Seòmar agus comataidhean

I will see how I get on. I will maybe take one at the end.

In dealing with substantive policy, we must of course take a cautious yet research-based approach. We also owe it to all the people living in Scotland to explore all options at our disposal to reduce harm in our society. That is why we must not shy away from creating a national conversation on how to do exactly that.

Change is needed as a matter of urgency. The UK Government needs to give serious consideration to radical reform of drug laws. After its decades-long failed war on drugs, to roll that out without due consideration would be a serious disservice, driven only by ideology rather than proper research and evidence. There are plenty of international examples that evidence that decriminalisation, or legalisation and regulation, can be successful in reducing drug deaths and harm.

There is more than one incentive to explore that potential. For example, organised crime groups would no longer thrive off the proceeds from the illicit drug industry, which are often used to fund other criminal operations such as human trafficking.

I do not know why the member is asking me to reflect on my tone; I think that that was uncalled for. In terms of reflecting on the issues that are bespoke to Scotland, that is exactly why we need powers here. A UK-wide approach is obviously not working for Scotland.

Maybe at the end—I will see how I get on.

Drug reform must be about taking a realistic and commonsense approach. We in Scotland are trying to forge a different path from the one being forged by the Government south of the border.

Like other countries with commonsense drug policies, Scotland has taken a public health approach to tackling the issue. Under the guidance of Angela Constance and within the limitations of devolution, this SNP Scottish Government has taken its responsibility on reform seriously by setting out a national mission to improve lives and save lives, committing an additional £250 million over the next five years to increase access to services for people affected by drug addiction and exploring the need for safe consumption rooms for people who use drugs.

It is not just a pity that we do not have the same level of commitment to Scotland from the Government in Westminster; it is an absolute disgrace. It has long been observed by clinicians that social determinants of health tip the scales against people who are addicted to substances in the already daunting quest to recover from any type of addiction. To be clear, the World Health Organization defines the social determinants of health as

“the conditions in which people are born, grow, live, work and age ... These circumstances are shaped by the distribution of money, power and resources at global, national and local levels”.

We already know that the cost of living crisis will do untold harm to just about all of us who have less than those in the UK Government, but, make no mistake, it will also have a wide and long-lasting impact when it comes to health outcomes and substance misuse issues.

To tackle the issue, Scotland needs full and comprehensive powers over drug reform in our Parliament. Perhaps a quicker fix is Scotland gaining its independence—I hear a few groans. Mitigating the worst of bad UK Government policy should be a thing of the past, and its current policy on drugs is inadequate. Stigma and criminalisation suppress the potential for future rehabilitation, harming an individual’s employment prospects and often leading to the continuation of generational cycles of poverty and adverse childhood experiences.

Penalties related to drug consumption should not be more damaging to an individual than the consumption of the drug itself. The picture of drug harm in Scotland is different from that south of the border. That is why it is so important that we in Scotland have full powers over our destiny, to ensure that our Government, laws, customs and values are reflective of the people who choose to live here. The UK Government continuing to cling to powers that should be in the remit of the Scottish Parliament is not just ineffective but actually damaging.

I am speaking fast so that I have time to take youse in.

However, Scotland is a progressive nation brimming with innovation and confidence in our role in the world. On matters devolved, we are at the forefront of tackling some of the biggest issues in the 21st century. As we look to the future, fantastic work is already under way to make positive change. Perhaps someday soon, with the full powers over our own destiny, Scotland can join other progressive nations that have been able to radically decrease the rate of harm caused by unsafe consumption of illicit substances. Change is needed.

I have 30 seconds to take an intervention.

With regard to the reduction in the minimum age for obtaining a gender recognition certificate from 18 to 16, which we have already touched on, some quite polarised views have been expressed on the competency of the young person in that respect and whether parental consent should be involved. I would be interested in hearing your views on that.

That is great. Thank you. As I have said, your answers have been full and comprehensive, but perhaps some of them have been outwith the scope of what the committee is scrutinising.

I will reiterate and re-emphasise this question: what, if any, impact will the bill and the simplification process for a GRC have on sports organisations?

I am really interested in seeing and taking note of how support and guidance for young people will develop. Ellie, do you want to respond to the same question?

Good morning. You have given full and comprehensive answers to a lot of the questions; however, I will pick up on a point that follows on from some of the answers that you have given.

Do you consult with experts and other third sector organisations when you develop and shape your policies? You spoke about performance measures and said that testosterone levels are perhaps not the way to go. Some cisgender women take testosterone for medical reasons, so those kinds of measures are not pertinent to what you are looking at. What medical experts and third sector organisations do the bodies that you represent consult with?

I am pleased to have the opportunity to speak on the motion, with the caveat that everything that I will highlight has hard-working staff behind it; I acknowledge them and everything that they have done throughout the Covid pandemic.

Since forming a Government, the SNP has built a strong record of delivering high standards of care across the country. That is driven by our ethos of compassion, dignity and respect, which is at the centre of everything that we do on health and social care.

That was firmly outlined when Shona Robison brought forward the new health and social care standards for Scotland in 2017. Traditionally, health and social care has involved those who require support being taken out of their homes and placed in unfamiliar settings. However, as we have moved forward with the integration of health and social care, we have ensured that person-centred care and support is at the heart of everything that we do. That has led to more people being able to receive support in the comfort of their own homes. By doing that, we are continuing to improve outcomes for people who require care while utilising the best technology that we have access to.

By scaling up our services through the £1 billion NHS recovery plan, we can tackle the pressures on our NHS. We are providing general practices and their patients with support from a range of healthcare professionals in the community, and we will recruit 1,500 more staff over the next five years for our national treatment centres, alongside 1,000 community mental health staff. We are increasing primary care investment by more than 25 per cent to support GPs, dentists and pharmacists, and we are investing more than £400 million to create a network of 10 national treatment centres across Scotland.

I was really pleased to see record investment from the Scottish Government across our health and social care sector, with £18 billion going to fund health and social care. That will go a long way in supporting people to access the support that they need while ensuring that carers who work in the sector are paid more, which is a key aspect that underpins the service.

Investment in our services and our population is key to Scotland’s recovery from the pandemic. More than ever, we realise the fragility of our mental health as well as our physical health. In part of my constituency, the Aberdeenshire health and social care partnership has moved progressively to develop a hospital at home policy. The health and social care partnership recognised that it had an ageing population and that, in order to have a system that supported the delivery of a long-term, sustainable service, a fundamental shift in thinking—progressive thinking—was required.

The opportunity to develop a hospital at home service presented itself when NHS Grampian undertook a whole-system redesign, which included the transfer of resource from acute to community services. That change meant that acute geriatricians could be aligned to manage patients within the community. Alongside the redesign was the acknowledgment that our population is better served when we receive care, whenever possible, in our communities. That has been at the forefront of the Government’s record in health and social care.

Before the introduction of the hospital at home service, various community models were already in place in Aberdeenshire. Those included community hospitals, virtual community wards and a multidisciplinary approach, so the concept of managing patients within the community was already well established in the health and social care partnership. The hospital at home service was the next logical step.

In the context of our response to Covid-19, we have benefited from strong relationships with local authorities and the NHS. That enabled us to take a swift and cohesive approach that ensured that our residents and staff had the protections and support that they needed to stay safe.

Operation home 1st, as it is known, became the next phase in the health and social care response to Covid-19 across NHS Grampian. The partnership involved all three health and social care partnerships and the acute sector, and it harnessed the strong collaborative working and the whole-system approach that were adopted across all sectors during the response phase. That innovative and person-first principle, in which place-based care is of paramount importance, embodies a framework in which we can create the right environment for keeping people at home safely, reduce hospital admissions when an alternative intervention is possible and ensure that people who need care in hospital do not need to stay there for longer.

A key focus is directing support towards prevention, and there is an increased community focus to improve outcomes for all, not least elderly people. That prioritises the goal of home first for all care, which will ensure that the system remains flexible and agile enough to respond to any surges in demand and that the whole person—their circumstances and support—is considered. That model of best practice can be reflected across Scotland in a national service.

I am sure that I am not the only carer in the chamber or the only person to have experienced a loved one receive care. In that respect, choice is an absolute necessity. The option to stay at home must be a right. For many people, there is no place like home, and I am glad that that sentiment is embedded in policy for a progressive approach to healthcare for all.

One million pounds to help exports hardly seems like fair compensation, given the utter havoc that the Tories’ hard Brexit has wrought on the fishing and seafood industries. They were completely ignored during the negotiations that brought about the trade and co-operation agreement, and it now seems likely that the Tories will, once again, throw our fishers and those in the seafood industry under the bus in a trade war with the EU. Does the cabinet secretary share my view that, if that happens, it will put beyond any doubt the UK Government’s disinterest and the contempt that it has for Scotland’s seafood sector?