Chamber and committees

As a healthcare professional who works in acute care as well as out in the community and has taught nurses in the past, I know that there have been challenges—we have heard that in the evidence that the committee has recently taken regarding digital access and access to case notes—but would it not be better to employ a digital strategy separately, because we are talking here about primary care, secondary care and care in the community? With the evolution of artificial intelligence, would it not be better to look at that separately, rather than inserting it into the bill?

Brian Whittle: No, because all healthcare should be connected. The connection between healthcare professionals, and how we move care from part of the NHS into primary and secondary care and even, in some cases, the third sector, should be seamless.

As I have said many times, this country is way behind the rest of the United Kingdom, which is way behind much of the rest of Europe. The longer we leave the issue, the harder the solution is going to be. It is incumbent on the Parliament to send a message to the Government and set a target. I know that the cabinet secretary agrees with me on that.

We need a general platform that allows there to be autonomy across the whole sector for the deployment of different kinds of software. It is incredibly important, especially in an acute setting, that a person is able to access pharmacology or whatever has come out of primary and secondary care. If somebody has come out of hospital, it is important that everybody understands their role in delivering their care and understands what other care has been given. I find it very frustrating when I listen to the cabinet secretary, because there are many mixed messages coming out of the Government, and we are not making any progress.

I urge the committee to pass amendments 116 and 117, because, if anything is to come out of the bill, it is fundamentally important that the digital platform is put in place.

As a healthcare professional who works in acute care as well as out in the community and has taught nurses in the past, I know that there have been challenges—we have heard that in the evidence that the committee has recently taken regarding digital access and access to case notes—but would it not be better to employ a digital strategy separately, because we are talking here about primary care, secondary care and care in the community? With the evolution of artificial intelligence, would it not be better to look at that separately, rather than inserting it into the bill?

Brian Whittle: No, because all healthcare should be connected. The connection between healthcare professionals, and how we move care from part of the NHS into primary and secondary care and even, in some cases, the third sector, should be seamless.

As I have said many times, this country is way behind the rest of the United Kingdom, which is way behind much of the rest of Europe. The longer we leave the issue, the harder the solution is going to be. It is incumbent on the Parliament to send a message to the Government and set a target. I know that the cabinet secretary agrees with me on that.

We need a general platform that allows there to be autonomy across the whole sector for the deployment of different kinds of software. It is incredibly important, especially in an acute setting, that a person is able to access pharmacology or whatever has come out of primary and secondary care. If somebody has come out of hospital, it is important that everybody understands their role in delivering their care and understands what other care has been given. I find it very frustrating when I listen to the cabinet secretary, because there are many mixed messages coming out of the Government, and we are not making any progress.

I urge the committee to pass amendments 116 and 117, because, if anything is to come out of the bill, it is fundamentally important that the digital platform is put in place.

Carol Mochan mentions stigma, which is important. Would she agree that social media is an issue that can contribute to the increased prevalence of eating disorders? Stigma, social media and various other aspects are all tied in and are leading to an increase in the numbers of young children and adolescents with eating disorders.

Dennis Robertson MSP led the first debate in Parliament on eating disorders awareness week in 2012, following the loss of his daughter, Caroline, in February 2011; she had been diagnosed with anorexia nervosa. This is what Dennis said then:

“I want people to be aware of the symptoms and get help as soon as they can. I’m trying to ensure GPs and other medics become more aware of the dangers.”

As Dennis said, people need to get help as soon as they can.

I thank colleagues across the chamber for signing my motion to bring the debate to the chamber. This year, eating disorders awareness week runs from 24 February until 2 March. The eating disorders charity Beat provides so much support, and I welcome to the public gallery Alex Jones from Beat, along with members of the lived experience panel and trustees of SupportED. I thank them all for being here.

It is necessary to continue to raise awareness so that, as knowledge improves, better care can be provided. An estimated 1.25 million people in the United Kingdom, and one in 50 people in Scotland, are living with an eating disorder right now. These devastating illnesses can affect anyone of any age, size, gender or background, and they can easily go undetected. We know that the signs and symptoms are not always visible or easy to pick up, but people’s symptoms can include spending a lot of time worrying about their weight and body shape; avoiding socialising when they think that food will be involved; eating very little food, making themselves sick or taking laxatives after they eat; exercising too much; having very strict habits or routines around food; and changes in their mood, such as being withdrawn, anxious or depressed.

Each year, eating disorders week takes a different theme that focuses on the many types of eating disorders. They include anorexia and bulimia nervosa; avoidant restrictive food intake disorder—ARFID—and binge-eating disorders; and variants that are classified under other specified feeding or eating disorders, or OSFED.

Last year’s debate highlighted ARFID, and those in previous years have included a debate on diabulimia, which is a condition where a person with type 1 diabetes deliberately omits taking their life-saving insulin in order to help them to lose weight. Eating disorders have the highest mortality of all mental disorders and have serious medical consequences, as well as risks of suicide.

A lot of work has been done in recent years, and there have been advances in treatments, as well as in tackling associated stigma. Inclusive services have been created to treat all people, regardless of age and severity, with the development of all-age services and early intervention approaches. Last year, the number of children and young people who presented to child and adolescent mental health services and were then admitted to hospital with an eating disorder increased rapidly. Children and young people are presenting to paediatric settings later and are often more physically unwell. In the past seven years, there has been a significant increase in the annual incidence among 10 to 14-year-olds.

The prevalence of anorexia nervosa in the general population is approximately 1 per cent among women and 0.5 per cent among men. It is reported that half of those who meet diagnostic criteria in the community do not access treatment. Bulimia nervosa is reported to have a prevalence of about 2 per cent, and binge-eating disorders a prevalence of up to 4 per cent. The population prevalence of ARFID is not known, largely because it is a relatively new diagnosis and is still not well known.

At the Scottish Government’s request, NHS Education for Scotland has delivered education seminars as a response to the high number of children and young people presenting. That is providing support and learning to staff who work in acute paediatric settings in order to help better support children and young people and their families. I am keen to hear from the Minister for Social Care, Mental Wellbeing and Sport about the uptake of those seminars, including attendance rates by NHS board and by clinician specialty, including general practitioners. It would be good to hear how GPs are engaging with assessment and onward referral for persons who have a suspected eating disorder. It would also be good to hear feedback on the uptake of the Turas online learning platform, especially in rural health boards such as NHS Dumfries and Galloway and NHS Borders.

The national review of eating disorder services in Scotland published its report in June 2021. The “Scottish Eating Disorder Services Review—Full Report” contained 15 short-term, medium-term and long-term recommendations. Subsequently, the national eating disorders network has been established, chaired by Professor Cathy Richards, to take forward the remaining medium-term and long-term recommendations.

It is interesting that the first recommendation related to the Covid-19 pandemic. It asked for emergency funding to

“be provided ... as a direct result of an increase in the number and severity of ... presentations related to the Covid-19 pandemic.”

The recommendation prioritised physical health stability, risk reduction, supporting in-patient discharge and preventing admission to hospital.

Recommendation 4 was to establish a lived experience panel to

“advise the Implementation Group and work alongside the National Eating Disorders Network.”

That recommendation advised that

“The ... panel should include patients, families and loved ones, and third sector representatives”,

with diversity of membership, including representatives of

“all eating disorder diagnoses, men with eating disorders, LGBT representatives and people from ethnic minorities.”

Again, I welcome members of the lived experience panel to the public gallery.

I also highlight recommendation 7, on early intervention, which states:

“Key Stakeholders and Healthcare professionals should be able to identify the signs and symptoms of all eating disorders including at early stages and know how to support and sign post people into treatment.”

The Scottish intercollegiate guidelines network’s guidelines from August 2022 contain key recommendations on early intervention, support for family and carers and achieving and maintaining recovery, as well as healthcare professional training. I remind members that I am a healthcare professional, as I am still a registered nurse.

Beat has developed training for health professionals that has the potential to save lives, and it is free. The Royal College of Psychiatrists recognises how important it is to have guidance across all healthcare settings, and it has created the “Medical emergencies in eating disorders (MEED): Guidance on recognition and management”. That replaces the previous management of really sick patients with anorexia nervosa—MARSIPAN—and junior MARSIPAN guidance.

A lot of actions have been implemented. I am conscious of time, so finally, I would ask anyone who has a worry about themselves or a family member to consider calling the Beat helpline in Scotland on 0808 801 0432 and speaking in confidence to an adviser.

There is so much work being done, and I say to the minister that it needs to continue at pace. I look forward to hearing colleagues’ contributions and the minister’s response.

As the minister is aware, many of the young people in Skye house were diagnosed with eating disorders. We know that compassionate care and treatment are essential parts of optimal recovery.

This week marks eating disorders awareness week. Can the minister advise how the Scottish Government is working to support improvement of in-patient eating disorder services and wider services in Scotland, including for people who require further care and treatment?

Does the First Minister share my disbelief and outrage regarding the United Kingdom Government consulting on giving English whisky a geographical indication, which would give it the same status as Scottish single malt? If approved, that move—which has been entirely enabled by Brexit—would trample on the reputation and tradition of our whisky industry and our Scottish brand. Does the First Minister agree with the Scotch Whisky Association’s view that the integrity of our single malt would be damaged by inferior whisky product, which could potentially harm industry, jobs and trade, including in the new distilleries in the south of Scotland and, indeed, across wider Scotland?

Good morning. I am thinking about the language that has been used and, in particular, the word “messy”. I think that the situation is complicated rather than messy.

The rural payments and services section of the Scottish Government’s website includes the whole-farm plan guidance that was published in October 2024. There are different steps that farmers can go through. There is a link to one page that lists the milestones that need to be reached by 15 May 2025. The guidance is about helping farmers—whether they are involved in small farms, crofts, dairy farming, beef production, sheep farming or whatever—to transition in such a way that there are no cliff edges. That is what we talked about when we considered the Agriculture and Rural Communities (Scotland) Bill.

The fundamental reform that you have talked about relates to how we support food production and food security. You mentioned the war in Ukraine. I do not think that the Government is sitting around not doing anything. People need to hear such assurances. All the work that is going on in the background with ARIOB and so on is part of the process of helping to support food production and food security in Scotland and beyond.

There are various platforms on social media in addition to Elon Musk’s X. Is the Government proactively looking at which social media platforms or other methods of communication can be used to promote such programmes?

Iain Carmichael has basically answered my question about the differences between crofters and bigger beef farmers, and I think that I understand that there are exemptions for conservation grazing or for small herds. I want to clarify that there is no one-size-fits-all policy but that there is engagement with everybody about how they will manage their plans for small crofts.

A few weeks ago, we had a round-table discussion with forestry folks. One of the issues that came up was the difficulty that farmers and crofters experience in accessing funding for agroforestry. I have had a look at the Government’s website, and I can see that there is support available for broadleaf planting, improving biodiversity and so on. However, I would be interested to hear whether the Government is working to make it easier for farmers to access grants for agroforestry.