Chamber and committees

I must make progress.

Indeed, it was many months from the group’s first request, and several embarrassing First Minister’s questions, before the cabinet secretary first met Long Covid Scotland.

The outlook for support remains bleak, and we have heard nothing to change that today. John Mason, unwittingly, did the job of those on the Opposition benches when he revealed his Government’s failure of sufferers of long-term conditions such as ME during its 15 years in office.

I am haunted by the words of eight-year-old Anna Goss, who, in describing her condition, said, “I hate it.” You can hear the anger and frustration of such a young life so badly restricted by a condition that no adult around her can fully explain, and for which she is not offered adequate support. Anna cannot wait for the amassing of data that Gillian Mackay described as a “prerequisite to support”. We can help her today, but Ms Mackay’s Government chooses not to.

What is more, we can protect children like Anna—or those who might become like her—not by cutting off the bottom of classroom doors but by installing high-efficiency particulate absorbing filters in every classroom in Scotland, which would clean the air and allow children and their teachers to breathe. If Government policy is to live with Covid, we have a duty to protect our children from what it can become.

It is clear from the factual and clinically informed speeches that have been prepared for SNP MSPs today that the Government understands the pathology of long Covid, but I am not persuaded that it understands the humanity or urgency of this awful condition.

Sandesh Gulhane has described his experience in the foothills of the pandemic. Does he recognise that people who had long Covid from the first wave perhaps did not have a positive test result on their medical records, because we were not testing at that point? Similarly, we are not testing now, so people who develop long Covid as a result of their infection will again have to fight to get that diagnosis.

I have heard several Government members say that a one-size-fits-all approach will not work, and that is right, but does Evelyn Tweed not recognise that, up until this point, what we have had from the Government has been a case of no size fits all?

Will the member take an intervention?

Finally and belatedly, we debate this devastating condition in Government time. It is shameful that the SNP-Green coalition has made sufferers wait this long.

Long Covid was first recognised more than 18 months ago, as we have heard several times. It affects more than 150,000 Scots and that figure is rising. It has been characterised as possibly the biggest mass disabling event since the first world war, but the Government’s progress on it has been utterly glacial.

Long Covid is insidious, debilitating and widespread. It manifests in any combination of hundreds of symptoms, including air hunger, diarrhoea, muscle spasms, brain fog and chronic fatigue. It ruins livelihoods and it hobbles lives.

Until now, sufferers have been deprived of a voice in the proceedings of the Parliament. Today, they speak through those of us, such as me, Jackie Baillie and Dr Sandesh Gulhane who, from the Opposition benches, have dragged the Government to this point. Today we speak for sufferers such as Anna, who, at just eight years old, has had her education and her childhood ruined by long Covid. When asked by her mum Helen Goss, one of the founders of Long Covid Kids, to describe her condition to the first meeting of the long Covid cross-party group in the Parliament, she did so using just three words: “I hate it”.

Anna is just one of more than 10,000 Scottish children who are battling the condition and who seldom get the attention that they deserve.

I speak today for Stuart, my constituent, who is with us in the public gallery. He is a man of an age with me. He had his whole career before him but now cannot be sure whether he will have the strength to leave the house on any given day. Even now, despite the belated recognition in the remarks of the cabinet secretary, each of those people, and the 150,000 people like them, would be better off moving to England where there are long Covid clinics, care pathways and dedicated research trials.

On this matter, the Government has been woeful. Only after considerable pressure did the cabinet secretary announce £10 million for long Covid in September last year. Until this month, however, not even a penny of that money had been allocated.

Prior to that point, and at every time since, long Covid has only ever been raised in the chamber during Opposition time. In November, I led the first parliamentary debate on the matter. In January, my colleague Beatrice Wishart asked the Government to provide an update on the impact of long Covid, and she was told it would perhaps be discussed as an option at the bureau. In February, I highlighted to the First Minister that fewer than 1 per cent of long Covid sufferers had been referred to the Chest, Heart & Stroke Scotland support service. She told me that there was no need to intervene. In March, Jackie Baillie, Sandesh Gulhane and I pressed the First Minister on why none of the £10 million had been allocated to the long Covid support fund, or had even been spent. She said that the allocation would be made in the following weeks, but weeks and weeks have passed.

The weeks and months have passed and the SNP-Green coalition’s approach to this awful condition is one of manifest disinterest. To add insult to injury, neither party could be bothered to send a representative to the national long Covid hustings ahead of the council elections.

I say to the Government, both SNP and Green, long Covid sufferers see you and they will find you out. The announcement that £3 million will be spent this year is eight months too late. It is wholly unequal to the challenge and it will not touch the sides, but that is what we have come to expect from the Government when the main resource that it has made available to sufferers during these past two years has been the Chest Heart & Stroke Scotland support line.

Make no mistake—that is a valuable service for those long Covid sufferers who reach it. It offers them a safe way of speaking to their advice line nurses and provides wider support through the long Covid patient support group. I want to make it clear that my frustration about the lack of progress is not about the Chest Heart & Stroke Scotland service, but that fewer than 1 per cent of long Covid patients have been referred to it. The First Minister might believe that there is no good reason to intervene, but I can assure her that there absolutely is. There is currently no primary care pathway to the service, which means that when someone with long Covid visits their GP, it is unlikely that they will be referred to the service automatically. They might be lucky enough to have a GP who is aware of the support line and encourages them to call it, but many will not be.

In England, by contrast, people who visit their GP about long Covid can be referred to a post-Covid clinic, where they can be assessed by a doctor, a nurse or a physiotherapist. The Government may say that those clinics do not always get the best feedback, but at least patients in England have the option of using them. That option is not available here. As a result, Scottish sufferers are being left far behind and are not getting the help that they need.

The Scottish Government must recognise the enormity of the public health disaster that the long Covid situation represents. The cabinet secretary must start listening. He must listen to Chest Heart & Stroke Scotland, which has told ministers that an integrated automatic referral system needs to be put in place; he must listen to Long Covid Scotland and the other third sector organisations that are calling for a human rights-based approach to provision; and he must listen to long Covid sufferers such as Stuart and eight-year-old Anna, who are crying out for him to take account of their experience and to act.

When Scotland’s pandemic story is written, the tragedy of that story will undoubtedly be found in our care homes, but the scandal of that tale will be told in the Government’s indifference to Scotland’s long Covid sufferers.

I move amendment S6M-04472.2, to insert at end:

“; recognises the work of Chest Heart and Stroke Scotland in operating the vital long COVID support service; regrets that less than 1% of people with long COVID have been referred to the service, and urges the Scottish Government to take immediate action to expand the pathways to support, including enabling GPs to refer to the long COVID support service automatically.”

I thank my friend Jackie Baillie for bringing to the chamber this important debate on an issue that is far too often ignored in the Parliament. There are currently almost 700,000 unpaid carers in Scotland, and almost 210,000 people working professionally in the Scottish care sector. In total, carers account for 16 per cent of our overall adult population, which is astonishing. The services that they provide are indispensable. It is estimated that unpaid carers alone contribute a value of £36 billion every single year in Scotland. The positive impact that a carer will have on the person for whom they care, and on that person’s family and community, is unquantifiable.

The American professor Leo Buscaglia has said:

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear ... all of which have the potential to turn a life around.”

That is the true value that carers visit on their charges each and every single day, through their ability to soothe, reinvigorate and fortify. Families should be able to rest easy, knowing that, regardless of who is caring for their loved ones, it is someone whom they can trust and who has the capacity, resources and fortitude to deliver the best possible standard of care.

Unfortunately, however, we know that that is all too often not the case, as our carers are stretched to breaking point. While all carers work unbelievably hard to provide care, they are simply not given the right support to enable them to keep up with the inordinate workload. At least 15 per cent of the caring workforce regularly work unpaid overtime, while unpaid carers have to go for long periods of time without breaks and have to sacrifice other aspects of their life. We know that during the pandemic, in lockdown, the closure of services such as adult respite care only compounded the situation in which unpaid carers found themselves. All of that puts significant strain on carers’ health and wellbeing.

Worryingly, despite an act of this Parliament enshrining the rights of those same carers to access support and advice, according to a survey that was conducted in 2019, only 16 per cent of carers knew about that legislation and the rights that it provides, and more than half of them had not heard of the Carers (Scotland) Act 2016 at all. That is why the Scottish Liberal Democrats have campaigned for an update to the act in the light of the pandemic, and have campaigned to actively include carers and service users in the process to better bind lived experience with the legislation that we passed in the chamber.

As we have heard, and as the motion mentions, the cost of living crisis has had a devastating impact on social care. Half of unpaid carers across the UK report that they are unable to afford their monthly household expenses. Meanwhile, professional carers feel that their salaries can no longer provide the income and stability that they sorely need and deserve.

The situation is dire, and it needs urgent attention. Kevin Stewart would argue that the answer lies in the creation of a so-called national care service, but it does not. A national care service would strip individuals and local communities of the little agency that they have left. It would put powers with ministers: the very same ministers who were responsible for sending untested and Covid-positive patients into our care homes when we were in the foothills of the pandemic.

The Scottish Liberal Democrats believe that the answer lies not with centralisation and bureaucracy, but with localism, giving the ability to make decisions to the people who are most affected by them. That includes working with local government to introduce a package of new carer benefits; establishing a new fund to support training and education for carers who are returning to work; and moving away from narrow work-based contracts towards more holistic, flexible roles.

Those are all Liberal Democrat policies, and they could be implemented right now without building complicated and unnecessary structures, so what is the Government waiting for? We are legislating on the precipice of the worst crisis in a century; it is our duty to protect the vulnerable and those who are caring for them, and we must do so urgently. That is why the Scottish Liberal Democrats will support Labour’s motion.

Will the minister give way?

I thank my friend Jackie Baillie for securing the debate, and I thank the Royal College of Nursing for its tireless work in representing its profession.

As Jackie Baillie said at the top of the debate, we celebrate international nurses day on the anniversary of Florence Nightingale’s birth. She was a truly remarkable pioneer. However, her contemporary and fellow nurse Mary Seacole is not often talked about enough. She was born to a Jamaican mother and a Scottish father. She often talked affectionately about her Scottish heritage. Like Nightingale, she nursed her way throughout the Crimean war. However, unlike the lady of the lamp, she was shunned by the British Army. She instead established her own hospital, where she provided help to countless British soldiers. She was the only person to do so right on the front line. Determined to care for those who needed it, she said,

“I ask no greater or higher privilege than to minister to it.”

That sentiment encapsulates the heart and the character of nurses everywhere.

Seacole spoke openly about the racial discrimination that she faced, and, indeed, it is widely believed that such prejudice means that, even today, she does not get the recognition that she deserves. In a parallel sense, I want to note that it was disconcerting to read in the RCN workforce report the variation in the treatment and experiences of nurses depending on their ethnicity.

As has been made blisteringly clear time and time again, and as has been stated eloquently many times in this debate, we owe an enormous debt to our nurses, so why is it that that debt remains so poorly serviced? A record 9 per cent of registered nursing posts are still unfilled. That is having a devastating impact on workload and wellbeing. An astonishing 70 per cent of nurses feel undervalued and almost half feel unable to give patients the right level of care. One nurse practitioner admitted that they always enjoyed the job and found it rewarding but said that it now feels like

“we are sinking in quicksand with no way out.”

When Jackie Baillie and I attended a round-table event with nurses that was hosted by the RCN, we heard many such stories. It is appalling that that is the experience of a single nurse in this country, yet, as the report suggests, it is a commonplace one.

Despite that, nurses continue to go above and beyond in the face of the inordinate pressure that they come under. I was particularly struck by that given what nurses in my constituency experienced in January. Due to mismanagement—we have talked about this several times in this place—numerous nurses were unable to park at the Royal infirmary of Edinburgh. Nurses told me that they were sacrificing the little sleep that they get to wake up hours earlier than they usually do just to make it on time for their shift. That is one of countless stories that demonstrates the difficulties that nurses face being compounded by decisions made by management.

This Government is presiding over what will soon be, if we do not act fast, the disintegration of one of the most important workforces in our health service. There is so much more that the Government can do and should be doing. For example, it needs to set out a clear and urgent timetable for the safe staffing aspect of the Health and Care (Staffing) (Scotland) Act 2019 to be activated. The legislation has existed for three years, but it has still not been utilised properly. All the while, staff and patients are left unsafe on the shifts that they are asked to deliver.

Although the Government has pledged £12 million for staff wellbeing, we are yet to see a viable plan as to how such investment is being implemented into tangible and accessible support for staff. Instead, our proposal for a burnout prevention strategy has been routinely dismissed by the Cabinet. Meanwhile, more nurses are being pushed away from the job that they love and more patients risk losing out.

I will end on a quote from the ineffable Maya Angelou, who said:

“If you find it in your heart to care for somebody else, you will have succeeded.”

If that is the metric of success, nurses succeed tenfold every day and it is about time that we politicians started recognising that success with more than just words.

I rise to speak for the Scottish Liberal Democrats at stage 1 of the bill. When we were forced to lock down in March 2020, Scottish Liberal Democrats reluctantly agreed to the deep and wide-ranging powers being granted to the Scottish Government, which were necessary to get us through the work of the pandemic. We turned those bills around in just days; however, they were not meant to last forever.

Lessons have undoubtedly been learned from the pandemic, and it is right that sensible reforms are made in response to that. The situation caused public services to innovate, and many found new ways of working and adaptations that should, by rights, be retained. Much in the bill falls into that category, particularly those items that will allow the sensible use of technology when appropriate, providing that the necessary infrastructure is in place and that the changes are given scrutiny.

However, my party and I are clear that many aspects of the bill represent an unprecedented power grab by the Scottish Government and, despite the concessions that were announced this afternoon by the Deputy First Minister, the bill still represents an unacceptable transfer of power from the legislature to the Executive. The Parliament would never have countenanced handing over many of those powers to ministers before the pandemic, and we must not do so now.

The bill will represent a permanent transfer of some powers from the Parliament to the Executive, undermining democracy and civil liberties in the process. That is chilling. It is made even more troubling by the fact that it is wholly unnecessary and perhaps even unhelpful.

On 24 March 2020, just as millions of people were put into lockdown, Nicola Sturgeon said:

“I am very clear that the emergency powers are necessary, but that they should be used only if and when we deem it necessary and they should exist only for as long as they are needed.”

She went on to say:

“at a time when we are taking emergency powers and we are asking the public to do things that restrict the liberty of all of us, scrutiny is absolutely essential”.—[Official Report, 24 March 2020; c 18.]

So what has changed? It seems that the Government has simply grown quite accustomed to having those unprecedented powers and no longer feels the same sense of unease or solemnity.

To ask the First Minister when the Cabinet will next meet. (S6F-01083)