Chamber and committees

On a point of order, Presiding Officer. I am not sure whether my vote was recorded. I would have voted no.

I, too, thank Emma Harper for securing this important debate and for acknowledging the powerful work of Make 2nds Count and Breast Cancer Now in giving a voice to those who live with incurable secondary breast cancer.

Behind every statistic, there are real people—mothers, daughters, sisters and friends. There are people such as Rhoda, one of my constituents, who bravely shared her story with me by email. Rhoda was first diagnosed with secondary breast cancer back in 2012. She told me that, by the time she had found the lump, the cancer had already spread to her lymph nodes and bones. With surgery, radiotherapy and on-going hormone treatment, she was stable for many years and was able to continue to work full time and volunteer in her community. However, earlier this year, sadly, her cancer recurred and spread further.

Despite her courage and determination, Rhoda told me that what troubles her most is not her illness but the lack of progress in recording how many people in Scotland are living with advanced breast cancer. She asked me how we can plan cancer services when we do not even know how many people are affected. It is a simple but profound question, which gets to the heart of the debate.

As others have mentioned, we do not know how many people in Scotland are living with secondary breast cancer. Although new diagnoses are recorded, cases where breast cancer has returned or spread are not consistently tracked or published. As a result, thousands of people such as Rhoda are in effect missing from our health data. They are not reflected in official numbers, NHS Scotland does not plan consistently for them and, without being properly counted, they cannot receive the care and support that they need and deserve.

Almost 10 years ago, the Scottish Government committed to changing that. That commitment was renewed in the cancer action plan for 2023 to 2026. However, here we are, nearing the end of that plan period and the promise remains unfulfilled. As other members have done tonight, I therefore ask the minister to give us more information on that. Without comprehensive data, we cannot plan services, target resources or make fair and informed decisions about access to treatment. As Rhoda rightly pointed out, how can we decide which new cancer drugs to fund or negotiate fair prices with the companies if we do not even know how many people might benefit?

It is not just about data; it is about dignity and treatment. People who are living with secondary breast cancer deserve to be recognised, counted and properly cared for. We should have confidence that decisions about their treatment are built on real understanding, not on guesswork or gaps in information. We need to make sure that those who are living bravely with secondary breast cancer, like my constituent and many others across Scotland, are no longer invisible to the system. It should be there for them and we should know who they are.

Like others, I thank Paul Sweeney for securing the debate.

Just over two years ago, my father died of a terminal illness. It was a really hard time for my mother and for us as a family. We were fortunate: my father was in his own home, well off and able to have the care that he required. I find it almost impossible to imagine going through such circumstances when there is financial poverty in the family as well.

It has been said that the moral test of any society is how it

”treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in shadows of life,”

people who live with disability or long-term illness. Today, we have heard a sobering truth: that in Scotland, each year, more than 6,500 people living with a terminal illness die in poverty. That is not simply a number. That is mothers, fathers, grandparents, neighbours, friends and, sadly, sometimes children, whose final months are overshadowed not only by illness but by financial hardship and anxiety. Instead of dignity, too many experience cold homes, empty cupboards and mounting bills. For those who face the end of life, every moment should matter, yet poverty steals away that precious time and replaces it with fear, exhaustion and indignity.

I fully accept that the UK and Scottish Governments are trying to deal with those issues and that there are tireless campaigns on end-of-life poverty but, as we have heard from others, the dial is not moving and, in some communities in Edinburgh and the Lothians, things have become even worse. That is a shame, because it is not inevitable. Poverty at the end of life is a policy failure, not a personal one. Every person, no matter their circumstances, has equal dignity, worth and purpose. Our duty as parliamentarians is to care for one another, and especially for the most vulnerable.

Organisations such as Marie Curie have shown that there is a better way. Its research with Loughborough University has highlighted both the scale of the problem and, as Mr Doris pointed out, the practical steps that can be taken, including support from the Scottish Government, Social Security Scotland and local authorities to ensure the maximum uptake of disability benefits through a values-first approach that removes any stigma from receiving those benefits.

That is not simply a matter of numbers or budgets; it actually defines what sort of country we are and what sort of nation we want to be. I want to live, as I am sure we all do, in a Scotland that values life not based on productivity alone but on its inherent worth. Because I am human, I have inherent worth.

When someone reaches the end of their life, our collective responsibility is clear. We must deliver dignity and care without the burden of bureaucracy or delay. That is why I am so pleased that this Parliament was the first in the UK to introduce the six-month rule for social security benefits, which has made a big difference. I am also thankful for the work of the Marie Curie and St Columba’s hospices in this city.

Like others, I call on members to unite behind the simple moral goal that no one in Scotland should die in poverty. The true measure of a compassionate society is found in how it treats those who have the least, especially when they have the least time left.

As a member of the Social Justice and Social Security Committee, I add my thanks to those who gave evidence—in particular, those who gave their personal experience from their own lives.

The report paints a bleak picture of where we are as a country. Nowhere is that more evident than in how we treat women—as others have said, it is mostly women—who are trying to rebuild their lives after abuse. Every week, women across Scotland make the incredibly brave decision to leave their abusive partners; however, too often, that courage is met not with safety or support but with financial barriers, bureaucracy and a lack of somewhere safe to go.

We talk about fairness and dignity in social security, but what dignity is there when a woman who is fleeing violence has to wait weeks for financial help? As Maggie Chapman pointed out, the Scottish Parliament has for 10 years had the power to establish split payments in Scottish benefits, but the Scottish Government has done nothing about that. Words are easy, but action is lacking in that area.

On a point of order, Presiding Officer. Apologies, but I had the same problem again. I would have voted no.

I am afraid that I do not have time.

Let us be clear. The SNP Government has had its powers over social security and housing for years, yet women’s refuges are closing, councils remain overwhelmed and the promise of safety remains just a promise.

Even when women seek justice, they find another wall in front of them. As many speakers have pointed out, the legal system works only if there are enough lawyers to do the work—and there are simply not enough lawyers in Scotland doing that type of work right now. That is because legal aid is underfunded and lawyers are simply walking away from it. That is not justice but a failure to protect the most vulnerable. Only the Scottish Government can be held liable for that.

We owe it to every woman who has to pack a bag in the night and run to make sure that she finds a system that is ready to protect her, not one that makes her live through her trauma over and over again.

It is time for the Scottish Government to act, not just talk, and to provide real housing, real support and a justice system that truly stands with survivors, ensuring that equally safe becomes a living reality, not just some fantasy that the Scottish Government has dreamt up.

On a point of order, Presiding Officer. My phone would not link. I would have voted no.

I add my congratulations and thanks to Marie McNair for securing the debate. I must confess that I knew nothing about bile duct cancer. I have learned a lot just from listening to other members. The reason that I am speaking in the debate is that one of my constituents emailed me and asked whether I would briefly tell her story. It is my honour and privilege to do so. She wrote:

“I hadn’t heard of it until it changed the course of my family’s life in 2023. My beloved Mum, Valerie, was diagnosed with it in April 2023, after feeling a pain in her side. I couldn’t begin to put into words how shocked and devastated we were when she was diagnosed with terminal cancer after minimal symptoms and still being at work up until very close to the diagnosis. The worst thing was being told that there was absolutely nothing they could do, despite symptoms only showing a few days before. From here, things escalated at a terrifying pace. Mum passed away just 33 days after her diagnosis aged just 63. I went from everything being fine, to planning a funeral for my Mum at the age of 25 only 33 days later.”

I am sure that everyone would want to pass on their best regards and sympathy to my constituent.

Sadly, my constituent’s story is not unique. It is a story that other people have told me since hearing about the debate. As other members have said, cholangiocarcinoma is very difficult to diagnose and, even when it is diagnosed, it is very difficult to treat. I think that we all agree that it is a cancer on which specialised research needs to be undertaken. We need to find ways of enabling people to receive an earlier diagnosis, and we need to find an effective treatment for dealing with a horrible disease.

As other members have said, bile duct cancer is a cancer that affects more people who are perhaps older, but it is becoming more common in younger people. I fully understand that there are budgetary pressures on every Government and that, in almost every members’ business debate, members will ask the Government to find more money to fund the issue that has been raised, but I genuinely ask, on behalf of my constituent and all those who have gone through the same thing, for money to be found to put into specialised research, so that we can give hope to people who will face the condition in the future.

I understand the point that the member is trying to make, but does he recognise Pam Duncan-Glancy’s point? Whether we are for or against the bill, we are, as a Parliament, being asked to write a blank cheque. As we are often told by the Scottish Government—and by Mr Doris—we have a fixed budget. That money will have to come from somewhere. Does Mr Doris acknowledge that some other service, whether it is education, another health service or transport, will be affected if the financial resolution is passed?

What costing has the Scottish Government given to the amendments should they pass at stage 2? Where does the cabinet secretary believe that that money would come from? From which budget would he take the money to pay for such costs?