Chamber and committees

To ask the Scottish Government what its response is to reported concerns raised by the chief constable and the Scottish Police Authority chair regarding the impact of the resource spending review on service delivery in Police Scotland. (S6O-01555)

Police officers in Scotland have been sounding the alarm for some time about the lack of support that they have been experiencing. Police Scotland has already been starved of funding by the Government. Senior officers have explicitly called for access to equipment such as body cameras, but have stated that they have no budget to be able to deliver what is described as basic kit, which would give them parity with their counterparts elsewhere in the United Kingdom.

The cuts will have devastating implications for community policing, elongate call-out times and enable crimes of dishonesty to increase—unresolved—across our communities.

Will the cabinet secretary listen to front-line police officers? How will he deliver the basic equipment and resources that they need against the backdrop of his proposed cuts?

On a point of order, Presiding Officer. My device would not connect. I would have abstained.

I think that we can all agree that it is important that this debate has been held in the chamber today, because it is clear that chronic pain is a public health crisis that is deserving of time and attention in this place and that it demands the focus of the Government.

As we have heard from many speakers, the cross-party group on chronic pain has been calling for this debate for some time now, and we should acknowledge the work of the group’s work—in particular, the work of Dorothy-Grace Elder and, indeed, the co-conveners, who have contributed to today’s debate. It is in that cross-party group that, very often, all of the concerns that we have heard today get raised, articulated and explored. Much more important, it has also acted as a support group for people who have experienced chronic pain, perhaps for the first time in their lives.

If the new framework is truly to deliver meaningful improvement for people living with chronic pain, it must go further and be underpinned by clear investment. If it delivers the improvements that we all seek, we will give the Government credit, but it is clear that there are people who feel that it could fall short of the mark. We must see investment to match the aspiration.

I acknowledge the minister’s response to the issue that Jackie Baillie raised with her, and I hope that she will say more about it in her closing speech. The reality is that thousands of people have waited an unacceptable amount of time for their first appointment at a chronic pain clinic, and we have heard about the challenges with regard to the availability of pain clinics across the country.

We have also heard from colleagues across the chamber about issues in their communities and the things that people have experienced in getting the treatment that they need. Monica Lennon and Finlay Carson highlighted issues that have been experienced by people such as Liz Barrie, from accessing medication and pain management injections right through to—this is, I think, most important—the mental health issues that people experience and the poor mental health that goes hand in hand with chronic pain. Indeed, I thought that the contribution about Liz Barrie was very powerful.

The briefing for today’s debate that Versus Arthritis has shared with each of us highlights how people in this situation feel, including the desperation that they often experience while waiting for updates on their treatment or access to treatment for chronic pain. That sense of not knowing, of not having information and of not being able to get on with one’s life is hugely challenging and deeply concerning.

The Government has said that it is grateful to respondents for taking the time to contribute to the consultation that informed the framework, but it is fair to say that people have also been voicing their concerns that they have not been listened to enough. It is clear that a consultation cannot be just a case of listening to and reflecting on people’s views and then acting without them. As we have heard from Alex Cole-Hamilton, Jackie Baillie, Pam Duncan-Glancy, Miles Briggs and others, people must be at the heart of influencing and scrutinising the framework and driving it forward, because, as we know, lived experience has to be at the heart of everything we do. We have heard some very powerful contributions from colleagues—Pam Duncan-Glancy, Emma Roddick, Christine Grahame and others—who have spoken bravely about their own experiences, and it is important that we reflect on the fact that what they have told us is the story of our constituents, too. They want to be able to share their experience and to see that experience reflected in the framework.

The Scottish Government should be working in partnership with patients, putting them at the heart of service design and using their experiences to inform the best way forward. We also have to do that in relation to new and emerging issues such as long Covid. It is important that Alex Cole-Hamilton brought that issue to the chamber again, given how those who experience long Covid are very often not believed, not given the right information and then dismissed. Indeed, we have heard that today not just about long Covid but about many issues associated with chronic pain.

I absolutely agree with Alex Cole-Hamilton, and in that respect, I would highlight the work that has been done by the cross-party group on long Covid to bring some of those issues to the fore. I hope that the minister will have time to respond to that issue when she sums up.

Alternative pathways for people with chronic pain are to be welcomed; indeed, any solution that offers people relief and respite is to be welcomed. I thought that Rona Mackay’s contribution in that regard was particularly important. We have to look outside the box and think about different avenues, and we have to learn from the Covid pandemic about how we might use some of the innovations that were put in place then to make things better. I think that Miles Briggs highlighted that issue, too.

I am conscious of the time, Presiding Officer, so I will turn briefly to workforce issues. We know that workforce shortages are affecting the delivery of chronic pain treatment, and as we have heard this afternoon, there are issues with accessing specialist doctors and advanced nurse practitioners. We know, too, about issues with allied health professionals; they play an important part in delivering these services, but, as workforce data shows, more than 346 whole-time-equivalent physiotherapy places are vacant. We need to get those vacancies filled and expand the workforce to ensure that people are available to provide the support that is required.

We heard important contributions on the balance between specialist services and self-management; indeed, I thought that Bob Doris’s speech was particularly important in that regard. He said that it should not be one or t’other, and I think that he is right. That point was also highlighted by Pam Duncan-Glancy. People cannot be left just to self-manage and be pushed to the bottom of the list. There have to be specialist services along with good, high-quality inputs in terms of self-management.

People in chronic pain cannot wait. The Scottish Government must listen most carefully to those people who are suffering with chronic pain and deliver services that offer relief and help improve quality of life. That is the yardstick by which we on the Labour benches will judge progress on the Government’s plan.

I thank Bill Kidd for bringing the vital issue of mental health to the chamber for debate. I also thank SAMH and all the other organisations that support our mental health in Scotland. I take the opportunity to place on the record my thanks to SAMH, Co-op, Mind and Inspire for their hard work in producing the excellent “Together Through Tough Times” report.

I struggle to think of anything that is more important than the mental health and wellbeing of everyone who lives in Scotland. I also struggle to think of a more important duty that we carry as legislators in Parliament than the responsibility to speak up and support the most vulnerable people in our society.

In the aftermath of the pandemic, coupled with the pressures that people face as a result of the soaring cost of living, the importance of mental health awareness and the fight against stigma have never been more acutely in focus. That is why the report is so timely and important. I know that many people felt that sense of importance last night at the reception that was hosted in the Parliament.

The circumstances that have brought about that focus continue to bring about challenges, hardship and losses in communities. We have a unique opportunity to confront head on the issues that are associated with mental health and wellbeing in a way that we have never had before.

As I am sure all colleagues did, I recognised in the report much about communities in my life and region. I think of the amazing resilience of communities across West Scotland, some of which are in the lower quartiles of the index of multiple deprivation. I think, for example, of the power of bereavement groups in local churches, which have been run for many years and have done the really important informal work of supporting people when they lose a loved one.

I think of the work of the community support and check-in groups that I saw in my community throughout Covid, and the work of people who come together and check in on one another at difficult times.

I also think of the excellent work that football clubs, such as Greenock Morton FC and St Mirren FC—two teams that one does not often hear mentioned in a positive way in the same sentence—have done around supporting young men, in particular, in communities to speak out, have a sense of ownership of the place where they live and that they care about, and to talk about how they feel and what is going on in their lives. All that support is important, and the report highlighted those examples clearly.

It is clear that there is an opportunity now to really focus on some of the more informal structures and give them the support that they need. I am sure that the Government will want to try to seize the moment with partners and do what is needed.

We are told time and again that poor mental health and suicide are priority issues for the Government. We have to reflect that Scotland has high rates of suicide, and we know that many vulnerable children and young people are struggling and waiting a long time to access mental health services—indeed, some of the recommendations in the report focus particularly on access to child and adolescent mental health services.

We must ensure that work such as that which the report highlights is well supported, and that groups have the funding that they need to be able to thrive. I have mentioned the issue of support for third sector groups in the chamber a number of times. As we continue to go through the cost of living crisis, we need to see a really dedicated effort to support those groups.

In an excellent and very important piece of research, which SAMH published last year during the pandemic,

“people reported feeling like a burden and anxious about adding to the pressure of the health service by asking for help and support.”

It is clear that we need to move towards a system of reformed referrals and triage services, and to operate “No wrong door” approaches, which might be through local community groups rather than through services that are more formal. It could mean that referrals for mental health support come from a range of sources, and that pathways towards support and accessible and adaptable services would depend on what each of us, as an individual, needs. We want communities that are more resilient.

I believe that by focusing on what is outlined in the report and reforming how we go about delivering services, we can ensure that no one is rejected from support and that every referral is signposted to the right service, so that everyone has the right care, in the right place, at the right time.

I wonder whether I can return us to the way that the bill came about. We have heard a lot about co-design after the framework bill is passed and we have heard a lot about that co-design being done through regulations.

My sense, across all the contributions here today and more widely, is that there are things that could be dealt with right now using existing powers in relation to pay, terms and conditions and the recommendations in the Feeley review and the Fair Work Convention, and that it might have been better to sit down and co-design something in a meaningful way before we got to the legislative process.

Is it fair to say that that is the position of trade union members and that that is why there is a call to pause the bill? Do you feel that it would have been better to do the co-design up front and to have a meaningful discussion about what that would look like?

I find it extraordinary that no one approached the trade unions and said that that would potentially be the process.

I will ask about finance. A massive structural change such as we are discussing brings with it a financial burden. There has been a lot of comment in this committee and others about the financial memorandum that accompanies the bill—we have heard it being referred to as a blank cheque. I am keen to get your sense of what that could mean when it comes to the local authorities’ finances.

Good morning. I will direct my questions to Alison Bavidge and Colin Poolman because they are relevant to their submissions. In its submission, the SASW said:

“As it stands, this Bill is unlikely to deliver improved quality and consistency of social work services.”

In its submission, the RCN said:

“the Bill will not achieve”

its

“purpose without the Scottish Government first tackling the workforce crisis across health and social care”.

Given the answers to the convener’s question, does the process seem to be back to front? Should there have been more input into the framework legislation in order that things could have been put in the bill that could affect the issues that you spoke about in your submissions? Should we then have looked at how to go forward from there?

Sure. I was just quoting back to you the concerns in your submission about delivering quality and consistency and asking whether you would rather have seen more detail in the bill. You mentioned putting things in the bill, but could you expand on what could have made a difference?