Chamber and committees

I know that we are conscious of time, so I can stop there.

I know that I am not a regular attendee of the committee—I am here as a substitute—but I would like to comment. In the notification, it says that the SI is to

“adjust the level of European seabass that may be caught within British fishing limits”.

I am aware that only one licence has been issued for catching sea bass in Scotland, so, when the notification talks about adjusting, does that mean both up and down?

I want to pick up on Jim Fairlie’s questions and ask about emissions in other countries. In debates in the chamber, we have talked about how much water it takes to produce a litre of almond milk. It takes about 101 gallons of water to make a cup of almond milk, which is not even made in this country. In comparison, we grow grass really well in this country, and that can support our diet.

At the Health, Social Care and Sport Committee, Alice Stanton, an expert witness, talked about the misinformation that consuming red meat causes cancer, as there is now evidence that that information is not quite accurate.

How can we support food production and emissions reduction? How do we compare with other countries on those issues?

I will be really quick because a lot of information has been covered already.

I am thinking about data management and collection. Jackie McCreery said that two thirds of dairy farms have done a carbon audit. However, I am thinking about measuring other emissions reduction. There are biostimulants, such as those produced by Tricet, such as Pro-Fortis and Pro-Soil. There are also other products for emissions reduction, such as yeast-based products for ruminants like Biocell. Then there are other products such as Slurrycell, which helps to reduce nitrogen emissions in slurry.

Do we measure that kind of stuff? Do we know what farmers are using Slurrycell or Biocell? Do we know who is using biostimulants, which are not organic but are regenerative and will help to reduce nitrogen?

I will direct that question to Andrew Moir first and then Jackie McCreery.

I welcome the debate and, indeed, the Scottish Government’s upcoming dementia strategy.

My first job after I left school was in a care home, and my first placement as a student nurse was in the care of the elderly module. My experience helps me understand that there has been lots of knowledge development and changes to care delivery over recent decades for people living with dementia.

The commitment from the minister that the Scottish Government will work with people with lived experience of dementia to deliver the strategy, which keeps Scotland at the forefront of dementia policy, is also welcome.

Improving care and support for people living with dementia and those who care for them has been a major ambition of the SNP Government since 2007. Since then, dementia services have been transformed, with excellent contributions from staff working across health and social care and the wider public, third and independent sectors.

Just a fortnight ago in Stranraer, I spoke with a dementia nurse specialist who shared the view that, although progress has been made, we can go much further. I was also interested to hear from her that young-onset dementia is increasing in Scotland, and I ask the minister to say in closing whether the Scottish Government is addressing that.

The Scottish Government’s previous dementia strategy recognised the importance of taking a person-centred and flexible approach to providing support at all stages of the dementia journey, from work on diagnosis through all stages of the illness and in all care settings. Those principles are important.

The Scottish Government wants everyone with dementia to live with good quality of life for longer, at home or in a homely setting or in another place of their choosing, where they are connected to friends, family and community. I therefore ask that the next national dementia strategy should look at self-directed support and, in particular, at what stage a person has to be in their dementia journey to receive self-directed support. At the moment, various social work departments apply SDS in different ways, and I have had several local cases in which SDS decisions were reversed. SDS can be a crucial tool. Therefore, I ask the minister for a commitment that SDS will be looked at as part of the strategy and that its use nationally can be evened out and maybe become a wee bit fairer.

The Scottish Government wants more people living with dementia to be able to live well at home for as long as possible. Last year, a major forum on housing and dementia published a series of recommendations on living well with the condition. Housing has a huge role to play in supporting people who are living with dementia to feel safe and able to play an active role in their local communities as their needs change.

Loreburn Housing Association in Dumfries and Galloway has built dementia-friendly housing alongside an innovative employment hub on the site of the former Garrick hospital in Stranraer. Young people living at the youth foyer are expected to be in education, an apprenticeship, employment or training, and they have access to volunteering opportunities in the community. The youth foyer also offers community access areas, a state-of-the-art conference facility, breakout spaces and access to wifi. The aims of the site are fantastic and, as the Scottish Government takes forward the new strategy, I encourage it to look at that model. I invite the minister to visit Stranraer—I would be happy to join him.

I know that this afternoon’s debate is short. My focus has been on self-directed support, but I know that we could have had a longer debate about dementia care. I will close there.

I am interested in what we have learned from other countries. My understanding is that 45 other countries have taken forward a DRS.

I have been doing some work around derelict buildings, and I am listening to the debate because the matter is important to me. Does Carol Mochan agree that

“local authorities have several discretionary statutory powers available to tackle derelict ... buildings”,

which the report outlines? Amenity notices, defective building notices and dangerous buildings notices—those are powers that local authorities have.

I asked the previous witnesses about the commissioner not focusing only on safety, because care and compassion are at the heart of how we support a patient’s journey—whatever care they are in receipt of—and determine whether harm has occurred. Do you have any comments on whether we should focus only on safety aspects or whether we should consider the whole patient journey in relation to care and compassion?

I know the work that Dr Gordon Baird and the Galloway community hospital action group have done to get the petition to the Parliament, and I know that local people feel powerless. I know that Professor Sir Lewis Ritchie is interested in how Australia’s National Rural Health Commissioner works—Australia is also a big rural country. I also know that a centre of excellence for remote and rural medicine is being created, but it does not have an advocacy role. That is what Professor Sir Lewis Ritchie said when he gave evidence.

The proposed agency is not about picking up individual casework. That is not what Dr Gordon Baird was after when he asked for an agency to be created. It is about advocating for and giving a voice to people who feel powerless and who do not know that, for example, they should be offered a choice of care that might be closer to home. That is one of the challenges.

NHS Dumfries and Galloway committed to addressing cancer care pathways and then Covid came along. Therefore, when the board comes in front of us, we will need to ask specific questions about where it is with altering cancer care pathways and what steps it has taken. This is not about addressing all the challenges overnight. I know that there are real challenges—everybody does; I was a healthcare clinician as well.

I am keen to ensure that, whatever pathway we take, Dr Gordon Baird is permitted or invited to give evidence about the challenges for remote and rural healthcare and advocacy for patients.

I am well aware of this petition; I was at the Citizen Participation and Public Petitions Committee meeting at which it was presented by the petitioners, and I know that other members in the room were there, too. I know the history behind it, and I am keen that we do not lose sight of rural health and social care needs and that we hear people’s voices.

The example that I have before me is the experience of people in Stranraer. A key issue that the petitioner has been trying to raise for 20 years now relates to the fact that NHS Dumfries and Galloway is part of the south-east cancer network and that, as a result, patients in the south-west of Scotland—which isnae in the east of Scotland—end up having cancer treatment in Edinburgh instead of at the closest cancer centre for radiotherapy, which would be in Glasgow. It means that, instead of just going up the road to Glasgow, people who are undergoing radiotherapy or other cancer treatment have to travel a distance that is pretty hefty for them.

My understanding is that, for 20 years now, Dr Gordon Baird, who is a retired GP and former chief medical officer at the Galloway community hospital, has been trying to look at ways in which we can hear the voices of people who live in remote and rural parts of Scotland, particularly Dumfries and Galloway—although, as we can see from the other petitions, the issue goes wider than that to, for example, Caithness. The question is how we support what is best for patients; it is not about telling them, “You’ll get your treatment where we tell you,” but about giving them the best opportunity to get the best care where they choose and reducing the issue of travel.

Currently, the people in question are means tested for their travel, whereas those in other parts of Scotland are not and get their care without having to cough up from their own finances. That is a health inequality issue, too—means testing people for their care should not be happening.

There are other issues regarding maternity services. I know that a review of the midwifery-led service in Galloway is happening right now because no baby has been delivered in Stranraer for four years. That is similar to the issue at Dr Gray’s hospital, which has been raised in the chamber of Parliament on a number of occasions.

My concern is that, for 20 years, little progress has been made to hear the voices of the people who live in remote and rural areas, whether that is in the area that NHS Dumfries and Galloway covers or more widely. If we in the committee do not keep the petition open and hear from witnesses, I am concerned that we might lose sight of what the real issues are for people in remote and rural areas.