It gives me great pleasure to stand up this evening to congratulate the Scottish Government on leading the way in bowel cancer screening across the United Kingdom. I take this opportunity to thank the more than 67 members of this Parliament who have supported the motion. That support and the fact that I am able to stand here as an Opposition member to congratulate the Government show a strength in politics that we should all be proud of.

This session of Parliament is probably different from a lot of previous ones, in that three MSPs have had a cancer diagnosis during it. I was delighted when I saw Ruth Maguire back in here earlier this month, but, along with other members of this Parliament, I was devastated when I learned that Christina McKelvie was not to come back.

One in two of us will get a cancer diagnosis during our lifetime. That is perhaps a good thing, if the diagnosis is for a cancer that can be treated. Every year, 4,000 Scots get a diagnosis of bowel cancer. That diagnosis often comes from doing what I have euphemistically called the poo test. People are sent a test kit every two years when they are over 50, and it is a very easy test to do. Actually, if anyone wants to do it earlier, they can get the test online. I checked to see how much that would cost and found that the cheapest test—which is double the sensitivity of the Scottish Government-approved test—costs only £20. Therefore, if any person in Scotland has any of the symptoms, such as blood in their poo, stomach pains, weight loss or a change in bowel habits, or a lump in their stomach, they should, of course, try to see their doctor, but, if they cannot, they should buy an online test, because it can indicate a need to see their doctor at the earliest opportunity.

I thank the cabinet secretary for that intervention.

As I was saying, Scotland is leading in bowel cancer screening. The faecal immunochemical tests that NHS Scotland sends out have a sensitivity level of 80 micrograms of blood per gram of poo. We have led the way for a long time, but I have to say that I am now disappointed to find that Wales has caught up—as a Scotsman, I never like to see Wales too close to us when it comes to these things. Wales has equalled that target, so I believe that it is time to move on, and the following figures should help the Government in that decision.

First, we know that, if you catch bowel cancer early, at stage 1, there is a 90 per cent chance of survival after five years. If you catch it at stage 2, there is an 85 per cent chance of survival. However, if you catch it at stage 3, that drops to 65 per cent, and, at stage 4, it is 40 per cent. That indicates that the earlier you can catch it, the better it will be. If you catch it earlier, it means not only that there is a greater chance of survival but that less treatment is needed, at less cost.

No one really talks about treatment for bowel cancer, but it can be quite invasive. For me, it was radiotherapy, then chemotherapy and eventually surgery. The chemotherapy is a hard course to go through. It involves three hours of sitting in a room with other cancer sufferers, on a drip, getting your chemotherapy, and then two weeks of pills—12 pills, morning and night—and feeling pretty sick on the back of it. You are not able to do little things, such as getting milk out of the fridge, because you cannot touch anything cold. You are made to feel pretty tired by the treatment, and pretty isolated.

My view is that there is every reason why we should ensure that people can avoid the treatment. Let us be clear, too, that there is a huge cost in treatment to the national health service. The “Cost of cancer in the UK” report has shown that, if someone’s cancer is caught at stage 1 or stage 2, the cost is about £33,000 in the first year; if it is caught at stage 3 or 4, the cost goes up to about £46,000. That is just for the treatment—it does not include surgery. If someone goes for surgery, the costs can be huge. I know that personally, because I saw the bills related to my treatment. The total for surgery is probably the two figures that I have quoted, combined together, on top of the original costs. There is a huge cost to not catching bowel cancer early.

So, how do we catch it early? As I explained, in my opinion, increasing the sensitivity of the FIT would be the easiest way of doing that. I have discussed that with the Minister for Public Health and Women’s Health, who I know takes a personal interest in the subject—she does not have much of an option, because I pester her about it the whole time. The cost of increasing the sensitivity of the test is that we will need more colonoscopies. I have done some research across Scotland, and I know that the average cost of doing a colonoscopy in the NHS is about £18,000. If you go private, you can get it done very quickly, and the cost is about £3,000. It does not take a lot of maths for me to be able to highlight the situation to members: if the costs for treatment are going to be close to £60,000, how many colonoscopies would we need per patient to make it justifiable?

My call to the Government, and to everyone, is that we need to catch bowel cancer early. We can do that by increasing the sensitivity of the test, and we should—to my mind—be pleased to know that there is no reason why we cannot do that if we train more colonoscopy teams across Scotland. I say to the minister that, if we cannot do that, we should rely on the private sector to deliver those colonoscopies. The benefits of that approach are that we will be saving Scotland money and saving lives—what is not to like about that?

Let us be honest: if we make the test more sensitive, Scotland will be leading the way again, which is where we should be.

I want to make it clear at the outset that, although I am a member of the Net Zero, Energy and Transport Committee—I am its convener—I speak in the debate as an individual. In case anyone asks me questions on farming, which I am delighted to talk about, I also declare that I have an interest in a farm in Moray.

We are in a difficult position. Budgets have been produced that the committee and the Parliament have had to consider. The problem is that they are not like any other budget that I, as an individual, have ever looked at in my entire career. We are told that we are to achieve targets but not how we will achieve them, the route to achieving them or the costs. That causes me problems.

If the Parliament is to have a climate change plan, the most important thing is that we move forward in a credible way and take the people of Scotland with us. If we do not do that and families do not know what it will cost them and how much they will have to invest in it, when they come to the stage at which it gets tougher, as Patrick Harvie suggested—as we get closer to the targets—they will start to balk at the route that they are taking. We cannot afford that.

I will concentrate my speech on the fact that we are getting very close to the back end of this parliamentary session. What concerns me is that we have delayed the process because of the way that it has been changed, and we are still at the stage of approving or disapproving the carbon budgets, but a climate change plan will not be laid in front of the Parliament before the end of October or early November. The cabinet secretary has said that she aims to produce it at that point. That is only an aim. I would much rather know that she will produce it, so that it can be discussed.

We will then go through a process of 12 weeks of public consultation and work by parliamentary committees. There will probably then be a month in which to summarise those views. For those who can do the maths—I am sure that all members can—that takes us to March, giving us about 27 days in March, not all of which are sitting days, to go through the climate change plan. Once that process has finished, the Government will have 90 days in which to lay its climate change plan before the Parliament. If it chooses not to lay the final climate change plan after the consultation, the Parliament will be in a situation in which the plan does not come to fruition.

I seek some certainty from the cabinet secretary that she will do more than just aim to lay the draft climate change plan by the end of October and that she will do it by the end of October. If she cannot do that, she should give the Parliament an assurance that it will be done before 7 November, so that we will have time to get through the process, do the right thing and consider the climate change plan. I hope that, when the cabinet secretary gets a chance to speak, unless somebody else sums up, she will clarify whether the Government is going to do that rather than just say that it aims to do it.

There are a few supplementary questions on the back of what we have just discussed.

I am sorry, cabinet secretary, but I am now more confused than I was at the beginning.

I do not remember the exact figure that we were given for the cost of dualling the A9, but it was something like £3.7 billion at 2023 prices, so we will be somewhere north of that. If MIM—I do not like using that term. If the mutual investment model does not work, what happens then? Where will the money come from? Do you have a plan for that?

I see that, and I see that the Spey bridge is being resurfaced again, although it is less than a year since that was previously done. That adds to the confusion about road works.

I will link the issue to our previous topic of active travel. For active travel, the missing bit on the A9 is between Aviemore and Carrbridge, which is one of the areas that are to be dualled. If we are underspending on the active travel budget, should we sort that bicycle lane and the pedestrian walkway before the road works start? Otherwise, things will be even worse. Surely that would be a good investment.

Michael Matheson has some further questions.

Sure.

A number of members have supplementary questions, and I will go to Douglas Lumsden in a minute. Before I do, cabinet secretary, I appreciate your offer of help with regard to an additional LCM, but it would be wrong of me, as convener, not to ask you when we can expect to receive it. You have offered—I am asking.