Chamber and committees

We are talking about the delay in diagnosis. The First Minister’s reassurance will come as cold comfort to everyone who is waiting for the post this morning in want of an appointment for diagnosis. His regret will not save lives.

In Scotland, more people die of lung cancer than of any other form of the disease. It kills 4,000 Scots every year. If someone comes from a poorer background, their chances are far worse. Three years ago, the United Kingdom National Screening Committee recommended that the whole of the UK introduce lung cancer screening to help to prevent the disease or to catch it early. Screening would be targeted at those who are at the highest risk—people aged between 55 and 74 who smoke or who used to smoke. Experts have called the recommendation a “game changer”.

Survival rates for lung cancer in Scotland are not much better than they were in the 1970s. That intervention could save hundreds of lives every year. The cancer screening programme is being rolled out across the whole of England, but not here. Why not? Why are we years behind? Why are we so slow? Why are Scots missing out on that life-saving detection service?

I welcome the minister to his new role.

Improving neurodevelopmental care pathways is such a vital issue for the Scottish Liberal Democrats that we used our only debating day this year to bring a debate on it to the Parliament. People should not have to wait seven years for a diagnosis or to face life-defining exams without support. The minister’s statement is utterly silent on the issue of shared care, which we raised in our debate. It used to be that families could get a private diagnosis and thereafter obtain a national health service prescription, but that option is no longer available in the NHS Lothian area. Doctors have ended it because of concerns about the credentials and safety of private diagnosers, but also because they fear that they could be overwhelmed. The executive medical director of NHS Lothian has now written to several practices to say that she cannot support that decision. There is an impasse between NHS Lothian and local general practitioners. Will the Scottish Government bring those two parties together to agree a protocol for shared care that can be delivered safely, with adequate resources, to ensure that people can start being seen?

Presiding Officer, on behalf of the Scottish Liberal Democrats, I thank you for your service to the Parliament as an MSP and, in particular, for your commitment to the integrity and values of this chamber. We wish you well.

I listened to what the First Minister had to say about cancer and to his digging into the statistics of one health board, but this comes down to the fact that, when cancer is coming for someone, they deserve to know that they have the best possible chance of survival. Under this SNP Government, that is not happening. Even if we have not had cancer, we will know somebody who has, and treatment times for patients who are referred with an urgent suspicion of cancer are worse than at any point on record. When this potentially lethal disease turns someone’s world upside down, the last thing that they need is a long wait for life-saving care. Does the First Minister not think that those people deserve better?

Sharon Dowey says that the EHRC has given clear guidance following the Supreme Court judgment. She must not have seen the select committee’s evidence hearing with Baroness Kishwer Falkner of the EHRC, at which anything else was true—it was certainly not clear. Lord Sumption and Lady Hale have said that the possibility of misinterpreting the judgment by the EHRC is clear and redolent. What does Sharon Dowey have to say to those eminent former Supreme Court justices?

But—

I am pleased to speak on behalf of the Scottish Liberal Democrats but I am ashamed that, as the cabinet secretary rightly pointed out, I am one of only four men in the chamber. This issue should matter to all of us. As I said in my intervention, we will only get meaningful progress if we enlist men as allies in the crusade and change the way in which we raise our boys. That is a lesson to all of us.

The Liberal Democrats absolutely welcome this first annual statement on gender policy coherence. It is right that the Scottish Government has responded in the way that it has done to the recommendations that were laid out by the national advisory council. Recognition matters, and the statement recognises that gender inequality is structural, persistent and entirely unacceptable in modern Scotland.

However, recognition alone of that fact is not enough. The cultural shift that we seek towards genuine gender equality demands action and delivery from the Government and from us all as parliamentarians. It demands that women’s voices are heard and respected, not only in policy papers but in this Parliament and in the council chambers across Scotland’s 32 local authorities. We are still far behind where we need to be, particularly when it comes to female representation in those local authorities.

I would like to focus my remarks specifically on health and health inequalities. In 2021, one in five women aged 16 to 24 reported a mental health condition. When it comes to physical health, women live longer than men—that is a statement of fact—but they spend less of their lives in good health. We have also seen tangible examples in recent years of how women’s health concerns are too often downplayed and treated as an afterthought. I will never forget—and I am sure that colleagues will never forget—the injustice faced by the women who suffered the devastating effects of transvaginal mesh implants and how they had to fight to be recognised and compensated. If it had been an implant for males, I am not sure that the fight would have needed to be so long lasting or so strong, but there we are.

The women’s health plan that was introduced in 2021 was a step forward. It rightly widened the lens beyond reproductive health and included menopausal care, post-natal contraception and conditions such as cardiac disease—areas that are too often overlooked or misunderstood in women.

Meghan Gallacher makes an excellent point. It is incumbent on us all, in debates such as this one, to remind young women in particular of the health interventions that are available to them, which could keep them in better health or even save their lives or protect their unborn children. I will come on to talk about younger women if I have time.

The appointment of Professor Anna Glasier as Scotland’s first women’s health champion was absolutely a step forward, but for many, the progress still feels painfully slow.

Endometriosis is another stark example of an area that is misunderstood. Too many women continue to suffer for years before receiving a proper diagnosis or treatment. That is not equality of healthcare.

If we are serious about gender equality, we must also transform access to work. Today, women in Scotland are more likely to be in insecure work, stuck in low-paid, stereotypically female sectors, and less likely to reach senior roles, even with the same qualifications as their male peers and even with the policies that the Parliament has introduced. That is still a fact. That must change.

The 1,140 hours of free childcare for three and four-year-olds is key to that. As we know, the bulk of childcare still falls on women, despite our wish to change our societal norms. Across much of Scotland, local authorities are cutting back on that provision by providing free hours from the term after the child’s third birthday, rather than from the day after their birthday. That means that many families are missing out on up to four months of free provision. Again, women bear the brunt of that.

The Government needs to ensure that local authorities are provided with the funding that they need to roll out support consistently across the country to avoid that postcode lottery. The last thing that mothers who are trying to return to work need is an unfair roadblock. My party wants to go further by extending funded entitlements so that more two-year-olds get the benefit, with a view to extending the provision to one-year-olds as well.

However, all those policies must be backed with workforce support, proper pay and reliable delivery, or they risk becoming empty promises. That brings me to the unpaid workforce that keeps our society going. In 2023-24, 73 per cent of unpaid carers were women. One in four economically inactive women cited looking after family and home as the reason for their being economically inactive. That is nearly four times the rate of men.

The Liberal Democrats have consistently championed carers’ rights, and we have led calls to make the carers allowance system fairer and more flexible. We won an increase in the earnings threshold for carers allowance, allowing unpaid carers to earn more from part-time work without losing vital support through benefits.

I welcome the ambition and focus of the annual statement, but action and delivery are what count.

Will the member give way?

On that point—

Yesterday, my colleague Willie Rennie told the chamber that public service reform should be boring. So far, the statement is doing a good job of keeping the promise of that directive.

The real path to reform must embrace the transformative technologies that are now at our fingertips. Our universities are packed with research projects on AI, but risk aversion in the national health service and a lack of dedicated funding mean that such projects are not making it to the front line, where they could bring down waiting times and improve patient outcomes. How does the Government plan to roll out the use of AI and other emerging technologies, where appropriate, to deliver faster, smarter public services?