Chamber and committees

I have a quick question, which could be dealt with as part of the response to Evelyn Tweed’s question that you send us.

The cervical cancer self-screening research that is being done at the moment is interesting. I got involved in that because NHS Dumfries and Galloway was taking forward the self-sampling procedure in order to capture the 6,000 women who had defaulted on their cervical smear test. I would be interested in an update on how the research is progressing. Are we likely to see a roll-out of self-screening for cervical cancer, which is particularly focused on human papillomavirus infection, in Scotland?

I am not sure how many European or other countries have vaccine certificates, corona passes or green passes, or whatever we want to call them. How many European Union countries have introduced vaccine certificates or their equivalent?

What I would say is that I am keen to progress the work that is being taken forward to use whatever digital technology we can to enhance everybody’s access to the internet. We know that that is important as we are planning our recovery from this pandemic.

The programme for government outlines a specific commitment to establish a new national park in Scotland. I want to highlight the work of the Galloway National Park Association, which is lobbying for it to be located in Galloway, particularly through its new “It’s got to be Galloway” campaign, which I support.

The programme for government also makes a commitment to implementing the strategic transport projects review 2, which will improve road, rail and other infrastructure across Scotland.

In response to Oliver Mundell’s intervention on Mark Ruskell about roads, I note that, on ITV’s “Representing Border” last week, Patrick Harvie said that he does not oppose improvements on roads on the grounds of safety and efficiency, specifically mentioning the A75 and the A77. Therefore, I certainly cannae wait—[Interruption.] I do not have time to take an intervention. I certainly cannae wait to hear what investment will be announced when STPR2 is announced later this autumn.

The programme for government is full of progressive commitments, including the doubling of the carers allowance, establishing the neurodiversity commissioner, improvement in tenants’ rights and protecting health. I look forward to the programme for government being implemented.

The Conservatives continually say that the Scottish Government is prioritising independence over recovery from the pandemic. However, I would argue that independence will aid our recovery. It will give the Scottish Parliament full control over our finances, criminal justice, reform of drugs policy, employment law and equalities, to name just some areas. Without full control over those areas, the Scottish Parliament is restricted in what it can do. Independence is required to deliver that fair, progressive and equal Scotland, and I want to be part of that.

From the outset, I want to join the First Minister in recognising the impact that the pandemic has had on every part of our society, in particular the physical and mental health of our fellow citizens. My condolences go to everyone who has lost a loved one to Covid-19 and, equally, my thanks go to all the health and social care staff in the community and in hospitals who work every day to keep us safe, healthy and well. I remind the chamber that I am still currently a registered nurse.

The programme for government will work to protect families, businesses and communities across Scotland and is focused on the recovery from the pandemic. Since being elected in May, the Scottish Government has already taken positive steps to support our NHS and health and social care workforce. The Government has published an NHS recovery plan setting out how it will achieve a 10 per cent increase in activity in key services. I am a member of the Health and Sport Committee, and today we heard from the Cabinet Secretary for Health and Social Care, Humza Yousaf, about the plans that are in place to address many of the health needs that have been identified, including issues around non-communicable diseases, which were highlighted in the report that the British Heart Foundation published yesterday.

A 4 per cent average pay increase this year for NHS agenda for change staff has already been implemented and was seen in pay packets in June, and the Government is already on course to increase direct investment in mental health services by 25 per cent over the course of the session, which is particularly welcome given the impact that the pandemic and its restrictions have had on health and wellbeing. The Government has also begun the consultation on legislation to establish a national care service, and I look forward to closely engaging in its progress.

The first three rapid diagnostic test centres for cancer have already opened. One is in Dumfries and Galloway, in the new Dumfries and Galloway royal infirmary. That is good news and good progress. However, I want to raise an issue around cancer pathway arrangements across Dumfries and Galloway. Currently, people with cancer across the area are required to travel to Edinburgh—a 266-mile round trip from Wigtownshire—for types of cancer treatment such as radiotherapy instead of going to Glasgow, which is closer. That is because Dumfries and Galloway is part of the South East Scotland Cancer Network and not the West of Scotland Cancer Network. NHS Dumfries and Galloway says that patients are offered a choice of place to attend but constituents tell me that they are not. Additionally, unlike in other rural parts of Scotland, such as the Highlands and Islands and Ayrshire and Arran, patients in Dumfries and Galloway do not automatically receive reimbursement for travel over 30 miles. The reimbursement that can be accessed is means tested. I, along with Dr Gordon Baird, Dr Angela Armstrong and Galloway community hospital action group, have been calling for changes to the situation around place of treatment and travel costs. I will be grateful for action on those points as we progress this ambitious programme for government.

The programme for government also commits the Scottish Government to building on our already world-leading environmental policies in the face of the global climate emergency. I welcome that, in doing so, the Government has committed to protecting outdoor green spaces and promoting and enhancing biodiversity.

A consultation closes today on the proposal in England and Wales to increase the qualifying age for free prescriptions from 60 to the state pension age of 66. Age UK has branded the move as a “kick in the teeth” for older people. The proposal highlights the difference between the progressive Scottish National Party Government in Scotland and the cruel politics of Westminster. Will the First Minister confirm that no one in Scotland will be left struggling or unable to afford medicines that they need to stay as healthy as possible, and that prescriptions will remain free for all?

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 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.

On a point of order, Presiding Officer. Rachael Hamilton has stated that I want a hard border, which is absolutely not true. I refute that, and I am grateful for the opportunity to state it in the chamber.

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?

Will the member take an intervention?