Chamber and committees

Good morning to the panel. I want to focus on the signposting journey. Throughout the evidence that we have taken so far, we have heard that one of the barriers to signposting is perhaps the constantly changing landscape of service providers. There are also barriers for patients in relation to communication and understanding what is available. How can we improve people’s understanding of what is available and the communication that exists to let people know about it?

That is very helpful.

At the most recent meeting of the cross-party group on learning disability, the issue of access to vaccination was once again raised by people who have a learning disability and their family carers. Will the First Minister ensure that people who have a learning disability and can be more vulnerable are called for the spring booster programme? Will she ensure that, when reasonable adjustments are required—such as for people who have autism and find it difficult to be in large vaccination sites—they are made?

I am pleased to contribute to this extremely important committee debate and to follow powerful speeches by colleagues across the chamber.

I also pay tribute to colleagues in the Equalities, Human Rights and Civil Justice Committee for their work thus far in investigating and reporting on conversion practices and for the report’s recommendation of a comprehensive legal ban. As a substitute member of the committee, I have had a little insight into the power of testimony that has been offered by witnesses, particularly from those who have suffered the pain of so-called conversion therapy.

It is also right that we pay tribute to the petitioners, to End Conversion Therapy Scotland and to the many organisations that have supported them and the committee’s work.

Conversion practices are dangerous and cruel, and they cause lasting damage to those who experience them. They are in violation of fundamental human rights and, as Amnesty International points out, they are

“inherently humiliating, demeaning and discriminatory”.

Evidence shows that the majority of conversion practices are carried out in a faith setting. As a person of faith, I find that horrifying and, as a gay person, I have found that terrifying. I am fortunate that I have never had to experience what survivors bravely spoke about to the committee. As a survivor from Glasgow described,

“I’m not sure I could ever put into enough words the effect it has had on my life. I mean, it has nearly cost me my life on several occasions because I could not cope with who I was—who I am. I feel robbed of joy, of safety, of self-worth, of opportunity, of who I actually am, and who I should have been, free to explore and live my life. So much of what I went on to experience, and how I have struggled to navigate through life has stemmed from this.”

That is hard to contemplate, because joy, safety and self-worth are fundamental to our very existence.

Although I have never directly experienced conversion practices, as a Christian, I have had some encounters that I believe can lead to those practices being employed. I have been told that being LGBT+ is a sinful choice for which conversion is required and that there is something intrinsically disordered about LGBT+ people. I have been held to different standards to my heterosexual peers. When I was young, someone at church wrote to my dad to out me, in the expectation that he would do something about the incompatibility of my faith and my sexuality. I was lucky—in response, my family has shown me only love and affirmation, but not everyone is so fortunate.

As we have heard already, 7 per cent of LGBT+ people in Scotland have undergone or been offered so-called conversion therapy, including 10 per cent of trans people. We know from evidence that that is often as part of family pressure.

I was particularly pleased to be at the committee on the day that Jayne Ozanne of the Ozanne Foundation gave compelling evidence in that regard, and I have been heartened to see the committee find that the majority of religious organisations are opposed to conversion therapy and support a ban. On an international level, I particularly praise the work of Father James Martin SJ and Dr Mary McAleese, former president of the Republic of Ireland, for their work, which has had a profound impact on me and my faith.

Today is another step towards ending conversion practices in Scotland, but we now need a bill for a comprehensive ban. I note what the minister has said with regard to that and I associate myself with the comments of colleagues on the need for urgency. However, legislation alone is not enough. We need resources and support services for victims and survivors, as well as a comprehensive awareness campaign on the unacceptability of conversion practice.

For now, for LGBT+ people of all faiths and none, I finish with a quote:

“I am fearfully and wonderfully made”

and so are you.

I thank my colleague Alex Rowley for securing this extremely important debate and for his powerful speech outlining the issues. I pay tribute to all our care workers across Scotland, who work, day in and day out, to look after and care for older people, people who have disabilities and people with long-term and life-limiting conditions. Their contribution is immense and their work brings dignity, respect and, indeed, happiness to the lives of so many and their families.

Caring is an essential service in our communities, but it is more than that. It is a vocation; a role that dedicated and compassionate people offer themselves to—and we know from the figures they are very often women.

Colleagues might not know this, but, when I was a student, I worked in a care home. I was an activities organiser, which means that, among other things, I can call a really mean—[Inaudible.]—bingo. The experience taught me a lot about older people and the challenges of living with an illness such as dementia. Although I played a small part in a wider team, it was nothing compared with the contribution of the care staff: they taught me the most.

I was always in awe of the dedication and patience of the care staff and the genuine care with which they supported the people living in the home. They took time to get to know them and their families, found ways to brighten their day with stories or songs, fiercely protected their dignity and independence, and shared with families all the news and important moments that they may have missed during the day or week.

In my job prior to being elected to the Parliament, I had the honour of helping to tell some of the most amazing stories about personal assistants at Enable Scotland and the work that they did during lockdown. That work included recreating at home the Friday nights spent at the favourite social club of the person whom they cared for, arranging for local pipers to play outside people’s homes and linking people up with their loved ones via digital methods. They went above and beyond because they cared.

Respect for their work and the rates of pay never matched what those staff gave, despite the efforts of some employers—particularly in the third sector—and they still do not today. That should shame us all. We must acknowledge the skilled and vocational nature of the work and pay people what they deserve, as the motion calls for.

I was struck by the recent Common Weal report highlighting the current failings in our care system and calling for ambitious reforms with the advent of a national care service to deliver the changes that we need. As I have said in the chamber many times, this has to be about values, not structures, and those values begin with our people—the people who deliver care across Scotland.

We do not have to wait—we can act now. Scottish Labour has joined our trade unions—particularly my union, the GMB—in calling for a £15-an-hour minimum wage for care workers. We advocated for that in the last two budget processes, but it has been rejected in favour of a 48p rise. If we are serious about honouring what was said in the pandemic about the value of carers, who were called “Covid heroes”, that must be matched by our action.

There is more to do. We need to provide better support for the wellbeing of care staff through breaks and the supply of food, rest areas and support services; more standardised qualifications that can be accredited and recognised across the care system; apprenticeships in care, which would show that it is a valued and important career choice for our younger people; and clearer progression routes for workers, so that they can get on.

It is clear that we owe all our carers across the country a huge debt of gratitude. We trust them with the most precious thing in our lives—our family members—in often difficult and challenging circumstances, so we should offer them a rate of pay and a set of conditions that meet that huge responsibility and reflect their talent and dedication.

Labour members will continue to urge the Government to act, while offering our own vision of what care should be in Scotland.

Will the cabinet secretary clarify what is being done to raise awareness of the tenant grant fund and ensure that tenants who are in need of help with rent arrears are able to access the support as soon as possible?

The importance of today’s debate cannot be overstated. Our care homes have been at the centre of the pandemic over the past 2 years. Let me put on record my thanks to the amazing staff of our care homes, who are often underpaid and feel undervalued, and who have done all that they can to protect people and to support their families. We know that people who live in care homes and their families all across our country have suffered immensely.

The reality is stark. From 2020 to 2021, there were more than 2,500 excess deaths in Scottish care homes—each person the loved one of someone. We know that there are still many questions to be answered about how that was allowed to happen, so answers must come in the inquiry.

What made the pain even worse for families was that not only did they lose loved ones, but they could not even be there to hold their hands or stay by their sides in their final hours. That was not the case only in 2020, when we were all under tight restrictions; it continued to happen over the following year. As restrictions for the rest of the country eased, care homes had to remain under repeated lockdowns, which caused untold harm and trauma to residents and their families.

I am sure that all members agree that such a situation is terribly tragic. As restrictions are lifted and we understand our new Covid reality, we must ensure that such a tragedy never happens again. That is why I support the motion in Jackie Baillie’s name.

The story of Anne Duke has touched the hearts of thousands of people across our country. The continued efforts of her husband Campbell and her daughter Natasha Hamilton have helped to bring the issue to the fore in public debate.

We should not hesitate: the Government should not wait but should act with the sense of urgency that the situation deserves. The SNP’s amendment to the Scottish Labour motion shows that the SNP still does not get it. I find the amendment to be quite insulting in its failure to acknowledge Anne Duke and her family, and the contribution that they and other campaigners have made.

The Government wants to defer implementation of Anne’s law until the introduction of the national care service—a process that will take many years—despite the fact that, in the recent consultation, there was virtually unanimous support for Anne’s law and the right of people who live in adult care homes to see friends and family. Respondents also thought that the right should be enshrined in law in order to ensure parity across our country, rather than relying on the discretion of individual care homes. That shows the importance of introducing Anne’s law.

The Scottish Government’s actions in the care home sector led the Scottish Human Rights Commission to express concern about social care users’ experiences during the pandemic. The commission said that the situation in care homes raised concerns under article 2 of the European convention on human rights, on the right to life.

Even now, after a consultation has told the SNP that there is support and the commission has pointed to failings and concerns, there are still challenges for families who want to see their loved ones regularly. Indeed, care homes have been receiving confusing messages from public health teams about when they should and should not restrict access. I raised the matter with the First Minister in early January, but there are still issues.

Never again should we have such a situation in care homes in Scotland. As we have heard from other members, it is vital that our loved ones have the right, when they are in someone else’s care, to see and have important contact with their families and friends.

It is time for the cabinet secretary and ministers to listen to relatives and care users. It is time to implement Anne’s law and to end the pain of loved ones being parted when they need one another most.

Good morning, panel. The theme that I am focusing on is the patient perspective. You have already said a lot about that in your answers, which is most helpful, but perhaps I can drill down a wee bit into what patients said in response to our call for views. One thing that they highlighted is a negative perception of reception teams in general practice. We can all probably relate to some of that. When we consider people’s attitude towards those staff, they are often seen as gatekeepers or, negatively, as barriers to seeing a GP, which is often wrong.

How can we communicate better on the triage pathway that now exists in many practices? Triage pathways are perhaps clearer in emergency medicine than they are in general practice. I am keen to understand your experiences of that and how we can continue to communicate with patients.

That was a helpful answer. You mention how to create space for training, perhaps by diverting people to other pathways, and NHS 24 having a bit of a support role. What are your experiences of things like NHS 24? I know that people are directed there more often as an alternative to presenting at accident and emergency but, in the past wee while, we have seen frustration with the accessibility of that service, with 240,000 unanswered calls in a two-month period. The convener mentioned frustration with phones ringing out at GP surgeries, too. Are our alternative systems for phone advice up to par and able to support people?

A number of witnesses have commented on the potential for alternative pathways to increase—[Inaudible.] We have heard that in many of the answers.

I want to get a sense of the mitigations that we can put in place. We have heard about some of those, particularly digital mitigations, although it is still not clear how we can ensure that people have digital access. That is a bigger question and goes beyond health. Do the witnesses have ideas about any mitigations that could be put in place immediately?