Chamber and committees

To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues and rural businesses regarding action to improve and enhance rural skills development. (S6O-00392)

I welcome the opportunity to speak in this important debate ahead of world pancreatic cancer day tomorrow, 18 November, and I congratulate Clare Adamson, who is sitting right in front of me, on securing it. Clare has done a huge amount of work to raise awareness of pancreatic cancer, and has led the debate each year since 2017.

I am also glad that Miles Briggs and Gillian Martin mentioned former MSP John Scott, and it is good to hear how well he is doing. I thank the clinicians and staff who care for people with pancreatic cancer. I remind members that I am still a nurse, and many of those folks are my former colleagues.

It is worth noting that the Covid pandemic has created many additional challenges for cancer services across Scotland. I agree with Pancreatic Cancer Action Scotland that increasing awareness, encouraging awareness of symptoms earlier, improving pathways to diagnosis, and support, information and care are more important than ever before.

As colleagues across the chamber have stated, pancreatic cancer is currently the deadliest common cancer in Scotland, with statistics indicating that, each year in Scotland, 800 people die within just two weeks of a diagnosis. That is a pretty stark statistic.

The Scottish Government has invested in research, and its current action plan, “Recovery and Redesign: An Action Plan for Cancer Services”, recognises the disease and less survivable cancers. The announcement of £653,000 of funding to support the Scottish HepatoPancreatoBiliary Network’s improving pancreatic cancer pathways project is extremely welcome.

The example of research on which I will focus my comments, and which Gillian Martin also touched on, is the Precision-Panc platform. I spoke about it last year, too. Not all pancreatic cancers are the same. Precision-Panc clinical trials are delivered through the NHS, and match people who have a diagnosis of pancreatic cancer to the clinical trial that is most likely to work for them. Precision medicine is about tailoring treatments to an individual’s cancer. The trials, involving chemotherapy, are based on the genomics of the patient and their tumour.

The Precision-Panc platform brings together expertise from the University of Glasgow, Cancer Research UK, the Beatson Institute for Cancer Research, the CRUK Cambridge institute, the CRUK Manchester institute, the Institute of Cancer Research in London, the University of Oxford and the wider NHS.

There is excellent evidence that participation in clinical trials is associated with better outcomes for patients, so there can be optimism. Those types of clinical trials allow researchers across the country to share expertise and knowledge, as well as to create and share infrastructure, which leads to trials that are quicker to set up and recruit for.

The Precision-Panc platform has a proven track record of delivering positive outcomes and research for pancreatic cancer patients, so there can be optimism, as Clare Adamson has already stated. Development of biomarkers, prognosis and response to treatment have taken place and the platform has successfully identified why pancreatic cancer is resistant to some drug therapies.

Current trials are PRIMUS 001 to 005 as well as the master protocol, some of which are now reaching the clinical report stage, which is scheduled for early next year. I ask the minister to give a commitment that the Scottish Government will continue to support that vital work.

I briefly want to highlight the issues that my constituents across Galloway face when accessing treatment for pancreatic and other cancers. Despite living in one of the most remote and rural parts of Scotland, people who live in Dumfries and Galloway, including in Stranraer and Wigtownshire, do not have access to non-means-tested travel reimbursement to and from treatment appointments. I know that the minister is aware that I have pursued the matter and I ask that she continues to assist me in that work for constituents.

I again congratulate Clare Adamson on introducing the debate and I welcome the on-going work to advance treatment of pancreatic cancer, which means that we can continue to be optimistic.

Will the member take an intervention?

Thanks, convener—it is very short.

I believe that cognisance will be taken of an approach dealing with rural areas such as Dumfries and Galloway and the Scottish Borders in my South Scotland region. Am I right in thinking that? This can be a yes-or-no answer.

I know that we have asked our NHS and social care staff to work through these unprecedented times, often in unfamiliar settings, and that many have been asked to learn new skills and to work in new roles and in unfamiliar teams, for instance. Are we tracking how staff might be retained so that we can address all of that and not lose staff because of poor mental health?

I have a quick supplementary question. There has been a lot of work done on tackling stigma; it is now less stigmatising for a person to say that they have anxiety or a mental health disorder. Has that contributed to the challenges? Has the fact that more people are coming out and saying that they have struggles affected the ability to tackle the issue? The Government has done a lot of work on support for mental health in that way.

As a registered nurse, I have been participating in the vaccination programme. Colleagues have told me about how they have been coping or not coping with their mental health. I know that a lot of work has been done, for example through the national wellbeing hub and programmes such as clear your head, to support staff in healthcare and social care. How are we monitoring and evaluating the way in which people engage with those programmes?

We have our winter preparedness plan for 2021-22, and there is a parallel health and social care winter overview. We have in front of us a short list of the challenges this winter: recruitment and retention, which links back to my previous question; nursing staff in care homes; infection control in care homes; staff wellbeing; services and support for unpaid carers; and delayed discharges.

I know that there are challenges, and that there are complexities in how we manage our health and social care system. Could you could give us a brief overview on how the plan will practically assist providers and social care services in meeting the challenges in the sector over the winter?

What will be the impact of the COP26 agreement on remote and rural communities? What support will be available to enable those involved in the agricultural industries to reduce carbon emissions—particularly those in the dairy sector, which is an important industry for the south-west of Scotland?

I welcome the opportunity to lead this debate to raise awareness of world COPD day tomorrow, 18 November. This year, the theme is “Healthy Lungs—Never More Important”. As the founder, and now the co-convener, of the cross-party group on lung health, I, along with my co-convener, Alexander Stewart, and the deputy convener, Mark Ruskell, who apologises for not being able to speak in the chamber this evening, thank members on all sides of the chamber who have supported my motion.

I also thank the Asthma UK and British Lung Foundation Partnership and Chest, Heart & Stroke Scotland for providing briefings and for the important work that they do every day. In addition, I highlight that my colleague Patricia Gibson MP will represent the Scottish National Party in a world COPD day debate in Westminster Hall tomorrow.

Chronic obstructive pulmonary disease is a progressive and long-term lung condition without a cure. It is an umbrella term that is used to describe several lung conditions, including emphysema and chronic bronchitis. One of the best descriptions of how COPD feels is that it is like trying to breathe through a wee straw repeatedly—that is awfie difficult to do. COPD constricts the flow of oxygen into the lungs and its circulation, and it causes breathlessness, tiredness and coughing. The condition often causes poor mental health and depression, and it can lead to a person feeling lonely and isolated.

At every stage and at every age, there is an opportunity to prevent or treat COPD. Improvements in treatment are vital, as there are 300 million cases of COPD around the world and the disease is the third biggest cause of death globally. Exposure to tobacco smoke and other inhaled toxic particles and gases are the main COPD risk factors. Treatments for COPD include inhalers, tablets and—for a small number of people—surgery or a lung transplant.

Pulmonary rehabilitation is also effective and can prevent an exacerbation of COPD. That typically leads to a hospital stay of between four and eight days, which can cost the Scottish national health service an estimated £3,000 per person per stay.

The Asthma UK and British Lung Foundation Partnership has just published a report entitled “Failing on the fundamentals—Insights from those living with chronic obstructive pulmonary disease (COPD) around the UK”. The organisation surveyed 8,000 people from all four nations of the United Kingdom who have a diagnosis of COPD and asked them whether they felt that they were receiving care based on the five principles of COPD care. Those principles include offering assistance with smoking cessation, offering pneumococcal and flu vaccination, offering access to pulmonary rehabilitation, providing a personalised self-management plan and optimising treatment for comorbidities. The majority of the respondents to the survey conveyed that they were not receiving those five fundamentals of COPD care.

It is worth highlighting that, of the respondents, only 652—8.1 per cent of the total—were resident in Scotland. That number seems low, so it might be an interesting opportunity for the Scottish Government to pursue a wider survey or audit of Scottish residents with COPD.

The survey has highlighted that improvements in COPD prevention and care are required, especially given that many people with poor lung health shielded during the first lockdown and the fact that winter, when those with COPD are at higher risk of infection, is fast approaching.

In Scotland, a wide range of action is being taken to better support those who are living with COPD. The “Respiratory Care Action Plan: 2021-2026”, which is being led by Dr Tom Fardon from NHS Tayside, sets out the Scottish Government’s vision for driving improvement in the prevention, diagnosis, care, treatment and support of people living with respiratory conditions. In summer 2021, an implementation programme was initiated to roll out, in partnership with the respiratory community, the commitments that are outlined in the plan.

The conditions that are covered in the plan—asthma, COPD, idiopathic pulmonary fibrosis, bronchiectasis and obstructive sleep apnoea syndrome—make up the majority of the workload of respiratory physicians in Scotland. Although each condition presents its own challenges, there are common problems. The plan encourages new and innovative approaches and is intended to share best practice to promote a whole-system approach to respiratory care. That work is welcome, and I look forward to seeing it continue to progress.

Dumfries and Galloway, in my South Scotland region, has a higher prevalence of COPD than any other part of Scotland. Across Dumfries and Galloway, 4,600 people are living with COPD—that is three in every 100 people, in comparison with the Scottish average of 1.8 in every 100. In addition, Stranraer is an unexplained hotspot for COPD, and researchers from the border and regions airways training hub—BREATH—project, which was funded by €7.7 million of Interreg funding, are examining possible factors including air quality, ozone levels, genetic links, social deprivation and the agriculture and industry in the area.

Prior to the debate, I received an update from Professor John Lockhart on the work of the BREATH project. I am pleased that it has recommenced school visits, most recently visiting Girvan academy. The project recently awarded a BREATH challenge certificate to Moffat academy and to Belmont primary school in Stranraer. The award is provided to young people for the education that they receive on the importance of maintaining good respiratory health. I am joining the team for a visit to Douglas Ewart high school in Newton Stewart in the new year, and I thank Dr John Lockhart and the team for their research.

There have been calls for the creation of a COPD centre of excellence in Stranraer. Although I understand the reasons for that, it would require co-operation and collaboration with NHS Dumfries and Galloway, and leadership, clinicians and a multidisciplinary team would all need to be in place. Consideration might be given to a wider approach that would cover other conditions that require the input of a respiratory team—perhaps a Scotland-wide digital centre for lung health excellence, or a lung health hub. That would allow for learning from, and engagement with, Scottish NHS experts more widely.

In raising awareness of world COPD day, I want to highlight that COPD is often a hidden disability. Yesterday, at a meeting of the cross-party group on lung health, we heard from Julie McLeod of the Breathe Easy Clackmannanshire Community Group. Julie has COPD and is quite breathless sometimes, but she was told by someone that she did not look disabled. COPD is quite disabling for many people who are diagnosed with it.

Much work is already under way. I again welcome the work of the respiratory care action plan team, and I look forward to seeing their progress. I look forward to hearing contributions from other members ahead of tomorrow’s world COPD day, and I thank the Presiding Officer for allowing me to speak this evening.