Chamber and committees

The true extent of the impact of long Covid is still unknown, and it may remain so for some time. As we have heard, it has been estimated that around 100,000 people are living with long Covid in Scotland. However, that figure does not adequately capture the devastating impact of the condition on many of those affected. Long Covid can have a significant impact on the quality of life, and its effects range from fatigue and shortness of breath to brain fog, chest pain, sleep disturbance and other symptoms that we are still discovering. The variation of those symptoms means that people have had to fight for diagnosis and treatment.

In its briefing for the debate, the Royal College of Physicians of Edinburgh highlighted that there is still no internationally agreed clinical definition or clear treatment pathway for long Covid and the evidence base for the condition is still developing. That presents a significant challenge for health services, and long Covid requires concerted, co-ordinated efforts to treat.

We must not underestimate the pressure that that will place on health services. Forward planning is essential. We should prioritise further research into long Covid, and I welcome the Government’s commitment to that. Such research must include the effects on children and young people and should be intersectional, as there is already evidence that certain groups are disproportionately affected by long Covid. Organisations such as the Health and Social Care Alliance and Long Covid Scotland have called for improved data collection on long Covid, so that we know exactly how many people have the condition, how they are being affected and who is most at risk.

Accurate, reliable data will enable us to design services that will properly meet the needs of people with long Covid, many of whom will require long-term care. Data published in The Lancet shows that 43.5 per cent of people had at least one complication after having acute Covid. Supporting people to self-manage their symptoms where that is appropriate is essential. A number of organisations have highlighted the need for patients as well as health and social care staff to be informed about how to find support if symptoms present.

In short, we need to ensure that people know what symptoms to look out for and where to go for help when they need it. I call on the Scottish Government to do all that it can to raise awareness in that regard.

We also need to raise awareness of the disproportionate impact of long Covid on certain groups of people. We know that the pandemic has not affected everyone equally. The most recent Office for National Statistics data release shows that long Covid is more prevalent among women, despite the fact that acute cases of Covid tend to be in men over the age of 50. Close the Gap has highlighted that women are more likely to be in occupations where there is an increased risk of developing long Covid, such as healthcare and education. Their concentration in low-paid, precarious work also makes them more likely to miss out on statutory sick pay.

There are wider impacts on people’s employment. A recent survey conducted by Long Covid Scotland of people’s experiences in employment revealed that 52 per cent of respondents were unable to return to work, and 72 per cent reported that their current work patterns were unsustainable.

I echo calls made by the Trades Union Congress and Close the Gap for the UK Government to urgently recognise long Covid as a disability under the Equality Act 2010 so that employers cannot legally discriminate against workers who have it. Those workers would then be entitled to adjustments to remove, reduce or prevent any disadvantages that they might face. No one who is experiencing long Covid should be denied reasonable adjustments at work.

We need to take a holistic view of how people have been impacted by long Covid and provide wraparound support. People have been physically affected, and that may have knock-on effects on their employment, housing and education as well as their mental health and their need to access health and social care.

In its briefing for the debate, the alliance rightly highlighted the impact of long Covid on mental health. Physical symptoms combined with potential issues around employment, financial worries and struggles to gain access to treatment will all take their toll on people’s emotional and mental wellbeing; studies have already demonstrated that. It is therefore essential that mental health support is considered alongside any treatment for physical symptoms.

Long Covid is a new condition and research into its effects is still in its infancy. It is therefore vital that we allow clinicians the time that they need to undertake their own learning. We all know the extraordinary pressure that health services are under at the moment and the huge demands that are being made on clinicians’ time, but clinicians must have protected learning time to ensure that they can deliver the best care to their patients.

Primary care will play a vital role in the identification of long Covid, and I am aware that the Royal College of General Practitioners has long been calling for protected learning time to be built into the working week of GPs. Given that this is a new condition, it is vital that we listen to the people who have long Covid. Unfortunately, many report having to fight for their voice to be heard or for their symptoms to be recognised.

We need to take a person-centred, rights-based approach that enables people with long Covid to feed into and shape the design of support services. I was glad to hear some of those points reflected in the cabinet secretary’s speech. I would welcome any further comments on how the Government plans to engage with people and reflect lived experience.

The impact of the pandemic will still be felt for generations to come, not least by those with long Covid. Any recovery plans must include support and care for people with long Covid, to be provided now and for as long as they need it in the future.

As many others have done, I thank all social care workers and unpaid care workers for everything that they do.

As the co-convener of the cross-party group on carers, I will focus on the impact of the cost of living crisis on unpaid carers. At CPG meetings, I have heard at first hand how unpaid carers and those whom they care for have been affected. Many have been experiencing rising costs against the backdrop of a global pandemic, during which they have been worried about the effect on Covid-19 on their loved ones, while also coping with the impact on their own mental and physical health of taking on more care.

As we know, Covid resulted in some people’s care packages being reduced or withdrawn, and it often fell to unpaid carers to fill the gaps. Research published in 2020 showed that an estimated 392,000 additional people in Scotland have become unpaid carers as a result of the pandemic, bringing the total number of carers in Scotland to around 1.1 million.

The cost of living crisis has a disproportionate impact on unpaid carers, many of whom face significant financial hardship because of their caring role. Research recently published by Carers Scotland revealed that 92 per cent of carers surveyed had seen their energy bills increase, and two thirds were already cutting back on heating.

There may be additional costs associated with caring. Carers often find themselves paying for items to keep the people they care for well and safe, such as personal protective equipment and cleaning supplies. According to the Carers Scotland report, those costs have risen in the past six months.

There may also be additional energy costs associated with running electrical equipment if the person who is being cared for has mobility issues, because they may spend more time at home and therefore have higher energy consumption. That also applies to people who are receiving palliative care at home. Recent Marie Curie and Loughborough University research highlighted that the double burden of income loss and increased costs of living that are brought on by a terminal illness, such as higher energy bills and home adaptation costs, can leave people struggling to make ends meet.

All those factors must be taken into account when we consider the impacts of the cost of living crisis on carers and the level of support that is required.

Contrary to the advice that was recently offered by a certain UK minister, people, especially carers, cannot simply work more hours or move to a better-paid job to offset rising costs. Caring, which is often a full-time job in itself, impacts on unpaid carers’ ability to take up paid employment. According to Carers Scotland, six in 10 of those who care for 35 hours or more a week are not in paid employment.

I fully support the call in the Government amendment for the UK Government to take forward an emergency budget to address the cost of living crisis and increasing fuel costs, including the impact on unpaid carers. We need to see action on that now, because people are struggling and have been for some time.

I do not have time; I am sorry.

Carers Scotland warned that, as well as the financial impact, the cost of living crisis is having an increasing impact on carers’ mental and physical health, with 80 per cent reporting that they feel stressed, anxious and worried about the steps that they would need to take to manage their current finances.

The greatest impact is often felt by full-time carers. We must deliver the right for unpaid carers to take breaks from caring as part of the national care service as a matter of urgency, and we must make sure that those breaks address the multitude of caring responsibilities that some people have.

I look forward to the publication of the Scottish Government’s carers strategy, and sincerely hope that it will set out clear actions that can be taken to improve support for unpaid carers across Scotland. Unpaid carers should be recognised as equal partners in care; our social care system would collapse without them, and the support that they provide is worth more than £10.9 billion to the Scottish economy each year. It is vital that we recognise that. We thank them for their efforts, but they need more than warm words and applause; they need action on the cost of living crisis and improved support that helps them to care for their own mental and physical health as well as that of the people for whom they care.

The Genetically Modified Food and Feed (Authorisations) (Scotland) Regulations 2022 authorise nine GM food and feed products, making them available for consumption in Scotland. The Scottish Greens have long-standing concerns about the environmental impact of genetically modified crops, which are not properly addressed in the regulations. Our concern is that our status as a GM-free country will be eroded by the decision.

I also note our strong concern about the constitutional implications of the regulations and, indeed, other decisions about GM products. Scotland should have the power to make the decisions that it sees fit to protect the environment and the public. However, the reality is that it does not matter what decision we make about the regulations or any future authorisations for GM food or feed. Even if we were to withhold authorisation, that would have no material impact, because the UK has already allowed access to such products and, as a result of the United Kingdom Internal Market Act 2020, the Scottish Parliament cannot choose a different path.

Good morning, minister. One of the criticisms of the public consultation on the NCS was that there needs to be more public engagement and more involvement from clients and other people who access care and support. We have touched on the matter a lot already this morning, but what is your response to that, and what work is being done to ensure that more people are involved during the consultation and implementation processes?

Another issue that was raised by respondents to the consultation was that the paper focused on organisational restructuring and did not focus as much on the transformative cultural change that is needed, which would prioritise person-centred services. What is your response, and how will you ensure that structural change is matched by the cultural change that is needed?

I apologise to members for the fact that I will be absent from the chamber during closing speeches. I am stepping in to give this speech on behalf of another member who is unwell, and I have another engagement during the closing speeches. I will return as quickly as possible, and I thank the Presiding Officer for her tolerance.

The process of passing two pieces of emergency legislation at the height of the first phase of the pandemic, and before remote participation arrangements had been made, was a difficult one for the Parliament, but it was one that I believe showed us in our best light: responding to a crisis—in general, collegiately and with common purpose.

However, the coronavirus acts that were passed did not get everything right. One of the key questions that we are presented with today is whether we want to leave ourselves in the position of needing to go through that process again. Do we want to delay potentially life-saving and self-evidently obvious actions even for a matter of days, if we are again hit by a pandemic that is unlike anything that has been experienced in living memory? Alternatively, should we consolidate what we have learned from our experience of Covid so that the necessary powers are available, in the event that they are needed?

I welcome the Deputy First Minister’s commitment to introduce a gateway section, which is something that the Greens were keen to see to address perfectly valid concerns about the primacy of Parliament over Government. In the previous session, the Greens amended the UK Withdrawal from the European Union (Legal Continuity) (Scotland) Bill, with amendments that were designed to provide appropriate limits and safeguards on the Henry VIII powers that were being afforded to the Government through that process. I am glad to see similar restraint being shown now, without it unduly interfering with the Government’s ability to fulfil its obligations to the public during a future health crisis.

Beyond the powers that are specific to the circumstances of a public health emergency, we can all recognise that some of the changes that were introduced in the two coronavirus acts simply made sense and should probably have been the case all along.

The most obvious example of that is that processes that previously had to be completed in person and by using hard-copy papers can now be done digitally. If we are committed to delivery of efficient, effective and easily accessed public services, a return to the pre-pandemic situation in that respect would clearly be a retrograde step. Those provisions will be of particular benefit to people in more rural communities, for whom the reality of travelling to a council office to register a relative’s death is quite different to that of urban residents.

It is important to highlight that that is not an either/or situation. The Association of Registrars of Scotland was right to point out that, for some people, the opportunity to complete such a process in person is important, whether for personal reasons, because of lack of digital access or some other circumstance. It is not permission for councils to move some services entirely online.

During the two emergency bill processes, Green MSPs put considerable effort into provisions on housing—specifically, protection of tenants, including those in purpose-built student accommodation. Since then, we have joined the Government on the basis of an agreement that includes our proposal for a new deal for tenants, which is now being taken forward by Patrick Harvie in his role as the minister who has responsibility for tenants’ rights.

We felt that it was far too easy before the pandemic for landlords to evict tenants; it is still too easy now. The protections that were brought in in 2020 made a real difference to many people who were at risk of losing their homes. There is no good reason for going back to where we were before—a system in which all the cards were stacked in favour of landlords.

A number of other progressive provisions that were first introduced in the context of the emergency are now, appropriately, being extended. Those include the bankruptcy protections that were—if I remember correctly—first pushed for by Jackie Baillie.

The duty on providers of purpose-built student accommodation to take account of the chief medical officer’s advice should avoid any repeat of the scenes that we saw at the Murano Street student village in Glasgow, and elsewhere, in autumn 2020. There are other provisions that I am glad to see being included, but do not have time to cover now.

The bill takes a pragmatic approach to maintaining the improvements that were brought about as a result of our response to the pandemic. It gives the Government the powers that it would need in the event of another such crisis, and the amendments that have been confirmed today will strike the appropriate balance between parliamentary oversight and Executive action. For those reasons, the Greens will support the bill.

I, too, thank Jackie Baillie for securing this important debate.

It has become almost clichéd to acknowledge the impact that the pandemic has had on our public services and the country more widely, but nowhere are the impacts of Covid-19 more evident than in the toll that it has taken on our health and care system over the past few years. When the pandemic was at its most precarious and most of us were asked to stay at home to protect ourselves, our loved ones and the NHS, and no vaccines or recognised therapeutics had yet been developed, our nurses and healthcare workers were on the front line, risking their health and wellbeing to ensure that the many thousands of those who were hospitalised with Covid and, indeed, with other illnesses, were treated in the most challenging of circumstances.

I thank nurses at Forth Valley royal hospital for the support that my loved ones received over the pandemic. Without the nurses in the stroke ward, mum would not have been able to have those few phone calls with us, and without the phenomenal district nurses in Grangemouth, grandpa probably would have ended up in hospital far earlier than he did. Nursing staff allowed us to stay with mum for as long as we needed, making sure that we had what we needed. Our story is not unique; people’s experiences of those who went above and beyond—from school nurses to intensive care unit nurses—are repeated across the country.

Although it is only fair to recognise nurses for all the great work that they do, we must also recognise the circumstances in which nurses find themselves now. NHS workforce vacancy statistics that were published in March show the continued trend of rising vacancies, emphasising the need to refocus on retaining and recruiting staff.

NHS Lanarkshire alone is experiencing a high vacancy rate of 10 per cent of available posts. The Royal College of Nursing Scotland has also relayed that, according to its workforce survey, 61 per cent of nursing staff are thinking about leaving their current posts. Those numerical factors alone underline the need for support to ensure that those within the profession are supported to continue in their roles.

The NHS in Scotland continues to be under significant strain as we begin to emerge from the worst of the pandemic, and it is necessary to ensure that existing staff are retained and that recruitment is significantly stepped up to fill vacancies.

Workforce planning remains central to providing long-term, effective healthcare, and the Scottish Government must consider its approach in the light of those recent publications. After all the NHS has done for us over the past two years of the pandemic, it is vital that we build back a system in which nurses feel valued and in which their safety and wellbeing are a priority.

Although I am proud of some of the measures that my party has helped to deliver over the past few years, such as creating a legal duty on the Scottish Government to ensure that there are appropriate NHS staffing levels, I join the RCN’s calls on the Government to implement the Health and Care (Staffing) (Scotland) Act 2019. I hope that the cabinet secretary might be able to lay out a timetable for that.

The Scottish Greens have also helped to ensure that all nurses have the legal right to funded continuous professional development. We still have great strides to make to ensure that nursing is a long-term occupation for those who enter the profession. Those are tangible steps towards progress.

It also merits mention that nursing is not a singular block of professionals—they are people who are split across various and specialised areas. Mental health needs across Scotland and the historical lack of recognition of them have become much more focused in the public eye as a result of the pandemic. Successive lockdowns, although necessary for public health, exacerbated existing mental health conditions, and continuity for those receiving treatment is essential. A recovery response to the growth and acknowledgement of mental health conditions caused by Covid-19 needs to take a holistic approach that addresses the wider social, systemic and structural inequalities of health and wider society, rather than placing the onus entirely on the individual.

In closing, I point out that international nurses day is about celebrating all that nurses do and thanking them for everything that they do. I thank nurses for all that they have done for my family—and, I am sure, for the families of countless others in this chamber—and for going above and beyond to deliver for constituents in my Central Scotland region. I thank them for all the enduring support that they provide.

As we have heard, the First Minister will be aware of the loud protest outside the Sandyford clinic in Glasgow yesterday. Not only do such protests intimidate many of the people who use those services, but clinicians have contacted me to say that the protest forced the clinic to close particular rooms on one side of the building, due to the amplification system that the protesters were using. As part of the summit that the First Minister has just committed to, will she ensure that clinical and trade union representatives are present, as well as patients’ representatives, to ensure that clinicians are not subject to harassment when they are simply doing their jobs?

What will the strategy do to improve data on health inequalities? We have heard in other pieces of work issues around data specifically relating to different minority ethnic groups for example. I am quite keen that we continue to work on that area to ensure that everybody’s healthcare matches the reality of their lives.