Chamber and committees

Audit Scotland has found that the Scottish Government will fail to meet its own target for increased GP numbers, which is indicative of its failure in workforce planning over many years. However, it is not just a recruitment issue. There is also a significant issue with capacity in GP surgeries. Surgeries are bursting at the seams, and the British Medical Association has found that 81 per cent of practices currently exceed capacity.

In the village of Neilston, which I represent, I spoke with GP partners of the Neilston medical centre, who told me that they are struggling to find the physical space to meet demand. They applied to the Scottish Government for loans to increase space, but the application was rejected. If the practice cannot expand, it might be forced to close its books. Why is the Government not giving GP surgeries the support that they need to expand the provision of general practice in their communities?

I, too, thank Roz McCall for bringing this important debate to the chamber and for speaking so powerfully and personally about her commitment to these issues. I am grateful to have the opportunity to speak on behalf of Scottish Labour, and I am also pleased to do so as the chair of the newly established cross-party group on care leavers, which was set up in the current session of Parliament.

Adoption UK has produced “The Adoption Barometer”, to which the motion refers, which is a highly useful resource that provides illuminating insights into the experience of families with adopted children in Scotland. It is encouraging that, in most areas, Scotland is performing comparatively well on the levels of education support that are provided for families with adopted children. As we have heard, however, experience of the support that is offered is often patchy and not consistent. Doing comparatively better cannot be the limit of our ambition for these young people.

Although the situation is better in Scotland than in the rest of the United Kingdom, only half of adoptive parents believe that teachers have a good understanding of the needs of care-experienced children. Let us be honest—that is simply not good enough.

That point was emphasised clearly in “The Promise” report, which highlighted the importance of teachers and school staff being appropriately trained to empower them to be fully aware of the challenges faced by care-experienced young people, and to equip them with skills to encourage those young people to support themselves and become more resilient—indeed, to reach the absolute limits of their potential.

Already in the debate today, and more broadly, we are hearing about the Promise and looking again at what was committed to in it and how we are delivering in those areas.

More broadly, it is critically important that the Government gets the Promise right and continues to deliver on that commitment, because, sadly, the reality for too many care-experienced young people and children is that much of their life has been shaped by broken promises—by adults who made commitments to them to improve their lives in one way or another and then failed to deliver.

As we have heard, the First Minister will be remembered in years to come for making those commitments to young people in the Promise. It is for all of us to commend her for focusing on care-experienced people, and particularly children and young people, and bringing the subject into the light of our national discourse and debate in a way that had perhaps not happened previously.

However, the First Minister’s resignation, which comes three years after the publication of the care review, provides an opportunity for us to pause, take breath and assess the effectiveness of the current approach and the impact of the Promise. There are some issues around accountability, and I know that concerns are being shared by third-sector organisations that work in this space.

An issue that has been raised with me is who in the Government will be accountable for delivery of the Promise, given the outgoing First Minister’s very personal commitment? Will it be the Minister for Children and Young People or the Cabinet Secretary for Education and Skills, or will it be the equal responsibility of everyone in the Cabinet and all ministers? I think that we all want to see it as everyone’s responsibility but, very often, when something becomes the responsibility of everyone, it can quickly become the responsibility of no one.

I understand the rationale for having an organisation that is distinct from Government and seeks to be accountable to the people of Scotland for delivery of the Promise. That is important and admirable. However, we need to look at how we can have more parliamentary oversight of delivery of the Promise. Perhaps that could be achieved if we had specific ministerial responsibility or specific committee responsibility in this Parliament. We should consider all those things to ensure that all of us in this place hold the Government’s feet to the fire and indeed hold our own feet to the fire in relation to what we are trying to do for care-experienced young people in particular.

It is imperative that we do not fail care-experienced children and young people. As parliamentarians, we all have a responsibility to ensure that their voices and the voices of those who care for them are present in our debates and in every decision that we make in the chamber. Let us work together to ensure that our ambition matches the rhetoric and that it transforms into the meaningful change that care-experienced children and young people so richly deserve.

I know that SNP back benchers will be comparing the performances of their respective candidates last night.

Clearly, there is no unity in the Government on the way forward with the bill. In a matter of weeks, we have shifted from the Cabinet Secretary for Health and Social Care and other senior ministers defending the bill to the hilt to the cabinet secretary now admitting that the bill, in its current form, needs to be paused and overhauled.

The Government’s motion suggests that the timetable for completion of stage 1 should be moved to June, but the Government has failed to explain why June is the most suitable time. Is it because it is politically expedient for the Government to move stage 1 until after the SNP leadership election, once the candidates have finished ripping one another to shreds and the Government has cobbled together a common position?

Presiding Officer,

“How much longer do people who need adult social care need to wait until we’ve got a system that isn’t being called into disrepute by the trade unions, local government and four parliamentary committees?”

Those are not my words; they are the words of Kate Forbes from last night’s debate, when she was eviscerating Humza Yousaf’s record as Cabinet Secretary for Health and Social Care. It appears that she and I agree on something, because she is right.

If the Government is serious about re-engaging with stakeholders, bringing people back around the table and building confidence in its national care service proposals, the stage 1 process cannot be moved down the tracks to a more suitable time for the SNP with no action in between to re-engage those stakeholders. It must be paused until at least the later part of the year to give sufficient time for the bill to be redrafted and brought back to the Parliament by a new health secretary for scrutiny. Indeed, that is exactly the position that the current health secretary is advocating since his Damascene conversion to supporting a pause to the bill.

How can the bill proceed on a June timetable when the Government is in such a state of disarray? Last night, it was made abundantly clear for all the public to see that Humza Yousaf’s own Cabinet colleagues do not have faith in his ability to serve as health secretary. Kate Forbes said the quiet part out loud when she less than discreetly admitted that she would sack him as health secretary if she became First Minister.

We need a proper pause to the National Care Service (Scotland) Bill to allow an opportunity for stakeholders to get back round the table and to make it right. Moving stage 1 until June does not allow sufficient time for that vital work to be undertaken. In the context of the Government being in a state of total disarray with Cabinet colleagues publicly arguing and contradicting one another, we need a proper pause until at least November to ensure that we have a proposal for a national care service that is fit for purpose and has the confidence of key stakeholders. That is what we, on the Labour benches, have argued for consistently. It is time that the Government got a grip and got on with redrafting the bill.

I move amendment S6M-08151.1, to leave out “30 June 2023” and insert:

“1 November 2023”.

This week, we have heard much about the proposed National Care Service (Scotland) Bill, not in the chamber but in the newspapers and, of course, on our televisions, including during last night’s unedifying—I think that that is putting it mildly—SNP leadership debate.

Indeed, positions on the bill have been shifting more quickly than the bureau and the Parliament can keep up with. Last night, the national care service was discussed—sorry, rammied over—by the candidates. It has been clear since the start of the leadership campaign that all the candidates are now articulating different forms of a pause to the bill. [Interruption.] I am pleased that the SNP leadership candidates have now accepted what Scottish Labour, trade unions, professional bodies and local government have been arguing for months, but it is becoming—

Will the minister give way?

I recognise what the minister said about that investment, but I think that it is fair to say that that money was the restoration of previous cuts. Also, we have already heard about the various flavours of a national care service, so we are not sure what the future of the bill will be or how it will address the postcode lottery in the way that the minister suggested. We are in a wait-and-see situation right now. The reality is that, no matter how well intentioned the dementia strategy is, it cannot and will not succeed in achieving its aims until the Government gets serious about tackling the systemic issues in the NHS and social care.

That is why Scottish Labour has been calling on the Government to end the indignity for dementia patients who are stuck in hospital when they could be back living in their house or care home. That issue could be resolved if the Scottish Government took the necessary action to increase the availability of care packages. At present, provision is patchy and access to suitable packages depends on where someone lives. All members’ inboxes show examples of people who are in real need, so we need real action.

The SNP promised to scrap non-residential care charges in its manifesto, as recommended by the independent review on adult social care, and it is time that it took action and delivered on that commitment.

The Scottish Government must deliver for the social care workforce, because it is the backbone of ensuring that people get the care provision that they need. We have consistently called for an immediate pay rise to £12 per hour, rising to £15 per hour. If we are serious about rewarding the workforce and increasing staff retention, we have to make that move. Week after week, the minister has derided calls from those on the Labour benches for £12 per hour, rising to £15 per hour, for social care workers, claiming that it was unreasonable and unaffordable, yet this afternoon in the Daily Record, his colleague Kate Forbes, the finance secretary, stated her commitment to deliver as First Minister what she steadfastly opposed and refused to introduce as finance secretary: £15 per hour for social care workers. It is amazing what U-turns can be performed when there is an SNP membership to be won over. Given the Government’s track record on delivery, I will not be holding my breath.

The challenge for the Government is that it needs to close the gap between the rhetoric and what is delivered to ensure that people living with dementia and their families and carers have an improved quality of life. It is time for the Scottish Government to get serious about delivering for people with dementia, and that starts by fixing the omnicrisis in the NHS and social care.

I move amendment to motion S6M-08053.1, to insert at end

“; regrets that the current NHS workforce challenges are impacting on dementia care, with timely access to diagnosis and post-diagnostic support becoming a postcode lottery, and calls on the Scottish Government to publish a plan for ending the high level of delayed discharge among dementia patients, and to improve support for people with dementia by removing non-residential social care charges and increasing the availability of care packages, supported by efforts to grow the social care workforce by delivering an immediate increase in pay to at least £12 per hour, and a plan to increase pay to £15 per hour by the end of the current parliamentary session.”

I am sure that most, if not all, members in the chamber have been impacted by dementia in some way. When I was a student, I worked in a care home as an activities organiser. I know that colleagues will struggle to see me as the home’s redcoat, but in many ways that allowed me to get a better understanding of people living with dementia, and to build relationships with their families and understand something of the illness and the support that is required to ensure that we work hand-in-hand with families to deliver the care and support that is needed.

It is estimated that 90,000 people in Scotland live with dementia. As we heard, new research from Marie Curie estimates that the number of people dying with dementia as the primary underlying cause of death will rise by almost 200 per cent by 2040.

I begin with the areas of consensus that exist in the debate. Our public health approach to dementia must recognise and respond to the increasing prevalence of dementia across society. That is why that we, in the Labour Party, believe that it is imperative that we have a person-centred approach to dementia that focuses our energies on empowering people with dementia to continue to live fulfilling lives with access to additional care and support when they need it.

Any strategy for dementia must, first and foremost, recognise that people who live with dementia are human beings just like you and me. They have social needs and are supported by their loved ones, who, as we have heard from members, are often struggling in their own ways to cope and find the space to deal with the illness. We must explore how we make our communities more dementia inclusive and dementia friendly, so that people with dementia can live at home for as long as they are able to do so. We support the work of the dementia-friendly communities network, which brings together hundreds of dementia-friendly communities that have made meaningful changes to local villages and towns across Scotland to create inclusive spaces for people with dementia.

When the Government launched its national conversation on a new dementia strategy for Scotland, last autumn, we welcomed that development, and we take seriously the responses of people with lived experience, clinicians, third sector organisations and the family carers whom I have spoken about.

What is clear from the conversation is that people who live with dementia and their families need to see action. They need to see tangible signs of progress from the Government, because national conversations become devalued unless they result in substantially improved outcomes for patients. We have had a national conversation, but have we really been listening to what has been said? Despite encouraging rhetoric, the Government’s delivery record has been less than impressive.

The SNP has been in power for 15 years and the first dementia strategy was published 13 years ago, yet people with dementia and their families still face a postcode lottery for diagnosis and post-diagnostic support. The most recent statistics, which are from 2019-20, show that only 42 per cent of people who are newly diagnosed with dementia are referred for post-diagnostic support. Indeed, during the pandemic, people with dementia and their families were at the centre of that maelstrom and they did not receive support in their lives often enough. In some ways, that reflects the Government’s failure to learn lessons since the implementation of the first national dementia strategy, in 2010.

The minister talked about the importance of keeping people at home. Does he accept that, if we are to do that, there have to be good-quality care packages and we need to retain care workers in the system by paying them £15 per hour? Does he agree with the finance secretary’s current position, which is that she would support £15 per hour for care workers? He did not agree with the approach in previous exchanges with me in this chamber.

On behalf of members on the Labour benches, I associate myself with the comments of Stuart McMillan and Jamie Greene on the tragedy in Greenock on Friday. I spent yesterday at the Port Glasgow New parish church, where a space for reflection had been provided to local people to ensure that they could have time to channel the palpable sense of grief in the local community.

How will the minister ensure that messages about marine safety, which will ensure that local people have confidence in what is happening on the river, get out and about in a community that is as close-knit as Greenock?

I begin by thanking Joe FitzPatrick for bringing the debate to the chamber this evening as we mark LGBT+ history month 2023.

It is good, once again, to have an opportunity to speak about the rich and diverse history of LGBT+ people here in Scotland and around the world. Ours is a story often marked by pain and struggle, but also by love, solidarity and joy. I am sure that, like so many, we are thinking of our own histories and our own moments on the journey—the good and the bad, the painful and the joyful. We think on the progress that we have made, here in Scotland and around the world. We take stock with pride, but we also look forward to what we still have to do to create a more equal society for all LGBT+ people.

As we have already heard, the theme for this year’s history month is “Behind the Lens”. It is not only a celebration of LGBT+ people’s contribution to creating cinema and film; it is also a call to look behind the lens and to listen to all LGBT+ people’s lived experiences, particularly when, as we have heard, their lives are in the media, so sharply and so darkly, over the past year.

That is a really good way to approach the month: to get behind the lens of the world that we live in and to understand how we created this Scotland that we live in: a Scotland where LGBT+ people can be accepted for who they are, a Scotland where section 2A lies in the dustbin of history, and a Scotland where I could say “I do” to my husband, surrounded by our friends and family, joined together legally by the state—and, for us, blessed by the love of God.

Behind the lens of this happy image we must remind ourselves of the struggles to make it a reality, remembering those in this place who stood up and spoke out, and those outside who marched and wrote and persuaded. We should remind ourselves that it was not always this way. For too many in the world, it still is not, and we have more to do. It is not so long ago that being gay was a crime in this country. It is not so long ago that the state actively sought to imprison people for who they were and who they loved.

One of my favourite poets is Edwin Morgan, the first makar, who addressed the Parliament in verse as this building was opened in 2004, a man who came out at the age of 70. Edwin Morgan wrote some of the most beautiful love poetry I have ever read. I have a copy of “Strawberries” on the wall of my office upstairs:

“the taste of strawberries
in my memory
lean back again
let me love you

let the sun beat
on our forgetfulness
one hour of all
the heat intense
and summer lightning
on the Kilpatrick hills

let the storm wash the plates”.

I read that poem through the lens of a love between two men finding love in the simple things of everyday life and everyday relationships. Morgan did not gender his poem, however, and that adds a universality, but it also speaks of a different time: a time in our history when the love that he so beautifully describes was hidden and had to be hidden. Those days may seem distant for so many people in Scotland today, but they are all too real for many LGBT+ people around the world. That is a reminder to all of us that rights are hard fought for and hard won. They are also fragile, and it is on all of us in this place to protect and enhance them, to row forward and build that more equal society that we would all wish to see.

As this LGBT+ history month comes to a close, let us all acknowledge the past, stand up and speak out in our present and seek to build a more equal future.