Chamber and committees

For some people, face coverings are an inconvenience but, for others, they make the difference between being able to go about their lives safely and contracting a serious illness. Face coverings reduce risk, and they provide an extra layer of protection to people who are vulnerable to the virus, many of whom will be concerned about the decision to convert the legal requirement into guidance.

Has the Scottish Government consulted disabled people’s organisations about the impact that that decision will have on people who are clinically vulnerable?

The pandemic has been an extremely difficult time for many care-experienced people and their families and wider support networks. According to the Promise’s “Change Programme ONE” report:

“it was the children and families the current ‘care system’ doesn’t work for, who faced some of the greatest challenges.”

The pandemic has exacerbated the effects of poverty, trauma and poor mental health. People who were coping before have been left struggling. Change is needed now, more than ever.

It is also clear that the pandemic has placed enormous pressure on public services. Although progress towards implementing the Promise has been made, it has been slow and there is still far to go before we achieve transformative change.

Who Cares? Scotland says:

“Longstanding recommendations and commitments, including increasing the access to independent advocacy for Care Experienced children and young people, have not been fully realised and need addressed”.

I am sure that, for young people who are currently in the care system, change cannot come fast enough.

The Government needs to be clear in its commitment to change, so I welcome the update on progress and the publication of the implementation plan.

During the pandemic, resources in public services were redeployed and redirected. According to the Promise, there is a profound risk, over the coming year, that a consequence of Covid-19 will be that more decisions are taken that lead to children entering the care system, when, with support, families could stay together. We need to ensure that resources are directed towards prevention and supporting families to stay together.

There are other barriers to radical reform. The lack of accurate data on the number of people who experience care and the continuing stigma have both been cited as blocks to progress.

The Promise highlighted that Scotland collects data on the care system and its inputs, processes and outputs, rather than what matters—that is, the experiences and outcomes of the people who live in and around the system. I am pleased that the implementation plan acknowledges the need to collect data that captures the lived experiences, relationships and day-to-day lives of care-experienced people and their families and support networks.

We also need to capture the wishes and views of children and families. “Plan 21-24” set out “The Fundamentals” that need to be built into everything that organisations do to keep the Promise. Those fundamentals are: what matters to children and families; listening; poverty; children’s rights; and language.

The “Change Programme ONE” reports highlights, however, that,

“Whilst there is work underway on every Fundamental, there is a mismatched, inconsistent national and local picture”.

I would therefore welcome further detail from the minister about what action is being taken to ensure that the fundamentals are embedded in every aspect of implementation work.

Regarding stigma, the Promise has highlighted the fact that, for years, care-experienced children and adults have said that language needs to change so as to normalise their lives and shift away from professionalspeak, which is stigmatising for children and marks them out as different.

We need to create a culture change regarding how care is viewed and spoken about, as stigma is a significant barrier to families asking for help. I am pleased that the implementation plan commits to that culture change and to using destigmatising language at every opportunity. It also recognises that there needs to be a shift in wider public attitudes, and I look forward to further detail about the work being made available.

Before closing, I will focus on the national care service. Organisations such as Who Cares? Scotland have raised concerns about the setting up of the service further delaying implementation of the Promise. As such, large-scale public sector reform will leave services in a state of flux. We need to ensure that implementation remains a priority, and that the creation of the new national care service honours the contributions given by care-experienced people, their carers and families to the independent care review and honours the vows to keep the Promise.

Above all else, we must remember that behind the plans and targets are people, and that everything that we do has an impact on them. Care-experienced people deserve love and respect. They deserve to be safe and to have nurturing relationships built on patience, kindness and compassion. We must implement the Promise so that all Scotland’s children can realise their full potential.

6.

To ask the Scottish Government whether it will provide an update on its discussions with the United Kingdom Government to ensure that refugees arriving in Scotland from Ukraine have access to the resources that they need. (S6O-00939)

I thank Marie McNair for bringing the debate to the chamber. As the motion states,

“ovarian cancer is the sixth most common cancer faced by”

people with ovaries

“in the UK”.

It is important that we highlight the symptoms and causes of cancer, so that everyone knows what to look out for. That is particularly important for ovarian cancer. As we have heard, symptoms can be difficult to recognise, particularly in the early stages, because they are so often the same as symptoms of other conditions such as IBS. The earlier ovarian cancer is diagnosed, the better the outcome. When it is diagnosed at its earliest stage, 98 per cent of people with ovarian cancer survive the disease for one year or more, and 93 per cent survive for five years or more.

However, according to Ovarian Cancer Action, 90 per cent of women and people with ovaries cannot identify the main symptoms. Cancer is a worrying subject and can be difficult to talk about, but, in order to raise awareness, we need to have those difficult conversations. If someone we know is experiencing symptoms of ovarian cancer, they might not identify those symptoms as signs of cancer, or they might be worried about going to their GP when they are so busy. We all have a role to play in raising awareness of the symptoms and encouraging people to seek help when they experience them. Starting a conversation with someone about cancer can seem daunting, but it might save a life.

It is also important to raise awareness of risk factors so that people can determine their level of risk. Between 5 and 15 per cent of ovarian cancers are caused by an inherited gene. Someone whose mother or sister had ovarian cancer is about three times more at risk. The risk of ovarian cancer also increases with age, with most cases occurring in people with ovaries who are over 50 years of age. However, as Jackie Dunbar said, the cancer does not discriminate by age. Other risk factors include certain medical conditions such as endometriosis, and hormonal factors such as starting periods young or having a later menopause. I encourage anyone who has concerns to visit the NHS Inform website, where more information about risk factors can be found. The Macmillan Cancer Support website can also offer helpful information and advice.

It is worth noting that, unlike with cervical, bowel and breast cancers, there is still no reliable and effective screening method for ovarian cancer. That is why it is so important that people are aware of the signs and risk factors. GP practices are open and are seeing patients, so if you have persistent concerning symptoms, please seek medical advice. Ovarian Cancer Action recommends that people with concerning symptoms keep a record of what they are experiencing and have their notes to hand when they speak to a doctor.

As we have heard, the 62-day cancer referral standard is not currently being met by any health board, and performance against that standard has worsened since December 2020. That is concerning, and the pandemic has obviously had an impact. Staff are working extremely hard to work through the backlog, and we need to ensure that they have the support to continue to do so.

I am aware that the Scottish Government has set out plans to address workforce issues in the national workforce strategy and the NHS recovery plan, but we need to make sure that we retain staff across the NHS, particularly in nursing. We need to ensure that there is a joined-up, integrated workforce so that we do not simply move existing staff from one service to another.

Given that this is ovarian cancer awareness month, it is worth ending my speech by reiterating the main symptoms of ovarian cancer: increased abdominal size and persistent bloating; persistent pelvic and abdominal pain; and difficulty eating and feeling full quickly or feeling nauseous. If you experience those symptoms regularly, please make an appointment with your GP. Women’s pain is not always taken seriously, but you know your body better than anyone. If something does not feel right, please seek help.

Do you see any difficulty around enforcement if a 15m no-smoking zone encompasses areas that are not part of hospital grounds, such as public footpaths?

Thank you.

Good morning, cabinet secretary. Witnesses have told the committee that a culture change is needed with regard to social prescribing, because many patients are still not comfortable with the idea. Some organisations heard that people felt short-changed when they were redirected to links practitioners rather than a GP, and GPs also made the point that time constraints limited their ability to explain social prescribing to patients. What action is being taken at the national level to facilitate that sort of thing and to promote and explain social prescribing and its benefits to the public?

In a previous meeting, I asked witnesses about the inverse care law and how, as the system becomes more complicated to navigate, with people being expected to self-refer to different services, we mitigate the risk that those with lower levels of health literacy might become less likely to engage with health services. Witnesses highlighted that “targeted communication” is vital, in addition to

“detailed analysis of the data that is being collected on ... who is accessing different services directly instead of through GP referrals”.—[Official Report, Health, Social Care and Sport Committee, 8 March 2022; c 25.]

What action is the Scottish Government taking on that, and what plans are there to collect and analyse that data?

We know that, in urban areas, there are sometimes barriers to people attending different sites for appointments and so on. Could geographical variations in the provision of alternative pathways exacerbate inequalities, particularly for people in rural areas, where the distance between appointments might be significant?

In 2020, the Scottish Parliament passed the Scottish Elections (Franchise and Representation) Bill, which expanded the franchise and candidacy eligibility for local and Holyrood elections. The 2020 act expanded voting rights to everyone lawfully resident in Scotland, regardless of nationality and candidacy rights, and candidacy rights to everyone with indefinite leave to remain.

At the moment, only foreign nationals with indefinite leave to remain in Scotland have the right to stand as candidates in Scottish elections, whether for local government or for Holyrood. That includes EU nationals with settled or pre-settled status. However, the 2020 act did not confer candidacy rights on people with temporary forms of leave to remain. The Senedd made similar changes to the local government and Senedd franchise in 2020.

As things stand, EU nationals who are lawfully resident in England have retained their right to vote and to stand in local elections. Through the UK Elections Bill, which aims to remove voting and candidacy rights from EU citizens who arrived in the UK after 31 December 2020, the UK Government is hell-bent on restricting the franchise further. That leaves us where we are, with stage 1 of the Scottish Local Government Elections (Candidacy Rights of Foreign Nationals) Bill.

Following Brexit, the UK Government has already entered into treaties with Luxembourg, Poland, Portugal and Spain that confer reciprocal voting and candidacy rights for their nationals in the UK and UK nationals in those respective countries. That includes anyone with lawful residence, not just people with settled status, pre-settled status or indefinite leave to remain. In some cases, those treaties cannot be fully ratified until they are enshrined in law in England, Scotland, Wales and Northern Ireland.

The Scottish bill will ratify existing treaties to ensure that legislation across the four nations is consistent. It will result in an expansion of candidacy rights for local government elections to some EU nationals who are living in Scotland with limited leave to remain.

The Scottish Parliament does not currently have the right to confer legal residence or citizenship on people who live here, but we do have the power to make our electoral franchise as inclusive as possible. Therefore, the Scottish Greens would like to see us go further and ensure that candidacy rights mirror voting rights. If we want a residence-based franchise, that must extend to candidacy rights.

Ensuring that everyone who lives in Scotland has the ability to vote and to stand for election should be an aspiration that we all share. The bill is a step in the right direction, but it risks creating an unequal patchwork of candidacy rights that gives people from a select few countries enhanced rights compared with others. That is something that we should seek to fix.

Let us take refugees as an example. They are initially granted five years’ leave to remain and can then apply for indefinite leave to remain. People in that position cannot stand as a candidate purely because of the type of leave to remain that the Home Office has decided to grant them. We know that we need more diverse representation in elected positions. Our elected bodies at all levels should reflect the people whom they serve, and creating a truly residence-based franchise and candidacy eligibility is an important part of fixing the problem. Otherwise, we will be left in a situation in which people are potentially not able to represent their communities for two or more electoral cycles. We need more young people to stand for election, but the situation could deny young refugees such as those coming from Ukraine that ability for a long time.

The big question is whether it is fair and proportionate to exclude someone from standing for election just because the Home Office has given them a temporary visa. The Scottish Greens remain committed to pursuing electoral reform that enables more people to stand as candidates at Scottish Parliament and local government elections and we look forward to working with the minister and the Scottish Government to achieve that. However, although we would like to see future legislation go further, we will be supporting the bill at stage 1.