Chamber and committees

No health board has successfully implemented or used it. You mentioned integration joint boards. In Dumfries and Galloway, we have health and social care partnerships, one health board and one local authority. Having only one health board and one local authority might make it easier for PBMA to work there.

I welcome the minister’s continued commitment to delivering initiatives that save lives, such as the Thistle centre in Glasgow, the delivery of naloxone kits and the new drug-checking facilities. I note that the minister will meet the UK Government and representatives of other devolved nations to discuss drug-checking facilities. Will she provide an update on how that is progressing and what further action we need to see from the UK Government to instil some pace?

I have loads of questions, some of which are based on what the Health, Social Care and Sport Committee discussed yesterday.

I will direct my first question to Dr Gillian Purdon. The population health framework talks about health-harming products, and we know that the framework is supposed to align with the good food nation plan. Health-harming products include tobacco, vapes, alcohol and gambling, but health-harming foods are not mentioned. Many people will know that I have been following the work of Henry Dimbleby, Chris van Tulleken, Tim Spector and now Dr Stuart Gillespie on ultra-processed foods and ultra-high-processed foods. I am curious to know why ultra-high-processed foods are not included in the population health framework.

I have a wee supplementary question on data, and I also have a question for Gillian Purdon.

Yesterday, the Health, Social Care and Sport Committee took evidence on the good food nation plan from the Cabinet Secretary for Rural Affairs, Land Reform and Islands. We are having a discussion about it in this committee today, and the good food nation plan is about local government as well.

I was interested in what the cabinet secretary said about data evolving. We might not know what data we need to collect, and it is complex, so we need to reach out to the people who are part of analysing what information we will need.

Lisa Hislop-Smith, what needs to happen on the ground to engage with food producers—who are our farmers, and even the small market gardeners—to acknowledge their contribution to the good food nation plan? Does there need to be more direct on-the-ground engagement? That goes back to what Adam Forrest said about the people on the ground being the food producers.

David Thomson just mentioned that there has been a calorie reduction due to the reformulation of products, which is welcome. That makes me think about how the good food nation plan can be implemented if there are challenges with advertising. Some policies are reserved to Westminster and cannot be delivered in Scotland, and I am not sure whether that has been considered. There are things that we can control in Scotland, such as advertisements on bus stops, but we cannae control advertising on television, for example. Does the United Kingdom Internal Market Act 2020 impede or enable the delivery of the good food nation plan?

I thank Kenneth Gibson for lodging the motion, which gives us all an opportunity to highlight the profound impact of chronic kidney disease on individuals, families and our national health service. I, too, welcome the visitors in the gallery, as I do the briefings that we have received.

In many ways, chronic kidney disease is a silent epidemic. As has been mentioned, it affects more people in Scotland than cancer—its prevalence is about 3 to 4 per cent. It can have a huge impact on people’s ability to deal with their daily living, and on families. It can hugely affect people’s ability to go about their day-to-day lives, including work. Kenny Gibson has highlighted that well, and I will not rehearse it further.

The outlook and prognosis for those living with chronic kidney disease have improved immeasurably over the years. Many conditions are now treatable and manageable in the long term, and the advances in transplant technology and its availability over the years are incredible.

I am a registered nurse, and I worked in California, albeit a long time ago. I had the privilege to be part of the liver transplant team and, on many occasions, took part in kidney and pancreas transplants. I put on record my thanks to everyone in the transplant and dialysis teams and all the support services for all that they do to improve the lives of their patients. The teams offer hope to many who might previously have had no options.

In NHS Dumfries and Galloway, in my region, over recent years, there has been an expansion in dialysis services. As well as the site at Mountainhall treatment centre—the previous Dumfries and Galloway Royal infirmary site—there are dialysis sites in Stranraer and Kirkcudbright. That saves those who need dialysis as part of their chronic kidney disease treatment from travelling long distances to Dumfries three times a week. I imagine that that would have been quite cumbersome for people before the Stranraer and Kirkcudbright sites opened.

Home-first dialysis also offers the potential for a better quality of life for those who receive treatment—in particular, those living in rural areas, who face the biggest practical barriers, as I have just described, to accessing that life-saving support. It will not be suitable for everyone, but we should strive to make it the default position for those for whom it is suitable, as it will support patients and reduce the pressure on secondary care facilities in our NHS. That embedding of treatment for kidney diseases in our communities is hugely welcome and is evidence of how our health service is developing in the right direction as resources allow and as the medical technology that is available for treatment improves all the time.

Embedding also has to include primary care at the GP or community health level. We need to ensure that those professionals who are usually the first to see patients presenting with symptoms have the necessary tools and training to make that diagnosis and get the earliest possible intervention put in place, whether that be a referral to secondary care or simply the identification and management of issues at the local level.

Early intervention is key. As with many other conditions, the longer that problems are left untreated, the greater is the potential for long-term complications and more serious medical intervention. Given the way in which CKD interacts with other health conditions—for example, the risk of its association with high cholesterol and high blood pressure—identifying it at an early stage offers the potential for interventions targeted at those conditions, thereby boosting the health outcomes not just in renal health but across the board.

I do not have time today to delve into the detail of the implications of CKD at stage 1 through to stage 4. That would take a whole lecture. However, I welcome the Government’s on-going work on the long-term conditions strategy. The consultation on that has closed recently. I am sure that the Government is working to determine the process for moving forward, so I look forward to hearing the minister’s response.

Again, I thank all our dedicated professionals across our NHS, and campaign groups such as Kidney Research UK, for their support towards improving the prognosis for everybody who is affected.

I said that I would come back to ultra-processed foods. We are here today to look at the good food nation plan and you have also mentioned the national population health framework. The population health framework says that health-harming products are tobacco, vapes, alcohol and gambling, but it does not mention ultra-processed foods, and the good food nation plan does not mention them either.

Lindsay Jaacks said that investigations are still happening around ultra-processed foods and the health-harming additives that they contain. I am thinking about stabilisers, emulsifiers, flavourings and colourings—chemicals, really. Does the plan need to take ultra-processed foods into account more, or do we need to wait another five years for the Scientific Advisory Committee on Nutrition to do more robust research on that?

The supermarkets and the massive global food companies determine how the system works, which makes things complicated. Does the national plan help to encourage good collaboration with supermarkets, for instance, in order to support healthy consumption?

Tomorrow, the Rural Affairs and Islands Committee will hold a round-table session on the good food nation plan, and the Local Government, Housing and Planning Committee is holding one today. I am keen to hear about how we reassure Scotland’s farmers. Without farmers, we will have no food. How do we reassure the small farmers and big producers that you have mentioned that they will be considered when we look at the current plan and future iterations of it?

Does the food commission need to help by providing a template for each local authority and health board to follow, which would provide guidance?