Chamber and committees

Thanks very much for indulging me, convener. My question is for Dr Matt Lowther. He mentioned the place standard and described the 14 questions in the framework that aim to let communities, public agencies and voluntary groups find aspects of the place to target health, wellbeing and quality of life. How do we know that people are aware of the place standard tool and are using it? Yesterday, I called Dumfries and Galloway Council planning department. It was not aware of the tool but was certainly going to look into it. How do we ensure that such tools, which can support better planning for public health, are available and used?

That is good to hear. It was only one person I spoke to, so it might be worth my following it up more widely as well.

I have not. Maybe Dr Josie Booth could answer it.

Yes, I have a quick follow-up question about collaboration and the third sector. There are so many different roles being played. It is important that Mike Corbett mentioned minority groups. We do not want to leave anyone behind.

We can get everyone around the table, but how can we ensure that everyone understands what everyone’s role is? Can more be done to improve that?

Good morning. You have talked a bit about what the national planning framework contains with regard to aspirations for supporting health and wellbeing. Does the framework give enough priority to health and wellbeing in relation to planning decisions? I am not sure who would like to answer that.

It has been quite interesting to hear everyone’s thoughts so far. I want to ask a couple of questions about collaboration and multi-agency working, which some of the witnesses have mentioned. Kevin Kane mentioned Scouts Scotland and Jacqueline Lynn described the role of sportscotland in that regard.

I know that the aim is to have multi-agency working. Will the witnesses provide examples of where there has been good collaboration with schools to support health and wellbeing, and set out what some of the barriers to greater collaboration might be? As Kevin Kane mentioned youth workers, Scouts Scotland and rural issues, I will go to him first, if that is okay, convener.

I have a brief supplementary question for Irene Beautyman or Matt Lowther. Is it sufficiently clear which developments generate significant health effects? I am thinking about how someone’s mental health and wellbeing can be impacted by living next to derelict buildings or vacant or abandoned land. There is research that says that abandoned buildings and shops can make us feel unsafe and that run-down environments contribute to anxiety and low mood.

If we are trying to support planning to help mental health, should we be trying to expedite planning to deal with the derelict and vacant buildings that affect mental health? There are many such buildings across the region that I represent, from Stranraer to Dunbar, such as the George hotel in Stranraer’s town centre. Do we need to ensure that developments generate significant health and wellbeing effects, and also deal with the issue of derelict buildings?

On a point of order, Presiding Officer.

This point of order relates to section 7 of the “Code of Conduct for Members of the Scottish Parliament”, as it refers to members’ conduct in committees.

I seek your advice on a situation that has occurred, in that Sandesh Gulhane MSP has misrepresented, in the press, the intent of the Health, Social Care and Sport Committee’s proposed inquiry into alternative pathways into primary care and has made comment in the media that has promulgated misinformation, undermined the committee’s work and disrespected the convener and other colleagues.

Yesterday, Dr Gulhane gave a comment to a newspaper that appears to uphold a false intention of an inquiry, which has been agreed to by all colleagues across the parties, into the availability, capacity and public uptake of alternative health pathways in community settings.

An agreed press release, which quoted the convener, went out from the committee, but a newspaper has decided wilfully to misinterpret the intent and has reported that the Government wants to curtail access to general practitioners and, specifically, that our convener wishes for that result. As you and most members of this Parliament understand, committee inquiries and scrutiny are not Government work or Government policy design, and the comments of any convener are not representative of any party or Government position.

I am certain that all committee conveners pride themselves on upholding that important standard. By failing to challenge that false assertion about the committee’s work and, in fact, upholding the false assertion that our inquiry is a Scottish National Party policy move, it is my belief that Dr Gulhane has undermined the committee’s work, falsely pre-empted any committee recommendations and deviated from an agreed committee purpose with regard to the inquiry.

As a result of Dr Gulhane’s actions, several of his colleagues have repeated the false assertions online, which I believe has been the cause of targeted abuse and phone calls to constituency offices, including mine and, I believe, that of the convener.

I would be grateful for your guidance on how that deviation from the members’ code of conduct can be addressed.

As co-convener of the cross-party group in the Scottish Parliament on lung health and a registered nurse still, I welcome the opportunity to speak in this important debate, and I thank my colleague Jackie Dunbar for securing it. She has covered asthma and associated treatment extremely well, and I have learned a lot myself.

It is important that we raise awareness of activities in our constituencies and regions by people and charities that focus on health issues. That work, which can ultimately save lives, is really important.

I thank Jackie Dunbar for highlighting very well the important work of the Asthma and Allergy Foundation and the my breath is my life project. That project has achieved outstanding success since its inception, and it has delivered workshops to more than 14,000 pupils and trained more than 700 teachers and support assistants on asthma. The project has demonstrated excellently that, when education is provided to persons with asthma, their parents or carers, teachers, classroom assistants and the wider public, better knowledge and understanding are achieved. The workshops that the project carried out included ones on what asthma is, how to identify symptoms and triggers, education and learning, how to manage the condition and how to manage breathing emergencies.

I watched the my breath is my life project video on the asthmaandallergy.org.uk website. In that video, the clinical specialist Professor Stephen Turner said that education is extremely important, that it needs to be person centred, and that simple messaging needs to be provided, such as that the blue inhaler that a person has been given is to be taken only when they have asthma symptoms, and the brown inhaler is to be taken all the time. The blue inhaler contains the rescue medication, which should be taken when asthma symptoms, such as wheezing or shortness of breath, occur. It provides an immediate effect or immediate relief. The brown inhaler contains prevention medication, which should be taken every day as prescribed. That can mean more than once a day.

I agree that simple messaging is key. Many people do not realise that people can die from an asthma attack. I cannot imagine the grief that is suffered by those who have lost a loved one to asthma.

The British Lung Foundation has created a number of lung health champions in the Scottish Parliament. Members from across the chamber have taken on the role to help to raise awareness of the many lung health conditions.

I am the asthma champion, and I have learned a lot from many people, including Asthma UK, the BLF and Dr Tom Fardon, who is a respiratory and asthma consultant at NHS Tayside. Dr Fardon played a lead role in developing the Scottish Government’s “Respiratory Care Action Plan 2021-2026”. I have had good advice and support from Damian Crombie, who, until recently, was AstraZeneca’s public affairs manager for the Parliament. He sponsored an asthma round-table session that I chaired prior to the pandemic, which had a particular focus on the importance of inhaler education, the different types of inhalers that can be used and how we can best support people to engage with their specialists to review the care that they need.

I also acknowledge the help that I have received from respiratory nurse consultant Dr Phyllis Murphie. Many members will have heard me talk about her in the past, as she is my big sister.

Since the inception of the cross-party group on lung health, along with the great work that has been carried out by many of the people and organisations that I have mentioned, great progress has been made to improve treatment and outcomes for people with asthma. The Scottish Government is implementing its respiratory care action plan, which provides an overarching strategy for health and social care services on dealing with respiratory conditions. The plan identifies key priorities and commitments to improve outcomes for people in Scotland with respiratory conditions such as asthma. By enabling all health and social care staff to have a firm understanding of respiratory health, it will improve clinical and wellbeing outcomes for people with such conditions.

I welcome the work of the my breath is my life project and the work that the Scottish Government has undertaken to improve asthma education, and I again thank Jackie Dunbar for bringing the debate to the chamber.

As a member of the Parliament’s Health, Social Care and Sport Committee, I welcome the opportunity to speak in the stage 3 proceedings of this vitally important bill.

I put on record my support for, and recognition of, all women who have had their lives changed as a result of mesh implants. I thank all the women who have taken part in focus groups on the bill and who have contributed to the committee’s scrutiny of it. It is because of the courage of the women affected that we are at this point. I also welcome the cross-party way that the bill has been taken forward, both in the chamber and in committee.

The bill is narrow and has a limited function: to refund women who have paid for private surgery to remove transvaginal mesh and reasonable connected expenses, such as additional medical intervention, pre or post-op, which could require more time in hospital, which is an issue that I raised during scrutiny of the bill.

The bill will be directly relevant to a comparatively small number of women across Scotland, but the impact on them is hugely significant, as other members have mentioned.

The bill rightly brings the Parliament’s attention to the traumatic experiences of those women who have suffered pain and distress after having mesh implanted. Some have experienced extreme pain and health issues, which have affected and completely changed their lives. In committee, we heard directly from women about the physical symptoms and psychological distress that they experienced, the latter of which was often made worse because they felt that their experiences were not taken seriously enough when they sought help.

During those sessions, we heard how, regrettably, many of the women who have been impacted have lost trust in the ability of the NHS to address the issues relating to mesh implants. Having listened to those women, I completely understand why they have lost trust and why it is important that those concerns are addressed. I therefore welcome the steps that are being taken by the Scottish Government—which will be enhanced through the bill—to improve the care offered to affected women and ensure that their voices are heard and that their treatment wishes are granted in a person-centred way.

In particular, I welcome the national specialist mesh removal service in Glasgow, which has been offering full mesh removal since July 2020. So far, 33 women have had mesh removal surgery at the centre. New surgeons have been recruited and there are now four urogynaecologists. That allows women more choice over who they are treated by and gives them the option to be treated by a surgeon who has not been previously involved in their care. The service benefits from a multidisciplinary team approach, with contributions from specialist nurses, physiotherapists, pharmacy staff and a clinical psychologist. All of that is extremely important.

Alongside the national specialist service, the bill allows the Scottish Government to make it possible for women to choose—because of a lack of trust or past experiences in our NHS—to be referred for surgery in NHS England or the independent sector. That alternative pathway approach uses a specialist centre in NHS England, Spire Healthcare in Bristol or the Mercy hospital in Missouri.

In evidence to the committee, we heard how some women had already paid to have private treatment for corrective and mesh removal surgery before arrangements were in place for women to be referred for that surgery. I therefore welcome the provisions in sections 1 and 2 of the bill that allow for women in that circumstance to be reimbursed. I ask the cabinet secretary for an assurance that the payments will be made in a timely manner following any claims that are made.

I note again that the bill is narrow but essential. It will ensure that all women who have been impacted by transvaginal mesh—many of whom have been seriously impacted physically and psychologically—receive the care that is suited to them and that they choose. I agree with Gillian Martin that the bill is only part of the care process and I look forward to continuing to monitor progress.