Chamber and committees

The member survey by the RCN, coupled with new statistics today that show record nursing vacancies in Scotland, is shocking. Nurses are at breaking point, and there are reports of nursing staff walking off wards due to stress and the pressure that they are being put under. That comes after 15 years of the Government slashing bed numbers, failing to tackle delayed discharge and failing the nursing profession by cutting training places and presenting no meaningful workforce planning.

I put that issue to the Deputy First Minister at First Minister’s question time a few weeks ago. He said:

“we are working to ensure that we can address the issues that are of concern to members of the Royal College of Nursing.”—[Official Report, 26 May 2022; c 20.]

With yet more deeply concerning evidence, what exactly is the cabinet secretary doing to address those extremely serious issues, which threaten not only the wellbeing of staff but the safety of patients? Is not it time to offer nurses a proper pay award and decent terms and conditions?

As the First Minister knows, delayed discharge rates are soaring. With an increase of 8 per cent in March this year, that means 1 in 10 beds is occupied by a person who is ready to be discharged. That is a result of continued failure by the Government to properly fund social care in Scotland and to support the workforce. Does the First Minister accept that if her Government was serious about freeing up bed capacity in our NHS it would properly fund social care and show that it values social care workers and unpaid carers by committing to a proper workforce plan, decent terms and conditions and a wage of at least £15 per hour?

In the past two years, Covid-19 has dominated every part of our lives, particularly our actions on health inequalities. I am keen to get a sense of the witnesses’ views on the Covid-19 recovery plan. What should be prioritised in the plan to tackle health inequalities? I appreciate that that is a big question.

I am keen to understand more about the policy interventions that we can make in a devolved context. The committee has heard quite a lot of evidence and had quite a lot of discussion about what happens at the reserved and devolved levels, but I am keen to get a sense of what policy makers can do in the devolved context to make a difference. I ask Ed Pybus to start, because I know that his organisation, CPAG, has been close to the work around the Scottish child payment. Ed, I am keen to get your sense of how we can go further.

Of course.

I am pleased to have the opportunity to close this important debate on behalf of the three committees, Health, Social Care and Sport, Criminal Justice, and Social Justice and Social Security. The committees have, as we have heard, undertaken joint scrutiny work on the issue of tackling drugs deaths and drug harm.

I begin, as colleagues have, on behalf of the committee by offering our condolences to anyone who has lost a loved one to drugs. I thank everyone from all sides of the chamber who has contributed to the debate, bringing their experience and ideas. I particularly thank our committee conveners who opened the debate, the minister and the party spokespeople, and I echo everyone’s compliments to Collette Stevenson for her powerful and personal speech.

The debate and the joint work that preceded it have been important.

The debate and the joint work that preceded it have been important and broadly positive and are a strong example of cross-committee collaboration in Parliament. That work also reflects the cross-sectoral nature of the significant challenges that we face in tackling drugs deaths and drug harm and the variety of actions needed to address them. We have heard some of the ideas and thinking about those issues today. We heard from Russell Findlay and Sue Webber about the challenges in rehab services, the limitations of the Misuse of Drugs Act were outlined by Gillian Mackay, and Stuart McMillan outlined the need for long-term support in everyday life.

The evidence that we took as a joint committee from the UK Minister for Crime and Policing, Kit Malthouse, and from Angela Constance as the Scottish Government minister with responsibility for drugs policy, showed that many complex responses and interventions are required and that those will be found at many different levels of Government.

From the perspective of the Health, Social Care and Support Committee, today’s debate has been particularly useful in shining a light on the public health aspects of drugs policy, a number of which the committee will undoubtedly want to explore further as part of its future work programme. Those include the issues of stigma, as raised by Emma Harper, and of safe drug consumption facilities, as raised by many speakers from across the chamber. There will no doubt be other aspects that colleagues in the Criminal Justice Committee and the Social Justice and Social Security Committee will want to take forward.

I hope that the committees can continue collaborating effectively as we progress with our important scrutiny work. It is clear that scrutiny and ensuring Government delivery will be important, particularly on issues such as the MAT. We must ensure that we scrutinise the members’ bills in the names of Douglas Ross and Paul Sweeney that we have heard mentioned today.

Some contributors mentioned the tone of the debate. Gillian Martin spoke about the need to ensure that our tone is respectful, as did Michael Marra and Jamie Greene.

We must continue to focus on finding common ground on the issue, because there is a common view across the Parliament that this is a national emergency that warrants an urgent and concerted response. What we have seen demonstrated today is that there is perhaps less of a consensus on what the solutions might be and how we should move forward.

In the joint committee, I had an exchange with Kit Malthouse in which I asked whether he acknowledged that poverty is an underlying cause of the drug deaths crisis and he responded by saying:

“I do not. I think that it is the other way around”.—[Official Report, Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee (Joint Meeting), 1 February 2022; c 14.]

He said that violence drives poverty rather than it being the other way round. However, there are contrary views. Some of the written evidence that we received in committee from alcohol and drug partnerships across Scotland specifically highlighted poverty and deprivation as being important contributing factors to drug harms. That evidence points to a significant overlap between our most deprived communities and an increased prevalence of drug harms and deaths.

However, it is also clear that we must drill down further to understand the particular challenges in our Scottish context and why our drug deaths are higher than those of other parts of the UK. I think that there continues to be broad agreement in this Parliament that Scotland’s drug deaths crisis is first and foremost a public health crisis and that our policy response needs to treat it as such, but we must acknowledge the relationship between health and justice, which has all too often jarred over many years.

Ultimately, if we are going to find impactful solutions, we need to follow the evidence, and it is important that we do that without prejudice or preconception. This afternoon, we have heard multiple examples of collaborative work throughout Scotland, the impacts that it is having in tackling drug harms and the further measurable impacts that it could offer for workable solutions that will reduce drug deaths.

In winding up the debate, I will highlight another example. In its written submission in response to our call for evidence, East Renfrewshire alcohol and drug partnership told us about Turning Point Scotland’s successful bid to deliver the WAND initiative in greater Glasgow and Clyde, including East Renfrewshire. The WAND initiative delivers four key harm reduction interventions on an outreach basis, focusing on wound care, the assessment of injecting risk, the provision of naloxone and dry blood spot testing for blood-borne viruses. We heard a lot about many of those interventions across the country in the debate today.

The WAND initiative is one of many innovative approaches that the committee has heard about in written evidence. It is an example of efforts to deliver consistent harm reduction interventions in communities across the west of Scotland. As legislators, we have a responsibility to evaluate and learn from those approaches and to try to replicate what works. That is why it is so important that, in this afternoon’s debate, we heard strong calls for evidence-based decision making, reporting to this Parliament and continued scrutiny and analysis of what is being done in this national mission.

We also heard in written evidence and all our discussions on the subject that early intervention is an important element of an effective policy response. We need to be mindful that an early intervention approach takes time to be embedded and to start delivering results, but it is no less important for that.

On behalf of the committees, I note the minister’s continued willingness to engage with us and be subject to on-going scrutiny in the committees and in Parliament, not only in relation to the work of the Drug Deaths Taskforce and its implementation but with respect to the new national collaborative. As a committee, we look forward to continued engagement and scrutiny of the decisions that the minister takes.

I believe that, across the Parliament, we all share a common goal, which is to achieve a sustainable long-term reduction in drug deaths and harms in Scotland and, ultimately, to eliminate the blight that drugs currently inflict on so many lives. I hope that, over the coming months, we will continue to do that in a collective dialogue, maintaining a laser focus on scrutinising progress. It is through effective collaboration across committees and parties, and by taking an evidence-based approach, that we will have the best chance of delivering on the national mission to reduce and ultimately eradicate drug deaths and harms in Scotland.

Another day, another inadequate answer from the minister on this issue, which is affecting our communities across every part of Scotland. The cuts are having enormous consequences in the lives of everyday Scots who depend on rail services to get to work, attend appointments and access childcare.

In a letter from ASLEF to the First Minister, Kevin Lindsay has called on the Government to get back round the negotiating table, and I appreciate that the minister has said that that will happen. Will the minister confirm that the Government will negotiate in good faith on the key issue of driver recruitment? ASLEF has said that 130 drivers need to be recruited in order to staff our railways safely? Will the minister and the First Minister get around the table in good faith to ensure that we end the negative cuts that are having such an impact on people across Scotland?

To ask the Scottish Government what its response is to reported concerns by the Scottish division of the train drivers union, the Associated Society of Locomotive Engineers and Firemen, regarding proposals to make further cuts to ScotRail services. (S6O-01143)

On Monday, Julie Lambeth, chair of the Scotland board of the Royal College of Nursing, said that fair pay is needed to stem an exodus of staff and retain younger nurses in our national health service. She also made it clear that, right now, the two priorities for dedicated nursing staff are pay and safe staffing.

Nursing and midwifery vacancies climbed by a shocking 170 per cent between 2020 and 2021, and I have heard at first hand from nurses who have made it clear that the current normalisation of staffing gaps is taking its toll on their mental and physical health. Those are some of the most dedicated and hard-working staff in our NHS, who are leaving the profession that they love, broken.

When will the Government get a grip and engage with the RCN on safe staffing, fair pay and the meaningful workforce planning that has been so desperately lacking?