Chamber and committees

I, too, thank Clare Adamson for bringing the debate to the chamber. It is sobering to take part in a debate on malnutrition. As we head into the second winter of the pandemic, malnutrition awareness week is especially important and poignant. The pandemic has highlighted the fragility of our food systems and has placed previously food secure adults at increased risk of malnutrition. Social isolation and loneliness have peaked, which has increased the risk of more Scots, particularly the elderly, becoming undernourished. That increased risk is not theoretical, given that demand for services from Food Train, for example, has increased by 51 per cent since the onset of the pandemic.

Although most Scots are familiar with the risks of obesity, large numbers of undernourished older Scots remain invisible to most of us. Malnutrition can no longer be a taboo topic; we need a wider discussion on that public health issue to help to tackle the root causes of malnutrition head on.

As food insecurity among older people is a multifaceted issue, we must have a holistic civic response that connects all the elements. Factors such as reduced mobility, social isolation and general frailty have been exacerbated by the pandemic, and many of the levers to respond to poverty still rest with the UK Government. However, the challenges cannot be used as a cover to do nothing. We need to move forward with a programme of preventative actions that start making a positive difference now. A recent report by the University of Glasgow in partnership with Food Train made recommendations that included community screening for early signs of malnutrition, embedding malnutrition issues into basic health and social care training and investing more in community initiatives that address social isolation, such as befriending, which a few members have spoken about.

The key overarching basis on which we need to respond to malnutrition among older people is to ensure that we all recognise the critical way in which food connects people—for example, an older person might struggle to eat alone after losing their partner. Befriending groups and other community responses can offer critical support. Some older people have become less physically mobile during the pandemic. A reluctance to go out as a result of Covid cases remaining high can lead to poor eating habits, and the risks of malnutrition accelerate as mental health and general wellbeing deteriorate.

If we are all educated in the importance of strengthening connections for older people, we reduce the risks of older people becoming undernourished. Food Train’s pilot work seeks to raise awareness of older people who are at risk from malnutrition and to help them back to health, and that could become an exemplar across Scotland. Only by taking a truly collaborative partnership approach that involves the NHS, local government, the third sector and housing organisations can we create the necessary environment to prevent malnutrition.

Beyond the moral imperative of ensuring that everyone has access to wholesome and nutritious food, there is also an economic imperative. People who are suffering from malnutrition are twice as likely to access general practitioner services and three times as likely to be admitted to hospital, which places further strain on our NHS. Identifying malnourishment early and taking positive action reduces unnecessary strain on our NHS and council care services by, for example, reducing falls as well as mental health issues that are caused by isolation.

In closing, I will widen the discussion to food insecurity. I commend the Scottish Government on its plan to make food banks the last port of call. That uplifting plan is yet another example of Scotland taking a different and more dignified approach to supporting people at a time of crisis, compared with the approach that Westminster is pursuing. There is no doubt that the Scottish Government’s wider focus on food insecurity will ensure that malnutrition among older people is no longer a heartbreaking, invisible blight on our society. Our older people deserve so much more. The right to food is a human right that must not and will not be denied.

I fully support the motion and welcome the minister’s announcement of a rapid review of services. Although some areas of disagreement remain, the debate demonstrates a collective determination to save lives by addressing the tragic and unacceptable level of preventable and avoidable drugs deaths in Scotland.

Rightly, given the urgency of the situation, much of the response to Scotland’s drug deaths crisis must focus on medically assisted treatments, but that is only part of a wider story; we must also focus on the importance of taking a person-centred approach. One size does not fit all—a personal approach makes successful recovery far more likely.

One-to-one support is imperative from the outset. Current work that focuses on building better links between mental health and substance use services is vital. As others have said, the Scottish Government’s £120 million investment in the mental health recovery fund to strengthen those links is very welcome, as is the £250 million investment in the national drugs mission.

I am aware of the impact that substance misuse has on our communities and the awful stigma that is still embedded in our society around addiction and mental health. Along with the media and others, we in the Parliament have a responsibility to help to reduce the stigma and to be a positive influence on public opinion. In reality, providing the right help at the right time in a way that is free from discrimination and stigma will improve and save lives and make our communities safer places to live, work and play.

Listening is key, so the motion rightly commits to listening to people who have lived experience, those who are living with addiction, and family members. Listening to and respecting each individual paves the way for delivering the faster and more flexible treatment that people need and deserve.

The motion also mentions the need for treatment and assistance to be

“offered from the first point of contact and consistently throughout each person’s journey”.

By delivering services from a clinical setting and on into the community, we can provide vital wraparound care for those who need it most. Public compassion and understanding will give people the confidence to speak openly and discuss the root causes of their addiction.

We must begin by tackling the underlying issues and inequalities that lead to substance misuse. Having worked in some of the most deprived areas across Lanarkshire and Glasgow, I have seen at first hand the impact of drugs on communities and how the cycle continues again and again. It is time to stop that cycle; a human rights-based approach to tackling inequality and poverty will be key. Transforming how people access care, delivering immediate support and following up with sticky support for as long as each individual needs it already works in other countries; it will work in Scotland, too.

As James Dornan said, it really is time to put the war on drugs behind us, because wars put people on the opposite side to their neighbours. Wars create anger, fear and hatred and wars have no winners—only losers. Let us move on, start to build new expectations and heal the trauma of substance abuse person by person. I ask members to support the motion.

I am looking for clarity about booster vaccinations and the NHS Scotland Covid status app, because residents in the Uddingston and Bellshill constituency have been in touch with me with concerns about reports that boosters will not be recorded on the NHS app and that, as a result, international travel could be restricted 12 months after their second vaccination. Can the First Minister provide reassurance on that matter?

I want to ask about the poverty-related attainment gap. What lessons have been learned from the 2020-21 session? What plans do you have to incorporate those lessons? What longer-term strategies are you considering?

That is great. It is good to know that we are looking at what success looks like and taking forward the collaboration and engagement.

I want to ask about class contact time. The Organisation for Economic Co-operation and Development report raised the issue of preparation and planning. Will that have an impact on the attainment gap? Will there be a focus on that?

I will pick up on the comments about the wellbeing and confidence of children.

Michael Marra talked about data. The Audit Scotland report on education outcomes noted that better data is needed to understand whether outcomes such as wellbeing and confidence are improving. It was mentioned that a survey will come out in December. What plans are there to work with stakeholders to develop and publish consistent and robust national data that reflects those priorities of health, wellbeing and confidence? Will that be built into the national framework through its being updated to reflect that data and the fact that it is a priority that impacts outcomes?

Welcome, cabinet secretary. My question is similar to Gillian Mackay’s question. Have there been any discussions about opting out when it comes to patient confidentiality and the sharing of data?

I noticed that, in relation to the legislative consent memorandum, the Department of Health and Social Care advised that it had undertaken engagement in round-table and smaller discussions, including with the NHS Confederation, which covers England, Wales and Northern Ireland. What consultation, if any, has taken place with NHS Scotland?

What data does the Scottish Government have about the level of public compliance with the mandatory wearing of face coverings in indoor public places and on public transport?

Over the past couple of years, you have had to make lots of huge decisions and do a huge amount of work in a very short period of time, and that work is not necessarily what you have been used to doing in the past. I am interested in the work that you are doing now, and I go back to what Ross Greer talked about earlier. What work are you doing on plans and strategies for models of co-production? Given young people’s views on parity, and taking on board teachers’ views, are you able to collaborate and take decisions together?