Chamber and committees

Does anyone else want to come in on that?

That is helpful.

My only other question is about the impact of RAAC, which I know that all councils have been working on. Perhaps you could provide us with written evidence on that, unless there is anything specific that you want to put on record today.

Good morning to the panel. Thank you for joining us today. I have a few questions on different topics. My first one is on the three shared priorities in the Verity house agreement and specifically on the net zero priority. Given what we have heard about cuts to capital budgets—Kirsty Flanagan outlined them in some detail—what impact do you think that they will have on realising your net zero commitments?

One of the key issues that we need to address is the fact that, before health and social care integration, a chief executive’s letter provided the certainty and opportunity for our hospice sector to fund the work that it does. Is the minister considering whether that could be reformed as part of the national care service to achieve the sustainable funding that the sector desperately needs?

I want to start by paying tribute to and thanking Bob Doris for bringing this debate—the final debate before recess—to Parliament and for his work chairing the cross-party group on palliative care. It is important to recognise the cross-party working that takes place in the Parliament on this issue.

As we look forward to Christmas, which is just round the corner, it is quite telling that many families will be using the services that our hospice sector provides. Marie Curie will be at the heart of that, especially for many of my constituents in Lothian. I put on record our thanks to Marie Curie at what will be a difficult time but what must also be a really good time for people who are celebrating Christmas—some know that it might be their last Christmas. The work that hospices will be doing to make sure that many wishes come true for people this Christmas is incredibly important.

Across Scotland, what our hospice sector does day in, day out, 24 hours a day, must be recognised and understood. I put on record my thanks to Marie Curie and our whole hospice sector for what they do.

However, as has been outlined—I associate myself with what other members have said—we know that there is huge unmet need for palliative care in Scotland. Despite Marie Curie and our hospices trying to meet that need and fill that gap, there is unmet need, because around one in four people do not have access to the palliative care and support that they need at the end of their life. As we have heard and as Bob Doris outlined, poverty is often a barrier to accessing palliative care, which is one of the key challenges that we must address.

I was taken by a point in Marie Curie’s briefing for the debate. It compared a finding from the “Report on a National Survey Concerning Patients with Cancer Nursed at Home” from 1952 with a 2022 survey and found many overlapping problems that we have not resolved. That should result in a real demand that we all step up to address this issue, because we know that the need for palliative care is increasing and that an ageing population will present more challenges for our health service. Our hospice sector will be there, wanting to help to fill that gap. We as parliamentarians, and the Government especially, need to be there to help.

The funding problems that the sector faces today and will face in future are at the heart of what the Government must look at. We see a cross-party consensus on what needs to be a better deal for our hospice sector. Many people will have views on how that is shaped, and I know that the Government has views on it. However, it is an emergency situation for some hospices that are using their own reserves now, and that needs to change. I hope that, in the new year, the Government will look towards a solution.

I hope that the new year will present opportunities for the palliative care sector. We have the National Care Service (Scotland) Bill. I hope that, unlike what we did as a Parliament on the integration of health and social care, we will make sure that the hospice sector is at the heart of what that bill delivers. That is why I hope that the Government will also look towards enshrining a right to palliative care in the bill. We need to solve the problems that prevent us from addressing the issues. A person should be able to have a prompt assessment, and some people want specific services to be developed. Positive conversations around death can then take place with family and friends, with the individual at the heart of the decisions.

I hope that, from this and previous debates, the Government will take away the fact that there is real cross-party belief in the need to look at what palliative care means in Scotland for the future and understand that that is an ask of Government. There is an opportunity for Parliament to unite to do something that sustains and takes forward our palliative sector next year.

As others have done, I pay tribute to Marie Curie for what it has achieved over the past 75 years. It is a remarkable milestone anniversary, but I know that it is not resting on any laurels. It wants to make sure that it is there for every family and individual.

Deputy Presiding Officer, I take this opportunity to wish you, everyone else in the chamber and those watching a very merry Christmas.

I send my thoughts to the families and friends of people who have died while homeless, which relates to the question. Over the past decade, 2,175 people have been discharged from hospital with no fixed abode registered. I welcome the fact that the figure is coming down from a high of 336 in 2017 to 58 in 2022-23. Will the review of housing policy include a public duty that no one should be discharged from hospital with no fixed abode?

When she announced the Scottish Government’s intention to take the UK Government to court, eight months ago, the cabinet secretary told Parliament that it was keen to be as transparent as possible on the matter. Now that the Scottish Government has abandoned its legal battle against the UK Government, will it publish its legal advice? Given that the Scottish Government has spent more than £230,000 of taxpayers’ money on the failed court action so far, will it also publish the estimates of the costs that would have been incurred if it had challenged the ruling?

That is an interesting point.

The Verity house agreement includes a commitment to jointly agree a monitoring and accountability framework. We already have the national performance framework, which is meant to be doing that in practice. Do the witnesses have a view on how that should work, or will the new framework just be another measurement that will, as you said, provide data that will not necessarily be of much use or prescribe what it is being used for?

Donna, given that you have already done this in Wigan, what examples should we take on board?

Do you have anything to add, Jim?

Good morning, and thank you for joining us. I want to play devil’s advocate with regard to why we have not seen more progress. In a scenario where central Government, be it the UK Government or the Scottish Government, has concerns about the performance of a local service in a local authority area, what should a system to address that look like in order to ensure that we do not see large disparities between outcomes in different parts of the country? We often hear the situation being referred to as being a postcode lottery. What should such a system look like and how can it be taken forward? Maybe you could answer first, Jim.