Chamber and committees

We are having a discussion at the moment about our long-term future planning, and I think that a lot of our work for many years to come will be dominated by workforce planning issues and ensuring that we get the recovery right. Will you say something about the imminent challenges of the winter? We are about to embark on a difficult winter period in the NHS. I note that the national workforce strategy will be published in December, but by then we will be into the winter pressures, and a lot of the recommendations will take time to flow through.

Will you comment on the pressures on staffing in the winter? The question relates not just to the NHS, but also to social care, because it is important to be able to discharge people from hospital more quickly and to have care packages in place. I am keen to understand the cabinet secretary’s thinking on that.

I am keen to hear more about early cancer diagnostic centres, which have already been alluded to. We know about the delays in setting them up. They add a lot of value through early diagnosis and opening up new pathways for people who do not have clear-cut symptoms, and there is a sense that we could utilise them in every health board area. I am keen to understand from the cabinet secretary what the plans are to roll out centres further and what the timescales for that are.

Dr John Thomson, vice-president for Scotland of the Royal College of Emergency Medicine, said in July:

“the Emergency Medicine workforce in Scotland is not adequately staffed to deliver the highest quality patient care. This has led to an increase in intense pressures on the existing workforce and is very likely to be a contributing factor to the continued deterioration in performance.”

He went on to say that

“before the pandemic, the increase in demand put ... pressure on staff”,

and it was a

“struggle to meet the four-hour”

target.

Given that A and E pressures in summer are resembling those in mid-winter, given that the NHS recovery plan has been met with scepticism by the British Medical Association and the Royal College of Nursing, and given that we have the worst waiting times since records began when this Government took office, is it time that the cabinet secretary stopped denying that there is a crisis, acknowledged that the crisis is on his Government’s watch and started listening to the serious and real concerns of the people who know best, that is, the doctors, nurses and workers on the front line?

I take the opportunity to thank our GPs and acknowledge the importance placed on high-quality care in general practice when GPs have time to nurture and maintain relationships of trust with patients.

According to a recent British Medical Association survey, one third of GPs are considering taking early retirement. In relation to the Government’s remobilisation plan, Dr Lewis Morrison, the chair of BMA Scotland, has said that the plan contains “worrying gaps”, including the “crucial omission” of any plan to retain current NHS staff.

The plan states that there will be 800 new GPs by 2026 or 2028, depending on which paragraph you read. Will the cabinet secretary clarify that target and outline what action will be taken during the current crisis to retain GPs and ensure that there is sufficient capacity for people to see their doctor?

I thank Emma Harper for helping to bring the debate to the chamber and I recognise how close the issue is to her heart. I also thank Diabetes Scotland for its work and the informative briefing.

We often forget how far, scientifically, we have come in comparison to 100 years ago. We have already heard that, 100 years ago, diabetics did not have many ways to treat their condition and did not lead long lives, because there was little medicine to provide for them at that time. Thankfully, we have seen a remarkable leap in technology and medicine to help people live with diabetes. We have already heard the statistic tonight that 312,000 people in Scotland have diabetes, which equates to one in 20 people in Scotland, so it is likely that all members know people whose lives are affected by it. I have close family and friends who are diabetic and rely on insulin in order to live their daily lives. My dad has been diabetic for many years, so I have seen at first hand the changes that have come as he has lived with his condition, particularly technological advances in monitoring his blood sugars and administering insulin. I have also seen the universal power of insulin transcending borders. Once, on a family holiday to Rome, my dad forgot his insulin; I am not sure whether Emma Harper has ever had that experience. The Italian medics advised us to go to the Vatican pharmacy to see whether they had any of the insulin that is prescribed in the UK. Alas, the pharmacy did not have any, but the medical staff assured is that Italian insulin works just as well and duly prescribed him some.

Louisa Gault from Port Glasgow is one of my younger constituents; she is eight and was diagnosed as a type 1 diabetic during lockdown, having been rushed to accident and emergency, thanks to the quick action of her GP and practice nurse, after her mum and dad, Jan and Joe, noticed the four Ts—toilet, tired, thinner and thirsty. During an extremely challenging time for the NHS, the family has embarked on a rollercoaster journey in which insulin has played a huge part. Louisa is now insulin dependent and her intake of carbohydrates is closely monitored. At the age of eight, she already makes many of the decisions that Emma Harper referred to. Louisa’s family members have described all that as a huge learning curve, but they have commended the support of our NHS, particularly at the Royal hospital for children in Glasgow and Inverclyde Royal hospital, as well as charities, such as the Juvenile Diabetes Research Foundation. At a young age, Louisa has demonstrated great courage and a desire to show that she will not let diabetes hold her back. She is a budding gymnast and tells her mum and dad that she wants to be a diabetic nurse one day, so I hope that the Minister for Public Health, Women’s Health and Sport will take note to reserve a future training place for her.

The reason why I mention Louisa tonight is to reflect on how far we have come in the past 100 years. Life has been changed and been dramatically improved by developments in medicine, such as insulin. Just think where we could be when Louisa is an adult, and indeed beyond that, with another 100 years of research and development. However, we must ensure that everyone who needs access to advances has it. We know that constant glucose monitors, for example, allow a greater level of freedom for people with diabetes by allowing them to understand their bodies and what works for them. However, as has been alluded to, access to those technologies is not always equal, due to variations in what health boards can provide.

I know that members will agree with me that we must do better to bring a more equal level of quality care to those living with diabetes. The Government has an opportunity to issue strong guidance to health boards to ensure that high-tech monitoring equipment is available to all patients who require it.

Diabetes Scotland has called for a greater public health approach to be taken to help our children to understand our foods and make healthier choices to reduce the risk of developing type 2 diabetes. We need far more work in that field to help us to develop as a healthy society. I hope that the minister will say something about that in her closing remarks.

With actions such as those that I have talked about, we can help people to have healthier lives and make Scotland a happier place, and we can create a world where children such as Louisa can thrive.

I am arguing that local government funding has consistently been cut by the Scottish Government and that the added pressures that have been placed on local government have created a perfect storm. The fact of the matter is that people in councils are having to make decisions that are unthinkable—I refer to the example of libraries in the member’s city of Glasgow. The fact is that there are choices to be made. Not nearly enough has been done to ensure that councils have the money they need to deliver the services that are so relied on.

I am sure that SNP members will be keen to stress—they already have—that local government has been supported in the first 100 days through eye-catching policies such as those on the refurbishment of every play park in Scotland and free bikes for children who cannot afford them. However, what is the reality of the delivery of those policies? There is not nearly enough funding, and local government is making it clear that it needs flexibility and no further cuts to environment budgets just to keep play parks safe and open.

With only £60 million promised, it is clear that that is not nearly enough money to fulfil the pledge. It is plain to me that the Government is disconnected from what is happening on the ground in councils. What was the reality of the pledge on free bikes for children in Scotland who need them? A pilot, when councils are struggling to find funding to support physical activity programmes in schools and communities.

At the heart of local government is its workers. After all the work that they have put in to support our communities throughout the pandemic, they should be treated with decency. The Government should therefore have started the session with a promise to properly fund local workers with a fair pay rise and £15 an hour for care workers. We have already heard that the Scottish Greens used to support that and pledged to it in the election.

The truth of the matter is that the Government has tripled austerity for councils between 2013-14 and 2021-22, and we have seen non-ring-fenced local government revenue funding cut by £937.3 million in real terms. It is disingenuous of SNP members to claim credit for funding music tuition, core curriculum charges in education, increased school uniform grants and refurbishing play parks, as their cuts have caused those needs in the first place.

As we promised at the election, Scottish Labour will focus on providing real alternatives that address our national recovery, protect the NHS and properly fund local government to ensure that all our communities have the support that they need to come through this difficult period and recover fully. Beyond yet another self-promoted historic 100 days and another historic deal with the Scottish Greens, Labour members will focus on speaking up for our communities, which are being badly let down by the Government.

I support Anas Sarwar’s amendment.

We have already started to see in the debate the truth about the first 100 days of this Government. The commitments that were contained in the SNP’s first steps document were not those of a new Administration ready to tackle Scotland’s recovery but those of a tired Government that has run out of ideas. Many of the key actions in the 100 days plan are either recycled announcements or feeble promises that prioritise rhetoric over the substance of delivery for the people of Scotland.

It is worth reminding members that the first 100 days of the current Scottish Government ended nearly 14 years ago. Positioning the Government as something new and bold would be comical if the reality were not so serious in our health service, schools and communities across Scotland.

Just as the Government is recycling its first 100 days rhetoric, it is also recycling policies, pledges and promises. I note the congratulatory tone of the Government motion, but what have those 100 days really been marked by? Health services are struggling to cope with pressures on A and E and ambulance services. Covid cases are rising, vaccinations are stalling and people are now struggling to access testing. Teachers, pupils and parents are worried about the return to school and the lack of action over the holidays to improve ventilation. Councils are once again facing cuts in the midst of hugely unprecedented times when services and hard-working staff are stretched to breaking point.

Is it not the case that the priority during those 100 days has been formalising the new coalition with the Greens, which formalises what councils have known over the past five years—that budgets will continue to be cut and services, communities and jobs will suffer as a result. I want to focus my remarks on local government in particular, and I declare an interest, Presiding Officer, as a serving councillor. I have seen at first hand how the cuts passed down from the SNP Government and voted through by the Greens have gutted our councils and forced councillors and hard-working staff to make decisions that we never wanted to make.

Over the weekend, I raised the need for digital vaccine certificates in the context of foreign travel. I note that the First Minister said that an app would be available from next month, but it would be helpful to have a clearer timescale, if that is possible, given that some of the commentary on the matter has been vague. Constituents have rightly been asking why it has taken so long to get an app in Scotland, given that such apps exist elsewhere in the UK and in other parts of Europe.

Will the First Minister confirm that the app will be compatible with vaccination records from across the UK, which is particularly important for students who are travelling to university? Will she ensure that the app has the ability to deal with cases in which someone has had one dose of the vaccine in Scotland and one in another UK nation, or vice versa? I have heard from constituents that there have been problems in that regard with paper vaccination records.

On 2 July, “STV News” covered the story of Brian, who works in test and protect. He described his working environment as “toxic” and said that staff are being “overwhelmed” by the demands of increasing infection rates and that

“morale is at an all-time low.”

This week, I have met test and protect staff, who told me that, at the start of their work, they felt pride as key workers, but that they now feel nothing but stress. Test and protect is stretched to breaking point, and staff need better support. Therefore, will the First Minister agree to support those staff through additional resource? Crucially, what can the Government do to support the mental health and wellbeing of those key workers?

The situation is, indeed, deeply concerning. Our thoughts are with all the women affected. I appreciate what the minister has said about funding for the Jo’s Cervical Cancer Trust helpline to support anyone who is concerned, but will she confirm that the funding will last for as long as it is needed and that all sufficient resources will be given to the trust to ensure comprehensive individual support? Further to that support, will the minister advise what is being provided to GPs and other health professionals, who may be the first point of contact for women but who are in the midst of remobilisation from Covid?