Chamber and committees

Representatives of the social care sector have raised concerns that, although there is an NHS recovery plan, there is not a recovery plan for social care. With legislation coming on a national care service, services still need support in the interim period until a national care service is established. Does the Scottish Government recognise the need for a social care recovery plan? What plans are in place to ensure that our social care services have appropriate support as we emerge from the pandemic and before we get national care service legislation enacted?

I want to follow up the point about GPs. Some GPs have expressed concerns about unhelpful messaging, particularly about GP practices being closed during the pandemic. What is the Government doing to try to improve communication with the public regarding the pressure that GPs are currently under and to ensure that everybody knows that they have access to their GP?

That is me finished, convener.

You have laid out the measures for GP recruitment, but I want to ask about out-of-hours services. The pressure on GPs who do out-of-hours work is particularly acute at the moment because of the pressures elsewhere in the NHS. Those GPs are a particularly dedicated workforce. What else can we do to prioritise GPs’ wellbeing so that they will want to continue to contribute towards out-of-hours services? While we recover from Covid, pressures in other areas undoubtedly mean that more people are accessing out-of-hours services than was previously the case.

I am concerned about recruitment and retention in the NHS recovery plan. You have said that work is under way to recruit at least 1,500 additional front-line staff who are required for the national treatment centres. Are you confident that you will be able to fill those posts?

There have been on-going issues with NHS recruitment, and we have heard that the recruitment of pharmacists into GP surgeries has caused workforce challenges in community pharmacies. There is a risk that moving staff from one part of the NHS to another could cause problems and will not solve anything when it comes to recruitment. How do you plan to avoid that and ensure that there is capacity across all services?

I have some concerns about how the introduction of vaccine certification could affect disabled people, those with underlying health conditions and those from the global south who might not be able to access proof of vaccination from the countries in which they were vaccinated. How will the Scottish Government ensure that the introduction of vaccine certification will not negatively impact those whom I have already mentioned and those who are most at risk from the virus?

Will the Scottish Government write to the UK Government to ask for an extension of the furlough scheme to be available, should Scotland need it?

I, too, thank Emma Harper for bringing the debate to the Parliament. As the motion states,

“there are more than 312,000 people living with diabetes in Scotland”,

a number that has more than doubled in the past 20 years. My younger cousin was diagnosed with type 1 diabetes at a similar age to Paul O’Kane’s constituent, and I very much recognise that my aunt had to take many of the same decisions that Emma Harper has talked about this evening, and they were not popular with a cousin who had three non-diabetic cousins.

We need a greater focus on prevention if we are to reduce the number of people being diagnosed with diabetes. About 90 per cent of people with diabetes have type 2, and reducing levels of obesity will help to prevent further diagnoses. Tackling the obesogenic environment will be central to achieving that, and I look forward to the Government introducing legislation to restrict the use of promotions on food and drink that are high in fat, sugar and salt.

We must address the health inequalities that continue to plague Scotland. Obesity rates are highest among those from the most deprived communities, and no one should be subject to food insecurities in 21st century Scotland, but it is still the case that food banks are being used.

According to a report published by the UK Parliament Select Committee on Food, Poverty, Health and Environment, the inability to

“access a healthy, balanced diet”

places people at greater risk of developing obesity, as they may be

“both overnourished with calories and at the same time undernourished in relation to key nutrients.”

As I have mentioned, our food environment is saturated with low-cost, unhealthy foods. The select committee found that

“healthy food has been shown to be three times more expensive, calorie for calorie, than less healthy alternatives.”

We cannot expect people to eat healthier diets until we address the fundamental issues of poverty and access to affordable, healthy food.

We also need to address unequal access to care, as has been highlighted tonight. Many complications arising from diabetes are preventable, as they arise mainly through poor glycaemic control—or when blood sugar levels are too high. In the past few years, great advancements have been made in the development of technologies that help people to maintain good glycaemic control. However, those technologies are not available to all, and there is a postcode lottery in Scotland. Constituents have written to me about being unable to access that technology, which monitors glucose levels day and night and can make a substantial difference to how people with diabetes manage their condition. Some people with diabetes have had to pay for those technologies themselves, but not everyone is able to do so. Diabetes Scotland is calling for clear guidance to health boards that technology such as glucose monitors, insulin pumps and looping should be made available to all those who need them, and I urge the cabinet secretary to give serious consideration to that. I would be grateful if the minister had anything to say on the matter.

Covid-19 has highlighted the health inequalities that continue to plague Scotland, and we cannot afford their widening further. Health and wealth are inextricably linked, and the poorest people in the UK are 2.5 times more likely to have diabetes at any age than the average person. People with diabetes in deprived areas or from minority ethnic backgrounds are less likely to have key health checks, putting them at increased risk of developing complications. We need to ensure that everyone has access to the resources that they need to manage their condition and prevent complications, with dedicated information campaigns that raise awareness of the symptoms and encourage people to get checked.

Having a long-term health condition can undoubtedly take a huge toll on mental health, and having diabetes makes people more vulnerable to developing a serious illness if they catch Covid-19. The pandemic may have been a particularly distressing time for people with diabetes. Some people with diabetes will have been shielding, which may have put them at greater risk of isolation and loneliness, and others may have had appointments postponed, all of which can have a serious impact on mental health. People with diabetes are more likely to experience anxiety and depression, and research conducted by Diabetes UK found that seven out of 10 people with diabetes feel overwhelmed by their condition and are not getting the emotional support that they need.

It is vital that we do not view diabetes simply as a physical condition in isolation from mental health. We need to talk more openly about how long-term conditions can affect mental health, ensuring that emotional support is integrated into physical healthcare.

There have been incredible advancements in diabetes care and treatment since the discovery of insulin, and we must now do more work to ensure that everyone can benefit from them. If we give people the tools, resources and support that they need to manage their diabetes, we can substantially improve their quality of life.

I, too, take the opportunity to welcome Patrick Harvie and Lorna Slater to their new jobs. I am sure that they will have every success in them.

I welcome the debate on the first 100 days of this session of Parliament. While Covid cases continue to soar and our NHS is placed under increasing pressure, it makes sense to reflect on what has been achieved in the first 100 days and how much further we have to go before the pandemic is behind us and our health service can fully recover.

Although the Covid crisis is by no means over, it is never too early to begin learning lessons from the pandemic. I am therefore pleased that the Scottish Government has taken steps to establish a public inquiry. The Covid crisis has left thousands of people with long-term health effects and many have tragically died. We have witnessed this terrible virus devastate care homes, put our loved ones in hospital and change the way in which we live our lives. The Government’s handling of the pandemic must be thoroughly scrutinised so that we can establish how Scotland could have better prepared and ensure that we are in a better position to handle future pandemics.

It has been almost 18 months since the first Covid case in Scotland, and, during that time, healthcare staff have gone above and beyond to protect us from the virus while continuing to deliver emergency and routine care. Staff are exhausted and demoralised, and, as we make plans to help our NHS recover, we must avoid placing extra pressure on them. The NHS recovery plan must be accompanied by clear messaging from the Scottish Government. Ministers need to be honest with the public about what level of service the NHS can provide while it recovers and about how long the public will be expected to wait for routine treatment. It cannot be left up to already overburdened staff to deliver that message.

Just last week, a GP wrote to me about the negativity that practice staff had faced when explaining to patients that they could not access general practice in the way that they used to, saying that staff had often been in tears. The GP said that comments in the media when the plan was published about GPs opening up for face-to-face appointments were unhelpful. General practice has always been and remains open. Throughout the pandemic, GPs have held face-to-face appointments when clinically necessary. Due to rising patient demand, GPs are having to triage patients so that the most urgent cases are seen first. The reality is that that will continue for some time. We need to see leadership from the Government on that issue, and a public information campaign that clearly sets out how people can expect to access health services in the wake of Covid.

In order for our NHS to recover, recruitment and retention must be prioritised; attractive pay and conditions will be key to that. We know that some clinicians and trade unions have expressed disappointment at the proposed pay increases for NHS staff. The chair of the British Medical Association Scotland, Dr Lewis Morrison, has said that the 3 per cent pay uplift fails to address years of pay erosion and does virtually nothing to address low morale.

As we work to help our NHS to recover, another major focus of this Parliament will be social care reform. The Scottish Government’s consultation on a national care service has now been published, giving people the chance to have a say on how the service should be shaped. This is an historic moment, when we have the chance to transform the way in which people access social care, to improve choice and autonomy, to deliver greater recognition of unpaid carers and to design an ethical commissioning process, to name a few. That will be some of the most important work that we will undertake in this session of Parliament, and I look forward to working with colleagues across the chamber to ensure that we have a truly human rights-based, person-centred service.

There is also much work to be done to improve our existing public services in the wake of Covid. Rail strikes are growing across Scotland—swift resolution is needed, because we risk serious disruption at COP26, when hundreds and thousands of people will be travelling to Glasgow. Abellio has a duty to its staff and passengers to resolve the situation. It is a problem of the operator’s own making and one that it has an obligation to fix. Scottish Greens are strongly supportive of moves to bring ScotRail entirely into public hands. Discussion of what a people’s railway will look like when the franchise is taken over by the state needs to start now, and that should include consideration of how we achieve timetables that work and reduce journey times rather than increasing them.

This is the year of COP26, and this Parliament’s response to climate change is rightly under increased scrutiny. The citizens assembly on climate change has produced groundbreaking recommendations and given the people’s consent to transformative change. We must rise to that challenge. In response to last session’s climate change plan update, the Environment, Climate Change and Land Reform Committee set out a series of recommendations. It is vital that we see a meaningful response to those in the run-up to COP26. While reflecting on the past 100 days, it is worth stating that the next 100 days will also be crucial. Our ambitions and decisions in the run-up to COP26 can make a significant difference for generations to come.

I extend my condolences to everyone who has tragically lost a loved one to drug overdose.

As others have said, we need action now to prevent further loss of life. In June, a majority of MSPs supported my amendment to the Government’s motion on drug-related deaths. That amendment called on the Scottish Government

“to investigate, as a matter of urgency, what options”

it had, within the current legal framework,

“to establish ... safe consumption rooms”.

Will the cabinet secretary provide an update on what progress has been made on establishing safe consumption rooms as part of wider harm-reduction strategy and treatment options?

I welcome the First Minister’s commitment to continue to provide support to those who are eligible if they are required to self-isolate. However, given that the latest figures show that only 24.2 per cent of people who are aged 18 to 29 have received two doses of the vaccine, many in that group will be unable to take advantage of the exemptions to self-isolation requirements and will therefore be the most greatly affected by those requirements. Will the First Minister consider extending self-isolation support to those who are not yet, or who cannot be, double vaccinated, so that they are not unfairly penalised?