Chamber and committees

The public know that the NHS has been under extreme pressure for the past two years. As we hear more about the impact that that is having on staff, is there a risk that that will impact recruitment? How do we persuade people that the NHS, primary care and the sectors that you all work in and represent are still great places to work? How do we continue to attract people into health professions? Could I go to Julie Mosgrove first, please?

Good morning. Do you feel that the Government has undertaken sufficient workforce planning to ensure that multidisciplinary teams will be in place to allow delivery of the GP contract?

Thank you for those answers. Has the Government undertaken sufficient planning with regard to how infrastructure will need to change to accommodate an expanded multidisciplinary team? Do practices have the physical capacity, as well as the IT infrastructure, to accommodate that team? I suppose that that leans into the issue of data sharing, which we discussed with the previous panel.

That would be a good idea.

Yes—I am happy for us to move on.

Good morning. Are our witnesses concerned about the ability of the NHS to recruit sufficient staff to fulfil the ambitions that are set out in the NHS recovery plan and the national workforce strategy for health and social care? How likely is it that staff will be redeployed or recruited from elsewhere to fill gaps?

A couple of Rs have just popped up in the chat box.

I, too, thank everyone caring for people at the end of life, throughout the pandemic and beyond. Anyone who has seen Marie Curie nurses caring for a loved one in the final days and weeks of their life will be keenly aware of the incredible work that they do. They give people a good death and provide kindness, care and compassion for people and their families as they go through the unimaginable. Constituents have told me about the incredible support that Marie Curie nurses have provided to them and to family members and how the nurses did everything possible to make the most difficult experience in their lives a little less painful.

I also take the opportunity to associate myself with the remarks that Stephen Kerr made about the Strathcarron hospice in our Central Scotland region. The hospice does amazing work and has wide-ranging support from people and businesses across the area.

The pandemic has led to more open conversations about what a good death looks like and how we can afford people dignity in death. We must keep those discussions going as we enter recovery. Scotland’s ageing population means that a greater number of people will die in the coming years. Marie Curie research suggests that up to 10,000 more people with palliative care needs will die each year by 2040. People will also be more likely to die in the community, either in their own homes or in residential care homes. We should enable people to have the death that they want and that reflects their wishes. Palliative care will play an essential role in that.

Many people who die at home will be cared for by family and friends. It is vital that they get the right support while they are in the caring role and after their loved one has died. Marie Curie estimates that, every year, around 40,000 to 50,000 carers in Scotland are bereaved. We must ensure that they can access dedicated mental health support when they need it. People can often be left not knowing where to turn after the death of a loved one or who can help them to process their grief. We must be proactive about identifying carers who have been bereaved and signposting them to support such as that provided by Marie Curie’s bereavement support service.

We must also improve our ability to identify people with palliative care needs at an early stage. There is currently significant unmet need, as one third of Scots with terminal conditions die without having an anticipatory care plan in place.

Marie Curie has pointed out that the inverse care law applies to palliative care just as it does to other parts of the health and care system, and that significant inequalities exist. People from minority ethnic backgrounds and from rural and deprived communities are less likely to receive palliative care. They are also less likely to ask for it. Research conducted by Marie Curie has revealed that many people from ethnically diverse groups do not access palliative care and that, when they do, palliative care delivery is not always sensitive to their different needs, particularly around culture and religion.

Research has also shown that one LGBTQ+ person in six is discriminated against when using public services such as palliative care and that half of LGBTQ+ people expect to be discriminated against. That can discourage them from accessing the care services that they need.

There are also misconceptions about who is entitled to palliative care, such as that it is only for people with cancer. Those misconceptions must be challenged. We need to improve awareness of what palliative care is available and how it can be accessed, but we also need to ensure that palliative care services are person centred, are culturally competent and have the resources that they need to identify and engage with people who are terminally ill.

I thank Gillian Martin for bringing the debate to the chamber, and I thank everyone who works at Marie Curie. As the motion states,

“Marie Curie needs … £250,000 per week to support its frontline services”,

which is why it is so important that the Parliament takes the time to highlight the great daffodil appeal and encourages people to support it however they can.

This will be a worrying time for people who were previously shielding and who are still being cautious and reducing social contact. The transition away from routine asymptomatic and then symptomatic testing will make it much harder for them to avoid coming into contact with people who are Covid positive. Will the Scottish Government consider continuing access to testing for families and carers of people who are clinically extremely vulnerable? What other mitigations will be put in place to ensure that vulnerable people continue to be protected from Covid?

I thank the Equalities, Human Rights and Civil Justice Committee for its work in gathering evidence and compiling the report into ending conversion practices in Scotland. I thank campaigners, the witnesses who gave evidence and all those who have written to their MSPs to express support for decisive action.

When we see significant moments of progress for LGBTQ+ people, such as the repeal of section 28 or the bringing in of marriage equality, it can be all too easy to think that the job is done and the fight for equality is won. It can be easy to forget all those who have been left behind or forgotten in those moments, and those whose stories we never get to hear.

By definition, conversion therapy is silencing. It tells LGBTQ+ people that who they truly are must be shut up and hidden away, that they are broken and need to be fixed, that they are sick and must be cured, and that they are wrong and should be converted.

I hope that we can all speak today with one voice and without reservation or hesitation to all of Scotland’s LGBTQ+ people and especially to those who are not yet able to say this aloud for themselves. You are not broken. You are not sick. You are not wrong. You do not need to be fixed, cured or converted, because who you are is perfect. We will protect you from those who would try to change you.

Although we have seen progress on LGBTQ+ equality in Scotland during the lifetime of the Parliament, in recent years we have also seen a deeply concerning rise in transphobia in Scottish public life, and especially online. At the heart of homophobia, biphobia and transphobia is hatred and fear of those who are different—of those whose sexual and gender diversity goes against what has often been considered to be the norm. Conversion therapy puts that hatred and fear into practice. It tells people—and often forces people—to shut up, deny themselves and go back into the closet.

One of the most common concerns that I have seen in public debate in recent months is about the impact of a ban on conversion therapy on trans people, and especially young trans people. Some people seem to be concerned that a ban on conversion therapy will criminalise parents who are trying to support children who are struggling with their sexuality or gender identity, or that we will be complicit in forcing confused young people to be trans. That is not true.

The idea that there is a big conspiracy or agenda to turn young people trans is a lie that is designed to scaremonger. It is one that we have heard before against cis lesbians, gay and bi people in the debates around section 28 and equal marriage. It is designed to stir up fear and anxiety about those who are different. What was true then is still true now: LGBTQ+ people are not trying to turn people’s children gay or trans. They are trying to build a world where gay or trans children are safe, loved and accepted.

I am grateful to the committee for spelling out so clearly in its report the reality of affirming care and what it means for young people. It does not mean that anyone will try to turn someone into something that they are not. It means that people who are struggling with their sexuality or gender identity will be given a safe and accepting space in which to come to terms with who they truly are, without prejudice or pressure.

I hope that, one day soon, we will be not just debating conversion practices but passing legislation that ends them for good. Scotland’s young people deserve a country in which they can grow up to be who they truly are, and that requires a conversion therapy ban that protects all of Scotland’s LGBTQ+ people.