Chamber and committees

Is it the ALLIANCE’s contention, therefore, that something that is in the control of ministers and on which they are accountable to 128 of us in Parliament would provide more accountability for people than accountability to the local authority? Am I right in thinking that that is what you were saying?

Thank you, convener, and thanks to the panel for indulging me again.

Co-design is to be at the heart of the process, and, as we understand it, there will be an element of co-design in, if you like, the secondary stages of the bill. Do you feel that that was the right way to go about this, or would you rather have seen more co-design at the front end, before we reached the legislative stage?

I am interested in the transition from childhood to adulthood, and the associated services. There is a member’s bill on that issue and there are Government bills going through Parliament that relate to a lot of issues that are to do with what we are talking about. Might it be better to capture some of the elements of those bills in this legislation? Is there an opportunity to do that? Frank McKillop and Andy Miller have been close to some of the work on those bills, so I would like them to respond to that first of all.

I suppose that when the Scottish Public Services Ombudsman was before the committee she would have raised concerns about duplication of processes, if we had gone for a new national complaints procedure. The Scottish Social Services Council and the Care Inspectorate would probably say similar things.

Would the intention be that there would be a requirement to resource a new national complaints service—in essence, to spend money at national level on people to handle complaints, do an investigation and then feed back to whoever was providing the care? Is that the vision that has come through the consultation?

I know that Community Integrated Care said that there was concern that taking the complaints process out of the local context is perhaps not helpful. If there is time, perhaps Karen Sheridan might want to comment on that.

I am pleased and proud to have the opportunity to open the debate on behalf of the Scottish Labour Party as we mark world AIDS day 2022. It is genuinely a pleasure to follow the minister, whom I know is very committed in this area, and Jamie Greene, who, as always, spoke with openness, frankness and integrity. It is always good to hear about his lived experience. As someone who is younger than he is, I find that it is always good to listen to him talk. [Laughter.] What he had to say about sexual health clinics, in particular, is important, and that is why Labour members will support the Conservative amendment today.

Today, we remember those people who have lost their lives to AIDS, we stand in solidarity with those who are living with HIV/AIDS and we commit to redoubling our efforts to eliminate HIV transmission, not only here in Scotland but across the world. We all stand on the shoulders of those who have gone before. As is so often said on world AIDS day, we remember the dead and we continue to fight for the living.

It is estimated that almost 7,000 people in Scotland are living with HIV. In recent years, we have made steady progress, with 92 per cent of people who are living with HIV being diagnosed, 90 per cent of people attending specialist services and 95 per cent of people who are accessing treatment reporting an undetectable viral load.

However, we cannot be satisfied with improvements because, although improvements are always welcome—every step that we take is welcome—it is not a case of job complete; it is very much still a work in progress. I think that we all recognise that and want to redouble our efforts to move forward.

As we have heard, not enough work has been done to widen access to PrEP to all areas of Scotland. That often results in a postcode lottery for treatment and access to things such as testing and drugs. I think that there is a particular issue in remote and rural communities, where people who may be eligible for PrEP are simply unable to access it because of their postcode. Jamie Greene spoke about some of the challenges that exist in that regard.

I am pleased to hear that the minister intends to proceed with a pilot to address some of those issues, and I hope that she will look at rurality as part of the pilot and seek to establish how we can quickly get more people to be able to access services online.

When it comes to education, it is clear that stigma is still associated with an HIV diagnosis. We must do more to tackle the outdated and often homophobic myths that continue to pollute the discourse in this space and have done over many decades. Although we are far on from those darkest of days, it is clear that such discrimination persists. I welcome the minister’s commitment to mounting a large campaign to address those issues in the public discourse. I look forward to receiving more information on that and, I hope, making a contribution to how we shape and progress that work.

In Scotland, there are certain groups of people who are more at risk. Those groups include gay and bisexual men, people who inject drugs and people who come from certain minority ethnic groups. It would be utterly wrong, though, if we continued to allow to persist the stereotype that HIV can affect only certain groups of people. We need to acknowledge that it can and does affect anyone.

I think that that is clearly borne out in the most recent statistics, which show that, in 2019, when there were 176 new diagnoses of HIV, the likelihood of men who have sex with men contracting HIV was only marginally higher than the transmission rate among heterosexuals: 37 per cent of new diagnoses were among men who have sex with men, while 32 per cent were among those in heterosexual relationships.

An important point that Jamie Greene made is that it is critical to remember that it was only last year that changes to blood donation rules allowed gay and bisexual men to give blood. That began to rectify an outdated and deeply homophobic practice, which was the product of the moral panic around homosexuality and the HIV/AIDS epidemic of the 1980s. Earlier this year, I was proud, as Scottish Labour’s first openly gay male MSP, to give blood for the first time since I was 17. It is undoubtedly the case that that historic change in the law has helped us to tackle the stigma relating to HIV/AIDS and it is clear that we must do more to continue that work.

I know that there is a consensus in the chamber that we must eradicate HIV transmission by 2030. To achieve that aim, we must have important interim markers that allow us to assess our progress on the journey to elimination by 2030. That is why our amendment calls on the Government to outline clear timescales for our work to eliminate HIV. In that regard, we can learn from other Governments and from plans elsewhere. For example, in Wales, the HIV action plan for 2023 to 2026 sets down clear actions regarding eliminating new HIV infections, improving quality of life and reducing stigma.

I welcome the commitments that the minister has made today, which will be helpful to us all in scrutinising the work, getting it right and moving it forward. We have an opportunity to look at how concrete actions will be followed through and at how much of the work can be mainstreamed into the HIV elimination plan.

We know that it is not enough to focus on the issues for just one day a year. We must do that day in and day out, week in and week out, and it should be a public health priority for the Government, Parliament, local authorities and us all.

The minister’s commitment to set up a group to look at implementation is very welcome. Parliament will want to take time to scrutinise that work. That is why our amendment calls for regular reporting to Parliament, so that we can all have a say on those issues.

On this world AIDS day, we must commit to moving the debate beyond good sentiment and warm words and must focus on having clarity to deliver tangible actions to eliminate HIV transmission in Scotland by the end of the decade, which we can and will do.

I move amendment S6M-07025.1, to insert at end:

“, and calls on the Scottish Government to outline a clear timescale for eliminating HIV transmission in Scotland by 2030 and commit to providing the Scottish Parliament with an annual progress report.”

Trade unions, local government, professional associations, care providers in all sectors, carers and front-line workers are calling for a pause to legislation, but they are also concerned that the legislation will not meet the aspirations of the Feeley review into social care. Therefore, can the minister explain why he has failed to introduce the key recommendations of the Feeley report, such as ending non-residential care charges—which was, incidentally, a Scottish National Party manifesto pledge—and say when he will listen to the serious concerns of those stakeholders?

I am pleased to have the opportunity to contribute to this vitally important debate as we mark the 16 days of activism against gender-based violence. I intend to focus my comments on the role that men must play in challenging and eradicating violence against women and girls.

I am proud that, today, my colleague Pauline McNeill launched our party’s consultation paper on ending violence against women and girls. I commend that work, and the work of people in our party such as Pauline McNeill over many years on these issues, to ensure that we can tackle such pernicious and serious issues. Indeed, this week, I heard these issues labelled by the Queen Consort, no less, as a “pandemic” of “heinous crimes” that exists not only in our country but around the world. I think that we would all recognise that, in her contribution to the 16 days of activism, she highlights something that we really need to focus on tackling.

Over the years, women have shown bravery, courage and strength in calling out the horrific abuses of power and acts of sexual exploitation and violence that have been carried out by men who believed that their income and status would protect them from being challenged, called out or held accountable for their behaviour. We should take a moment to thank those brave women and to remember all those who have been killed as a result of violence against women and girls, the names of whom we have heard from colleagues on all sides of the chamber today.

I make it clear that the primary burden of challenging dangerous, toxic and violent behaviour by men should be on men. Men have to take responsibility to change their behaviour. We must be part of the solution, because misogynistic attitudes remain deep-rooted in the foundations of our society. Those attitudes reveal themselves in small, subtle actions, or they present in a more overt and aggressive manner, through derogatory comments on women’s appearance and sexist humour, including sickening rape jokes. We know that, in this day and age, that exists online in a way that it never did in generations past. Pauline McNeill’s contribution in that regard, and the amendment that Scottish Labour has lodged, are crucial in enabling us to begin to deal with what happens in those online spaces.

In recent years, there have been particularly disturbing increases in the number of incidents of women having their drinks spiked in our bars and clubs.

Men must challenge their male relatives and male friends and must call out behaviour towards women that is problematic when they see or hear it—for example, when they hear an inappropriate joke about a woman’s appearance.

The role that men play in this space is vitally important, which is why I support White Ribbon Scotland and the fantastic work that it does in getting men to challenge violence against women and, we hope, to begin the process of eradication of violence against women. I first encountered White Ribbon when I was a local councillor, and I pay tribute to local authorities across Scotland, which play a vital role in the 16 days of activism against gender-based violence. As other members have said, they play a particularly important role in encouraging our schools, colleges and universities to educate people—especially young men—on the role that they must play.

A variety of activity is taking place across our local authorities in the 16 days. For example, my colleague in Inverclyde, Councillor Francesca Brennan, is running a Reclaim the Streets glow up walk in Greenock on 6 December. She is encouraging younger women and girls, in particular, to take part in that and to stand up against the violence that is too often experienced on our streets.

We need to focus on shifting attitudes and changing cultures. Peer-to-peer action is crucial in shifting the dial and dismantling toxic masculinity. Men must challenge one another to be the best version of themselves by calling out and challenging damaging, dangerous and corrosive attitudes against women.

I want to touch on the specific issue that exists in sport because of the public platform and adulation that accompany success for many men in the sporting arena. Athletes, footballers and ice hockey players can be heralded as idols and viewed by their younger supporters as role models whom they look up to and would seek to emulate. That raises the crucial issue of how sexual misconduct is addressed in sport. It is clearly an important barrier that impedes the participation in sport of many women and girls.

I am glad that the Health, Social Care and Sport Committee is keen to look at that area and, in particular, at the barriers that exist in sport, and I hope that we will be able to take a more focused look at how allegations of sexual misconduct are handled.

This year, there have been high-profile cases involving professional sports clubs in Scotland. In football, Raith Rovers and, in ice hockey, the Glasgow Clan have rightly faced significant criticism for signing men who have been guilty of rape and sexual assault. That led to a backlash against those signings, which forced the clubs to reverse their decisions. In the case of Raith Rovers, club directors and staff resigned and, ultimately, the women’s team cut its ties with Raith Rovers and was established as McDermid Ladies, in homage to the wonderful Val McDermid, who did so much to lead that campaign and to call out the club for its handling of the situation.

We will never achieve a systemic rebalancing of sports participation if we are not all willing to work to challenge the toxic attitudes and atmospheres that persist in our stadiums and clubs across the country. Government and sports regulators need to play a more proactive role in ensuring that sport is a safe environment for women and girls. There are many options that we could explore, such as manager training and education sessions that are focused on identifying misconduct and signposting people to appropriate means to report such misconduct.

I reiterate that the responsibility for tackling violence against women and girls lies with men. It is for men to take responsibility for their own actions and to be better. I urge all men to speak up, to challenge other men to do the same and to be the best version of themselves and a strong ally in tackling violence against women and girls.

I will try to draw some of this together and think about the broad theme of how we will measure the success or otherwise of the bill. There has been a lot of discussion this morning, and with other witnesses, of Derek Feeley’s review and of how to achieve what was set out in that review. How will we assess and measure the success of the national care service bill, and will the current level of detail in the bill be sufficient to allow us to judge whether it has achieved its aims? I will start with Peter McCormick, and then Margaret McCarthy, Fanchea Kelly and Nick Price might want to come in.

Rachel, CCPS submission’s says:

“The Scottish Government appears to have taken the view that aspects of the detailed implementation of the Bill should be subject to codesign but that the overall approach to system redesign and structural reform should not.”

Do you think that that is back to front in some ways and that there should have been co-design in advance of the bill to inform what it looks like? How would you respond to those who have called for a pause on the bill to try to get it right?

In the Randolph Hill submission, you spoke about being concerned about an absence of criteria to judge success or failure. Do you recognise that there is not enough detail in the bill to measure success against?