Chamber and committees

Thank you. I will begin the questions.

With the Covid-19 rules and restrictions lifted in Scotland, there has been a reduction in the quantity and the quality of available data, although I know that data is still being published on a weekly basis and that it still offers some insight into Covid-19 trends and cases. Álfrún, what is your view of Scotland’s Covid-19 recovery dashboard during the height of the pandemic and following the lifting of restrictions?

Thank you, Deputy First Minister. I think that we all appreciate how challenging circumstances are at the moment for the Government.

We move to questions. I will begin. The latest data estimates that one in 25 people in Scotland currently have Covid. Due to the vaccinations, we are in a much better place than we were in 2020 but, sadly, in Scotland, we lost 2,864 people to Covid in 2022, and 81 people have lost their lives to it so far in 2023. Our thoughts go out to every family, but behind those statistics is the stark reality that Covid is still a threat. Can the Deputy First Minister give us an update on the Scottish Government’s plans for the next round of booster vaccinations, including the predicted timing, targeted groups and estimated funding requirements?

Sorry, Jackie, but can I move on to John Mason? We will come back to you if we can. We are short of time.

As the cabinet secretary might be aware, the issue of youth vaping is one that I have taken a particular interest in, and I am looking forward to a members’ business debate on the subject at the end of the month.

Has the Scottish Government conducted an assessment of advertising by the vaping industry?

I have mentioned in the chamber numerous times the experience of a constituent of mine who received a transvaginal mesh implant. She shared with me her story, which she described as a “12-year nightmare” of excruciating pain. Her continual pain had a knock-on effect on all aspects of her life, including her career and her family.

I note that the petition that we are considering today is not explicitly about transvaginal mesh but is about mesh used in surgery elsewhere in the body. The reason that I mention the experience of my constituent is that the story of Roseanna Clarkin, one of the petitioners, echoes what my constituent went through. That all-encompassing pain can have a devastating effect on a person’s life.

I thank Roseanna and Lauren McDougall for bringing the petition to Parliament, because it gives us a chance to speak about this very important issue and hear other people’s stories. It is clear that the Minister for Public Health, Women’s Health and Sport and the Cabinet Secretary for Health and Social Care are taking the issue seriously and are listening to concerns as well as to the evidence.

Given the statements that the Scottish Government has issued and the scientific research that is available, it would not be wise to call for a suspension of the use of surgical mesh in other parts of the body. As we have heard, mesh is routinely used in hernia surgery, and, in Scotland, around five times as many hernia mesh procedures have been carried out as pelvic mesh or TVT implants. Furthermore, hernia repairs are among the most common surgeries carried out globally.

As with any surgery, it carries risks and can have side effects. The Scottish Government commissioned research into the use of mesh in a commonly performed hernia repair, which resulted in the publication of the Scottish Health Technologies Group’s report on the use of mesh in primary hernia repair in adult males. The report concluded that, compared to non-mesh procedures, using mesh resulted in lower rates of recurrence, fewer serious adverse events and a similar or lower risk of chronic pain. A further report by the group found that evidence supports the continuation of using surgical mesh in hernia repair as an option. As the minister has previously stated, the use of mesh in operations is long established, and in many situations there are few—if any—viable alternatives. Therefore, the suspension of mesh treatments would leave people with no option.

Informed consent is a very important point that has been raised by the petitioners, the Government and research bodies. It has been reported in the media that Roseanna was not told that her operation would involve the use of mesh and that she did not find out until much later that mesh had been used. I obviously cannot comment on the specifics of the case, but it is unthinkable that something like that could happen.

I agree with the minister and healthcare professionals that, with the exception of emergency procedures, the use of mesh should be carried out only with the fully informed consent of a patient who understands the potential risks and the other options that are available to them. I know that the then chief medical officer wrote to health board medical directors in 2018 to highlight the importance of informed consent. I ask the cabinet secretary, in his closing speech, to confirm that the need for informed consent in relation to mesh surgery is still being highlighted across health boards.

I will draw my remarks to a close. I completely understand that some members of the public who signed the petition will be disappointed that mesh surgeries are still going ahead. I trust that communications from the Scottish Government and healthcare professionals will give reassurance on the reasons behind that.

Fundamentally, it is crucial that we listen to those people who are suffering from mesh surgery complications. My constituent was not listened to, and Roseanna Clarkin was dismissed at first and told that her pain was “in her head”. I am sure that many others will have had similar experiences. Only by continuing to listen to people with lived experience can we start the important process of supporting anybody who needs this type of surgery and ensuring that the best possible care is in place for the future.

As convener of the COVID-19 Recovery Committee, I wish to highlight the committee’s inquiry into long Covid, which was launched last week.

Figures from the Office for National Statistics estimate that around 2.1 million people in the United Kingdom are experiencing self-reported long Covid, and in Scotland it is estimated that 187,000 people have self-reported long Covid, which is around 3.5 per cent of the population.

Our inquiry will focus on three issues; it will explore awareness and recognition of the condition, examine whether there is adequate therapy and rehabilitation services and consider what further research may be needed to better understand long Covid. We plan to speak directly to those impacted by long Covid over the coming weeks and take evidence on what additional steps the Scottish Government could take to support people who live with the condition.

I am sure that I am not the only member with a mailbox full of inquiries relating to long Covid. I encourage members to share details of the inquiry with interested constituents, whose input would be greatly valued.

Our call for views will run to 10 February. We will then take evidence during February and March. We also aim to hold a parliamentary debate in the chamber on our findings prior to the summer recess.

In 2021, 1,330 people in Scotland lost their lives to drugs. As we know, each such death is a tragedy. I echo the view of my colleagues that the number of drug deaths in Scotland is simply unacceptable.

We are all in no doubt that our drug deaths crisis is a public health emergency. However, we are starting to see positive progress as we tackle it. Police Scotland data shows that, during the 12 months to September 2022, there were 21 per cent fewer drug deaths than there had been during the 12 months to September 2021. However, it is important for us to recognise that, although there has been a reduction, a lot more work is still to be done.

The first core principle of the Scottish Drug Deaths Taskforce’s report is the most important. Drug deaths are preventable. We must act now, and it is everyone’s responsibility to take action. Today, the minister has outlined that the cross-Government response to the report has so far resulted in more than 80 actions to drive forward our national mission.

As other members have done in their contributions, I will focus on the view that we can tackle drug deaths by ending stigma and taking a public health approach. In 2005, the World Health Organization dubbed Glasgow the murder capital of Europe. In the previous year there had been?83 murders?in the city, where gangs were known for their crime culture. Police in Glasgow decided to rethink their strategy. They set up a?violence reduction unit,? guided by the philosophy that violence is a public health issue. Violent behaviour spreads from person to person. To contain it, we therefore need to think in terms of transmission, risk, symptoms and causes. Thanks to taking such an approach there was a dramatic reduction in crime in Glasgow and it became a model that other countries could follow. A public health approach worked for that and I fully believe that it could work for drug deaths, too. I am pleased to hear that the Scottish Government shares that view.

Statistics and evidence are, of course, important, but if we get too bogged down in them we run the risk of taking the humanity out of the problem. By taking a people-centred approach we can get to the root causes of addiction and support people who are addicted. After all, it is important to remember that no one makes an active choice to have a drug addiction.

As always, the minister has been very honest about our monumental task and the amount of work that is required. However, I would welcome more powers being handed to her and to the Parliament to take further, more radical action. The Royal College of Physicians of Edinburgh notes that bold action is required to tackle the issue. It supports decriminalisation of the possession of drugs and the provision of safe drug consumption facilities. However, we know that the policy area that includes criminal justice sanctions for drugs offences is currently reserved to Westminster. Without control of that, we cannot possibly take an all-encompassing public health approach. We are where we are, though, and we will do all that we can with the limited powers that we have. I am pleased to see that in the budget the Government has increased to £160 million its investment in reducing the avoidable harms associated with drugs and alcohol. That is much needed and will help to address the many complex factors that come into play.

As we know from many studies, drug deaths are closely related to deprivation and austerity. Research published by the University of Glasgow and the Glasgow Centre for Population Health suggests that, across the UK, people are dying younger as a result of austerity brought about by the UK Government. Such austerity has two impacts: one is reducing the levels of important services such as those for addiction, housing, mental health and welfare rights; and the other is cutting individual incomes through reductions in social security payments, leading to further drug use as a coping mechanism or an escape from grim reality. Furthermore, the research shows an association between cuts to disability-related social security payments and increased drug-related deaths across all local authority areas in Great Britain. The Scottish Drugs Forum said that today’s drug use in Scotland is linked to the economic impact of deindustrialisation in the 1980s.

The reason that I mention all that is that, all too often, our national conversation on drug deaths is warped and misguided. We still hear people saying things such as “People make their own choices” and “They get what they deserve”. Not only is that outlook completely wrong; it is inhumane. That is why it is so important that we make tackling the stigma around drug use a priority.

In my Ayr constituency, a new support organisation called Harbour Ayrshire has been set up by local businesses and is already doing fantastic work to help people with addiction issues. It focuses on prehab, rehab and aftercare to empower individuals to become independent and get involved in their local communities, and it also provides employment opportunities through those businesses.

I will end my contribution by recounting a moment from several years ago that really touched me. As a councillor at the time, I was listening to an inspirational man who had managed to break his addiction to drugs and had become clean. He used the following analogy, which has always stuck with me. If you come across a dying, withering plant in the corner of a room, do you go over and tell it to get its act together, then ignore it? No, most people would water it, nurture it and give it what it needs to grow and flourish. That is the approach that we and the Scottish Government must take. We must stop stigmatising people with addiction issues as Scotland’s shame.

No, it should be done for us.

Were you already working together as a team or were you brought together when Covid came in March 2020?

I will come in on one point. I know that there is currently no workforce development strategy in place. I take it from what you have said that genome sequencing is quite specialised. Would there be any challenges with training staff, or staffing issues, if you were to develop a future workforce strategy?