Chamber and committees

To what extent are you sympathetic to extending the PSC’s remit to include acting as the voice of staff? Do you agree that widening the remit could enable the PSC to get a clearer picture of patient safety concerns, given the different ways in which such concerns are raised, or do you think that it would risk adding duplication or potentially streamlining the remit across all those different ways?

Paul Sweeney was just talking about exercise being seen as a punishment and how, with influencers and so on, we do not want that to become a thing for young women and teenage girls. However, there is still the older cohort of young women for whom, in the early noughties and so on, that was the reality of physical exercise and activity. Many of us shied away from exercise and organised team sport for those punishment-related reasons. Many of those women will now feel that they should know what physical activity and sport they enjoy doing.

How can we reverse that damage and give that age group opportunities—without stigma—to come back to physical activity and take up new things of the sort that they shied away from when they were younger?

Given that, as you have just mentioned, minister, the remit is slightly wider than that of the Patient Safety Commissioner for England, do you have any concerns about duplications on the medicine side of things and between the roles of the two commissioners? Do you think that the role for the new commissioner for Scotland is realistic, given its breadth and potential workload?

A part of the inquiry that I am interested in is how we build a movement toward sport for life, which is probably difficult to do for the age group that you were looking at. How can we better facilitate changes in activities that naturally happen during people’s lives—such as switching from one sport to another? Can we focus, in particular, on where following pathways into elite sport comes in for those young people in late primary school and early secondary school? Also, how do we ensure that they have the skills to be able to go out for a run or go to the gym, which are the physical activities that most people do weekly?

They are using it for overall wellbeing.

Obviously, among the other barriers for women coming out of university is when they go into a working environment and have to establish new routines, as is the case when they go into a different working environment and must establish a new routine. Everyone at the table would probably say that our current employment is definitely a barrier to our getting out and getting active. Would four-day weeks, flexible working and things like that provide more space to mothers, women with caring responsibilities and those of us who are just plan busy, in order that we could get out and prioritise our health a bit more?

I agree. It is key that we tackle the big structural issues as well as individual behavioural issues. That comes down to the planning side and to the employment side.

As many others have done, I thank Jackie Baillie for bringing this important debate to the chamber.

Long Covid occurs after a mild, severe or asymptomatic Covid-19 infection and can cause a wide range of symptoms across the body. It can be a multisystem illness and cause organ damage and cognitive dysfunction, as well as gastrointestinal, respiratory, cardiac, nervous and musculoskeletal problems. It can affect anyone of any age, including children, irrespective of their previous health.

As we mark the first international long Covid awareness day, there are an estimated 175,000 people in Scotland living with the condition. As long as Covid is with us, the potential for more people to develop long Covid is a real and present danger. We should always take opportunities such as this debate to encourage everyone to take the basic infection control measures that can help keep everyone safe. We should continue to make sure that we wash our hands thoroughly and, if somebody is ill, they should try to stay at home.

As we have reopened after lockdowns, many people have gone back to normal. I am sure that many members who are in the chamber and people who are watching the proceedings have witnessed visibly ill people out and about. We know that, for many people, staying home when they are ill is not a reality, especially during the cost of living crisis, and we need to challenge employment practices that are inflexible and potentially put staff in harm’s way. Anything that we can do to reduce transmission will ultimately mean that fewer people will develop long Covid.

I thank all the long Covid groups that have been in touch with briefings ahead of the debate. Every person involved should be proud of the effect that they are having on the direction of long Covid care. I will focus on a few asks of the groups.

Long Covid care and knowledge are likely to develop for many years to come. We need to ensure that we accurately capture data on long Covid. Because many people who contracted long Covid during the first wave of the pandemic lack the positive test, they might not immediately get a diagnosis of long Covid. We need to ensure that the clinical guidance is robust, so that people in those circumstances are given the appropriate diagnosis and that lack of a positive test when they could not have had a test is not a barrier to that diagnosis.

We need to make sure that we know how many people there are and where they live so that services can be planned to support them. Many of those suffering are children and will likely need support for many years. Services need to be able to keep up with that demand.

Because of the high numbers, we might always have struggled to upscale services quickly enough to meet the demand for the number of people who are now experiencing long Covid, but ensuring that those who are experiencing symptoms are able to voice their experience and access the support that they feel they need is imperative.

We also need to ensure that scientific studies are representative of all those who are living with long Covid to ensure that treatments are appropriate for all. Too often in the past, studies have not been representative of, for example, women, ethnic minority groups and those with disabilities or health conditions that may have put them at greater risk of Covid in the first place.

We also need to ensure that general practitioners and other professionals have protected time to update their knowledge as knowledge on Covid updates. There are many conditions, undoubtedly including long Covid, that would benefit from that approach, and a move to electronic prescribing, for example, might free up some time to accommodate it, although there will be many competing priorities for any freed-up time, so some more creative solutions might need to be found.

Campaigners are also asking for proper diagnostic testing and not just rehab. Due to the multisystem nature of Covid, it is possible to have damage to more than one organ or process within the body. Although general rehab may work for some, it makes sense for there to be appropriate diagnostic testing, such as scans, to ensure that the damage is known and is appropriately supported. That could be especially important because we know so little. We have no idea whether symptoms may resolve for some and get worse for others, and if we do not have people’s baseline correctly documented, we cannot hope to make projections or offer advice for anyone who may come after.

I realise that I am out of time, so I would once again like to thank Jackie Baillie for the debate.

I, too, thank Kenny Gibson for bringing this important annual debate to the chamber.

Eating disorders are serious mental health issues that affect an estimated 1.25 million people in the UK. Eating disorders can affect anyone, of any age, gender, ethnicity or background. They have severe impacts on individuals and their families. Types of eating disorders include binge eating disorder, bulimia, anorexia, other specified feeding or eating disorder and avoidant-restrictive food intake disorder. Eating disorders have high mortality rates, with anorexia having the highest, and with one in six people with binge eating disorder attempting to end their life.

The theme of this year’s eating disorder awareness week is eating disorders among men. Unfortunately, there has not been a lot of research on that. However, an estimate based on the existing research suggests that about one in four of those with an eating disorder are men.

Men face increased stigma when it comes to eating disorders, and the current research is not representative enough, as it focuses mainly on white, cisgender men, so the true number might be much higher. Stigma is undoubtedly a factor in the low representation of men in such studies. For many, the perception that eating disorders affect only women and girls will undoubtedly prevent people from recognising their symptoms in the first instance.

Many of the signs and symptoms that we have spoken about in recent years or those that are reported do not align with the symptoms that many men might suffer. Not knowing that their symptoms are a problem, let alone that they might be a sign of an eating disorder, will prevent people from seeking help. Those who know that they might have an issue might not seek help for fear of perceptions of their problems and the associated stigma.

Beat’s website has this quote from a man sharing his experience:

“I feel like eating disorders are often spoken about in relation to women. I didn’t expect that this would happen to me. When I initially developed an eating disorder, I didn’t know I had one. I didn’t exactly fit the common stereotype, and even if I did, I was in complete denial”.

As Emma Harper and others have said, social media is one of Beat’s areas of focus. Social media has a huge part to play in this and, as someone who loves a good TikTok scroll before bed, I know that the sheer number of videos—often sponsored videos or adverts—that promote different diets, weight loss and fitness regimes is enormous. That is not to say that such videos in and of themselves are harmful, but what strikes me is the number of them and the often conflicting information.

That could certainly be looked at.

As members on all sides of the chamber have acknowledged, eating disorders are a societal problem. I would like us to look at all the different places where we could provide young people with nutritional information. We could certainly look at including such information as part of personal and social education, so that young people develop those habits early in life and cannot be influenced by the misinformation that we see on social media.

However, there is no easy solution to the issue. I remember growing up in the late 1990s and early 2000s, when diet culture was at its height. To a certain extent, even though attitudes move on and there is now more of a mainstream focus on being body positive, we have not got rid of that toxic diet culture. In a way, it rolls around every new year, when the goal—I have done this myself—is to lose weight rather than eat better and look after yourself. I cannot imagine how triggering that must be for people who have an eating disorder.

I realise that I am rapidly running out of time. Once again, I thank Kenny Gibson for bringing this important debate to the chamber, and I thank Beat for its continuing work.