Chamber and committees

I am interested in continuing professional development. I think that one of the witnesses has already alluded to the importance of it. The committee has taken evidence on the clinical skills managed educational network, and we have heard about the mobile skills unit that goes out to rural areas to provide simulation training and so on. I am interested in your thoughts on the requirements to value education. I say that as a former clinical educator, and I am still a registered nurse. My job was to work with allied health professionals and nurses in teaching clinical skills across NHS Dumfries and Galloway. What needs to be valued when it comes to continuing professional development?

Okay, thanks.

I will pick up on what Sharon Wiener-Ogilvie said about travelling a great distance to engage in education, whether it is paramedic training or other skills learning. I am aware of a reduction in relation to spirometry. That can be delivered by nurses, GPs and physios, but the quality and outcomes framework reduced the spirometry payments for general practices, so it is now not conducted there. That means that, in remote and rural settings, there will be a reduced ability to assess whether someone needs a chronic obstructive pulmonary disease or asthma diagnosis. That is just one issue that has come up. What is NES’s role in supporting education and continuing professional development?

You mentioned Turas digital training. I am familiar with that and know that it is valuable for some things, but face-to-face training is also valuable.

You made the point that integration means that work is patchy. You said that OTs are employed by local authorities. That probably needs to be investigated, so that the silo approach doesnae happen.

I am pleased to speak today and have enjoyed hearing members’ contributions. I add my support for the UN’s international day of persons with disabilities, which is an opportunity to reflect on how we can ensure that disabled people have freedom, dignity, choice and control over their lives.

I will focus my contribution on hidden disabilities and on the progress that Scotland continues to make to support those who are living with a disability.

The impact of living with a non-visible disability can be very slight, or it can have a huge effect on one’s life. I note that I have an invisible disability: I have type 1 diabetes, which is included in the Equality Act 2010. I know that there are people who have type 1 diabetes who do not consider themselves to have a disability, but it means that they have, at work or at school, protection from discrimination that is based on their diabetes. It is hard, and it can be challenging, to manage blood glucose wherever your work takes you, and it is worth raising that.

It is estimated that 70 to 80 per cent of disabilities are invisible, and there are a wide range of impairments and conditions that are not visible to others. Those include mental health conditions; autism and other neurodivergencies; cognitive impairments; hearing, vision and speech impairments; and energy-limiting conditions such as fibromyalgia and, since the pandemic, long Covid.

I will pick up on something that Oliver Mundell mentioned in his intervention on the minister about the Usual Place in Dumfries, which provides people with different abilities, including hidden disabilities, with education and training for employment. I again highlight the work of the Usual Place, and I re-emphasise calls for the Scottish Government to provide it with any support that it can give.

Because an invisible disability is not outwardly observable, people who are living with one often face disregard or disbelief about their disability. One of my councillor colleagues, who has multiple sclerosis, told me about a member of the public who had a right good go at her. He was harrumphing right in her face because, from just looking at her, he did not believe her to be disabled when she parked in a disabled space outside a grocery store. She was having a good day with her mobility that day and had used a disabled space so that she did not overexert herself.

Many people with invisible disabilities report unequal opportunities and difficulties accessing the services and support that they need. Removing societal barriers for people with invisible disabilities enables them to participate fully in day-to-day life, including work and education.

I thank Martin Whitfield for that intervention. We recently had a debate that mentioned having, in toilets, facilities for people like me, so that I can put my insulin pump down when I need to change it, or for people with a colostomy, for instance. We need to be cognisant of what our public services and hospitals have in the way of facilities for people with hidden disabilities.

We need to improve awareness and understanding of invisible disabilities, to reduce stigma and exclusionary practices and to support self-identification and disclosure of hidden disabilities. Disability charities including Inclusion Scotland have stated:

“Accessibility standards that address barriers in built and online environments may improve access and inclusion.”

That covers public awareness raising, such as by extending the “Not Every Disability is Visible” campaign and persistent work to combat the stigma that surrounds hidden disability. I ask the minister for assurances that people with hidden disabilities will be on an equal footing, as the Government progresses legislation to enshrine the human rights agenda in Scots law.

Social security is a human right. Being disabled or having a long-term health condition can come with a wide range of extra costs, as other members have mentioned. The costs can include paying more for accessible transport, equipment or therapies. The Scottish Government, through interventions including the adult disability payment, the child disability payment and the carer support payment, wants to ensure that people with a disability and their carers get all the extra financial support that they are entitled to.

A nationwide campaign was launched in the spring to raise awareness of available social security and to help to remove stigma around applying for the support that people are entitled to. It is welcome that this is the first time in the UK that disability benefits have been proactively promoted on television and social media as part of a national advertising campaign. Like disability stakeholders, I would welcome an update from the minister, in time, on the success of those advertisements.

As the motion indicates, if Scotland is to be a modern and inclusive nation, as we aspire to be, we must respect, protect and fulfil all internationally recognised human rights. The upcoming human rights bill seeks to do that. The Scottish Government has ambitious proposals that will protect and promote those rights in every aspect of life in Scotland, and will ensure that they apply equally across society. I welcome that happening, as we move forward.

I support the motion and I look forward to hearing the minister’s response.

I have previously raised regeneration and economic renewal in relation to addressing the many vacant, abandoned and derelict sites across south Scotland, such as the Arches restaurant in Stranraer and the Interfloor factory in Dumfries.

Does the cabinet secretary agree that it is crucial that funding to address derelict sites ensures that rural areas such as D and G are included? Will he agree to meet me to discuss how those sites can be better addressed?

Does the new national centre for remote and rural health and care need to have an advocacy role to address some of the challenges that people might have with their healthcare, no matter whether we are talking about adult, child or maternity services? I am interested in how we advocate for patients when they feed in to the system to ensure that the system reacts.

Just to pick up on that suggestion of a whole-system approach, Professor Smith, I was reminded of some of the challenges that we have experienced in our local casework. For example, the bus from Stranraer to Dumfries doesnae have a toilet on it, and people have been feeding back to me that they avoid taking their diuretics on the way to hospital appointments, which they shouldnae be doing. At this point, I remind everybody that I am a registered general nurse in Dumfries and Galloway, which is quite remote and rural in many places.

When you talk about a whole-system approach, it makes me think of that example: we have asked for a toilet, but the bus company or the regional transport partnership are not even on the integration joint board or part of the health and social care partnership. Obviously, part of the system is not connecting if people are having to avoid taking medicine on the bus, just because the journey might be two hours and there is no loo available. That is an example of how part of the system is not working right now.

Good morning. It has been interesting to listen to the discussion and to hear colleagues’ questions. I am interested in looking at how the Government will develop policy in the future.

In preparing for this inquiry, I accessed loads of papers and research related to remote and rural healthcare, whether for adults, children or maternity services. I have in front of me a 2007 report from the remote and rural steering group. There have been discussions with Lewis Ritchie, there have been Derek Feeley papers and I remember Jason Leitch talking about the Nuka healthcare system in Alaska being used to develop rural healthcare in Scotland—that was in 2000. We have been talking about how we deliver healthcare in remote and rural areas for decades now. I know that the issue is complicated; indeed, that is why so many policy papers have been discussed.

What current issues must the Scottish Government address in order to deliver remote and rural care? The situation has been challenging after Covid, but we learned from the pandemic when we immediately switched to the Near Me platform. I am interested in hearing your thoughts about current Government policy and what we need to do as a matter of urgency.