To follow up on Sandesh Gulhane’s question, one of the things that we do not talk about is electrical waste in hospitals. The nature of how healthcare is now delivered means that a number of big machines do a lot of work across hospitals, but they often come to the end of their lives either because patient safety issues mean that they are no longer considered safe to keep doing their job or because companies make software updates and machines become redundant as a result of those updates.

What work is being done to reduce the level of electronic waste across the NHS, and how do we ensure that anything that has to go, for patient safety reasons or any other reason, is recycled or repurposed, so that we do not put loads of stuff into landfill?

I think that I was using electronic prescribing as an example of a quite basic thing that we have not achieved yet. Where, in your mind, is the blockage in that respect? Is it a lack of money to do these things? Is it a matter of prioritisation and getting the bigger things rather than the smaller ones over the line? Is it about the cumulative impact?

Drilling for oil and gas in the Rosebank oil field is set to tip Scotland over the edge of climate disaster. This week, we also learned that that work will directly fund a company that is complicit in the illegal occupation of Palestine. Campaign group Uplift has obtained legal advice that says that granting permissions for Rosebank could be a breach of the Geneva conventions. The Scottish Government used to have a clear position on that. Under Nicola Sturgeon and Humza Yousaf, it was opposed to Rosebank. Under the current First Minister, no one is sure.

Can the First Minister confirm whether he still stands by Parliament’s commitment to boycotting Israel? If so, does he agree that the Rosebank oil field should not go ahead?

Previous First Ministers have provided a clear yes or no as to whether they are against Rosebank, and it would be good for this First Minister to do so.

However, warm words are not good enough when climate destruction is funding illegal occupation, and we must put a stop to that. The First Minister must understand why so many of us are frustrated by the news this week. The National has reported that, following this Parliament’s historic vote last year to boycott, divest from and sanction Israeli companies, the Scottish Government has not commissioned a single briefing from officials on how to implement that action. My colleague Patrick Harvie’s questions on the subject from October remain unanswered 17 weeks later.

Is the First Minister’s Government truly committed to boycotting Israel and supporting the people of Palestine? If so, when will we see action?

I spoke in favour of regulating the medical aesthetics industry when Stuart McMillan held a members’ business debate on the topic back in October 2024. In his contribution this afternoon, he reflected on how we support those who have made a genuine mistake, including supporting them to improve. Given some of the bad press around these procedures and the potential for practitioners to be demonised for a genuine mistake, we need to make sure that regulation supports improvement across the sector and that opportunities for learning are taken. I hope that that ethos will be at the heart of the regulation, rather than there just being punitive measures.

During its evidence sessions, the Health, Social Care and Sport Committee heard that the bill will create a level playing field, as healthcare professionals already provide aesthetic procedures in HIS-regulated clinics. If the bill is passed, it will ensure that all providers have to meet the same standards. We know that there are and always will be rogue operators. The bill aims to simply ensure that all those who operate in the sector can be held to the same high standards.

In committee, a representative from the industry argued that the cost of treatment has to be considered as well. If what is proposed in the bill becomes a hugely costly exercise for business, the burden of cost will be passed on to the consumer. However, I think that it is important that we do not look to drive down business costs at the cost of patient safety.

I fully agree with Stuart McMillan’s point about driving up standards. The heart of the bill is about patient safety and making sure that people are safe when they enter into these procedures.

Healthcare professionals are subject to high fees but also to high standards. We should expect that the same applies to any others who carry out procedures that include a risk of complications that range from burns and infections to scarring.

The committee report acknowledges business concerns and includes a recommendation that the Scottish Government should provide appropriate support and guidance to help responsible providers of non-surgical procedures to make a successful transition to the new regulatory framework. As Alex Cole-Hamilton and Maurice Golden acknowledged, there are skilled and ethical practitioners who should be supported. The Scottish Greens endorse that approach, because it would support businesses to do the right thing while still prioritising patient safety.

We support a ban on procedures for people under the age of 18, although I note the calls from the Royal College of Nursing, which said that there is merit in considering additional safeguards, such as requiring a GP or healthcare professional to carry out all procedures on younger people. That is worth considering if the bill proceeds to stage 2.

During its evidence sessions, the committee also heard that the fines proposed in the bill could be absorbed as a business cost by so-called rogue operators. It is essential that any sanctions within the bill act as a sufficient deterrent to those operating outwith regulations. The committee report calls on the Scottish Government to establish stronger penalties for offences committed under the terms of the bill, and the Greens fully support that.

Healthcare Improvement Scotland will have an extremely important role to play in light of the bill, as it would be granted new inspection powers under enforcement to investigate unregistered settings suspected of breaching the law. The committee heard about the challenges that that could pose for HIS, including the added burdens that it will place on staff and resources. It is vital that HIS is properly resourced to carry out its functions and the committee report calls on the Scottish Government to provide assurances that, in the short term, it is committed to putting funding in place to ensure that HIS can properly enforce the bill from the outset.

The committee report also calls on the Scottish Government to publish an implementation route map, and we fully support that, too. If the bill is to be effective in improving patient safety and tackling rogue operators, it must have sufficient funding attached. I look forward to hearing from the Scottish Government about how it plans to achieve that.

16:41

In my opening contribution, I want to spend some time reflecting on why we need the bill in the first place.

In March 2024, healthcare professionals warned that Scotland had become the worst country in Europe for unqualified practitioners injecting customers with cosmetic treatments. In its submission, the British Association of Plastic, Reconstructive and Aesthetic Surgeons—that is not easy to say at this time on a Thursday—said:

“The impact on the NHS and public resources is significant. Our members are witnessing an alarming increase in severe complications from procedures performed by unqualified practitioners, many requiring emergency NHS care or even resulting in loss of life.”

Moreover, the Royal College of Nursing highlighted:

“None of the procedures listed in this Bill are without risk and there is a lack of any reliable data on the cost to the NHS of complications arising out of these procedures.”

Although we need to improve the data in order to better understand the full costs, the evidence from clinicians is clear. A survey that was conducted by the Medical and Dental Defence Union of Scotland in October 2024 revealed that 35 per cent of respondents who worked in a medical field in Scotland had treated patients who had needed care following complications that arose from unregulated cosmetic procedures, and 86 per cent thought that the number of patients each year who seek care following complications resulting from unregulated cosmetic treatments had increased.

The proposed ban on procedures for under-18s is particularly important. The Royal College of Surgeons of Edinburgh has said:

“Facial structures continue to develop into early adulthood, and starting these procedures from a young age can have long-term effects. Procedures such as dermal fillers and Botox too young can lead to muscle atrophy and tissue damage and should rightfully only be available to those over the age of 18.”

We do need to protect young people from the damaging long-term effects of cosmetic surgery, but it is also vital, as we have heard from others, that we protect people who are over 18 from side effects. The Royal College of Surgeons lists the serious complications associated with some cosmetic procedures, including

“infections, blocked arteries, necrosis, blindness and stroke”,

and it makes it clear in its submission that the introduction of the bill will

“reduce the likelihood and severity of any risks and complications.”

However, I believe that the bill should be strengthened in that regard, and that duties should be placed on practitioners to inform customers about the risks attached to procedures. I look forward to working with the minister on that.

The committee heard that the bill could have an impact on equality, as it will affect a female-dominated industry and might lead to reduced access to cosmetic procedures in remote and rural areas. The lack of regulation in the industry has led to unsafe practices that disproportionately affect vulnerable groups, but we need to ensure that those who are safely and ethically carrying out these procedures have the ability to adapt to whatever regulation might come in.

There will always be cosmetic tourism, rogue operators and poor standards, but we cannot let them stand in the way of improving patient safety in Scotland. Those kinds of unsafe practices will occur, with or without regulation, so we should ensure that the vast majority of procedures are carried out in a safe, hygienic way in a properly controlled environment. That said, I think that we should still monitor the equality impact of the bill. I strongly believe that the bill will improve public safety for marginalised groups, as all good legislation does, but there could be unintended consequences.

In its submission to the committee, the Cleft Lip and Palate Association warned that access to cosmetic procedures becoming more bureaucratic or costly could act as a barrier

“for those who seek aesthetic enhancement to address cleft-related lip asymmetry, scarring or functional issues. It is important the Bill allows recognised healthcare professionals … working in the cleft pathway to continue to offer safe lip‐fillers or adjunctive therapies under appropriate clinical governance.”

Overall, however, the bill will improve safety for people undergoing non-surgical cosmetic procedures and protect young people under the age of 18. I believe that the evidence for regulation is clear.

16:12

I thank the cabinet secretary for advance sight of his statement. The creation of the safety and public confidence oversight group is a welcome development, but will the cabinet secretary provide more detail about the group’s membership? He mentioned that there will be active engagement with patients, families, the wider public, staff and whistleblowers, but will he confirm whether there will be patient and staff representatives on the group?

Jim Wallace was one of the founders of devolution. Without him, our Parliament would be a weaker and less ambitious place.

I did not know Jim Wallace on a personal level as well as many others did but, the few times that I met him, he was warm, funny and quick to offer genuine advice to a very new MSP who had a lot to learn. I regret that I have not had the pleasure of working with him or serving in this Parliament with him.

In preparing my remarks, I spoke to colleagues who had worked with Jim. Their view, as has been the case so far across the chamber, was unanimous. They describe an unwaveringly decent and kind person who took Parliament seriously and took Scotland seriously. When he worked, it was with integrity. When he disagreed with colleagues, it was always in a spirit of respect.

Jim was only the second person who was not a Kirk minister to take on the role of Moderator of the General Assembly of the Church of Scotland since the 16th century. Moderator is clearly a non-partisan, party-neutral role. Jim did what he had to do and resigned his membership of the Liberal Democrats for the year of his tenure—it was a commitment on his part that his public service was above party politics.

My co-leader Ross Greer was grateful to know a deeply thoughtful man with an unparalleled commitment to serving Scotland through both politics and the Kirk. His term coincided with Glasgow hosting the 26th United Nations climate change conference of the parties—the COP26 climate summit. That resulted in Ross’s personal highlight of the conference: forming a temporary double act with Jim for a guest lecture at Trinity College Glasgow about faith and small-g green politics. That experience illustrated Jim’s commitment to public service, his love for his country and how his deeply held personal faith influenced his political life.

In this Parliament, we should remember the committed and dedicated voices who came before us and the wonderful legacies that they leave. We should be inspired by Jim Wallace’s work and should try to conduct ourselves in the manner in which he conducted himself. A long-serving Liberal Democrat MSP, Deputy First Minister, acting First Minister and Moderator of the General Assembly, his commitment to public service can never be in doubt. His sudden loss will be keenly felt by colleagues in the Parliament, and I extend our condolences in particular to our colleagues in the Liberal Democrats.

Most of all, I send my condolences to Jim’s friends and family. I sincerely hope that they take comfort in the universal affection and respect that have been expressed by MSPs across all parties.

14:33

I want to be clear that the Greens will not oppose the business motion, but I want to raise the late notice of changes and its wider impact. Over the past few weeks, we have had a series of very late decision times, which have impacted those of us with caring responsibilities or other responsibilities at home. I hope that, as we go through the rest of the session, we will remember that we need to take the decisions in a timely manner and remember the impact that late changes have on everybody across the Parliament.