Chamber and committees

I thank Tim Eagle for securing the debate. It has been a popular subject, which has enabled members to talk about issues in their own rural areas. I managed to write some additional notes as previous speakers were making their contributions.

At the end of last year, just before recess, the Parliament’s Health, Social Care and Sport Committee published its report on remote and rural healthcare in Scotland. The committee made recommendations on education and training; staff recruitment and retention; the current design and delivery of services; primary care; multidisciplinary and team working; and the importance of the third sector. It was good to hear Christine Grahame mention those aspects, too.

A prevalent issue was the lack of housing in remote and rural areas, not only for full-time workers but for people who have been assigned placements as part of their training in more remote and rural areas. I have been raising these challenges in the Parliament for the past eight years: cancer pathways; maternity services in Wigtownshire; the recruitment and retention of health and social care staff; addressing delayed discharges; and ensuring that our local social care system is able to cope with increasing high demand. I have also been working with former GPs Dr Gordon Baird and Dr Angela Armstrong to raise rural Wigtownshire healthcare issues here in the Parliament.

I will touch briefly on some of those challenges. With an older population, there are more hip and knee replacements and more cataract surgery. I have a background as an operating room nurse and was previously a clinical educator for NHS Dumfries and Galloway, so I know that such surgeries are complex as far as anaesthesia and the required technique and skills are concerned. Only three or four hip or knee surgeries can be done in a day. I welcome the fact that we now have national treatment centres that can focus on addressing those issues.

Some work is being taken forward. NHS Dumfries and Galloway has successfully recruited nurses from Uganda. As part of embedding them into the work environment, it provided them with support on the Scots language and phrases, so that they would ken when somebody said, for example, that they had a sair heid or that their lugs hurt. That is really positive.

NHS Dumfries and Galloway has experienced a high number of deregistrations of dental practices. Minister Jenni Minto is well aware of that: she has been paying attention and has taken loads of questions in the chamber about it. We know that many people are now paying for private treatment and others have no dentist at all. Just last week, I met a constituent who is a retired dentist whose practice had focused on paediatrics and the prevention of dental caries. He welcomed the fact that the baby box now contains a toothbrush, which helps to prepare babies for the feeling of having a toothbrush in their mouth. That is another good news story. I know that the Minister for Public Health and Sport is working with NHS Dumfries and Galloway on dentistry. However, my dentist constituent said that he suggested 20 years ago that a mobile dental hub model should have been created for rural dental services in the area.

I will not pursue maternity issues, because Finlay Carson has covered those. I invited Mr Carson and Colin Smyth to join me at a pre-arranged meeting with the minister, because I wanted us to have a cross-party and apolitical approach. The minister met us last November. Engagement is happening.

The final area that I want to mention is delayed discharges. I know that the Cabinet Secretary for Health and Social Care, Neil Gray, is all over the issue with NHS Dumfries and Galloway. There are challenges with rural care packages and delayed discharges, but more than 90 per cent of all hospital discharges now happen without delay.

Throughout the Covid-19 pandemic, thousands of nurses and other healthcare professionals across Scotland administered crucial vaccines to the wider population. I remind members that, as a nurse, I was part of Dumfries and Galloway’s vaccine team during that time.

The vaccine programme was one of the most pivotal moments in tackling the pandemic, reducing harms and deaths, enabling a return to a certain level of normality and reuniting friends and family by enabling safe socialisation. Will the Deputy First Minister speak to what lessons the Scottish Government has learned on the medical response to the pandemic, particularly through the vaccine and testing programme, and how those will enable better planning and pandemic preparedness in the future?

I welcome the opportunity to speak in the debate. I thank members of the Citizen Participation and Public Petitions Committee and its clerks for producing the report, and I join members in congratulating campaigners, including the petitioner, Laura Hansler, on their tenacity in seeking improvements to and the dualling of the A9, which is a critical route. As other members have done, I welcome Laura to the chamber.

Members will undoubtedly be aware that, in relation to the South Scotland region, I have championed the need for significant improvements to the main arterial routes in the south-west—the A75 and the A77. Those roads connect Scotland with Northern Ireland, Ireland, England and wider Europe. I know how much commitment, dedication and work it takes to champion road improvements. I wanted to speak in today’s debate partly because many of the issues that have been uncovered in the committee’s inquiry into the dualling of the A9 are mirrored elsewhere.

The A9 and all our roads must be safe, reliable and resilient. Members have described their experience of driving along the A9 and encountering specific hotspots—or not-spots, even—such as the Dunkeld junction. The magnitude of the investment that is required and the complexities that are involved in upgrading infrastructure on such a scale in the current financial environment have been and will continue to be considerable. However, that is a challenge that the Scottish Government is committed to meeting.

The cabinet secretary has described in detail the status of the contracts that are under procurement and those that are about to be procured. The Scottish Government anticipates that nearly 50 per cent of the A9 between Perth and Inverness will be operating as dual carriageway by the end of 2030 and that that will rise to 85 per cent by the end of 2033 and 100 per cent by the end of 2035. I am sure that campaigners will welcome the progress that has been made.

The former cabinet secretary Fergus Ewing brought up the subject of frameworks for contracts, and it was interesting to hear his comments on that. It is clear that the dualling of the A9 will sustain and improve the quality of life of people in rural Perthshire, the Highlands and beyond.

Emma Roddick gave a good description of the challenges that drivers on the A9 face. I have been that position, too, although not very often. People are not familiar with driving on a road that is a single lane in some places and a dual carriageway in others. I am sure that many people who visit the Highlands have gasped when they have tried to cross the road or even when they have tried to drive north or south.

The report says that the dualling of the A9 is expected to improve safety, which is crucial. It is forecast that there will be fewer fatalities and fewer casualties with serious injuries every year. Driver stress and accidents will be reduced, as will journey times for emergency vehicles, which will increase the survival chances of people who need urgent emergency care. Those benefits will be transformative for a route that serves 35 per cent of our landmass and carries cargo that accounts for around 10 per cent of Scotland’s gross domestic product.

It is of paramount importance that we consider the safety of our roads. One life lost on Scotland’s roads is one too many. It is welcome that the Scottish Government is committed to achieving safer road travel in Scotland, now and in the future. The Government does not accept that road casualties are inevitable, and it is vital that we continue to work to bring overall casualty numbers down. It is important that we do that on all our roads, including the A9.

Improvements are long overdue, and it would be remiss of me not to again call on the cabinet secretary to progress at pace the recommendations in the strategic transport projects review 2 on the main arterial routes in the south-west and on how we can progress at pace the A9 improvement work.

The Government has demonstrated its commitment to dualling the A9, and progress is being made. I again thank the members of the Citizen Participation and Public Petitions Committee and its clerks for undertaking the inquiry, as well as the witnesses who provided evidence, and I look forward to the cabinet secretary’s response.

Good morning. Some of your answers will probably be on issues that we have already covered, as social benefits for local people in our areas are all intertwined with the issues that we have been talking about—housing, skills development and the recruitment of apprentices.

I will come to Stuart Goodall, first, on local issues regarding ownership and employment. Forestry coverage in Dumfries and Galloway is 31 per cent. Forestry is a big industry in the south-west of Scotland and you mentioned the south-west in relation to skills. I am interested in hearing about how rural communities in Scotland benefit from forestry and woodland.

I am an MSP for South Scotland.

I am looking directly at you because you just said that you are a birder.

I have a brief supplementary question about biodiversity. Recently, I have been engaging with a local farmer who is worried about the loss of curlew and lapwing, which are ground-nesting birds. Forestry gets blamed for encroaching on the open spaces that are needed for waders, and there is predator impact from foxes, badgers, crows and the rest of the corbie population. I am also aware that there is a habitat management programme with farmers in the Clyde valley that is working well and improving bird numbers. What work is being done or should be done on conservation for those types of birds?

I thank Lyn Pornaro, Tressa Burke and Marianne Scobie for being here this morning.

I remind everybody that I am a registered nurse. To continue on a similar trajectory, I am thinking about autonomy. We have talked about the definition of “terminal illness”. The bill is designed to apply to individuals with a terminal illness, and the definition of that might need to be altered. How can we address the concerns of disability groups while respecting the autonomy of those who are seeking to access assisted dying?

I am looking at Lyn first, but only because she is in the room—I am sure that Tressa and Marianne will want to answer, too.

I have a final question. Is assisted dying any different, in principle, from a person’s right to refuse treatment or intervention such as artificial hydration and nutrition? In my experience of looking after people at the end of their life, they sometimes choose no further methods that would support them, such as subcutaneous fluids.

I am interested in whether you think that health professionals have the appropriate skills to assess whether an individual who seeks assisted dying support has been coerced.