The final item of business is a members’ business debate on motion S6M-18624, in the name of Paul Sweeney, on dying in poverty at the end of life in Scotland 2025. The debate will be concluded without any question being put.
Motion debated,
That the Parliament welcomes the publication of the Marie Curie report, Dying in Poverty in Scotland 2025; understands that the report is based on research carried out by Marie Curie and Loughborough University; notes that it found that end of life poverty in Scotland remains unchanged since 2024; understands from the research that one in four working age people and one in six older people still die in end of life poverty; considers that terminal illness exacerbates existing inequality and deepens the inverse care law where people in the most need of support are least likely to receive it; notes the report’s findings that symptoms of terminal illness and diagnosis can result in higher energy and housing costs; believes that a terminal diagnosis can force both a dying person and their carers to reduce their working hours or give up paid work entirely; notes the view that more must be done to target support to people at the end of life and their carers, and further notes the calls for the Scottish Government to take action to prevent people, including those in the Glasgow region, from dying in end of life poverty.
17:01
I thank everybody in the chamber who supported my members’ business motion. During the week that saw the start of stage 2 proceedings on the Deputy Presiding Officer’s Assisted Dying for Terminally Ill Adults (Scotland) Bill, it is good and proper that the Parliament takes a moment to consider end-of-life poverty in Scotland. Regardless of members’ views on the bill, it has been made clear from the discussions in the Parliament and across the country that we are all united, by a massive majority, in wanting the best possible support for those who are suffering with terminal illness.
Ensuring dignity in the final months and days when someone is suffering from a terminal illness should be a paramount consideration for the Parliament. No one needs to die in poverty, spending their final moments worrying about bills, how to afford their final meal or the implications for their loved ones. Unfortunately, as the preliminary data from Marie Curie’s 2025 report shows, dying in poverty is still the norm in too much of Scotland. We want to believe that we live in a land where everyone dies in the comfort of their own bed, surrounded by family and friends, in a peaceful, dignified and pain-free way, but a staggering one in four working-age people and one in six pensioners with a terminal illness die in poverty every year in this country. We can all agree that that is completely unacceptable.
Scotland remains such an unequal society in so many ways—most notably, in relation to income—and a closer look at the figures shows that areas such as my home city of Glasgow are affected the most, with one in three working-age people dying in poverty. A legacy of deindustrialisation, austerity and social neglect has led to too many of my constituents spending their whole lives, from the cradle to the grave, in poverty—indeed, it is a life sentence before they are even born. Where there should be dignity and support, instead, there is a constant, exhausting and overwhelming battle that does not end until their untimely passing.
In the past couple of weeks, there has been news of a credit union’s funeral plans being pulled at a moment’s notice by a completely unscrupulous provider, which shows that, even in death, some people are stripped of the dignity of the funeral that they might have planned. The fear of the pauper’s funeral still looms large in this country. It is the final indignity—a funeral being stripped from elderly, low-income Scots with no recourse. I hope that we can at least change that.
The terrible overlap of class and health inequalities was brought home to me, as I have mentioned previously, when I visited the Marie Curie hospice at Stobhill hospital—the hospital where I was born. I met a lady there who was suffering from terminal throat cancer. She had grown up in Bridgeton and had had a difficult upbringing—she had been involved in drug taking and various other things. She had two young boys and had just got her life back on track, or so she thought. She had had a persistent cough and a sore throat, and she went to the doctor umpteen times to try to get help. She was sent away with painkillers and told that it was just an infection. By the time she got a referral and was diagnosed, she had incurable throat cancer. She was in her late forties.
I walked around the hospice—as members of the Scottish Parliament, we often visit such places—and was suddenly confronted with this most horrendous, shattering story. What do you even say to someone in that situation? She felt that she had been robbed of her life because, due to her upbringing, she was not taken seriously and was unable to advocate for herself. She was suffering a terminal illness; she was going to die.
What were the implications for her? What about her young kids? It was a really difficult conversation, but we tried to turn it into something positive by talking about the impact that she had had on her children and how they were doing really well. We tried to gather some degree of positivity from the situation. She made the point that, if she had grown up in Bearsden rather than Bridgeton, she might still be alive today. I got a call just the day afterwards to say that she had passed away.
In many ways, we need to think about the reality of the avoidable deaths that happen every day in Scotland because of this economic and social problem, and about the lack of equality.
I am very grateful to Paul Sweeney for his incredibly powerful speech. Does it not speak to the disparity between what we believe to be the social contract among us all here in Scotland and the reality that many constituents face? I compliment Marie Curie on its powerful report, which provides an opportunity to look at the issue and to recommit to a full social contract that reaches out to people, including the woman Paul Sweeney has spoken about so powerfully.
I thank my friend for his intervention. I could not agree more. Despite all the immense work that hospices and our national health service do, too many people are simply stripped of dignity at the end of their lives. Too many people are robbed of the ability to die at home, rather than in a horrible clinical setting in a hospital.
That does not have to be the world that we live in. Marie Curie made a number of recommendations in its report that would help us to alleviate poverty and dying and to take the burdens off those in their end-of-life journey. One way would be for the Scottish Government and local authorities to work together to exempt terminally ill people from paying council tax, similar to the Manchester discretionary council tax support scheme. That would lift the financial burden for those close to death and would be a small step in creating a state that cares actively for those who are dying and recognises the struggles that they are going through by minimising the stress of what is an already impossible situation to come to terms with.
I realise that I have only touched on the initial findings of this fine report. I am sure that colleagues from across the chamber will highlight its other important findings during the debate.
It is important to stress that we in the chamber have the power to end the scourge of end-of-life poverty. It could happen to a family member or a friend of ours, or it could be us—who knows? We can build a social security system that is once again a truly cradle-to-grave system of protection. If we do not do that, the consequence will be that large numbers of our fellow Scots will continue to suffer the humiliation and indignity of suffering at the end of life.
I thank Marie Curie and Loughborough University for releasing the preliminary findings ahead of the publication of the full report, “Dying in Poverty in Scotland 2025”, to enable us to have the debate this evening. I look forward to hearing contributions from across the chamber that show a united resolve to end end-of-life poverty in Scotland once and for all.
17:08
I thank Paul Sweeney for bringing this issue to the chamber. It is important that we discuss the preliminary findings of the “Dying in Poverty in Scotland 2025” report by Marie Curie.
The report is another significant contribution from Marie Curie in raising awareness of the issue and setting out the lived experience of those who are approaching the end of their life. Marie Curie also produced the “Dying in the Margins; The Cost of Dying” report, which was published not that long ago, and the organisation has made a series of other immense contributions.
As the chair of the cross-party group on palliative care and as deputy convener of the Social Justice and Social Security Committee, I see the report as vital in driving forward some of the work that I would like to do in this Parliament.
I thank Mr Doris for referencing the “Dying in the Margins” study. It is really important, because the dead cannot advocate. The power of that study and exhibition, which diarised people at the end of their lives and told their stories—which might otherwise have been completely lost—was incredible. People who are coming to terms with the grief of losing a relative are not necessarily going to turn around and advocate for them. That was a powerful point to make.
I can give you the time back, Mr Doris.
I am pleased that Mr Sweeney put that on the record. I agree.
The most powerful thing about the preliminary report is that it suggests solutions and provides recommendations for change, rather than putting up with things as they are now. It shows us that one in four people of working age who are approaching the end of life are in poverty, while, for pensioners, that figure is one in six—which is still too high, of course. The report recommends that the state pension should be accessible to everyone of working age at the point at which they receive a terminal diagnosis. That is a powerful recommendation that we should come together to look at.
The report identifies the understandable impact on families when a family member has a terminal illness—it often pushes them below the poverty line because of childcare issues, housing issues and energy costs. More needs to be done. The Scottish Government should be maximising the uptake of disability and childcare benefits as speedily as possible. If the Scottish child payment was a stand-alone benefit instead of being attached to universal credit, we could perhaps be more flexible in how we deploy that payment for families in which someone has a terminal illness. We could absolutely do that, too. We should also fast-track benefits—more than we do already—for those living with disabilities who have a terminal condition.
Marie Curie also talks about sharing innovation and possible best practice. I, too, name-check the Manchester experience, where council tax has been zero rated for households in which someone has a terminal illness. That is certainly worth considering in Scotland. It would not be easy, and there would be financial challenges, but, if that can be done in Manchester, let us see what we can do across Scotland’s local authorities.
Given that one in five people who have a terminal condition live in fuel poverty, we need to look at energy costs. Marie Curie suggests that, given that people who are living with a terminal condition are at home more, rely on medical devices more and are often already in poverty, a social tariff across the United Kingdom, with at least a 50 per cent discount on energy costs, could be applied. It would take political will in the UK Parliament and in Scotland to deliver that, but, together, we could do it.
I will make one or two other observations. Marie Curie spells out—I find this important as the chair of the cross-party group on palliative care—that we spend £2.3 billion investing in people with a terminal condition in the last year of their life. Only £0.5 billion of that is spent on social security. About £1.1 billion is spent on care in hospital, and 59 per cent of that is for unplanned visits to accident and emergency departments. What is left over—only 14 per cent—is spent on community care.
It is hardly surprising that one of the main things that we can do for those living with a terminal illness to make the last year of their life as dignified, pain free and poverty free as possible is to take a whole-systems approach. It is not just about the money in their pockets.
Finally—in the tiny bit of time that I have left—there has been some action in Scotland regarding the social contract, but we need to go further. Folk approaching the end of life often worry not about themselves but about those they will leave behind. We have invested in a run-on for carer payments in Scotland, so that payments can still be received once a loved one has passed away, and we have also introduced funeral support payments. Those are concrete investments in the social contract to make people’s lives better.
I attended—as you did, Deputy Presiding Officer—the Health, Social Care and Sport Committee when it was looking at your Assisted Dying for Terminally Ill Adults (Scotland) Bill. Everyone, irrespective of their perspective on assisted dying, agrees that we all must do better for those who are approaching the end of their lives. Together, irrespective of party or Parliament, let us get together and do all that we can in that regard.
17:13
I am pleased to speak in this evening’s debate, and I thank Paul Sweeney for bringing this important issue to the chamber. As someone who previously served as my party’s spokesperson on older people, and as the current shadow cabinet secretary for social security, I am delighted to speak on this topic and to congratulate Marie Curie on its work.
Marie Curie has raised issues that are important not just to the communities that I represent but to areas across Scotland. Its report, which comprises research by Marie Curie and by Loughborough University, shines a light on the reality for thousands of people across Scotland who are spending their final months in poverty.
The basic statistics are quite grim—more than 6,500 people with a terminal illness are in poverty at the end of life. In 2021, more than 56,000 people in Scotland died with a palliative care need, and the Scottish Government’s analysis shows that that figure could increase to 63,000 by 2040. I have no doubt that members on all sides of the chamber can agree that no one who is at the end of their life should have to spend their final days worrying about financial issues.
As with many health-related issues, the problem does not affect all parts of Scotland equally. The Government’s palliative care strategy, which was published last year, identified that levels of palliative care services vary significantly across different health boards.
In areas such as Glasgow and Dundee, the figure is one in three, but this is not just an urban problem; it affects rural communities such as the ones that I represent across Mid Scotland and Fife. In Clackmannanshire, which is in my region, transport barriers can limit access to specialist healthcare, and energy costs can make it very expensive for mains-powered medical devices to be plugged in at home.
For those who are living with a terminal illness, such pressures can be overwhelming. They can also be challenging for unpaid carers, who remain the backbone of the social care system.
Marie Curie rightly highlighted that local authorities have a role to play in tackling the issue. It identified the example from Manchester of discretionary council tax support, which is helping to support those with a terminal illness. Individual councils are well placed to decide how to provide extra support. Councils need to be properly funded in order to provide the right level of support. The onus is on the Scottish Government to discuss how the issue could be dealt with and how funding could be provided.
Marie Curie’s report shows us that dying in poverty is far more widespread than we think. It is also difficult for us to solve the problem. As we have seen, very little has happened to reduce the statistics between the surveys that came out in 2019 and those that came out in 2024.
The suffering is not inevitable, nor is it necessary. Through access to all levels of Government, solutions can be put in place to tackle that. For all those who have suffered with end-of-life poverty in the past and for those who might be suffering as they go into the future, I hope that the Scottish Government can work constructively towards solutions in order to help to give people security. I look forward to hearing from the minister in his summing up what steps the Scottish Government is taking to achieve those goals.
As we have said, nobody should be put in such a position at the end of their life. We—the Government and us as a Parliament—have a role to play in ensuring that we do all that we can to help to end suffering. I commend Marie Curie and Paul Sweeney for what they have done on the issue so far.
17:17
I thank Paul Sweeney for lodging the motion and so, for the second year running, leading this debate in Parliament. It has become a significant annual debate about an important annual report published by Marie Curie—and this year once again produced in collaboration with Loughborough University. The report is above all else about the way we live with terminal illness, and I say “we” because it could happen to any of us at any time—and I say “we” because we do not live as individuals or as consumers in a market; we live as citizens in a society, in a community where we look out for each other.
The preliminary findings also compel us to examine the world in which the Assisted Dying for Terminally Ill Adults (Scotland) Bill, which has been back before Parliament again just this week, is conducted. I cannot help thinking about the inverse care law—that those in the most need of support are oftentimes the ones least likely to receive it—and about how poverty and deprivation fuel conditions like clinical depression, how the suicide rate in our most deprived communities is two and a half times that of our least deprived communities and how, as the Association for Palliative Medicine has warned,
“palliative care is underfunded and unevenly available.”
Assisted dying, it concludes,
“risks deepening inequalities for vulnerable groups”.
That is why its members overwhelmingly oppose it, as do I.
Replying to the debate on the 2024 report by Marie Curie last December, the Minister for Public Health and Women’s Health told us that
“The Scottish Government is assessing the report and looking at where we can make changes.”
But the preliminary findings from this year’s report are absolutely clear—that end-of-life poverty has stagnated and has not improved between 2019 and 2024, despite some policy efforts, and in some areas, it has worsened. In the local authority areas that I am elected to represent in this Parliament—North Lanarkshire, South Lanarkshire and Falkirk—it has stagnated, with an average of one in four people of working age and one out of six people of pensionable age still dying in poverty. As we know from the findings of previous years’ reports, if you are from a black, Asian or minority ethnic background and living in Scotland, you are twice as likely to die in poverty than if you are white.
Last year in the debate, the minister also proclaimed:
“I believe that we have to approach the issue from a very non-political perspective and work together to get the best results for the people of Scotland.”—[Official Report, 5 December 2024; c 45, 47.]
Now, I am happy to work together, but this is highly political. We have grotesque poverty in the midst of obscene wealth.
These findings are not just about poverty; they are about inequality—a sordid inequality of not just income and not just wealth but a sordid inequality of power, which is class based. As long as we have an economy largely driven by the market and primarily run for the accumulation of wealth, and as long as we have a society that is self-evidently riven with class divisions, we will never end poverty.
That is why we need not just welfare interventions as amelioration; what we need is a decisive, an irreversible and a permanent shift in the balance of wealth and power, because these inequalities are structural. So we need radical action and fundamental change—economic as well as political change—with a change in economic relations and so power relations. We need a new equilibrium. That is the only way we will change the material conditions, the quality of life and the fate of the people we are sent here to represent.
17:22
I thank Paul Sweeney for securing the debate, which is on a topic that is hugely important to us all. As Richard Leonard pointed out, many of us in the chamber today spoke on the topic last year, and I think that many of us who return after next year’s election will talk about it again.
In my constituency of Carrick, Cumnock and Doon Valley, I see every day the quiet strength of communities that look after one another, especially when times are hard. However, I also see something that should trouble each and every one of us: people who are terminally ill and people at the very end of their lives spending their last precious months and days in poverty.
The preliminary findings from the invaluable research from Marie Curie and Loughborough University paint a devastating picture. More than 6,500 people in Scotland die in poverty each year, and more than 7,700 die in fuel poverty. Those are not just numbers on a page in a report—they are our neighbours, our parents, our friends or perhaps even our children. We know them, and we love them.
In rural constituencies such as mine, where we already face economic hardship, higher energy costs and an ageing population, the burden is even heavier. Families speak of loved ones who will put on another jumper and coorie under as many blankets as they can while they ration their heating so that they can afford food; they tell us of children taking on caring responsibilities while their parents skip meals to make ends meet; or, as the research tells us, family members give up work to look after a dying loved one and end up resorting to taking out costly loans just to survive. That is not dignity, it is not compassion and it is not the Scotland that we want to be.
The research makes it clear that one in four working-age people with a terminal illness die in end-of-life poverty. Imagine that. After a lifetime of work and of paying into a system, people spend their final days worrying about bills instead of spending time with those they love. It is heartbreaking and unjust. For me, this is a social justice issue as well as a health issue.
We must be bold enough to act. Marie Curie has called for people of working age who are living with a terminal illness to receive a guaranteed state-pension-level income, as my colleague Bob Doris pointed out. I fully support that call. No one should have to beg for financial security at the end of their life. Although we might not have all the levers when it comes to social security, I wonder what the Scottish Government can do within the scope of the powers that it has and how it can apply pressure at UK level and perhaps work together with the UK Government to find a solution to that problem.
Alongside financial justice, we must look at how we care for people. For too long, our model has defaulted to hospital admission, when what people truly want, and what research shows us leads to better outcomes, is to be cared for in their own communities, surrounded by familiarity and love.
In my constituency, we see that alternative approach working in practice. Dalmellington care centre is a shining example of community-based palliative care; it is a place where compassion and professionalism meet. The centre, which is located in an area that is having to deal with entrenched poverty and which hosts one of Scotland’s deep-end general practitioner practices, allows people to receive the care that they need close to home, supported by staff who know them, who understand the realities of rural life and who work hand in hand with the families, the communities and the community services. That is an innovative alternative model of care that should be replicated everywhere.
I was proud to see that the recent Care Inspectorate report recognised the outstanding work that is being done in Dalmellington. It praised the commitment, the warmth and the dignity that are offered to every resident. That report shows what is possible when we invest in care that is local, integrated and rooted in community values. The outreach and the follow-on support that are provided are second to none, and they ensure that all incomes are maximised.
As we debate how to tackle end-of-life poverty, let us also talk about dignity in care. Let us ensure that every person in Scotland, whether they live in a city, a tenement or a small Ayrshire village, has the right to a warm home, the right to financial security and the right to a peaceful, supported death.
A society is judged not by its wealth but by how it treats its most vulnerable. If we can find the compassion to act, to guarantee financial dignity, to expand community palliative care models such as the one that is offered in Dalmellington, and to support families who give so much, we will truly build a Scotland that cares, in every sense of the word.
17:27
I thank Paul Sweeney for again securing a debate on this important subject. I have spoken in previous years’ debates on the issue, and it saddens me that, once again, we need to raise our voices to speak out for those who are dying in poverty.
This year’s report tells us that we have not moved the dial one bit, so all our efforts must remain focused not on talk, reports or briefings but on the delivery of services and the redistribution of wealth. My colleague Richard Leonard put that so much better than I have done. The issue is about how, as a society, we can redistribute wealth and power.
As with so many things that we encounter in the course of our lives, the process of death is influenced by the poverty and inequality that are experienced by so many. That one in four working-age people and one in six older people still die in poverty should shame us all. I have said this before in the chamber, but I feel compelled to say it again: everyone deserves as pain-free and peaceful a death as possible, surrounded by those who love them, in a place that comforts them and that they have chosen.
Little attention is paid to working people and the strain that often comes with working multiple jobs or living in forgotten communities. What makes me say that? I grew up in a coalfield community. It is almost 40 years since the rapid closure of the mining industry began in coalfield communities in the South Scotland region, yet we are still seeing the consequences. Figures that I found last year suggest that 44 per cent of the working-age population in the Scottish coalfields are claiming some form of benefits, compared with a Scottish average of 23 per cent; 40 per cent of people in the Scottish coalfields have no qualifications, compared with a figure of 27 per cent for Scotland as a whole; and the mortality rate in the Scottish coalfields is 25 per cent higher than the Scottish average. That is why I feel that we do not prioritise the issue enough.
Poverty is the root of the injustice that permeates our society, and that injustice is often suffered from the cradle to the grave. I simply cannot accept that, which is what has driven me to speak in today’s debate. We must do more to stop so many having so little while the few have so much. The reality is that, at the end of life, the rich can often afford to stay at home and receive direct daily care in the places where they have lived and prospered. At a time of their choosing, they can move to a place that is more suitable to support them. However, for those who have suffered through a life of struggling to make ends meet, often, no such options exist. Their lives end, as they proceeded, with a sense of powerlessness.
Carol Mochan makes a powerful point. In the exhibition “The Cost of Dying”, there was an older woman who was dying and who had been so house-proud that she was photographing all her rooms to show how she had kept her house really nice. One thing that struck me was the humiliation of everything slowly falling apart around her as she was struggling to care for herself, and then that she was not even able to stay in her house at the end. It was devastating to witness that in that exhibition. It speaks powerfully to the point that Carol Mochan just made.
I was fortunate to see that exhibition in Glasgow and then in the Scottish Parliament. It brought home what is the reality for so many people who wish to stay in their own homes but who are struggling to do so. We must not forget that they do that throughout their lives. That injustice must be made right.
That powerlessness is the final injustice and we should be doing everything that we can to limit it. I am going to say some words again because, when I think about the issue, I think that we all need to understand this: everyone deserves as pain-free and peaceful a death as possible, surrounded by those who love them, in a place that comforts them and where they can make choices. Those choices should never be dictated by what can be afforded. I cannot accept that someone who is dying cannot get the care and comfort that they deserve in a time of need such as the end of life. Surely, we must be looking for solutions to providing all the care and comfort that are necessary. I will close on that point, Presiding Officer.
On a point of order, Deputy Presiding Officer. I apologise to my colleagues for making a point of order, but I inadvertently misled the Parliament during my contribution, when I mentioned the £2.3 billion that Marie Curie estimated was spent on the last years of people’s lives, the vast majority of which was in the acute health service. I said that half a billion pounds was spent on social security payments. It is not half a billion pounds—if it was thus, that would be fantastic—it is half a million pounds. It is important to put that on the record. I apologise for cutting in to the flow of the debate, which so far has been superb.
Thank you, Mr Doris. That is not a point of order, but it is now on the record.
17:32
Like others, I thank Paul Sweeney for securing the debate.
Just over two years ago, my father died of a terminal illness. It was a really hard time for my mother and for us as a family. We were fortunate: my father was in his own home, well off and able to have the care that he required. I find it almost impossible to imagine going through such circumstances when there is financial poverty in the family as well.
It has been said that the moral test of any society is how it
”treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in shadows of life,”
people who live with disability or long-term illness. Today, we have heard a sobering truth: that in Scotland, each year, more than 6,500 people living with a terminal illness die in poverty. That is not simply a number. That is mothers, fathers, grandparents, neighbours, friends and, sadly, sometimes children, whose final months are overshadowed not only by illness but by financial hardship and anxiety. Instead of dignity, too many experience cold homes, empty cupboards and mounting bills. For those who face the end of life, every moment should matter, yet poverty steals away that precious time and replaces it with fear, exhaustion and indignity.
I fully accept that the UK and Scottish Governments are trying to deal with those issues and that there are tireless campaigns on end-of-life poverty but, as we have heard from others, the dial is not moving and, in some communities in Edinburgh and the Lothians, things have become even worse. That is a shame, because it is not inevitable. Poverty at the end of life is a policy failure, not a personal one. Every person, no matter their circumstances, has equal dignity, worth and purpose. Our duty as parliamentarians is to care for one another, and especially for the most vulnerable.
Organisations such as Marie Curie have shown that there is a better way. Its research with Loughborough University has highlighted both the scale of the problem and, as Mr Doris pointed out, the practical steps that can be taken, including support from the Scottish Government, Social Security Scotland and local authorities to ensure the maximum uptake of disability benefits through a values-first approach that removes any stigma from receiving those benefits.
That is not simply a matter of numbers or budgets; it actually defines what sort of country we are and what sort of nation we want to be. I want to live, as I am sure we all do, in a Scotland that values life not based on productivity alone but on its inherent worth. Because I am human, I have inherent worth.
When someone reaches the end of their life, our collective responsibility is clear. We must deliver dignity and care without the burden of bureaucracy or delay. That is why I am so pleased that this Parliament was the first in the UK to introduce the six-month rule for social security benefits, which has made a big difference. I am also thankful for the work of the Marie Curie and St Columba’s hospices in this city.
Like others, I call on members to unite behind the simple moral goal that no one in Scotland should die in poverty. The true measure of a compassionate society is found in how it treats those who have the least, especially when they have the least time left.
I invite the minister, Tom Arthur, to respond to the debate.
17:37
I thank Paul Sweeney for bringing this important debate to Parliament and join others in placing on record my appreciation and gratitude to Marie Curie for its incredible work day in, day out to support people who are terminally ill, as well as their families and loved ones.
As has been noted, the report highlights, unfortunately not for the first time, some of the real financial challenges people face at the end of life. It cannot be right that, at that most difficult of times, families must also face that additional pressure. I also acknowledge the work of Barnardo’s, Age Scotland and the Poverty and Inequality Commission, which also provided helpful information and insight on the issue.
I thank members from across the chamber—Bob Doris, Elena Whitham, Carol Mochan, Alexander Stewart, Paul Sweeney, Richard Leonard and Jeremy Balfour—for their contributions. I noted a link between the contributions from Mr Balfour and Mr Leonard. Mr Balfour spoke about the inherent dignity and value of life and the true measure of a successful society, an idea that I felt was very much at the heart of Mr Leonard’s contribution. He spoke powerfully, as did Carol Mochan, about the structural inequalities and wider economic determinants that still too often characterise people’s experience not only of their life and their economic and social circumstances but of the end of life.
While we consider what further specific interventions we can make and what further support we can provide, it is important that we do not lose sight of that more profound question, which is becoming more and more pertinent and inescapable.
I want to respond to the point that Mr Sweeney and Mr Stewart raised about what is happening in Manchester. The advice that I have received is that that is being undertaken under the provisions of section 13A of the Local Government Finance Act 1992. My understanding is that the territorial application of those provisions extends to England only and, as such, we do not have discretion under the act to do the same thing in Scotland. However, I reassure Mr Sweeney and the wider Parliament that we will consider the matter as part of the Scottish Government’s wider work on looking at council tax reform, because it is a very important point.
I turn to the Government’s broader work. We continue to take important steps to address the challenges that are highlighted in the report, and we do so in the context of the powers that we have under the devolution settlement and the constraints of the budgets under which we operate.
The social security system in Scotland quite rightly takes a different approach, fast tracking disability assistance applications from terminally ill people to ensure that they automatically receive the highest rates of disability assistance that they are entitled to. Importantly, there are no time limits included in the definition of terminal illness, and the decision is rightly made by clinicians. The person-centred definition of terminal illness applies to all of our disability assistances—child disability payment, adult disability payment and pension-age disability payment.
Within the constraints of the powers and budgets, the Scottish Government is also committed to mitigating winter heating costs and supporting people to access all support that is available to them. In the coming winter—winter 2025-26—we will provide an estimated £28.3 million for winter heating payment, £11.4 million for child winter heating payment and £157 million for pension-age winter heating payment. Those benefits provide guaranteed support to people who have an identified need for additional heat over the winter months, including low-income households, pensioners and families with disabled children and young people.
The Scottish Government whole-heartedly agrees with the report’s recommendation that the UK Government should introduce a social tariff. Mr Doris touched on that in his remarks. In the Scottish Government’s view, a social tariff mechanism is clearly the best way to ensure that energy consumers are protected against higher bills. We called on the previous UK Government to introduce such a tariff, which was, in part, to ensure that people with terminal illnesses, whose bills can be thousands of pounds higher than that of the average household, would not have to make the horrendous choice between powering vital medical equipment, heating their homes and buying food.
We are also taking meaningful steps to address racial inequality, which members touched on with reference to the report, as it remains an unwelcome reality that communities across Scotland experience health, quality of life and even life expectancy differently depending on their circumstances. We are committed to addressing the significant and persistent health inequalities that are experienced by minority ethnic communities in Scotland. Those inequalities have unfortunately widened in recent years due to the impacts of austerity, the economic consequences of Brexit and Covid, and the subsequent cost of living crisis.
In his September 2024 anti-racism statement, the Cabinet Secretary for Health and Social Care identified racism as a key driver of those health inequalities and a “significant public health challenge”. The statement sets the expectation that anti-racism will be embedded across the health and care system.
In order to tackle the socioeconomic inequalities that are the root of health inequalities, we are complementing our health efforts with wide-ranging cross-Government action. On 17 June, with the Convention of Scottish Local Authorities, we published “Scotland’s Population Health Framework 2025-2035”, which is our refreshed 10-year cross-Government and cross-sector approach to population health. The framework, which is focused on prevention, sets a clear evidence-based aim to galvanise the whole system to action to improve Scottish life expectancy while reducing the life expectancy gap between the most deprived 20 per cent of local areas and the national average by 2035.
We want everyone in Scotland, regardless of age, race, diagnosis or location, to have access to timely, high-quality and person-centred palliative care. Our five-year palliative care strategy includes measures to better integrate specialist palliative care into hospital and community services and improve public information about living with life-shortening conditions. The strategy will help to ensure that people of all ages with life-shortening conditions, their families and carers should receive the right care and support in the right place at the right time and from the right people. Those are only some of the steps that the Scottish Government is undertaking to prevent people from dying in end-of-life poverty.
Again, I thank Paul Sweeney for bringing the debate to Parliament and all members for their contributions. I also thank Marie Curie for its report and for the brilliant and invaluable work that it undertakes day in, day out.
Meeting closed at 17:45.Previous
Decision Time