Chamber and committees

Thank you for breaking down the finances.

Much has been made of the cost of residential rehab. The Castle Craig clinic, which is mentioned in a BBC article, costs £2,500 a week for one person. There is a variety of residential approaches. The number of residential beds in Scotland has increased to 418, which is up from 365 previously. That is good news. There is a breadth of residential rehabilitation and a variety of costs. The Scottish Government is looking at a tailored person-centred approach that fits each person. You have talked about families and about Phoenix Futures.

Will you report back to us, in the chamber or in committee, on your assessment of all those pathways for funding and how they are working?

I have a quick question. The issue of drug-related deaths is complex and work is being done in many strands. In previous questions in the chamber, I was interested in the tackling of stigma. We know that the Scottish drugs task force, in collaboration with other partners, has a strategy for addressing stigmatisation among people, communities and families. Stigmatisation is an issue in rural areas as well.

How important is it to tackle stigma, so that the media uses correct images, or better ones, and so that healthcare professionals who do not work in direct services with alcohol and drug users—people such as myself, when I worked in the recovery room—have a better understanding around the use of stigmatising language?

All the matters that we have discussed this morning involve financial input, and I am aware that the Scottish Government has committed to increasing funding. There was £5 million at the end of the previous financial year, and an allocation of an additional £50 million of funding each year, which will total £250 million over this session of Parliament. That will support further investment in a range of community-based interventions, including primary prevention and the expansion of residential rehabilitation, which you have covered a wee bit. Will you provide a breakdown of how that funding is allocated? Will we have reporting from the alcohol and drug partnerships that spend the money, and will we get an idea of how that spending will be assessed and evaluated?

Recovery must continue after someone’s stay in residential rehab. That is also part of the funding. Assertive outreach is another part. There are lots of strands that support people through the process. The third sector and charities are important to any funding model that we consider.

I will pick up on what the convener was saying about naloxone. Front-line workers are carrying out testing for the naloxone pilot, and ambulance crews, front-line police officers and even families are being trained to use naloxone. How is that being received? Has being engaged in the naloxone testing been positive for front-line workers?

Does Carol Mochan agree that the Government is the first Government in the four nations of the UK to have a mental health minister?

I welcome the opportunity to speak in this debate on recovering, remobilising and renewing health and social care in Scotland. I too, offer my sincere thanks to all our health and social care staff, who are working flat-out every day under intense pressure due to the pandemic.

I remind members that I am a nurse. I am about to join the flu and Covid vaccination programme locally next week.

During the past 18 months, NHS colleagues and health and social care staff have really stepped up in the face of Covid-19, but many of my colleagues and NHS contacts are feeling undervalued. There are many reasons for that, including the fatigue that everybody is feeling. All the work that was being done in healthcare prior to Covid and that is being done now in dealing with Covid is driven by evidence and science-informed research. Science, research, healthcare and medical experts, GPs and consultants in acute care must all be valued by us all—by politicians, the media and members of the public. I therefore ask the minister in his closing remarks to provide assurances that those professionals are valued and that their knowledge, expertise, input and scientific evidence will continue to be considered when tackling Covid and when future healthcare decisions are made.

The Scottish Government’s NHS recovery plan is backed up by more than £1 billion of investment over the next five years. It is imperative to ensure that people receive care, including some cancer screening and non-elective procedures, which were paused during the pandemic.

Alasdair Allan mentioned the £400 million investment in national treatment centres, which will contribute to the delivery of more than 40,000 additional elective surgeries and procedures each year. That includes the new fast-track diagnostic centres, one of which was opened in Dumfries and Galloway in June.

The plan also provides £8 million to support the mental health and wellbeing of our health and care workforce. Mental health support has already begun. That includes access to counselling, support for managing stress and support for optimal work practices.

On mental health, it is extremely welcome—and right—that there is a focus on ensuring that the wellbeing of young people is supported. Through my casework, I know how pressed child and adolescent mental health services are and how that can have a negative effect on young people. They have had a particularly challenging 20 months so far. They have had to adapt to home schooling and they have not been able to partake in their usual activities, which has had an impact on their wellbeing. Therefore, ensuring that at least 10 per cent of front-line health spending is dedicated to mental health and the recruitment of 320 child and adolescent mental health service workers is necessary. The charity Scottish Association for Mental Health welcomes those measures.

The NHS recovery plan commits £130 million to delivering on Scotland’s national cancer plan. Although it is great to hear about that and about the commitment to re-establish a national centre of excellence for remote and rural medicine, I want to touch on the modernising patient pathways programme, which is also being progressed as part of the recovery plan. The programme will look at cancer pathways, and I ask the health secretary to commit that that work will ensure that no patients in D and G—including in Wigtownshire—will need to travel to Edinburgh for treatment when Glasgow is closer.

There is much to welcome in the Government’s recovery plan, including an increase in funding for primary care, GPs and allied health professionals that is worth more than £12 million, along with improved training and systems to enable more efficient triage of patients. Most important, the plan sets out the foundation for establishing a national care service. Other members have touched on that, but I will not because of time constraints. I welcome the plan and look forward to its progressing.

Covid vaccination certificates will play an important role in reducing risk while maximising the ability to keep open certain settings and events where transmission is a high risk, so it is important that staff at the venues that are affected are properly supported to implement the scheme. Can the First Minister provide an update on the work that is being conducted to prepare detailed guidance on how to use the NHS Scotland Covid check verifier app?

I congratulate my colleague Christine Grahame on securing the debate. Although the subject of the debate is not directly relevant to Scottish Government policy, I absolutely agree that it is important for us as politicians, as role models and as leaders of society, to call out comments that are completely unacceptable. The Prime Minister’s comments regarding former Prime Minister Margaret Thatcher’s decision to close the mines as having given the UK a “big early start” in tackling climate change are not only unacceptable but deeply offensive. They show nothing other than the contempt that the Prime Minister and the UK Government hold for former mining communities in Scotland.

Many of those communities are located in my South Scotland region. Christine Grahame has invited the Prime Minister to visit the National Mining Museum Scotland in her constituency, and I am sure that many members of former mining communities in my area would welcome a discussion with the Prime Minister on his views on the mine closures that happened under Mrs Thatcher.

The reality of what the mine closures meant has been highlighted by ex-miner Rab Wilson, who said that they had no bearing on tackling the climate emergency. Rab said:

“Kirkconnel, New Cumnock, Auchinleck—all these villages are only here because of the coal ... Socially and economically, it made these local communities. ... The Tories didn’t give a second thought to the social catastrophe they were creating.”

In his book of Scots language poems, “Accent o the Mind”, Rab said:

“The right tae work, that wis aa that we asked
Demands which the Tories said went too faur
Fir tellys, holidays, mibbes a caur ...
Ah’ll never forget it, it’s left its mark,
It festers there yet, somewhaur in the daurk.”

I have written to the Prime Minister to invite him to take part in the discussion that I have agreed to organise on the mine closures. Unsurprisingly, I have not had a response.

Christine Grahame laid out the detail in the report, which shows that billions of pounds should go to the miners. Annabelle Ewing mentioned the fact that the pension amount is as little as £65 per week.

The report talks about the privatisation of British Coal in 1994 and the arrangement that was made between the Government and the trustees of the mine workers pension scheme. In the 2000s, the coalfield communities campaign argued for a review of the surplus sharing arrangements on the grounds that the guarantee had been struck on actuarial advice and may, with hindsight, have been too cautious, and that a 50 per cent share of an unexpectedly large surplus was too much. The consequences of that caused problems for our miners. As Annabelle Ewing noted, not many are left now to benefit from reforms. I ask the minister to do whatever he can to support the miners in the continued effort to ensure that they benefit from anything that comes out of the select committee’s well-worked report.

I again thank Christine Grahame for today’s debate.

I thank the convener for having me here, and the committee for considering the petition. I am aware of the petition, as I know Dr Gordon Baird very well. He lodged it on behalf of himself and the Galloway community hospital action group, and another retired GP, Dr Angela Armstrong.

The petition calls on the Scottish Parliament to urge the Scottish Government to create an agency to ensure that health boards offer fair and reasonable management of rural and remote healthcare issues. Dumfries and Galloway is part of my South Scotland region and Stranraer is the town where I was born and lived until moving to the Dumfries area when I was 12. I am very familiar with the rurality of the south-west part of my constituency. I often hear from constituents that they feel forgotten, as many people automatically look to places north of the central belt, and even to the islands, when providing examples of remote and rural places in Scotland.

I will share a couple of examples, one of which the convener has already touched on. NHS Dumfries and Galloway is part of the south-east Scotland cancer network, meaning that people who live in Wigtownshire, Dumfries, Canonbie and Lockerbie are included in cancer pathways and treatment plans such that they sometimes have to go to Edinburgh for some types of cancer care, such as radiotherapy. That is a 266-mile round trip for folk living in Stranraer.

Based on the response to questions raised with the previous health secretary about the cancer pathway issue, my understanding is that patients in Dumfries and Galloway are offered a choice of place to attend as part of their treatment. If their treatment choice is Glasgow, that would therefore be the place to attend. However, nowhere in Dumfries and Galloway is closer to Edinburgh by travel time than Glasgow and the Beatson, for instance.

A second example to highlight regarding fairness is that persons in other health board areas such as Ayrshire and Arran and Highlands and Islands are offered travel reimbursement for journeys of more than 30 miles. That is not the case in Dumfries and Galloway, where people are means tested for any travel costs to be reimbursed. Those are only two examples.

The Scottish National Party’s manifesto proposes a centre of excellence for remote and rural health and social care. I have already had a response from Cabinet Secretary for Health and Social Care, Humza Yousaf, regarding initial progress on that. I welcome the Government’s introduction of the Scottish graduate entry to medicine programme. We also passed the University of St. Andrews (Degrees in Medicine and Dentistry) Bill in the most recent session of Parliament. ScotGEM has a focus on increasing the number of graduate doctors with a rural focus.

I would be grateful to the petitions committee for progressing this petition. I would seek to be proactive and objective and to have those proactive and objective measures taken forward. We need to highlight the health challenges in remote and rural areas. I would therefore welcome the petitions committee’s continued progression of the petition.