I thank Martin Whitfield for that helpful clarification.

I would also be interested to hear about the timescales for notifying the Presiding Officer of the need for a proxy. Obviously, bereavements, caring responsibilities and parental responsibilities can happen suddenly and are outwith members’ control, so I hope that the process will be responsive and adaptable to members’ needs, while respecting the need to give clerks time to get a proxy in place.

I welcome, in paragraph 36 of the report, the flexibility around allowing members to participate in chamber business

“for a period of time when the proxy is in place”.

Something akin to a phased return and participating in some but not all business would be beneficial to members who have been off with a long-term illness.

I welcome the report and the piloting of the proxy voting system, and I look forward to the outcomes of the pilot. I again thank the SPPA Committee for its work.

I thank Paul O’Kane for bringing this important members’ business debate to the chamber. I also thank carers up and down the country for all the work that they do in looking after their loved ones.

At some point in our lives, any one of us might have to provide care. We have heard at the cross-party group on carers that getting people to see themselves as carers in the first place is difficult in itself. I take the opportunity to shamelessly plug the good work of the CPG—we have a meeting tomorrow lunchtime for anyone who is interested.

Many members who are in the chamber know that I did not see myself as my grandpa’s carer. Like many other people, I believed that I was just doing what was done. We cannot get people to use the support that exists if we do not identify the people who need support in the first place.

Representation and parity are important parts of Paul O’Kane’s motion. It is key that carers be seen as key partners in the support of the person for whom they care rather than the last stop in the chain. Carers’ input is vital and can often provide an insight that gives a view of the whole person and their needs. We need to support carers to be involved in decision making and anticipatory care planning. Support is key to that. We hear that many carers are focused on getting from one end of the day to the other rather than on how to engage and further their to-do list.

I share other members’ concerns on the stark findings in the “State of Caring 2022” report. As noted in the motion, the report, produced by Carers Scotland,

“found that 40% of carers on carers allowance are cutting back on food and heat to make ends meet”.

The human aspect of that is stark and concerning. We are in a uniquely difficult situation with inflation now spiralling out of control. The direct results of the Conservative UK Government’s economic policies are hitting the most vulnerable the hardest and, through more austerity, stifling the devolved Parliament’s ability to mitigate that disaster.

The findings provide a stark reminder that we cannot be complacent about the progress that we have made. There is always more to do and the progress that we have made can so easily be rolled back.

It is important to note the distinction between paid and unpaid carers as we have these discussions. Although both provide vital care services, the circumstances in which paid and unpaid carers operate are starkly different. According to the “State of Caring 2022”, there are:

“approximately 800,000 people in Scotland who provide unpaid care”

and support to family and friends affected by disability, ill health or frailty associated with older age.

Carers save the economy in Scotland some £10.9 billion each year. The contribution of people who provide unpaid care in Scotland is massive. I welcome the support that the Scottish Government offers to unpaid carers through the Carers (Scotland) Act 2016 and the support that is available online, such as the carers charter and advice on carers benefits and local carers centres, about which we have heard from many different people.

The report also points out that nearly two thirds of carers say that financial worries are having an impact on their physical and mental health. For those on lower incomes, the impact was even greater: 73 per cent of carers on carers allowance and 84 per cent of carers with a household income of £1,000 a month or less said that the cost of living was having a negative impact on their health.

We need to provide the highest possible support for carers’ financial, physical and mental wellbeing. When people have to choose between heating and eating, we are not giving them the best chance of success.

I reiterate my deepest thanks for doing what they do to the people across the country who provide care. The Scottish Greens and I recognise the hard work that that takes—we would be lost without them.

What challenges currently face social care users and carers when making complaints, and how could those challenges be addressed by the bill? Are there any ways in which you would like the complaints handling provisions of the bill to be altered and/or strengthened and, if so, for what reasons? I see that Mhairi Wylie is nodding, so I ask her to answer first.

Yes.

I will follow that up. How do we ensure that the complaints process is transparent and accessible for everyone? Clare Gallagher summed things up very well. Due to the number of different providers and where, when and through whom you can complain to those different providers, there is a complete spider’s web of issues, especially for service users whose first language is not English or who have other access issues. How can we ensure that any national-level process takes account of geographic variability and who the providers are, as well as access issues, to ensure that the complaints system is fit for purpose? How can we ensure that information about how to access and navigate through the process is well advertised, so that someone who does not want to take up independent advocacy or who does not have someone to advocate for them can still navigate it in their own way and in their own time?

That is great.

Dr Nolan, what are the key considerations for you in the development of a model complaints system for the proposed national care service? For the service users that you support, what do you see as the biggest barriers in a nationally structured model of complaints handling?

Thank you.

I think that you have covered most of it. I asked what the key considerations are for you in the development of a model complaints system. What pitfalls must we look out for, particularly when we are considering service users?

My first question is for Rhona Willder. Should a single organisation such as Citizens Advice Scotland be appointed to provide or co-ordinate the provision of advocacy, or do you see that happening in a different way under the bill?

I begin by expressing my condolences to everyone who has lost someone they love to AIDS. I also give my thanks to all the activists who have led, and who continue to lead, the fight for better treatment, diagnosis and understanding of HIV and AIDS. We would not be where we are today without their efforts, which have often been made at great personal cost.

Huge medical advancements have been made in the decades since HIV was first discovered, and it is now a very treatable disease. However, access to diagnosis and treatment is still not equitable, both globally and in Scotland. Inequality drives risk and creates barriers to diagnosis and treatment across the world—70 per cent of new HIV infections are among people who are marginalised and often criminalised. According to the World Health Organization, division, disparity and disregard for human rights are among the failures that have allowed HIV to become, and remain, a global health crisis. We cannot make those same mistakes.

We can end HIV transmission only by scaling up HIV services, removing structural barriers and tackling stigma and discrimination worldwide. Those structural barriers are evident in Scotland. For example, the current HIV outbreak in Glasgow is closely linked to widening health and social inequalities—including those relating to poverty and deprivation—faced by people who inject drugs. Analysis by Public Health Scotland found that none of the deaths associated with the outbreak was from an AIDS-related illness. However, people who inject drugs face a range of inequalities that increase their risk of HIV infection and their rate of mortality, such as homelessness and poor access to healthcare. Those factors interact in complex ways, presenting significant barriers that prevent people from staying well.

The Scottish Greens believe that action to address underlying health inequalities will help to reduce the number of drug-related deaths as well as related harms such as HIV infection. Alongside tackling underlying inequalities, we need to ensure that it is as easy as possible to test for HIV. Vulnerable people who might be at increased risk can be labelled as difficult to reach, but, in reality, testing is not always accessible.

Early diagnosis is crucial to ensuring that people with HIV can live the healthiest lives possible. However, according to the most recent statistics from Waverley Care, three out of every 10 HIV cases are being diagnosed late. Waverley Care’s analysis states that access to HIV testing can be impacted by structural barriers such as lack of capacity, time constraints, lack of knowledge about how to obtain a test, low perceived risk of HIV infection, fear of a positive test result and issues relating to disclosure.