Chamber and committees

I absolutely accept that, and I thank Emma Harper for that intervention.

Of course, patients should be able to get a GP appointment when they need one, and that appointment should be face to face if that is clinically appropriate. No one is denying that. Remote consultations are not appropriate in all circumstances, which is recognised by GPs. However, for many patients, they offer more flexibility and reduce the need to travel.

According to the BMA, before the pandemic approximately 20 per cent of GP appointments were by telephone or video, so the presumption that a return to normal equates to a return to all appointments being face to face does not reflect the reality of general practice before Covid. There should not be a one-size-fits-all approach, and the Royal College of General Practitioners Scotland is clear that a mix of telephone, face-to-face and virtual appointments is the future of general practice.

We must also acknowledge that, due to on-going Covid protections, the physical capacity within general practices is limited. If we rapidly increase face-to-face appointments, patients could face longer waits for appointments due to reduced numbers of people being able to enter the building.

Patient safety is a serious consideration. For example, Asthma UK and the British Lung Foundation in Scotland do not support setting a target date for a return to majority face-to-face appointments because of the on-going risk from Covid-19 to people who are living with lung conditions. They have said that being worried about mixing with others in waiting rooms could force people to miss out on treatment.

I will end with a quote from a GP that has been provided by the BMA, which I think sums up why I have such serious concerns about the motion. The GP said that they have had a

“barrage of negativity from policy makers and smears from the media. General practice has been open all throughout the pandemic and yes, we are seeing patients face to face every day—examining, investigating, immunising, and treating.”

GPs deserve better and so do patients. They need us to be honest about the pressure that general practice is under and about why services are being delivered as they are. I hope that members will reflect on that at decision time.

To ask the Scottish Government how it supports vulnerable people in the prison system. (S6O-00134)

For those who find themselves needing further treatment, that could be a traumatising event. What other, wider support, such as mental health support, is available for those who need it?

People who leave residential rehabilitation are at increased risk of overdoses, because the period of abstinence lowers their tolerance to drugs. It is important that we recognise that people do not leave rehab cured and that they often need on-going treatment and support. How will the Government ensure that residential rehab services are well integrated with other health and care services and that follow-up support is provided to those who leave rehab?

Although many of Scotland’s drug deaths involve more than one substance, drug deaths figures show a continued upward trend in cocaine being implicated in the cause of death. The Scottish Drugs Forum has warned that efforts to get more people into treatment must take account of the needs of people who use cocaine as well as those who use depressant drugs. How will you ensure that drug treatment services serve the needs of people who are using cocaine or, indeed, a number of substances?

I want to pick up on an earlier point about access to rehab. There was a greater discussion about how residential rehab interacts with the rest of the mix of treatment options, but many people might be afraid of losing their tenancy if they enter rehab or they might have caring responsibilities, as the convener pointed out earlier. Some people have unplanned discharges from treatment, and there is the matter of the police and hopefully the wider public carrying naloxone.

You have touched on the issue slightly, but how do you see integration across various areas of Government, in relation to supporting people in their tenancies or encouraging more people to take up carrying naloxone? That could be used to support those people who find themselves in a period of homelessness in particular, as many people with drug and alcohol addiction do.

I have a quick question this time. People who use drugs may be subject to multiple stigmas, not just that related to their drug use. That can include stigma relating to homelessness, mental health and, for some, HIV status. How will the Government ensure that the multiple stigmas are tackled within systems used by people who use drugs, and not just in relation to their drug use and the stigma surrounding it?

I, personally, am still very much committed to working towards £15 an hour—[Interruption.] I am still committed to it—[Interruption.] Well—

I thank the cabinet secretary for that answer. There is some evidence that the Valneva vaccine could be more effective than other vaccines against variants. What impact does the cabinet secretary think the UK Government’s decision could have on our ability to protect people against further mutations of the virus?

I, too, would like to extend our sincere thanks to our health and care workers who are working hard to keep us safe and well. They have been going at a superhuman pace throughout the pandemic, and I can only imagine how exhausted they must feel. It is only right that we take every opportunity to express our gratitude for and appreciation of everything that they do.

My amendment, which was not selected for debate, focused on mental health. We know that the pandemic has had a devastating impact on our collective mental health, but we have not all been equally affected. The most recent report from the Scottish Government’s Covid-19 mental health tracker study found that young adults, women, people with physical and/or mental conditions and people in a lower socioeconomic group are more likely to report experiencing poor mental health.

The Scottish Government’s mental health strategy was published in the time before Covid-19, and we have to recognise that circumstances have materially changed since then. That is why I welcome the Government’s commitment to publish a refreshed mental health strategy and a mental health workforce plan as part of its agreement with my party. It is, of course, vital that the refreshed strategy takes account of how some people have been disproportionately affected by Covid-19. It must consider the social determinants of mental health if it is to effectively address the huge rise in mental distress that has been caused by the pandemic.

There must also be more of a focus on non-communicable diseases as we begin to emerge from the worst of the pandemic. Smoking and drinking rates among those who smoke and drink the most have increased over the pandemic. We need to prioritise good health for our nation, improving outcomes through reducing poverty, improving access to food and reducing the availability of health harming products. No company should be allowed to profit from damaging people’s health. We have the ability to make this the public health session of Parliament, and I hold on to the hope that we can work across parties to achieve that.

I want to focus on social care. The Scottish Greens and the Scottish Government are committed to ensuring that the national care service upholds the principles of fair work, which is why we have committed to a system of national collective bargaining on pay and terms and conditions within the social care sector so that we can build on all care staff receiving the living wage as a minimum while working towards a higher rate of pay.