Chamber and committees

The committee has seen other submissions and heard from other panels about workforce shortages and difficulties in recruiting in remote and rural areas, so I am not going to ask you specifically about recruitment. However, I am keen to hear from you, as academics, about how you see training and learning opportunities for staff in remote and rural settings. Are those areas attracting people to come to, and live and work in, those communities?

Professor Smith may want to start on that.

Our next item is consideration of two negative instruments.

The first is the Food (Scotland) Act 2015 (Compliance Notices) Amendment Regulations 2023. The purpose of the regulations is to correct an error in the Food (Scotland) Act 2015 (Compliance Notices) Regulations 2023, specifically to substitute an incorrect reference to regulation 6(2) of the Novel Foods (Scotland) Regulations 2017 with a reference to regulation 4 of those regulations.

The policy note states that the correction

“will allow Authorised Officers (AOs) to use compliance notices to deal with breaches of the requirements in the Novel Foods (Scotland) Regulations 2017.”

The Delegated Powers and Law Reform Committee considered the instrument at its meeting on 21 November 2023 and made no recommendations in relation to it. No motion to annul has been lodged.

Do members have any comments?

That is based on written evidence and evidence that the committee heard in its sessions. Simple things such as lighting in parks or on cycle paths would make them much safer places for women, and they would certainly feel safer there.

The Scottish Government’s commitment to doubling investment in sport and active living to £100 million per year over the current session of Parliament is welcome. However, a significant proportion of that funding needs to be targeted at increasing rates of female participation in sport and physical activity, particularly among those who face intersecting barriers to participation such as disability; ethnic, religious or socioeconomic background; or being from the LGBTQ+ community. On that subject, the committee heard evidence in support of greater use of equality impact assessments to ensure that sports infrastructure and facilities are designed to facilitate access for all.

Imagery and messaging aimed at encouraging greater participation in sport and physical activity should actively promote inclusion and diversity. We should be improving equalities education in schools to help overcome stigma and discrimination that might otherwise discourage girls who face intersecting barriers to their participation in sport and physical activity. Moreover, decision makers need to work together to identify and promote positive role models who properly reflect diversity and inclusion, and to pursue strategies aimed at recruiting a greater diversity of female applicants into coaching and leadership roles.

Although we have come a long way in recent years, there is still much further to go if elite female athletes are to achieve anything approaching parity with their male counterparts. The Scottish Government should consider setting up an independent women’s sport trust for Scotland, which could help grow revenue from women’s sports and reduce reliance on men’s sports for funding.

Women in elite sport need sustainable career pathways that enable them to pursue their sport while earning a sustainable income. The industry also needs to do more to produce clothing and equipment that meet the needs of women in elite sport.

In addition, there is a chronic lack of research into female physiology and the impact of menstruation and women’s health conditions on training and performance. Women in elite sport still lack appropriate support when it comes to decisions around pregnancy. It cannot be right that so many elite female athletes continue to be forced to make a choice between continuing their career and starting a family.

Sexism and abuse are on-going concerns. To address them, our report calls on the Scottish Government to consider setting up an independent body to tackle cases of misconduct and abuse in elite female sport. The media, too, has a crucial role to play in its promotion of women’s elite sport. There has been progress in that respect, but much remains to be done. Shockingly, the Scottish women and girls in sport advisory board’s 2019 report “Levelling the Playing Field” found that more than a fifth of online news articles relating to women’s sport included sexualised reporting and images. That has a hugely damaging impact on self-confidence and self-esteem, and undermines female participation at all levels.

Television sports coverage remains significantly skewed towards male sports. While the quality and quantity of the coverage of major women’s sporting events has improved, levels of coverage outside the window of those events drop to a small fraction of the overall sports coverage in the media. At the same time, there is evidence to suggest that the public has a real appetite for following more women’s sport in the media. The number of people watching TV coverage of women’s sport in the first half of 2022 doubled to more than 36 million compared with the same period a year before.

To further stimulate and encourage growth in coverage of, and public interest in, women’s sport, our report recommends that the Scottish Government consider whether additional public investment might be needed and, if so, where to target it for maximum effect. It would also be helpful to receive an update from the minister on the planned Scottish sport media summit and on what bearing the outcomes from the summit might have on further improving the quality and quantity of future media coverage of elite women’s sport.

For good or ill, social media have an undeniably huge impact on female attitudes to, and engagement with, sport and physical activity. Sports organisations and governing bodies can play an important role in disseminating and amplifying positive messaging around the health benefits of regular participation in sport and physical activity by girls and women, and in challenging misogynistic attitudes and behaviours.

The Scottish Government can also play a role by providing support and guidance around social media strategy development. The United Kingdom Online Safety Act 2023 could also provide a framework for stronger action, including sanctions, to address the harmful impact of the negative body image content that exists on social media.

In order to effectively benchmark progress towards closing the gender-based participation gap, we recommend commissioning a new population-level survey to give us an accurate and comprehensive picture of current rates of participation in sport across all segments of the population. We should also explore incentives to encourage research organisations to direct additional resources towards research in sports science, with a specific focus on women.

In conclusion, I look forward to hearing both the minister’s initial response to the findings of our inquiry and the other contributions in this debate. As our inquiry found, breaking down the many persistent barriers to female participation in sport will require on-going determination and focus.

I move,

That the Parliament notes the recommendations contained in the Health, Social Care and Sport Committee’s 7th Report, 2023 (Session 6), Female participation in sport and physical activity (SP Paper 445).

As convener of the Health, Social Care and Sport Committee, I am pleased to open this afternoon’s debate on female participation in sport and physical activity. On behalf of the committee, I thank everyone who engaged positively with our inquiry for their input and place on record the committee’s thanks to the clerks for their work.

I joined the committee as convener at a late stage in the inquiry, but I know that it was originally prompted by a key finding from the committee’s previous inquiry into the health and wellbeing of children and young people, which found a significant decline in the number of girls participating in sport and physical activity as they reached puberty. The current inquiry subsequently found evidence of a gender gap in the rates of participation that persists up to women in their early 40s.

We wanted to find out more about the reasons behind that worrying trend. The purpose was to identify key barriers to participation in sport and physical activity for females of all ages and to make recommendations for breaking down those barriers.

Teenage girls face particular barriers when taking part in sport and physical activity, both in and outside of school. A lack of understanding and awareness of menstrual health and negative attitudes among boys are important factors that contribute to the decline in girls’ participation from the age of adolescence. We need to improve learning and normalise discussions in school about the impact that menstruation can have on girls’ participation and to remove the stigma around managing periods. We must also do more to tackle misogynistic attitudes and foster mutual respect between boys and girls when they take part in sport and physical activity.

The committee heard about the positive impact that the active schools programme has had in broadening girls’ access to a wider range of sports and physical activities. However, the most recent full evaluation of active sports took place almost 10 years ago in 2014, and an updated evaluation of the programme is needed, with a particular focus on how it is helping girls to access the same range and quality of opportunities for sport and physical activity as boys.

Beyond school settings and teenage years, a lack of understanding, education and appropriate support creates barriers to the participation in sport and physical activity of women of all ages. It means that they lose out on the benefits of remaining physically active, with knock-on impacts on their long-term health.

Leadership is equally important in giving more women the confidence to be physically active. We need to do more to break down the barriers that prevent women from putting themselves forward for coaching, leadership and volunteering roles. That will create a virtuous circle in which the existence of more positive role models will encourage more women to participate at all levels. We also need to find solutions that will help to make it easier for women with childcare and other caring responsibilities to be able to participate regularly in sport and physical activity, including in leadership roles.

Sadly, the inquiry heard extensive evidence of girls and women being subjected to harassment and abuse while exercising. That is completely unacceptable. In sport and physical activity settings, we need to improve processes for receiving, handling and dealing with complaints to ensure that they are clear, transparent and easy to navigate. Too often, sport and active travel infrastructures and facilities are designed, constructed and maintained in a way that fails to take account of basic safety requirements for female users. Our report recommends encouraging the systematic use of feminist town planning to improve the safety of basic infrastructure, so that it is better suited to the needs of female participants.

Can Willie Rennie expand on what he, as a man, thinks the male population can do to tackle the misogyny that women experience in sport and physical activity?

I thank colleagues across the chamber for signing my motion marking world AIDS day, which falls on Friday 1 December. I look forward to hearing speeches from other members throughout the debate.

HIV remains a condition that has a profound impact on the health and wellbeing of people globally. However, with early diagnosis and effective therapy, HIV is, in many nations, no longer the terminal illness that it was in the 1980s. It is now established that, with effective treatment, the virus cannot be transmitted to others.

Of course, adverse impacts on physical and mental health remain, together with the requirement for lifelong healthcare and treatment. Living with HIV can worsen existing inequalities, and people might experience additional HIV-related stigma and discrimination. Therefore, there is a real opportunity and a real need to prevent HIV from being passed on in the first place.

By the end of 2021, 6,415 people were known to be living with HIV in Scotland following a diagnosis. That compares with 5,617 people in 2019. HIV can and does affect anyone—people of any age, sexuality, ethnicity or gender. However, we know that rates of access to HIV specialist treatment and care are relatively high in Scotland. Based on 2019 data, 90 per cent of people who had been diagnosed were attending specialist HIV services, 98 per cent of those attending were receiving antiretroviral therapy and 95 per cent of people treated had achieved an undetectable HIV blood level.

Over the past decade, the annual number of people in Scotland diagnosed with HIV for the first time has declined. The number reduced by 37 per cent between 2010 and 2019, and by a further 54 per cent in 2021. Thanks to scientific and pharmacological developments and the expertise of our leading sexual and reproductive health services, if they are on the right treatment, a person with HIV in Scotland can live a long, happy and healthy life.

However, we can go further. The goal of eliminating HIV transmission is now in sight. On world AIDS day three years ago, the then public health minister, Joe FitzPatrick, set the goal of ending HIV transmission in Scotland by 2030. To make good on that commitment, excellent work has been undertaken to examine what is working well in driving down the number of new transmissions and how those successes can be further capitalised on, and people are investigating what more we can do.

Back in 2020, the Scottish Government commissioned the Scottish health protection network to develop a proposal on how elimination could be achieved. That led to the establishment of the HIV transmission elimination oversight group, which published its report on world AIDS day last year with a set of recommendations to inform the Scottish Government on how the elimination target can be met. That report set out a total of 22 proposed actions within five key pillars of intervention. Those pillars are testing; education, including awareness raising and stigma reduction; combination therapy; entry into and retention in specialist HIV care; and contact tracing.

One of the specific asks is for the Scottish Government to commit to piloting opt-out HIV blood-borne virus—BBV—testing in accident and emergency departments in areas of the highest HIV prevalence. A similar opt-out testing scheme was launched in England and proved to be successful in identifying cases of HIV and other blood-borne viruses. There are estimated to be 500 people living with undiagnosed HIV in Scotland, and it is vital that we invest in ways to find all of them if we are to meet the 2030 goals.

I wrote to the Minister for Public Health and Women’s Health about that earlier this year. In her response, she advised that there would be an

“element of prioritisation for the recommendations, and this will be based on a number of factors, such as available capacity within services, likely relative impact, and timescales for delivery.”

Identifying undiagnosed and unknown HIV and blood-borne viruses should be a key public health priority. I ask the minister to consider the recommendation for opt-out testing as a matter of urgency. That action could save lives. I also look forward to hearing more from the minister in her closing speech about the actions that the Scottish Government will take to drive forward the recommendations to ensure that the 2030 goal becomes a reality.

World AIDS day affords us the opportunity to come together to stand in solidarity with all people who live with HIV. It allows us to remember those who have lost their lives to HIV and AIDS-related illnesses over the decades, as well as to celebrate activists and charities who have refused to let HIV stigma stand in the way of progress. As charities such as the Terence Higgins Trust say, nowadays, stigma is more harmful than HIV itself.

The stigma around HIV is not what it once was, but much more needs to be done to educate people about the virus, as a lack of knowledge about the medical progress over the years still fuels stigma. Research by the Terence Higgins Trust and the Scottish Government has laid bare attitudes to HIV in Scotland today. According to the study, only 35 per cent of people would be happy to kiss someone with HIV, 25 per cent would feel worried about receiving medical treatment from a doctor or nurse who has HIV and nearly half of the people in Scotland would feel ashamed to tell others if they were diagnosed with HIV.

Last month, I was pleased to lodge another motion in the Parliament, as well as to ask a question to the First Minister regarding the launch of the new national HIV anti-stigma campaign, led by the Terence Higgins Trust and funded by the Scottish Government. Aired on television in Scotland, the new advert provides an overdue update on the huge medical progress in the fight against HIV. It is the first TV advert on HIV since the UK Government’s infamous “Don’t die of ignorance” campaign, which featured falling tombstones, 40 years ago. I am sure that any of us who is old enough to remember that campaign does so.

Alongside providing up-to-date information about HIV, the new 60-second TV advert aims to tackle the stigma that still surrounds the virus, which usually results from misconceptions about how HIV has changed since the 1980s and 1990s. We still have a way to go in tackling stigma, but public information campaigns such as that one can make a difference and that, in turn, will save lives.

I remind members of the photo call to mark world AIDS day, which my colleague Karen Adam is sponsoring, after First Minister’s questions on Thursday. I encourage all members to join and show their support. Across the parties, we all share the same commitment to do what we can to eradicate new HIV transmissions by 2030. It is a visionary and ambitious target, and one that we can and must achieve.

Good morning and welcome to the 35th meeting in 2023 of the Health, Social Care and Sport Committee. I have received no apologies for this meeting.

The first item on our agenda is to decide whether to take items 4, 5 and 6 in private. Do members agree to do so?

Members indicated agreement.

The second item on our agenda is the first oral evidence session of the committee’s inquiry into healthcare in remote and rural areas. We will hear from representatives of the Scottish Government and NHS Education for Scotland. I welcome Stephen Lea-Ross, deputy director of health, workforce planning and development, and Siobhan Mackay, interim deputy director of primary care capability, both at the Scottish Government. Dr Pam Nicoll is associate director of medicine and leads on the national centre for remote and rural health and care at NHS Education for Scotland. We are expecting Professor Emma Watson, the executive medical director of NHS Education for Scotland, to join us. Dr Nicoll is joining us remotely. Thank you and welcome.

We will move straight to questions.

I am keen to hear how the work of the Scottish Rural Medicine Collaborative informed the plan for the new centre and what additional areas the centre will cover.

I remind those in the room that you do not need to operate your microphones; broadcasting will do that.

It would be helpful to see some more detail around that work plan because that certainly was not what I was getting from the reading that I did in preparation for the committee meeting.