Chamber and committees

I thank Jeremy Balfour for securing this debate on the Down Syndrome Bill, which has passed its stages in the House of Commons and the House of Lords.

As the motion states, Dr Fox’s bill received cross-party support across the house and has moved through its stages, allowing for important debate and discussion about the human rights of people who have Down’s syndrome and their families and carers. That is what is important tonight. I do not want to get bogged down in a constitutional debate; I want to talk about the important lived experience of the people we are talking about.

My Welsh Labour colleague in the House of Commons, Ruth Jones, spoke very powerfully at the bill’s second reading about her experiences as a paediatric physiotherapist and, in particular, about the work that she did in supporting children and young people. I believe that that was perhaps the first time that many of the issues experienced by those people and their families were heard in the United Kingdom Parliament, so it was crucially important.

Although the provisions of the bill relate to England, they have been welcomed by charities in Scotland. Eddie McConnell of Down’s Syndrome Scotland, who we heard about from the previous speaker, said that

“The Down Syndrome Bill has the potential to be a landmark moment in advancing the rights of people with Down’s syndrome.”

He went on to point to the important collaborative work already being done in Scotland to move forward the rights of people who have Down’s syndrome and other learning disabilities. I am proud to have already played a small part in that journey in my working life prior to becoming an MSP and I hope to continue that work in the Parliament.

The Down Syndrome Bill seeks to remind public bodies of their duties and gives legal weight to the rights of people and their families who are fighting to get the support that they need. That is so important for many people who describe trying to access the right support and services as a daily battle.

As I have said, although the bill has been broadly welcomed in England and by organisations in Scotland, it is fair to say that there have been some divergent views on how the far the bill has gone and the fact that it could have gone further. Mencap has said that it would have done things a bit differently had it been more involved at an earlier stage in the development of the bill. For example, it would have made the bill apply to everyone who has a learning disability and framed it in the language of a social rather than a medical model, going to greater lengths to engage more people with lived experience. However, rather than oppose the progress that bill represents, Mencap has acknowledged that it has looked optimistically at what the bill could lead to in the future in England. To be honest, I think that that is where we find ourselves in Scotland—with a very clear opportunity.

I have already alluded to my previous work. When at Enable Scotland, I had the great honour of working with people who have a learning disability, their families and carers, and organisations such as Scottish Autism and the National Autistic Society, to secure cross-party commitment to a learning disability, autism and neurodiversity bill, with the introduction of a commissioner to advocate, support and protect the rights of people across Scotland. I know that the current minister, along with Jeremy Balfour and colleagues across the chamber, share our passion and concern so that we get that right, working with people across the country, listening to what they need and delivering both that bill and a commissioner with a robust set of powers to make a real difference.

Now that I am a member of this Parliament, as convener of the cross-party group on learning disability, I will seek to act as a bridge between the many people who have a learning disability and the Parliament as we work to deliver a bill that will deliver for them. The work of Dr Liam Fox through the Down Syndrome Bill is an important start and we can draw inspiration from it, but I believe that we can and must do more for people across Scotland who have Down’s syndrome, other learning disabilities and autism. I look forward to doing that work, which must be done at pace because we do not want to be left behind and we do not want to leave behind the people who need such a bill. I look forward to the work, the discussion and the debates that we will have across the Parliament and our country. We will want to undertake to ensure that the voices of those who, all too often, are not heard in the Parliament are indeed heard.

Our hospitals are under immense pressure, and A and E waiting times are shocking. Care at home and residential care services are also under immense pressure, and schools in some parts of the country are having to temporarily close. Already high staffing shortages are being exacerbated by Covid-related absences. As a consequence, people who need support are often falling through the gaps and staff are struggling to keep things going. I am talking about older people who need care and young people who are preparing for exams.

What urgent additional support will the First Minister provide to support services that are in desperate need? Will she clarify the Government’s plans for self-isolation and testing as we move forward into the spring and summer period?

I thank the cabinet secretary for that response and I recognise what she says about aids and adaptations. In a previous answer from Kevin Stewart, I noted the commitment of £20 million of extra funding for housing, in order to bring people home from long-stay hospitals. Although funding has been committed, it seems that no real targets are attached to a lot of that money. Given that organisations such as Enable Scotland, the MS Society and MND Scotland have highlighted and campaigned on the need for speed in relation to adapted housing, will the cabinet secretary commit to a target of at least 10 per cent of new social housing properties to be fully accessible internally and externally?

To ask the Scottish Government what action it has taken to support local authorities in providing adapted housing. (S6O-00935)

I thank the cabinet secretary for that commitment.

We have also had discussions—I have been slightly banging on about this—about the need to provide digital spaces in locations in our communities. An obvious example that comes to mind is libraries. I have spoken before about how we can use libraries—and improve and protect their services—so that people can access digital services where they need to. That does not necessarily have to be in the main, public part of the library; there are definitely spaces elsewhere where people can be supported to do that in communities.

In a lot of communities, particularly in rural locations, the GP surgery is one of the few amenities, so it becomes the hub and focus. A challenge or a barrier can be that people might not want to go online alone at home. How do we ensure that an increasing number of facilities are available to people in community settings where they can access information and advice, or indeed get a consultation, online?

My question follows on from some of those that have been asked already and is about the data that is available. Figures from Public Health Scotland show that the number of whole-time equivalent GPs has gone down: we are at the lowest level since 2013. Although the head count is going up, the whole-time equivalent number is a better yardstick in helping us to understand the picture of services across the country.

We have not had any figures on whole-time equivalent GPs since 2019. I do not know whether the cabinet secretary has any information about that; if so, the committee would be keen to see it and to know where we are with whole-time equivalent GPs. Can you commit to providing that information?

Receptionists are not the only staff in GP practices. We have heard about signposting and gatekeeping and all sorts of things, and we had some good evidence from Dr Graeme Marshall, who talked about reception teams training with clinical staff and the more administrative staff. Do you see any opportunity to standardise some of that training?

Because of the nature of GP practices, this would be hard, but perhaps we could look at the pay and conditions of those on the more administrative side and how we might enhance their roles. After all, we know that they are doing more than just answering the phone and talking to patients.

We have heard evidence from patient groups, particularly the Riverside patient participation group, which I think is from Musselburgh, about digital exclusion and health needs. Those two things coincide. We understand that approximately 10 per cent of the population do not have access to new technology or the skills that are required to use it, and that those people are the most likely to have the greatest health needs—there is a clear correlation. I am keen to get a sense from the cabinet secretary of how those patients’ routes into primary care can be protected and enhanced, given the challenges.

To follow on from that point, I understand that the regulations cover hospitals, particularly—