Chamber and committees

I understand that conversations about the better performance of Scotland’s NHS are not what people who are on a waiting list want to hear. I would never minimise the real pain and worry of patients and their families or the pressure and stress among staff that issues in our healthcare system cause. However, in a parliamentary debate, it is perfectly reasonable to point out some facts about investment that the Scottish Government is making and action that it is taking.

The SNP Scottish Government is choosing to invest more than £19.5 billion in health and social care, thereby giving our NHS a real-terms uplift in the face of UK Government austerity. That uplift exceeds the front-line Barnett consequentials and means that resource funding for health and social care has more than doubled since 2006-07, including £14.2 billion in investment for our NHS boards and additional investment of more than £500 million.

That said, there is an urgent and critical need for health and social care reform. We have to change the way that things are done. This morning, in the Health, Social Care and Sport Committee, we heard about the difference that research can make, so I welcome the cabinet secretary’s announcement in that regard. Reform must focus on creating a healthcare system that is sustainable, performance must improve and we have to get prevention right.

We have been talking about prevention for an awfully long time. We have to shift resources and get that right, provide quality services and maximise access. The inequality in access and outcomes that a large number of the communities that I represent still experience is wholly unacceptable. Any reform must have a foundation of due consideration for the people who are at the heart of the health and social care system—patients, their families and, of course, the workforce.

When I speak in debates about reform, I never lose sight of the human aspect. Health and social care is not an abstract topic to me. Living in the area that I represent, I have the same first-hand experience as many of my constituents do, as do my friends and family, some of whom are employees, too.

In the context of an ageing population, persistent health inequalities and fiscal pressures, delivering a high-quality, person-centred service is indisputably challenging. I do not think that anyone in the chamber would be so arrogant as to claim that they are clear on exactly how to do that—clear that they have all the answers. In that regard, a national conversation is welcome. Elena Whitham’s eloquent remarks about her experience with her community will provide rich learning for the Government.

One thing about which the SNP Government is very clear is that the answer to the challenges that we face is not privatisation. My Labour Party colleagues are rightly proud of their party’s role in forming the NHS, and they are also talking a lot about change at the moment. Notwithstanding Jackie Baillie’s remarks, however, Ayrshire residents should be warned that there is the potential for Labour to short change them when it comes to protecting the NHS. These words have been read out before, but they are worth repeating. Labour’s health spokesperson said last week that the party

“will go further than New Labour ever did”

and that Labour wants the NHS

“to form partnerships with the private sector that goes beyond just hospitals”,

having previously admitted that he will be—and I am quoting directly—

“holding the door wide open”

to private interests in the NHS. Private healthcare investors have also stated that the Labour Party would

“kick-start private sector investment much more proactively than the Tories were able to do”.

We will need consensus on exactly how to reform and improve things. My worry is that, after 14 years of Tory austerity, the growing Westminster consensus between the Tories and the Labour Party now seems far more interested in selling the NHS than in saving it.

The founding principles that the NHS in Scotland remains in the hands of the public and is free at the point of use will never change for the SNP. It is clear today that the threat comes from Westminster. That is why, in the first 100 days after the election, SNP MPs from Ayrshire, I hope, and across Scotland will propose a new law at Westminster to keep the NHS safely in public hands—a new SNP law that will bind the hands of any UK Government and ensure that the health service is fully protected as publicly owned, publicly operated and, with its services, publicly commissioned.

The SNP will stand by the founding principles of the NHS of keeping it free at the point of delivery and keeping our health service where it belongs—in public hands.

Physiotherapists play a valuable role in improving the health and wellbeing of people across Scotland. Physiotherapy is essential in preventing hospital admissions, speeding up discharge and supporting people to live independently. In turn, such outcomes not only improve the lives of individuals; they help the healthcare system to run efficiently and effectively.

I congratulate Alex Rowley on securing cross-party support for bringing the debate to the chamber. I take very seriously the real-life experience of physiotherapists and the impact on their patients that he has just set out. The Chartered Society of Physiotherapy’s “Scotland needs more physios” campaign speaks to the need to expand the supply of physiotherapists to the NHS in Scotland.

Although we should acknowledge the clear challenges that Mr Rowley laid out, and always be mindful that, for someone waiting for treatment—or, indeed, for practices or teams of staff who are under pressure or unable to recruit—contexts can vary, it is helpful for us to acknowledge the Scottish Government’s work on the issue and the investment that is being made.

The number of physiotherapists working in our NHS has increased by 29 per cent over the past 10 years, and the Scottish Government has significantly expanded the primary care multidisciplinary team workforce. Those teams are supported by an investment of £190 million in the primary care improvement fund. So far, 144 students have been funded towards meeting the Scottish Government’s target to create 225 more musculoskeletal practitioners, thereby increasing the physiotherapy workforce. It is important, too, to note that although the number of training places in England might be higher, front-line health spending in Scotland per head remains, and has consistently been, higher than in England, against an undoubtedly challenging economic and financial context.

On training and development for physiotherapists, I am very interested in apprenticeships and other earn-as-you-learn pathways. In the context of shortages in the workforce, those things open up career progression to those who are unable to attend university because of geography—we have heard about that in the Health, Social Care and Sport Committee’s inquiry into rural healthcare—and older folk who are looking for a change of career. Family commitments may mean that those people cannot attend university full time.

At the beginning of my speech, I mentioned the context for those who are waiting for treatment, and I do not want to lose sight of that. In addition, many people will not know how treatment could assist them. When I was reflecting before this debate on the number of settings and treatments that physiotherapists provide, I thought about women’s health. Physiotherapy for women’s health can be life changing and prevent really debilitating problems and conditions that can have a huge impact on wellbeing and quality of life.

I ask members in the chamber to forgive me—I hope that this is not too much information, but I first experienced physio after the birth of my first child, which was only 27 years ago. [Interruption.] Yes—27 years. It was just a 10-minute chat in which the physiotherapist explained physiology, told me about some exercises and gave me strict instructions to do them every time my hands were wet. You wash your hands a lot when you have a newborn baby.

Twenty-five years later, I took that knowledge and used it in my recovery after cancer treatment. I believe that it helped to stave off what may potentially have been some of the worst side effects of that treatment. That side of things was not discussed in the treatment discussions that I had with clinicians, but I think that it should have been. I do not know whether that was down to a shortage of physiotherapists or whether the reason was that teams that treat folk with cancer are, rightly, laser focused on doing just that. However, we need to bear in mind the challenges and shortages that have been highlighted and understand that, where services are strained, priorities shift. I would be interested in hearing from the minister what we can do to ensure that women’s health is considered as a priority, and particularly that we note the importance of physiotherapy in that regard.

At present, we do not have to look too hard to see documentation of egregious human rights abuses being perpetrated against women and girls and, in the case of Gaza, even babies. I hope that I never become inured to those stark, shocking and heart-breaking images. Although it might be less present in the media, the context of Afghanistan continues to be categorised by constant prohibitions and restrictions on the rights of women and girls.

I am grateful to Michelle Thomson for securing cross-party support in bringing this important debate to the Parliament. I thank her for her long-standing and continuing commitment to women and girls, which she demonstrates weekly in the Parliament and beyond and which was well reflected in her excellent speech.

I am a parliamentary member of the Women’s International League for Peace and Freedom. I agree with it as it urges all states to take concrete action to hold the Taliban accountable for systematic gender-based violations and to condemn it for what those clearly represent: gender apartheid. The WILPF’s recent statement on Afghanistan provides chilling reading. Women are

“arbitrarily arrested on the streets for allegedly not dressing appropriately, and being illegally detained, often without information on their whereabouts provided to their families. There are reports of financial extortion of families in exchange for information on their female relatives’ whereabouts”.

Detained women are subjected to sexual violence by the Taliban. There were a

“few pockets of life that Afghan women and girls had found to resist, including through remote schooling and operating businesses from home”.

Those, too,

“are being violently cracked down upon by the Taliban. Women leaders of civil society organisations including in the humanitarian sector continue to be harassed, arrested, listed by the Taliban intelligence services, and forced to resign ... the rule of law and the justice system have been obliterated by the Taliban”,

leaving women and girls

“nowhere to turn”

in the face of myriad violations and living

“in constant fear of punishment due to unpredictable enforcement of Taliban rules.”

The UN special rapporteur on Afghanistan noted that

“the institutionalized, systematic and widespread nature”

of the discrimination

“justifies it being framed as ‘gender apartheid’.”

The situation in Afghanistan is setting a very dangerous precedent for women’s and girls’ rights globally. The Taliban regime must not be legitimised or normalised, and any engagement with it and the de facto authorities must put human rights front and centre and be fully informed by the recommendations of Afghan female activists.

As Kenneth Gibson set out in his speech on the historical context of women’s place in Afghan society, rights, once won, are not guaranteed for ever. The UN special rapporteur has stated:

“the weight of history ... offers little indication that the Taliban leadership is willing to embrace human rights.”

I join the Women’s International League for Peace and Freedom in calling on all states that genuinely stand for the rights of women and girls and gender justice to

“Take concrete actions to hold the Taliban accountable for these systematic gender-based violations.”

That includes

“supporting efforts by the International Criminal Court in prosecuting the crime of gender persecution; exercising universal jurisdiction regarding gender-based crimes; and issuing arrest warrants and travel bans against Taliban leadership”.

Those comments are on the record, and we will be able to discuss the matter further in private session.

Does the committee agree that it does not wish to make any recommendations in relation to the instrument that is in front of us?

Members indicated agreement.

Agenda item 2 is an update on the Scottish technology ecosystem review, and we will take evidence from Professor Mark Logan. I welcome Professor Logan and ask him to briefly introduce himself to the committee.

Wonderful. Liam Kerr has a supplementary question.

So you might come in at the end. Willie, are you content?

On that wonderful note, that brings our evidence session to a conclusion. Thank you, Professor Logan. I know that it has been informative for all of us around the table.

We will now have a suspension until 10.55 to allow for a change of witnesses.

Colleagues will ask questions on that, and we will certainly give you the opportunity to talk about it.

Thank you for being with us this morning. Your STER report made a total of 34 recommendations, 11 of which related to education. In your assessment, to what extent has progress been made on the education recommendations?