Chamber and committees

Nothing beats hands-on clinical skills training, whether it is a simulation with mannequins or something else.

Education budgets are often the first to be cut, and clinical educators are then disposed of. Is there a way to take a standardised approach to certain clinical skills or methods of training so that the same course can be delivered for different professionals? I know that pharmacists, dieticians, physiotherapists and GPs have completely different roles, but is there an opportunity for some education to be standardised for multiple professionals?

Thank you.

The minister will be aware that I have been working to ensure that the MAT standards are implemented for rural parts of Scotland, such as Dumfries and Galloway and the Scottish Borders. Will the minister provide an update on how implementation is working in rural areas versus urban areas? Will she comment on how stigma reduction work is progressing in rural Scotland through, for example, the important work of local recovery cafes such as those that are run by Borders In Recovery, which has cafes in Hawick, Gala, Kelso, Eyemouth and Peebles?

The finance secretary will be aware of the unique challenges of rurality and depopulation that are faced by Dumfries and Galloway and the Scottish Borders. Will she further outline how the budget will support people in D and G and the Borders who are most impacted by the Tory-created cost of living crisis and will help to address depopulation and attract people to the region by improving transport and infrastructure?

I welcome the opportunity to speak in this debate and congratulate Keith Brown on securing it. Jamie Greene has just delivered a powerful contribution. I am pleased to follow him in the debate and I want to thank him very much for speaking today.

Keith emphasised the fantastic work of Fighting With Pride, and I join him in welcoming that work on connecting LGBT+ veterans to organisations that can help them with whatever their needs are. I welcome members of Fighting With Pride to the public gallery this evening.

Fighting With Pride was established on the 20th anniversary of the complete lifting of the gay ban on LGBT+ service personnel—the UK Government even called it the gay ban. Fighting With Pride supports LGBT+ veterans and serving personnel and their families, particularly those who were affected by the ban, which was ultimately lifted on 12 January 2000. Before then, thousands of LGBT+ service personnel were removed or forced from service and abandoned, as has been described already.

The ban on LGBT+ service personnel was wide ranging and deeply hurtful to all those who were impacted. Some of those who breached the ban were either dismissed following a court-martial or administratively discharged. Others resigned or did not extend their contract due to the impact of the requirement to continually hide their sexuality. The policy was not enforced uniformly across the armed forces but, where it was enforced, it was usually carried out in a rigorous and often brutal way with long-term damaging consequences.

An independent review of the impact of the ban was published, and the statements that were taken as part of the review present shocking evidence. The testimonies demonstrate a culture of homophobia, bullying, blackmail, sexual assaults, abusive investigations into sexual orientation and sexual preference and disgraceful medical examinations, including conversion therapy and discharges without appeal. That led to appalling consequences in terms of mental health and wellbeing and homelessness. That takes me back to the days of the “don’t ask, don’t tell” policy that was introduced in the United States of America, when I lived in Los Angeles. That policy was ended in 2011 by President Barack Obama. Such policies and practices have no place in any society, and I welcome the fact that we have moved on and that reparations have been made to those who were impacted.

I want to touch on the work of organisations across Dumfries and Galloway and the Scottish borders to support veterans and service personnel who are part of the LGBT+ community. The Soldiers, Sailors, Airmen & Families Association is a trusted source of support for serving personnel, veterans and their families in their times of need. It was founded in 1885, and the Dumfriesshire and Stewartry branch of SSAFA continues to do fantastic work for veterans. Its support covers regulars and reserves in the Royal Navy, the Royal Marines, the British Army and the Royal Air Force as well as their families, including anyone who has completed national service. The team in D&G knows and understands the unique demands of service life in the UK and overseas and, in times of need, they enable forces families to thrive.

I am interested in the work that SSAFA has been doing with the Armed Forces Covenant Fund Trust, which has awarded a grant, on behalf of the Office for Veterans’ Affairs, to assist with the delivery of specialist support on the Forcesline helpline. Funding of £25,000 is being allocated to Forcesline to uplift and fully support any additional and specific needs from the veteran LGBT+ community that might result from the pre-2000 homosexuality ban. I remind folk that the Forcesline number is 0800 260 6767.

That work is also publicised by the Veterans Garden in Dumfries, which is run by army veteran Mark Harper—no relation. Mark is doing an amazing job at that garden at the Crichton, which provides a safe space for veterans, regardless of their sexual orientation. I hope that the minister will visit the garden to see its updated premises.

I again welcome the debate and thank Keith Brown for all that he does to champion veterans’ affairs.

I forgot to remind the panel that I was a clinical educator in a remote and rural area delivering what you are talking about—ECG, blood draw and things like that. It was part of my job. I forgot to remind colleagues and the panel about that. Thanks.

I have a quick question for Jaki Lambert about remote and rural midwifery practice. Because NHS Dumfries and Galloway stopped allowing babies to be delivered at Galloway community hospital in 2018, women are now having to travel 72 miles, and babies are being born at the side of the road. Indeed, Michael Dickson might want to pick up this question, too. I know that there are challenges with regard to education, competency skills and recruitment, and safety, too, is obviously a huge issue, so I would be interested to what Jaki Lambert has to say about the necessary requirements for skills, development and safety when it comes to delivering babies.

I have just a quick question. Outside of current issues, does the Scottish Ambulance Service have enough capacity to deal with remote and rural areas? We are talking not just about emergency transfers, but patient transfer to appointments, too. How would you respond to that? Is there enough capacity?

Thanks, convener and good morning to you all.

I will pick up on innovation, but also link it to advocacy for communities—the staff as well as the people who are receiving the care. Is there a role for the new national centre to advocate for the people in the communities? One of the submissions was from Dr Gordon Baird on behalf of Caithness Health Action team, the “Save our services” campaign on the Isle of Skye, and Galloway community hospital action group. Dr Baird wrote that he was

“hoping to work with the new centre to provide information and understanding of national and regional issues and prevent ineffective repetition through feedback on the effectiveness of local solutions.”

Throughout his submission, I am thinking that the word “advocacy” is a part of that. Would you support that being part of the work of the national centre?

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?