I have been contacted by many constituents who rely on the 500 bus service, which serves communities from Stranraer to Dumfries. Many people use the service to travel to hospital appointments, employment and social events. The journey can take in excess of three hours and there is no toilet on the bus. If there is a toilet, it is often locked, because the transport body, SWestrans, has never included a toilet in the contract. Does the minister agree that that is unacceptable? Could he suggest whether some kind of guidance could be created for regional transport partnerships to ensure that that situation is rectified and that it does not happen in other parts of Scotland?

To ask the Scottish Government what engagement Transport Scotland has with regional transport partnerships, such as SWestrans, regarding contractual requirements for key local public transport services, including the provision of rural buses. (S6O-03989)

I am pleased to speak in the debate for world COPD awareness day, and I thank Marie McNair for bringing it to the chamber—she covered the topic very well in her contribution.

Raising awareness about chronic obstructive pulmonary disease, or COPD, in Scotland is important to me. In session 5 of the Parliament, I was able to create the cross-party group on lung health, and I now co-convene it with my colleagues Alexander Stewart and Mark Ruskell; I am pleased to see Alexander Stewart in the chamber.

I thank the CPG’s excellent secretariat—the function is provided by Gareth Brown from Asthma and Lung UK Scotland—for its continued support and for the briefing ahead of this debate. I also thank Frank Toner and the team at Chiesi for their briefing ahead of the debate.

There is so much that we could cover on COPD care, but the goal today is to shine a light on the challenges of COPD and what we can do together to make a meaningful difference.

For many, the COPD journey begins with symptoms that might be easy to dismiss: a lingering cough, shortness of breath, wheezing or chest tightness. However, as the disease progresses, those symptoms escalate, impacting mobility, independence and quality of life.

Sadly, COPD is among the leading causes of hospital admissions in Scotland, placing a significant burden on our healthcare system and families alike. The exacerbations lead to hospital admissions. In Scotland, COPD accounts for about 122,000 emergency bed days annually, with an average in-patient stay lasting four to eight days, which is assessed as costing around £3,000. It is projected that the cost of COPD treatment will reach £207 million by 2030.

I was pleased to have invited one of the lung health choirs to sing in Parliament in 2018. I mention choirs, because singing is part of pulmonary rehab and the improvement of lung function that I will come on to speak about. The Cheyne Gang, which is another choir, has also sung in Parliament. Singing is an excellent way to improve lung function. It teaches a person to breathe more slowly and deeply, which helps use the full lung volume.

There are now 11 lung health choirs across Scotland. In addition to improving lung function, joining a choir and participating in learning new songs, singing, meeting new people and being part of a group with shared interests also tackles isolation and improves socialisation.

One aspect that COPD groups want to be supported is better diagnosis. Raising awareness about the signs and symptoms of COPD is essential to encourage people to seek medical advice sooner. Educating the public, especially those at risk, such as current and former smokers or individuals exposed to pollutants, as Marie McNair has described, can help to catch the disease in its earlier stages, when interventions can have the greatest impact. I ask that the minister considers Asthma and Lung UK Scotland’s request to run an awareness-raising campaign for COPD.

Supporting those who have already been diagnosed is equally vital. Part of that means advocating for better access to pulmonary rehabilitation programmes. Those programmes are supervised by health professionals and offer a mixture of education, exercise and lifestyle support to improve muscle strength, breathing and mental wellbeing. PR programmes last about six to eight weeks.

Originally, PR was delivered face to face, but Covid meant that it moved online, where it can still be delivered successfully. I would be keen for the minister to provide an update on the implementation of pulmonary rehab across the health boards as set out in the respiratory care action plan.

Finally, I declare an interest as a registered nurse. I give a wee shout out to my nurse consultant sister, Dr Phyllis Murphie, who got her PhD recently. She lobbied me to take action to create the cross-party group on lung health and urged me to lobby the Government for a formal plan to improve respiratory care in Scotland.

It is important that children and young people receive all the support that they need to flourish and thrive, including children and young people with a disability or additional needs who are in rural areas such as my South Scotland region. Will the minister set out what the Scottish Government is doing on additional support for learning for children and families in more remote and rural areas?

I wonder whether Carol Mochan is aware of the work of Dr John Lockhart, who worked with the University of the West of Scotland to look at the prevalence of COPD in the south-west of Scotland and in Ireland? The evidence that he has produced is quite interesting, as it shows that there are links.

I do not want to take us down a rabbit hole about vaping, but does the minister agree that we should be concerned about the increased prevalence of vaping, including among young people, and its links to COPD?

Okay. Would that include pharmacy staff? I saw Fiona McIntyre nodding.

Before I come to my question about conscientious objection, I ask Rami Okasha what he meant when he said that there is a definition in the bill that would open it up more widely. Is that the definition of terminal illness?

Would you prefer further provisions in the bill to protect professionals if the bill progresses and becomes an act?

It seems that 13.47 per cent of GPs responded to the survey that was conducted by the Royal College of General Practitioners. Is that quite a low number? Was it a UK-wide survey?