Chamber and committees

The gravity of this debate cannot be ignored. It is shocking that we have reached this point and that Scottish Labour has had to bring the motion to Parliament today. Surely all of us across the chamber must agree that no family should have to experience a battle to know what happened to their loved one when they died in one of our hospitals. No family should have to fight for the answers and no family should have to relive their loss every day because of a lack of closure and a lack of accountability. We must also agree that nobody who works in our NHS should ever feel that they cannot speak out and be heard on such serious issues.

However, after years of secrecy, denial and cover-up, not a single person has been held accountable for the catastrophic errors and infection scandal at the Queen Elizabeth university hospital. Since 2015, the issues have been raised time and again. There have been reports on contaminated water, deadly flaws in the building’s fabric, serious patient infections and death, the bullying of staff and the silencing of whistleblowers, but no one in the senior management or board leadership has been held to account.

Let us be absolutely clear once again that this is not about the doctors, nurses and care assistants who work day in and day out in the hospital treating sick patients—they have worked tirelessly, especially throughout the pandemic, and they rightly deserve our deep gratitude. This is about those in positions of leadership. We stand with the courageous staff and whistleblowers who have revealed the scale of infections at the hospital, in the face of denial and intimidation from the leadership. We stand with the families who have described their ordeal and their feeling that nobody in power is listening to them.

Two weeks ago, at First Minister’s question time, I raised the case of the Smith family from Greenock. Theresa and Matthew Smith’s baby daughter Sophia died at just 12 days old of an infection that was contracted at the Queen Elizabeth, despite initially responding well to treatment for breathing problems. I spoke to Theresa today. Her child is not just a statistic. She spoke to me about the unimaginable pain of being unable to find any closure or to properly grieve the loss of her child, because she does not know why she died. She said to me:

“How can you accept what you do not know?”

Theresa asked me to speak of Sophia today, to say her name in this place and to say that her life was worth the world to those who loved her for those short 12 days and who still love her today. The family want all of us in positions of power in this place to listen. They want us to listen when they tell us about the tortuous journey to try to get answers. They want us to listen to the fact that, for four years, they have felt locked in a battle, with phone calls, emails and letters stonewalled, when all they want to do is find some peace. They want us to listen to the fact that they feel constrained and silenced in the public inquiry.

The Government regularly cites that inquiry in response to calls for action on the issue. Last week, Theresa’s evidence to it was ruled too contentious to be made public, after legal applications by the Government and the health board. The legal experts have said that such orders should be used only as a very last resort, or there is a risk to public confidence in the inquiry. The First Minister told us in the chamber that she

“will not tolerate cover-ups or secrecy on the part of any health board.”—[Official Report, 18 November 2021; c 15.]

However, in this case, her officials acted to ensure that evidence was heard in secret. That cannot be how the inquiry is conducted, given how families have been treated.

It is clear that, for families such as the Smiths, trust is completely broken. They have little faith in the process, so we must act. This is about leadership and confidence in leadership. Crucially, it is about the trust of grieving families and the basic decency of ensuring that they can grieve in some peace. To begin to even think about a process of restoring trust, we must support the motion in Anas Sarwar’s name.

I rise in support of the motion in Michael Marra’s name.

As Scottish Labour’s spokesperson for public health, it is clear to me that more active ventilation in our schools is crucial to our continued efforts to reduce transmission of Covid-19, and that thus far action by the Scottish Government on that has been lacking.

Society expects public health measures to be front and centre in ensuring that buildings such as schools are safe for pupils and staff, and in ensuring that we have confidence in environments that are used day in and day out not only for learning by our young people, but for wider community use and our civic life. Rigorous systems are in place around water, sanitation and hygiene—now we must invest in systems that provide long-term and robust active ventilation across all our school estates. Indeed, as we have heard many times in the debate, we cannot be in the situation next year or the year after of having to open windows.

It is clear that we cannot tackle Covid-19 with a one-track strategy. We need a basket of measures, in line with an overarching public health approach. Vaccinations are incredibly vital in protecting people’s health, but vaccines alone are not enough. Science has shown repeatedly that proper ventilation is one of the most effective ways of preventing infection, due to the aerosol nature of Covid-19. We must have safe environments for our young people to learn in. That is why the motion advocates that there be at least two high-efficiency particulate absorbing filters in each classroom. As we have heard, they have been employed elsewhere in the world, and the Government has advocated their being placed in other settings.

It is clear that the work that has been undertaken to date by the Government has not been sufficient. The CO₂ monitoring that the Government has persevered with has no standardised approach. It has a methodology that the Government has refused to share, and its implementation was delayed, anyway. The Government has done nothing apart from cling to the incompetent approach of relying on CO₂ monitors alone, which I believe has wasted money and time and has brought us no closer to a long-lasting solution. It has also done little to inspire confidence in young people, parents and staff. Confidence in our public buildings and in the places where we live, work, learn and play is crucial, as I said earlier.

This morning, I received a copy of the results of survey work that was done on a wellbeing group of almost 400 teachers from across Scotland. Thirty-one per cent of them reported that they still have no CO₂ monitor, and 30 per cent have one that is shared throughout the school building. Of the teachers who said that they have access to a CO₂ monitor, 10 per cent have had it for only one day. Many teachers reported that opening the windows is their only means of ventilation—although teachers often teach in rooms that do not have windows. Of 102 teachers who had a CO₂ monitor, 11.8 per cent reported that it is frequently red and 43 per cent said that it is sometimes red. Those teachers have also reported classrooms being “uncomfortably cold”, as we enter some of the worst of the winter weather.

Although on paper opening windows is an attractive way to achieve ventilation, it is not working in practice. Not only are classrooms and learning spaces freezing, Covid cases are still rising, so clearly there has not been enough action.

Pupils, parents and staff deserve better, and so do local authorities, which are struggling to get things right in a variety of buildings and spaces. I declare an interest, as a serving councillor in East Renfrewshire Council.

The money that has so far gone to local authorities for monitoring has not been needs based. Instead of funding what is really needed, the money has been mainstreamed, with no clear methodology for allocating it. It is clear that we require a strong public health approach, with consistent funding and implementation. It is time for urgency from the Government; 20 months into the pandemic, it is clear that young people, parents, staff—

—and local authorities deserve better.

I thank Jamie Greene for bringing the debate to the chamber as we mark world AIDS day 2021, and I praise him for his very powerful speech.

I also thank all organisations that work to support people living with HIV, to improve sexual health, and to advocate for more services and action to eradicate HIV and AIDS, most notably the Terrence Higgins Trust, Waverley Care, the National AIDS Trust and HIV Scotland. I thank them all for the briefing material that they have provided ahead of our debate today and for the work that they do throughout the year.

As each world AIDS day is marked, I reflect on how far we have come and what we still have to do in Scotland and the UK, and around the world, to meet our ambitious target of ending new HIV infections by 2030.

I wish to begin by remembering all those lost in the 40 years since the first diagnosed cases of HIV. We think of all those who have died from HIV, AIDS and related illness, the pain and suffering caused to those who loved them, and the long-lasting impact of stigma and shame, which has dominated in our society for too long.

I remember only too well when I was growing up the sense of fear that existed: the sense of othering people, particularly those in the LGBT+ community; and the view of many in the mainstream media and more broadly in society that AIDS was somehow about lifestyle choices or some kind of punishment for being gay. The lack of compassion, the refusal to seek to understand and the lack of support led to unimaginable circumstances for people and long-lasting poor mental health.

When I look at my own adult life, I realise that I have been extremely fortunate in the support that is available now for LGBT+ people in particular to talk about the issues, seek advice on safe sex, know their status and now have access to PrEP and PEP. People living with HIV have better support to live a full life and, through advancements in medicine, to reach undetectable viral status, which means that it is untransmittable and they cannot pass the virus on. I think that we would all want to praise the U=U campaign—and, indeed, the work done by charities in that area—and I very much echo Jamie Greene’s comment that, if people do not know about that, they should take some time and look at it.

It is important that we look back and acknowledge the pain and suffering of a whole generation. As we have heard, recent TV dramas have helped to do that very well. “It’s a Sin” on Channel 4 very powerfully portrayed the darkest moments of the 1980s and the culture of fear and hate that was created. “Pose” on BBC iPlayer told a similar story, focusing in particular on the discrimination that was faced by transgender people decades ago. As Jamie Greene said, “It’s a Sin” was a difficult watch, but at the time I tweeted that it made me laugh, it made me cry and it made me feel angry for a whole generation of people. These stories must be heard and lives remembered, and we must educate people about how far we have come and what we still have to do.

As for what we still have to do, the fact is that although, decades on, our world is different, and the advances have been remarkable, stigma persists. A poll in 2019 by the Terrence Higgins Trust found that public attitudes to HIV remain stubbornly out of step with scientific progress, with 41 per cent of British adults believing that everyone living with HIV can pass on the virus and 64 per cent feeling uncomfortable having sex with someone living with HIV who is on effective treatment. Almost half would feel uncomfortable kissing someone living with HIV, despite there being no risk of transmission, and 38 per cent of people would feel uncomfortable going on a date with someone who is HIV positive.

We also have more to do to achieve our target of no new infections by 2030. Indeed, organisations such as the Terrence Higgins Trust have said that we need a step change to make that a reality. I know that, in closing, the minister will want to provide an update on developments in the Scottish Government’s work to end new HIV transmissions within the decade and on any considerations with regard to expanding the access of PrEP into other healthcare settings, in particular, and other actions to reach the target.

I am proud to have been able to contribute to today’s debate, to remember the dead, to fight for the living and to strive for a world without new transmissions.

I thank everyone for their contributions this morning. What is coming across is a sense that the approach needs to be evidence led and that we need to take our time with it. Necessity may be the mother of invention, but we want to take time to learn from the experience of the past 18 months.

I will touch on two points. On digital exclusion, I agree with what has been said about ensuring that people have the right support. My concern is that we often end up with a two-tier system, even within a digital offering. People who do not have access to the internet sometimes cannot do audiovisual participation and end up participating via a phone, which is not always the best option, particularly—Karen Wylie alluded to this—in relation to children’s hearings and family courts, in which the issues that are discussed are very emotive and can be very stressful and challenging for people. Participation on a phone can often mean that it is difficult to read people’s tones or get a sense of what support someone might need. In addition, if someone is being supported by an advocate or legal counsel, it can often be hard in a digital setting for that relationship to be well established and for the person to get the right support. There are certainly things that need to be looked at to ensure that there is parity of access, even within digital offerings.

Ruth Crawford touched on the public’s access to the courts and how, where appropriate, members of the public can ensure that they can be present, if they choose to be. Obviously, our public galleries at Holyrood have been empty for the duration of the pandemic, but we broadcast all the public meetings of the Parliament via the website through Scottish Parliament TV. The difference is that we have not quite reached all court proceedings being digitally available or available in live time. I am keen to understand how we can protect the right of the public to be present in court if there is a move to a digital setting.

I am currently a serving councillor. We have a strange process if a member of the public wants to join the meeting. They have to request to do so prior to the meeting and be let into the system that we use, otherwise they have to watch it after the live event on YouTube. We need to look at such issues so that we protect people’s fundamental right to be present.

More must be done to support post office provision not only in rural communities but in town centres. The town of Port Glasgow, in my region, has no post office, which is remarkable in a town of almost 15,000 people.

When post offices close, community groups and local development trusts often wish to take the services on but cannot get off the ground due to funding or resourcing issues. Will the First Minister look at how we might better fund community capacity to offer such services and retain them in communities?

In an answer at First Minister’s questions, the First Minister said that elderly constituents should not have to wait outside vaccination centres for hours, and that the cabinet secretary was meeting health boards to discuss the issue. Why are elderly constituents still having to wait outside in winter weather for their vaccine? What action is being taken to increase the availability of waiting facilities at vaccination centres?

In closing for Scottish Labour, I begin by reflecting the strong consensus that we have heard in the debate. Stage 1 of the bill marks a significant milestone in a long, painful and difficult journey for so many. The cabinet secretary rightly opened by reflecting on those who have brought us to our consideration of the bill. I, too, pay tribute to the steadfast determination of the members of the Scottish Mesh Survivors group, who have bravely told their stories and campaigned for the bill and other measures to support all those affected.

Having heard some of the testimony in committee, I am struck by the bravery of the women who have recounted the trauma that they have experienced and lived with in order to effect change not only for themselves but for the many others who have had the same experience. As we have heard, they have repeated those stories time and time again—something both hugely difficult and extremely courageous, as I am sure we would all agree.

I join colleagues in paying tribute to the MSPs, past and present, who have worked on the issue and brought us to this point, particularly Jackson Carlaw, Alex Neil and Neil Findlay.

The convener of the Health, Social Care and Sport Committee, Gillian Martin, spoke powerfully when she said that the bill

“could not, and does not, undo the ... trauma”

and that, for some, trust in our health service has been irreparably damaged. What she said about control over choices, over their bodies and over their lives for those women is key to all our considerations, whether in relation to the bill or more widely.

As deputy convener of the committee, I commend the work of all involved in scrutinising the bill and, like the convener, I thank all who gave evidence, particularly those with lived experience, who were supported by the Health and Social Care Alliance Scotland.

Sandesh Gulhane spoke about the fact that many women simply have not been believed for a long time. He was right to highlight that many took extraordinary action to fund their treatment, spending savings or taking out costly loans—anything to stop the pain.

In line with the consensus that we find across the chamber, Scottish Labour supports the overall aims and principles of the bill. My colleague Carol Mochan spoke in Labour’s opening speech of the power of our democratic process. There is a duty on us all to use the power of the Parliament for the good of those whom we represent, and Alex Cole-Hamilton echoed that view in his powerful recollections of how the Parliament has approached the issue over the years.

We heard many powerful stories from colleagues of how the experience has impacted their constituents. Stuart McMillan spoke of Michelle, and raised the issue of the lengths to which women have had to go in order to fund treatment. He made an important point about crowdfunding, which was echoed by Craig Hoy. It is clear that further clarity is required for women who funded treatment via crowdfunding or other fundraising routes. The committee has called for clarity on that from the cabinet secretary, so I hope that the minister will begin to address the matter in closing the debate.

David Torrance spoke of his constituent’s life-changing—or rather, as his constituent very sadly put it, life-ending—experience; she felt that her life had come to an end. As Pam Gosal said, it is very difficult for us to hear such stories, but that particular story brought into sharp focus the reality for so many. Siobhian Brown did something similar in telling Isobel’s story. I hope that, whatever else we do in the Parliament, we always seek to do anything that we can to—at the very least—make life more liveable for any woman who is affected.

My colleague Katy Clark, and Alex Cole-Hamilton, raised the issue of the use of mesh in other procedures, and referred to other petitions that have come before the Parliament. I believe that those petitions merit the cabinet secretary’s attention, and I am sure that he will want to reflect on that issue more widely as we move forward.

It is clear from today’s debate that, although the principles of the bill enjoy broad support, further clarity is required in some areas as the bill process moves forward. I welcome the cabinet secretary’s response, as did Gillian Mackay and other members of the committee, on the issue of residency requirements, and I hope that he will look at the timeline requirements, as he committed to do in his opening speech. Gillian Mackay also referred to the so-called “in-betweeners” and mentioned that my colleague Jackie Baillie had raised the same point at committee, when she attended as my substitute. The point is that we want a system in which no one is left behind; that point has been well made by members on all sides of the chamber this afternoon, and I am sure that the minister will cover it in summing up.

At the close of the open debate, Martin Whitfield posed some important questions for the cabinet secretary on waiting times for mesh removal and the protests that are occurring in Glasgow today. I know that the minister will want to say something on that in concluding, in order to give Martin Whitfield and other colleagues confidence that those issues are being looked at in the round and that we are trying to get it right for absolutely everyone who has been affected by them.

We should do all that we can to hold on to the consensus that has been established not only in today’s debate on the bill, but over the many years leading up to this point. We must acknowledge that there is more to do. We must never forget the pain and suffering that has been caused; the duty on us, in the Parliament, to make an attempt at reparation; and the courage of women who have fought, despite their own trauma, to try to bring light to a very dark experience in the history of our health service. We must try to ensure that it never happens again.

Good morning. Witnesses have already touched on the necessity during Covid to upscale and move forward what we are doing in relation to digital. Obviously, NHS 24 has had a key role in developing many of the services, and it is fair to say that, within that, there has been a degree of quick movement and upscaling of projects that were already planned.

I want to get a sense of Jim Miller’s reflections on what has worked well and what has been challenging. In my experience, certain applications have worked better than others and have needed refining and testing. Jim, can you kick off with your reflections on that issue?

Your assessment is fair. There is a sense that there were challenges in relation to getting things up and running initially—for example, on proof of vaccination, which took a while to come on stream in a digital format.

You make an interesting point about that younger cohort. However, my sense from my inbox is that it goes across age ranges—people have a real desire to have things in one place, such as in one app, particularly when it comes to their vaccination status. There have certainly been issues around where people can book vaccinations and so on. Covid has brought all that to fore.

There is ambition to bring those seams together and to have that one-digital-door approach. More broadly, it is also about how we access services. The question is how we bring all the parts of that together. Is there an ambition to have a one-door app that would allow us to access our medical records if we require them and also to use services? That might be Jim Miller’s bailiwick.