Chamber and committees

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.

The relationship that the member describes is also the relationship between the Scottish Government and councils, so the decision that her Government took to cut £250 million from council budgets will also have an impact. Does she not accept that?

The reason why I did not support the Scottish Government budget was that it cut £250 million from local authorities. The cabinet secretary said in her statement that she wants to work in partnership with local authorities in Scotland. I do not see cutting their budget by £250 million as any partnership that I would want to be involved with. The decision by Green Party and SNP ministers to cut that funding will impact on child poverty and they should be acutely aware of that.

Creating better jobs and fairer job opportunities for families is incredibly important and I welcome what was outlined by the cabinet secretary. There is cross-party agreement on that.

In the time that I have, I want to concentrate on children in Scotland who are homeless and living in unsuitable and temporary accommodation. The housing emergency in Scotland is contributing to the level of child poverty, with children and families often stuck in unsuitable and unaffordable homes, or in temporary accommodation for unacceptable lengths of time. Families are being accommodated in former hotels and bed and breakfasts, and many have to share toilets with strangers and have to cook on toasters and kettles. That is totally unacceptable.

Across Scotland, more than 7,500 children are living in temporary accommodation and the typical length of stay for families in temporary accommodation has nearly doubled from what it was year ago to more than 58 weeks. Alison Watson of Shelter Scotland described the number of children in temporary accommodation as “a national disgrace” and I agree. A permanent safe home is vitally important for a child’s wellbeing and development.

The number of children becoming homeless every year is equivalent to 32 Scottish children every day, which is equivalent to a primary school class. Homelessness has been shown to have long-term negative consequences for a child or young person’s development. Children who have been homeless are three times more likely to experience mental health problems and their risk of ill health and disability is increased by up to 25 per cent. Any teacher will tell you that children who are living in temporary accommodation often struggle to maintain relationships and have increased anxiety.

SNP and Green ministers need to drive action on the issue. Bringing cases of living in temporary accommodation to an end for all children should have the full attention of the Government. I am sorry to say that all my efforts to engage on that issue with ministers and, indeed, the cabinet secretary have fallen on deaf ears.

Here in the capital, 1,500 children are living in temporary accommodation. The City of Edinburgh Council is being short-changed by £9 million due to a bureaucratic anomaly. The cabinet secretary has not listened to my calls for action to assist the council on that, but it is something that we need to see. Simply telling me to speak to the council is not good enough. SNP ministers cannot wash their hands of the housing crisis that is driving children into temporary accommodation here in the capital today.

Shelter Scotland stated in its briefing ahead of the debate:

“The 2022-2026 Tackling Child Poverty Delivery Plan must outline how the Scottish Government intends to get thousands of children out of temporary accommodation and unaffordable homes and out of poverty, and into safe, secure and affordable homes as a matter of priority.”

I read the delivery plan before I came to the chamber and I found nothing new on the issue. We need to see a new approach and, if the cabinet secretary had consulted with other parties, I would have called for us to develop a plan that went further and banned the practice of children living in temporary and unsuitable accommodation. That could have been in the document, but I am sorry to say that it is not.

The negative impact that the pandemic has had on Scotland’s children and young people is only now starting to be fully understood, but for the most vulnerable children and young people in our society we know that the impact has been significant. Realising the potential of every child and young person in Scotland is something that we must all see as a focus, but it is one that the strategy does not include.

One area that I believe needs urgent action is the long-term impact of lockdown on vulnerable children’s learning. Long-term, system-wide support is required to help every child to catch up and recover from the educational disruption that there has been to both learning and child development. For the most vulnerable children that, again, will need targeted support.

We know that, prior to the pandemic, the Scottish Government was failing to close the attainment gap. What I would like to see, and ministers should be looking at, is where we can prioritise young people’s education with the delivery of additional support through catch-up schemes for disadvantaged children and young people. We have been calling for those.

It is clear that we need to see a cross-portfolio effort from Government to make progress on addressing child poverty and that targeted support is needed. I welcome the fact that the Deputy First Minister is participating in the debate, because I hope that he will be tasked with taking forward that work.

However, there are longer-term issues that we, as a Parliament and as a country, need to consider around intergenerational unemployment and the need to drive social mobility. The SNP set ambitious targets on child poverty five years ago, but we have not been able to meet those as a Parliament, and the Government has not been able to meet them with all the powers that it has. The strategy has presented an opportunity to genuinely consider refocusing that effort, and I hope that that is what we will see.

To conclude, it is critical that we hold the SNP-Green Government to account, as it is accountable to Parliament, and that we see ministers set out detailed plans around another strategy to reduce child poverty. We now need to see how that strategy will be delivered on the ground, and it is our work to ensure that ministers achieve what they are setting out to do.

We desperately need targeted resources, and we need ministers to outline what the tackling child poverty delivery plan will actually achieve and how councils will be given the resources to help implement it. I agree that we need cross-party work if we are going to meet those targets, and I hope that the Government will start working to live up to that too.

Good morning, Mr Walker and Mr Cameron. Thank you for joining us. How do you monitor social landlords on progress against the Scottish social housing charter, and how is that information used within your regulatory framework? We can start with that, then move on to a few other points.

The committee has received a number of submissions in relation to our scrutiny of the revised charter. Living Rent argues that the current process for landlords self-assessing against the charter indicators is not suitable and it would like a more robust and accountable regulatory approach to delivery of the charter outcomes. What are your views on that concern? Is what you have outlined almost a toothless tiger in relation to your ability to go after individual landlords to try to improve outcomes?

How often have those powers been used by the regulator?

What were the circumstances of those cases? I understand that you may not have the detail of that to hand, in which case you could write to us.

Thank you. That was helpful.

How do you use the charter to drive performance? Probably every MSP is used to hearing complaints about repairs and the very poor living conditions that people are sometimes in. As an MSP, I have had cases in which mould in people’s homes has not been fixed for years, so I have gone to the council to fight to have that rectified. How can the charter drive performance? Are there examples of interventions in which the charter has led you to take up such issues?