Chamber and committees

Good morning, panel. I am not sure whether my microphone is on. [Interruption.] It is. Sorry.

The previous ombudsman told the predecessor local government committee that some public bodies ignored the SPSO’s recommendations or delayed in responding. Is that still the case?

That is helpful. We have been hearing about that in different contexts, such as in planning departments, in the work that we have been doing.

I want to move on to a question about why many of the cases that are escalated to the SPSO are then subsequently closed by you, with the conclusion that they had been well handled by the public body. I believe that 908 cases were closed for that reason in 2021. What route would you recommend to complainants who feel that the door has been closed on their concerns?

That is helpful. Have you seen the increase because people have been asked to provide evidence through email, for example, or have not been able to get hold of documents from their general practitioner, because they have not been able to see them?

What would be the average time to do deal with one of those cases?

I mean the number of reviews of decisions on crisis grants, including applications being rejected by local authorities.

That will depend on what you say.

I thank the Standards, Procedures and Public Appointments Committee for its work. I am glad to speak in the debate, and I welcome the positive progress that is being made in extending candidacy rights to eligible citizens from Poland, Spain, Portugal and Luxembourg. Although the bill might not be generating headlines, it is an important piece of legislation.

The United Kingdom Elections Bill as drafted is designed to clarify the voting and candidacy rights of key groups of citizens in this country. It is important to note that European Union nationals who were resident in the United Kingdom before 31 December fall into the category of having retained rights and are fully eligible to stand as candidates and vote in elections. The bill that we are considering today simply aims to expand candidacy rights to include people from named countries with any type of leave to remain in the United Kingdom as well as those with settled or pre-settled status.

It is reassuring to note, as others have done, that neither the Electoral Commission nor the Electoral Management Board for Scotland has expressed any particular concern about the bill. I note from Mr Adam’s response on the bill to the Standards, Procedures and Public Appointments Committee that the Scottish Government will reflect on an amendment to the bill that would give greater clarity to the Scottish Government’s obligation to remove a country from the schedule. I think that Mr Adam suggested in his opening speech that he will lodge an amendment on that at stage 2.

As others have outlined, the council elections are an important opportunity to refresh our democracy. I hope that they will also be an opportunity to elect more diverse councils that better reflect their local communities. For example, a record number of female and black, Asian and minority ethnic candidates will stand for my party at the election. Across the chamber, all parties have taken positive steps to try to improve candidate diversity at the election. The Local Government, Housing and Planning Committee, of which I am a member, will undertake additional work in that area after the council elections to review the impact of the election results.

For the millions or hundreds of thousands of people who, I am sure, will be watching this debate, there are now just under 24 hours until 4 pm tomorrow to submit their nomination papers. I genuinely hope that people who want change in their local community will do just that and stand for election, as all of us have done, to make the positive change that they want.

The minister suggested that a wider election bill is likely to be forthcoming, which will be consulted on. I hope that we will see a number of reforms in that. I think that councillor remuneration is an issue. The Local Government, Housing and Planning Committee has heard that a number of councillors have decided to stand down at the forthcoming elections for career reasons.

We also need measures on the support that is available to councillors to serve their local constituents. We MSPs are lucky to have the support that we have for staff and communications, but councillors have very different support available to them. I hope that that can be reformed, too, and that support will not just be based on whether a council decides to provide it.

I have previously raised with the minister the idea that we need to consider the provision to councillors of a free mail election address, which MPs and MSPs are entitled to, especially given the current size of single transferable vote wards and, potentially, larger wards after Boundaries Scotland undertakes its review after the council elections. I hope that all parties will reflect on bringing that forward.

Overall, however, the bill is a measured and uncontroversial step. The extension of the franchise is limited to nationals of the handful of countries with which the UK has signed reciprocal agreements. We will therefore support the bill at decision time, and will welcome future such agreements that the UK Government may reach with other countries. The bill seeks to bring Scottish legislation into line with the nationwide UK law. That is a welcome step forward.

As the cabinet secretary said in her statement, the Child Poverty (Scotland) Act 2017 was passed unanimously by Parliament, setting a target to substantially reduce rates of child poverty in Scotland. It would be fair to say that we have not seen the progress that was expected or hoped for to deliver the reductions in child poverty that we all wanted to see. Indeed, since the bill was passed, many organisations have pointed to greater challenges that we face as a country. Nonetheless, eliminating child poverty must be a priority for us all.

I have to say at the outset that I have been disappointed by the Scottish Government’s approach to the plan. It has singularly failed to reach out across Parliament to develop the strategy or listen to ideas from other parties in the chamber, beyond the Green Party, on which it now relies for support. That is a decision that Scottish National Party and Green ministers are free to take, but it will leave the strategy all the poorer.

I am grateful to be able to bring the debate to the chamber today, and I thank members from across the Parliament for all their support on what is not only an important public health issue globally but, increasingly, a potential threat to domestic health security.

I pay tribute to the Edinburgh group of Results UK, which campaigns on international development issues, including tuberculosis. I have been working with the group since my election to Parliament in 2016, and I am pleased to welcome some of its members to the public gallery today. I have also sponsored a stand just outside the chamber, and I know that a number of members have already spoken to and engaged with the group. If they have not done so already, there may be a chance after the debate for them to speak to the group and find out more information.

I also take the opportunity to note the contribution made by two leading professionals in Scotland. Dr Helen Stagg of the centre for population health sciences at the University of Edinburgh was, until recently, chair of the UKAPTB. For those who do not know what that is, it stands for UK Academics and Professionals to End TB. Susan Duthie, who is the lead TB specialist nurse at NHS Grampian, also led on drawing up recommendations on the management of Afghan national TB screening in Scotland.

I also put on record our thanks for all the vital work that is carried out by clinical staff, scientists and civil society organisations, in Scotland and globally, to deliver on the sustainable development goal, which we all signed up to, of ending TB by 2030.

Tuberculosis is an incredibly infectious disease that is spread through coughing. It has killed more people than any other single infectious agent in history, including SARS-CoV-2. TB is curable, but people need support to get through the many months of treatment that are required.

As noted in the motion, around 1.5 million people die from TB every year and many millions more are diagnosed with the disease. That is a shocking statistic and something that we all need to reflect on. Presiding Officer, if you were a teenager before 2005—I am not sure whether you were—you may bear a small, circular scar on your bicep. That is by-product of immunisation against TB and a reminder of the prevalence of the disease in this country at one time.

However, the Covid-19 pandemic and its widespread effects on diagnosis and treatment have brought the disease of TB back to the forefront of the policy debate, especially in the context of public health in developing countries. Because of the similarities between TB and Covid, much of the precautionary equipment and many of the treatment centres and services that are usually the first line of defence for the former were refocused on the latter. The World Health Organization has suggested that the pandemic has set back efforts to end TB globally by more than a decade.

Researchers at the University of Dundee, who received a £3.8 million grant from the Bill & Melinda Gates Foundation to develop treatments, have warned that the impact of the pandemic could lead to a rise in tuberculosis infections around the world, as some patients will have gone undiagnosed amid the pandemic. Indeed, as with many services across our health landscape, we believe that diagnoses of TB dropped by around 20 per cent in 2020, as access to treatment became increasingly difficult.

Some projections suggest that progress against TB has also been significantly set back. Dr Laura Cleghorn of the University of Dundee said that there is a “pressing need” to develop new treatments for the illness, which some people wrongly think of as a “disease of yesteryear” . I agree. As I said earlier, it is a concern that, across the world, diagnoses of TB dropped by a similar level, with 16 countries accounting for 93 per cent of that drop. That suggests that countries that already have a higher burden of disease have fared far worse.

Of course, other issues have led to that protracted problem. For example, fewer people have been tested for TB and the number attending for tests has reduced. That might be due to people’s fear of contracting Covid-19 in hospital or because people with Covid-19 were not able to go to hospital. As we emerge from the pandemic, we urgently need to tackle that problem. Otherwise, we risk stepping backwards in the fight against deaths from TB.

That will, of course, require a sincere, co-ordinated and multilateral effort, but if the pandemic has demonstrated anything it is that immense benefit can sometimes be gained from proper and targeted investment in global public health. In recent years, concerted action has been taken to tackle TB and we need to see that work being recovered.

In 2018, for example, we saw the first high-level global meeting on TB. It produced a declaration of political will that can shape our approach going forward. Notably, it identified work to close the research and development funding gap. To date, that has been estimated to be more than $1.1 billion. I welcome the £20 million of UK Government research and development funding. A good portion of that has already been targeted towards such global health innovations.

There are still many concerns around research and development, and I hope that we can address those globally.

The first and most obvious concern is about treatment methods. Innovation will allow us to simplify treatment regimes, allowing them to be more easily deployed in all corners of the world, in contrast to what are currently lengthy and complex treatments for many patients that can often take more than three months.

Similarly, we need to see progress on diagnosis of TB. We need to be able to do it in a speedy, efficient and simple way. To circle back to my earlier points, Covid-19 has acted as a catalyst to the diagnosis question, and I hope that we will see investment around early diagnosis of TB, as we have seen around Covid.

Finally, and perhaps most importantly, we need to fund the research that will look at drug resistance. We are all acutely aware of a really worrying trend—a rise in drug-resistant or multidrug-resistant TB. More than 160,000 cases were recorded people last year alone, which is deeply concerning for global public health.

We know that Scotland is also behind in funding for latent TB screening in communities at risk and vulnerable to TB. I hope that the minister who closes the debate can outline the public health initiatives that are being developed to address those concerns around latent TB screening.

To conclude, I am incredibly grateful to members for allowing me to introduce the debate today, and for the opportunity to discuss these issues of public health policy around the world and of domestic health security.

Above all, I hope that today can present an opportunity for Parliament to re-affirm our collective mission and that of clinical staff, scientists and civil society organisations in Scotland and globally to meet the sustainable development goal of ending TB by 2030.

Very briefly, because I do not have a huge amount of time.