Chamber and committees

Lord Brodie’s interim report provides us with an important opportunity to reflect on the lessons learned. I am pleased that we now have a clearer understanding of what happened at the Royal hospital for children and young people. At the time, many of my constituents were deeply concerned by the delays and confusion relating to the opening of that new facility in Edinburgh. For those who were affected, all that was unnecessary and added an extra layer of stress at already difficult times.

As the cabinet secretary will be aware, a number of hospitals will require renewal and replacement in the coming years, including the Belford hospital in Fort William and the Gilbert Bain hospital in Shetland. Looking towards those projects, will the cabinet secretary outline what lessons have been learned from the Scottish hospitals inquiry, so that we do not find ourselves in a similar position further down the line?

Forgive me, Presiding Officer. I missed the time that you said I had.

A generous four minutes. That is very kind of you. Thank you.

I am pleased to speak on behalf of the Scottish Liberal Democrats in this important debate. I am grateful to Neil Gray and the Scottish Government for making time for the debate this afternoon.

Scotland has always been a nation of medical pioneers. From the discovery of penicillin to the invention of the hypodermic syringe, we have a proud history of innovation that has saved millions upon millions of lives. Although we are rightly proud of our history, we must not lose focus on where we are heading. It is clear that we need action, investment and leadership to drive the next generation of medical breakthroughs and reform a national health service that has been operating in crisis mode for years.

Scotland’s medical technology sector is thriving, with more than 250 companies employing more than 9,000 people. It is growing at an impressive 8 per cent a year, against market conditions that we know all too well. However, while the industry moves forward, our NHS remains stuck in the past. It is slow to adapt and is being held back by outdated systems that do not speak to each other and a Government that is too risk averse to embrace change. We should be leading the way, but instead we are still lagging behind.

That has not been helped by the UK Government’s cancellation of £500 million in AI research funding. If we want to move forward, we need to back innovation—not cut it off at the knees. AI is not just an idea for the future; it is delivering results today. For example, in Mid and South Essex NHS Foundation Trust’s area, machine learning was used to cut did-not-attend rates and fill last-minute cancellation slots, thereby preventing nearly 600 wasted appointments in that small region of the country alone. Imagine what that could mean for the Scottish NHS: fewer missed appointments, shorter waiting lists, and more time spent giving patients the care that they deserve, in the time that they deserve to have it. We have already seen the potential. To give another example, the system developed through the GEMINI project—Grampian’s evaluation of Mia in an innovative national breast screening initiative—has boosted breast cancer detection rates by 10 per cent. Such technologies are already making a difference, and they are saving lives. We need to embrace them if we are to shift our NHS from being a reactive service that is constantly in crisis mode to a proactive one.

We also need to make NHS tech more robust across the board. Cyberattacks on our health service, particularly those carried out through ransomware, have cost the taxpayer tens of millions of pounds. A stronger, smarter electronic infrastructure would not only prevent such attacks but make the entire system more efficient and secure. I need not remind members that we live in an increasingly hostile world, where the online cyberlandscape is the new battlefield. New technologies present us with a real opportunity, and Liberal Democrats want to see us seizing that. To do so, we need real leadership.

Agreements such as those enabling the health and transformation partnership and the work of the accelerated national innovation adoption pathway are steps in the right direction. I am pleased that the Government is now considering that approach and taking it seriously.

I am also glad that, later this year, we will see the introduction of the NHS app, which we heard about earlier in the debate. Right now, our systems are outdated and rely on bits of paper. All members see that in our weekly surgeries. For example, I remember raising in the chamber the case of a woman who had been referred to the dental hospital with suspected mouth cancer. She presented me with a letter that had printed on it the date of its dictation, which was three months before the letter was typed up. We are still using technology from the 1970s. Those bits of paper are passed between patients and medical teams, getting lost on the way. Sometimes, for example, the use of a broken fax machine can mean patient care being delayed. That is right—a fax machine. The NHS must be the only arm of our public services that still uses those outdated and obsolete technologies. Patients and staff alike are fed up with the day-to-day friction that is caused by a startling lack of innovation. That is not the fault of our hard-working NHS practitioners or our care staff; it is just a constipation in the delivery of the technology.

As he typically does, Paul Sweeney makes a good point. He speaks to a frustration that exists right across the NHS, in every directorate and in every department. Innovation is not in short supply; there is lots of it in our health service. What we lack is the delivery and execution of such innovation. There seems to be a constipation, or a fear of delivery, which we need to break through. There is low-hanging fruit there, and relatively quick fixes can make a huge difference. Let us make use of the technology that exists and grasp the technology of tomorrow. Let us back our brightest minds, invest in cutting-edge research and embrace creative solutions to the problems that we face. The tools are there, and so is the talent. Now it is time for the political will and, more importantly, the delivery to match that will.

Does the cabinet secretary recognise that the Equality Act 2010 came from a recognition that vast swathes of minorities in our communities were facing violations of their human rights and regular abuse, and that it was a necessary act that has functioned well?

I must make some progress, I fear.

The area of policy that we are debating this afternoon is one in which my party has long-held commitments. Those commitments are rooted in evidence and stem from the same understanding and principles that gave rise to the original gender recognition act—the Gender Recognition Act 2004—and the relevant aspects of the Equality Act 2010. That understanding stems from the reality that, for the vast majority of people, biological sex at birth matches their gender through life: a person is born a boy and they grow up to live as a man, or they are born a girl and they grow up to live as a woman.

However, for a tiny proportion of the population, that is simply not true—they come to understand that their gender and their biological sex at birth are not the same and they feel as though they have been born into the wrong body. In times past, that would have brought feelings of self-loathing and massive stigma in a society that feared them or refused to believe that they existed at all.

Our role as parliamentarians is to legislate and to govern for all our constituents, especially those who are in any kind of distress or who are likely to be marginalised in any way. That is not an obsession—it is our duty and our job. Across our family of nations, we have taken big strides to recognise and protect the rights of our trans constituents.

Because the issue has been mentioned, I want to touch briefly on gender recognition. The Gender Recognition Act 2004 finally allowed trans people to have their gender recognised and recorded by the state in the legal architecture that underpins their lives. I am talking about things such as birth certificates and death certificates. I am talking about the dignity of having who you are acknowledged by the state in the documents that you are legally required to hold.

However, after 10 years of operation, it became apparent that the gender recognition regime was flawed, as it was overly intrusive and traumatic for those who went through the process. There was a time when the Parliament was united in understanding the need for that regime to be reformed. For Liberal Democrats, the question of how we can take a humane approach to gender recognition remains unanswered, but the heat and the division that have engulfed the issue mean that to press on would serve only to harm the people whom we are trying to help.

So, we are not looking to relitigate the issue. Realistically, change will be brought about only by going back to first principles, fostering consensus and working across the four nations of these islands to make sure that there are no cross-border barriers to mutual acceptance.

I turn to the substance of the motion. The debate about single-sex spaces and who can use them is not a new one. For most of history, trans and non-binary people were viewed by the state through the lens of the biological sex that had been assigned to them at birth. That meant that they could not use public services or public spaces freely, which the courts rightly regarded as a fundamental breach of their human rights. Not unreasonably, they concluded that trans people need to recover from operations in hospital, try on new clothes or go to the toilet when shopping in town. Therefore, provision was made for them in the articles of the Equality Act 2010.

Crucially, as we have heard, that legislation also allowed organisations and public bodies to exclude trans people from single-sex spaces, when to do so represents

“a proportionate means of achieving a legitimate aim”.

That legal phrasing was deliberately left open to allow flexibility in the application of the law in places in our society where the complexities around the provision of single-sex spaces require such flexibility, and the courts have backed that up.

I know that many people—some of whom will be watching today’s debate—have questions and even some concerns, but agreeing to the motion is not how we should go about giving them comfort. Indeed, the Conservative motion seeks to reverse the progress that we have made for our trans constituents in this area, and to take us back to a time when they were stigmatised and ostracised in our society. If we followed it through to its natural conclusion—that toilets and changing rooms should always be biological single-sex-only spaces—who would police that? How would someone ascertain the biological sex at birth of a trans person who was seeking to use a changing room in John Lewis or a toilet in a garden centre or a high school? There is no policy that the Parliament could enact that would satisfy the movers of the motion and would not, ultimately, be confusing or cause far greater upset.

I will conclude by challenging the suggestion that is falsely implied in the motion—that trans people want to use spaces such as toilets or changing rooms to abuse or harass women and girls. We know, and empirical evidence tells us, that, by any metric, by far the biggest threat to the safety of women and girls comes not from the trans community, but from predatory men.

I think that our parliamentary time this afternoon would have been far better spent addressing that urgent reality.

In the time that I have, I will lay out the position of the Scottish Liberal Democrats in respect of the Scottish Conservative Party motion that is before Parliament today.

Let me say at the outset that my party is wholly committed to the safety of women and girls, and to tackling the violence and abuse that they still face all too often. However, we are not persuaded that the Conservative motion would deliver progress towards that.

Will the member take an intervention?

Does Brian Whittle recognise that this is, as such, a particularly Scottish problem and that we probably need a particularly Scottish solution? To that end, does his party support the further devolution of some aspects of the Misuse of Drugs Act 1971?

My first memory of the threat that was posed to our country by Covid-19 is of the images that were broadcast on the evening news of primary school children passing around a basketball that was covered in chalk dust so that they could learn about viral transmission. Within a matter of days, we had gone from those cheerful and charming images to the Government commissioning the NHS Louisa Jordan and requisitioning private ice rinks to bolster mortuary capacity.

I do not think that anyone in the chamber or in wider public life will ever forget the enormous impact that the pandemic had on all our lives, an impact that reverberates to this day. In some ways, it will always define part of us, just as it has defined our politics and our society for the past five years. Indeed, it has pulled on every thread that makes up the fabric of our communities, dominating our health system and impacting on education and the economy.

So many of our young people are still suffering under the long shadow of lockdown. That is borne out by the huge number who are still waiting for help with their mental health. Waiting times across our national health service have not improved, and 168,000 Scots are still living with the debilitating effect of what Covid can become. Adults and children alike are fighting against long Covid every day.

Moreover, many of Scotland’s high streets are still empty compared with how they were before the pandemic. All of us are, at some level, still recovering from the trauma of not being able to see or hug our loved ones, of not being able to attend their funerals when they passed away—as so many thousands sadly did—and of the disaster in our care homes.

We all hope that we will never have to live through such an experience ever again, but in the Parliament, we need to deal with events as we find them, rather than how we would wish them to be. As such, we must be guided by the lessons of the previous pandemic when it comes to dealing with the next. There is a lot that can be said about our response to Covid—for better and for worse—and about the decisions that were made, the transparency of the decision making and the way in which rules were made and followed, but that discussion is not for now.

Today, we remember the many people who have died and the many who fought to keep them alive, including our key workers and our health and care workers. Today, we remember all those who are still living with the pandemic’s cruel impact, and we wish comfort to those who grieve and those who still live and toil under its shadow.