Chamber and committees

Yes. Thank you, convener.

Margaret McKay’s observation was helpful, because public transport is a key issue in reducing isolation. However, does anyone else have a reflection on the digital element? We see challenges with library services and other places where people normally access IT if they do not have regular access. Obviously, the situation has been compounded by the pandemic, but there are challenges with the availability of services that are run by local authorities. Macmillan Cancer Support offers a cancer service in many libraries, which is helpful and welcome. Do we need more engagement with library services and more funding for them, perhaps from the health stream, to support libraries as hubs?

To ask the First Minister what urgent steps will be taken to address lung disease in Scotland, in light of the reported comments of Asthma + Lung UK Scotland that “the state of lung health in Scotland is shameful”, with over 7,000 people dying a year. (S6F-00854)

I note that the First Minister referenced the publication of the respiratory care action plan—indeed, it is now one year since its publication. However, implementation of the plan has progressed slowly with the creation of the Scottish respiratory advisory committee, and no commitments have yet been made on funding the RCAP. Will the First Minister make clear how much funding will be allocated to the implementation of the RCAP in order to improve Scotland’s lung health?

I welcome the introduction of the bill, and I associate myself with the comments of my colleague Pam Duncan-Glancy and with comments that members from across the chamber have made about the importance of respect in the debate.

I seek clarity on the proposed timescales. Delay has led to a vacuum, which is contributing to anxiety and, I think, to toxicity in public discourse. As legislators, it is now our duty to scrutinise the bill, so clarity on the anticipated timescale for each stage would be welcome. Is the cabinet secretary in a position to outline that for Parliament?

I will follow on from many of the points that have been made. Alison Douglas talked about the importance of reporting. Other witnesses talked about knowing what is working. In September, I asked the minister about alcohol and drug partnership reporting. Previously, we broke down information on the granular spending for ADPs by IJB. That certainly happened in 2016-17 and 2017-18, but we have not had that level of detail since, so is there enough certainty on funding to measure how effectively approaches are working?

I mean certainty that funding is available and that we are not seeing gradual cuts or more top slicing, which has been referred to. From that, how can we measure the effectiveness of the interventions that the spend pays for? Does that make sense?

I associate myself with the comments of colleagues on the unfolding horrors in Ukraine. Once again, I offer my solidarity to the Ukrainian people.

I thank Keith Brown for bringing the debate to the chamber. I know that veterans’ affairs are close to the cabinet secretary’s heart and to the hearts of many colleagues across the chamber—including, not least, the heart of my Labour colleague, Paul Sweeney.

It was great to hear Finlay Carson speak about Councillor Archie Dryburgh, who is a good colleague and someone with whom I worked very closely when I was at East Renfrewshire Council and we both served on the Association for Public Sector Excellence. The comments about him were well made.

When we talk about mental health, it is clear that enormous strides have been made in wider society in recent years. Whether it happens through having conversations with a loved one or with a stranger on the street, it is good to see the whole country moving along a more positive path and talking about those issues. To illustrate that point, my office recently held a time to talk day coffee and catch-up, when we all took a moment to support one another with conversations about our mental health. That brought home to me that, with regard to veterans, we need to think more about how we tailor our approaches and conversations to support people who have been involved in active service over many years. From all the contributions today, it is clear that we have more to do in that regard.

I commend the work of the Scottish Veterans Care Network, including the development of its action plan for tackling veterans’ mental health challenges. The report is to be welcomed, and I hope that all the recommendations will be not only accepted but fully implemented by the Government. It is vital that we ensure that we have adequate funding for that.

The third principle of the plan states:

“NHS Boards, Health and Social Care Partnerships, Local Authorities and the Third Sector should be appropriately supported to meet the needs of veterans and develop and deliver Veterans Mental Health and Wellbeing Support and Services.”

It is vital that the Scottish Government gives those bodies the right support and funding to ensure that the principles can be achieved. Alongside that, we in the Parliament must be able to track changes to ensure that they are fully implemented and that sustainable funding is provided over the years.

Accountability is incredibly important in ensuring that veterans feel fully supported when they retire from their service. We know the sacrifices that have been made—everything from risking their lives for our country to spending an unimaginably long time away from their families, which can cause anxiety and emotional strain. That should encourage us to do our very best for them, as they have done for us.

We also know what amazing assets veterans are to our communities and workplaces. Servicemen and women are adaptable and incredibly well trained, and have a work ethic like no other. We must ensure that we harness their potential and fully support them to transition smoothly into civilian life, wherever they choose to go.

Like colleagues, I will take a moment to highlight the amazing contribution of the third sector and charitable organisations. I am thinking in particular of Erskine, which is based in my West Scotland region, and the work that it does year on year to support people with housing and benefits issues or, indeed, to get them back into the workplace.

I, too, welcome the cabinet secretary’s comments on LGBT+ veterans and the work that will be done to better understand their needs after long misunderstandings about their particular mental health challenges. I am thinking in particular of those who served prior to 2007, when the UK Labour Government ended the ban on LGBT+ people serving openly in our armed forces. It is clear that more work needs to be done to understand the needs of LGBT+ people coming out of our armed services.

It is also clear that tragic situations continue to unfold for veterans across our country. Indeed, throughout the pandemic, we have seen more veterans suffer from increased anxiety, isolation and job loss, with services being either absent or perhaps slower to respond to their needs. We have heard previously from the Scottish veterans commissioner the call for strengthened strategic leadership and for an effort to be made to support partnerships across Scotland.

In some ways, it is regrettable that the new suicide prevention strategy has been delayed until September 2022, because too many lives are being lost and we need to take real and meaningful action as soon as possible. As Paul Sweeney has already mentioned, Scottish Labour is clear that the Scottish Government must update Parliament in advance of the strategy’s publication and action being taken to deliver veteran-specific suicide prevention training and improved mental health support. We very much welcome the cabinet secretary’s acknowledgement of our amendment in that regard.

Those who have sacrificed the most for our country deserve the best care possible. Although priority has been given to the healthcare of veterans, we cannot become complacent about the quality of services, including mental health services. My party and I will continue to call for greater access to and availability of support services for our Scottish veterans.

I know that the cabinet secretary will share my horror at the situation that is unfolding for LGBT+ people in Ukraine. Indeed, in today’s coverage, I read a statement from an 18-year-old student in Kharkiv who said:

“If we imagine that Russia occupies … Ukraine … they won’t allow us to exist … and to fight for our rights”.

Does the cabinet secretary agree that we must do all that we can to support the LGBT+ community in Ukraine and that the UK Government must have a solid plan to welcome refugees who fear for their lives? [Applause.]

I thank Dr Gulhane for bringing these important issues to the chamber for debate. What we have heard about the state of dentistry is deeply concerning. Jackie Baillie highlighted those concerns starkly in her opening speech.

As we have heard, more than 3.5 million NHS appointments in Scotland were lost during the first lockdown alone and 239,000 fewer children and young people are accessing dental care than was the case two years ago. In my West Scotland region, there have been reports that some people have not been able to see their dentist for 30 months. Alex Cole-Hamilton and other members across the chamber referred to that.

A more fundamental point is that, as my colleague Carol Mochan illustrated, the decline in access to dentistry is deeply unequal. Finlay Carson echoed that when he talked about particularly acute inequalities in rural communities.

Although the Scottish Government sings the praises of its recent changes to access, the implementation of free dental care does not count for much when it is nearly impossible to access appointments in the first place. It is clear that the current model is not sustainable.

If the Government proceeds on its current trajectory, the situation will only get worse. NHS dentists started sounding the alarm long ago. We have been heading towards a two-tier system of dental care in Scotland and the BDA believes that the Government’s funding model will be the final blow to a sector that is already struggling so much. Morale in the profession is at an all-time low, with more than a third of dentists stating that they will leave the profession altogether in the next 12 months, should the minister’s current funding model go ahead.

Without an immediate and comprehensive support plan being put in place, the Government risks the collapse of NHS dentistry in Scotland becoming its legacy. It is on that basis that we implore the Government to listen to the professionals and to rethink the current position and the wider implications for people across Scotland.

The minister must surely know by now that these issues have persisted for years and that Covid cannot be the explanation for them all. When we have more and more people turning to, and accessing, private dental care, we know that NHS dentistry is not collapsing due to the level of aerosol-generating procedures; rather, a fundamental overhaul of services is needed to stop privatisation through the back door. To cite only Covid undermines the hard work that NHS dentists have put in to mitigate years of problems and underfunding.

I support and welcome the Scottish Government’s commitment to further expand the childsmile scheme. We are proud that the actions that were taken by the previous Scottish Labour Government will continue to benefit all Scots.

Scottish Labour’s amendment acknowledges the concerns raised by colleagues across the chamber. Those are the concerns of our constituents and of professionals in the dental sector. Acknowledging the scale of the inequality that now exists is one step that needs to be taken before the Government can even begin to think about tackling it.

It is clear that we need a sense of urgency from the Government to make access to dentistry truly equal to all people, not just those who can afford to go private or those who live in urban communities. Scottish Labour knows that, in order to fix the system in Scotland, a comprehensive overhaul is required. However, we know that, for some reason, the Government seems unwilling to right the issues in NHS dentistry, or is incapable of doing so. We have seen those issues laid bare throughout the debate.

It is clear that the people of Scotland deserve much better than what is being offered and so do our dentists. I support the amendment in Jackie Baillie’s name.