Meeting of the Parliament

Meeting date: Wednesday, February 1, 2023

Official Report 869KB pdf

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Heart Month 2023

The final item of business today is a members’ business debate on motion S6M-07161, in the name of Paul McLennan, on heart month, February 2023. The debate will be concluded without any question being put.

Motion debated,

That the Parliament recognises that February 2023 is heart month; understands that ischaemic heart disease is still the single biggest killer in Scotland and that British Heart Foundation Scotland estimates that 11,000 people in East Lothian and 700,000 people in Scotland are currently living with the effects of heart disease; further understands that British Heart Foundation currently funds £53.1 million in ongoing research in Scotland across 10 universities in Aberdeen, Dundee, Edinburgh, Glasgow, St Andrews and Stirling, which is 54% of publicly funded cardiovascular research, and notes that British Heart Foundation Scotland’s priorities for heart disease services in East Lothian and across Scotland are to tackle heart disease risk factors, ensure timely and equitable care, and improve the collection and use of data.

16:41  

I am delighted to be opening this evening’s members’ business debate on heart month and I thank colleagues for attending tonight. February is heart month 2023.

I thank the British Heart Foundation for the briefing; there are a few key messages that it wants us to emphasise today. First, it asks us to do what we can to promote fundraising for the lifesaving research that the BHF undertakes. I will touch on that later.

Secondly, the British Heart Foundation is asking the public to learn cardiopulmonary resuscitation, with its new online tool, RevivR. For context, there are around 3,200 out-of-hospital cardiac arrests in Scotland each year and the survival rate is just one in 10. Performing CPR and using a defibrillator can more than double the chances of survival in some cases of cardiac arrest.

I have been involved in football coaching for many years and I have, sadly, seen two or three players die as young as 14, 15 or 16 years old. If there had been CPR or people who were aware of cardiac arrest and how to deal with it, those players might have survived. Every minute without CPR and defibrillation reduces the chance of survival by up to 10 per cent.

RevivR is a free online training course in which people can learn CPR in 15 minutes using just a phone and a cushion. The tool gives feedback on CPR technique and teaches the signs of cardiac arrest and when to call 999. It includes a step-by-step guide on how to use a defibrillator. I know that many of us will have learned that on first aid courses that run over a period of time, but RevivR is a really simple way to learn CPR that can be done at home in just 15 minutes.

I will give a bit of context by sharing some figures on heart disease from my constituency. In East Lothian, 11,000 people are living with heart and circulatory diseases and 1,800 people have been diagnosed with atrial fibrillation, which I will touch on later. Twelve thousand people have been diagnosed with high blood pressure, 750 have been diagnosed with heart failure by their general practitioner and 770 people have a faulty gene that can cause an inherited heart-related condition. In East Lothian, 27 per cent of adults are living with obesity and 16 per cent of adults smoke.

The British Heart Foundation is the largest public funder of cardiovascular research in Scotland. BHF Scotland is currently funding research worth over £53.1 million across Edinburgh, Glasgow, Aberdeen, Dundee, Stirling and St Andrews. That funding contributes an estimated £80.6 million in gross value added to the Scottish economy and supports almost 1,900 jobs.

Last year, along with a few other members, I had the pleasure of visiting BHF’s Edinburgh research centre at the Royal infirmary of Edinburgh. If members are interested, they should speak to BHF Scotland—I am sure that it would take them to visit the nearest centre.

BHF Scotland is also working as part of the non-communicable disease alliance Scotland to improve Scotland’s health. In 2021, nearly 53,000 deaths in Scotland were caused by non-communicable disease, which equates to 83 per cent of all deaths. Estimates by the British Heart Foundation suggest that around one in five of those deaths is directly related to alcohol, tobacco, weight and obesity. I know that the Scottish Government is currently working on all those issues.

This morning, along with Gillian Mackay and Dr Gulhane, I met the NCD alliance Scotland. Along with three other colleagues, we will be meeting the alliance monthly to discuss policy issues. NCD alliance Scotland is a coalition of 19 health organisations and charities that are campaigning for action to reduce the ill health and death that are driven by health-harming products including alcohol, tobacco and unhealthy food and drinks. Ill health and disability caused by tobacco, alcohol, weight and obesity are estimated to cost the Scottish economy between £5.6 billion and £9.3 billion every year. NCDs are estimated to cost the national health service £1.6 billion every year and the disease burden for NCDs is set to increase by 21.3 per cent by 2043.

I also thank Chest Heart and Stroke Scotland for its briefing, which raises important issues. Chest Heart and Stroke Scotland is Scotland’s largest charity supporting people living with chest, heart and stroke conditions. Last year, it supported 13,000 people through its advice line, community support services and stroke nurses. It also has a hospital-to-home service to support people who are living with heart conditions from the moment that they leave hospital. Again, I know that that is something that the cabinet secretary has raised on a broader basis.

I commend Chest Heart and Stroke Scotland for the work that it does in community sports outreach work. It does that in my constituency with walking football for many people who are stroke survivors and have heart conditions. I have seen the transformative nature of that work in the communities that I serve, although I have to say to Mr Yousaf that both my knees are now gashed because of it, which might put waiting lists up elsewhere in the system.

I can give you the time back, Mr McLennan.

I was going to touch on that subject. One of the key things that CHSS also mentions is that it facilitates 110 peer-support groups that provide emotional support, connection and advice to more than 2,800 people. It also talks about the groups that Bob Doris mentioned, so it plays a big part in the community.

I come back to the hospital-to-home service. It exists to support people as soon as they leave hospital, which is incredibly important. CHSS estimates that that service could support 38,000 people with chest, heart and stroke conditions each year if it was available in every health board. I have already mentioned that CHSS facilitates peer-support groups.

I also thank the Stroke Association for its briefing. Risk factors for stroke are similar to those for heart diseases.

I want to touch on atrial fibrillation, which I mentioned earlier. I will call it “AF” for ease. AF is a condition that causes an irregular heartbeat and raises a person’s risk of having a serious stroke. More than 105,000 people in Scotland have been diagnosed with AF, and it is estimated that around 35,000 people in Scotland are living with undiagnosed AF.

AF makes a person five times more likely to have a stroke. People who are diagnosed with AF have an individual stroke-risk assessment to make sure that they get the right treatment and advice. Strokes that are due to AF tend to be more serious, with more damage to the brain and worse long-term effects, so people with AF are offered any treatment that they need to reduce the risk of stroke.

An estimated six strokes are caused by AF every day in Scotland. In East Lothian alone, around 1,800 people have been diagnosed with AF. In a recent poll that was carried out by the Stroke Association, 67 per cent of people said they had never checked themselves for AF. When testing themselves, 79 per cent of people said that they found their pulse straight away or within a few seconds. It is easy to do and everyone should be doing it.

I want to close with a personal story. Two weeks past, my mum experienced numbness in her left arm and hand over the weekend. She phoned her general practitioner on the Monday and was seen that day. She was referred to the stroke clinic on the Wednesday—it was thought that she had had a mini stroke. She was booked in for an operation to remove a blockage in her neck the following Tuesday, the operation took place on the Wednesday and she was back home on the Thursday. She was diagnosed, referred and had the operation all within 10 days.

We have a fantastic national health service that we should be proud of. Let us make sure that we talk about the fantastic work that goes on every single day.

We move to the open debate.

16:48  

I congratulate my colleague and friend Paul McLennan on securing this members’ business debate, and I associate myself with his praise for the British Heart Foundation Scotland and for Chest, Heart and Stroke Scotland.

As Paul said, February is heart month. The heart is one of the most recognised symbols in the world, from the Greek philosophers, to I “heart” New York, to video games. The heart represents our strongest emotions, both positive and negative, and our needs: it represents love, fear, pain, health, lives.

The heart is our body’s power supply—without it nothing works. Electric pulses that are created by your heart supply energy to every organ in your body. If that power is switched off—if the heart stops—blood and oxygen no longer flow and the person starts to die.

Everyone in this chamber, I am sure, will have experienced the loss of a family member, friend or colleague due to cardiac arrest. Many of us, too, will know the relief of having a loved one survive. It is those experiences that lead us to try to make a difference, and to help more people to survive.

That is exactly what Mull and Iona Community Trust has done by investing in defibrillators. It has secured funding, sited defibrillators at strategic locations on the islands and appointed volunteer guardians, of whom there are 37, to check them monthly.

Research suggests that there should be one defibrillator per 1,000 people in rural areas. That equates to three defibrillators on Mull. However, the area of Mull is five times that of Glasgow, where a defibrillator every 200m is suggested, and it has around 600,000 visitors a year.

The survival rate for out-of-hospital cardiac arrests—of which there are around 3,200 in Scotland every year—is only 10 per cent. To put it starkly, every minute without cardiopulmonary resuscitation and defibrillation reduces the chance of survival by 10 per cent. With such statistics, members can understand why the Mull and Iona communities have worked so hard to increase the number of defibs on their islands.

To create such a network requires a lot of funding. People have raised money, and businesses in Argyll and Bute have worked with community councils to enhance the network of defibrillators. For example, Scottish Sea Farms has installed accessible defibs at its facilities and, when Cruachan’s iconic dam and underground power station played a starring role in the television series “Andor”, the Drax Group provided funds to help to create a rural defibrillator network.

However, something very simple could be done to boost the number of defibs across the country and ensure that our rural areas and less-affluent areas have access to them. It is, simply, to remove VAT from them. I have written twice to the Chancellor of the Exchequer to request that that modest proposal be considered. I very much appreciate the cross-party support for that request, and the support from a number of organisations, including St John Ambulance and community councils throughout Scotland. I hope that Westminster takes note of the Irish Government’s decision to remove the 23 per cent VAT levy from defibs on 1 January this year. The Irish Heart Foundation described that as

“a victory for common sense”.

I hope that the chancellor can have a heart and do the same.

I and others will not be giving up; the issue is simply too important. However, in the meantime, as Paul said, the British Heart Foundation Scotland is asking us to do two things: first, to ensure that defibs in our areas are all in the Circuit—that is, the national network of defibs that has been created by the BHF with the ambulance services for quick access to help to save lives—and, as Paul explained, to learn CPR with the BHF’s new free online tool RevivR.

This February, I urge everyone to think of hearts not just on Valentine’s day but all month; in fact, I urge everyone to think of hearts all year.

I found a haiku by the American writer Eric Overby that feels like the appropriate way to conclude my contribution:

“My heart beats with you,
Love runs red throughout my veins,
Making me alive”

I will give a gentle reminder and repeat the Presiding Officer’s earlier comment about informality: members need to use surnames as well as first names. I think that the minister may have led you astray in the previous debate.

16:53  

I thank Paul McLennan for securing the debate and congratulate him on doing so. It is timely and very important.

The figures in the motion highlight the devastating effect that heart disease can have on communities throughout Scotland. The numbers are stark, and they demonstrate the huge challenge that we face.

It is important that we take note of the work of the British Heart Foundation over the past 60 years and vital that we thank it for its significant contribution. It has been instrumental in countless life-saving discoveries. Its research has contributed to the first United Kingdom heart transplant, the development of pacemakers, the use of clot-busting drugs to treat heart attacks and the roll-out of genetic testing for inherited heart conditions. It is the largest independent funder of research into heart and circulatory diseases in Scotland, and it is currently funding more than £50 million of research in Scotland. That research is entirely funded by public donations.

Last year, I had the pleasure of visiting the team at the BHF shop in North Berwick in East Lothian. I met Jonathan Roden, who is British Heart Foundation Scotland’s policy and public affairs manager, and Patricia Prentice, who is the North Berwick store’s assistant manager. I had to rush off before buying something, so I pledge today that I will go back and make a purchase with Patricia and her team. I will say that there was a queue, before the minister chides me for that.

At the shop, I heard that volunteers are the bedrock of the work that the BHF undertakes and of the vital success that it has had with the funds that it raises. It was a reminder of the very positive experience of volunteering. As well as helping good causes such as the BHF, volunteering is a great opportunity to meet new people, gain new skills and help the environment by giving unwanted items a new lease of life, so I encourage people across East Lothian and the south of Scotland to take up the volunteering opportunities that are available with the BHF.

I want to raise the important issue of sudden cardiac death. Sadly, our Parliament has first-hand and recent experience of that. Last year, David Hill, a friend and colleague to many of us, sadly passed away while representing this Parliament in Dublin. He died playing rugby against the Dáil and the Seanad. He died playing a sport that he loved. What is particularly devastating about the condition is the way that it hits families such as David’s out of the blue with no warning. Some 80 per cent of people who die from it present no symptoms beforehand.

I take this opportunity to mention David’s family. Since his death, they have raised thousands of pounds to support the charity Cardiac Risk in the Young through a music event in Dumfries—“A Day for David”. There will soon be an annual rugby match between Holyrood and the Dáil at which the teams will compete for the David Hill memorial quaich, and there will be opportunities throughout the day to raise money for CRY.

We need to do more on that issue in Scotland, and I hope that the minister will consider how we might explore that. Every year, 600 young people lose their lives due to sudden cardiac death. That is 600 families who are left mourning the loss of a loved one. That is why I invite the minister to agree today to establish a national strategy for the prevention of sudden cardiac death in the young. If he is unable to do that today, is he willing to meet me and CRY to hear more about the subject?

Not only do these deaths devastate all the people who are connected to the person who dies but we lose the potential that that young person had and wanted to bring to the world and our society. All the skills that they had are lost and all the good things that they would have contributed are left undone. It is a problem that we face as a society and one that we can fix if we put our minds to it.

Once again, I thank Paul McLennan for securing today’s debate.

16:57  

I, too, congratulate Paul McLennan on securing this important members’ business debate. The subject is incredibly close to my heart, if members will excuse the pun, and the reason is my mother—my ma, Violet. She was an incredible woman. She took no prisoners in life, and she was upfront, honest and authentic. She was very funny, with quite a dark sense of humour. Her wit was as sharp as her mind, and she could wipe the floor with anybody in a quiz. She was a very politically active and aware woman who was an activist for Scottish independence and feminism way back in the 1960s. She loved rock music. I came across old pen pal letters of hers in which she was adamant that the Rolling Stones were far superior to the Beatles, which is perhaps a debate for another day. Most of all, her love of Elvis was what shone through. We had that in common, and it was a connection that we adored together.

That connection was lost almost 23 years ago, when she died suddenly of a heart attack aged only 49, alone and at home. A doctor discovered her while doing their rounds as she had called them and said that she did not feel quite right. If she had called an ambulance or if the symptoms had been escalated as an emergency, perhaps she would still be here now, but I can only speculate.

I will be 48 this year—nearly the same age as she was—and I wonder how far we have come in preventing this kind of devastating loss. I certainly do not want my fate or that of any other woman to be as abrupt and sudden as my mother’s.

Until recently, heart disease was the biggest killer of women in Scotland—it has now been overtaken by dementia—and I am still surprised to see how many people do not know that utterly shocking fact. Why do we still assume that heart disease and heart attacks are a men’s problem? The British Heart Foundation published a report called “Bias and Biology”, which was a welcome move to understand the underlying issues that might answer that question. There were five calls in the report, and I am delighted that the Scottish Government committed to include heart health as a priority in the women’s health plan, which was launched in 2021, along with those five asks. The report called for

“Improved awareness among the public and health care professionals of heart disease in women ... Improved data collection and linkage for heart disease ... A review of SIGN guidelines on heart disease to identify and address any relevant gaps relating to sex-specific issues ... The modernisation of cardiac rehabilitation to ensure that everyone can access personalised, responsive and flexible services suited to their needs”

and

“The appointment of a national Women’s Heart Champion to implement these changes.”

Fully actioned, the five calls will save lives and ensure a future in which families like mine will no longer have to deal with the devastating loss of someone who is so young. Women’s health must be taken seriously, and women must take their own health seriously. Much of what we will discuss in the debate is preventable, which is the starkest wake-up call of all.

In 2013, I travelled to Memphis to Elvis’s Graceland, where, wearing my mother’s ring, I squeezed my hand through some wooden bars to touch Elvis’s furry chair in his jungle room. It was a sentimental moment to symbolise a connection with someone who is no longer here—a moment that I wished my mum could have shared with me. I have personalised my speech because, during heart month, I want to highlight the human cost of heart disease. I ask women to take their heart health seriously and to prioritise themselves. Women’s hearts are often full of love and service for others, but our hearts are also our vital organ. I urge women to take care of their hearts and to demand that their health providers do, too.

17:02  

I congratulate my colleague Paul McLennan on securing this important debate. February is heart month, and I thank the British Heart Foundation Scotland for the vital work that it does in my Cunninghame North constituency and across Scotland, investing more than £50 million in more than 100 Scottish research projects. I have often visited and purchased items from its large shop in my constituency. I hope that, after First Minister’s question time tomorrow, all members will gather at the foot of the garden lobby steps for a photo call in recognition of heart month.

Cardiopulmonary resuscitation, or CPR, is essential to saving lives. With RevivR, a 15-minute online BHF training course, each of us can learn how to save a life. In 2021, there were 7,048 deaths in Scotland in which coronary heart disease—the most common type of heart illness—was the underlying cause.

The 19 per cent reduction in CHD mortality over the past decade is to be welcomed. However, further progress in the rate of decline has slowed in recent years, mainly due to our ageing population. Demographic change is another reason why, by 2043, the burden of cardiovascular disease is projected to rise by 34 per cent compared with 2019—more than for any other category of illness—according to a Public Health Scotland study that was published in November. Therefore, I am glad that the Scottish Government’s “Heart Disease Action Plan 2021”, which was described as “laudable” by Dr David Murdoch, a consultant cardiologist at Queen Elizabeth university hospital in Glasgow, included minimising

“preventable heart disease by improving the detection, diagnosis and management of risk factor conditions”

as its top priority.

Sadly, Scotland has a relatively high prevalence of key heart disease risk factors, such as smoking and poor diet. The heart disease rate in the most deprived quintile of the population is two thirds higher than in the least deprived one. British Heart Foundation findings show that North Ayrshire has the fourth highest death rate in Scotland. Indeed, around 2,000 people die from smoking-related heart disease in Scotland each year, which is approximately one in seven of all circulatory disease-related deaths. The chemicals in cigarettes make the walls of human arteries sticky, which causes fatty material to stick to them, clogging and reducing blood flow and increasing the risk of heart attack.

Research by the European Society of Cardiology shows that e-cigarettes raise blood pressure and heart rate, and they change artery walls so that they become stiffer and less elastic. They inhibit the function of blood vessels by damaging their lining. I was therefore grateful to my colleague Siobhian Brown yesterday for raising in the chamber the problems that are posed by widespread youth vaping.

We can only reduce the number of deaths that are caused by heart disease if we continue working to reduce the risk factors. One challenge in preventing heart disease is engagement with hard-to-reach segments of the population, particularly poorer households that are at high risk of preventable ill health. Many people in Scotland already live with at least one risk factor, often without being aware of it.

The British Heart Foundation Scotland has worked hard for decades to change that by working to save lives across Scotland, from its dogged campaign over 20 years on organ donation, to its pursuit of equal treatment for women with heart disease and encouraging people to learn CPR. I have been involved in all those efforts and have raised them in the chamber over the years.

Community defibrillator availability is important. As Paul McLennan and Jenni Minto have said, every minute lost awaiting CPR reduces survivability following a cardiac arrest by 10 per cent, and defibs double the chance of survival.

In August last year, a man suffered a heart attack while waiting for the train at Dalry station in my constituency. Fortunately, the train driver witnessed it and informed the passengers. A doctor stepped off the train and performed CPR, while two other passengers ran to Dalry cross and back to fetch a defibrillator, before the ambulance arrived shortly after. The patient fully recovered thanks to the quick reaction of everyone who was involved in helping—and the availability of a defibrillator. I am pleased that one has now been installed at Dalry station. Of course, more people need to learn how to use them.

It is clear that, although significant progress has been made in recent years in reducing the number of deaths that are caused by heart disease, Scotland faces challenges that are due to a combination of an ageing population and a relatively high prevalence of risk factors for heart disease, especially in areas that are in the most deprived quintile. Prevention already plays an important part in the Scottish Government’s heart disease action plan, but progress in the number of people training in CPR and the installation of more defibrillators remain vital.

I once again thank the British Heart Foundation Scotland for its invaluable work and Paul McLennan for bringing the issue of heart disease to the chamber.

17:06  

I begin, as others have, by congratulating my colleague and friend Paul McLennan on bringing this important and vital debate to the parliamentary chamber. I also thank the British Heart Foundation for the fantastic work that it does in Scotland. We know, as every member has mentioned in their contribution, that heart disease unfortunately remains a significant cause of ill health and, indeed, death in Scotland.

Let me also echo other members in congratulating the British Heart Foundation on the phenomenal work that it carries out to tackle cardiovascular diseases. As others have mentioned, it is the largest public funder of cardiovascular research in Scotland: it funds over £53 million of research across 10 Scottish universities, meaning that almost 13 per cent of the British Heart Foundation’s current research portfolio is spent in Scotland. That reflects its commitment to Scotland and to working with our partners here to address the issues around cardiovascular disease. It also reflects, I hope, the quality of cardiovascular research that is taking place right across our country. We should all be very proud of that, and a note of recognition is due to the researchers whose hard work is at the very heart—if members will excuse the pun—of that success.

Of course, the British Heart Foundation’s mission does not stop at funding research. It has a number of other priorities, which have been mentioned in members’ contributions:

“to tackle heart disease risk factors, ensure timely and equitable care, and improve the collection and use of data”.

Those priorities, which are outlined in Paul McLennan’s motion, are entirely aligned with the priorities in the Scottish Government’s heart disease action plan.

I will touch on some of the points that have been made in contributions to the debate. Paul McLennan started by urging us all to familiarise ourselves with the BHF’s online tool for learning CPR, RevivR. Others have mentioned that it is important not just that we know how to perform CPR correctly, but that we know how to use a defibrillator, too. Kenny Gibson made that point a moment ago, and it is a good reminder to all of us—even those who have learned first aid in the past—to make sure that we are refreshed on CPR techniques, as they could literally save lives.

I am a member of the Health, Social Care and Sport Committee, and it occurred to me that we did the RevivR training during committee one morning. Will the cabinet secretary consider whether it would be worth rolling that out to other MSPs on the Parliament campus?

That would be a decision for the parliamentary authorities, but it is an excellent idea. I will take it to the Government, because it would certainly be good for me and other ministers to do that training.

It reminds me of a time in my life when I witnessed somebody having a cardiac arrest. It was at a reception and I was talking to the individual when they fell on their back and had a cardiac arrest. There were another 20 or so people in that room, and I am sorry to say that I did not know what to do. I was not sure about the signs and what was taking place in front of me. Luckily, one of the waitresses was also a student nurse, and she leapt into action. There was also a defibrillator, and the paramedics had a very quick response time indeed. Luckily, the individual is alive and with us today, I am pleased to say. However, the paramedics made it very clear that the story could have been very different if that student nurse had not been in the room. I take the opportunity to thank every single one of our hard-working health and social care staff for their excellent work. Nevertheless, none of the other 20 people in the room leapt into action, because we were not sure what to do. That was the moment when I thought that I really needed to learn CPR and some basic first aid, and I went on a course shortly thereafter.

The other point that I want to talk about has been mentioned only indirectly: inequalities. One of those inequalities is racialised inequality, particularly around chronic obstructive pulmonary disorder and heart disease. It is important that we do not lose sight of the racialised health inequalities that we know exist. My mentor, the late Bashir Ahmad, a former member of the Scottish Parliament, passed away from a heart attack at the age of 68. We know that cardiovascular disease and COPD can affect ethnic minority communities disproportionately more than they affect the white Scottish population. It is therefore important that, when we look at inequalities, we look at the various factors that cause them, such as socioeconomic and racial factors, and the intersectionality between them.

A number of members made excellent contributions. Jenni Minto made an important point about the campaign that she has led, which other MSPs and MPs have joined, to remove VAT from defibrillators. I am happy to take that up with my UK counterpart. I was speaking to him today, but I will speak to him again to see what we can do to add our weight to a sensible campaign. I will certainly explore what more the Scottish Government can do to increase the number of defibrillators that there are in communities across the country. That can only be to the benefit of everybody. I am grateful to Jenni Minto for raising that point.

We will hold Craig Hoy to his promise that he will purchase an item from the BHF store in North Berwick. I am sure that he will keep that promise. More seriously, he made a point about sudden cardiac death, and I am more than happy to meet him along with the campaign group that he referred to. I am also grateful to him for mentioning David Hill’s story. David was known to many of us in the Parliament. I met his family some months ago, at a Scottish Rugby reception, and I am in awe of how they have turned those tragic circumstances into campaigning for better awareness of sudden cardiac death. Nobody would fault them for grieving the loss of David, and I am sure that they do every day, so I am grateful to them for doing what they are doing. I am more than happy to meet Craig Hoy and get that meeting arranged.

I would have loved to meet Karen Adam’s mum—it sounds as though she was an incredible woman. The point that Karen made about women’s health is so important. Heart disease affects not just men, and she is right in saying that it is a central part of our women’s health plan. A number of people were quite surprised that we included heart disease in the women’s health plan, but they very much understood the importance of women, as well as men, knowing the risk factors for heart disease.

I am grateful for all the contributions today. We will continue to work with partners such as BHF, CHAS and others, and I recommit and rededicate the Government to doing everything that we can to tackle heart disease across Scotland.

Meeting closed at 17:15.