Chamber and committees

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?

Has the pandemic undermined attempts to take a whole-family approach? Are schools finding it more difficult to engage with parents after remote learning? Mike Corbett, I will come to you first.

That is great—thank you.

In the current context, different schools are working in different ways, depending on their Covid situation. How difficult is it to take a whole-family approach when one child might be in secondary school and one child in primary school, or when different children might be at different stages of education?

Do the witnesses recognise that some of the Scottish Government’s aims and ambitions that the framework highlights conflict? For example, how does the action to support the whisky industry in order to provide sources of local employment line up with the public health aim to reduce alcohol consumption? That equally applies with regard to other areas that we have spoken about today, such as road building, and their impact on public health. Do you feel that public health should be prioritised over some of those other aims?

I thought you might.

Like many other members, I sincerely thank the women who have campaigned for the bill and for justice to be delivered. During committee evidence sessions, we heard first hand the impact that mesh implantation has had on their lives and the terrible pain and debilitating symptoms that many women have suffered. Their determination in the face of that is inspiring, and this victory is very much theirs.

I have been heartened by the spirit with which members have engaged with the bill. I note that concerns were expressed by members during stage 1 about its scope being too narrow, with the risk that mesh survivors would fall through the cracks of the reimbursement scheme, and I shared many of those concerns. However, I am pleased that the cabinet secretary has engaged with the committee and other members and has listened and responded to those concerns. The constructive engagement across the parties is reflected by the fact that we have reached stage 3 with only two amendments, highlighting how the Parliament works at its best.

I know that the aim of all members in the chamber and on the Health, Social Care and Sport Committee has been for the bill to deliver justice to the mesh survivors. However, our job is not done. We must ensure that the reimbursement scheme is flexible and achieves its intended aims. In the committee, we heard concerns about the in-betweeners, who are women who have already arranged private surgery but who have not yet received it, and I am grateful for the cabinet secretary’s reassurances in that regard this afternoon. I thank him for sharing the draft scheme and, like other members, I await the final detail of the scheme with keen interest.

The bill addresses the financial costs that many women have incurred when obtaining mesh removal surgery, but it does not address the emotional and physical costs. In the committee, I asked about on-going mental health support for mesh survivors, and it is worth revisiting that point. Many women may have experienced trauma as a result of mesh implantation, and it is vital not only that we provide them with the mental health support and treatment that they need but that we seek to rebuild the trust that may have broken down between them and NHS services.

The committee heard that follow-up care, including mental health support, physical health support and physiotherapy, for women who received removal surgery outwith the NHS was not always easily accessible in Scotland for individuals. We must ensure that those women are receiving comprehensive, wraparound care and that the people who are treating them are aware of their history.

We must not neglect the women who did not seek private removal surgery but who might have experienced trauma and a breakdown in trust. They, too, must receive the support and treatment that they need, and just as much emphasis must be placed on rebuilding their relationships with clinicians.

Scottish mesh survivors have on-going concerns about the treatment of people with mesh complications. It is important that we seek to address those. Concerns about waiting times for the national mesh complication centre were raised with the committee. Our NHS is under unprecedented pressure. The committee heard evidence that patients are facing long waits for appointments. Some women have experienced waits of at least nine months for assessment, with longer waits for appointments and surgery. I would appreciate any comment by the cabinet secretary about how we can work to reduce those waiting times.

As the committee noted in its stage 1 report, it is vitally important that any individual who has experienced complications caused by transvaginal mesh can have their case reviewed and can receive appropriate treatment as quickly as is practically possible via the complex mesh national surgical service. The committee has stated its intention to continue taking an active interest in that service and to take further evidence on that subject this year. I look forward to taking part in that important scrutiny work.

Scottish Greens will be delighted to vote for the bill at decision time.

I have previously expressed concern in the chamber about the removal of PCR testing for vaccinated people travelling into Scotland. I note the First Minister’s warning that no Government can rule out having to tighten restrictions once again if a new variant were to arise. However, does she recognise that the removal of PCR testing could undermine our ability to detect and therefore prevent the spread of new variants? Can the First Minister provide any detail on the new surveillance system that is to be introduced?

The bill is a vital piece of legislation that will protect health boards from facing unaffordable self-isolation payments. As has been observed, the Public Health etc (Scotland) Act 2008 was not written with a global pandemic in mind. Health boards would be severely financially impacted if the mandatory compensation power in the 2008 act were to resume. The Scottish Greens therefore support the general principles of the bill and agree with its intention. I agree that it is not financially sustainable for the power contained in the 2008 act to resume. However, I have some points regarding eligibility for the self-isolation support grant.

Several eligibility issues were raised during the COVID-19 Recovery Committee’s consideration of the bill at stage 1. In its response to the call for views, Shetland Islands Council acknowledged the targeted nature of the support provided by the self-isolation support grant but said that it

“would like to highlight the potential socio-economic impact on those with lower incomes or in areas where there is a significantly higher cost of living if this bill is passed and no consideration is given to reviewing the self-isolation support grant scheme, qualifying criteria and financial support”.

The Scottish Greens have long made the case for comprehensive financial and practical support for people who are self-isolating. There are financial and practical barriers to self-isolation, and addressing those will help to boost compliance. The Scottish Government’s own literature review of the evidence of compliance with self-isolation and quarantine measures found that

“Rates of compliance are heavily influenced by financial constraints and are dependent on income support, job protection and support with accommodation.”

We are two years into the pandemic, and the cost of living is rising. There have been serious financial consequences for individuals and their families. Many people are undoubtedly worse off than they were before the pandemic. Although I recognise that the 2008 act is not the appropriate means of providing financial support for those who are self-isolating, support must be on-going and should be regularly reviewed to ensure that it continues to be adequate.

The need for better communication of what support is available has been highlighted. In its response to the Government’s consultation on the bill, the Scottish Women’s Convention said that none of the women to whom it had spoken had successfully accessed the self-isolation support grant or the local self-isolation assistance service. Many women said that they had not heard of the scheme, and those who had heard of it did not think that they would be eligible. They also said that the application process could be daunting and confusing.

During the pandemic, many people have had to apply for benefits for the first time in their lives and were unfamiliar with the process, while many public and third sector services that would previously have assisted them were closed or reduced. I would therefore be grateful to hear from the cabinet secretary what steps can be taken to better publicise the grant and simplify the application process.

I will finish by focusing on the need for further pandemic-related legislation. The bill is intended to address a very specific issue, but we must consider the on-going relevance of the 2008 act. It was highlighted to the committee that, if it was not drafted with a global pandemic in mind and is not suitable to be invoked in that context, there needs to be a review of all pandemic-related legislation.

In an evidence session on the bill, the Law Society of Scotland said:

“We have recommended that the whole vista of emergency legislation needs some revision in relation to whatever emergencies there might be ... We need to consider a law for emergencies and make sure that it is fit for purpose and flexible enough to meet every contingency.”—[Official Report, COVID-19 Recovery Committee, 2 December 2021; c 10.]

We need to consider what further legislation is required to prepare us for future pandemics and ensure that we are ready to respond, as far as possible, without the need for emergency legislation.

As many others have done, I take this opportunity to thank the public for their efforts in self-isolating and keeping one another safe.

Figures that were published yesterday show that for the week ending 9 January only 60.4 per cent of patients who attended A and E in NHS Forth Valley were seen within four hours. I thank all the staff who continue to work immensely hard to try to improve that situation.

Given the pressure that has been placed on A and E departments, has consideration been given to reopening a minor injury unit in NHS Forth Valley?