Chamber and committees

Good morning—[Inaudible.]—UK Government—[Inaudible.]—Is the minister confident that there is still a way forward for Scotland to launch a pilot?

Thank you.

Just briefly, convener.

In his evidence at yesterday’s joint committee meeting, Kit Malthouse said that he did not recognise poverty as a driver of drug use and argued that drugs and violence drive poverty. I am deeply concerned about the apparent equating of drug use with violence and the UK Government’s belief that poverty does not drive it. What impact will that clear conflict between the Scottish and UK Governments’ understanding of the causes of drug use have on your ability to work together on the issue and on efforts to tackle the stigma surrounding drug use?

Did stakeholders raise any concerns about the frameworks? The committee did not receive any responses to its calls for views, but it would be good to understand whether any concerns were raised with the Government.

Good morning. It was recently reported that,

“Since 2014, Scots have been abused due to their sexual orientation more than 7500 times, while the number of hate crimes relating to transgender identity doubled between 2014 and 2020.”

We know that 40 per cent of LGBT young people consider themselves to have a mental health problem, compared with 25 per cent of all young people in Scotland. Are mental health and other support services equipped to deal with the particular issues and trauma that are faced by LGBT young people?

School counsellors are a phenomenal thing to have, but I have spoken to several stakeholders who believe that we need training places for mental health clinicians to be more accessible to people from a diversity of backgrounds. For example, as you will know, training to be a mental health counsellor takes a significant financial investment in terms of supervision and often requires a large amount of voluntary work to make up accreditation hours. Those barriers can often exclude many of the people we would perhaps like to see in a counselling position—people who experienced care as children and young people or people from lower socioeconomic backgrounds—from entering this type of profession. What can the Government do to ensure that we can have more of those people in place because, in order for children and young people who have these experiences to build trust, it is imperative that they have a counsellor who understands the lifestyle and background that they are coming from.

I, too, would like to thank Jackie Baillie for bringing the debate to the chamber. I also thank those organisations that have provided briefings. My thoughts are with everyone who has lost a loved one to cancer, those who are going through treatment and those who live with the worry that their cancer will return.

As has been noted, the theme of this year’s world cancer day is “close the care gap”. The theme is timely, as the pandemic has highlighted the health inequalities that still blight Scotland and impact on cancer outcomes. According to a report published by Public Health Scotland, cancer mortality rates are 78 per cent higher in the most deprived areas than they are in the least deprived, incidences of cancer are 34 per cent higher in the most deprived areas, and people living in deprived areas are more likely to get cancer and less likely to survive.

Those horrifying statistics are a reminder of the lack of progress that we have made in tackling health inequalities. Some of the main causes of cancer include alcohol consumption, smoking, poor nutrition and diet, lack of physical activity, and air pollution, but as Christine Grahame pointed out, cancer knows no class.

We know that people living in deprived areas are more likely to be affected by those factors. This morning at the Health, Social Care and Sport Committee, we heard from the Minister for Public Health, Women’s Health and Sport about the extent to which inequality is a driver of poor health. We need to ensure that everyone has timely access to cancer diagnosis and treatment, but we must also address the root causes of cancer, which means reducing poverty.

The pandemic has placed enormous pressure on cancer services, and we know that workforce issues and waiting times were impacting cancer care before Covid. It is vital that we build the workforce to enable the NHS to work through the backlog of care that has built up over the past two years. The earlier that cancer is diagnosed, the more the chances of survival are improved. I do not think that anyone could do more justice to how that feels than Christine Grahame did.

Cancer diagnosis involves a range of tests and a specialist workforce. Cancer Research UK has highlighted shortages of staff across radiology, radiography, pathology and endoscopy. Macmillan Cancer Support estimates that if the number of specialist cancer nurses stays at current levels, by 2030, the gap in the number of specialist cancer nurses in Scotland will be 348. I recognise that the Scottish Government has published its cancer recovery plan, and that a new health and social care workforce strategy is forthcoming. Cancer Research UK is calling for the strategy to include both short-term and long-term actions that will ensure that we have in place the right staff to detect, diagnose and treat cancer, and I would welcome any comments from the cabinet secretary on that.

In its briefing for today’s debate, Macmillan highlighted the financial impact on people who are diagnosed with cancer. According to its analysis,

“87% of people with cancer in Scotland experience some kind of financial impact from their diagnosis”

and a third

“are severely financially affected”.

I am sure that we all agree that no one should be financially penalised for being diagnosed with a health condition. However, for too many people, that is the reality of living with cancer. Financial penalties come in many forms, not just in the form of reduced earnings. Figures provided by Macmillan reveal that 47 per cent of people with cancer in Scotland see an increase in day-to-day living costs, 26 per cent experience extra costs of travelling to and from their appointments, and 19 per cent see their household fuel bills rise.

As many members already mentioned, Macmillan has a support line that is available seven days a week, 8 am to 8 pm, on 0808 808 0000, for anyone who has anxiety or concerns about their cancer diagnosis, including financial worries.

I would welcome any comments from the cabinet secretary about what more the Government can do to give practical support to people have been diagnosed with cancer.

I echo the pleas from my colleagues around the chamber for people to attend their screening appointments. From personal experience, I can say that they are never as scary as people think that they are. Our incredible nurse practitioners will be able to answer questions. Certainly, they put me more at ease.

People should also get their human papillomavirus vaccinations, if they can. There is now a whole generation who are less likely to develop cervical cancer as a result of that vaccine.

This year’s world cancer day also marks 20 years since Cancer Research UK was formed. I thank all the people at Cancer Research UK, who are working hard to raise awareness and improve outcomes for people with cancer. I have found their expertise and knowledge to be incredibly useful during my time in Parliament so far and I am sincerely grateful to them.

Good afternoon, minister. Do you think that the war on drugs has been a success?

Thank you, convener—we could discuss this subject all afternoon.

Minister, drugs are often cut with everything from baby powder to rat poison, and even cement dust. Testing drugs would prevent poisoning and thereby prevent further pressure on health services, which are devolved. In order to ensure that we can save lives, would you devolve powers to allow the Scottish Government to set up drug testing?

You said that you need more evidence on safe consumption rooms. There are at least 39 sites in Canada, there are peer-reviewed articles from Portugal and there is an evidence base in San Francisco, Seattle, Boston, Vermont, Delaware and Portland, Oregon—I have used the example of just three countries, from a cursory glance at the use of safe consumption rooms around the world.

The evidence is well established that safe consumption rooms save lives, and the Scottish Parliament has backed the approach. Given the evidence, and the democratic mandate for safe consumption rooms, what do you say to the families of people who could be helped by such facilities but currently cannot be, because of your Government’s decisions?