Chamber and committees

To ask the Scottish Government whether it will provide an update on the delivery of the Scottish welfare fund. (S6O-02216)

Last year, research into the cost of living crisis from the Poverty Alliance and the Scottish Women’s Budget Group recommended better promotion of the Scottish welfare fund. However, it has been put to me that Glasgow City Council feels that it cannot promote the fund because the fund is oversubscribed, which means that many low-income families in Glasgow cannot access this lifeline support. Given how much local authorities such as Glasgow rely on central Government for funding, will the cabinet secretary commit today to providing councils with the resources that they need to deliver the fund to families who desperately need it?

Labour will support the bill at stage 1, as we are supportive of its general principles, although we have some reservations about the detail and we will look to engage with the Government on amendments before stage 2.

As has been outlined, the bill seeks to establish the office of patient safety commissioner for Scotland, as described in section 1. The patient safety commissioner will have two primary functions:

“to advocate for systemic improvement in the safety of health care, and ... to promote the importance of the views of patients and other members of the public in relation to the safety of health care.”

Both provisions are warmly welcome.

As deputy convener of the Health, Social Care and Sport Committee, I echo the comments of the convener, the member for Rutherglen, about the committee’s excellent stage 1 report, which was published at the end of April. I would also like to take a moment to thank the clerks and officials for their work on the report. It is a great summary, and I recommend that all members take some time to digest it.

The bill is supported by a wide array of stakeholders, including Valproate Scotland, Haemophilia Scotland and the Association for Children Damaged by Hormone Pregnancy Tests, all of which gave evidence to the committee, and I am incredibly grateful for that.

The establishment of a patient safety commissioner for Scotland is long overdue. At present, the voice of patients and NHS service users is all too often forgotten, which frequently leads to situations where we do not learn from systemic mistakes that have been made and failures that have occurred in the past, and run the risk of repeating them.

The committee highlighted that issue in our report. It is safe to say that there was a large body of concern among stakeholders that the proposed commissioner will not have a remit to investigate individual complaints and that there will be no locus for the commissioner in matters that pertain to systemic issues in social care.

Given the inherently intertwined nature of health, the NHS and social care—something that the Government seemingly recognises, given the National Care Service (Scotland) Bill—it would be helpful for some thought to be given to how we expand, whether immediately or in the future, the commissioner’s role to include social care.

My colleague Paul O’Kane, a member for West Scotland, raised that point in committee. I know that the minister disagrees with the idea of extending the remit to include social care; however, we know how complex the policy and regulatory landscape currently is and I would hate for us to be back here again in just a few years doing something similar for social care when we could deal with it here and now, in this bill.

As the Scottish Public Services Ombudsman said in its evidence to the lead committee,

“Given the potentially seismic changes in the health and social care landscape in Scotland, it is evident to the SPSO that a legislative separation between health and social care, which is embedded in this bill (which focuses solely on healthcare), may be becoming outpaced by other developments.”

We, in the Scottish Labour Party, have some concerns, too, around the resourcing of the commissioner’s office. Currently, we are looking at a budget of around £644,000 per annum. Although I appreciate that that is a significant sum of money, we are talking about a role that is tasked with investigating extremely complex, deep-rooted issues, and I worry that it risks becoming a public relations exercise instead of a substantive mechanism for delivering justice and positive outcomes for patients.

I would like to clarify, too, that it is not only Labour that has that concern. The Royal College of General Practitioners Scottish patient forum has raised it, too, and it emphasised the disappointment that it would feel should future budgetary decisions cause the commissioner’s office to fold. It suggested that funding levels should be confirmed by parliamentary procedure. I would like to see the Government consider whether the budget is adequate; I would welcome further engagement and dialogue on that particular point as we progress through the legislative process.

On a positive note, we agree with the Government that a patient champion is required, although we might have slightly different views on exactly what that looks like in practice. We are also grateful to the Government for its commitment to the committee that the commissioner should be able to hear from staff about patient safety concerns as flagged by the Royal College of Nursing Scotland.

On a more general point—I am conscious of the time—I want to assure the Government that Labour will work with it to ensure that we end up in a place where we are all in agreement and can wave the bill through unanimously.

There are plenty of policy areas where we have disagreements, but I genuinely do not think that this has to be one of them. We are all looking for the same outcome here: to improve the voices of patients and to ensure that the systemic issues that many have experienced and have been adversely affected by do not come to pass ever again.

I commit to working constructively with the Government. I know that I speak for my Labour colleagues when I say that they also want to work positively with it, and we have heard from a wide variety of stakeholders that they want to do so, too.

I will conclude on that note. I look forward to the bill’s progression through its subsequent stages.

Addressing the CAMHS backlog is only one part of improving the mental health of our young people. Research by the Mental Health Foundation last year found that 54 per cent of college students presenting to student mental health teams had moderate to severe symptoms of depression. Therefore, will the minister provide an update on when the Government expects to conclude the development of the student mental health action plan and when it expects the plan to be published?

I proposed at the Delegated Powers and Law Reform Committee that an automatic inflator should be included in the bill. It is disappointing that the minister has not been more innovative in his response and that he has simply extracted a measure that is, as he has admitted, well intentioned. I am glad that he at least recognises that, but he must also recognise other Government practices, such as the fact that most benefits in the social security system are uprated every April in line with the consumer price index. That was the spirit in which this measure was introduced.

If the minister does not think that the stage 2 amendment was well drafted, perhaps he could give a commitment that the Government will undertake a review of the threshold figure every financial year by statutory instrument and that it will be uprated accordingly. It is true that an automatic formula might produce odd figures, but that could be adjusted by saying that the figure will be rounded to the nearest £100, in order to simplify the procedure.

Perhaps that could be an alternative mechanism to achieve the outcome that we agree is needed as a safeguard. Some sort of double lock could be created by committing to a statutory instrument to review the figure every financial year, so that it can be inflation proofed, as is done with social security benefits.

Will the member take an intervention?

The committee convener makes the important point that the threshold has been increased substantially, and we should welcome the Government’s response to that. I am not, in any measure, trying to make an intervention on that in bad faith, but we all want to achieve the same aim, which is efficient legislation. Section 43(2A) is a measure to ensure that the depreciation of the real value of the threshold is not eroded over time. We know that there are many instances in which Government is just busy and neglects to keep things up to date, and that provision is just a way of making sure that the figure is automatically adjusted so that we do not get into a situation, 10 years down the line, in which the threshold has been forgotten about, and people have their possessions taken as a result of neglect to keep the legislation up to date. If there was a mechanism by which the Government was compelled every financial year to uprate it through statutory instruments, that would be a satisfactory remedy, if the proposed amendment is not effective.

I thank the member for giving way on that important point. Does she agree that it was shocking to discover that in undertaking its assessments of communities fund allocations, Glasgow City Council never asked what would happen if it took that funding away and whether that would cause an existential crisis for those organisations?

Bob Doris is making an important point about the role of churches in providing a sense of community and a focus for communities. Does he share my concern that the potential closure of churches across Glasgow could affect the capacity to provide such services in the future?

I should clarify that. I meant that I had thought that it would be naff, but I was proved wrong. When I first read about it, I thought, “Who pitched that to the BBC?”, but it actually turned out to be really good.

One thing that struck me—I think that I had something in my eye at one point—was hearing the women talk about the challenges that they had faced in their lives. We might pass someone on the street or have a chat with them at a coffee morning or something like that, and never think twice about the profoundness of their life experience. I listened to what those women had to say about the amazing things that they had had to overcome. They were things that would have broken other people, but those resilient working-class women in the north of Glasgow had managed to overcome them, and they did not think twice about volunteering themselves to do a rap. I thought that that was remarkable.

One thing that they spoke about was how they had made friendships later in life. They had been through bereavement and had lost people whom they thought were their life partners—people whom they might, in their 20s, have assumed would always be there, but suddenly, in their 60s and 70s, they had to completely reconstruct their social lives. Hearing about those massive phases in people’s lives gave me a lot to think about.

At the core of what is being discussed today is how we build greater opportunities to enable our communities to interact better and to become more tightly knit. That is key. How do we help people in their moment of need, when that need is at its most severe? They might have experienced bereavement, relationship break-up or be losing their house, or they may have had difficulty with addiction. All those things can compound loneliness and a sense of social dislocation and isolation.

We need to meet people where they are. We need to be the person who, if necessary, cajoles a person into doing something that they might not otherwise do. It is so easy to get into a funk with things and to not be prepared to get ourselves back in gear. There are many organisations out there that provide a jump-start for people who are in a bit of a downward spiral. We need to give them the security and opportunity to do that.

We have heard a lot about the cuts to councils: In Glasgow, £1 of every £10 has been cut, which reduces capacity to do the types of things that we are talking about. There is an issue. We recognise the need for those services and for the opportunity for cost avoidance. Provision of those services saves us all money in the long run, however, whether that is in the national health service, where people may present in far worse circumstances, or elsewhere. Too often, however, our decision making is driven by reactionary accountancy at the end of the financial year. Activities are seen as being a bit “naff”, perhaps, and as soft and expendable—as something that can be cut in order to fund services that are seen as being more crucial. The irony is, of course, that in doing so, we simply load more and more pressure on to acute services.

As the member for Glasgow Maryhill and Springburn mentioned, a good example is palliative care. We cannot fully staff palliative care beds in Glasgow right now, yet that end-of-life care is critical. We need to provide people with an opportunity to die with dignity, and we need to enable people to support their relatives at that critical moment at the end of life. We might not want to talk about that, but it is crucial.

We also need to provide people with the means to get themselves back on their feet after they have given their all to care for their relatives. Too often, we simply assume that people will pull themselves together and get on with it, but we need to do so much more to support them.

I could go on for hours, recapping everybody’s comments in the debate. If I have not mentioned any key points, I apologise. The debate has been moving and informative, and I thank everyone who has contributed. I am happy to say that Labour will support both the Government motion and the amendment from the other party.