Chamber and committees

I will make two points. First, we now have the women’s health champion, which is a major step forward. That was not factored in when the petition was lodged. It would be interesting to find out what the women’s health champion’s thoughts are on the petition.

Secondly, as you say, there is a piece of work to be done on wider rural healthcare issues, but we need to make sure that we do not water down the points that are made in the petition.

Did you face any difficulties or hurdles that you had not envisaged?

Great, thank you. Dr Hughes, will you share with us your views of your first 100 days? Have there been any surprises or is there anything that you think that it would be helpful to us to know?

To ask the Scottish Government whether it will provide an update on what steps it is taking to address coastal erosion in the North East Scotland region. (S6O-01888)

Thank you, minister. It is really good to hear that some money is on its way. It would be good to see that actually delivered. The reality is that councils have never had the money to make multimillion-pound investments to turn the tide. Now that the revenue position has worsened, the people of Montrose are telling us that there are scant years left in the dune system and the historic golf course. A few fairways have already been lost to the sea, and there are huge implications with regard to flooding. When will the Scottish Government grasp the nettle and decide whether it will support a sand motor at Montrose?

I thank Ruth Maguire for securing the parliamentary time for such an important debate. Tragically, cancer is a major cause of death in Scotland. All of us have likely been touched in some way by its impact, and I know that all of us long for the day when it is eliminated for good.

It is a sobering thought that two women in the United Kingdom died today from cervical cancer, and this evening another nine women and their families are coming to terms with a diagnosis of cervical cancer. Some are mums, and some face the devastating prospect of losing their fertility as part of their treatment. However, there is hope, and that is through the cervical screening programme and the HPV vaccination programme.

On the latter, I was struck by the figures that were reported by Jo’s Cervical Cancer Trust: cases of cervical cancer have fallen by 97 per cent among women in their 20s as a result of the vaccine. I understand that in Scotland, uptake rates for the first dose of HPV have consistently exceeded 90 per cent, as Ruth Maguire said, and that is to be welcomed. However, as she pointed out, uptake levels for cervical screening are not as high, and that is where improvement is most needed.

Public Health Scotland data is available only for the period up to 31 March 2021, but it shows that the uptake rate for cervical screening was 69.3 per cent among eligible women. Worryingly, as Ruth Maguire said, uptake has declined in recent years and is especially low among women aged between 25 and 29.

Ruth Maguire also flagged up the multiple barriers to accessing a screening appointment. Anxiety and embarrassment can mean that women delay or decide not to do it. As she pointed out, experience of sexual trauma can also prevent women from being screened, and there are accessibility issues for women with a disability. Pain and fear of the result can also act as obstacles. We must do everything that we can to address those barriers, and it is important that we see leadership at the highest levels.

Jo’s Cervical Cancer Trust and other charities were vocal in their calls for the urgent appointment of a women’s health champion in Scotland. Bizarrely, that role was promised by the Scottish National Party as a “Medium-Term” action as part of its “Women’s Health Plan”, which is intended to cover only the period from 2021 to 2024.

I am pleased to see the position has now been filled by Professor Anna Glasier. However, like many of us, I was deeply frustrated by the time that was lost over the prolonged appointment process. I know that Professor Glasier is keen to focus her work on the menopause, endometriosis and polycystic ovary syndrome. I hope that she will also work with health boards and charities to improve cervical screening uptake and to explore new ways to facilitate that process.

In the meantime, I urge all eligible women to please, please book a cervical screening appointment when the letter arrives—it could save your life.

—but it is the participation rate, which measures contact with a dentist in the past 24 months, that matters most, so, let us take a look at it. The participation rate has fallen by almost 15 percentage points between 2020 and 2022—

Today, we have heard the scale of the crisis in NHS dentistry in Scotland. It is a profession “on its knees”, in a system that is “broken”—words that we are hearing all too often in the chamber under this SNP-Green Government.

Millions of dental appointments have been lost since the start of the pandemic—millions of missed opportunities to treat early tooth decay, prevent dental disease and detect the early stages of oral cancer. There is uncertainty over future funding in a system that is already chronically underfunded and there is an “exodus from the workforce” according to the British Dental Association. All of that is happening against the background of the SNP’s 2021 manifesto commitment to scrap NHS dental charges for everyone in Scotland.

The minister, Maree Todd, talked about reform, but she was unable to give any timetable and, once again, the SNP Government blamed Brexit and the pandemic. That is deflection and denial. The Government also took the credit from Labour for the childsmile programme, which was interesting.

I agree with Willie Rennie: this is an utter farce—just like Gillian Martin refusing to take an intervention from my colleague but taking a seemingly staged intervention from her colleague Jackie Dunbar.

Alex Cole-Hamilton shone a light on the fact that the Scottish Government wants to delete reality and that ministers’ heads are in the sand. Dr Gulhane raised the serious issue of many dental practices going to the wall because they are running at a loss—he gave example upon example of that. Paul Sweeney talked about the postcode lottery and Brian Whittle said that this Government operates an “everything will be fine” and “nothing to see here” model.

The Scottish Conservatives’ amendment highlights widening oral healthcare inequalities—something that was glaringly absent from the Liberal Democrats’ motion. According to Dr David McColl, chair of the BDA’s Scottish dental practice committee,

“Patients in Scotland’s poorest communities are paying the price for the crisis in dentistry.”

Make no mistake: SNP ministers cannot peg widening inequalities in oral health outcomes on the pandemic alone. Like so much with this SNP Government, it is a problem that has been years in the making. For example, the national dental inspection programme 2018 revealed that, although 86 per cent of children in Scotland’s least deprived areas had good dental health, that figure was only 56 per cent for children in the most deprived areas.

Of course, as we have heard today, the SNP likes to trumpet the number of people registered with an NHS dentist in Scotland. That is so typical of the SNP’s smoke-and-mirrors approach to policy and political PR—

I, too, thank Michael Marra for securing the time for the debate so quickly after it was postponed a couple of weeks ago.

Given the findings of David Strang’s 2020 report “Trust and Respect—Final Report of the Independent Inquiry into Mental Health Services in Tayside”, it is vital that parliamentarians continue to shine a light on the provision of those services. Grave concerns were first raised in the Scottish Parliament in 2018, and I am encouraged to hear Graeme Dey’s passion for change.

I was not a member of the Scottish Parliament in 2018, but I knew about the public campaign for an inquiry into Tayside’s mental health services. I read about the tragic story of David Ramsay, who hanged himself after a second emergency assessment at Carseview. I was horrified by the 61 per cent increase in suicides in Dundee.

My own family has experienced the devastating impact of suicide. My heart goes out to all the families across Tayside who have lost loved ones that way.

As an MSP for the north-east, I have seen Carseview through the eyes of constituents and I have felt their fear as they tried to navigate a frightening system that they felt was so stacked against them. I not only looked at the final report of the independent oversight and assessment group on Tayside’s mental health services with interest but had personal and professional investment in it.

Reading between the lines, I can see that a tremendous amount of work is still to be done. I particularly struggle to understand why Tayside executive partners and the IOAG “continue to be apart” in their assessment of progress. As Michael Marra rightly pointed out, the report states that Tayside executive partners have reported 33 green recommendations, and 16 amber. The IOAG has rated 20 green, 29 amber and two red. That is a gulf in assessment, not a gully. How can that be?

There are two other areas in the latest report that I find extremely concerning. The first is on the workforce; the second is on culture. On workforce, as the report emphasises, there is still a “long way to go”. That seems to be an understatement, given that it was reported just a couple of weeks ago that

“Tayside is at the epicentre of a ‘national scandal’ in adult psychiatry care”,

with serious issues in recruiting consultant psychiatrists. I hope that the minister will address that in closing.

On culture, the report identifies an “urgent need” to improve governance and public performance reporting as a

“means of developing a more open and transparent culture”.

We have heard that so many times, and it has been raised with me by constituents time and time again. Those are fundamental points that still require significant improvement.

The essence of David Strang’s report is trust and respect. He said:

“The successful delivery of healthcare services depends on good levels of trust between healthcare providers and patients, their families and carers.”

That is the gold standard, but Tayside falls well short.

Mental health services in Tayside still have a huge way to go. This might have been the IOAG’s final report, but it is definitely not the end of the line. The process still needs oversight and accountability, from Grant Archibald and his team to the highest levels of the Scottish Government. It cannot be brushed under the carpet any longer.

—with adults and children from the most deprived parts of Scotland less likely to attend than those in the least deprived areas.