Chamber and committees

Thank you very much for that detailed response, Nicky.

Louise, would you like to come back in?

I welcome the debate, which marks another step forward in the delivery of health and care services that understand and support people with chronic pain. I have listened carefully to the very informative contributions from members, especially Christine Grahame.

Chronic pain is defined as pain that persists beyond normal injury healing time and that recurs for longer than three months. It is a separate condition in its own right and frequently presents alongside other long-term health conditions.

It is often said that living with chronic pain is hard, but dealing with people who do not care or understand can be even harder. Older people represent a significant proportion of people with chronic pain and their lived experience tells us that their pain is sometimes responded to with an uncharacteristic lack of empathy from healthcare professionals, which leads to poor investigation and to little or no therapeutic intervention.

We know that chronic pain is complex and unique to every individual. We hear reports that, as people age and present with chronic pain, their experience of accessing local healthcare services is less than compassionate and lacks empathy. An older person who approaches their GP for advice, guidance and treatment options can find the response—unusually for the caring professions—to be based on assumptions and a sense of inevitability, with old age itself blamed rather than there being a focus on which aspects of the ageing process might be causing chronic pain and on how best to treat and alleviate the patient’s experience of that pain.

Moreover,

“there is evidence to indicate that there are links between adverse experiences and the incidence and impact of pain.”

When an elderly person goes to see their GP for advice and support but they meet with a response that does not acknowledge or engage with their experience, the impact of their pain can potentially be intensified. Indeed, a key finding of the framework that we are debating today is that people with chronic pain feel that

“the lack of recognition of its impact on their everyday life, including from healthcare professionals”

increases the challenges that they face.

The debilitating effect of unmanaged chronic pain reduces the quality of life and the wellbeing of older people, as it does for the rest of the population. The action plan notes

“an approach to care that prioritises empathy and kindness in order for it to be effective”.

I really like the fact that those words are explicitly included in the action plan. Everyone living with chronic pain has a right to expect such an approach when they approach the NHS for care. I hope that, when the plan talks about drawing

“on the expertise of people with lived experience of chronic pain”,

it will include older people, whose voices need to be included in the development of training for health professionals.

An increasing body of scientific research and practical evidence confirms the huge potential of therapeutic touch in reducing the impact of pain. I hope that the toolkit for healthcare professionals can reflect treatment options that are appropriate for older people, including physiotherapy, massage and other bodywork therapies.

It is almost impossible to overestimate the importance of health and care workers—including GPs and their team members—having an understanding of the challenges of living with persistent pain. That is vital in ensuring that they provide informed and compassionate care and it enables them to signpost older patients to appropriate, accessible treatments.

I welcome the fact that the first aim of the implementation plan, which is referred to in the motion, is person-centred care. I also welcome the fact that the actions that are identified to deliver that aim include developing a knowledge hub and a pain-informed care toolkit for healthcare professionals to promote in all care settings. Identifying existing best practice and establishing how the principles of trauma-informed practice can be incorporated as part of pain management care and support services is also a valuable element of the way forward.

I welcome today’s debate and the commitments made in the action plan. To foster an approach that is based on compassion, empathy and respect is the right thing to do. I hope that the work that follows will lead to a significant improvement in the experience of accessing NHS services for all those living with chronic pain, including our valued elderly population.

Tapadh leat, Presiding Officer, thank you—that was in British Sign Language—shukria. I am delighted to take part in this debate given that my first language is Punjabi, I learned English, tuned into Scots, and I am fully appreciative of Gaelic.

Dating back centuries, Gaelic is one of the oldest indigenous languages in Europe. Gaelic is more than 1,000 years older than English, and is an integral part of Scotland’s make up. It has been said:

“What is true for bones is also true for human language”.

It is clear that the essential elements are just one piece of a much wider, ever-evolving picture. Gaelic is more than the words that comprise it—it is an emotional connection to Scotland’s cultural heritage. I welcome the discussion today, which will celebrate its revival, and reconsider the key to its preservation.

Although Gaelic can appear a wee bit intimidating to those who do not speak it, Scots may feel more familiar. Now also recognised as a regional language under the European Charter for Regional or Minority Languages, Scots is much closer in style to English but varies considerably, even across relatively small geographical areas.

As Jennifer Smith, professor of sociolinguistics at the University of Glasgow said,

“Lots of people say ‘Oh, I don’t speak Scots’. But just because you don’t sound like Robert Burns, doesn’t mean you’re not speaking Scots.”

Professor Smith headed the University of Glasgow’s Scots syntax atlas, which is an incredible online research tool that was launched in 2019, which maps the use of Scots across Scotland. From the “gonnae nos” in Glasgow, to the “fit likes” in the north-east, the atlas confirmed that we do not have to travel very far to appreciate the rich differences. We should be proud of our vibrant local lexicon and indigenous tongue, as well as the host of other languages found here, including my own Punjabi and Urdu. There are more than 170 languages spoken in Scotland, including Makaton, French, Cantonese, German, Bengali, Spanish—the list goes on.

Embracing the nuances of our own history and heritage allows for a deeper respect and understanding of other cultures. I have been pleased to see a resurgence elsewhere that mirrors the Gaelic renaissance, such as within the Saami communities of Europe’s far north, and through the Indigenous Languages Act in Canada.

Here in Scotland, the revival of Scots and Gaelic has been aided in recent years by a variety of wondrous efforts.

In my own constituency of Glasgow Kelvin, Partick Thistle Football Club, in collaboration with Glasgow City Council Gaelic education services and Bòrd na Gàidhlig, became the first Scottish professional football club to have bilingual English and Gaelic signage at its stadium in a bid to increase the visibility of the language, and I encourage the club to add Scots to its signage in due course.

That is just one of a number of exciting projects and activities in the pipeline that seek to encourage engagement with Gaelic-medium education schools, which brings us to another gem in my constituency: the Glasgow Gaelic school, which opened in 1999. It is one of four nurseries, three primary schools and one secondary school in the city that currently provide Gaelic-medium education.

Although teaching Gaelic was sadly never part of my repertoire, I did find that children really connected with the Scots language, but I had to emphasise that it was not slang. I remember a couple of wee laddies who struggled immensely with reading and writing. Average texts in English were of no interest to them—they liked cars. I discovered the Scots poem “The Wee Rid Motor” by Sandy Thomas Ross, which captured their imagination because the words sounded like how they talked. Their imagination was engaged, and they were able to read it out loud to an audience of parents who listened intently as they read, having not been able to read before:

“In ma wee rid motor,
I can gang for miles,
Up and doon the gairden,
Through the lobby whiles.
Mony a bigger motor,
Gangs tae toons afaur,
Nane can gang whaur I gang
In my wee rid caur.”

Those are blithe memories indeed, of children reading, inspired by Scots.

The Scottish Government recognises the many benefits of Gaelic and Scots in our schools, and I am pleased to see that a new national strategic approach to Gaelic-medium education is one of the areas that is currently under consultation. These languages should be normalised in our institutions and across all our communities, and the proposed Scottish languages bill has the opportunity to contribute towards that significantly.

I echo the recommendations of Bòrd na Gàidhlig that the education strategy should include a workforce recruitment and development priority, and that any new education agencies that are created should have Gaelic education responsibilities embedded within them.

Research has demonstrated that bilingual children enjoy improved cognitive development, and the earlier that the second language is introduced, the better. In a way that most adults cannot, children absorb sounds, patterns and structures, and are unencumbered by years of lessons that drill into us a single way of communicating.

Languages equip us with so much—it is vital we protect them. Tapadh leat. Ta. Thank you—in British Sign Language. Shukria.

I am the constituency MSP for Glasgow Kelvin, where the unfortunate tragedies, which the commission referred to as “avoidable”, took place, and I was able to attend the launch of the final report at the Merchants house. Will the Scottish Government join me in pursuing recommendation 6, which calls on asylum accommodation support and care providers to immediately ring fence a fund of £5 million per annum for

“asylum seeker wellbeing and mental and emotional health support”

and treatment of trauma? Does the cabinet secretary agree that there should be no profiteering from pain?

Do you think that consideration of the impact of significant changes to the care system on the rights of children and their families can be undertaken in the time that it takes for the regulations to progress through Parliament? I would like to explore timescales and how they fit together a little bit further.

I will ask about the Promise and whether we are on target to implement it, so I am afraid that my questions will be mainly for Fraser McKinlay, but I invite the other witnesses to chip in as much as they can.

Fraser, in a letter to the Health, Social Care and Sport Committee, you said:

“Children and families repeatedly told the Independent Care Review the way the system works is a primary barrier to change”.

Will you expand on that? What are the impacts of the way that the system works at the moment? I want a bit more information about what the problems are with the current system. I am particularly interested in the views of the service users—children and parents—not those of agencies.

Correct me if I am wrong, but I think that the target is to implement all aspects of the Promise by 2030.

I am pleased to hear you say that you think that there is a strong commitment from all the authorities to keep the Promise. We heard from the witnesses on the previous panel that they were a bit concerned about people being distracted while the process is going on. How did you get that evidence? Where did it come from? Did you get it from people who spoke to you or from submissions that they sent you?

If children’s services were to become part of the national care service to help us to keep the Promise, how would that help to improve outcomes? You can have all the structures that you want, but we have heard how important it is that children’s lives change. How can we ensure that the national care service helps us to do that?

Does anyone else have a view?