Chamber and committees

It gives me great pleasure to rise to speak to the motion in my name. I am dismayed, however, that we are already 18 or 19 months into the pandemic, and it is at least 12 months since the first sufferers of the condition that we now know as long Covid had that condition identified. It is disappointing, therefore, that it has taken Opposition time, in a members’ business debate, to lead, for the first time, on this important subject in the chamber.

I know that this will not be the last debate, and that the matter will occupy our attention—rightly so—for many years to come, because long Covid is accelerating. In October alone, 13,000 new patients were identified with that terrible and debilitating condition. Every member in the chamber, and everyone in our communities, knows somebody who has had Covid and is still suffering from it many months later.

The effects can be brutal—in fact, long Covid has been described as potentially the largest mass disabling event since the first world war. It is not overly dramatic to say that. The Government’s response to long Covid in this country has been so poor that sufferers in my constituency—and in your constituency, Presiding Officer—would be better off if they moved to England, given the care pathway that is available to sufferers of long Covid south of the border.

That is why my motion calls on the Government to act in a meaningful way, beyond the long Covid service and the small amounts of money that have already been dedicated to the condition in Scotland, by bringing in long Covid clinics in every health board in the country and delineating a care pathway for sufferers to follow, from the moment that they are identified, into a range of interventions, whether that is aquatherapy and other forms of physiotherapy or other types of support.

The motion also refers to the need for dedicated nurses. Before Covid, I did a lot of work with myalgic encephalomyelitis sufferers, and I was horrified to find that there was only one peripatetic ME nurse on the whole eastern seaboard in Scotland. Many long Covid sufferers are too ill to leave their homes for long periods, and it is incumbent on us to ensure that the resources are there to offer them care in their homes.

Given the remarks about workforce pressures that the Royal College of Nursing made to a parliamentary committee this morning, the crisis affecting our NHS is really scary. We have already seen that the waiting times crisis has proved fatal. However, the last thing that the Government should do is rush towards and embrace solutions that are ineffective.

The Deputy First Minister has answered questions from Douglas Ross and Daniel Johnson by citing evidence and saying that he will follow the evidence. However, research that was published by The Lancet last week showed that, although vaccines are excellent at preventing harm, they are ineffective at preventing transmission. Liberal Democrats warned that when vaccination certification came in, there would be a steady creep into other aspects of our lives. The statement is the start of that creep.

The Deputy First Minster has dangled the threat to the festive period as possible justification for the further roll-out of vaccination certificates, but clinicians are showing him evidence that there no evidence base for their use. Will he therefore rule that out today, as it will not save Christmas?

Will the minister—

Martin Whitfield is absolutely right—we are behind the curve in how we respond to long Covid. It is a basket of conditions; I will come to that in a moment. People who suffer from long Covid experience a vast range—there are hundreds—of symptoms. They do not all occur together, and they may present very differently. They include, but are not limited to, breathing difficulties, to the point of asphyxiation; chest pain; numbness; fatigue; tachycardia; diarrhoea; and neurological conditions. Symptoms are often experienced in a relapsing and remitting pattern, and the impact on people’s activities, daily lives and ability to work is huge.

Aside from physical side effects, long-term Covid sufferers are faced with issues ranging from trauma to serious discrimination, which I will come to shortly. They report major difficulties in accessing primary and secondary care, and issues with healthcare practitioners who, despite being sympathetic, are unsure or unable to help as a result—as we have just discussed—of the lack of treatment pathways.

Long Covid Scotland has reported cases in which long Covid patients have been wrongly prescribed medical interventions, such as graded exercise therapy, that could exacerbate their condition. Graded exercise therapy was recently removed from the National Institute for Health and Care Excellence guidelines for conditions that are reported to have symptoms that are similar to those of long Covid, and yet it is still being prescribed as a therapy for long Covid sufferers.

We should make no mistake about it—the current situation is not the fault of the healthcare profession or of healthcare professionals. If the Scottish Government refuses to acknowledge long Covid or the serious debilitating nature of the condition, how can healthcare professionals be expected to offer sufferers the care that they deserve without the resources to do so? Long Covid patients are stuck in limbo, where researching and advocating for themselves or their loved ones is their only lifeline, and their only source of hope, in the face of this awful condition.

As I said, the physical symptoms are legion, but they are only half the story. Long Covid patients also have to deal with a range of other issues. General practitioners and charities are doing their best, but the size of the phenomenon is on a different scale, and Government web pages are not much use to someone with air hunger who feels as if they are suffocating and literally gasping for breath. Specialist Covid clinics should exist in every health board, peripatetic nurses should be available and there should be a dedicated care pathway.

Many people who suffer from long Covid end up experiencing significant financial challenges, either because they are unable to work or because they are having to shell out money for treatments and investigations. With regard to financial support, the benefits system has not yet responded to this debilitating condition, and there is real concern that, when it does, support will not be made available to everyone.

There is a particular inequality even among long Covid suffers themselves. I ask members to cast their minds back to March 2020, when our testing capacity was considerably limited; testing was available only to healthcare staff and a very small group of other key workers. Many of the “first wavers”—as they refer to themselves—were, therefore, never diagnosed with Covid-19, and it exists nowhere in their medical records. As such, it makes reaching a definitive diagnosis all the more difficult.

Many may never receive an official diagnosis, or the attendant sick leave or benefits to which they may become entitled. Most will be subjected to disbelief or accusations of malingering. Those who have caring responsibilities are at particularly high risk in that regard, and the threat of financial difficulties may mean that they end up pushing themselves beyond the limit and reducing their quality of life still further. People with long Covid are further discriminated against as a result of their lack of positive test and their not having been hospitalised, and because of pre-existing inequities relating to their socioeconomic status, race or gender.

I understand that I am coming to the end of my time, Presiding Officer, but there is so much more that we need to say about the condition. We do not know how many of our citizens caught Covid-19 in the first wave, nor do we know how many are nursing it now or how many will contract it in the future. We are told that we may have to live around Covid-19 indefinitely. There is no vaccine for long Covid, and we still do not know how long it lasts, if it ever stops at all. The condition will occupy the attention and the business of the Parliament for many years to come, and it should not have taken an Opposition debate, in members’ time, to bring it to the chamber for the first time. Nevertheless, I am proud to have brought the debate to the chamber this evening.

The minister seems to be very confident in the Scottish Government’s offer to sufferers of long Covid. She has rightly outlined the strategy paper and the money and action points that the Government has identified. However, the long Covid community has reported being devastated by that and feels that it was far too little, far too late. Is she telling Parliament and the long Covid community that that is the full extent of the offer to long Covid sufferers, or is there more to come?

To ask the Scottish Government what engagement it has had with the organisers of major events since the introduction of the Covid-19 vaccination certification scheme. (S6O-00322)

I commend the exceptional quality of all speeches that have been made in the debate and praise Gillian Mackay for bringing the topic to the chamber. I also thank organisations such as Back Off Scotland for their work on the issue. I congratulate Gillian Mackay on announcing her intention to introduce a member’s bill on the issue, which I will be supporting.

I have supported the introduction of buffer zones around any healthcare facilities that offer termination of pregnancy since I first entered this place, five years ago. I have sought out meetings with anti-abortion campaigners to discuss that issue with them. They maintain that there is a clash of rights at the heart of this debate, which I reject entirely. I do not believe that one’s right to freedom of speech should come at the expense of a woman’s right to medical privacy.

Campaigners have said time and again that the facilities are not used solely for abortions or terminations. I would say to them that, in that case, they are making things worse. They are creating a picket line to cross for people who are trying to access the most intimate forms of medical care. They say that they are not trying to be intimidating and that they are not being intimidating. I am sorry, but that is not for them to judge. If someone is in what is possibly the most vulnerable situation of their life, the last thing that they want to do is cross a picket line where they are being hectored and intimidated by people of a different view to theirs.

This is not a debate about free speech. Protestors are entitled to their freedom of speech—of course they are. Gillian Mackay has rightly indicated the very many platforms that are available for people who believe that abortion is wrong. Nothing about buffer zones impedes that right. The right to freedom of speech does not mean that one has the right to intimidate people—it just does not go there.

The decision to terminate a pregnancy is very seldom one that is taken lightly. We know that there are situations in which those who are pregnant change their mind about the procedure, but they deserve to be supported in that change of mind—that reversal of decision—by staff who are trained to navigate the complexities surrounding pregnancy, not by those who want to impose their personal opinion or judgment, often through a form of intimidation that, as I said, effectively asks people to cross a picket line. As a society, it is our duty to protect the mental and physical wellbeing of our fellow citizens. There are no caveats to that very human obligation.

I am proud to say that my party has long supported and campaigned on the issue. There is no incongruity—I speak as a liberal—between creating buffer zones and protecting freedom of speech, as I have already covered. We need to protect some spaces in our society that are free from any judgment or intimidation—such as those medical facilities that offer, as I have said, the most intimate forms of medical care—and we have been campaigning on those rights for years.

Three years ago, I wrote to the then Minister for Public Health, Sport and Wellbeing following the picketing outside the Chalmers sexual health centre. I also give particular credit to my colleague in London, Sarah Olney, who, in March last year, tabled legislation in the United Kingdom Parliament that seeks to prohibit anti-abortion protests within 150m of abortion clinics—as Back Off Scotland has asked for.

I have met anti-abortion campaigners and I will continue to engage with them, but my party will fight for the existence of buffer zones, because what is happening is simply not good enough. As we have heard, 70 per cent of people in Scotland live in health board areas where anti-abortion protests take place. In 2019, 100,000 people attended abortion clinics that were targeted by demonstrations. The people who are targeted by those protests do not report feeling supported or helped; instead, they report feeling embarrassed and shunned. I am sure that none of us is comfortable with the knowledge that thousands of people in Scotland face such intimidation.

I support Gillian Mackay’s motion, and I will certainly support her member’s bill.

When the scheme was first established, it was made clear to those in the industry that they would have to absorb the costs of getting ready for its roll-out. What assessment has been done of the financial impact on the sector as a result of the roll-out?

Given that 42,000 people have been unable to obtain a Covid identification card, what assessment has been made of the loss of revenue and loss of attendance, and will the Government make good on that loss?

The situation is not safe. Waiting times, such as the ones that were announced this morning, are actively putting people in danger. As has happened already, they could prove fatal.

This morning, we also learned that 250,000 operations have already been lost to the Covid pandemic, meaning that the ripple effect of the current health crisis could rumble on for many years to come. That is not the fault of the staff, who have been handed the crisis by a Scottish National Party Government that has seen manifest failures in matters such as workforce planning and resourcing. Will the cabinet secretary today commission an independent review into all unnecessary deaths that have been caused as a result of the waiting times crisis?

We have heard several times today that, in 2019, NHS Tayside was forced to give money back to the endowment fund following allegations of mismanagement. Can the cabinet secretary confirm that no other Scottish health board has been required to return money to the endowment fund on the same terms?