Chamber and committees

Will the cabinet secretary share how the Scottish Government, through Creative Scotland, will support smaller festivals that take place away from the central belt and are created by the community, such as the Stranraer oyster festival, Kirkcudbright festival of light and the Big Burns Supper?

I am sorry—I dinna have time. Four-minute speeches are quite short.

Rail modernisation has been one of the success stories of devolution, not just in the Borders but across the country. The system has been built on and expanded hugely over the past decades. The investment programme, which has included £20 million for building the Reston railway station in Berwickshire, has led to a huge increase in passenger numbers. It is that kind of investment that drives people to choose the railway to travel, because it leads to improved and faster services, cleaner and smoother travel, and modernised and reliable rolling stock.

I appreciate the point that we all want to pay less for our train and bus tickets. If the Scottish Government had the required financial resources, it could repeat or extend the off-peak trial. However, it seems from the Government’s amendment that that

“would cost up to £40 million of resource funding”

and, while our resources are subject to someone else’s diktat, I believe that we need to get the biggest bang for our buck.

I look forward to the refreshed rail decarbonisation plan that will be published this year, continuing the Scottish Government’s commitment to electrification across a huge swathe of our rail network.

On ticketing, customers travelling to or from Stranraer were able to take advantage of a two-for-one ticket offer from 18 November last year, with a £17.30 return for twae folk. However, there are challenges with the station’s current location at the end of the pier, and some people have mooted a reopening of the Station Street station near the town centre or a newer platform closer to the town centre. I would appreciate hearing from the cabinet secretary whether the two-for-one ticket offer boosted passenger numbers and whether there have been any discussions to review the location of the station, although I know that that is a Network Rail issue and is reserved to the UK.

Locally, there are challenges in parts of my South Scotland region. Lockerbie station relies on TransPennine Express, which is owned by the UK Department for Transport, for the vast majority of its services. ScotRail does not serve the station and has never served it. I have pursued that issue separately. Lockerbie is an important railhead for Dumfries and Galloway—it is particularly important for the whole of Galloway—but it is clear that we are being dealt a service that seems to be hitting the buffers with depressing regularity.

The ticket price of £24.70 from Lockerbie to Edinburgh or Glasgow might be challenging for many, but a look at the train service in the past week alone shows that ticket pricing is not the only problem. Last Friday, 16 of the 34 services at Lockerbie were cancelled completely and only 11—less than a third—turned up on time. The day before, 10 of the 36 services were cancelled and eight were more than half an hour late. On Sunday, only five of the scheduled 30 services turned up at the station on time.

I am sorry, but I am not gonnae take any interventions. I am looking at the seconds that I have left.

It does not matter what the rail fare is if the trains do not turn up. I know that it is not the Scottish Government’s fault as TransPennine Express is not part of its remit. Nevertheless, I would be grateful if the cabinet secretary could advise me whether she will contact her counterpart at the UK Department for Transport and prod them on how the service could be improved so that people in D and G can rely on the transport that they need to get to the capital city, to Glasgow and wider areas.

First, I welcome the news that the feasibility study into extending the Borders railway will get going, after some foot dragging from the Tory and Labour UK Governments. I hope that, when the feasibility study reports to the by then re-elected SNP Scottish Government, it will study the recommendations carefully.

The Scottish Government’s programme of rail modernisation has, among those of all parties, been one of the success stories of devolution, not just—

To ask the Scottish Government what its response is to the announcement by Creative Scotland that it will provide multiyear funding to deliver cultural and creative programmes. (S6O-04350)

As a healthcare professional who works in acute care as well as out in the community and has taught nurses in the past, I know that there have been challenges—we have heard that in the evidence that the committee has recently taken regarding digital access and access to case notes—but would it not be better to employ a digital strategy separately, because we are talking here about primary care, secondary care and care in the community? With the evolution of artificial intelligence, would it not be better to look at that separately, rather than inserting it into the bill?

Brian Whittle: No, because all healthcare should be connected. The connection between healthcare professionals, and how we move care from part of the NHS into primary and secondary care and even, in some cases, the third sector, should be seamless.

As I have said many times, this country is way behind the rest of the United Kingdom, which is way behind much of the rest of Europe. The longer we leave the issue, the harder the solution is going to be. It is incumbent on the Parliament to send a message to the Government and set a target. I know that the cabinet secretary agrees with me on that.

We need a general platform that allows there to be autonomy across the whole sector for the deployment of different kinds of software. It is incredibly important, especially in an acute setting, that a person is able to access pharmacology or whatever has come out of primary and secondary care. If somebody has come out of hospital, it is important that everybody understands their role in delivering their care and understands what other care has been given. I find it very frustrating when I listen to the cabinet secretary, because there are many mixed messages coming out of the Government, and we are not making any progress.

I urge the committee to pass amendments 116 and 117, because, if anything is to come out of the bill, it is fundamentally important that the digital platform is put in place.

As a healthcare professional who works in acute care as well as out in the community and has taught nurses in the past, I know that there have been challenges—we have heard that in the evidence that the committee has recently taken regarding digital access and access to case notes—but would it not be better to employ a digital strategy separately, because we are talking here about primary care, secondary care and care in the community? With the evolution of artificial intelligence, would it not be better to look at that separately, rather than inserting it into the bill?

Brian Whittle: No, because all healthcare should be connected. The connection between healthcare professionals, and how we move care from part of the NHS into primary and secondary care and even, in some cases, the third sector, should be seamless.

As I have said many times, this country is way behind the rest of the United Kingdom, which is way behind much of the rest of Europe. The longer we leave the issue, the harder the solution is going to be. It is incumbent on the Parliament to send a message to the Government and set a target. I know that the cabinet secretary agrees with me on that.

We need a general platform that allows there to be autonomy across the whole sector for the deployment of different kinds of software. It is incredibly important, especially in an acute setting, that a person is able to access pharmacology or whatever has come out of primary and secondary care. If somebody has come out of hospital, it is important that everybody understands their role in delivering their care and understands what other care has been given. I find it very frustrating when I listen to the cabinet secretary, because there are many mixed messages coming out of the Government, and we are not making any progress.

I urge the committee to pass amendments 116 and 117, because, if anything is to come out of the bill, it is fundamentally important that the digital platform is put in place.

Carol Mochan mentions stigma, which is important. Would she agree that social media is an issue that can contribute to the increased prevalence of eating disorders? Stigma, social media and various other aspects are all tied in and are leading to an increase in the numbers of young children and adolescents with eating disorders.

Dennis Robertson MSP led the first debate in Parliament on eating disorders awareness week in 2012, following the loss of his daughter, Caroline, in February 2011; she had been diagnosed with anorexia nervosa. This is what Dennis said then:

“I want people to be aware of the symptoms and get help as soon as they can. I’m trying to ensure GPs and other medics become more aware of the dangers.”

As Dennis said, people need to get help as soon as they can.

I thank colleagues across the chamber for signing my motion to bring the debate to the chamber. This year, eating disorders awareness week runs from 24 February until 2 March. The eating disorders charity Beat provides so much support, and I welcome to the public gallery Alex Jones from Beat, along with members of the lived experience panel and trustees of SupportED. I thank them all for being here.

It is necessary to continue to raise awareness so that, as knowledge improves, better care can be provided. An estimated 1.25 million people in the United Kingdom, and one in 50 people in Scotland, are living with an eating disorder right now. These devastating illnesses can affect anyone of any age, size, gender or background, and they can easily go undetected. We know that the signs and symptoms are not always visible or easy to pick up, but people’s symptoms can include spending a lot of time worrying about their weight and body shape; avoiding socialising when they think that food will be involved; eating very little food, making themselves sick or taking laxatives after they eat; exercising too much; having very strict habits or routines around food; and changes in their mood, such as being withdrawn, anxious or depressed.

Each year, eating disorders week takes a different theme that focuses on the many types of eating disorders. They include anorexia and bulimia nervosa; avoidant restrictive food intake disorder—ARFID—and binge-eating disorders; and variants that are classified under other specified feeding or eating disorders, or OSFED.

Last year’s debate highlighted ARFID, and those in previous years have included a debate on diabulimia, which is a condition where a person with type 1 diabetes deliberately omits taking their life-saving insulin in order to help them to lose weight. Eating disorders have the highest mortality of all mental disorders and have serious medical consequences, as well as risks of suicide.

A lot of work has been done in recent years, and there have been advances in treatments, as well as in tackling associated stigma. Inclusive services have been created to treat all people, regardless of age and severity, with the development of all-age services and early intervention approaches. Last year, the number of children and young people who presented to child and adolescent mental health services and were then admitted to hospital with an eating disorder increased rapidly. Children and young people are presenting to paediatric settings later and are often more physically unwell. In the past seven years, there has been a significant increase in the annual incidence among 10 to 14-year-olds.

The prevalence of anorexia nervosa in the general population is approximately 1 per cent among women and 0.5 per cent among men. It is reported that half of those who meet diagnostic criteria in the community do not access treatment. Bulimia nervosa is reported to have a prevalence of about 2 per cent, and binge-eating disorders a prevalence of up to 4 per cent. The population prevalence of ARFID is not known, largely because it is a relatively new diagnosis and is still not well known.

At the Scottish Government’s request, NHS Education for Scotland has delivered education seminars as a response to the high number of children and young people presenting. That is providing support and learning to staff who work in acute paediatric settings in order to help better support children and young people and their families. I am keen to hear from the Minister for Social Care, Mental Wellbeing and Sport about the uptake of those seminars, including attendance rates by NHS board and by clinician specialty, including general practitioners. It would be good to hear how GPs are engaging with assessment and onward referral for persons who have a suspected eating disorder. It would also be good to hear feedback on the uptake of the Turas online learning platform, especially in rural health boards such as NHS Dumfries and Galloway and NHS Borders.

The national review of eating disorder services in Scotland published its report in June 2021. The “Scottish Eating Disorder Services Review—Full Report” contained 15 short-term, medium-term and long-term recommendations. Subsequently, the national eating disorders network has been established, chaired by Professor Cathy Richards, to take forward the remaining medium-term and long-term recommendations.

It is interesting that the first recommendation related to the Covid-19 pandemic. It asked for emergency funding to

“be provided ... as a direct result of an increase in the number and severity of ... presentations related to the Covid-19 pandemic.”

The recommendation prioritised physical health stability, risk reduction, supporting in-patient discharge and preventing admission to hospital.

Recommendation 4 was to establish a lived experience panel to

“advise the Implementation Group and work alongside the National Eating Disorders Network.”

That recommendation advised that

“The ... panel should include patients, families and loved ones, and third sector representatives”,

with diversity of membership, including representatives of

“all eating disorder diagnoses, men with eating disorders, LGBT representatives and people from ethnic minorities.”

Again, I welcome members of the lived experience panel to the public gallery.

I also highlight recommendation 7, on early intervention, which states:

“Key Stakeholders and Healthcare professionals should be able to identify the signs and symptoms of all eating disorders including at early stages and know how to support and sign post people into treatment.”

The Scottish intercollegiate guidelines network’s guidelines from August 2022 contain key recommendations on early intervention, support for family and carers and achieving and maintaining recovery, as well as healthcare professional training. I remind members that I am a healthcare professional, as I am still a registered nurse.

Beat has developed training for health professionals that has the potential to save lives, and it is free. The Royal College of Psychiatrists recognises how important it is to have guidance across all healthcare settings, and it has created the “Medical emergencies in eating disorders (MEED): Guidance on recognition and management”. That replaces the previous management of really sick patients with anorexia nervosa—MARSIPAN—and junior MARSIPAN guidance.

A lot of actions have been implemented. I am conscious of time, so finally, I would ask anyone who has a worry about themselves or a family member to consider calling the Beat helpline in Scotland on 0808 801 0432 and speaking in confidence to an adviser.

There is so much work being done, and I say to the minister that it needs to continue at pace. I look forward to hearing colleagues’ contributions and the minister’s response.

As the minister is aware, many of the young people in Skye house were diagnosed with eating disorders. We know that compassionate care and treatment are essential parts of optimal recovery.

This week marks eating disorders awareness week. Can the minister advise how the Scottish Government is working to support improvement of in-patient eating disorder services and wider services in Scotland, including for people who require further care and treatment?