Meeting of the Parliament

Meeting date: Wednesday, May 17, 2023

Official Report 1149KB pdf

---

Lyme Disease

The final item of business is a members’ business debate on motion S6M-07769, in the name of Evelyn Tweed, on national Lyme disease awareness month. The debate will be concluded without any question being put.

Motion debated,

That the Parliament acknowledges that May 2023 is National Lyme Disease Awareness Month; notes that Lyme disease is a bacterial infection spread to humans by infected ticks, which are tiny spider-like creatures found in woodland and moorland areas that feed on the blood of birds and mammals, including humans; understands that many people with early symptoms of Lyme disease develop a circular rash around the tick bite three to 30 days after being bitten, often described as looking like a bull’s eye on a dart board, whilst some people may develop several rashes in different parts of their body, and around one in three people will not develop a rash; further understands that some people with Lyme disease also have flu-like symptoms, including tiredness, muscle and joint pain, headaches, a high temperature, chills and neck stiffness; notes the calls encouraging anyone who has been bitten by a tick and develops a rash or flu-like symptoms to speak to their GP and tell them that they have been bitten by a tick; further notes, however, that diagnosing Lyme disease is often difficult as many of the symptoms are similar to other conditions; acknowledges that NHS Scotland advises that Lyme disease is treatable, however, that without treatment, more serious and longer-term symptoms may develop, including pain and swelling in joints, nerve problems, memory problems, difficulty concentrating and heart problems; understands that there is currently no vaccine available and that the best way to prevent Lyme disease is to adopt simple measures when in the countryside or near wildlife, including tucking trousers into socks and wearing insect repellent, and notes the calls encouraging anybody who is concerned that they have contracted Lyme disease to contact their GP and for everyone to take precautions when in the countryside.

17:47  

I am very happy to speak in the chamber in Lyme disease awareness month. This is a very personal debate for me, as I first became aware of Lyme disease through my good friend Pauline Bowie, who I have known since our university days. Pauline is now an ambassador for the Lyme Resource Centre, and she is in the gallery tonight with fellow Lyme disease sufferers, colleagues and young people from St Peter the Apostle high school in Clydebank. I warmly welcome them to our Scottish Parliament.

Working at a summer camp in 1989, Pauline noticed a small circular rash on her thigh. She was told by the director that it was probably ringworm. Over the next few years, she suffered a range of debilitating symptoms, from flu-like symptoms to inflamed joints, nausea, insomnia and dizziness. She had breathing difficulties and heart palpitations, and she was diagnosed with anxiety and hyperventilation. She was told how to use a paper bag to breathe into. She was unable to do many of the things that she loved, but she could not get answers from doctors.

Years passed and her symptoms worsened. By the mid-2000s, she had extreme joint pain. In 2017, she suffered two incidents of pain so extreme that she was hospitalised with a suspected heart attack. Dizziness, speech slurring, blurred vision and brain fog were all put down to anxiety, and tests were inconclusive. Thirty years later, after hearing that her cousin was ill with Lyme disease, Pauline googled it and was very shocked to find that she was a textbook case.

Lyme disease is caused by a bacteria called Lyme borreliosis, which can be passed on to humans by infected ticks. Ticks infected with Lyme disease are found all over the United Kingdom. There are ticks anywhere that there are pets, wild mammals and birds—in woodland, in open countryside and even in urban parks and gardens. Removing ticks quickly helps to prevent infection, but removing them incorrectly can actually increase the infection risk.

Many people with early symptoms develop a circular red skin rash around the tick bite, which is often described as looking like a bull’s-eye on a dartboard. Lyme disease can also cause flu-like symptoms, fever, fatigue and migratory joint or muscle aches and pains.

There are conflicting opinions on how best to treat Lyme disease, but it is most often treated through a course or courses of antibiotics. Lyme disease can often be treated effectively if it is detected early on, but if it is not treated early or treatment is delayed, there is a risk of developing severe and long-lasting symptoms, such as Pauline’s.

For people without the red rash, laboratory tests are used to diagnose Lyme disease. However, the tests are not sensitive and cannot tell the difference between current and past infections. There are enormous challenges in diagnosing Lyme disease. Many people do not notice that they have been bitten by a tick. It is easily missed given that some bites are as small as a poppy seed. Often, when symptoms appear, people do not associate them with ticks.

That is what happened to Lesley Paterson, world champion triathlete and Oscar-winning screenwriter, who is from my constituency. Lyme disease took her out for a year. Even now, it still impacts her, and like many others, she has no idea where or when she was infected.

What we see as the classic indicator of Lyme disease—the bull’s-eye rash—often does not look like a bull’s-eye. It can appear in different shapes and have different presentations on darker skins, and it does not appear at all in about a third of cases.

Lyme disease’s wide-ranging symptoms can look like any number of other conditions, resulting in the disease being called “the great pretender”. Symptoms that later turn out to be caused by Lyme disease are misdiagnosed as other conditions, such as anxiety or chronic fatigue.

Patients have been dismissed and told that the symptoms are in their heads. When Pauline told her doctor that she thought that she might have Lyme disease, she was told that she was jumping on a fad. Inevitably, that lack of awareness among general practitioners has a detrimental effect along existing lines of inequality. Those who are already marginalised—women, disabled people and people of colour—are less likely to get a diagnosis and timely treatment.

Lyme Disease Action developed an online training course in collaboration with the Royal College of General Practitioners, covering how to identify and treat the disease. However, the charity Lyme Disease UK notes that only a very small percentage of GPs have taken the course.

Tick bites are often associated with recreational activities, such as hillwalking, and working in sectors such as forestry and farming. However, more evidence is being found of the risk of tick bites being much closer to home. The big tick project found that one third of dogs that were checked in its study had ticks attached to them. Pet owners are at risk as ticks can drop off in the home or transfer, but 47 per cent of owners were not aware that they, too, are at risk of infection from tick-borne diseases.

The British Medical Journal has called for more national and international debates on Lyme disease, which I am glad we are contributing to today. It has also called for a solid research agenda, as well as robust public awareness campaigns. Indeed, Dr Lucy Gilbert, a senior research fellow from the University of Glasgow, has noted the need for more research into tick populations and Lyme disease in urban areas. However, funding remains a challenge.

There is huge appetite for change in this area, from committed and well-informed organisations such as the Lyme Resource Centre that are leading awareness campaigns, to a start-up in the Highlands that is developing an app to map the risk of Lyme disease. As well as awareness raising, action such as bracken control can help to mitigate risks.

The issues here are multisectoral and overlap with healthcare, education, forestry and land management, and academia. To take successful action—

Will the member take an intervention?

Yes, I will take an intervention.

From what Evelyn Tweed is saying, deer are a key host of ticks. Therefore, it is important that we support our rural workforce to ensure that we have individuals who are able to effectively manage deer populations to stop the spread of Lyme disease.

Anything that we can do in looking at the tick population and Lyme disease needs to be considered.

I will go back to the part of my speech that I was just finishing off. The issues here are multisectoral and overlap with healthcare, education, forestry and land management, and academia. To take successful action, a collaborative approach is required.

I look forward to hearing everyone’s contributions to the debate and what steps the Scottish Government will take to engage stakeholders and tackle the issues surrounding this complex disease.

17:56  

I congratulate my colleague Evelyn Tweed on securing this important debate and on her thoughtful and knowledgeable opening speech.

I am pleased to be able to speak in tonight’s debate on raising awareness of Lyme disease. It can be devastating to people, and it is vital that everyone knows how to prevent its transmission. I am a committed campaigner on the issue, and the debate is very welcome as a useful vehicle to get the message out.

In Scotland, there has been a significant increase in the number of cases of Lyme disease that are reported each year. Lyme disease is an increasing problem, and as we enter the warmer summer months, it is vital that, alongside our healthcare partners, we do all that we can to ensure that our constituents are properly informed about its danger.

One of the few benefits that came out of the Covid-19 pandemic was that many people took the time to explore everything that Scotland has to offer. They spent time walking, hiking and enjoying our beautiful outdoor spaces. We are so fortunate to have such fantastic countryside on our doorstep, but with that renewed desire to explore those areas, there has been a sharp rise in the number of people being bitten by ticks, the main driver of Lyme disease in Scotland.

Recent research found that almost two thirds of people in Scotland have been bitten by or know someone who has been bitten by a tick. More concerning than that, however, is that the same research found that more than half of people in Scotland do not know what to do when bitten by a tick. Those are extremely concerning figures, which show just how much work we still need to do.

I am pleased to repeat the experience of my constituent Pauline, who joins us here today in the public gallery alongside pupils from St Peter the Apostle high school in Clydebank. Pauline is keen to raise awareness of the disease’s impact and share her story. As Pauline’s MSP, I am happy to do so and ensure that the voices of my constituents are heard in our Parliament.

After Pauline was bitten by a tick more than 30 years ago, she experienced flu-like symptoms and an expanding bull’s-eye rash. She was misdiagnosed numerous times, and it was not until 2018 that, after seeing a range of specialists, she was finally diagnosed with Lyme disease. Unfortunately, she spent decades facing a wide range of debilitating symptoms before getting the treatment that she needed. It was an absolutely horrific experience for Pauline, and we must do everything that we can to ensure that situations like that do not happen again.

I was also struck by the case of Rico Franchi, which was publicised by the national health service. Rico is a 40-year-old father of three who has lived with Lyme disease for more than 12 years. He went from being a super-fit gym goer to being completely floored. His lifestyle was significantly disrupted. If it can happen to Rico, it can happen to any of us.

There is no cure for Lyme disease, so we must do three things. We must educate people about prevention, improve our testing capacities and ensure that patients with Lyme disease get the treatment and support that they need. With the warmer summer months just around the corner, it is important that we prioritise the first of those actions, which involves educating people about how to deal with tick bites.

People should always check for ticks after spending time in green spaces, carefully remove any ticks as soon as possible, make sure that their socks are tucked into their trousers when they are in green spaces and see their GP urgently if they develop a red circular rash and flu-like symptoms.

We want to ensure that people enjoy their time in Scotland’s beautiful outdoors, but we also want to ensure that they do so safely, so that they do not have to go through what Pauline, Rico and many others have had to endure.

18:00  

I thank Evelyn Tweed for securing this important debate recognising national Lyme disease awareness month.

Since I was elected in 2016, I have been involved with the campaign to improve awareness, diagnosis and treatment of Lyme disease, meeting with petitioners, professors, doctors and groups such as Tick-borne Illness Campaign Scotland to try to make progress on improving materials and education on the disease.

Sadly, as we have heard, many sufferers of Lyme disease are misdiagnosed due to the lack of knowledge surrounding the disease, which can have long-lasting and debilitating effects. Although we encourage people to enjoy the outdoors and explore our beautiful countryside, thousands of new cases are detected every year across the United Kingdom, so we need to educate medical staff to ensure that they recognise the disease. We know that early diagnosis and treatment of Lyme disease is vital. If that does not happen, patients risk developing devastating symptoms. As we have heard, early signs can include the bull’s-eye rash, flu-like symptoms and fatigue. If untreated, the condition can develop into joint pain and swelling, nerve problems, heart problems and chronic fatigue syndrome.

It is very troubling to hear of the appearance in the UK of the new tick-borne encephalitis virus, which reportedly can be fatal, and I hope that the Scottish Government engages with a UK-wide approach to improve detection of that.

The issue that we are discussing is not just a rural one, as budget cuts to councils have resulted in less grass cutting in urban parks—it is often dressed up as conservation, but it actually just creates a breeding ground for ticks and more infections.

Although advice such as rolling up our socks might seem sound, it is akin to the former First Minister telling schools to chop the bottom off doors during the pandemic. It is a poor substitute for improving resources and public awareness campaigns from the Scottish Government.

We need to ensure that all avenues of raising awareness are used, so I was very interested in LymeApp, a service that was piloted in the Highlands a few years ago. However, I have heard no more about progress on that or when it will be extended across Scotland. I hope that the minister can update us on that tonight.

I am also delighted that the first-ever conference on tick-borne diseases will be held in Inverness later this month.

Over the past few years, I have raised numerous questions in Parliament to find out what action is happening. The Scottish Government recently confirmed that it will continue using its own platforms to highlight the risk and symptoms of Lyme disease. However, three years ago, when I asked how much traffic those webpages obtained, I noted that the results were poor. The Scottish Government’s page on avoiding bugs and germs outdoors, which also contains information relating to Lyme disease, had a little more than 12,000 views in the three years to 2020. I would be interested to hear the updated figures for that and other sites.

Further, I note that, in a world with social media at our finger tips, neither the Scottish Government account or the office of the chief executive of NHS Scotland account has tweeted about Lyme disease since last year, and the NHS National Services Scotland account has not tweeted about ticks or Lyme disease since 2020. Not one of those accounts—or other relevant accounts such as those of Public Health Scotland and NatureScot—has tweeted in support of Lyme disease awareness month. Can the minister tell me where the public campaigns that the Scottish National Party Government promises are?

I am not sure whether the member has not seen it, but I noticed a Scottish Government awareness campaign about ticks yesterday.

I am very glad for the member, but I do not think that that reduces the point that there are numerous sites within the control of the Scottish Government that should be pushing awareness of Lyme disease and are clearly failing to do so.

I repeat my question to the minister: where is the information being spread to warn as many people as possible of the risks of ticks, and what commitments will the Scottish Government make to improving awareness, testing and treatment of Lyme disease?

Finally, who exactly sits on the Scottish Government-led Lyme disease awareness-raising group, and what action has it taken this month? I ask that because, after seven years of being involved in this subject, the silence is deafening.

18:05  

I thank my colleague Evelyn Tweed for securing this vital debate on Lyme disease awareness month. My speech will be based around cause and effect.

Lyme disease is spread by ticks, so the effect of not controlling ticks and their habitat is more Lyme disease. I used to marvel at the skill and stockmanship of the people I used to refer to as the high hill folk, who farmed cattle and sheep on the hills over thousands of acres with wild-bred sheep and dogs to match. Ticks were of huge concern to them, which was why the old sheep-dip pens would be a hive of activity at least twice a year as neighbours rallied around to get the hill ewes dipped. The spring rise before dipping could see literally hundreds of ticks hanging from pregnant sheep, causing anaemia and poor thrive or sheep-killing diseases such as louping ill virus and tick-borne fever in young stock. In areas of high infection, louping ill could kill anywhere between 5 per cent and 10 per cent of young stock in any given year.

The need for hill-bred sheep to be bound to the ground is in large part due to the ability of the sheep to deal with tick-borne infections as a result of the genetic make-up of generations of sheep that have been bred on the same ground over many decades—if new sheep are brought on to that ground, losses due to tick-borne fever or louping ill can be as high as 60 per cent of infected animals. It is for those reasons that chemical preventions such as the old-fashioned—and now no longer used—organophosphate dips were created. They were highly effective at killing ticks and scab mites on sheep, and I can remember quite vividly the clean smell, as well as the lift in the health condition and vitality of freshly dipped sheep. However, those dips were not without side effects, particularly for humans, and were replaced by the synthetic pyrethroid dips, which were good for controlling scab mites but not ticks. That led to the invention and evolution of the pour-on insecticides that are now used and that are extremely effective at killing huge numbers of ticks, which, in turn, makes it easier for humans and dogs to avoid being bitten.

Presiding Officer, the reason for me asking for this indulgence in describing hill farming and its history of controlling tick infestations is that, over the past 20 to 30 years, literally hundreds of thousands of hill sheep have been taken off the hills as farmers have found it harder and harder to be profitable. What that has meant is that the tick has been allowed to thrive unchecked over the huge swathes of Scotland from which the sheep have gone. For a number of years, grouse moor managers bought hundreds of male castrate sheep—called wethers—and ran them over the hills as tick mops to try to control tick numbers. Those wether sheep would be treated with chemical pour-on and released to the hill. As they swept over the ground, they would mop up huge numbers of ticks that would, in turn, be killed by the insecticide on the sheep.

I agree with the measures that are taken to reduce the load of ticks in the environment and, therefore, reduce the impact on humans. Does the member agree that bracken control is absolutely vital in reducing tick load in the countryside and that, right now, there is only one chemical herbicide—Asulox—that can do that effectively? We are waiting for an emergency authorisation to use that; NatureScot has called for that provision to come into force. Does the member agree that we need a year-on-year licence to allow that chemical product to be used, rather than the annual circus where we see farmers and sprayers having to argue their point each year?

Patience is a virtue—I am coming to that issue.

Treating sheep for ticks has helped ground-nesting birds, other wildlife, grouse moor managers and sheep and cattle farmers; a by-product of that intervention is that it has helped the folk we tell to get out and enjoy the countryside—the ramblers, walkers, hikers and campers who take to the hills in their thousands every weekend—by cutting down the sheer number of ticks that can infect people, mammals and birds alike.

One of the interventions that we can use, among others, is habitat control, and that brings me on to the subject that is high on the agenda right now: bracken control. As we know, bracken is a noxious weed that grows in abundance on our hills, reaching up to five or six feet tall, blanketing literally thousands of acres of hill ground and ensuring that nothing else can grow.

That creates virtual deserts of bracken that are, importantly, a harbinger of huge numbers of ticks. The height of the bracken means that the ticks waiting for a host to feed on can be at shoulder or even head height to a human. My colleague Fergus Ewing will talk more about this, but bracken control is difficult, especially on hill ground, which is often too steep and dangerous for mechanical interventions.

I urge the Scottish Government to please issue with maximum urgency the licences that are needed for arial bracken control using asulam. For the avoidance of doubt, no one uses Asulox unless it is an absolute last resort, not least because of the cost. There has been no new science this year that is any different from that of last year. I very much hope that the decision to issue the licences is imminent.

18:10  

I thank Evelyn Tweed for bringing this interesting debate to the chamber. I am not putting myself forward as an expert in tonight’s debate and I have tried really hard to listen to all contributions by the members and will endeavour to go back and speak to the Labour group because this seems to be an important issue and we need to push to get it right for people. I am grateful for the opportunity to speak in the debate on behalf of Scottish Labour, and to make that commitment.

Like many members, I represent a rural region, South Scotland, which has so much beautiful woodland and outdoor space so, even before tonight’s debate, I recognised the issues around ticks and the associated bacterial infection of Lyme disease. We know that the symptoms might not be easily recognised and diagnosed, which means that they can be missed, as Evelyn Tweed said, so I hope that highlighting the issue will ensure that there is better awareness among the population thus reducing the risk of infection. Raising awareness will also help to support NHS staff and the healthcare workforce to recognise the signs and symptoms, which will result in appropriate diagnosis of the condition.

As we have heard, Lyme disease is a bacterial infection that is spread to humans by infected ticks. Many of us who have dogs who enjoy long woodland walks recognise ticks as tiny spider-like creatures that are found in woodland and heath, although they can be found in any area of deep or overgrown vegetation where animals feed. Although reported to be more prevalent in the Highlands of Scotland, we are not just talking about rural areas: woodlands and dense vegetation in urban parks see plenty of wildlife, including the spider-like tick. Members have brought out very well that we are now seeing them in other areas where humans walk.

Ticks feed on the blood of birds and mammals, including humans, and that is, of course, where the problem lies. Ticks bite and those bites could infect us with Lyme disease. A tick bite can only cause Lyme disease in humans if the tick has already bitten an infected animal. Some of the research that I looked at talked about the different ways in which farmers manage their animals nowadays.

Members have mentioned the important information that is needed to recognise the signs and symptoms of tick bites and when people should seek medical advice. I appreciate that there are other matters that I did not go over when researching my speech, around the management of farmlands and the beautiful countryside around us, that are also relevant.

A couple of things struck me as being important to raise with the public and the minister, the first of which is that ticks will bite and feed on people’s dogs and cats, which is relevant in urban areas. They can be on the dog or cat for a few days before dropping off and they can pass diseases, including Lyme disease, on to the pet. During my research for tonight’s debate, I noticed information about the signs and symptoms in dogs and cats, and I believe that the pet-loving Scottish public would wish to know some of them, especially as they are also relevant in the prevention of tick transfer to humans.

My second point is about workplace safety, which Rachael Hamilton raised. Scottish Woodlands has Lyme Disease UK as its charity this year because it is aware that its staff could be affected by Lyme disease and it is keen to see further research into Lyme disease.

In the interests of time, I will move on. In my speech, I had planned to talk about some things that other members have talked about—the sensible things that people can do—but it is really important that the minister feeds back to us on the fact that we need to raise public awareness of the reasonable and easy things that people can do and how we manage the issue in the countryside. I thank the Presiding Officer and all the members who spoke tonight.

18:15  

It has been a few years since I have had the opportunity to take part in a debate on Lyme disease, which is an important but often under-recognised issue. Therefore, I warmly congratulate Evelyn Tweed and thank her for providing this opportunity. I also extend my welcome to those in the gallery who join us this evening, and I thank those who have provided briefings for this evening’s debate.

I first came into contact with the issue of Lyme disease when I was a member of the then Rural Affairs and Environment Committee, back in the 2007-11 session of Parliament. We have come a bit of a distance since then and it would not be fair to say that there has been no progress. I noticed that the Scottish Land & Estates briefing acknowledges that medical awareness of Lyme disease is better than it was. Is it as good as it needs to be? Possibly not—there is variability in awareness—but a bit of progress certainly seems to have been made.

Nevertheless, as Evelyn Tweed and others have identified, we are looking at an increased incidence of tick-borne Lyme disease, as a result of many different factors. Jim Fairlie referred to the change in farming practices. The extension of forestation now and going forward is likely to play a part as well. However, some of the issues around climate change are also having an effect by increasing the number of ticks and, therefore, heightening the risk of infection. We are also seeing high numbers of people being diagnosed, but it is accepted there is still underreporting of cases and, certainly, continued missed diagnoses and underdiagnosis.

All that speaks to the need to redouble efforts, raise awareness and improve diagnosis and the treatments that are available. Evelyn Tweed is right to point to the fact that there is no magic bullet in that respect, but early diagnosis and early treatment certainly improve people’s outcomes. Clearly, there are people who are at risk, such as farmers, foresters, land managers and those who access the countryside, such as hikers and ramblers.

However, Evelyn Tweed, Carol Mochan and others made the point that we also need to deal with the risks to those who do not necessarily fall into that category, such as dog owners—I say that as the owner of a springer spaniel who spends far too much time sticking his head where it should not be and picks up ticks regularly. Raising awareness among groups that perhaps do not really see Lyme disease as an issue for them will be a focus of attention going forward.

Jim Fairlie was also right to say that, yes, there is a human risk but that the risk to livestock, particularly from louping ill, should not be underestimated either. Therefore, I join others in underscoring the need for increased research—and for bracken control, for which there is no magic bullet. However, there is no doubt that a more sensible approach to the licensing of asulam would help and make a huge difference.

Continued efforts in the area of awareness raising are also needed. That will need to be done carefully, because we do not want to spread fear and alarm or discourage the public from accessing the countryside responsibly. We do not want to overload laboratories with testing that is not necessarily of benefit. However, we need to acknowledge that there is a heightened risk that needs to be addressed. That awareness-raising campaign, as Alexander Burnett pointed out, will need to be ramped up and extended and become a bit more sophisticated in the social media age, to communicate the very important message that Evelyn Tweed has allowed the Parliament to reinforce this evening.

18:19  

I warmly congratulate Evelyn Tweed on bringing this debate to the Parliament and for her very moving account of the horrific impacts that the disease has had on her constituents who are here this evening.

Because of such impacts it is vital that we take all steps to prevent people from being in the position of likely exposure to infection with Lyme disease.

As other members have said, bracken habitat is by far the most important reservoir habitat for ticks and tick-borne disease. Professor Roy Brown, who is a lifelong expert on bracken and ticks, has highlighted that because there is far more bracken—it has increased exponentially—there are far more ticks. A far higher proportion of the ticks—especially, I understand, adult females—are infective and carry various diseases, of which Lyme disease is perhaps the best known. Louping ill, which Liam McArthur mentioned, is another. Ticks are also related to other forms of ill health.

At the moment, the only way to tackle the problem effectively is through use of asulam, in the form of Asulox. Scottish Land & Estates has confirmed that in its representations to us for this evening’s debate. Unfortunately, Asulox is the subject of a process of annual emergency authorisation. Frankly, it should be used automatically—the science now is the same as it was last year—but the laborious emergency authorisation process has to be undergone. The four Administrations in the UK must issue approvals to the Health and Safety Executive, which has delegated responsibility for giving advice to the four Administrations. As a process, that is fine, but it is too slow.

I was in correspondence with the HSE on the matter last year and have been in correspondence with it again this year. Just before the debate, I was informed that it has not yet taken a decision. No one wants to get into the blame game, but it is apparent that the delay, regardless of why it has occurred, is now very serious. That is especially the case because manufacture of the drug has, as it happens, been shifted to India, so there could be a further delay of six weeks before it can be procured. In addition, the drug needs to be applied in a season that finishes in August and September. The window is very short indeed: we are in the last week before authorisation can be given and be effective. Therefore, we really need a substantive response from the HSE. I would be grateful to the minister, who I know is very knowledgeable about Asulox—before her elevation to ministerial position, she worked alongside Mr Fairlie, me and others on the issue—if she would advance the arguments that I am making this evening.

When I raised the issue with the First Minister at First Minister’s question time last week, he said that uncontrolled bracken represents a serious threat that needs to be dealt with. In his response, he said that the HSE had made a recommendation and that the Scottish Government had “considered and ... responded” to that recommendation, but he did not say what that response was. Being an inquisitive kind of guy, as members might know, I would like to know whether the minister can share with us—we are all coming from the same angle; we want to get this sorted—what that response was. I believe that Minister Slater is the minister who is responsible. Did she say yes or not? What was the response? We need to be clear that Scotland has played its part in getting a yes.

There has been some suggestion from the UK Government that another treatment called amidosulfuron—Squire Ultra is its commercial name—is being considered. I make it clear that that treatment is not effective. The clear advice is that it will not work, so if the UK Government is considering using it, it should think again.

Liam McArthur is right: we do not want to set hares running. On one hand, we do not want to cause alarm among people who want to enjoy the countryside, but on the other hand we owe it to our population to take all practical and sensible steps to avoid more people—people who work in rural Scotland, as members across the chamber have highlighted—getting that ghastly disease. It would be catastrophic if a cumbersome and unnecessarily complicated process of approval were to become the enemy of achieving the purpose of that very process, which is designed to protect the public against the risk of contracting a disease that, as Evelyn Tweed said, is extremely serious, albeit that it is not sufficiently well understood or appreciated in society as a whole.

18:24  

I join other members in the chamber in thanking Evelyn Tweed for lodging the motion for debate in the chamber during Lyme disease awareness month. I welcome Pauline Bowie and others to the gallery and hope that their recovery continues. I am pleased to have the opportunity to close the debate and to highlight the importance of raising awareness of Lyme disease.

Although we know that the majority of cases of Lyme disease can be treated with antibiotics, for some people it can have a serious impact on their daily lives.

Will the minister take an intervention?

I am only 30 seconds into my speech. I am sorry.

My first encounter with a tick was almost 50 years ago, when I spotted an odd growth on my spaniel’s head. Thankfully, a friend knew what it was and quickly whipped it out with tweezers. At that point it was just an ugly beastie, but now I know so much more about the impact that ticks can have on our health and about the importance of removing them safely. I appreciate the contributions that members have made in the debate. Now, after every walk, I check my collie, Jim, for ticks, as well as ensuring that I am tick free, too.

I will touch on some members’ contributions to the debate. First, I will take Douglas Lumsden’s intervention.

I have been contacted by a constituent—Emily Gilmour, from Inverurie—who, with her son, has Lyme disease. So far, she has spent £40,000 on private treatment abroad. Will the minister look into her case and see whether she can get the treatment that she requires in Scotland?

I cannot comment specifically on individual cases, but I would be happy to look into that further. The personal stories that Evelyn Tweed and Marie McNair spoke about are so important and emphasise the need for increasing awareness and ensuring that a co-ordinated approach to Lyme disease is taken. Marie McNair spoke about educating, testing and supporting the right treatment. Alexander Burnett commented on the awareness campaign. I had a wee look: the Scottish Government tweeted five days ago about Lyme disease and we have posted about it on Facebook and Instagram. We will have a wider campaign.

Jim Fairlie mentioned that the Scottish Government had tweeted about Lyme disease, which I accept. However, if I am not mistaken, none of the health social media accounts have tweeted or posted about it. Could the minister comment on that, as the matter is in her portfolio?

This debate is important and the Minister for Public Health and Women’s Health account will tweet about it, which I will retweet. I hope that Alexander Burnett will join me in retweeting those posts.

Jim Fairlie made a point about sheep being tick magnets, which I have heard from a number of my constituents. Carol Mochan emphasised the importance of having debates such as this in the chamber, and of recognising that ticks are also prevalent in urban areas, in workforces and on our pets, which I have noted. I thank Carol Mochan for recognising that and look forward to hearing about how she speaks about the matter more in the Labour group.

I appreciate Liam McArthur’s acknowledgement of the need for careful education and of the importance of awareness among the population, as well as the importance of proportionate control. I agree that we should not be alarmist.

A number of members mentioned Asulox. As Fergus Ewing pointed out, it does not fall within my portfolio. However, the Scottish Government recognises the concerns about the potential risk of uncontrolled bracken. It is aware of the role that bracken plays in tick populations and the role that Asulox has played in recent years. As the member pointed out, Asulox has no UK or EU authorisation and the HSE is responsible for assessing emergency authorisations. The Scottish Government has, as the First Minister has said, responded to the HSE’s recommendation, as will all UK Administrations, and it is the HSE that will respond to the applicant when it is ready to do so. I am afraid that I cannot, at this point, provide a further update.

Will the member take an intervention?

I have taken a few, Mr Carson, so I will continue. I note the points that Mr Ewing and others have made.

As we have heard, the debate coincides with Lyme disease awareness month, but it is also important because we have seen a rise in cases in Scotland in recent years, as Marie McNair noted. We in Scotland are blessed to have such amazing opportunities to get out and explore our wonderful country, whether we are climbing mountains, walking in woodland or simply enjoying a stroll in park. Although we believe that there is no such thing as bad weather, and that there is just bad clothing, it is true that in spring and summer more people are likely to be enjoying the outdoors. Therefore, provision of information on how to avoid being bitten by a tick, on how to remove an attached tick safely and on the signs and symptoms to be aware of is absolutely key.

We know that prevention is the best defence against Lyme disease. The Scottish Government is committed to raising awareness of Lyme disease and it is currently running a campaign—“Find a tick? Remove it quick.”—with posters and information cards in every community pharmacy in Scotland. We want to highlight the key messages of tick avoidance, the signs and symptoms to watch out for and signposting to NHS Inform for further information. I thank the Lyme Disease awareness raising group, whose membership includes representatives from the Lyme Resource Centre, VisitScotland, Ramblers Scotland, and Public Health Scotland, as well as Scottish Government officials from the infectious diseases, early learning and childcare and active Scotland divisions, who co-designed the campaign.

We are planning a follow-up in the summer, with posters in general practices, leisure centres, libraries and community centres and, we hope, on public transport. That will reinforce key messages for people who have already seen the campaign and will target people who are visiting Scotland from the rest of the UK or abroad.

I appreciate that work needs to be done to raise awareness of Lyme disease among health professionals, to ensure their confidence in diagnosing the condition and in starting patients on antibiotic treatment as soon as possible. If early signs are missed, it is more likely that longer-term symptoms will develop. I absolutely recognise the importance of that, because a member of my family spotted the symptoms and, thankfully, had a very aware GP.

We are making progress in Scotland on testing and diagnosis, and we are working closely with stakeholders and clinicians through the health professionals education sub-group. Following the recent identification in Scotland of a probable case of tick-borne encephalitis, which is a potentially serious infection, clinical surveillance has been increased. Public Health Scotland has requested that the UK Health Security Agency undertake tick capture and testing in Lochearnhead in mid to late June, to assess whether TBE infection can be identified in ticks in Scotland.

It is important to note that one probable case is not evidence of a significant change to the risk to human health in Scotland from TBE. However, the Scottish health protection network tick-borne diseases group, which is a multidisciplinary expert group that is dedicated to Lyme disease, has—rightly, in my view—recently reconvened following the Covid-19 pandemic and officials have requested that surveillance, including for TBE, be included as part of their future work.

In closing, I reiterate that the risk of Lyme disease should not put people off spending time outdoors. There are a few simple steps that people can take to protect themselves. People should cover up bare skin—ideally, wear long trousers and tuck them into socks when in long grass, as has been said, and use insect repellent. They should check themselves and their clothing for ticks after being outside. If a tick is found, people should carefully remove the whole tick using a tick remover or fine tweezers, and speak to their GP if they develop symptoms.

I reiterate my thanks to Evelyn Tweed for bringing the motion to the chamber, and to everyone who has contributed to the debate to raise awareness of Lyme disease.

Meeting closed at 18:34.