Chamber and committees

The minister and the Cabinet Secretary for Net Zero, Energy and Transport will be aware of the Caley railway works in Springburn, which was forced to close in 2019, despite being profitable, having a highly skilled workforce and being of strategic importance to Scotland’s railway infrastructure. Since that closure, ScotRail trains are routinely sent to England and Wales for maintenance, repair and overhaul, due to a lack of capacity to do that work in Scotland.

There is interest in returning the Caley works to use as a railway engineering and maintenance site, but it is likely that intervention from the Government and its agencies will be required to make that happen. Will the minister agree to meet me and representatives of the trade unions, alongside Scottish Government agencies such as Scottish Enterprise, to find a workable and viable solution that will bring long-term benefits to Scotland’s economy through the reopening of the Caley railway works?

To ask the Scottish Government what discussions it has had with Transport Scotland about the future of the railway industry, including its supply chain in Scotland. (S6O-01887)

Will the cabinet secretary take an intervention?

I thank my friend Mr Marra, a member for North East Scotland, for lodging this vital motion for debate in the chamber. I was happy to support it.

Three years ago, Dr David Strang set out a list of 49 recommendations for NHS Tayside and two for the Scottish Government. It was a clear list of remedies to solve Scotland’s mental health crisis but, as we debate this important motion three years down the line, well over half of those 49 recommendations for the health board are marked by failure. That is a worrying sign of the lack of urgency and the complacency that define Scotland’s mental health crisis.

In the two years following Strang’s report, there were 144 probable suicides in Tayside. When reading the report and listening to the speeches this evening—harrowing as they have been in some cases—it is all too easy to find oneself lost in the numbers and statistics, but it is crucial to remember that behind those figures were 144 lives lost to suicide in Tayside. Had more urgency been shown in enacting the recommendations, how many of those vulnerable lives would still be here today, still with their families and friends and still a part of their communities?

The Tayside mental health report paints a disturbing image of how we are willing to treat our most vulnerable. However, the problems facing NHS Tayside do not exist in a bubble. I ask members who are in the chamber whether they can confidently say that mental health patients in their constituencies receive the treatment that they deserve.

The mental health crisis that threatens Dundee and its surroundings is prevalent in many post-industrial Scottish cities. Stark comparisons can be made between the experiences of Glaswegians and Dundonians over the years. Both Dundee and Glasgow have stubbornly high suicide mortality rates that stand well above the Scottish average. Those higher-than-average suicide rates in our cities can be put into context by some of the cruel ways that inequality impacts health and social outcomes in Scotland. Indeed, National Records of Scotland highlights the point that the rate of suicide in the most deprived areas of Scotland was almost three times higher than the rate in the least deprived areas.

That relationship between poverty and poor mental health is the ultimate reminder of how hard life can be for those who find themselves at the bottom of our social hierarchy and of how unfair our system can be. Against that backdrop, it is deeply disappointing that funding for mental health services in the next financial year will be frozen despite the health budget overall increasing by 6.2 per cent, which means that the Scottish Government’s is failing on its aspiration for mental health expenditure to be a 10 per cent share of the entire national health service budget.

Although mental health is a difficult topic to discuss, the general trend in Scotland allows for optimism in some cases. In 2021, the number of people dying from suicide fell to its lowest level since 2017. That was partly driven by an improvement in outcomes for female mental health patients. A noticeable decrease in suicide rates for any group should be acknowledged. However, it is imperative that we remain cognisant of the disproportionate impact of suicide among young men.

Last week, I spoke in the chamber about the effects that the cost of living crisis is having on young men’s mental health. Samaritans reports that demand for its call lines has skyrocketed, with more and more people mentioning finance and unemployment concerns as stressors.

The Tayside mental health report shows clearly that we cannot become complacent. Despite a recent decrease in suicide numbers overall, the mental health crisis is far from solved in Scotland. We know the effects that poverty has on mental health and suicide rates. The cost of living crisis is driving more Scots into poverty and making life more and more difficult each day.

Scotland faces a growing crisis: a mental health crisis that is being compounded by our failing economy. We must act now. We must ensure that the report’s recommendations are seen as essential, not optional, and that adequate resource is dedicated to implementing them. Only by putting words into action can we protect our most vulnerable in Tayside and across Scotland.

Labour agrees with the Liberal Democrat motion and will support it if it is unamended. Our amendment seeks to add a request that the Government provides an update on the progress that has been made with its oral health improvement plan, which I hope is something that every member can agree with.

I thank the member for Edinburgh Western for bringing his motion to the chamber for debate. NHS dentistry and dental services are often overlooked and tend not to generate the headlines that we see in relation to acute NHS services or, indeed, mental health services, but that does not mean that they are any less important. After all, in the same way that we will all need some form of medical treatment during our lives, we will all need dental treatment, too. Therefore, it is vitally important that people can rely on dental services and are confident that they will be able to receive treatment in a speedy manner when the time comes.

That takes us to the very heart of the issue. At present, there is a postcode lottery when it comes to the availability of dental services in Scotland. In August last year, the British Dental Association and the BBC identified more than 8,500 dental practices across the UK that they believed held NHS contracts. As part of their research, they contacted almost 7,000 practices to find out whether they were able to offer appointments to new adult or child NHS patients. In Scotland, a staggering 82 per cent were not accepting new patients. Even more shockingly, the researchers were unable to find a single practice in Dundee, Midlothian, Dumfries and Galloway, Moray, Orkney, South Ayrshire or the Western Isles that was taking on new adult or child NHS patients.

We face a crisis that is creating a two-tier dental system in Scotland. Patients who are unable to afford private dental care are forgoing services entirely in a crisis that risks collapsing NHS dentistry in Scotland in the long term to a basic extraction service—getting a tooth yanked out, if you needed to, because you were in pain.

We are already seeing the beginning of that demise. In 2022, more than 2 million fewer patients were seen by NHS dentists, compared with 2019. When it comes to participation rates, the situation is even worse and tells a tale of widening oral health inequalities among children and adults. In September 2008, the gap in child participation rates between the most and least deprived quintiles in Scottish society was 3 percentage points. In September last year, it was 20 percentage points, which is the highest difference that has ever been reported. That is shocking. Over the same period—from September 2008 to September last year—the gap in adult participation rates between the most and least deprived quintiles grew from 3 percentage points to 11 percentage points, which, again, is the highest difference that has ever been reported.

Why does that all matter? It matters because those cold, hard facts are illustrative of a bigger problem—an inertia in the Scottish Government when it comes to our healthcare system and, in particular, inequality in our healthcare system. We know what problems our NHS faces. One of those problems is that of staff retention, which exists in dental services, too.

Just last week, the BDA issued a stark warning:

“In just two months the ‘bridging payments’ to NHS practices in Scotland will cease. There is no clarity on what support will take its place.”

That is a terrifying prospect.

I accept that that is the case, but, as my dentist told me yesterday, that will not offset the multiplier effects that were previously in place, and it does not address the financial detriment that is faced by dentists. There is no reason for them to engage. The extension of bridging payments is not sufficient to address the problem.

The situation is compounded by the fact that many dentists—young dentists, in particular—are simply leaving the profession. The BDA went on to warn that

“An exodus from the workforce appears to be in motion”,

and that

“Dentists are reconsidering their futures working in a broken system”,

as is happening with junior doctors.

That should be of huge concern. Without a highly skilled and trained workforce that is able to provide NHS dental services to adult and child patients, a fundamental cornerstone of our public dental system will collapse and, when it does, it will be those from the most deprived backgrounds who will suffer. My plea to the minister and the cabinet secretary is simple: listen to the sincere warnings from professionals in the field, harness their expertise and bring to the Parliament a plan that can command support from across the chamber before it is too late.

I move amendment S6M-07812.1, to insert after “Scottish Government to”:

“provide an update to the Parliament on the progress made in delivering on its Oral Health Improvement Plan, which was published over five years ago,”.

One of the major legacies of the Covid pandemic in Scotland has been its impact on mental health. What is the Deputy First Minister’s response to reports that there were no mental health beds available in Scotland last weekend? What steps is the Government taking to honour its pledge to increase spending on mental health to 10 per cent of the total national health service budget, given that funding for the coming financial year has been frozen?

It is certainly the case that the way in which the funding has been managed is deeply regrettable and frustrating—in particular, for Glasgow. The people’s palace remains derelict and there is no funding for Glasgow’s museums, yet Edinburgh’s museums are given national funding. The M8 is crumbling, although that project for levelling up funding remains as critical as ever. Those projects have had business cases developed and are ready to go: they are, to quote the Deputy First Minister, “shovel ready”. Will the Scottish Government look to collaborate with Glasgow City Council to raise funding, perhaps through issuing local government bonds, or will it investigate other ways in which we could capitalise those projects, which are needed as badly as ever?

I start by thanking the member for Perthshire South and Kinross-shire for securing this motion for debate in the chamber today. I was happy to sign it in support and I commend him for a moving speech that really hammered home how important the issue is in our society. We often hear about public health emergencies and crises and, in my opinion, male suicide is a public health emergency that is often overlooked.

It is a public health emergency that disproportionately affects certain age groups more than others. It severely impacts on people from more deprived socioeconomic backgrounds, and it drastically impacts on men more than women. It is vital that we understand why that is the case, but it is more important that we put in place tangible and measurable policies to deal with what is clearly an enormous problem. Those policies will require a whole-Government approach. We cannot simply view male suicide as a health problem and leave it to the health directorate to solve.

As Samaritans says, suicide is rarely caused by one thing but we do know that it is often an inequality issue and that there are strong associations between financial difficulties, poor mental health and suicide. We all know that the cost of living crisis is hitting working people hard and causing serious difficulties for millions of people who might otherwise never have experienced financial hardship. That should be a real cause for concern.

As Samaritans has reported, from August 2022 to October 2022, more than one in every 14 calls to its helpline were about concerns related to finance and unemployment—the highest level for at least five years. Between January 2022 and September 2022, its data shows that more than 100,000 emotional support contacts mentioned finance and unemployment concerns.

When we combine all those factors and consider the evidence and the data, that shows the impact that financial hardship can have on men, on those from particular socioeconomic backgrounds, and on those of certain ages. It is the recipe for a perfect storm.

As legislators and policymakers, we need to be alert to that and that is why today’s debate is so important. We often throw metaphorical brickbats at each other across the chamber, but today’s debate gives us the chance to come together and say as one Parliament that the issue requires not only a cross-Government response but a cross-party response that will have to encapsulate policy change in our public health system, our education system, our justice system and our housing and social security systems. Such a response will be required to get to the root cause of the fundamental inequalities that are engrained in our society and it will have to bring people together in the spirit of openness and transparency.

In that spirit of openness and transparency, and in an attempt to show that this is a crisis that does not discriminate and can impact on anyone, I will briefly share my own experience. Members will be aware that I lost my seat as a member of the House of Commons in 2019, and less than three months later we were in a national lockdown with no end in sight. I live alone and, after just a few months, I found myself relying on benefits to make ends meet. I was doing some volunteer work with a couple of different charities that were helping asylum seekers who were living in hotel accommodation in Glasgow, and I was working with Peter Krykant at the unofficial overdose prevention centre in Glasgow’s Trongate. Every day, I was seeing people who were living on the very edge having been forced there in many cases by Government policies, whether drug or asylum related, and it took its toll.

There were times when I would be going home to my flat alone, staring at the four walls, struggling to see an end to the lockdown and failing to see any kind of light at the end of the tunnel. There was no positive destination in sight after various job opportunities fell through. At times, it felt as though there was nothing more ex than an ex-MP. My mental health was really suffering. There were times when I did not care whether I was alive or not.

I did not have an immediate feeling that I was going to do something deliberate to end my life, but there was certainly an ambivalence about whether I wanted to continue living. My self-esteem and sense of purpose were at rock bottom. It was only thinking about the impact that it might have on my family and friends that held me back.

I do not say this for sympathy and I certainly do not say it for attention. I simply say it to raise awareness and illustrate how quickly things can turn and how quickly people can be impacted who might never have felt feelings like that before. No matter how secure, happy or successful someone might seem to be, it does not take much for those pillars of support in life to collapse. The resulting trauma and despair can be all too tragic for many people, and we have heard today how it affects them.

I once again congratulate and applaud the member for Perthshire South and Kinross-shire for bringing the motion to the chamber today. I assure him that he has an ally in me and I will work with him and anyone else to bring about an end to an often-overlooked crisis in our country.

I congratulate the member for Ayr on securing this members’ business debate, which ensures that this topic is given the prominence that it deserves in this chamber. I was pleased to sign her motion. She is not alone in noticing the huge rise in the number of young people who are vaping, which should be a cause for concern for every one of us.

The rise in the number of young people using disposable vapes is clearly an issue, and we are not alone in thinking that it is. Research by Asthma + Lung UK Scotland shows that 83 per cent of Scots are concerned about the use of vaping products in schools and that 82 per cent are concerned about the marketing of such products. There is an obligation on us to respond to those concerns. Although there remains some dubiety about the long-term health risks, I believe that it would be foolish to assume anything other than that vapes are, ultimately, bad for young people and for the wider public. That is the basis on which we, as legislators, should determine our public health response.

I agree with the calls for increased regulation of such products, particularly disposable vapes, given the environmental damage that they cause, but I remain unconvinced by the calls for outright prohibition and a blanket ban. The reason for that is quite simple: I do not think that outright prohibition works in reducing the harm of any so-called vice in society. As we have seen throughout history, attempts to ban products such as alcohol or drugs often lead to a black market—unregulated trade that is dominated by organised crime—which often makes the problem worse.

That said, however, I believe that we have to be more diligent in the regulation of the industry. It seems perverse to me that we put cigarettes behind shutters and regulate packaging to make cigarettes less attractive but we allow vapes to be displayed prominently in shop windows in shiny, colourful packages, which are clearly designed to attract younger people to try them out. Indeed, just yesterday, a constituent sent me an email about a store in Glasgow that advertises vapes right next to slushies and desserts of the same flavour. That is clearly and cynically designed to manipulate young people’s consumer habits.

I do not know whether anyone is a fan of “Mad Men” but, in the pilot episode, which is set in the 1960s, Lucky Strike is concerned about Reader’s Digest first reporting the risk of cancer from cigarettes, so it decides to market them with the slogan “It’s toasted” to make them sound more benign and less potentially hazardous for consumers. That shows that a deceptive form of marketing that tries to seduce people into thinking that products are benign—whether it is cigarettes or, potentially, vapes—has long been a characteristic of the tobacco industry and similar vendors.

If the health risks are deemed to be similar, the regulation and policy response must surely be equally stringent. I would like the Government to explore that when considering a response to this growing problem. When dealing with increased regulation, we also need to consider the sanctions for those who are caught selling such products to under-18s. Anecdotally, it seems that young people under the age of 18 find getting hold of vaping products easier than getting hold of cigarettes, and we have to look at why that is the case. Clearly, the regulations that the Government introduced in April 2017 are proving to be ineffective in that regard. I am in favour of tougher sanctions on shopkeepers to ensure that they are suitably deterred from illegally selling such products.

In addition to the potential health risks, there are environmental concerns about the prevalence of disposal vapes. Those concerns have merit, so Labour supports, in principle, the Government’s position on a ban on disposable vape products. I hope that further study will show that that would result in a reduction in the levels of youth vaping.

As I said earlier, I am generally sceptical of outright bans, but it would be worth while to carry out an exercise to see whether we can reduce harm. At the very least, we need to make such products look significantly less attractive to young people, and we need to deal with the environmental impact of their use. If a ban is not appropriate, we should consider whether a return scheme of some description could be rapidly introduced to minimise the impact of their use on the environment.

We clearly have a problem on our hands, and the policy response to it will need to be multifaceted and measured. Taking a sledgehammer to crack a nut will not solve the issue. This is a perfect example of the need for us, as legislators, to know our limits. In the long term, although we might not want to introduce an outright ban, I hope that regulations of the kind that we have discussed today might exert a more positive influence on consumer behaviour in order to reduce public health risks and the environmental harms that we see today.