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Chamber and committees

Meeting date: Wednesday, May 10, 2017

Meeting of the Parliament 10 May 2017

Agenda: Portfolio Question Time, National Health Service Pay, Business Motion, Parliamentary Bureau Motion, Decision Time, International Nurses Day


Contents


International Nurses Day

The next item of business is a members’ business debate on motion S5M-05165, in the name of Emma Harper, on celebrating international nurses day on 12 May 2017. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises International Nurses Day 2017, which is celebrated around the world every year on 12 May; acknowledges that this date is the anniversary of Florence Nightingale’s birth; considers that Mary Seacole also contributed immensely to furthering the caring for ill and recuperating patients; understands that nurses are the single largest group of healthcare professionals in the UK; acknowledges that nursing encompasses the autonomous and collaborative care of individuals of all ages, families and communities in all settings, and includes the promotion of health, prevention of illness and care of people who are ill, disabled and who are dying; considers that advocacy, promotion of a safe environment, research, participation in shaping health policy and education are also key roles in nursing, and notes calls for everyone to mark International Nurses Day in some way, whether it be by sharing messages of support on social media, learning more about the hard work nurses do, or fundraising for a charity that supports nursing staff.

17:06  

I am really pleased to be leading this members’ business debate celebrating international nurses day, which is on Friday.

The motion states

“that nurses are the single largest group of healthcare professionals in the UK”.

There are estimated to be more than 20 million nurses and midwives in the world, accounting for 52 per cent of the healthcare workforce. The motion also

“acknowledges that nursing encompasses the autonomous and collaborative care of individuals of all ages, families and communities in all settings, and includes the promotion of”

physical and mental

“health, prevention of illness and the care of people who are ill, disabled and ... dying”.

Outstanding care happens everywhere and at every stage of life in Scotland and across the world.

The International Council of Nurses presented a paper of case histories about the work that nurses do in different parts of the world, from HIV treatment and care in South Africa, to family partnership for improved maternal care in urban USA, to accessing food aid in Syria, to bariatric perioperative best practice in Australia, to caring for people who have contracted the Ebola virus in Sierra Leone, to developing community respiratory early warning scoring systems for persons with chronic lung health problems in NHS Dumfries and Galloway.

I have my own case history.: I am a nurse. Prior to Hollywood—I mean Holyrood; Hollywood was another place where I worked. Prior to coming to Holyrood in 2015, I was a nurse for 33 years. My specialties are surgery and education. Even although I am not currently working as a nurse, that does not stop me thinking like one and approaching problems with my nurse heid on. My sisters are nurses, too: between us, the Harper sisters have 130 years of nursing experience and have contributed more than a quarter of a million nursing hours of patient care. Having a career in nursing allows us all to travel internationally and to work and learn from other professionals and cultures about the best way to care for people. We sisters have worked with medical personnel from across the world. The medical community is wholly international, and what we learn from each other truly contributes to enhancing not only the lives of our patients, but our own lives.

According to the Royal College of Nursing, nurses are the superheroes of healthcare. I met two superheroes a couple of weeks ago: Marcia Ramsay is director of operations for Alzheimer Scotland and Clare Stroyan is the service manager at its recently opened dementia resource centre in Stranraer, in Wigtownshire. Both are nurses, and both are proud of the new facility and the opportunity to develop a great support service for people who have had a diagnosis of dementia, and their families.

May 12 was chosen as the date on which to celebrate international nurses day because it is the birthday of Florence Nightingale. Florence is probably one of the most famous nurses. She modernised the approach to care during the Victorian age and was instrumental in improving care by implementing the new mathematical science of statistical analysis.

Other famous nurses are worth celebrating, including Mary Seacole, the Jamaica-born contemporary of Florence Nightingale. The two women took different approaches to care, but they had the same goal of reducing mortality among the soldiers for whom they cared. Both proved to be formidable women who worked to save soldiers’ lives. Let us also celebrate Pauline Cafferkey, who almost lost her life when she contracted the Ebola haemorrhagic virus while caring for victims of the virus in Sierra Leone. I think that one of my colleagues will talk a bit more about Pauline Cafferkey.

Each year, the International Council of Nurses celebrates nurses day by focusing on a specific theme. This year the theme is, “Nurses: A voice to lead—Achieving the Sustainable Development Goals”. The 17 sustainable development goals were set by the World Health Organization and the United Nations and tackle issues that affect people by stimulating action on the themes of

“people, planet, prosperity, peace, and partnerships”.

Goal 3 is about good health and wellbeing, but all goals can be directly linked to nursing and the optimisation of people’s lives—for example, the goals that are about addressing poverty and hunger and about promoting education and gender equality. David Hope-Jones and Kathryn Chipperfield, who have been on the Scotland Malawi Partnership’s stand outside the members’ block this week, also support the sustainable development goals. If members have not visited the stand to have their photo taken and learn about the sustainable development goals in the context of the relationship between Scotland and Malawi, I urge them to do so.

I do not have time to explain all 17 goals. I urge everyone to read more about the targets that are to be achieved over the next 15 years. Nurses are key partners in work to achieve the WHO and UN SDGs. These are not new tasks in the already challenging work that nurses face daily across primary and acute care. The International Council of Nurses wants to make it clear that the sustainable development goals are already embedded in current practice across the globe—it wants to highlight that to us all. I urge everyone to celebrate the work of nurses and to thank their nurses when they meet them.

I thank the Scottish Government for choosing to keep the bursary that supports nurses during training at universities and in Scottish hospitals. A career in nursing is hugely satisfying—my three sisters and I can testify to that. The Scottish Government should continue to promote the profession and to support men and women to step into nursing.

I note that the sun is shining on me right now. I call on everyone to mark international nurses day by doing wee things. Members can share a message of support on social media, watch and share the Royal College of Nursing’s support video, which contains messages of thanks from people who have received care from nurses across many specialties, or donate to a nurse charity.

I reiterate to nurses across the world and certainly here at home that they are already contributing to the sustainable development goals. Let us tell everyone that, celebrate it and celebrate international nurses day.

17:14  

I thank Emma Harper for lodging the motion. Like her, I come from a family of nurses: I am married to a nurse and both my brothers are nurses. I am not sure that we have clocked up as many hours of nursing practice as Emma and her family, but we are getting there. I refer members to my entry in the register of members’ interests: I am a registered mental health nurse and I hold an honorary contract with Greater Glasgow and Clyde NHS Board, which allows me to continue my practice as a nurse.

Florence Nightingale is often described as “The Lady with the Lamp” but, as we can all appreciate, she was so much more than that. Not only did she challenge expectations; she was a truly gifted healthcare professional, who was as skilled in the study of healthcare as she was in the creation of new standards and practices, was as committed to research as she was to statistical analysis, and was a true pioneer in the planning of hospitals and wards. She was an innovator—she introduced new strict cleanliness regimes that drastically reduced mortality on her wards, and she was compassionate, heading to the horrors of the Crimean war to help the wounded. Fundamental and radical service redesign is how nursing was born with Florence, and it is how it continues to stay relevant and at the forefront of healthcare.

My experience in mental health nursing has borne that out: there has been a concerted effort to reduce the stigma around mental illness, and we have encouraged people to access care and treatment at an earlier stage. We now talk about mental illness instead of shying away from it, which is a tremendous success that I have seen as a mental health nurse. However, those changes were difficult. Service users, carers, staff and the public were worried and concerned about bed and hospital closures, about services not meeting their expectations and about safety.

Change is the one constant for nursing; we develop and adapt to new ways of working and new practice. In short, we move forward with what works rather than sticking with outdated ways that do not deliver the results that we need. Florence Nightingale created and reformed nursing, in part by redesigning wards and improving outcomes of care by reframing the environment. In mental health nursing, we continue to follow that spirit of reform, by moving care away from existing models and hospital settings and into the community.

We have to be open to discussion about what can be done differently and more effectively in order that we can do what is best for our patients. “Service redesign” is a term that can still instil fear, but it is how nursing began. Changes to services can be challenging, but with the challenges come opportunities to make real and positive changes to real people’s lives.

This year, the ICN has chosen, as the theme for international nurses day, “Nurses: A voice to lead—Achieving the Sustainable Development Goals”. Every day, nurses’ work has a significant impact in delivering SDGs—not just in ensuring healthy lives and promoting wellbeing, but in areas such as education and poverty. Those social determinants of health are the conditions in which people grow, work and live, and the work of nurses across the world seeks to address those wider issues and not just immediate clinical needs.

Pauline Cafferkey, who is one of my constituents, is an exemplar of the dedication of nurses to help to improve the lives of people who face health and social challenges. Pauline and many other volunteer nurses have worked tirelessly to help people in Sierra Leone who have been affected by Ebola, and she herself became infected. Despite that, she is planning to return to Sierra Leone and will continue to help people who need assistance.

Pauline and our nursing staff here in Scotland are at the forefront of healthcare, with nearly 60,000 nurses working across the NHS in Scotland to improve the care and the lives of our fellow citizens. Every day, each of our nurses contributes to service redesign and to developing and redefining best practice—each carrying on the work of Florence Nightingale.

The RCN is running a Twitter thunderclap, in which we can all offer our support online. Through its nurse hero programme, we can also write about a nurse who has made a difference to our lives or the lives of our families.

I ask Parliament to join me in marking international nurses day on 12 May in a small way. Let us tell our nurses that we appreciate the amazing work that they do, and encourage the next generation of nurses, too.

17:19  

Sadly, I cannot make it three nurses in a row. I feel as though I am letting the side down.

I thank Emma Harper for moving the motion. I, too, want to put on record my admiration and respect for our nursing staff across Scotland.

This chamber is definitely a richer place when MSPs from a wide variety of professional backgrounds are able to bring their invaluable experience to debates such as this evening’s. I pay tribute to Emma Harper and Clare Haughey for their speeches, which were informed by their day-to-day experience.

Nurses are, by and large, the public face of the NHS in our hospitals and community health centres. They do an incredibly tough job, often on unsociable working hours, and, as we heard earlier this afternoon, they are taking on an increasing workload as demand grows. They are the bastions of our health service, and we must always remember that.

As Emma Harper intimated in her motion, international nurses day was set up to coincide with the birth of Florence Nightingale, one of the most famous nurses in the world, who is largely credited as the founder of modern nursing. As has been said, her persona as “the lady with the lamp” made her a beacon of hope to the soldiers who were injured during the Crimean war.

However, it is for her significant contribution to modern nursing that she is and should be best remembered. Her book “Notes on Nursing” was published in 1859, yet many if not all of its contents continue to have stark relevance today. Today, we talk about hospital cleanliness. Florence Nightingale tackled that. Today, we talk about the importance of diet. Florence Nightingale tackled that. Today, we talk about making sure that our homes are clean, ventilated and warm. Florence Nightingale tackled that. As Churchill said,

“Those who fail to learn from history are doomed to repeat it.”

That springs to mind when we talk about Nightingale’s observations on healthcare.

One nurse whom the motion does not mention is Elsie Inglis. I want to mention her briefly as we debate the motion because, as well as being a famous Scottish nurse, she was an incredible person. She founded the Scottish women’s hospitals unit, which provided nursing staff and a variety of auxiliary personnel to battlefields across the European continent, despite the incredible barriers that women faced at the time. Her pioneering work saved thousands of lives, and she and many others who go unrecognised in history should always be remembered.

I have mentioned some famous and renowned female nurses because it is important to understand and remember that nursing is a predominantly female profession. The most recent statistics show that almost 90 per cent of nursing staff in Scotland are female—just under 60,000 women are employed as such, compared with 7,000 men. That is not to say that we do not value our male nurses as much; of course we do.

Nursing is also a profession with vacancies. I make that point not to score a political point but to raise awareness of the fact that all of us need to do more to encourage more men and women to take up nursing as a profession. We need to promote the sector to young people who are about to leave school or university and are unsure of what path to take. Nursing can be extremely rewarding, and it provides people with an immeasurable number of important skills. As we continue with the shift in care from acute to community-led services, the importance of community nursing will grow significantly.

Nurses are extremely important in our NHS, and we must always recognise that.

I apologise for intervening during a members’ business debate—I know that that is not the usual form—but I just wanted to state for the record that Elsie Inglis was a doctor, not a nurse.

By the way, it is possible to intervene in members’ business debates; it is not a precious regime.

I might take that up with the member at a later date. My information is that Elsie Inglis was a nurse.

Nurses are the lifeblood of the health service. Without their work, the service would not survive. I thank the Royal College of Nursing for its service in representing nurses across Scotland and for its continued efforts to improve that service. I wish all nurses the very best for international nurses day on Friday.

17:23  

I thank Emma Harper for securing the debate and I congratulate her on her immense service, and that of her family, to the NHS. I am always struck by the number of people we come across who are from NHS families and who have brothers, sisters, aunts, uncles, sons or daughters who work in the profession and dedicate their lives to caring for our fellow citizens. I offer a genuine thank you to Emma Harper and to all those people across the country who dedicate their lives to our national health service.

I also put on record my gratitude to all those bodies and unions that represent our fabulous nurses, from the RCN—I am delighted to see that Theresa Fyffe of the RCN is in the gallery this evening—to trade unions such as Unison, which support those nurses all year round.

Emma Harper rightly mentioned the sustainable development goals and the Scotland Malawi Partnership, which this week has a stall in the garden lobby. It is important that we recognise the universal healthcare system that we take for granted in the United Kingdom, and it should be our ambition for people around the world to have access to a universal healthcare system. No matter whether they are from the poorest background or from the wealthiest background and no matter their race, religion, nationality, gender or sexuality, they should have a healthcare system that is there to care for them whether or not they have money in their pocket.

I hope that we can realise that ambition either directly through our work with the Department for International Development—which I am proud to say was introduced by a Labour Government and had its budget trebled under a Labour Prime Minister—or through individual healthcare workers going from here to spread their expertise and knowledge in other parts of the world. Pauline Cafferkey is just one of many people who risk their lives going to other parts of the world—sometimes the most dangerous places—to care for others.

It is, however, important to realise that our NHS workforce in Scotland still face challenges. On a daily basis, our NHS staff have to deal with people who exhibit threatening behaviour and people who are in difficult emotional situations. They have to face that on the front line, and we owe them a huge debt of gratitude for that.

As Donald Cameron mentioned, there are pressures and strains on the NHS and earlier this afternoon we had a debate about the stresses and strains on our NHS staff here at home. I note with disappointment that the Parliament has voted down a pay increase for NHS staff just prior to a debate that, I am sure, we all want to take part in as we celebrate international nurses day. As Graham, a nurse whom I met this morning, told me, good will is one thing but good will does not put food on the table. It is important that we remember that.

I hope that all of us, across the Parliament, can resolve to work together to champion the valuable role of nurses—both at home and abroad—not only on international nurses day, but all year round and that we can continue to have a national health service that is a gold-standard beacon not just for the rest of the United Kingdom but for countries right around the world. We must show that they can have effective healthcare that is free at the point of need and that their societies can come together and pay their dues to care for all their members, no matter what their background. That is a principle of the NHS in Scotland that I am proud of, and it is one that our nurses live and breathe every day. I hope that we can all resolve to make that principle a reality for people right around the world.

17:27  

I am proud to join other members in celebrating international nurses day. I thank Emma Harper for securing the debate, for her contribution to nursing and for sharing her passion and expertise on the issue.

Nurses throughout our national health service and social care system do truly heroic work. We must celebrate their achievements and thank them for their dedication and tireless care. From our neonatal units to our hospices, nurses care for the most vulnerable and lead increasingly complex care in community settings. I also thank all our healthcare support workers for the vital work that they do alongside our nursing staff to support patients. In the time that I have available, I will focus on the tremendous impact that nurses have on children and young people’s health.

Sadly, not every family can take their newborn baby straight home from hospital, and one in 10 babies who are born in Scotland will be admitted to a neonatal unit. Neonatal nurses deliver very technically skilled care and support families through unimaginably stressful experiences. However, recent surveys that have been led by Bliss show, unfortunately, that too many neonatal nurses are not getting the protected time that they need for training and professional development. We should have comprehensive standards for nurses becoming qualified in their specialty and developing further in specialised clinical practice areas, but we must ensure that nurses have real opportunities to develop their skills, and good staffing ratios are key to that.

As our children grow older and move into education, school nurses provide child-centred primary care and can play a key role in tackling health inequalities in childhood. School nurses are trusted, they are well-placed to help schools and families with income-maximisation advice and they provide universal, non-stigmatising mental health support. The Government has indicated that school nurses will start to take on a refocused role this year or in 2018 and will work more with children who have additional support needs and with young carers and looked-after children. I hope that the minister can update us on the progress of those plans.

Strengthening preventative healthcare in schools is essential, because we are seeing real increases in the number of children and young people with mental health problems and children and young people who need intensive emotional support. Nurses make up over 40 per cent of the total child and adolescent mental health services workforce, and demands on the sector are intense. The Royal College of Nursing has called for continued additional investment in CAMHS to enhance early intervention and preventative work, and to ensure that there is a well-trained and well-supported workforce.

Nurses who work in our communities are at the very centre of early intervention. I support the expansion of the family nurse partnership programme, which is an important preventative health programme that gives younger first-time mothers additional support during pregnancy and through the baby’s early years. Evaluations show that that approach improves antenatal health, promotes strong attachment, and leads to better health and developmental outcomes for children. That is all because of the therapeutic relationship between specialist nurses and new parents. Making that focused support available to more parents aged up to 24 is a good step forward.

The key relationship between nurses and patients is at the heart of our health service, and I am proud to celebrate it and to ensure that it is at the centre of our health and social care system in the future. We know that there are real challenges in recruitment and retention in Scotland, and we must do more to provide more training opportunities in remote and rural areas and attract new entrants to the profession a bit later in life.

Due to demographic changes, the role that nurses play in supporting the elderly and vulnerable will change, too. We know that a high level of nursing posts are vacant in our care homes and that, as health and social care become more integrated, we must have robust workforce planning to ensure that nurses can support people well in their homes for longer.

It is often said that we have more statues of animals than statues of women in the city of Edinburgh. As the deputy convener of the cross-party group on animal welfare, I welcome those statues of animals, but we could do far more. Last year, a plaque was unveiled in Edinburgh to commemorate 500 nurses who died during world war 1. The sacrifice and the contribution that nurses have made are often overlooked in this society, and I would certainly welcome a campaign to recognise that with a statue in Edinburgh.

17:32  

I thank Emma Harper for providing the opportunity to discuss this important subject.

The thing that I most noticed in Emma Harper’s motion was the name Mary Seacole, of whom I had not heard anything whatsoever in my life. I therefore very much welcomed the opportunity to investigate who she was and what she did with her life.

Like everyone else, I have a few nurses in my family. My father-in-law was a psychiatric nurse, as was my sister-in-law—both trained in Inverness in the 1950s. My Aunt Stewart—another Stewart Stevenson—and her sister Daisy registered as nurses in Bradford in 1925, my niece Susan is now a transplant co-ordinator in Queensland, Australia, and there is also my sister Mairi, of course.

Perhaps most critically from my point of view, I spent five months working as a nurse in Stratheden psychiatric hospital in 1964. Members may think that things are a bit difficult now, but we did a 108-hour fortnight—12 days on and two days off—for £6.50 a week. The staffing ratios were horrendous. One weekend when we were working double shifts, two of us looked after 32 physically ill psychiatric patients. That would just never happen now. Progress is therefore being made.

One important thing about nurses today that we should think about and support them for is that they are highly trained and have skills and knowledge that I, when I was a nurse in 1964, and all my antecedents, ancestors and relatives definitely did not have. Nurses are now trained to a level that is higher and more effective than my father was trained to as a general practitioner—he qualified in 1945 at the comparatively elderly age of 44.

My individual experience of nurses has been universally good. I have a campaign scar from being bitten by a dog during the Falkirk West by-election in 2000. It was a nurse who put the six stitches in my hand that allowed me to return to canvassing for our candidate—unsuccessfully; the nurse was therefore not that successful in repairing me. I spent five weeks in Bangour hospital some 30 years ago for a condition that I will not share with members, but which was one that none of them will wish to experience. I was not critically ill but was certainly in need of nursing. Therefore, in my personal life, I am grateful to nurses.

In modern times, of course, like many of my age group, I have a particular relationship with the Macmillan nurses, because one gets to an age when more of one’s friends and relatives are reaching the end of their lives. In particular, the work that the Macmillan nurses do in supporting people to end their lives with dignity and in comfort in their own homes is absolutely magnificent.

The motto “Nurses: A Voice to Lead” sounds to me absolutely spot-on. Nurses are important in primary care in a way that they did not used to be. I would rather see the practice nurse for most of the things that I would wish to go to my GP for. Fortunately, I do not even know the name of my GP—that is how infrequent a visitor I am, and I hope to remain in that position.

Some nurses are brave beyond the point of foolhardiness. My best man’s mother was a nurse, and she met her husband during the last world war in a hospital where he had been taken because he had been badly burned when his tank was blown up. Such was the personal charisma of that nurse that my best man’s father proposed to her and married her three weeks after meeting her. However, the real trick was that he was badly burned and bandaged from the neck upwards, and when she got married to him, she had not even seen his face. That is nursing bravery of the highest order, but I can tell members that it worked extremely well.

For me to end on a humorous note does not in any way diminish the very serious and valuable work that nurses throughout our health service do on behalf of us all. Let us hope that we never have to meet them, although we know that they are there when we need them.

I never fail to wonder where you are taking us with your speeches, Mr Stevenson, but I never fall asleep.

17:37  

It is a great pleasure for me to speak in this members’ business debate led by Emma Harper, not least because my own mother was a nurse. I well remember her telling the story of how she became a nurse. At the time, she worked as a young secretary in an architects’ firm in Ayr, and one day the senior partner came dancing into her office singing about her becoming another Florence Nightingale. For some reason, he, rather than she, had received the letter confirming her acceptance for nurses training in Glasgow. It was not too many years later that my Aunt Esther followed her big sister Edith into the nursing profession, making it a Murray sister double act.

International nurses day—or week in the United States of America and Canada—gives us all the opportunity to reflect on the outstanding work that is done by nurses across the world and on the particular invaluable abilities that are required of those in the nursing profession. A selfless, caring, patient, understanding and dedicated attitude and approach: those are just some of the qualities that are associated with these important workers in our health services. They are people whom we depend upon to help us through some of the toughest times that we experience in life or who have been there for some of those closest to us in the most difficult of times.

I know that many of us in the chamber have pointed already to examples of nurses in their lives or others’ lives who have taken up these roles, and that is exactly what this day encourages us to do. I know that I and my brothers and sisters all benefited from our mother’s skills and training as a nurse, and I know that countless others did as well, including in my mother’s later life when she worked as a volunteer nurse at children’s summer camps.

On a day such as this, it is important to remember the debt that we owe to all our healthcare professionals, who work to help save life and limb; in particular, it is important to remember our nurses on this day.

When the Murray sisters worked in the Gorbals in Glasgow in the late 1950s, they could walk alone through the streets in their nurses’ uniform, night or day, without any fear of harm. Sadly, it is not uncommon nowadays to hear stories of a lack of respect being shown not just to nurses in our hospitals, but to others in essential emergency services.

It is important that we re-emphasise the need for respect for our nurses and the work that they do. Nurses are essential in our society and deserve all our respect. I hope that by celebrating this day, including in the Scottish Parliament, we can reinforce that message.

Thank you very much, Mr Lindhurst. It is always interesting to hear about members’ backgrounds, which we would not hear about otherwise than in members’ business debates.

I call Maureen Watt to close for the Government.

17:40  

I thank Emma Harper for bringing this important debate to the chamber, and I congratulate her and her sisters on their amazing contribution to the NHS.

Nurses make up the largest single profession in our NHS. They are at the heart of care for every single person, young or old. They work not just in hospital wards but in GP practices, homes and care homes, and in communities across the country. Every person in the chamber has—often literally—been touched by a nurse and our lives have been improved because of that encounter. It is my privilege as a Scottish minister to thank each and every nurse across our country for their commitment and professionalism. On behalf of all the people of Scotland who are recognising international nurses day, we thank them for their unstinting service. We value and appreciate them.

The Government is committed to supporting our nurses and ensuring that we have a sustainable workforce who have fulfilling careers and are able to play the fullest part in delivering the health and social care that Scotland needs, today and in the future. Scotland has a long and proud history of supporting our skilled nurses. The first nursing unit to be set up at a British university was opened in 1956 at the University of Edinburgh by another nursing heroine—who has not been mentioned—Elsie Stephenson.

Nursing has changed beyond all recognition from the pioneering days of Florence Nightingale and Mary Seacole. I am surprised that my general knowledge on this occasion is better than Stewart Stevenson’s, because I knew about Mary Seacole. When I was on Clapham High Street in London the other month, I passed a Mary Seacole centre and was able to tell my daughter who she was. That is one up on Stewart Stevenson, for once.

As Donald Cameron mentioned, the basic commitments of nursing that Florence Nightingale pioneered—the hygiene, and the food and diet—are still very much to the fore, but the equipment and skill that are required by our professional graduates, who deliver increasingly complex care to a more diverse population in a wide range of settings, are certainly challenging. It is more important than ever that we ensure that our nursing workforce is fit for the future with the right numbers, the right skills, the right opportunities and the right support. It is important that we make sure that everyone who has a desire, aptitude and ability to go into nursing can do so. That is why our chief nursing officer has commissioned a review of the ways to support and widen access to nursing education and careers, which is being led by Professor Paul Martin CBE.

To support nursing, the Scottish Government is delivering a record number of qualified nurses and midwives. There are over 3,400 more nursing and midwifery staff working in our NHS today than there were five years ago. We are creating 1,000 extra training places for nurses and midwives over this session of Parliament and supporting our student nurses by keeping their tuition free and protecting their bursary, as other members have said. We have created a £1 million discretionary fund as a safety net for students in the greatest need.

We are transforming nursing roles to maximise nurses’ vital and unique role in the health and social care system. Our chief nursing officer is developing a fresh vision for nursing in Scotland and is taking it forward in partnership with nurses throughout the country.

We are investing £3 million to train an additional 500 advanced nurse practitioners as part of our health and social care system, plus a further £2 million to enhance the skills of general practice nurses in supporting the wider primary care transformation aims.

We are committed to enshrining safe staffing in law. We are doing groundbreaking work to place our nursing and midwifery workload and workforce planning tools on a statutory footing.

It is important to mention the return to practice scheme. We have a rich resource of former nurses who have dropped off the register for one reason or another. In January 2015, we announced £450,000 over three years to reintroduce a national return to practice scheme. Robert Gordon University in my constituency is at the forefront of that work.

Others have mentioned the international context. We know about Florence Nightingale’s nursing team in the Crimea and we heard about Mary Seacole not being allowed to join that team but going anyway, which showed her determination.

Clare Haughey mentioned the nurses and clinicians who go to other countries to learn about other ways of working and to help achieve the development goals. We have supported Scottish NHS clinicians to work with nurses in Malawi’s major hospitals in order to improve their skills, which has included working with oncology nurses at the Queen Elizabeth hospital in Blantyre to develop a multidisciplinary approach to cancer treatment. We supported Malawian breast care nurses to visit the UK to gain experience in diagnostics and follow-up clinics. I visited Mount Mulanje hospital in the south of Malawi, which has a lot of connections with Scotland.

As we speak, nurses are working away saving lives, comforting those in pain and delivering world-leading care in our communities and hospitals.

In recognition of international nurses day, I note that the Scottish global health collaborative seeks to create a framework for volunteering in global health that recognises challenges and constraints as well as the benefits at home and overseas. It intends to develop guidance that is helpful to clinical and non-clinical staff for those in training, those who are trained and their employing organisations.

We are in safe hands, not just on international nurses day but every single day. We thank nurses and appreciate them.

Meeting closed at 17:49.