Chamber and committees

I do not think that we can excuse ourselves. I cannot be faced with this need and not take action. I am absolutely clear that the powers to tackle this fully lie at Westminster, but that does not mean that the Scottish Government cannot do anything. We have to do everything that we can. We are faced with immense need on a daily basis and we have to do what we can to rise and meet that need. There is no way of avoiding that, but there are bigger challenges at the door of the UK Government. Of course, my solution would be for us not to be subject to the whims of the UK Government, but that is a choice for the people of Scotland.

A lot of work goes on in order to improve the pay in the Scottish NHS. As you know, people who work under agenda for change in Scotland are paid more than their counterparts are in the rest of the UK. I imagine that the gender pay gap in the NHS arises from the fact that a great deal of women work in the NHS—more than 50 per cent of employees in the NHS are women. However, as we see reflected in many other aspects of society, the people who are in the highest-paid managerial jobs tend to be men.

You are absolutely right to draw attention to that huge gender pay gap. My own profession of pharmacy has one of the biggest gender pay gaps that there is. That gap does not start at the point where women have children, but at the point where we graduate from university. From the point of leaving university, female pharmacists tend to earn less than male pharmacists, and we need to put in place policies to tackle that.

I am confident that the women’s health champion will be in place by the end of the summer. In “Women’s Health Plan: A plan for 2021-2024”, which was the first such plan to be set out in the UK—I was really privileged and proud to launch it last year—are a number of short, medium and long-term outcomes that we hope to achieve. There will be an update to Parliament in the autumn, but we are very much on track to achieve and surpass all our short-term outcomes. We have made huge progress in improving the information that is available to women on a variety of conditions including endometriosis, menopause—

But I have not finished yet, Tess—

That is actually a standard way of delivering all sorts of education—there is an intake on certain dates of the year. It is how education works in Scotland: if your child turns four, you will be able to send them to school only if their birthday falls before a certain date. If they are not four before that date, they will have to wait a whole year before they go into primary 1.

It is a function of delivering the policies, and it makes things manageable for local authorities, because they know how many children will be coming into the system over the year. Of course, some local authorities have used discretion and will fund a child’s ELC place from their third birthday, while others have chosen not to do so. I am sure that my Conservative colleague will be supportive of ensuring that such local decisions are made according to local priorities and that those powers are not taken away from local authorities.

I also emphasise that children in Scotland who are particularly vulnerable—the eligible two-year-olds who make up about 25 per cent of children in Scotland—are funded from the age of two.

It is simply a function of the delivery of education in Scotland. Local authorities can exercise flexibility; many, but not all of them, do.

So you are clearly not interested in the steps that we are taking to implement the women’s health plan.

We are working with officials to ensure that the specification for that recruitment is absolutely where we want it to be. As you will know, the national women’s health champion will have to liaise with the individual board champions who will also be put in place, and will, I think, make a significant difference with regard to the women’s health plan. We have set that out as a medium-term ambition. As I have said, we are working on the job specification and we are looking at how it will be funded and what the level of funding will be. We are considering what sort of people we think might apply and are tightening up what will be required before we advertise the position. As the First Minister set out in Parliament last week, we expect the person to be recruited by the end of the summer.

I would be delighted to share that.

Absolutely—self-sampling will help. There are a number of reasons why people do not engage in the cervical screening programme. Sometimes there are disability issues, which make it very difficult for women to access somewhere that they can actually get a smear. There are sometimes cultural issues that make it less likely that women will come forward for a smear, and more likely that they would do it at home. A big factor, which we do not often talk about, concerns women who have experienced sexual violence and how hard it is for them to undergo such an invasive test. Of course, we know that many women in society have experienced sexual violence.

There are a number of reasons why women do not come forward for cervical smears. I absolutely believe that self-testing at home will improve the situation, but it is not the entire solution. For example, our bowel screening programme is all done at home, and it is easy to do and not invasive, but we do not have 100 per cent uptake for it. We have more work to do to make it easy for people and to help them to understand why it is so important.

We now have an opportunity to eradicate cervical cancer because of the advances in smear sampling and in vaccination. The World Health Organization is very keen on developing a programme of work on that, and I am very keen that Scotland should participate in that. I would love to see cervical cancer eradicated.

Tragically, however, one of the associations that we see is that the very people who are less likely to participate in the vaccine programme are those who are less likely to come forward for a smear. That makes it very difficult. I am seeing that in my work on blood-borne viruses too. We have to work extra hard to understand why some people do not participate, and we have to go to extra lengths to reach them. Eradicating blood-borne viruses and hepatitis C, and the transmission of HIV, is within our grasp, thanks to advances in technology. We just have to work hard to find those people and ensure that we get them into treatment.