Chamber and committees

Thank you.

Will the member take an intervention?

I congratulate Jackson Carlaw on bringing the motion to the chamber. I am genuinely sorry if he thinks that I was glowering in any way. It was certainly not the intention. It is just my face. If he does not like it, I am sorry, but it is the only one that I have.

I have no particular objection to what is written in the motion. Jackson Carlaw makes the point that, if a proposal of this kind was taken forward, it would have a wider regional impact and perhaps even a national impact. It is reasonable for Parliament, as the national forum for debate, to discuss it. I have no objection to that.

I have to admit that I expected a little more hyperbole in the speeches. We have not been disappointed, as a little bit of the “war on motorists” rhetoric has come up a couple of times in some of the speeches.

There are two perspectives through which we can see the issue: one is transport and the other is local government. I will split them up.

On transport, whether the Conservatives agree or not, I believe that there is an overwhelming case for a shift towards lower car use and greater investment in, and more availability and affordability of, public transport. Instead of vehicle excise duty being the principle means of raising revenue from road use, we should be shifting towards something that is closer to a polluter-pays principle, whether that is through road user charging or some other form. The UK Government has been praised—or perhaps “has been given a cautious welcome” is the right phrase—for taking some baby steps in this year’s budget to introduce a polluter-pays principle for road use. Even if the UK and Scottish Governments and local government all recognise that some kind of change of that kind has to come in time, I think that they all lack the courage to say so. If we make such a change then, of course, border and boundary issues will have to be addressed. I am aware that some areas in East Dunbartonshire, for example, have a residential road that is so close to the boundary with Glasgow that entering Glasgow is the only way for a person to leave their street. Of course, some of those issues will have to be addressed, but they are not insurmountable.

As for the local government perspective, I believe that the proposals that are under consideration from Glasgow City Council reflect local government’s position more generally, which is a lack of funding and a lack of power. Of course, I make the case that the Greens have done more than any other party in recent years to protect local government funding in many years of budget negotiations, and we have also successfully made the case for new financial powers for councils, some of which are now in place. Is it enough? No, but we are the only party to have made serious progress and to have shown how to fund that fairly from progressive taxation.

As we all know, and as has been acknowledged for many years, the specific issue that Glasgow City Council faces is that a great many high-value properties outside the city are generating costs for Glasgow without contributing council tax. That is a historical inequality since the break-up of Strathclyde region. The failure to reform local government taxation is one of the chronic issues that the Parliament has repeatedly refused to resolve, which leaves Glasgow City Council being forced to consider options that probably would not be its first preferences if it had solutions to the wider issues.

The Clyde tunnel is nationally important infrastructure, but its specific costs are borne by Glasgow City Council, simply because of the designation of the road, rather than the nature of the infrastructure. Comparable bridges are not funded by local authorities. Does anyone, whether that is Glasgow City Council, my party, or anyone else, think that the proposal is a wonderful thing, to use a phrase from Jackson Carlaw? I do not think that anyone does. It is one option to address legitimate issues. It is not the only option and it may not even be the best option, but the challenge to anyone who does not like what the council is considering is, if not that, then what? The answer needs to address questions about local government funding, the inequality that is facing an urban centre such as Glasgow—

To ask the Scottish Parliamentary Corporate Body what consideration it has given to staff employed within the Parliament as contractors and whether they should have the same employment terms and conditions as corporate and MSP staff. (S6O-05226)

It needs to support the transition to a sustainable transport system that reduces road traffic levels and invests in high-quality public transport and the needs of people and planet.

I am glad that the Parliament takes the principle of fair work seriously, but no minister, MSP, clerk, researcher or anybody else would really be able to do their job if it was not for those who clean the building, maintain it to keep it safe or cater for the various other needs that contractors fulfil in the building. I think that we are all aware that not all those people have the same wage protection, security of employment, union rights and so on as other staff members. We will not be a fair work Parliament until that changes. What further steps is the corporate body able to take, or what changes in the law would be required, to allow it to take more steps to achieve the universal application of fair work principles?

No. I do not have time.

My real worry at the moment is that the Tory and Labour position—the new antagonism to any kind of credible climate policy—not only is bad in its own right and harmful in indulging the interests of the fossil fuel industry and rebooting climate denial, but is worse because of the effect that it is having on both the Labour and SNP Governments. They are clearly reaching the conclusion that they can persuade people to compare them to those who are looking to rip up climate legislation instead of being judged against what the science demands. In reaching that conclusion, they have clearly decided that they can get away with doing the absolute minimum on climate policy or even going into reverse.

That is why the Scottish Government thinks that it is fine to scrap road traffic reduction targets, scrap any halfway-serious action on clean heating, reject the UK Climate Change Committee’s advice on agriculture, and demand a massive tax break for the fossil fuel giants that have brought the world to a state of climate emergency. Clearly, it is also why the UK Government thinks that it is fine to betray the trust of those who thought that the Labour manifesto commitment on oil and gas meant something. I was always sceptical, but I know that there were those who thought that “no new licences” was a pledge worth having. Now it is clear that the UK Government will always put the interests of the fossil fuel giants first, and it does not care much for the last shreds of climate credibility that it once had.

It is easy to forget that it is only a few years since the Scottish Parliament had complete consensus in recognising the reality of the climate emergency. The public still want climate action, and growing Green parties in all the nations of the UK will continue to call out those who back the multinationals. We will stand up to the fossil fuel profiteers, and we will show that a fairer, greener and more equal society is the only viable path ahead of us.

Will the member take an intervention?

I thank those members who have stayed a little later than expected, as well as all those who signed the motion, allowing us to debate the subject this evening.

MSPs from all sides of the chamber raise the issue of waiting times in our national health service regularly. In a search of the Official Report from the past two weeks alone, I saw members rightly expressing concern about failures to meet waiting-time targets of 12 months for some conditions, and 62 days in another case. A member raised the issue of waiting times again at portfolio question time today. There are many examples, and we all understand the impact of the problem on our constituents’ lives and the immense challenges that the NHS faces in addressing it.

However, the example that I raise today is extreme. The data from Public Health Scotland, which are mentioned in the motion and were published last month, illustrate a wholly unacceptable situation throughout Scotland, but in particular at the Sandyford in Glasgow, where the service is utterly overwhelmed. That is Scotland’s largest gender identity clinic; it is the service for eight health board areas covering almost half the Scottish population. As at March this year, in comparison with the previous year, there were three times as many people on its waiting list who had been there for more than five years. The clinic was offering first appointments to people who had been waiting for six and a half years.

A six-and-a-half-year wait for a first appointment is bad enough, but that is not what new patients today are facing. With almost 4,000 people on the waiting list and fewer than 50 first appointments being offered in the course of a year, new patients will be looking at the situation in utter despair. At that rate, it would take 80 years to reach the head of the queue. That is not even the worst estimate—independent research has put the figure far higher and shown that the situation there is by far the worst in any part of the United Kingdom.

Whether we measure a theoretical waiting time like that in decades or in centuries, it is hardly helpful. Either way, it is clear that, without transformational change, most people will simply never be seen. They will never even get a first appointment, let alone actually receive the healthcare that they need. More to the point, only those with the resources to go private will be able to do so, and even then, they will find it next to impossible to get an NHS general practitioner who will accept them and treat them.

All that stands in stark contrast to the Scottish Government’s stated commitments. In 2021, it committed to

“reform the current model of Gender Identity Services to meet the needs of the community”,

bringing the service

“within national waiting times standards.”

The “NHS gender identity services: strategic action framework 2022-2024”, which promised “transformation” of the service, was published in late 2021 and was due to be implemented between 2022 and 2024. As part of that, a commitment was made to

“test new multidisciplinary models for delivery of gender identity healthcare”,

among many other improvements.

How must the people who are waiting for year after year after year feel, knowing that such promises were made and that the situation has simply continued to fall apart? Well, many of them have told me how their lives are affected. I have heard from those who have been left with no option but to seek private treatment, including those who have been forced into debt to do so. I have heard from those who have been refused treatment from their GP or who have had to change their GP multiple times.

I have heard from those who were offered no support of any kind while waiting, and no clarity at all about how long the wait would be. I have heard from those who suffer the distress of having a complete lack of control over their own lives, not as a result of being trans, but as a result of the indefinite wait for support or treatment.

I heard from one constituent, who is herself a doctor working in the NHS. She was told that the waiting list was two years long when she joined it, only to be told, as two years passed, that the wait would be another two years. She has now been waiting for six years and fears that she may be waiting for many more.

My constituent’s description of desperation in seeking private care—as she described it,

“to bridge the gap while waiting”,

only to find that the wait would become interminable—was distressing enough to read. What I found even harder to read was her request that I quote from her experience, but not use her name. She said:

“I mostly just don’t want to be potentially harassed at my workplace if this is linked back to me.”

That is from someone who worked to provide emergency care during the Covid-19 pandemic to serve her community and her country.

We need to recognise the context in which all this is happening. Recent years have seen a continually rising tide of transphobia, generating hostility, fear and prejudice. We see legal demands for segregation. We see flat-out denial of trans and non-binary people’s identities, of their human rights and of their dignity. We see a campaign to stir up and weaponise transphobia—a campaign that is every bit as ugly and toxic as the homophobia of the 1980s and 1990s, and in the early years of the Parliament. That campaign is coming not only from the far right, but from across the political spectrum.

Turning to the subject of the motion that we are debating, we see outright attempts to abolish trans people’s healthcare altogether. I know that the Scottish Government does not intend to support that, but the position now is so severe that, without transformational action, that is what will have happened by default, and the Scottish Government will have allowed it.

We must not permit that—not the Government, and not the Parliament. Every MSP has constituents who are waiting for too long, and waiting for us to act. They have a right to expect better. They want to hear from the Minister for Public Health and Women’s Health today what is going to happen now to resolve the crisis, and so do I.

Will the cabinet secretary take an intervention?