Chamber and committees

It is not often that the chamber is in agreement, especially when a bill has been introduced at an expedited pace. I am pleased to say that there is consensus today in support of the bill and that there are no changes at the amending stages. That means that there is less to say in our speeches, but I will persevere, albeit less colourfully than my colleague Stephen Kerr.

The legislation completes its parliamentary passage after the local elections in May, when we were reminded of the importance of local democracy and of what an immense privilege it is to represent communities across Scotland.

The bill is required because the UK Government has agreed four treaties with Luxembourg, Poland, Portugal and Spain for reciprocal voting and candidacy arrangements in local government elections. Although Scotland’s law on voting rights already complies with the treaties, further legislation is needed to comply on candidacy rights. As such, the bill is necessary and welcome. The Scottish Conservatives would, of course, welcome similar agreements that the UK Government makes with other countries, as we have said.

I note from the policy memorandum that it would have been possible for the bill to go further, for example by extending candidacy rights to all foreign nationals with limited leave to remain. However, the decision was taken to limit the bill’s scope. Given the expedited timeframe of the bill to allow ratification of the treaties with Poland and Spain, that was the right decision.

One point that emerged during the scrutiny of the bill by both the DPLR Committee and the SPPA Committee was in relation to Scottish ministers’ functions when a candidacy rights treaty ceases to apply. Specifically, there was some debate as to whether the Scottish ministers should have a power or a duty to remove a country from schedule 6A in the event of a suspension of treaty rights. That was largely because it is difficult to anticipate the intentions of future Governments and, as parliamentarians, we must be mindful of future-proofing legislation when we can. I understand that, after consulting counterparts in the UK Government, the verdict was that it would be preferable to maintain consistency between the Scottish and the UK bill provisions.

As always, the devil is in the detail, and I am grateful to both committees for their commitment to scrutiny when legislative timelines are very tight. That is how it should be.

The number of nursing and midwifery vacancies has increased by nearly 40 per cent in a year, with more than 6,200 vacancies currently open across NHS Scotland. I repeat: the vacancies are in NHS Scotland.

The shortfall in registered nurses has risen to a record high under the Scottish National Party Government, while in Scotland growth in nursing and midwifery is the slowest in the UK. The situation is so bad that the RCN has evidence that students are being enlisted to plug staffing gaps, which is a potential breach of the law.

Given that record shortfall, does the cabinet secretary agree with RCN Scotland that the SNP-Green Government’s plan to increase the workforce by just 1 per cent over the next five years is totally inadequate?

To ask the Scottish Government what its response is to reports that less than a quarter of nursing shifts have enough staff. (S6T-00764)

The findings of the Royal College of Nursing’s last-shift survey are shocking. Almost 70 per cent of staff in Scotland felt that safe and effective patient care was compromised on their last shift, due to insufficient staffing levels. That is significantly higher than the number anywhere else in the United Kingdom.

We have asked this question before without getting a clear answer, so let me try again. When will the Scottish Government provide a timeline for implementing the Health and Care (Staffing) (Scotland) Act 2019, which was passed unanimously by the Scottish Parliament three years ago?

As volunteers week 2022 comes to an end, I would like to thank my colleague Sue Webber for securing the time for this afternoon’s debate. The value of medical charity research is an important topic, and the debate is a fitting tribute to the fundraising efforts of thousands of volunteers in the north-east and across Scotland who help to raise money for potentially life-saving medical research.

The funding contribution that charities make to medical research is startling. The Fraser of Allander Institute estimates that, without it, the Government would need to increase direct funding by 73 per cent to cover the shortfall. The work of such organisations and others like them has brought hope to thousands of people who face life-limiting conditions and illnesses.

Cancer Research UK supports pioneering research into more than 200 types of cancer. Its contribution to the medical research base should not be underestimated. Over the past 40 years, cancer survival has doubled in the UK. Meanwhile, the British Heart Foundation has invested £50 million in more than 100 projects in Scotland to research heart and circulatory disease.

In my region, the BHF funds two PhD studentships and 10 other research staff at the University of Aberdeen. Led by Professor Dana Dawson, researchers in the granite city are carrying out the first national study into broken heart syndrome, a potentially fatal heart condition that is experienced by thousands of people the length and breadth of the UK. At the University of Dundee, where the BHF supports seven research staff, researchers have been running a treatment trial into high blood pressure.

However, the reality is that those organisations, like so many others, have been hit by the Covid-19 pandemic. At the height of the pandemic, medical research expenditure by charities fell by around 44 per cent as retail trading came to a halt and household budgets faced significant uncertainty. While the UK has largely returned to business as usual as Covid-19 restrictions have been lifted, concerns remain about future investments in medical research. There has already been a significant reduction in research spend from the Association of Medical Research Charities for 2021-22, amounting to around £150 million. The BHF reports that it will take three or more years before charity research spend returns to pre-pandemic levels.

That has implications not just for Scotland’s health research and development but for our economy. As well as helping to improve health outcomes for the population, third sector medical research contributes to job creation, technological innovation and national infrastructure, and it helps to develop Scotland’s skills pipeline. Moreover, the Fraser of Allander Institute found that a pound spent on medical research funding by charities has a significantly larger impact than the average pound spent in Scotland.

As the Scottish Government looks at the levers that it can pull to build a strong economy, I urge it to think holistically about the value that third sector medical research can add to the Scottish economy and society.

Will the minister take an intervention?

Will the minister recognise that there are different prescribing regimes in England and Scotland and that there is therefore a disparity? Can we do some work to bridge that?

The average number of available staffed hospital beds in NHS Scotland is at its lowest level in a decade; it has decreased by 10 per cent. In NHS Grampian, the number of available staffed beds has fallen by nearly 30 per cent, which is a shocking figure. What urgent steps will the Government take to restore beds in our NHS and to boost capacity for patients in North East Scotland?

I am grateful to Collette Stevenson for securing time for this debate. At the outset, it is important to acknowledge that people who are seeking to access cannabis-based medicine are often in significant pain and have a diminished quality of life. It is very difficult to ignore the desperation that they feel, especially when the health and wellbeing of children is involved. Collette Stevenson mentioned Cole Thomson, who, at not even 10 years old, suffered up to 20 epileptic seizures a day before being privately prescribed cannabis oil. That must have been unimaginably distressing for him and his mum, Lisa, who has been a tireless advocate for her son.

In particular, patients feel a deep frustration that, although the scheduling of cannabis-based products changed in 2018, clinical use remains low and is only for specific conditions and in exceptional circumstances. Many people have sought private treatment, which has significant cost implications. As we have heard, the costs sometimes amount to hundreds and even thousands of pounds a month, which is simply not a sustainable financial outlay.

Others have accessed illegal forms of cannabis to treat symptoms. Research by the MS Society has shown that almost a quarter of MS sufferers have obtained cannabis-based products that are illegal to possess. Often, the strength of THC and the quality of the ingredients in those products are not known, and there is potential to cause harm to the user.

It is also important to note that the prescribing regimes for medicinal cannabis are different in England and Scotland. That geographic disparity is felt acutely by sufferers of MS north of the border, where Sativex has not been approved by the Scottish Medicines Consortium. I understand from the Scottish Parliament information centre—the minister has confirmed this today—that that is because the holder of the NHS marketing authorisation has not made a submission for the product. I hope that there will be some action following today’s debate.

Although the therapeutic benefits of cannabis-based products for certain conditions have been conclusively demonstrated, there is a risk that such products could be seen as a panacea by people who are in acute pain and discomfort. As those individuals seek to effectively manage their conditions, clinicians and healthcare professionals are trying to manage patient expectations. Doctors are professionally responsible for any medicine and have to weigh up an individual’s suffering as well as their safety. However, we do not want people to turn to the illicit market and the harms that that could involve.

It is for clinicians and not politicians to determine the risks and benefits of medicinal cannabis. However, I agree with Collette Stevenson’s call for further research in the area, with high-quality and robust clinical trials to contribute to the evidence base. I understand that there are more than a dozen on-going trials in the UK, which is welcome.

I conclude by echoing the calls for collaboration and co-operation between the Scottish and UK Governments on the issue. The UK has a thriving life sciences sector that is at the forefront of scientific research, and we must capitalise on that expertise across the four nations.

The Scottish Government’s “Women’s Health Plan: a plan for 2021-2024” seeks to address health inequalities experienced by women. The plan says that it

“has not specifically investigated the impact of Covid-19”.

I have a question for Claire Sweeney first, but the other panel members may want to answer it as well. Do you believe that the plan is still workable and deliverable with that caveat that it has not addressed the health inequalities that have been experienced by women due to Covid?