Chamber and committees

Professor Stobart, you made the point about the fact that there can be corruption as far as assessment—[Inaudible.]—so I just wanted to check that you are satisfied that Scotland’s approach—[Inaudible.]—fair and robust in that standards were checked across teachers’ approaches in schools and departments, across local authorities and nationally. I want to check that that is a good indicator and that, if we are going in that direction, you have confidence that—

Orders not to attempt cardiopulmonary resuscitation—often called DNRs, or do not resuscitate orders—have been in the news. That has created fear, because there is a feeling that some use has not been consensual. I have looked into this, I know that families instinctively want to save their loved ones and want them to have as long a life as possible, but DNRs can also prevent harm and distress. A lot of people do not understand how distressing resuscitation procedures can be. Are we looking at the public message about people having kind, compassionate and comfortable deaths, rather focusing on the use of DNRs, which involves a fear factor? What are we doing to improve that?

Thank you, minister; and thank you to Marion, too. There is not much at all in what you said that I could disagree with.

We know that the women’s health plan is not all encompassing. I am thinking of conditions such as menopause, hyperthyroidism and even endometriosis, which I have suffered from. The number 1 point that we must address is that women are dismissed and disbelieved, as we have seen with the mesh situation.

When I was suffering from endometriosis, it took more than 10 years to get a diagnosis, as has also been the case for so many others. The disease was really severe and I have had several operations. I have a daughter and, like every parent, the last thing that I want is for her to go through the same thing. She is getting to the age at which she might be affected.

Great training is provided in medical school, but how do we propose to change the deeply embedded attitudes to women who present with health issues? A lot of the time, the attitude comes from the top. It is not just male doctors or consultants who are the issue; females can be just as bad. In my experience, the same dismissal of and disbelief in what we say has been apparent in relation to not only women’s health issues, but to our children’s health issues. How will we tackle that?

I accept that we have been doing things on that. When taking evidence, the committee has often heard about how health professionals’ focus tends to be on the targets that they are measured on. How do we ensure that prevention and inequality are suitably prioritised? The health professionals said that those matters end up being pushed to the side because they have other numbers that they need to hit. We all know about what is measured.

There have been recent announcements about priorities relating to place and wellbeing and about preventative and proactive care being based in communities. That might involve 20-minute neighbourhoods, where people have different services to hand.

You spoke about shining a light on pre-existing health inequalities and their drivers. The Christie commission report has been around for quite a long time now—it has a big anniversary this year. What progress has there been with regard to the findings of Christie?

It was good to hear from Dr Buist about Tayside, where the NHS is working together with local authorities to roll out the enhanced community model, which relates especially to older people at home. However, my question is for Annie Gunner Logan and perhaps John Mooney. Integration joint boards have done quite a bit of work on preventing admission to hospital and ensuring that people are discharged as quickly as possible, which fits with the Tayside model. What are your views on how helpful that can be? How much of that model do we need to incorporate in future?

My question is about ensuring fair access to events and travel. What arrangements are in place to ensure that people who cannot receive Covid vaccines because of confirmed or suspected allergic reactions obtain a medical exemption letter from the vaccination certification scheme?

I thank Alex Cole-Hamilton for bringing this important topic to the chamber. The numbers of people with long Covid are high, and that is a major public health matter. More than 75,000 people in Scotland are currently estimated to be suffering from long Covid and, as the pandemic continues, the numbers will only grow.

One of my constituents, Suzanne, who is suffering from long Covid, contacted me to try to help me understand the impact that it is having on her life. She told me:

“Having contracted Covid in October 2020, I have been unable to return to a normal life. I struggle daily with fatigue and a number of other symptoms that vary on a day-to-day basis. I have gone from being a full-time working mum who studied part-time and went to the gym three times a week to somebody that I no longer recognise. I barely leave the house now as I need to prioritise what little energy I have to take care of my two young daughters.”

Although the physical health impact of long Covid has been severe on Suzanne, the story does not end there, and there are many like her. The life-changing impact of Covid also impacts on the mental health of both the sufferer and their family.

For those who are unable to work, long Covid is causing financial distress too. Long Covid sufferers, often for the first time in their lives, face the daunting prospect of navigating the cruel complexities of the United Kingdom’s social security system, which is unlikely to prove flexible enough to respond to their needs.

While there is still much that we do not know about long Covid, we know that doing nothing is not an option, and that we must act. That is why I warmly welcome the Scottish Government’s £10 million long Covid support fund for national health service boards. The fund is an excellent start to help NHS boards to develop flexible models of care that can respond to patients’ changing and varying symptoms. Those flexible care responses are essential. People who are suffering from long Covid make it clear that there is a need for primary care to be strengthened, and to embed healthcare staff and allied health staff locally to provide the necessary support, including rehabilitation services.

It is also important to ensure that long Covid knowledge hubs have the latest up-to-date information, so that those suffering from long Covid can better self-manage their changing and variable symptoms.

Alongside front-line investment in services, research into long Covid is vital. The Scottish Government’s £2.5 million of funding to support nine research projects will be a rich source of data that can help to improve services in the future. It is that dual track of immediate strengthened service response and medium-term scientific research that will improve the long-term lives of so many Scots who are suffering from the life-changing effects of long Covid.

Let us not forget our children and young people. While young people are statistically less likely to suffer severe Covid symptoms, there can be serious long-term impacts on their health, too. On a personal level, I know two teenagers who were infected with Covid way back at the beginning of the pandemic. One of them now has immune system issues, and the other has heart complications. Both of those are long term. I thank goodness that our young people in Scotland are receiving vaccines, too.

Before I close, I will highlight the growing evidence that younger working-age women are more likely to suffer from long Covid. We cannot allow long Covid to further embed gender inequalities. Today’s debate is an important opportunity to hear the voices of people with lived experience of long Covid, and I hope to hear more from other members. It is only by hearing their stories and listening to their asks that we can truly embark on improving their lives. We must listen now, and we must keep on listening.

I, too, thank Gillian Mackay for bringing her motion to the chamber for debate. Women in Scotland have a fundamental right to access pregnancy healthcare services and they should have the right to access them without harassment and intimidation. The targeting and harassment of women who access abortion services, as well as of those who provide them, is unacceptable and I condemn it completely.

Opting to end a pregnancy is seldom a straightforward decision for any woman, nor is it one that is taken lightly. Many women attend their abortion appointment alone, too. It is almost unbearable to imagine how women feel when approached, harassed or intimidated by anti-choice protesters in those circumstances, but that is exactly what I ask all members to do right now—to pause and imagine exactly how that feels for women. I hope that, when members do that, they will agree that all women must be protected from having their privacy invaded at such an emotionally sensitive time.

In 2019, more than 100,000 women were targeted outside clinics across the UK, and 70 per cent of women in Scotland live in a health board area where protests have taken place. Women have reported being followed, photographed, prayed at, jeered at, lied to and generally degraded. There have been instances where women have been prevented from entering clinics, too.

It is distressing for anyone to be hounded by strangers in the street but, at such a personal and private moment, the impact of those protestors’ actions has left already vulnerable women traumatised. Yes, we have the right to protest and the right to free speech, but we do not have the right to harass, intimidate and bully other people. Those are not reasonable expressions of free speech, and there is a difference between protest and harassment, just as there is a difference between free speech and misinformation.

Although anti-choice protestors may not intend to intimidate, there is no doubt that most women attending an abortion feel intimidated when so-called vigils are taking place. That is why I support buffer zones and why I support the Scottish Government’s commitment to work with the national health service and local authorities to find ways of preventing women from feeling harassed and intimidated when they are accessing abortion services.

Since a buffer zone was declared around a clinic in Ealing in 2018 through a public spaces protection order, the situation has improved dramatically. The clinic reports that instances of harassment have virtually disappeared since the order came into force.

Regardless of whether one agrees or disagrees with abortion, the issue is about women being able to access their fundamental right to healthcare. Introducing buffer zones does not impede the right to free speech. Protests can still be held, just not directly outside clinics. People can still contact their MSP and share their beliefs—they have every right to do so.

Ultimately, what women really need is to feel empowered to continue their pregnancy, not pressured by strangers in the street who know nothing about their personal circumstances. Women need to know that they will be supported in the changes that they make and that their life opportunities will not be impeded by choosing to continue with their pregnancy.

As Engender Scotland said,

“Access to safe abortion healthcare is essential for the realisation of women’s economic and social human rights.”

I believe, therefore, that the establishment of buffer zones is essential. Aligned with the Scottish Government’s women’s health plan, they will create a safe place for women attending clinics. I disagree with those who say that creating buffer zones should not proceed due to the threat of legal action. Doing nothing is not an option and women deserve better.