Chamber and committees

The cabinet secretary asked people to think twice before calling an ambulance. Now patients in Lothian are being told to hold off completely unless their condition is “life threatening”.

This winter, the NHS is reaching the crux of years of underresourcing and mismanagement; it is in genuine jeopardy. I do not have a medical degree, so I would be grateful for some advice from the cabinet secretary. What exactly does “life threatening” mean? Does he accept that asking people to judge for themselves whether their condition is life threatening will possibly prove to be deadly?

I did not know David Amess, but I recognise him. I recognise the descriptions of the warmth and generosity with which he greeted members of all parties. I recognise his commitment to, and work towards, good causes including fire prevention and animal welfare.

In particular, I recognise the description of the final moments before he was attacked. Sir David was murdered at work, in a constituency surgery not unlike those that are held by each of us in church halls, offices and libraries the country over, week in and week out. He was killed while performing one of the fundamental duties of a representative of democracy—he was making himself available to his constituents, offering them help and receiving their instructions.

What happens in those venues is often more important than anything that happens in this chamber; there is no more important function in the role that we perform as elected public servants. We never know exactly what is coming through the door. Sometimes, it can seem straightforward; at other times, it will be deeply complex.

At face value, the issues are sometimes mundane and sometimes earth shattering, but the unifying theme in almost every surgery appointment and casework meeting is that the issue that is described to us is the most important thing in the person’s world. For the passage of half an hour or so, we have to make it the most important thing in our world. By all accounts, Sir David’s time revolved around his constituents.

Discussions about the safety and security of our elected members have once again begun in earnest. That is understandable, but this act of remembrance is not the time for such debate. All I will say is that, whatever what has happened gives rise to, it must not make it harder for people to come and see us.

I hope that a thousand years from now these islands will still enjoy the freedom of a representative democracy. Our society at that time will be unrecognisable to us now, but that fundamental pillar of the social contract—a person in need seeking help and finding it in the hearing of their elected members—will and should remain.

I offer my sincerest condolences and those of my party to everyone who knew and cared about Sir David.

On 20 September, the Government announced that all adults aged over 50 would be able to book a booster vaccination through the portal in October, yet October arrived and the Government quietly slid the opening of the portal to mid-November. Such a delay will cause anxiety to those who may be coming up against the recommendation to have a booster after six months.

The First Minister called today for the public to step up their compliance with basic protections. The Government also has a duty to step up its efforts to get the basics right. Why does the Government keep missing its own timetable? Why are elderly people without transport, including some who have a vaccination centre on their doorstep, being sent to hubs far away? Why are people still being turned away from appointments due to inaccurate record keeping?

I welcome the fact that the Government has made time for this important debate, particularly when it has done so in a cross-departmental way. I would like to see more of that, because the issue absolutely walks hand in hand in terms of our response to the drug death emergency and in recognition of its link to mental ill health.

The Dutch psychiatrist Bessel van der Kolk wrote:

“Traumatized people ... feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs”.

It is well documented that people who seek to mask unresolved trauma do so with drug use. The Scottish Liberal Democrats have a long and proud history of putting people at the heart of discussions about the issue. We have long recognised the link between this social problem and unresolved trauma, so I welcome again the inclusion of the £120 million mental health recovery and renewal fund, which my party helped to secure in last year’s budget negotiations.

The drug death crisis that Scotland faces is not just a national scandal of global proportions but a tragedy. Every statistic represents someone who has lost their life and whose life has more often than not been blighted by a set of circumstances that were outwith their control, which has led to a level of suffering that most of us cannot even begin to comprehend.

I have said before and will say again that drug deaths are a symptom of trauma and not simply a cause of it. In 2017, 74 per cent of drug death casualties in Tayside were known to have a co-existing mental health condition. Statistics show that, of those who are sent to prison for drug use, 11 per cent will die within the first month of having been released. Assistant Chief Constable Steve Johnson told the Scottish Affairs Committee at Westminster of the helplessness and hopelessness that his officers feel.

The drug death catastrophe is one of the worst health inequalities in our society. Last year, 96 per cent of drug deaths in Scotland occurred outside the most affluent areas. My office is conducting research into the connection between drug deaths and care experience, because we know anecdotally that the link is disproportionately large.

In some areas of deprivation, drug use has become an almost generational rite of passage, but nobody ever chooses to become addicted to drugs, in the same way as nobody chooses to develop a mental illness. Those who suffer from addiction deserve the same level of care and compassion as those who do not. People are most at risk of death from drug use when they are at their most vulnerable, such as after being released from prison, after a bereavement, after a relationship breakdown, when in poor mental or physical health, or when without a home.

Earlier this year, I was disgusted when I heard reports from Shelter Scotland that several drug-abusing patients were unable to claim housing benefit while in residential rehab. That is a scandal. We cannot brush over people becoming homeless because they need access to rehab. That is a real and present problem in our system. The Conservatives at Westminster may oversee housing benefits, but access to benefits should not be so limited that people must make a choice between obtaining the treatment that they need for a potentially deadly illness—

I was just about to recognise that commitment in my next remarks—the minister has done it for me.

Although I am glad of the focus and resources that the Government is directing towards addressing this crisis, I have serious concerns that they are sometimes directed towards the wrong place. Had my amendment been selected, it would have noted the concern that we have about the Scottish Government’s current attempts to centralise drug and alcohol rehabilitation through the creation of a national care service, my opposition to which is long standing and a matter of public record.

We have seen time and again that the centralisation of public services by the Scottish Government leads to tragedy. I therefore urge the Government to think again and to listen to its own words. Centralising something as fragile and as complex as drug rehabilitation is the very opposite of a person-centred approach and risks making this tragedy even more awful than it is already.

I will.

Muscle spasms, chronic fatigue, diarrhoea, and air hunger to the point of gasping for breath—figures released today show that 79,000 people are now living with long Covid. It could be the biggest mass disabling event since the end of the first world war.

The Scottish Government’s initial intervention could help only 60 people a month, which is why the much-delayed long Covid plan that was published last week should have been transformative. I have spoken today with a constituent who suffers from long Covid. He was, in his words “devastated” to discover that nothing has changed. I have previously warned that people who have the condition are better off moving to England where there are well-established clinics and a care pathway, and nothing in the Government’s long Covid plan will match that.

Long Covid Scotland has been trying to meet the Cabinet Secretary for Health and Social Care, but he has refused at every turn. If he has not met those people, how can he possibly know what they need? Will the First Minister either meet them herself or instruct her health secretary to do so at the earliest possible opportunity?

To ask the First Minister when the Cabinet will next meet. (S6F-00339)

The First Minister told Douglas Ross that many other countries are adopting vaccination certification. However, as we learned last week, Scotland is the only country in the whole of Europe to do so in isolation without the alternative of a lateral flow test verification.

Last week, the Information Commissioner said that trust is key to the success of vaccination certification and that people should be able

“to enjoy a night out ... without wondering if their data is at risk.”

Well, what little confidence existed crumbled on Thursday night. The launch was shambolic. Thousands of attempts to access Covid identification cards hit the buffers.

I warned that the Government’s information technology system would not be up to the job when the First Minister first unveiled the scheme. The Government has seen a litany of tech problems since before the crisis and, once again, it cannot even get the very basics right. Is the First Minister confident that the scheme enjoys public trust? Is there finally clear and practical guidance to support the venues that are required to carry out the checks in accordance with the Information Commissioner’s ruling?

The Royal College of Nursing told me in June that the NHS workforce had upwards of 4,000 vacancies in nursing and midwifery. The crisis does not come from nowhere; it follows years of Scottish National Party mismanagement of the workforce. Will the cabinet secretary commit to an updated workforce management plan, and annual workforce management plans thereafter, so that a workforce crisis of this scale is not repeated, given that he has announced today that only 200 registered nurses from overseas will be recruited by March 2022?