Chamber and committees

Does that mean that, if someone is going to administer a dermal filler, they will need to have the antidote on site? Time is critical if the blood supply to someone’s upper lip has been injected instead of the tissue around it. That would mean that the antidote would need to be readily available at whatever site is determined to be a Healthcare Improvement Scotland-regulated clinic.

On the back of the questions from Joe FitzPatrick and Sandesh Gulhane, I note that hyaluronic acid is a dermal filler that is registered as a medical device by the Medicines and Healthcare products Regulatory Agency, whereas the antidote, hyaluronidase, must be prescribed. There could be an issue with that. Osteopaths who are not medically trained do not prescribe, but they can give a device. Does that create a problem? If so, what work is being done with the MHRA to examine how we regulate that device? I note that it is not actually a device but a medication that has to be injected.

I represent communities that are served by both the A75 and the A77, so I welcome the cabinet secretary’s announcement that work will progress to adjust speed limits for HGVs on single and dual carriageways. I have raised that issue previously with transport ministers. Will the cabinet secretary outline an indicative timescale for that work? Does she anticipate any changes being implemented on the trunk roads?

I am happy to support and speak to the motion, and I congratulate Rona Mackay on securing this debate on aphasia, which is a hidden communication disorder that affects many lives in Scotland, as Rona Mackay highlighted well in her opening speech. I, too, welcome everyone to the gallery.

Aphasia arises when the language centres of the brain are damaged, most commonly due to stroke but also through brain injury or neurological disease. It impacts a person’s ability to speak, understand, read or write and text, yet it leaves intelligence intact, which leads to misunderstanding and stigma.

In Scotland, the incidence of aphasia following someone’s first stroke varies across regions and affects approximately 54 people per 100,000 each year in NHS Borders. Given that a third of stroke survivors have aphasia, there could be as many as 128 new cases in Dumfries and Galloway annually. That means that, across the country, thousands are entering a world of sudden silence. Nationally, an estimated 350,000 people in the United Kingdom live with aphasia: nearly two-thirds of stroke survivors, which is more than those who are affected by Parkinson’s disease, multiple sclerosis or cerebral palsy. However, nine out of 10 people have never heard of the condition, which is exactly why we are here today, so it is worth having this debate.

I have heard of aphasia, because I have been a registered nurse since 1988. In my work, over many years, I have looked after many people with aphasia and I have witnessed not only the challenges that are faced by the person who is affected but challenges to my ability to interpret and provide the best care.

Without visible signs, many people with aphasia are dismissed as confused or even drunk, as Rona Mackay has stated. However, all that they need is for us to have patience and take a wee bit of time to understand them.

The consequences of aphasia can be profound and include isolation, loss of confidence, difficulty in work and relationships and mental health challenges. After my close friend Mike—who we sadly lost a couple of years ago—had a severe stroke, he was left without speech. We could see how frustrated he was, because he knew what he wanted to say, but he could not get the words out.

A research report that was published by Chest Heart & Stroke Scotland describes the devastation that is felt by people who are not able to communicate, which leads to feelings of isolation and loneliness and to mental health issues. We can and should do better. Thankfully, inspiring initiatives are emerging here and across the UK. Last June’s rocking aphasia campaign saw painted pebbles left in public places, with each stone holding a story, urging finders to learn more, speak slower and listen with intent. Similarly, City St George’s, University of London collaborated with Aphasia Re-Connect to use music in storytelling concerts, underscoring how much remains behind the silence.

What can we do in Scotland? First, we must raise awareness. We must share aphasia facts, such as the fact that the condition affects up to a third of stroke survivors and that society often misjudges those experiencing aphasia. We need public education campaigns during stroke and dementia awareness weeks. We can promote the use of simple communication tools, which include picture boards, written cues and supportive care packs, such as those offered by the Stroke Association.

Secondly, we must support speech and language services. Organisations such as the Aphasia Alliance, Chest Heart & Stroke Scotland and Dyscover provide essential therapy and specialist aphasia support and run community groups. Funding those services must be a priority, particularly in rural and island communities where provision is uneven, including Dumfries and Galloway and the rest of the south-west of Scotland.

Thirdly, we need community inclusion. Councils, transport providers, retailers and public services can take simple steps to adopt aphasia-friendly practices, such as using slower speech in announcements and displaying appropriate written signage. A wee bit of patience can transform lives.

Finally, we must listen to lived experience. People with aphasia know best what helps, which can involve everything from adaptive therapy sessions to everyday social events. They should be at the heart of policy conversations.

Let me leave members with this: aphasia is not rare. It is common, disabling and deeply isolating. However, with education, training, support and inclusion, we can give voices back to those who are silenced by aphasia.

Can the First Minister advise how the Scottish National Party Government is working to deliver our health service in Scotland, continue to drive down waiting times, and invest in a well-funded and well-supported NHS for those who need it?

The evidence is clear that Scotland’s NHS is turning a corner, with downward trends across nearly all waiting list indicators. To suggest otherwise does a huge disservice to our fantastic NHS staff. I suggest that Jackie Baillie and her colleagues think twice about the impact of their scaremongering about our health and social care system in Scotland and the effect that that is having on the wider population—and perhaps also reflect on the dismal record of their colleagues in Wales and England before turning to our record. [Interruption.]

I had a good long conversation with a member of the senior leadership of West Coast Sea Products in Kirkcudbright, in your constituency, convener, which is part of my South Scotland region. I learned about how shells are being transported to the Netherlands for poultry farming and to Ireland for freshwater filtration. There are uses for them, but there is a lot of detail in the amendment. I am not opposed to it, but I am interested in finding out more about how those measures would be taken forward, especially if further consultation and affirmative legislation were needed.

Are you saying that, because my amendments do not cover rivers such as the Tweed, we would need to work with Westminster if we wanted to alter legislation to bring the provisions for the River Tweed into line with my amendments?

In the interests of time, I will not say anything other than that it has been recognised that there are differences with the River Tweed.

I am content to work with the cabinet secretary ahead of stage 3, because Fisheries Management Scotland is keen to ensure that the drafting is correct. I am happy to withdraw amendment 273, to not move the other amendments in the group and to work with the cabinet secretary.

I have concluded.