Chamber and committees

I rise for the Liberal Democrats to offer our support for the motion in the name of Anas Sarwar. I echo the condolences that have been offered to everyone who has been affected by the tragedies at the hospital.

It is rare that the leaders of all Opposition parties attend such a debate, but the topic that we are discussing is of such public importance, with feelings running deep in our society, that we have all been compelled to lead for our parties.

It is dismaying, then, that the First Minister has not found an hour in her diary to attend Parliament to address the problems at the hospital—a hospital that she commissioned and that serves patients in her own constituency, and one in which problems have gone unaddressed on her watch. I find that contemptible.

Three years ago, we learned about serious safety and cleanliness issues at the QEUH, ranging from grime-damaged facilities to contaminated supplies. At the time, I and others urged that the hospital be put under the closest of surveillance. Evidently, that did not happen. The hospital was opened in 2015 and its construction alone cost £842 million. As we have heard, it was heralded as a superhospital, built to provide the most excellent and efficient healthcare to those who need it.

Ever since its creation, the Queen Elizabeth university hospital has been troubled by problems embedded in the very fabric of the building. Similar problems put a stop to the opening of the new hospital for sick kids in Edinburgh, and millions of pounds and 18 months were spent on putting those problems right. The problems were caught just before the sick kids hospital came into operation, but the problems at QEUH emerged only one by one, in the years after it opened, and they emerged because they were allowed to have a catastrophic impact on patient health.

The failures in standards are shameful, and the fact that such failures have led to loss of life is unforgivable. We have already heard about Andrew Slorance, who was a father of five and a dedicated public servant. Milly Main was just 10 years old when she passed away in the paediatric hospital. Last week, we learned about two other deaths of children possibly linked to infections in that hospital. As the father of three young children, my stomach turns just thinking about that. When anybody uses the hospitals in our country, they entrust their own lives and the lives of the people they care about into the hands of others. No one should expect their life to be endangered—or even lost—not by the condition that they were seeking help for, but by the place of treatment.

Enough is enough. Now is the time for decisive action, which is why the Scottish Liberal Democrats support Scottish Labour’s motion. Those who are responsible must be held accountable, and the NHS board must be escalated to stage 5, accompanied by additional oversight and checks to prevent any further risk to life.

This is not a criticism of NHS staff—anyone who says otherwise is gaslighting those same staff. As Dr Christine Peters said on Twitter last night, the NHS staff working at the Queen Elizabeth university hospital have acted with the utmost compassion, bravery and self-sacrifice, aware that the fabric of the building in which they were operating was harming the patients whom they were trying to support. They deserve our utmost respect, but they, too, have been egregiously let down by mismanagement. It is only because of whistleblowers that we have some of the information that we do have.

As I mentioned, Dr Christine Peters took to social media last night to tell us about the reviews into the whistleblowing. The so-called independent review did not look at a culture of bullying in the health board. Those are the things that we need to uncover. Those are the things that deserve our attention.

We should be very clear about what has caused the scandal: failure of management and of leadership, both by Greater Glasgow and Clyde NHS Board and an SNP Government that has been complacent in presiding over one of the worst scandals in the history of devolution.

Although it will not make up for the grief, disappointment and anguish that has been created, the very least that this Government could do is prove that it cares by supporting the motion and acting swiftly.

The emergence of new variants will always be a source of real concern as we try to navigate our way out of this crisis. We have learned to expect the unexpected, and, for as long as the global south remains largely unvaccinated, this will keep happening. Right now, richer countries such as Great Britain are stockpiling vaccines far in excess of what we will ever need. Many will go to waste when they could have gone to developing countries. I reflect the First Minister’s remarks in my own and say that that needs to change.

We need to stop omicron in its tracks—or, at the very least, buy ourselves enough time to learn more about its effects and get more boosters into arms. We know that the contact tracing system is already under immense strain. Will the First Minister consider instructing a programme of door-to-door surge PCR testing in communities around affected areas?

I thank the minister for providing advance sight of her statement. She knows that she carries the good wishes of the entire chamber towards the end that she has described.

We still face a problem of global proportions—we are still the worst in the world in this area—and our response must be equal to that. I am grateful to the Government for committing to increasing the number of rehabilitation places to 1,000, but I am very concerned that it will take us till 2026—five years—to get to that number. People are dying today.

What is keeping us? Why will it take us so long to deliver the increased number of places?

It gives me great pleasure to speak for the Liberal Democrats in support of the bill’s general principles at stage 1. When it comes to domestic health scandals, in my short career as an MSP, I cannot remember another issue that has captured the universal support, concern and horror of members in the way that this issue has done.

I recognise the valiant work of Jackson Carlaw, Alex Neil and Neil Findlay in bringing the issue to our attention and introducing us to some of the survivors of the mesh scandal. Nobody who met those survivors when they came to the Parliament can forget their abject pain or the profound dignity with which they conducted themselves.

I welcome the bill. It has the potential to provide further closure to women at the heart of the issue who have already taken the step to have mesh removed privately.

I want to take a moment to remember why we are here in the first place and why the bill is so necessary. Four years ago, I was contacted by a constituent of mine, who has given me permission to share her story.

In 2010, after suffering very mild issues with incontinence, Cathy was referred by her physiotherapist to a consultant who suggested that she should undergo a marvellous new procedure. Somewhat bewildered, she was asked to sign a consent form then and there. She said that it felt like she was entering some kind of clinical trial—a feeling that is characteristic of many women’s stories—although it was never quite spelled out to her in that way. In fact, nothing was properly spelled out to her. Despite being booked for the most invasive transobturator tension-free vaginal implant—secured via spikes through the obturator muscle—she received little information other than that her procedure would cure her of her incontinence.

When Cathy woke after surgery, she could not move. The nerve damage that she had sustained to her obturator muscle radiated pain through her abdomen, legs and back. Her condition was so bad that, after she was discharged, she would not allow her son to drive at more than 30mph along the bypass. She tried to call the hospital for three days and through the following week after being discharged, but never received a call back from nursing staff or doctors.

When Cathy visited her doctor, they told her that the pain might be related to her having stopped smoking at the time of her operation, and that she should try cutting out fat from her diet to help. However, at no point did any medical professional suggest that there might be a physical problem with the mesh implant. Cathy went a full five years of trying to cope with abject pain before its cause was identified as the mesh implant itself.

A routine check-up with her gynaecologist revealed that the tape was in too tight on the right-hand side and, as such, was constantly tearing at her obturator muscle. On seeking the advice of her surgeon, she received the devastating news that, because tissue had grown around it, the implant could not be removed without further significant nerve damage—imagine her horror at receiving that news.

Had someone taken her call at the hospital in the days after her operation, a reversal or correction could perhaps have been performed then and there. Let us consider that she, like several others, had been told at the time of surgery that mesh plastic would simply melt away over time.

Once the cause of Cathy’s pain was identified as the physical obstruction inside her, she was heavily medicated with gabapentin, which had such a soporific effect on her daily life that it forced her to retire from the job that she loved long before she had planned to do so. Cathy’s implant has had a significant impact on her mobility, intimacy with her partner and mental health, and has devastated her quality of life. She is left with a Hobson’s choice of making do or having the implant removed, with potentially far greater nerve damage and resulting pain.

She is far from alone in feeling that way—we have heard countless other cases that are like hers. I am saddened that it has taken us so long just to get to the point to reimburse those people who have taken the step to have harmful mesh removed privately. Even the bill will not give back to my constituent the quality and the period of life that she has lost.

I do not want to downplay the importance of the bill; it is important and we will support it. The financial reimbursement is an essential part of regaining the trust of so many victims of that scandal and recognising its harm. Carol Mochan was absolutely right to say that the bill sends an important signal to those mesh survivors that we see them, hear them and recognise what has been done to them.

Members have recognised that the uncertainty around who might be eligible for reimbursement as a result of the bill is a cause of concern. We are also concerned that the bill might impact only a limited number of people. We will work to improve the bill as it goes through the Parliament.

I want to explore whether the reimbursement could be extended to survivors of hernia mesh removal who paid for the procedure privately. I might have a meeting offline with the cabinet secretary, if he is willing, as I raised with his predecessors a number of cases of people in equally debilitating pain as a result of hernia mesh implants, which at present are not in the scope of the bill. I do not imagine that to be a huge number of people, but the issues are much the same.

We have to offer more than warm words but, until now, that is all that we have been able to do. It is fair to say that we have talked about the matter for years—we have known about Dr Veronikis for years. The removal procedures have only recently started to take place, and it is a shame that we have managed to do only 33. Although I recognise the limitations that we face, I hope that we can increase the rate at which we help people.

To the survivors of the scandal, I say that what you have been through is an outrage. No one should have to suffer so much physical or emotional pain because of a procedure that they were reassured would increase quality of life. You deserve so much more, and I am so sorry that the Governments that were supposed to protect you have successively let you down.

This is one of the worst medical scandals in the history of this country. We must offer more and we must do so urgently.

For two months, the Scottish Human Rights Commission has been asking for the scientific evidence base behind the assertion—which the Scottish Government made again today—that vaccination passports prevent transmission. We got that evidence paper on Friday, and it was mince.

We know that lateral flow tests have always been superior to vaccination certification, because they allow venues to understand who is sick and who is well. It is gratifying that the Government has finally realised that today, but it has done so only after weeks of uncertainty and panic have been caused to Scottish businesses.

We are in a situation in which one scheme that has been proven not to work is being combined with one that we know works well. We were told at the start that the fundamental reason for vaccination passports was to drive up vaccine uptake, because of their mandatory nature. Now that they are no longer mandatory, that reason falls away. Therefore, is it just embarrassment that is preventing the Scottish Government from accepting that it was wrong to begin with, abolishing vaccination passports altogether and building a scheme around lateral flow testing at large-scale events?

I, too, warmly congratulate the citizens assembly and welcome its work. It is incumbent on all the parties in the chamber to reflect on the challenge to do politics differently. I wish the young people’s assembly that is to come out of this well. I hope that it will be given a proper platform to do good work, unencumbered by constitutional skirmishes in the chamber.

Recommendation 33 of the citizens assembly calls for

“permanent mental health support liaison officers in every school”.

I cannot see a response to that in the report that the cabinet secretary has introduced. Does the Government plan to introduce such officers?

I thank Dr Sandesh Gulhane for securing time for this important debate. It is dispiriting that, once again, it is Opposition time that has been given over to the workforce crisis in our health service, particularly after the warnings that were given to the Scottish Parliament’s Health, Social Care and Sport Committee this week. Nonetheless, I congratulate Dr Sandesh Gulhane and assure him of the support of the Liberal Democrats at decision time, notwithstanding the caveats that Jackie Baillie rightly raised about the complete removal of the cap. However, I support his intent. Likewise, we will support Labour’s amendment.

A person’s decision to dedicate their life to joining the medical front line is a noble one, but it can also feel like a thankless one. As the past 19 months have highlighted, if they make that decision, they choose a career that is defined by self-sacrifice and perseverance in incredibly demanding circumstances. People who enter the profession do so because they care passionately about serving our sick and our vulnerable. There is no higher calling in our society. We are very fortunate to have so many such people in Scotland, but evidence shows that we are losing them. We cannot afford to do so in the current context.

This May, the BMA released a report that said that 15 per cent of consultant roles in Scotland could lie vacant. To put that into perspective, that is an entire large hospital’s complement of consultancies, should we not fill them.

At the Health, Social Care and Sport Committee last week, the Royal College of General Practitioners told us that there is an enormous strain on the workforce. As a result, individuals are having to choose between sacrificing their profession or sacrificing their wellbeing. At the same committee meeting, the Royal College of Nursing told us that nurses in Scotland face a similar struggle, which has led to a significant issue of retention in the nursing workforce.

That is just not acceptable. No one should have to choose between their profession and their mental health. As a result of that choice and other factors, front-line medical professionals are choosing not to work in Scotland and are instead deciding to work south of the border or abroad, or they are giving up their professions entirely. We must do more to prevent that, given how much we have invested in those individuals.

A key part of the solution lies in planning for our workforce. As we are being told, the Scottish Government’s workforce strategy is not equipped to deal with the crisis that our NHS is experiencing. Members should remember that this is the same Government that delivered its integrated workforce plan a whole year late. That is why the Scottish Liberal Democrats have called for the presentation of an annual workforce report to debate in this Parliament, which would include a study of reasons why newly qualified staff leave NHS Scotland to work elsewhere.

Moreover, we need to look at the way that we deal with people who work in our NHS—the way that they suffer burn-out and the way that we are not supporting them with their mental ill health. We need to do that from the very start of their career in the NHS. Currently, just over half of medical students at our universities are Scottish. We must ensure that Scots who wish to train and work on the NHS front line are equipped and incentivised to do so.

It should be no surprise that there are severe burn-out and mental stress issues, which may be off-putting. Among ambulance staff alone, mental health absences are up 300 per cent since 2017 according to a freedom of information response that was received by the Scottish Liberal Democrats. That is why we have called for a substantive mental health package for front-line staff to help to deal with the crisis.

The crisis is one that has grown under a complacent SNP Government. Perhaps we should not be surprised. After all, it is the same Government that is led by a First Minister who, in her tenure as health secretary, cut 300 student nurse places, claiming that it was the sensible way forward. That was not a sensible way forward, and we are reaping the rewards of that whirlwind now. Restricting training places, neglecting strategy and not providing staff with adequate support is not a sensible way forward in anybody’s book.

The NHS is one of the most vital services—if not the most vital service—in our country. The people in it provide a service that we could not do without. Front-line staff deserve from this Parliament the same unwavering care, effort and support that they have continually shown to our country.

I extend the thanks of Scottish Liberal Democrats to everyone who kept COP26 safe and made it possible.

Keeping the 1.5°C goal alive will require concerted action both at home and abroad, which means we cannot wait for COP27 or COP28. As we have heard a number of times today, Scotland has repeatedly missed its own targets in that vital area.

The First Minister says that she wants to be challenged to go further and faster. I invite her to consider some of the proposals that my party has laid out to give new hope in the climate emergency. One is an end to the reliance on fossil fuels for all new-build houses. We seek a new rail-card entitlement that would allow all passengers to benefit from rail-card fares, and we seek the removal of this Government’s commitment to a third runway at Heathrow.

I was proud to speak alongside Gillian Mackay in her members’ business debate on the issue, joining members from all parties in our shared belief that somebody’s right to freedom of speech does not trump somebody’s right to medical privacy or the right to seek intimate medical care without molestation. The minister shattered that consensus by saying that the Government was unmoved.

If the minister is determined to state that there is a difference of legal opinion, I note that the opinion that the Society of Local Authority Lawyers and Administrators in Scotland received was “unequivocal” that byelaws could not be used by local authorities to create buffer zones. Has the Scottish Government sought legal opinion to the contrary? If so, will she publish it?

If any proof were needed that vaccination certification is unnecessary and that there are better alternatives, it can be found at COP26. The First Minister just said that it was the safest possible environment. Using daily LFD tests, attendees were three times less likely to test positive for Covid-19 than the general population, in which vaccination certification is at large.

We know that LFDs are superior to vaccination passports in two significant ways. First, they provide an on-the-day snapshot of someone’s Covid status, rather than their vaccination status. That helps venues to ascertain who is sick and who is well. Secondly—and, perhaps, most important—it prevents the need for people to pass part of their medical history or evidence of recent treatment to someone who is not their clinician.

A mixed bag or combination of the two schemes will not cut it. Will the First Minister abandon vaccination certification entirely and instead build a scheme around lateral flow testing?