Chamber and committees

I thank Carol Mochan for bringing this important topic to the chamber for debate, as well as Scottish Health Action on Alcohol Problems and all the people on the front line for their tireless work in this area.

We know that Scotland has long struggled with alcohol-related harms to the great detriment of our collective wellbeing, and we must not ignore the harmful impact on individuals and their families and on our society. One of the most insidious yet rarely acknowledged or understood consequences of prolonged problematic alcohol use is the damage that it can do to the brain. Some of the most harrowing cases that I encountered when I worked in the area of homelessness involved the people who were affected by that condition. Most of them were in their 40s and 50s, but the youngest person was 20, and what I witnessed trying to support him lives with me 20 years down the line.

Alcohol-related brain damage is a hidden condition that services and folk alike are just not sufficiently aware of. As we have heard, it takes many forms, ranging from cognitive impairments to memory loss and difficulties with decision making and emotional regulation. It affects not just the individual but their loved ones. It can be a significant barrier to not only accessing and maintaining recovery but accessing many other services that people depend on. Despite that, too many people go undiagnosed and untreated, and they are left to struggle on their own.

Urgent action is needed. We must develop national treatment standards and a strategy that ensures that ARBD is identified early and treated comprehensively, and that support is available to those who need it most. This is not just about healthcare; it is about creating a society where no one is left behind, where individuals suffering from ARBD receive the care and support that allows them to rebuild their lives.

First, we need to raise awareness across the healthcare sector. Many healthcare professionals, including GPs, emergency workers and even those working directly with alcohol and drug partnerships are not equipped with the tools to identify alcohol-related brain damage at an early stage. Training for front-line staff must be a priority so that they can recognise the signs of ARBD, refer individuals for appropriate diagnosis and ensure that they are provided with the right support. As we have heard, there can be a partial recovery and a reversal of symptoms. Everybody should be offered the opportunity to realise that recovery if that is possible.

Secondly, we must ensure that diagnosis is not a drawn-out process. Delays in diagnosis can lead to worsening symptoms and, ultimately, to irreversible damage. We need a streamlined pathway for diagnosing ARBD and providing timely intervention. The earlier the intervention, the better the chance of improving quality of life and recovery. That intervention needs to be holistic—physical, mental and social support should all be part of the care plan.

We must ensure that the intervention also includes provision of specialist rehab services. We have heard from members about how important that provision is. Whether specialist rehab services are provided by Penumbra or Simon Community Scotland and its managed alcohol programme, which is helpful in identifying people who have ARBD, we must ensure that they are supported and funded.

Moreover, we must take a whole-community approach. Problematic alcohol use is not an isolated issue—it is interconnected with poverty, trauma, adverse childhood experiences, housing insecurity, mental health challenges and social isolation. Treating ARBD without addressing the wider societal factors will not yield lasting results. It is essential that we work across sectors—health, housing, social services and justice—to provide a comprehensive solution to the problem.

Prevention needs to be a key strand of the work. We must focus on public health strategies to reduce harmful drinking before it leads to brain damage. Prevention must be integrated into our public health campaigns, schools and communities, because we cannot afford to wait for the damage to be done before we act. We heard from Carol Mochan about some of the best-buy deals that we know affect ARBD. We think about minimum unit pricing, but we must also think about availability and marketing.

Finally, we must ensure that people living with alcohol-related brain damage are not stigmatised. Too often, individuals with ARBD are misunderstood, blamed for their condition and excluded from society. That only deepens their isolation and makes it harder for them to access the help that they need. It is time to build a culture of understanding and empathy. We must see people for who they are—not just their condition—and offer them the dignity and respect that they deserve.

Scotland needs a strategy that identifies alcohol-related brain damage early, treats it comprehensively and supports those affected through every step of their recovery journey. We must take a collaborative approach, working across sectors and communities to tackle the issue in a way that reflects our values of fairness, compassion and respect for all. This is not just a healthcare issue—it is a social issue and a human issue. It is the challenge that we must meet with urgency, determination and care.

I will come back on that briefly. I could also speak about this topic all day, given my background as a Scottish Women’s Aid worker.

Do you feel that we are at a point at which we are speaking a lot about the issue but have not quite realised the embedding and mainstreaming of full equalities, including taking a gendered look at the different policy decisions that we make? Will the absence of a human rights bill make that more tricky to achieve? Do you feel that it is the panacea that will help us to get over that hurdle and implement those things on the ground?

I will be brief. We have already touched on human rights budgeting. Does the commission think that there is enough resourcing out there to allow effective human rights budgeting to be done? I am thinking specifically about resourcing for local authorities and about the ways that they directly resource some of our many other delivery agencies. How can we ensure that we achieve human rights budgeting within resource allocations?

My apologies, convener—the technical issues that I experienced at the beginning of the meeting meant that I missed the first few discussion points.

I wish to explore the structural barriers to justice a little bit further and, specifically, how those relate to the quest for human rights budgeting. We could also think about that issue in terms of the mainstreaming of equalities, perhaps with a gendered lens on it—that is, we need to think about gender budgeting as well. I am really aware of the issue of access to justice for those seeking remedy for domestic abuse, specifically in remote and Highlands and Islands areas. Would either Angela O’Hagan or Luis Yanes comment on that, please?

That illustrates well the issue that I have come across over many years. When we talk about the size of the pie, we forget about how the pie is divvied up and how organisations are responsible for divvying it up in a way that reflects the needs of the people they are seeking to serve. It is helpful that we have that on record in the committee this morning. Thank you.

I know that the cabinet secretary agrees with me that no child in a country as prosperous as Scotland should live in poverty. Recent analysis by the Joseph Rowntree Foundation indicated that Scotland will be the only place in the United Kingdom where child poverty will fall over the next five years. Does the cabinet secretary agree that that can be attributed to Scotland-specific policies, including those relating to welfare, and that the report must act as a clarion call for the UK Labour Government to work in tandem with the Scottish National Party Government on its efforts to end child poverty, including by abolishing the hugely damaging and pernicious two-child limit?

To ask the Scottish Government whether it will provide an update on its national mission for tackling child poverty. (S6O-04345)

One of my colleagues will ask questions about the co-design.

Before we get to that, however, do you believe that our producers, at this point in time, are able to decide what they will do with regard to regenerative practices? As you set out in your letter to us, a code of practice will not be law and will not be a legal requirement, but what payments producers are able to receive will be contingent on them adopting such practices.

Producers will be deciding how to invest and what to do between now and the code of practice coming out. Do they have enough information at the minute to be making the best decisions for the future of their farm or croft?

Finally, do you believe that that will help to ensure that there is a just transition and that we take the sector with us? Will it ensure that the sector will not come to a cliff edge in relation to accessing future payments?

I have a wee follow-on question. My concern is that, on the ground, farmers and crofters might not understand what concessions are available to them. It is about understanding the nature of the very small industry that they preside over. Is there another way for the changes to be communicated effectively? None of us would want any farmer or crofter to decide to give up and not go any further at this early stage, because, as Rhoda Grant narrated, they form an integral part of how our landscapes and our biodiversities work in many parts of Scotland.