Chamber and committees

To ask the Scottish Government what steps it is taking to make homes easier to keep warm, in light of the need to tackle the reported cost of living crisis. (S6O-00999)

Does the minister agree that there is a stark contrast between the UK Government’s approach to energy policy, which places all its bets on expanding nuclear power and squeezing out even more oil and gas while neglecting the much quicker and more significant impact that investing in energy efficiency can bring, and that of the Scottish Government, which is seeking to do everything that it can to ease energy costs for hard-pressed households?

I, too, thank David Torrance for securing the debate.

Multiple sclerosis is a lifelong disease that is estimated to affect 2.8 million people across the globe and more than 15,000 people in Scotland. The experience of living with MS is not always limited to having MS, as additional complications can come with the disease. They can be wide ranging and include bladder and bowel issues, paralysis and alterations to people’s mental state, including symptoms such as forgetfulness, depression and even epilepsy.

The theme of this year’s MS awareness week is uncertainty. I asked a very dear friend of mine if she would mind writing something about her experience of MS. She is a wonderful woman who will support anyone who needs it and never complains about how she is feeling. This is absolutely reflected in her thoughts, which I am pleased to be able to share in her words today. She says:

“Indeed, the biggest issue with MS is the uncertainty of everything. It usually takes years to get a proper diagnosis due to the fact that you would normally experience symptoms over time, which, on their own would never point to MS. Its only when you start experiencing several symptoms together that you tend to get an MRI scan. Sometimes, that can be inconclusive but in my case, the scarring was easily visible.

When you are first told that you have MS, it’s quite a devastating blow because there are no doctors or neurologists who can give you a roadmap of what you will experience. Every single person will experience something different and quite often have different symptoms at the onset. It’s difficult to come to terms with the fact that you have no guarantee on how quickly it may progress.

When I was first diagnosed, I was told that I had remitting/relapsing MS. In my mind, it was a case of seeing how long I was going to get between episodes. Each time, you relapse, it’s

1. the uncertainty of how long it will last

2. as each week goes by, you know that there is less chance of regaining all the functionality that you had before the episode

3. In the earlier episodes, I was able to see an improvement after a few weeks & then as the years went on, the symptoms of the relapse would linger for months.

It got to the stage where, after a relapse, I never had any improvement & I have now been diagnosed with secondary progressive MS.

I feel incredibly lucky because I am still able to walk and can manage to still look after myself but I find it difficult to plan things due to the uncertainty of the disease. I can feel reasonable one day & the next, I am in so much pain that I am unable to do anything. My sister had MS & she ended up in a wheelchair very quickly, so that’s another reason to feel lucky.”

I put on record again my thanks to my friend for giving me her comments.

Just two decades ago, there were no treatments available for those who had MS. However, thanks to all those involved in the MS community, the NHS, charities and dedicated researchers, 17 disease-modifying therapies have now been approved in Scotland to treat MS at various stages. Those range from treatments that address the severity and frequency of MS relapses in those who are living with relapsing-remitting MS to—more recently—treatments that have now been green-lit to address secondary progressive MS, which we have heard about tonight.

Even before the pandemic, the MS Society estimated that those living with MS faced costs of an additional £600 to £1,000 per month to access essential goods and services. For example, additional electricity is required to power assistive technologies and higher heating bills result from the need to stay warm. Those who are living with an underlying and persistent health condition such as MS face living costs amounting to, on average, the equivalent of half their income.

I thank the MS Society Scotland for its incredible work in supporting those who live with MS, for its work to fund research and for representing the MS community across the political sphere and wider society. As parliamentarians, we must tackle these very prevalent challenges, especially the cost of living crisis and the impact of the Covid pandemic, and ensure that MS sufferers are provided with the support they need to have the best quality of life.

Antimicrobial resistance is a global concern and my speech will focus largely on the global situation. AMR threatens our ability to treat common infections and could lead to the rapid spread of so-called superbugs, which cause infections that are not treatable with existing antibiotics. According to a report that was published in January on the global burden of bacterial antimicrobial resistance, an estimated 4.95 million deaths were associated with such resistance in 2019, including 1.27 million deaths that were directly attributable to bacterial AMR.

The World Health Organization has warned that not enough new antimicrobials are being developed and that a lack of access to quality antimicrobials remains a major issue. Antibiotic shortages are affecting countries and healthcare systems all over the world. The UK Government’s five-year strategy states:

“Antimicrobials are crucial medicines in modern healthcare, yet up to two billion people still lack access to them.”

For most antimicrobials, few replacements or alternatives are being developed. According to the UK Government,

“Research and development of the vaccines, diagnostics, tools and tests needed to prevent infections is similarly lacking.”

The WHO has highlighted that greater innovation and investment are required in the research and development of new antimicrobial medicines, vaccines and diagnostic tools. The UK Government must provide greater support for that as a priority.

The cost of antimicrobial resistance to both healthcare systems and patient care is significant as it means prolonged hospital stays and more expensive and intensive care.

If we do not tackle AMR, more people will be pushed into poverty. Although it is true that AMR is a global problem that affects all countries regardless of borders, it does not affect all countries equally. Studies have shown that the burden is disproportionately higher in low and middle-income countries. We therefore have a responsibility to act.

High rates of resistance to antibiotics that are often used to treat common bacterial infections have been observed globally, and they indicate that we are running out of effective antibiotics. A well-known example of a bacterium that is resistant to a number of antibiotics is MRSA, which has caused infections around the world that are difficult to treat.

As we have heard, antibiotic resistance is not purely a health issue. Evidence and research papers continue to be published on the implications of routine antibiotic use in farming, which can expose people to antibiotic-resistant micro-organisms through contaminated food or water. Although routine antibiotic use is less prevalent in Scotland, we should keep it in mind when scrutinising trade deals that the UK Government is seeking post Brexit.

That is also not confined only to terrestrial farming practices. Globally, aquaculture is an increasing contributor to antibiotic use. According to an article in the journal Nature by Schar et al, global antimicrobial consumption in aquaculture was estimated at 10,259 tonnes in 2017.

While antimicrobial use in Europe is likely to reduce by 2030, in Africa, for example, it is likely to increase. We need to ensure that sufficient protein sources can be produced in developing nations to meet nutritional needs, while tackling the global issue of antimicrobial resistance. That makes it a social justice issue, as well as a health one.

Releasing antibiotics or their metabolites into the environment could increase the emergence of antibiotic genes. That release could be from hospitals or agricultural run-off, for example, and could enter the food chain or water system. Antibiotic resistant organisms can also follow the same path. Another paper by Schar et al, published in Nature in 2020 says that those types of environments become likely hotspots for the development of new antibiotic resistant genes. Humans come into contact with resistant micro-organisms through numerous routes, including the consumption of contaminated foods, interactions with animals and in contaminated environments. Ensuring that we minimise antibiotic use and explore other therapeutic avenues will, I hope, reduce the instances of those interactions.

Antiviral drug resistance is also an increasing concern among immunocompromised patients, as resistance has developed to most antivirals. Without the tools to prevent and treat drug-resistant infections, more treatments will fail and medical procedures will become more risky. While new antimicrobials are needed now, if the way that we currently use antibiotics is not changed, then they will suffer the same fate as existing ones. Antibiotics have saved millions of lives since they were first invented. We must act now to ensure that treatment with antibiotics remains effective, now and for generations to come.

Given the extent of subcontracting in construction, has the Scottish Government considered mechanisms to go further in ensuring that fair work criteria are implemented throughout the construction supply chain and not just for those who are employed directly in public procurement?

To ask the Scottish Government what steps it is taking to implement the Fair Work Convention’s recommendations on building fair work into the construction industry. (S6O-00967)

Good morning and welcome. I am sorry that I cannot be with you in person today.

Audit Scotland previously recommended that data on waiting times based on the categories in the clinical prioritisation framework should be published. However, that has not yet happened. To what extent is there transparency regarding how long patients will be expected to wait and how they are prioritised?

We sometimes hear from constituents that they are placed on a list but then hear nothing more about when they will be seen or how they will be prioritised, which obviously impacts on a patient’s experience of the system as a whole.

I will follow up on what my colleagues have been asking about and on what was said earlier about data. I have spoken to a couple of stakeholders about the climate impact of medicines. In your opinion, do we have sufficient data to be able to assess any climate impacts of changes in medication and how we prescribe medication? I am thinking about asthma inhalers in particular. The powder ones are infinitely better for the planet than the more traditional ones are. Do we have the data that we would need to assess the impacts of moving away from, for example, the more harmful types of asthma inhalers?

The report notes that data on primary care needs to be improved. For example, it says:

“Data on the number of GP appointments carried out is not available”.

How important is it that that data is collected and what impact would that have on how services are planned?

This morning at the Levelling Up, Housing and Communities Committee in the House of Commons, Lord Harrington, the Minister of State for Refugees, said that he had previously inadvertently given the wrong information on the £10,500 per person tariff that local authorities would receive to support refugees from Ukraine who are settling in our communities. He clarified that the funding would now only be available based on the number of people coming through the homes for Ukraine scheme and not anyone settling through the Ukraine family scheme. Does the minister agree that such a lack of parity for people who are fleeing the same war is unacceptable?