Chamber and committees

Minister, court exemptions were discussed last week. Are you likely to review them?

You mentioned the impact that there will be if we do not pass the SSIs. Will you expand on that?

Good morning. Last week, we heard from Dr Andrew Tickell about the constitutional issues and the complexity with regard to any bill on this matter and the need for Governments to work together to address them. Can the cabinet secretary comment on the discussions that she has had in that respect with the UK Government? From this morning’s discussion, it does not look as though the process has started yet, but as far as the issues with the Supreme Court are concerned, when is it likely to commence? I am quite concerned about that.

The Supreme Court judgment raises a lot of issues, and I am glad to hear that there will, I hope, be positive dialogue.

At last week’s committee meeting, witnesses mentioned the need for clear communication with stakeholders, and the issue has been mentioned again this morning. With that in mind, how will you keep in touch with stakeholders? Obviously, there will be discussions about the programme for government and so on, but how will you do that in a positive way that allows them to work alongside you?

I certainly welcome your comments, cabinet secretary.

Thank you. Ms Chapman, having heard from the minister about the impact if we were to annul the SSIs, have you taken into consideration the impact on the courts, and particularly on the tribunals service, if your motions were successful?

Thank you.

I mentioned your name, but obviously you did not pick that up.

On a point of order, Presiding Officer. My voting app froze. I would have voted no.

I am grateful to my colleague Clare Haughey for securing this incredibly important debate and for raising awareness of liver disease.

First, I hope that the chamber will allow me a moment of remembrance. Sadly, in June 2019, I lost my friend Linda McColl to non-alcoholic liver disease. Linda was a former councillor and the first female depute provost of West Dunbartonshire Council. I will never forget her kindness and guidance when I was elected, so in her memory I will do everything that I can to raise awareness. For Linda, and the great many people who have lost their lives to liver disease, we must do more to promote awareness as part of our prevention strategy. We must also improve support and services for those who are impacted by it.

Liver disease does not discriminate, but unfortunately some folk are more at risk than others. It is imperative that we highlight the disease, not only for people who are currently suffering from it but for those who are at risk, because, unfortunately, it is a silent killer. As has been mentioned, people with a history of excessive alcohol use, or of obesity, and those with viral infections such as hepatitis B or C, are much more at risk of getting liver disease.

Worryingly, many people do not experience symptoms until the disease has reached an advanced stage, so it is important to look out for the symptoms early. Some common symptoms are: loss of appetite, yellow skin, a yellow tinge in the eyes, itchy skin, and feeling or being sick. When it is damaged, the liver can repair itself, but only up to a point. That is why it is so important for us to know the risk factors early, so as to protect our livers.

Although it is welcome that, in Scotland, chronic liver disease rates have generally decreased from a peak in 2003, they are still too high. More definitely needs to be done. According to the British Liver Trust, nine out of 10 cases of liver disease could be prevented. Risk factors such as obesity and alcohol misuse increase our chances of contracting it. As Clare Haughey’s motion states, we cannot comprehensively tackle liver disease unless we also tackle its root causes. Health inequalities play a major part in that respect.

It is quite fitting that this debate follows the debate on challenge poverty week, as both poverty and deprivation are linked with liver disease. Public Health Scotland estimates that chronic liver disease death rates are 3.8 times higher in the most deprived areas compared with the least deprived. Therefore, policies that tackle health inequalities and reduce the harms of alcohol and unhealthy foods are very important.

A great example of that is minimum unit pricing of alcohol. Although it is subject to regular, and often misleading, criticism at times—including, unfortunately, from some sectors of the mainstream media—our academics are clear about its success. A report undertaken by Public Health Scotland found strong evidence that minimum unit pricing in Scotland has reduced deaths directly caused by alcohol consumption as well as hospital admissions due to chronic causes. Deaths caused by alcohol dropped by an estimated 13.4 per cent and hospital admissions by 4.1 per cent, with the largest reduction seen among men and those living in the most deprived areas. That is significant and, I believe, extremely important from the perspective of saving lives.

Finally, I thank the British Liver Trust for all its work in raising awareness of liver disease, and for bringing the love your liver roadshow to Parliament earlier this year. Although Alcoholics Anonymous is not a liver disease charity, I put on record my sincere thanks to it. I have known many people who have turned their lives around through its groups and who have subsequently improved their health as a result. For that, I am grateful.

We must do more to raise awareness. We must also improve early detection of the disease and ensure that treatment and support are easily accessible. The impact that liver disease is having in Scotland needs our full attention. Our constituents expect no less.