Chamber and committees

Annie Gunner Logan talked about citizen leadership when she gave evidence. That is kind of what you are talking about in relation to identifying people with lived experience—unpaid carers and people who use care services. Is the Scottish Government doing any work to promote or enable citizen leadership?

Good morning, minister and officials. I have a couple of questions about leadership.

The Audit Scotland briefing states:

“The health and social care sector needs stable and collaborative leadership to address the ongoing challenges.”

We previously took evidence about how we support leaders. I know that the Scottish Government can lead on leadership. What is it doing to address the challenges in retaining senior leaders in social care?

I welcome the opportunity to speak in the debate and congratulate Beatrice Wishart on securing it.

Increasing development in the marine environment is leading to the discovery of a greater number of undetonated munitions. Clearance of unexploded ordnance is commonly undertaken by high-order detonation, as Beatrice Wishart described, which uses a controlled explosion that leads to loud blasts and disturbs protected marine mammals. I agree with Beatrice Wishart that such blasts cause a huge welfare concern to marine life and to our natural marine environment.

Since 2019, I have been raising my concerns over the levels of unexploded ordnance items that are washing ashore across beaches and coastal areas in Dumfries and Galloway. Although exact figures are not available, the Maritime and Coastguard Agency and the Royal Navy bomb disposal unit have reported that the number of unexploded ordnance items washing ashore is increasing. While the exact reasons for that remain unclear, expert opinion suggests that it may be due to a combination of sea levels rising, increasing offshore projects such as the construction of offshore wind turbines and increased marine traffic.

Beaufort’s Dyke is a national deepwater trench located in the north channel of the Irish Sea between Ireland and Portpatrick in the south-west of Scotland. It is widely understood that, at the end of the second world war, instead of surplus unexploded munitions being dumped directly in Beaufort’s Dyke, which was approved as a dump site, the weapons were often dumped outside or around the site to save money and time. It is therefore little wonder that we are now discovering more unexploded ordnance washing ashore.

According to the Ministry of Defence, over 50,000 tonnes of explosives are disposed of in Beaufort’s Dyke. In July 1945 alone, 14,500 tonnes of 5-inch, 130mm artillery rockets filled with phosgene gas were dumped. In addition, according to documents from the Public Record Office, approximately 2 tonnes of concrete-encased metal drums, filled with radioactive laboratory waste and luminous paint, were dumped in the dyke during the 1950s.

I have previously contacted the UK Government—the Secretary of State for Scotland and the Secretary of State for Defence—to ask whether a risk assessment of the stability of Beaufort’s Dyke and the area around the site has been carried out, so that constituents across the region can be assured of its safety. I have sought assurance that there are no future plans to use the dyke as a dump site in the future.

Unsurprisingly, other than one response from the MOD indicating that it believes Beaufort’s Dyke to be safe and to pose no threat, I have had no response from the Scottish or defence secretaries and, therefore, I repeat my calls for Beaufort’s Dyke to receive a full safety inspection. That would not only reassure constituents but protect our marine environment. The RSPB’s director, Anne McCall, has shared concerns over the impact of undersea explosions on sea life.

Alternatives to high-order detonation are now available on the commercial market. Some alternatives have been developed or are being developed in a military context and are not used commercially, whereas others have been developed purely for industry use. Those alternatives require the use of explosive material to effect clearance, but in much smaller volumes than the donor charges required for high-order detonation. Alternative methods cause lower noise levels, which reduces the impacts on the marine environment. I agree with Beatrice Wishart that their use is welcome and I ask the minister to do all that she can to press the UK Government to make use of those alternatives as standard practice.

I repeat my calls on the UK Government to carry out a full safety inspection of Beaufort’s Dyke and I ask the minister to press the UK Government to use proven alternatives to high-order detonation.

Thanks to Jackie Baillie for securing the debate and for her contribution this evening. I remind the chamber that I am a registered nurse and I was able to practise as a Covid vaccinator over the past two years. I thank the RCN for its two very helpful briefings ahead of the debate, one for the Scottish National Party and one for the Opposition.

The theme today for international nurses day 2022 from the International Council of Nurses is “Nurses: A Voice to Lead—Invest in nursing and respect rights to secure global health”. My contribution will focus on my amendment, and I thank colleagues who have supported it. My amendment intends to celebrate the immense contribution of nurses, to value nursing as a highly skilled, highly varied profession and to note the progress that has been made to support the nursing workforce in Scotland, especially in the past two years, during the global Covid-19 pandemic. The pandemic has definitely had an impact on the mental health of all in our healthcare workforce, including nurses, and I welcome the Scottish Government’s action to address that.

Nurses work in a variety of areas, including adults, children, learning disability, mental health, maternity, perioperative—that was my job when I worked as a nurse—resuscitation, diabetes and cardiac as well as expert cancer care, as the Macmillan briefing that we received noted. Nurses make up the largest single profession in our NHS and are at the heart of the health service. The diversity of jobs in nursing is demonstrated through their work in our hospitals, general practitioner practices, homes and care homes, as well in schools and communities across the country.

Nurses in Scotland have some of the most advanced clinical skills of nurses anywhere in the world and we are leading the way. I cannae go through the whole of the ICN report, but, according to the ICN, there are huge benefits in investing in nurse education. The ICN states that that is needed to meet the

“changing health needs and rising expectations of individuals and communities”.

For example, in Scotland nurse-led education for patients on the management of conditions such as diabetes, medications and the prevention of ill health plays a hugely important role in promoting the positive health and well-being of the nation.

However, nursing skills in Scotland are not replicated across the globe. We should, therefore, be celebrating the competence of our nursing workforce in Scotland and use that competence as evidence to improve healthcare systems internationally. As co-convener of the lung health cross-party group, I joined the recently created International Coalition of Respiratory Nurses, which was initiated by Andreja Šajnic, who is a specialist respiratory nurse from Croatia. The ICRN has political support from Željana Zovko MEP, who is the co-convener of the lung health cross-party group in the European Parliament. We are proposing to work together to look at lung health across Europe and across the globe. ICRN is a global coalition aiming to promote best practice for respiratory education for nurses.

As we celebrate IND, I recognise the workforce challenges. I welcome the steps the Scottish Government is taking to address workforce recruitment and retention challenges. Scotland has a £10,000 per year bursary for nursing students. We are ensuring that nurses receive the best and fairest pay deal, with nurses in Scotland being on average the highest paid in the UK. The Scottish Government’s nursing vision to 2030 is welcome and shares many of the points from the World Health Organization’s global strategic directions for nursing and midwifery. The WHO strategy aims to ensure that nursing is better understood by the public, to increase nursing’s appeal as a career option, to retain a focus on supporting people experiencing periods of acute ill health, to promote prevention and to tackle inequalities. I ask the cabinet secretary for a commitment that those will be built on.

This is a day to celebrate. It is a day to be cheerleaders for our nurses. It is a day to thank nurses across the globe for all that they do on this day, international nurses day.

The issues that Carol Mochan is highlighting are really important, and it is important that we debate them. However, it is kind of difficult to do that when we are allotted four minutes in which to speak. Is it worth reflecting on that?

I thank Jamie Greene for that intervention. I agree that we need to make it easier for LGBT people to identify others and to engage in whatever activity they want to do. We can support them. One of the things we talk about in the Health, Social Care and Sport Committee all the time is reducing and tackling stigma. It is a huge issue that we need to address.

We know that services can be harder to access in rural areas like Galloway and the Scottish Borders. It was interesting that Emma Roddick also mentioned rural issues. Here is what I ask of the minister: can the Government commit that rural Scotland will continue to be included when it is improving alcohol services for LGBTQ+ people?

Alcohol use has become deeply engrained in LGBTQ+ society as a result of history and we have spoken about alcohol providing an easy way to meet. When I lived in California, that was the way people met each other and it was acceptable: individuals felt safe in gay bars. Stonewall has stated that that is why excessive drinking has become normalised. It is important that we work to change that.

The SHAAP report shows that some alcohol service providers are, due to lack of training, uncomfortable discussing LGBTQ+ issues, particularly trans issues. As a former nurse educator, my final ask of the minister is this: what training is being provided to alcohol service providers on LGBTQ+ issues so that they can support people to achieve the best possible treatment outcomes?

First, I congratulate Emma Roddick on securing her first member’s debate. I must apologise because I will be leaving early, as I am sponsoring an event tonight in the Parliament.

The debate is important and timely. I am a member of the Health, Social Care and Sport Committee, which took evidence last week from the minister about our relationship with alcohol, in Scotland. I specifically raised the issue of LGBTQ+ persons’ experience of alcohol services at the evidence session, following the submission to the committee from Scottish Health Action on Alcohol Problems. I thank SHAAP and LGBT Scotland for their hugely helpful briefings, ahead of the debate. Different social groups are affected by alcohol problems in different ways, and people develop negative relationships with alcohol for a number of reasons. Emma Roddick highlighted that extremely well, for which I thank her.

It is important that we do not generalise about people who use alcohol to the detriment of their health. We need to recognise that harmful use is a complex issue that requires various responses. There is no one-size-fits-all solution.

The harm that is caused by alcohol is a very serious problem in the LGBTQ+ community. A study that was carried out by Alcohol Focus Scotland suggests that up to 25 per cent of the LGBTQ+ community has moderate alcohol dependency, compared with 5 per cent to 10 per cent of the general population. Additionally, 25 per cent of bi women reported heavy drinking.

Despite the many challenges, awareness of LGBTQ+ harm from alcohol is growing, and many treatment facilities now tailor programmes—or, at least, aspects of programmes—to meet the unique needs of LGBTQ+ individuals. That is welcome, but as SHAAP has pointed out, work must continue in order that we ensure that our alcohol services meet the needs of the LGBTQ+ community. It is particularly important that the work be carried out quickly, because SHAAP’s study reported

“service providers assuming that all patients were heterosexual”

and that services and peer-support groups tend not to provide “safe and welcoming” spaces.

In order to tailor services to the needs of individuals, it is important to look at why LGBTQ+ people have higher levels of alcohol dependency. One of the most important reasons is the bigotry that the LGBTQ+ community faces daily, with stigma, shaming and abuse. I echo what Emma Roddick said about people feeling abnormal, vulnerable and alone, especially during the pandemic.

I am interested in how we will support people who have post-Covid syndrome. Many different symptoms seem to be demonstrated, including neurovascular, cardiovascular, gastrointestinal and musculoskeletal ones. There is a wide range of symptoms. What are we doing in Scotland to support people with long Covid?

I will be quick, convener. The Scottish graduate entry medicine—or ScotGEM—programme, which was launched in 2018, is unique to Scotland. We have just seen 54 graduates come out of it, and it is part of the way in which we are trying to address GP recruitment in rural areas. Can you comment quickly on how successful ScotGEM has been for Scotland?

When it comes to screening such as bowel cancer and cervical cancer screening, if we screen people early, we can diagnose early, which means that the treatment can be more efficient and beneficial. Cancer Research UK said in its briefing that statistics for Scotland have shown that, before Covid, the uptake of bowel cancer screening had increased.

I support continued consideration of how we can improve uptake of bowel cancer and cervical cancer screening, and I know that self-sampling for cervical cancer is in the pipeline.