Chamber and committees

Good morning to the panel members. I want to focus on the idea of having a single electronic record for health and social care. That has come up time and again, not only in our scrutiny of the bill but more broadly in our work, including in many of our inquiries. Many people feel that having a single record is important, particularly so that people do not have to repeat their stories and explain their issues time and again.

What are your views on the benefits or otherwise of having a single electronic record? Is there sufficient data in the system to deliver such a record?

On Sunday, international teams will begin to compete for the biggest prize in world football, but they will do so in a state that denies the rights of LGBT+ people, suppresses the rights of women and has demonstrated quite clearly that it has no regard for the lives or wellbeing of migrant workers. Only a few weeks ago, Qatar’s world cup ambassador branded being gay as “damage in the mind”.

Senior figures of the Scottish Football Association will be attending world cup events on the day the tournament kicks off. LGBT+ people, many of whom are passionate football fans, our allies in stands across the country, the tartan army, the Scottish Trades Union Congress and Zander Murray of Gala Fairydean Rovers, of whom I think we should all be immensely proud, have voiced concern and disapproval about this world cup and have called on the SFA to think again.

The SFA has said that it is

“supportive of all measures to improve human rights conditions in Qatar”,

but does the First Minister believe that members of our football governing body attending this world cup can send any other message than a validation of the human rights record of Qatar, and what message does she think that it sends to LGBT+ people, in particular, in Scotland?

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.

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.

Kay McVeigh comes from a personnel and development background. What is your sense of what the bill needs to do? We have just had a conversation about what is not in the bill. Regardless of that process, what key actions are needed to drive that parity, particularly from a local authority point of view?

I have a brief follow-up question. Much discussion of costs has taken place in recent weeks, in this committee and other committees that are scrutinising the proposed legislation. Are you concerned about the cost of transferring the staff in setting up new services? Is that a worry for local authorities?