Official Report 233KB pdf
We move to the debate on motion S7M-01200, in the name of Angela Constance, on addressing the harms of health misinformation.
15:09
I am very pleased to open the debate on addressing the harms of health misinformation. Nothing is more important to us than our health and the health of those we love. We are fortunate to have a national health service that provides high-quality healthcare, free at the point of use. Across Scotland, healthcare professionals work every day to prevent illness, promote wellbeing and provide care when people need it most.
Effective healthcare requires hospitals, clinics, medicines and treatments, but it also depends on public trust. The “Scottish Health Information Integrity Strategy” marks a significant step in providing NHS Scotland, educators and patients with the tools to compete with health misinformation and it places Scotland at the forefront of international efforts to address harms arising from false and misleading health information.
Understandably, people feel strongly about their own health and that of their friends and family, and sharing health information is entirely natural. The sophistication of false and misleading health information today means that we are all susceptible to sharing it. More often than not, people share health information out of concern for others and with the best of intentions. That is why we talk about information integrity. Most false and misleading health narratives are shared for very different reasons, and the response must be different.
In health, we challenge the narrative rather than the individual. Health misinformation can be viewed as a signal of the information that people need. When good information is delayed, absent or inaccessible, falsehoods fill the vacuum. Our strategy is about providing good information. Access to accurate, evidence-based health information helps people to make informed choices about their health and wellbeing. It supports productive conversations between patients and healthcare professionals, enables effective public health action and underpins trust in our health and care system.
Today, that has become more important and more challenging than ever before, because the availability of information is unprecedented. People can access vast quantities of material on almost any subject at the touch of a screen. Information that once required professional advice or extensive research can now be found instantly. That transformation has brought significant benefits. People are more empowered to engage in decisions about their care, access to knowledge has become more democratic and patients are often better informed and more actively involved in managing their health.
However, those benefits also bring risks. Health and scientific advances have always attracted false and misleading narratives. Throughout history, false claims, misconceptions and misunderstandings have accompanied developments in medicine and public health. The difference today is the speed and scale at which misleading information spreads.
Content that is inaccurate, misleading, unscientific or entirely false can reach millions of people within hours. Information that is designed to provoke fear, anxiety or anger is often shared before healthcare systems, researchers and communicators have the opportunity to understand what is happening. As a result, people are making health decisions in an information environment that is crowded, complex and not always aligned with the best available evidence. The consequences are significant.
Does the cabinet secretary agree that the situation that she is outlining for us regarding the crowded landscape and the perennial attack of misinformation is complicated even more by the fact that the most powerful man in the White House is adding to it, given his hugely significant global platform?
The motion that is before us today certainly calls on every member of this Parliament to act with integrity in how we use information. It is not for me to advise the President of the United States of America, but it would be helpful if he spent less time on X or Twitter or whatever it is called these days.
I go back to a crucial point. Health misinformation can, as we know, undermine confidence in interventions such as vaccination programmes; reduce support for public health advice during emergencies; delay people seeking appropriate medical advice; increase pressure on NHS services; and cause financial harm through ineffective or unnecessary products, tests and treatments.
Health misinformation can deepen health inequalities by targeting specific communities with false narratives or by creating distrust among groups that already face barriers to healthcare. Perhaps most harmfully, it corrodes public trust. False narratives undermine trust in institutions, professionals and scientific evidence. Reduced trust then creates the conditions for further misinformation to flourish. It is a cycle that can be difficult to reverse. Public trust in the NHS is one of our health service’s great strengths and remains our strongest defence against harmful health misinformation. Protecting and maintaining that trust must be central to our response.
Public concern about false information is growing. Increasing numbers of people report regularly encountering misleading information online. Healthcare professionals express growing concern. During the development of our health information integrity strategy, many clinicians and public health experts highlighted patient interactions that were shaped by false or misleading information that was encountered online.
The challenge continues to evolve. The emergence of artificial intelligence brings enormous opportunities for healthcare. AI is already helping to drive innovation in research, diagnostics and public health. However, it is also transforming the information ecosystem. Creating and disseminating convincing false content has become easier than ever. Deepfakes and other forms of AI-generated content are becoming increasingly sophisticated and will soon be impossible to distinguish from authentic material. A fabricated video that appears to show a healthcare professional, scientist or public figure making false claims about health interventions could influence behaviour long before its authenticity is questioned. That means that we must be alert and agile, and we must ensure that Scotland’s health and care system is adapted to today’s information environment and remains adaptable for the future.
There are important lessons to take from the Covid-19 pandemic, which demonstrated the importance of trusted information during periods of uncertainty and how quickly false narratives can emerge and spread during health emergencies, when demand for reliable information is high. If good information is not made available to the right people by the right means at the right time, bad information will flow in. The Scottish Government’s standing committee on pandemic preparedness recognised that in its report “Pandemic Ready: Safeguarding Our Future Through Preparedness”. Among its recommendations are the need for Scotland to develop the capability to identify and address challenges arising from false narratives during future pandemics and to strengthen resilience to the harms of poor-quality information.
The recommendations highlight an important point: it is not enough simply to produce trustworthy health information. Health institutions must also understand when harmful false narratives are emerging and respond appropriately, ethically and proportionately when such narratives present risks to public health.
It is against that backdrop that the Scottish health information integrity strategy has been developed. The strategy represents Scotland’s first comprehensive approach to addressing harms that are associated with false health information. To the best of our knowledge, it is the first national health information integrity strategy anywhere.
The strategy recognises that the situation presents more than a communications challenge. It requires a comprehensive response, with co-ordinated action across health and social care and beyond.
The strategy is structured around three pillars. The first is leadership and co-ordination. Addressing harmful health misinformation requires clear leadership, strong partnerships and effective collaboration, and the strategy sets out a framework that brings together expertise from the Scottish Government, NHS Scotland, public health agencies, academia, educators and other partners to ensure a coherent national approach.
The second pillar is about building Scotland’s resilience to false health information. The strongest defence against misinformation is an informed and confident public. Building resilience means improving access to trusted information, supporting digital literacy, strengthening the understanding of how false information spreads and helping people to navigate an increasingly complex information landscape. It also means engaging respectfully, listening to concerns, communicating clearly and meeting people where they are.
The third pillar is rapid response to false health information. Where harmful narratives emerge that pose a risk to public health, Scotland must have the capability to identify them, assess their impact and respond appropriately. That capability is increasingly important as technologies, platforms and patterns of communication evolve.
The approach that is set out in the strategy is guided by important principles.
I do not disagree with any of that, but what practical impact does the cabinet secretary think that the Government will be able to make, and in what timescale will that be achieved?
That is a fair point. The strategy is designed to be practical in its implication and implementation and, therefore, helpful not just to Government but to our stakeholders and partners. However, it is important to recognise that the technology around us is evolving all the time. There are positives to that, but there are also risks. There is a sense that we all need to pick up the pace on that across the public sector.
As I started to say, as well as its practical implication, it is important that the strategy is underpinned and guided by principles. The first is to do no harm. Responses to health misinformation must be safe and proportionate. Even well-intentioned interventions can have unintended consequences if they are not implemented carefully. For that reason, our emphasis will remain on building trust, addressing concerns early and supporting access to reliable information.
Secondly, our approach must be ethical and transparent. Public trust depends on openness and accountability. Decisions about how misinformation is identified, assessed and addressed must be guided by clear ethical principles and transparent processes.
Thirdly, we will continue learning from others. The challenge does not stop at national borders, and valuable work is taking place around the world. Scotland will continue to learn from emerging evidence and best practice.
Fourthly, our approach must be co-produced. Solutions are far more effective when developed alongside those they serve. Communities, patients, educators and young people all have a vital role in shaping effective responses.
Fifthly, we will build on the strengths and assets that are already present in Scotland. Trusted relationships, local networks, public services and community organisations all form part of the solution.
Finally, we will adopt a culture of continuous improvement, learning from experience and adapting the evidence and approach as it evolves. Implementation of the strategy’s recommendations is under way, and work is progressing across NHS Scotland and the wider health system to strengthen capability, improve co-ordination and support health literacy. That work will continue to evolve as the evidence develops.
The information landscape does not stand still, but by taking a measured, evidence-based and trust-centred approach, Scotland is well placed to meet the challenge. At its heart, the strategy is about helping people to access information that supports better health; it aims to protect and build confidence in the healthcare professions and scientific evidence, strengthen our resilience in our communities and ensure that Scotland is prepared for the future challenges.
I welcome the publication of the strategy and the work that is under way to implement the recommendations. I invite members to support the motion in my name and I indicate that I will support the Labour Party amendment and the Conservative Party amendment.
I move,
That the Parliament notes with concern the increasing risk of the global spread of misinformation relating to public health on social media, including through the use of AI-altered content; recognises that accessible, science-based and trustworthy health information is essential to supporting people to make informed decisions about their health, maintaining confidence in public health interventions and improving health outcomes; acknowledges the importance of taking an ethical approach to information integrity, and that misleading or false health information has a detrimental impact on society; notes with concern the rise in vaccine misinformation that has been spread in society since the COVID-19 pandemic; agrees that anyone who is eligible for life-saving vaccinations should be able to access the care that they need without the risk of harmful misinformation causing unnecessary concern or fear; further agrees that every Member of the Scottish Parliament has a responsibility to ensure that they use factual, science-based and trusted sources of health information from the NHS, public bodies and academia to protect public health, and that members should collaborate to tackle the rise of harmful online misinformation.
15:24
I look forward to more detail on what we have just heard. There is obviously a lot behind that, so it is hard to know whether we agree or disagree.
I want to pick up a couple of things that the cabinet secretary said. She said that everyone here should act with ethical principles and integrity, and I am happy to say that I am sure that we are all going to do that.
She also said that “do no harm” is an important point. It certainly is, and sometimes we need to look at what the evidence is. It is possible to glance through the motion—as I think that Willie Rennie did—and think, “Well, it means well—I’m sure the details will be fine.” However, we should look at a few things.
The Scottish Government’s motion refers to “concern” about
“the use of AI-altered content”.
That is fair enough—it is a concern. It is a concern that, all the time, the algorithms bring up advertised content, often from big companies, and then the most-searched content on a subject, even if it is not the closest match to what someone is looking for. I am sure that everyone uses AI; I am sure that we have all done it for this debate.
The Scottish Government also
“notes with concern the rise in vaccine misinformation … since the COVID-19 pandemic”.
It is a good point. In 2023, a Scottish Government study as part of post-shielding research found that only 29 per cent of the public trust health information from the Scottish Government on Covid-19.
A maxim in science is that science is never settled—there is no absolute final word. We would be wise to consider that. Perhaps people believe less in the Government health information since the Covid years because almost everyone has their own experience of ill health and, despite being assured every day by our former First Minister during Covid of absolute facts, those sometimes changed when the advice changed.
Everyone had to test for Covid and stay at home for 10 days if a test was positive and then, at some point, if they were well, they could go to work and stop testing. Viruses mutate and Covid is undoubtedly still about, but that was how it happened.
Will the member take an intervention?
I will not, thank you—I have a lot to go through.
People are not daft. They distrust advice from companies and from people with a financial interest. Vaccine companies have made huge profits risk free due to commercial indemnities. Indemnity might have been reasonable during the Covid crisis, but those companies still have it: a get-out-of-jail-free card. It does not matter how much evidence or anything else comes forward; they can continue to say, “Please vaccinate every year” and they are laughing all the way to the bank.
Let us look at some of the evidence—[Interruption.] Sorry—who spoke? Did someone ask to come in?
The member must be allowed to speak.
People are not daft, and the Scottish Government has to take responsibility for its agencies’ own advice. We cannot rely on commercial companies; I do not know if the cabinet secretary was suggesting that, but we certainly cannot.
There is an arguable fact about Covid in its origin story. People can believe that a bat 1,000 miles away from Wuhan was transported to a wet market and gave a respiratory virus to a pangolin or similar, and somebody then ate it and got the respiratory virus. That did not sound terribly convincing at the time.
Interestingly, the World Health Organization still maintains that, on the balance of probabilities, that might be the case. China, which bankrolls the WHO, would certainly have accused anyone at the time who tried to challenge that narrative, which most people now think has turned out to be misinformation. If you find a survey on it, you will see that most people believe that the virus came from an accidental release from a Wuhan laboratory that was carrying out gain-of-function research on coronaviruses.
We cannot just believe what we are told—the science is never settled. The motion calls for
“accessible, science-based and trustworthy health information”.
That is music to my ears. I am a veterinary surgeon; I read a lot of research, and I have often thought that there should be more engineers, doctors and nurses—I do not think that they are in the chamber, but there are some—and scientists in the Parliament. I have often thought that biology should be compulsory in schools so that people can understand health and medical issues.
Reform’s amendment calls for information to be “unbiased”. People should be able to make their own fully informed decisions for themselves and their families, so where will they get that information? What about the BBC? It is not Reform members’ favourite, but it is certainly the favourite of some others in the chamber
Five days ago, the BBC—through its BBC verify service, so it must be right—reported the running costs of the Covid vaccine damage scheme at £83 million. Admittedly, a lot of that relates to process, but it is still a lot. The rising number of claims is the cause, and we should note that those claims are still coming in—they are not just legacy claims. Members in this chamber have heard from such people in the past.
The yellow card scheme is a United Kingdom system, but Scotland signs up to it. It monitors suspected adverse drug reactions, including deaths. The Medicines and Healthcare products Regulatory Agency recognises that all vaccines and medicines have side effects. Anyone who has been given a medicine and read about the side effects has probably thought, “Hmm, I don’t know if I am going to take that, that sounds quite bad.” Of course, however, we all do—we all make an informed judgment and we decide whether we are going to take these things.
Something that is acknowledged in the leaflet that is given to people who receive a Covid vaccine is that they should wait for 15 minutes before driving. I do not know whether any of the members in the chamber have ever done that, or have even read the leaflet, which is handed to people as they go in. The reason for that advice is in case the person who receives the vaccine gets anaphylaxis, which is a known side effect.
The Government cannot just hand out blanket recommendations and ignore the evidence. People can claim for damages following a vaccination and their case is found to be valid, and the vaccines that are eligible for such a payment are those for Coronavirus, diphtheria, haemophilus influenzae type B, flu and so on.
The issue is so well recognised that the Covid inquiry heard from the vaccine injured and bereaved, who told us that they felt that they were almost being pushed into the shadows during the pandemic, and that they are “the uncomfortable truth”.
The inquiry heard from a father of two boys who had a high-powered job until suffering a side effect—vaccine-induced thrombosis and thrombocytopenia—and falling into a coma for four weeks—
The member did not take any interventions, so she will have to bring her remarks to a close.
So, we must be unbiased. Our amendment calls for unbiased information, which people should be able to access without the risk of being accused of spreading harmful misinformation.
The Government needs to set an example. Was it misinformation when NHS Greater Glasgow and Clyde said that its new hospital was safe?
You should set an example.
I am setting an example for the people who have been ignored.
Was it misinformation when the health board said at the inquiry that the hospital was safe, and then admitted later that it knew it was unsafe?
The Government is either responsible for those agencies, or it should be very careful about what it takes responsibility for. The tenor of the Government’s motion suggests that it is taking a much more authoritarian approach, and it does not have the information for it.
I move amendment S7M-01200.3, to insert at end:
“; agrees that in addition to being factual and evidence-based, information must be unbiased and balanced to allow people to make fully informed decisions and calls on the Scottish Government, in its own decision-making, to follow the example it expects others to; notes that a 2023 study, commissioned by the Scottish Government, found that only 29% of the public believed that its own current COVID-19 guidance was trustworthy, demonstrating the need for the Scottish Government to understand the role that it has played in the public losing trust in health information that it issues; believes that health information covers everything related to health, and considers statements that the Queen Elizabeth University Hospital was safe, when some wards were known and later found not to be, to constitute misinformation.”
15:32
I thank the cabinet secretary for holding this important debate, and I welcome the content of her speech.
We live in deeply uncertain times. The rise of social media, the misuse and abuse of information, and the plethora of unreliable and incorrect information on public health issues demand that action is taken.
Regrettably, dangerous misinformation in the public health sphere is not new. We all remember the example of the campaign that was led by the now-discredited Dr Andrew Wakefield that claimed that the measles, mumps and rubella vaccine caused autism. There was no evidence for such a statement, and the result of the campaign was that thousands of children did not receive the life-saving vaccinations that they needed. All that Wakefield’s campaign did was sow the seeds of mistrust in medicine, and it turned out that Wakefield was not just a dangerous quack, he was a fraudster who sought to financially gain from his claims.
We need to challenge those who seek to spread dangerous mistrust in our medical and scientific sectors, and expose the reasons for their deception. Medical disinformation can come from any corner, and we would be turning away from an uncomfortable truth if we did not admit that one party in particular has a clear problem with disinformation.
Dr Timothy Kelly—remember him?—the Reform candidate in East Kilbride and Strathaven, claimed that the Covid-19 vaccine, which is regarded to have saved countless lives, was neither safe nor effective. Further, Reform invited Aseem Malhotra to speak at its conference, where he blamed the Covid vaccine for causing cancer in the royal family. Indeed, the leader of Reform, Nigel Farage, is co-founder of Action on World Health, a very shadowy organisation that is dedicated to opposing the WHO and undermining its central messages.
Misinformation has potentially dangerous consequences, and I think that some parties in this chamber—one in particular—need to be mindful of that.
I think that the cabinet secretary would concede that vaccination levels are too low. In Scotland, last year, we had 28 laboratory-confirmed measles cases. We experienced an earlier flu season, driven by influenza A, all while thousands of eligible Scots did not get their flu vaccine in time. Human papillomavirus vaccine coverage has declined over the past 10 years, and childhood vaccine take-up is down. That does not only present issues now, because low vaccine uptake creates a ticking health time bomb. That is why it is in all our interests to drive up vaccine uptake and tackle misinformation at every turn.
That is why our amendment calls for greater flexibility for primary care teams, so that they can ensure that all those who need vaccinated get vaccinated. In particular, I am thinking about general practitioners in rural areas who use the opportunity of patients’ being in their practices to vaccinate them. We need more flexibility to make sure that we capture more people in vaccination programmes.
Although we agree with the spirit of the Government’s position, there is a certain irony in its rhetoric, because trust is essential, and the Government itself is guilty of providing misinformation about the future of Monklands hospital, its failure to deliver transparency for the victims of the Eljamel scandal, and, above all, its complicity in the cover-up of the reason for deaths at the Queen Elizabeth university hospital. We agree with the Government that action must be taken to tackle misinformation, and I just hope that it realises—and that we all realise—that we all have a key role to play in that effort.
It is time to call out the quacks and the dangerous influencers who seek to spread misinformation, but it is also time to demand more from our Government and to demand transparency and truthfulness at the very highest levels.
I move amendment S7M-01200.1, to insert at end:
“; is concerned by declining childhood vaccination rates and continuing barriers to access to vaccination programmes, and believes that additional flexibility is required for trusted primary care teams to improve vaccination uptake.”
I call Miles Briggs to speak to and move amendment S7M-01200.2. You have up to six minutes.
15:36
This is an important debate and a reminder of how our society and we as individuals are seeing a significant change in how we access—and how we can trust—information in relation to our health. Misleading information can lead to real harms, as we have heard, and it has led to people not engaging with or taking up our world-leading public health vaccination programmes. That is at the heart of the issue, because it undermines those programmes’ ability to deliver population-level immunity.
The motion rightly diagnoses the problem, but we also need to use this opportunity to prescribe some solutions. As the cabinet secretary said, trust is at the heart of that. A recent Canadian study showed that people trust their friends, neighbours and work colleagues on social media more than they do journalists or Government leaders—and, to be honest, I do not think that was just about President Trump.
Let us face it: today, we are all broadcasters of information. Social media spreads ideas far and fast, and everything that we share, like and comment on multiplies the power of that information to all our followers, influencing the views and beliefs of friends, family and, yes, total strangers. Unfortunately, there is a lot of false and misleading health information out there. Ahead of today’s debate, I did a simple Google search on some health conditions and looking for advice, and, to be honest, I was shocked at where it takes you—from claims that sunscreen causes skin cancer to perhaps the most challenging and constant myth around vaccines, which is that they cause autism, as has been raised. That myth continues to be shared online and driven towards parents, including in online parent chat rooms, and it has had hugely damaging consequences.
We need to look at how we can turn that around, because, as Jackie Baillie outlined, we are already seeing examples of how that impacts on our health in Scotland. Misinformation around the MMR vaccine has contributed to vaccine hesitancy on the part of many parents, and, as has been said, Public Health Scotland has already reported 28 lab-confirmed measles cases in 2025 and eight in the first quarter of this year. Since 2024, Scotland has also experienced substantial increases in cases of whooping cough.
I can recall many of the challenges that we saw during the Covid-19 pandemic around misinformation and mistrust, particularly among our ethnic minority and eastern European communities, resulting in significantly lower vaccine uptake rates during the pandemic and since.
One part of the debate that has interested me, and which we need to recognise, is people’s increasing disconnect from the family doctor. As has been debated, we must consider the difficulty in accessing GP appointments and how that is also causing people to seek information in different ways. GPs are the most trusted source of health information, so if people cannot get an appointment to see or speak to a medical professional, they will look for health information on the internet and are often directed to these so-called patient chat rooms. The question that we should be asking ourselves is how we can build information resilience in our society.
On Monday, I attended the launch of Movember’s report on men’s health in Scotland. I segue to that because there were a number of key recommendations in that report, which I hope that the Government will consider. The report is stark, especially around the evidence that shows that around 13,000 Scottish men died prematurely in 2024. That is 35 men dying prematurely every day in Scotland. The report calls for a public health approach to addressing online harms and disinformation affecting boys and young men, building on the Scottish Government’s “Online Safety Taskforce Action Plan 2026/27”. That also needs to be taken forward in relation to health information for men and boys and the different ways in which we engage in seeking health information.
The report specifically calls for a men’s health action plan, which I believe is needed. Although the Government responded by saying that it was not looking to take that forward, I hope that ministers will look again and positively engage on a cross-party basis. That could be at the heart of addressing a number of the Government’s priorities in relation to men and boys.
The report states:
“While a woman’s relationship with her health and healthcare is established early during adolescence, built around her reproductive and sexual health needs, young men tend to have fewer touchpoints with the health system, reducing opportunities to develop ‘health literacy’”.
The lifelong skills needed to understand and look after ourselves are complex to develop, and that also includes access and understanding of online information. That is why the Scottish Conservative amendment includes a specific ask, which is
“to review how all public health information can build trust, improve health literacy and open routes”
to supporting people into services
“as part of a more coherent national approach to service redesign and public policy.”
The days have passed when people accessed their information from health information leaflets on GP practice coffee tables, but we need to make sure that NHS Scotland is fit for the future. We need to make sure that the digital and information ages, in which people now live, provide the bespoke and accurate public health information that we all want to see.
I move amendment S7M-01200.2, to insert at end:
"; supports the development of a new national approach to health literacy, that enables people to find, understand and use public health information to make informed decisions about their health and to support others to do so; notes the recent Movember report on men’s health in Scotland and its call for a public health approach to addressing the online harms and disinformation affecting boys and young men, building on the Scottish Government’s Online Safety Taskforce Action Plan; further notes that such an approach should be adopted as a cross-government priority, and calls on the Scottish Government to review how all public health information can build trust, improve health literacy and open routes into support and services, as part of a more coherent national approach to service redesign and public policy."
15:42
I thank the Scottish Government for lodging the motion. As many people have said, this is undoubtedly a prevalent and defining issue of our time, accelerated by the pervasive impact of social media on everyday lives and, it is fair to say, hastened at such a pace that Governments all around the world are struggling to catch up with it. It is therefore important that we consider the wide-ranging impacts of misinformation on our health, specifically in Scotland.
As we learned from the Covid pandemic, when we have disease outbreaks, countries that operate as lone actors—because they think that they can pull up a drawbridge to keep diseases out—are completely delusional in a world and an economy that are knitted together at every level, with overlapping supply chains and operations.
On a small scale, misinformation can look like an Instagram fitness guru saying that if people drink celery juice for a month, their skin will clear up and they will have great bowel movements. A harder example would be politicians, for years, peddling myths in society about how HIV and AIDS spread or saying that they affect only gay men. The myths around autism, which we have spoken about already, have stirred up the type of eugenics thinking that says that a dead child is often better than a disabled one.
We know that social media algorithms are built to give people what they want. For example, misinformation on diet culture can be funnelled to someone with an eating disorder when they are just trying to google for help.
Tackling misinformation is not simply a matter of producing more facts; it is also about building trust and helping people to develop the skills to assess the information that they encounter.
Naturally, everyone in the Parliament, across the political spectrum, bears a responsibility to address misinformation. Yesterday, we heard a lot of opinions about how international affairs should not concern us, but health is a strong example of where they should. Health does not care about borders and it impacts on all of us.
I started by highlighting concerns. However, I recognise that, as the cabinet secretary mentioned, with the modern advances in health technology, we have never been better equipped to address such issues.
Patients and members of the public can now encounter health claims from influencers, commercial organisations and AI systems alongside information from doctors, scientists and public health organisations. The difficulty is that those sources can look equally authoritative and factual, even though their quality and accuracy could be very different.
We can mitigate the impacts of global health issues and disease outbreaks with effective screening, planning and preparation. However, doing that effectively requires empirical truth to be the driving factor behind decisions. If truth is not what is driving policy and decision making in Scotland, how can we maintain trust across the board? That matters because health information influences real decisions. People’s decisions about whether they choose to vaccinate their child, whether they seek medical advice about symptoms, whether they follow treatment for cancer or whether they use an unproven alternative therapy can have significant consequences for those people, their wider communities and society. Vaccination provides the clearest example of why that matters: as Jackie Baillie mentioned, falling vaccination coverage creates the conditions in which diseases that were previously well controlled can return.
It is important to say that misinformation is not the sole reason for changes in levels of vaccination uptake or mistrust in healthcare. Decisions about vaccines are influenced by many factors, including access to services; socioeconomic circumstances; trust in institutions, which Miles Briggs alluded to; previous experiences of healthcare among those in the minority ethnic community; and the accessibility of reliable information.
A key aspect of our addressing health misinformation is long-term interventions such as education. Media, digital and health literacy are becoming increasingly interconnected. People need to know not only how to find information but how to question where it came from, understand evidence, recognise conflicts of interest and distinguish between genuine expertise and content that merely looks authoritative.
As has been mentioned, the growth of AI makes that challenge even more urgent. It can make health misinformation considerably more convincing because it can almost instantly generate fluent, personalised and apparently authoritative answers. I have heard from GPs who say that patients have come to them and said, “I asked ChatGPT first; this is what it told me,” and what it had said was completely bonkers. That is unhelpful for both parties. AI systems can produce inaccurate or fabricated information and present it with confidence. Systems that appear to be helpful can give people information that is incomplete, misleading or plainly wrong.
Scotland’s health information integrity strategy recognises that responsibility cannot sit only with one organisation or one profession. The Government, the Parliament, NHS Scotland, Public Health Scotland, schools, universities, community organisations, charities, healthcare professionals, researchers and technology companies all have different roles to play. I agree with the cabinet secretary that tackling misinformation should not mean shutting down debate; it should mean making it easier for people to distinguish evidence from speculation, expertise from unsupported claims and reliable information from content that is designed primarily to attract attention.
The Scottish Greens will back the Government’s motion and support the Labour and Conservative amendments on the dangers of medical misinformation. I hope that members in the rest of the chamber will consider the need for us to come together again and back this stance, not only on misinformation in relation to health but on the misinformation that is going around the world in relation to welfare, disability, diet culture, the rights of sex workers, housing, immigration and much more.
15:49
I thank the cabinet secretary for having this debate. I am pleased to follow Kayleigh Kinross-O’Neill’s excellent speech, which included many of the excellent points that I am about to make—what can you do?
In many ways, today’s debate is fundamentally about trust: who do we trust, what information do we trust and what sources of information do we trust? As we know, trust in our institutions is, by many measures, at a very low level. When people are scunnered by a feeling that things are going backwards, that systems are failing and that problems are being left unsolved, some people just switch off altogether. Others turn to sources of information and commentary that, in the past, would have held far less weight than they do today.
That dynamic is potentially most harmful when it comes to public health, where the wrong information at the wrong time can have devastating consequences. The internet and social media have opened up the world and given almost instantaneous access to information, but they have also opened the door to misinformation and to people who are willing to exploit uncertainty and fear. That has been complicated further by the meteoric rise of artificial intelligence, whereby, as we have heard, even a simple Google search can now produce an AI-generated answer.
Increasingly, people are turning to AI for health advice rather than speaking to a doctor or another healthcare professional. Some people are turning to popular YouTubers or social media personalities with enormous reach and influence. Those people often generate fear around particular health conditions or negative health outcomes and then market products that they claim will prevent that harm or cure that illness. We need to be clear and robust in calling out falsehoods when they appear, particularly when they have the potential to cause real harm or, ultimately, cost lives.
However, there is an important point to be made about how we do that. If someone does not trust evidence-based health information, talking down to them or shaming them is unlikely to change their mind. We need to make sure that people feel able to ask questions; no question about their health should be off limits. People should be able to raise concerns, challenge information that they have seen and get clear, accessible answers from a trusted source.
One way in which we could do that is by making better use of the NHS app. We should have a comprehensive NHS digital service that puts reliable information from a source that people know they can trust and access to services at their fingertips. We know that the MyCare app was significantly delayed before its launch earlier this year and that what it offers falls below what it could provide. The wider roll-out of features and enhancements that the Government has said will come soon is needed so that people can benefit from a combination of reliable, evidence-based information from a trusted source and easier access to healthcare services.
I refer the member to the NHS Inform website, which provides a lot of the information that he is talking about.
I absolutely take that point. I do not dispute what Clare Haughey said, but there is something quite powerful about people having an app at their fingertips. Increasingly, people have the ChatGPT app or the Claude app at their fingertips, which enables them to get immediate feedback that is tailored to their situation. Something along those lines, provided by the NHS, would be really powerful and would really help.
All of that matters, especially as we head towards winter. Doctors, nurses and other staff who work in our emergency departments are already hugely up against it, even before the full force of winter pressures has begun to hit. The roll-out of flu vaccination is hugely important not only in protecting vulnerable people, but in taking some of that pressure off the NHS. However, distrust in vaccination, which was prevalent before the pandemic and has increased since then, has made that job more difficult. We must keep making the case for vaccination by providing clear, accessible and evidence-based information.
That brings me to the responsibility of members of this Parliament. We all have platforms. People listen to what we say and share what we post, and, increasingly, we can reach thousands of people. That gives us a responsibility to ensure that what we share is accurate and evidence based, and that it comes from sources that we and others can trust. Of course, that does not mean that we should not question things—we absolutely should question the Government, challenge decisions and raise concerns—but, when it comes to public health, we should always be focused squarely on the public good, on positive outcomes for people, on clarity and on evidence. Ultimately, the aim should be very simple: to ensure that everyone has access to reliable information and the services that they need to prevent ill health, to make informed decisions about their health and to give them the best possible chance of a positive outcome when they need treatment. That is how we rebuild trust, and it is a responsibility that falls on all of us.
We move to the open debate.
15:55
I refer members to my entry in the register of members’ interests. I am an NHS Greater Glasgow and Clyde bank nurse.
The concept of misinformation is not a new one, and it is increasingly pertinent in today’s world. In the health context, misinformation can take many forms. It can include false claims about the causes of ill health, misleading information about vaccines, inaccurate dietary advice, unproven treatments or exaggerated claims about the benefits and risks of particular interventions. The consequences can be particularly serious in a health context, because people may use information found online to make decisions about their own health or the health of others.
A recent study from King’s College London showed that one in seven of the respondents used AI chatbots for health advice. A fifth of those said that the technology did not encourage them to seek a professional opinion, and a similar proportion decided against doing so because of something that a chatbot told them.
In January, an investigation by The Guardian newspaper showed that Google AI overviews were placing at the top of online searches not just inaccurate health information, but potentially dangerous information, including on pancreatic cancer, liver function tests and women’s cancer tests.
Last year, researchers at University College Cork published a report regarding online searches for information about reduced fetal movement. They found that more than half of the search results contained misinformation, primarily from US commercial websites, which contradicted clinical guidelines in the UK and Ireland and which could delay crucial medical assessments if followed.
I will give a final example. The UK used to be really good at beating measles. In 2017 the World Health Organization declared that the disease had been eliminated. Sadly, that is no longer the case. Last year, there were almost 1,000 confirmed cases in England and 28 in Scotland, mostly in young children. In Scotland, second-dose MMR vaccination rates hover around 91 per cent; across the UK as a whole they sit around 85 per cent. Global vaccination rates have fallen, and many experts blame, in part, the spread of anti-vax conspiracy theories, including ones that rehash absolutely discredited theories about links between the MMR vaccine and autism.
All of those examples highlight how crucial it is to nurture trusted information touchpoints between the healthcare system and those who access it. If there is a vacuum, misinformation such as anti-vax messaging can slide into that space and become the dominant narrative.
None of us are as immune to misinformation as we would perhaps like to think. Ipsos polling for the Academy of Medical Sciences found a 41 percentage-point gap between how difficult people think it is for others to spot misleading health information and how difficult they believe it is for themselves. It is understandable how misinformation can take root when people are vulnerable, anxious, overwhelmed or searching for answers. The Ipsos research also shows us that those most likely to be affected are those who are already facing health inequalities, which can lead to delayed care and can worsen outcomes.
Tackling health misinformation must be part of our wider efforts to reduce health inequalities and to help people make informed decisions about their health. That is not about discouraging people from learning about their health; it is about empowering them and making trustworthy sources accessible and prominent. That is why I welcomed the publication of “The Scottish Health Information Integrity Strategy” last year. It was developed by multiple stakeholders and provides a framework for a co-ordinated, evidence-based and ethical response to health misinformation. Among the key planks of the strategy are building trust and resilience, strengthening health literacy and developing and supporting trusted and reliable networks and voices, so that those are the ones that people turn to when they need advice or support.
I particularly wish to emphasise and welcome the part of today’s motion that underlines the fact that
“every Member of the Scottish Parliament has a responsibility”
to use and amplify
“factual, science-based and trusted sources of … information”.
The Scottish Council on Global Affairs made that point last month in a report about misinformation and disinformation in Scotland more generally, as part of its state of the world series.
A member of this Parliament is on the record as saying that they
“persuaded many other people not to have”
the Covid-19 vaccine and
“would like them stopped”.
Quite frankly, that beggars belief. To be crystal clear, I note that misinformation on vaccines is dangerous. Misinformation in any health area is dangerous, and members should know better than to contribute to false claims and put the safety of Scots at risk by pushing those claims on to the public.
The SNP Scottish Government will always stand up for the sharing of accurate and detailed information when it comes to not only health, but all policy areas. We must have a collective agreement across this Parliament to ensure that the harms of health misinformation are not pushed forward by any party. I hope that we can have a constructive debate this afternoon and that we can reach consensus on that important point.
The rest of this Official Report will be published progressively as soon as the text is available.