Chamber and committees

I am interested in the point that Michael Paparakis made about there being relatively few cases at the moment. Clearly, the bill envisages a greater role for courts in the administration of trusts. There will be several new opportunities to involve the court in trust matters. Does that give a greater reason to expand the options for people?

On the point about some of the evidence that we have heard about court costs, there is certainly a public perception—including on the part of many people involved with trusts—that the sheriff court could be a more expensive route. If the bill goes ahead, what do you plan to do to publicise information on the likely costs of going to the sheriff court?

Briefly, convener. I had planned to ask about the codification of trust law later, but would you rather that I asked about that now?

In the same evidence session, we also heard concerns that people might try to draft around the provision or include clauses to create the flexibility to make changes outwith that period. Multiple witnesses at that session seemed to agree that that would not be desirable. Do you take that point on board?

Thank you.

Coming back to the points that your officials have made, minister, do you think that this has been a missed opportunity? Some people have been in touch with the committee to say that there could have been a wholesale codification of trust law. Given that we have not had major legislation in this area for a long time and that the bill has come to the Parliament through the SLC process, I imagine that it is unlikely that the Parliament will legislate on trusts on this scale for years. Have we missed the opportunity to do that codification exercise?

That would be helpful. It feeds into a wider issue—one which will potentially be referenced in other questions—about how people navigate the legislation, bearing in mind that a lot of the individuals who interact with it are not going to be legal professionals. Many people put themselves forward for smaller charitable trusts to try and do something good for society, and having clear advice and guidance for them on how legislation affects them would be useful.

You say that you do not expect an increase in litigation. However, the bill creates a lot of new opportunities for the courts to get involved in trusts, so it is hard to see how there would not be an increase in cases. What is your analysis based on?

I will leave it for now, convener.

I raise the plight of a vulnerable and deteriorating individual with severe learning difficulties who is in the care of Dumfries and Galloway Council but who has, for complex reasons, ended up trapped in a residential home in the south of England. For over a year, her sister has been desperately trying to get her back home closer to family and, at every turn, social work has deliberately obstructed that, and seems to be willing the lady to die or become too weak to travel in order to save itself cost and hassle. Despite notice being served by the existing home and a best interest meeting that agreed with the family that she should return to Scotland, progress has been extremely limited. If I provide her details privately, will the First Minister step in and ensure that her human dignity is respected?

Through my own, albeit limited, life experience and my work as a constituency MSP, I am well aware that, for many people, hospital is not the best place to be. Of course, no one really wants to be in hospital at all if they can avoid it, but, for some people, the disruption and change that is involved when admitted to an acute setting can teeter on the brink of outweighing the benefits of medical treatment. For those individuals, this initiative is and has the potential to be transformative.

However, if the initiative is to work, it must be promoted on that basis. It should be for the patient’s benefit, not merely to serve the system. Indeed, as Professor Andrew Elder has stressed, as mentioned by Alex Cole-Hamilton, access to acute hospital care for older people has been a hard-won right and it should not just be given away because an alternative is there. That alternative must meet the needs of every patient who is pushed towards it.

Looking now beyond the individual, I have to say that I am always fearful when I hear this SNP Government promoting the expansion of relatively new initiatives. Those concerns stem from the staffing and cash crisis in our NHS, and from my experience of a persistent lack of rural proofing when it comes to policy implementation.

The chief of NHS Dumfries and Galloway, which covers my constituency, has told this Parliament that the level of financial challenge is such that

“technically, I cannot afford one in 10 of my workforce”.—[Official Report, Health, Social Care and Sport Committee, 2 May 2023; c 13.]

Therefore, when I hear my colleague Finlay Carson asking about the future of cottage hospitals, it is hard to trust the decision that the health board is making because it is operating in financial circumstances in which it is making the best of the resource that it has got rather than doing what is best for its patients.

We already see patients unable to access core day-to-day services such as GP and dentistry services. We see challenges around recruiting and retaining specialist medical professionals. Who are the consultants who will be helping with patient care? Social care and care home beds are being rationed, with care deserts emerging in some parts of the region.

I set that out not because I do not support the concept of hospital at home but because many constituents, patients and hard-working staff will be questioning the capacity to pull that off at any significant scale in the current climate.

I am also concerned that, when it comes to stabilising our local health service, this SNP Government is not willing to confront the realities on the ground. All the strategies and policies that have been laid out today speak to that, as they simply do not match with the scale of the challenge that lies ahead. In place of a laser-like focus on, for example, getting people who are already in hospital home, we come up with new ideas and initiatives rather than trying to resolve the existing serious underlying issues.

I am equally worried about how the policy can be delivered in a constituency such as mine, where people live a considerable distance from the hospital that is overseeing their treatment. They may even be being treated outside the region altogether, never mind having to travel for pushing an hour from Dumfries and Galloway royal infirmary in Dumfries. Care at home should mean that they have access to good-quality local healthcare in their region. We must take account of the additional costs, pressures and time constraints that rurality brings in order to deliver projects such as hospital at home across vast and sparsely populated rural areas. Given the Scottish Government’s record, I am not convinced that it has got that right.

It is often easier to ban things and demonise people who are overweight than it is to encourage and empower people to make positive lifestyle choices. With only one in five adults in Scotland eating the recommended five portions of fruit and veg a day—a figure that has remained unchanged since this Parliament was created—what practical steps is the Scottish Government taking to ensure that people who live in Scotland, a food-rich nation, can benefit from affordable local produce, which promotes good health and supports our farmers?