Chamber and committees

From Monday, the Covid certification scheme ceased to be a legal requirement, but the app remains available to support businesses that wish to implement a voluntary scheme. Does the cabinet secretary agree that although it is right to lessen restrictions as we cautiously move forward, such voluntary certification schemes are valuable tools in maintaining our vigilance on Covid?

I thank my colleague Emma Harper for bringing this important debate to the Parliament.

Eating disorders remain one of the most taboo topics for discussion. I hope that this debate, in eating disorders week, will shine a light on such illness. The focus of this awareness week is on ensuring that all medical schools provide adequate training on eating disorders and that doctors are equipped with the knowledge and training that will enable them to identify signs and symptoms and intervene, so that we can end the pain, suffering and often deadly consequences that eating disorders cause.

As we heard, eating disorders include anorexia nervosa, bulimia nervosa, restricting food, binge eating and overeating, to name but a few. They are a serious form of mental illness, with serious medical consequences and the highest mortality rate of all mental disorders.

In recent days, I heard the story of Grace, who started dieting at 16 because she was overweight as a result of eating convenience food. Like many teenagers, she wanted to lose weight and started eating healthily at first but then began to cut corners, so that she would be able to eat what she wanted. Her mum spotted the pattern that Grace was falling into and took her to the general practitioner. The doctor put it down to a “thing that girls do” and sent her to a dietician.

That is a familiar story from people who have visited their GP, but what else can we expect when, in medical schools, it is often the case that less than two hours of training is dedicated to eating disorders? Indeed, one in five medical schools offers no training in the illness at all.

I acknowledge all the great work that is being done by Beat, the UK eating disorders charity, and through Scottish Government investment. In a survey conducted by Beat in late 2021, 60 per cent of patients with an eating disorder felt that they received poor care from their GP and 58 per cent felt that their GP did not understand eating disorders. Out of 93 supporters in Scotland who had lived experience, 51 felt that the care that they received from their GP was poor or very poor. That must change. The lack of training is having devastating consequences.

Let me go back to Grace. As she waited to be seen by a dietician, she found herself sitting in a waiting room with four other girls she knew. That is a sign of how common eating disorders can be. Grace recalls sitting with the dietician and feeling that the appointment was just a tick-box exercise in which she was asked questions such as, “What is wrong and why aren’t you eating?” “How do you feel when you eat?” She was put on a diet plan and asked to write a food diary, but she lied and no one ever checked up on her. When she talked to the other girls, they all said that they had done the same thing: they lied on the forms, and not one medical professional ever checked or questioned them about that. Eventually, Grace stopped going to the service and fell off the radar.

Grace grew from a teenager into an adult, taking the eating disorder with her. At 23, she made a breakthrough with a doctor in Ayr. The young female doctor understood her, listened to her and wanted to help. What would have happened if her first doctor had been like that? Unfortunately, the doctor in Ayr did not remain at the practice for long, and Grace went back to square 1.

The Scottish eating disorder services review in 2021 recommended that there should be appropriate training for all professionals and that there should be a particular focus on early intervention, medical aspects of care, and support. It recommended that training should range from undergraduate healthcare training to specialist training.

There is good news: the University of Glasgow medical school has been an early trailblazer in delivering the new training package. We must lead the way by ensuring that all five medical schools and the foundation programme in Scotland deliver such training.

Yes, I agree with Oliver Mundell. There is dedicated funding at the University of Glasgow, and the Scottish Government absolutely is aware that the approach needs to be rolled out in all five medical schools.

Let us fast forward from Grace at 23. She is now 29 and she talks quite openly about the struggle that she faced. Although the mental effects have subsided, the physical effects have not. She knows that she has caused herself damage, but the answer from the doctor is more pills and a diagnosis of irritable bowel syndrome. No one will listen.

We need to listen to people with lived experience. Recovery is possible—we need only look at Grace. The plea from people like Grace is that eating disorder is not just a thing that teenagers do but a serious mental illness with grave consequences. As such, it deserves to have money and resources ploughed into it, with funding for research.

The Scottish Government needs to ensure full implementation of the Scottish eating disorder services review recommendations, including on the allocation of sufficient funding, and workforce and staff training. We know that the pandemic has compounded the issue, made it worse for those who are battling the illness and affected others for the first time.

I will finish by repeating what my colleagues have already said: help is out there. People should take down this number: 0808 801 0432. It is for Beat, whose trained advisers can offer one-to-one help. If talking is too hard, people can email [email protected]. Please seek help.

I will ask the first question. First, I thank the Scottish Government for the revised strategic framework that was announced this week. The lifting of restrictions later next month is welcome news for many.

There is currently uncertainty regarding the future of testing, but as our framework identifies three broad threat levels—low, medium and high—if testing is reduced in capacity considerably, how will it be possible to monitor outbreaks of new variants to determine what threat level we should be at?

Sorry, Jim—I am conscious of time, so I have to move on to questions from Brian Whittle.

I am sorry, Mr Fairlie. We are running out of time. We move to Alex Rowley.

The question is, that motion S6M-03168 be agreed to. Are we agreed?

Members: No.

There will be a division.

For

Brown, Siobhian (Ayr) (SNP)
Fairlie, Jim (Perthshire South and Kinross-shire) (SNP)
Mason, John (Glasgow Shettleston) (SNP)
Rowley, Alex (Mid Scotland and Fife) (Lab)

Against

Fraser, Murdo (Mid Scotland and Fife) (Con)
Whittle, Brian (South Scotland) (Con)

I thank all the witnesses for their written submissions, and everybody else who responded to the committee’s call for evidence.

The first thing that stood out to me when the committee launched its inquiry was that Scottish Government data showed that the number of deaths in Scotland was 11 per cent above the average for that time of year, and that it had been, on average, for the previous 26 weeks. That caused us alarm, and we wondered whether that would be a growing trend. However, the data that was published on 14 February shows that the number of deaths in Scotland is currently 6 per cent below average. Does anyone have any insight on, or explanation for, that trend?

My second question relates to a point that one of my colleagues brought up in the private briefing that we had before the meeting. The majority of respondents who answered our call for evidence did not think that there had been enough of a strategic focus on non-Covid conditions and suggested increasing staff and bed numbers. We will all appreciate and understand the pressure that there has been on the national health service over the past two years and that you cannot just magic up staff and beds overnight. However, can anything be done in the short term to address the backlog, given that so many capacity challenges still exist? Moreover, could the Government do anything in the short term to bolster the health and social care workforce?