inevitably lead to tragic and avoidable deaths.

“These awful figures occurred even when attendance levels were at their lowest level since February. That sums up how Michael Matheson has failed to support my dedicated colleagues on the frontline.”

Scottish Liberal Democrat leader Alex Cole-Hamilton said the NHS was in a “perilous position as we enter 2024”.

He said: “It’s clear now that Humza Yousaf’s NHS recovery plan has failed.

“NHS staff have been sounding the alarm for months but the SNP just hasn’t been listening. “Staff are working flat out and getting burnt out because they simply don’t have the beds, safe staffing and resources they need. Scotland desperately needs a government that is laser-focused on the day job and will put the voices of NHS staff first.”

Mr Matheson said the winter pressures on the health service were “not unique to Scotland”.

“Although we are seeing a slightly better performance than this time last year, particularly in terms of the number of long waits, we absolutely recognise that the system remains under pressure, and waiting times are longer than we want them to be for some patients.

“We are determined to provide boards with the support they need to manage continued seasonal pressure on services.

“Our winter plan is supporting boards to maximise capacity to meet demand and the expansion of Hospital at Home services is already helping more people receive care at home or as close to home as possible, where clinically appropriate – which aims to relieve pressure on the front door of our A&Es.

“Hospital bed occupancy continues to be a major factor impacting on performance.

“To address this, the delayed discharge and hospital occupancy action plan is being implemented at pace, delivering actions we know work to ensure patients receive the right care in the right setting.”