Chamber and committees

That is great.

Good morning to the panel. Last week at committee, I asked Dr Peter Cawston, of GPs at the Deep End, whether services are trauma informed. He highlighted that

“Tackling ... stigma involves every person who works in a health and social care setting ... having a better understanding of how trauma impacts throughout a person’s life, and how it affects ... behaviour.”—[Official Report, Health, Social Care and Sport Committee, 21 June 2022; c 30.]

He went on to say that, although trauma-informed training is more widely available, there is still much work to do.

What is the Government doing to promote the importance of services being trauma informed and to ensure that all health and care staff undergo trauma-informed training?

To ask the Scottish Government whether it will provide an update following the summit on safe access to abortion services convened by the First Minister. (S6T-00821)

I welcome the offers from the First Minister and the minister for women’s health to work collaboratively on my bill. Members from every party are now committing to back me on that issue. We know, however, that legislation takes some time. What can the Government, local authorities and the police do in the meantime to ensure that we reduce the impact on those entering clinics?

Abortion rights are under attack in many countries and last week saw the devastating rollback of reproductive rights in the United States of America. I am sure that members would like to express their solidarity with those in the US. We also see legislation similar to mine that was introduced in Northern Ireland by my Green colleague Clare Bailey being challenged in the Supreme Court. It is more important than ever to protect access to abortion and to support to those who need reproductive healthcare. How can the Government ensure that people who are affected by protests outside clinics, including staff and patients, receive any emotional support that they might need? Will the minister join me in expressing solidarity with all those in the US and elsewhere who do not have access to safe legal abortion care?

The Scottish Drugs Forum has highlighted that stigma is still acting as a barrier to people accessing MAT. It causes people to present later for treatment and means that they are often not as fully supported as they might be. What action will the minister take to tackle that and ensure that nobody is prevented from accessing MAT due to stigma? Will she consider requiring mandatory stigma training for all staff who work in ADPs?

The cost of living crisis is placing incredible pressure on people across Scotland. Inflation hit 9.1 per cent today. People are being plunged into poverty by cuts to universal credit and the benefit cap. They face rising energy bills because of the Tories’ failure to implement price controls or transition away from unsustainable fossil fuels such as gas, as well as rising food prices, due to Brexit.

Just today, the Resolution Foundation published a study that reveals that Brexit is making the cost of living crisis worse, with the average worker in Britain on course to lose £470 in pay each year by 2030, after rising living costs are taken into account.

I have spoken in this chamber about the impact of the cost of living on unpaid carers. As co-convener of the cross-party group on carers, I have heard from carers about the effect on them and the people they care for. Carers are facing rising living costs, but many carers do not have the option of taking on more work, due to their caring responsibilities. The situation is exacerbated by the fact that, earlier in the pandemic, many people’s care packages were reduced or stopped and carers took on more responsibilities as a result.

Carers might face additional costs that relate to home adaptations, personal protective equipment and other equipment, transport and cleaning supplies, the cost of which is also rising.

People who develop care needs as a result of a new diagnosis will experience the double pressure of having to reduce their working hours or leave their employment while incurring new, care-related costs. Research by Marie Curie found that being terminally ill and reaching the end of life can substantially increase the risk of poverty, not just for the person who is terminally ill but for the carers and family members who look after them.

Current social care charging arrangements can be difficult to navigate. Rules around free personal care can cause confusion, particularly where they relate to the eligibility criteria and what qualifies as free personal care, which varies across the country. For example, personal care can cover personal hygiene but not laundry.

Not just the charges but the systems that are behind them create issues for people. That is why we need the large-scale reform that the national care service will deliver. The independent review of adult social care found that charging for services and the support that is needed presents major issues for many people, as it reduces their income and limits their options and their control over what they want to do with the support that is put in place.

That is why the Greens and the Scottish Government have committed to the abolition of non-residential social care charges as part of a national care service that is built on human rights and lived experience. We are working towards that as a priority and the policy will be implemented during this parliamentary session. I am confident that if it can be done more quickly, it will be.

I welcome the commitment from West Dunbartonshire Council. We in this Parliament often talk about sharing best practice. We heard this afternoon from members such as Gillian Martin and Ruth Maguire about other things that councils are doing to help with the cost of living crisis. I hope that all those measures, including the approach of West Dunbartonshire Council, are being shared, via COSLA, to ensure that councils share best practice and ideas that benefit their constituents.

The Scottish Greens remain committed to the ending of non-residential social care charges. We will work with the Scottish Government to bring the measure forward as soon as possible.

We have touched on various factors that might have stigma attached to them. In what ways, if any, do current working practices in health and other public services entrench stigma? Further to what you have said, what work needs to be done to address that at the heart of the services that we are talking about?

Good morning to the panel. To what extent are health services trauma informed? What improvements need to be made in that area? How do we ensure that all public services take a trauma-informed approach?

I thank Bob Doris for bringing the debate to the Parliament. Last year, I spoke in his members’ business debate on MND awareness day, and I recognise his efforts to raise awareness of the condition.

As members have said, MND is a rapidly progressing condition and the average life expectancy is just 18 months from diagnosis. Diagnosis of MND can be devastating for people—and for their families, who have to come to terms with the fact that their loved one might lose the ability to walk, talk, eat, drink or breathe unaided, sometimes in a very short timeframe.

According to MND Scotland, most people will need adaptations to their home, such as hand rails, ramps and wet rooms. If such adaptations cannot be made, the person might need to move into another, more accessible home. However, as we heard, there are major issues with the availability of accessible housing. According to Inclusion Scotland, many disabled people do not live in a home that meets their needs, and 86,000 households that include a disabled person need an adaptation but do not have one.

For people with MND, waiting lists are often longer than life expectancy, which means that they spend the time that they have left with their family and friends fighting for accessible housing that meets their needs. Unfortunately, some people die before they get such housing.

In its report “No time to lose”, MND Scotland has emphasised the importance of early intervention. Too often, local authorities fit adaptations reactively. People are asked not to apply until they need them and are then faced with a long waiting list. The report suggests that adaptations that a person with MND will need, such as wet rooms, ramps and hand rails, could form part of forward planning from the point of diagnosis.

Although there is evidence of good practice in some local authorities, the current postcode lottery is such that some people are told that they are asking for adaptations too soon. Given the rapidly progressing nature of MND, there should be no such thing as “too soon”. MND Scotland is calling for improved understanding of the condition among people who work in local authorities. Poor understanding can mean that people with MND miss out on support to which they are entitled and can be traumatised by the experience of having to explain their condition over and over again to multiple key workers.

When good practice takes place, that is often because an individual practitioner, such as an occupational therapist, has a good understanding of the condition and how it progresses, and they have pushed for adaptations to be installed more quickly. The report found that some key workers, including occupational therapists, are doing great work in that regard and are excellent advocates for their patients. Increased awareness and understanding of MND will mean that more patients receive such levels of support.

Where adaptations cannot be made, people with MND might have to move to other accommodation. Leaving one’s home can be a stressful, emotional time, and we need to support people through the process when it is necessary.

MND Scotland’s report highlights that applying for an accessible home is often an arduous and time-consuming process. MND Scotland said:

“people are left spending time and energy fighting for homes that meet their accessibility needs and requirements. For many bereaved family members and carers, this meant there was less time spent with the person diagnosed. Instead, navigating forms and arguing for needs took up time that they did not have and took time away from doing things together and making memories.”

Support for people with MND who are applying for adaptations or new accommodation must be greatly improved. Processes should be streamlined, where possible, and people with MND and their families should be supported by well-informed key workers who appreciate the rapidly progressing nature of the condition. That will help people to spend the time that they have left with their loved ones rather than fighting for housing that meets their needs.