Chamber and committees

I welcome the opportunity to bring the 100 years of insulin debate to the chamber this evening, and I thank all colleagues who have supported it.

I thank Diabetes Scotland for its briefing ahead of the debate and for the amazing work that it does to continually support people living with diabetes, particularly during the Covid pandemic. If exposed to Covid, people with diabetes are at higher risk of severe illness, hospitalisation and even death. Figures released early in the pandemic showed that 20 per cent of Covid-related deaths were of people with diabetes.

Insulin is life saving for all people who are diagnosed with type 1 diabetes. Insulin is a hormone excreted by the pancreas directly into the blood stream so that glucose can move from the blood circulation into the cells of our body. Insulin is vital for metabolism and survival. Type 1 diabetes occurs when the beta cells in the pancreas fail and the pancreas is unable to produce any insulin at all. I note for the record that I am one of those people with type 1 diabetes. My twae sisters and my mum also have type 1, but that is a whole other story.

This year, it is 100 years since the discovery of insulin, which is one of the most significant advances in the history of medicine. Insulin was discovered in April 1921. Frederick Banting, Charles Best and Scotsman John James Rickard Macleod initially isolated insulin from the pancreatic islets of dogs, then James Collip assisted with purified cattle insulin so that it could be administered to human patients with type 1.

Before 1921, it was extremely rare for people with type 1 diabetes to live for more than a year or two. In 1921, injection was the only delivery method for insulin, and that is still the case in 2021. When my wee sister Buffy was diagnosed at nine years old in 1977, my mum reused a small glass syringe and steel needles by sterilising them in boiling water. It worked, but it was not very practical. By the time I was diagnosed in 1979, plastic syringes, which were supposed to be for one-time use, were available. They caused less pain and were easier to use.

Scotland has played its part in supporting the development of technology to treat diabetes. As well as Scotsman John Macleod, my motion mentions Dr Sheila Reith, who was a consultant at the Southern General hospital in Glasgow. Her daughter had type 1, and Dr Reith had the idea for a more portable insulin cartridge, pen-like delivery device. Dr Reith worked with colleague Dr Ireland in the late 1970s, and the Penject device, as it was called then, was subsequently created. Insulin pen delivery devices have evolved and are still used today as part of multidose therapy for people with type 1 and type 2 diabetes.

One hundred years on from the discovery of insulin, where are we now? Insulin is still the safest method of reducing blood glucose levels, and things have improved significantly. Advances in technology, such as insulin pumps, closed-loop systems, which are basically an external pancreas, and digital blood glucose monitoring devices—buttons in our arms—are helping people to live better with fewer complications. As members can see on my phone’s screen, green is good for me today. My apologies for the prop, Presiding Officer.

Diabetes complications are a huge cost burden on the national health service in Scotland, but advances, such as the pumps, are so good that such complications can be reduced. In Scotland, 312,000 people have diabetes, and the rate of diabetes is 80 per cent higher in the most deprived communities. Type 2 diabetes is a health inequality issue. It is estimated that the Scottish NHS spends £1 billion on diabetes—10 per cent of its budget. Therefore, avoiding complications will benefit people with diabetes and also our NHS.

Managing type 1 diabetes is a complex issue. A 2014 Stanford University study found that people living with type 1 diabetes make an extra 180 decisions each day compared with someone who is not diabetic—that is one extra decision every five minutes while awake. Those decisions include finding out what their glucose level is now; working out how many carbs are on their plate and whether those are fast or slow carbs; whether they should eat now or wait for two hours; whether they might go hypoglycaemic when driving home; whether they should programme their pump to deliver insulin slowly or quickly; and whether they have replacement supplies in their car, at home or in their office in case the cannula pump gets pulled out. Having diabetes is not a piece of cake; it is complicated.

We have amazing support from our NHS staff. Our endocrinologists, dietitians, specialist nurses and healthcare support workers are fantastic in supporting patients, and I thank them for their work.

There is a lot in the Scottish Government’s refresh of the diabetes improvement plan, which I welcome, including continued collaboration with the third sector and stakeholders.

I bring to the minister’s attention the work of the brothers Anthony and Ian Whittington and their fixing dad, fixing families and fixing us programmes. They helped their dad to lose 5 stone in weight. He reversed his type 2 diabetes by engaging in the fixing dad social prescribing programme, which Ian and Anthony created. That worked. Perhaps fixing dad could help to inform actions to include in the diabetes refresh strategy as it evolves.

I agree with Diabetes Scotland that everyone should have free and equal access to what they need to live healthy lives. In a recent survey of more than 1,000 people living with diabetes in Scotland, one in five said that they were having difficulty getting key diabetes technology devices. I therefore welcome the fact that the diabetes plan mentions access to diabetes technology in priority 2 and the commitment to review access to diabetes technology. Can the minister provide information on the timescales for that review and when the review of the data will be available? That will no doubt help to inform future care approaches. Could guidance be produced for all Scottish health boards to ensure that all who could benefit from diabetes tech can access it free of charge? Now is the time to ensure that everyone can access what they need. I would be grateful if the minister committed to that in her closing speech.

There are many issues to address and speak about, many of which I could not cover. I look forward to hearing colleagues’ contributions on the 100-year anniversary of insulin.

What Sandesh Gulhane describes in relation to Ramblers and outdoor access is often referred to as social prescribing. Does he think that there are challenges in how we market that language? Some folk do not know that outdoor access might be social prescribing.

I welcome the agreement between the SNP and the Scottish Green Party. Can the First Minister give an assurance that, in addition to green transport projects such as the potential for the rail links from Dumfries to Stranraer and Stranraer to Cairnryan, the co-operation agreement will not prevent improvements and upgrades to the A75 and A77, which have long been lobbied for, particularly with regard to safety aspects of the roads, when the strategic transport projects review 2 is finally published?

I welcome the opportunity to speak in the debate, and I congratulate Rachael Hamilton on securing it. She has highlighted the fact that so much good work is being done.

I also congratulate GreenTweed Eco on bringing together this year’s great Borders river clean, which took place from 15 to 16 May and was supported by the Fallago environment fund. As part of that important work, 460 volunteers took the time to clean up the River Tweed. I congratulate the Tweed Forum on the important role that it plays in helping to educate people on the River Tweed’s importance for biodiversity and the role that it plays in tackling the climate emergency.

The work of the volunteers led to more than 3,000kg of rubbish being removed from the Tweed, which is remarkable, considering that most of the heavy items, such as car tyres and scrap metal, are still under several feet of water. The amount of waste recorded was a real testament to the determination of all involved to remove as much rubbish as possible from the river banks. Rachael Hamilton mentioned some of the interesting finds, which included major car parts, an intact fishing rod and a broken kayak, as well as the usual detritus of our modern lives, such as bottles, plastic toys, clothing and hundreds of thousands of wet wipes. The river clean demonstrates what communities can achieve when they come together in a good cause, and I again congratulate everyone involved.

A lot of work is also being done by hard-working volunteers across Dumfries and Galloway in the west of my South Scotland region to clean our rivers and coasts. One example is the work of the Galloway Fisheries Trust, which is working to ensure that we have clean riparian habitats and management. Riparian management can bring important benefits to the surrounding catchment. Watercourses can be damaged by overgrazing livestock, overshading bankside trees or the presence of alien plant species. The Galloway Fisheries Trust has completed various improvement works, including the installation of bankside fencing, the organising of controlled grazing agreements and extensive spraying of Japanese knotweed, giant hogweed and skunk cabbage, as well as the removal of riparian coniferous forestry and the planting of deciduous trees in the riverbank zone. All that work has led to a reduced acidity level in Galloway rivers, such as the River Bladnoch near Wigtown, the Water of Dee near Castle Douglas and the Old Mill Burn near Newbie, which is close to Annan.

In addition to the important work of the Galloway Fisheries Trust, the Solway Firth Partnership has been working extremely hard to tackle marine litter by organising beach and water cleans by volunteers throughout the region. Marine litter is human-created waste that has been deliberately discarded, accidentally lost or transported by winds and rivers to the sea and the beaches. As well as being unsightly, marine litter can be dangerous, causing harm to public health and injury to our marine and coastal wildlife, our birds and other sea life.

The D&G Eco Warriors group is worth a mention. It has been working to address coastal littering. I was pleased to join its members in 2019, and I hope to do so again. We found a few nurdles on the beach near Kirkcudbright.

The Solway Firth Partnership and D&G Eco Warriors are particularly concerned about the impact of fly-tipped waste, which I have previously highlighted. I ask the minister to tell us in her closing speech what action the Scottish Government is taking to assist local authorities with education on fly-tipping and enforcement action against those who commit fly-tipping offences, especially when such offences are committed in coastal areas, where they can present a real threat.

The River Tweed is described by our own Alasdair Allan in his book “Tweed rins tae the Ocean”. I am sure that the Borders river clean has helped greatly to maintain its appeal for walkers and visitors to enjoy. I remind everybody that all the money raised by Alasdair Allan’s book will go to charity.

Will the member take an intervention?

I wonder whether the proposed right to recovery bill will seek the devolution of drug policies, so that we can have the powers that we really need in this country if we are to do more to tackle the issue.

Does the member agree that the respiratory care action plan that is being implemented right now by the Scottish Government includes long Covid?

I welcome the further easing of Covid-19 restrictions, which will allow people to meet up in greater numbers. However, more people indoors means a greater risk of spreading the Covid-19 virus. That can be mitigated by good ventilation, as the First Minister has described, by introducing CO2 monitoring in schools and even by high-efficiency particulate absorbing air filtration for virus that is aerosolised. Can the First Minister expand on the introduction of CO2 monitoring and on whether further support with ventilation or HEPA filtration for public, third sector or business places is being considered?

I would also like to offer my condolences to the families of all those who have lost their lives.

The Scottish Government has rightly identified tackling drug-related stigma as a priority in our national mission of reducing drug deaths and harm. Therefore, can the minister outline what education is being provided or is intended to be provided to healthcare professionals who do not work directly in drug and alcohol services, such as hospital and community staff, as well as to the wider public, to tackle drug-related stigma?

Like Rona Mackay and Christine Grahame, I agree that this is an important issue. Has the Scottish Government assessed whether the divergence from Covid-19 restrictions in England, with the approach of the dangerously named “freedom day” on 19 July there, will create confusion about the Scottish Covid-19 rules and, therefore, barriers to their enforcement? Can the First Minister reaffirm that action will be taken to ensure that people in Scotland and those visiting from other parts of the UK, including to my South Scotland region, are aware of Scotland’s more responsible approach to easing Covid-19 restrictions?