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I will touch on Mr Lumsden’s second point later in my speech. I am afraid that I cannot give timelines, but that conversation started earlier today with regard to moving on audiology in the community.

The Scottish Government has a strong desire to deliver care as close to the patient as possible. That is an example of where our population-based planning principles will provide benefits to patients and staff.

As I highlighted, we have been working specifically on the “Independent Review of Audiology Services in Scotland” report. That is part of the work that we are doing to ensure that we have the right evidence base so that we deliver value for money and ensure sustainability in the longer term. The commitment is evident through our on-going work with the Royal National Institute for Deaf People to deliver the Near You service, which is supported by nearly £250,000 of funding. Christine Grahame mentioned the service in NHS Borders. I had the privilege of seeing the work at first hand during a visit to Portobello library in the NHS Lothian area in February.

As Christine Grahame noted, Near You offers free hearing checks, hearing aid services and aftercare, as well as information and peer support on matters such as hearing aid maintenance and assistive technology for those who are deaf and are experiencing hearing loss or tinnitus. The feedback from users has been extremely positive, with regard to both decreasing the pressures on our acute services and providing direct support to those who are affected.

In response to Mr Lumsden, I say that that is one of the key things that we must remember. As I say in a lot of meetings, it is about the third sector, health boards and the Government working together to make those connections. I heard from users of the Near You service and the RNID, which provides that service, about the importance of the relationship. The RNID felt that it could take people away from the front door of hospitals to allow hospitals to treat those with more acuity. I agree with Mr Lumsden that we must make sure that there is aftercare, but we need to check where that aftercare is best placed.

Ms Dowey and others noted that independent audiology providers have the skills, information technology connectivity and capacity to support our audiology services. I do not disagree that independent audiology providers are giving a great level of care to those who use them. However, the NHS continues to be the majority care provider for the people of Scotland, accounting for around 80 per cent of all audiology care.

We must also recognise that, due to shared pipelines, independent providers face similar workforce challenges to the NHS. We are working to address the shortfall in the number of trained audiology graduates through our commitment to develop a career pathway for those studying healthcare sciences. We are working with stakeholders across Scotland to ensure that that will provide a pipeline of staff to bolster audiology services.

Overcoming those workforce challenges will not happen overnight, and it will take time to support students in our workforce. During that time, it is therefore vital that we work together to ensure that the people of Scotland receive the care that they need to manage their conditions. I commit to keeping open any lines of communication with representatives of independent providers, and I will invite their input when discussions on the development of a community model for audiology progress.

I agree that there is much to do and that it is vital that we get this right for the people of Scotland. I am confident that we in Government are already taking the right steps to deliver sustainable, safe, effective and efficient services to support hearing loss for our population in the longer term, and the matter has my full focus.

I agree that we must focus on the prevention of cardiovascular disease. That remains a priority for the Scottish Government, which is why we have designed a service that focuses on proactive case finding of cardiovascular disease issues. Through our £10 million investment in the new CVD enhanced service agreement, we are encouraging innovative ways through which general practices can engage with individuals who might be at higher risk of cardiovascular disease.

As I said earlier, the new long-term conditions framework will focus on ensuring equitable and sustainable access to the services that all people with long-term conditions need, while still allowing for targeted action on condition-specific care and support where appropriate.

Responses to the current framework consultation will be carefully analysed, alongside other available evidence, to establish opportunities for actions that benefit all people with long-term conditions. Where condition-specific work is appropriate, that, too, will be informed by evidence, including that from the consultation, which is currently live.

I, too, thank Clare Adamson for raising this important topic in Parliament, and I thank every member who has taken part in the debate, because it has been really helpful.

As Clare Adamson said, gambling addiction is a serious public health issue. As we have heard from every member who has contributed, it affects not only people who gamble, but their families and relationships, communities and wider society. As Clare Adamson and other members said, gambling exacerbates health inequalities—I think that it was Claire Baker who specifically highlighted that—with the burden of harm being borne by those already facing disadvantage. Those who gamble tend to have lower levels of mental wellbeing in comparison with those who do not, and gambling can, sadly, even lead to an increased risk of suicide, as both Alexander Stewart and Stuart McMillan mentioned.

Anyone can be harmed by gambling, and it is estimated that at least six people are directly affected by the person who is experiencing gambling harms, with women more likely to be one of the others affected.

I am also aware that women could be gambling in a hidden context, which Alexander Stewart talked about. It is a wider harm that is often overlooked. We need to ensure that those people know—

I thank Clare Adamson for her intervention. I was trying to work out a way of introducing that side of things, so I thank her for commenting on that. When watching certain television programmes, the number of different styles and colours that are used in the adverts is noticeable and, as Clare Adamson said, there is a pulling in through friendship.

I have met the Advertising Standards Authority to talk about that. Sometimes, as a switch-off, I play games on my phone, and there were a couple of adverts on there that I was really concerned about. I felt that they were being directed specifically at young people, so the authority was able to have a look at that. It is important that, in our roles, if we spot such things, we know the right people and can emphasise to them the damage that could be done.

Along the same lines, I welcome the recent launch of the Aila website, which has been developed by the RCA Trust and Simon Community Scotland to provide a resource that is focused on women’s experiences of gambling-related harms. It is also a source for finding support when it is needed, and it has advice on how to provide professional support to women in need.

As I have highlighted, it is important that our children are protected from the harms of gambling. I am concerned, as are many members, about the reports of increasing numbers of children experiencing gambling-related harm. A number of members talked about the impact of children’s games, and we need to be aware of that. I welcome the work of Fast Forward to develop an early intervention and prevention programme, providing workshops, training and resources for children, young people, parents and carers, practitioners and communities for gambling-related harm across Scotland.

In April 2020, the Scottish Government and Public Health Scotland, along with partners in the Convention of Scottish Local Authorities, academia and the third sector, convened a national gambling harm working group to develop a Scottish public health approach to reduce gambling-related harms. Critically, that included holding engagement sessions earlier this year with those with lived experience and third sector stakeholders to inform our approach. Their voices and experience were welcomed, and I thank them for their advice.

As another part of that work, Public Health Scotland has also published a healthcare needs assessment that describes what is needed for gambling treatment services, from local recovery support through to specialist clinical input. Last year, Ms Todd and I met Glasgow City Council, which, between 2022 and 2023, led a pilot of a whole-system approach to tackling gambling harm that demonstrated the complexity of the local system and the number of factors in gambling-related harms, including, as members have mentioned, the number of betting shops on our high streets.

Even though it is there in full view, we know that gambling is a hidden condition that is highly stigmatising and can have a significant impact on the mental health of individuals and their families.

As Ben Macpherson, Alexander Stewart and Stuart McMillan said, we do not talk about gambling enough and we need a person-centred approach. Just under two years ago, I was at a gambling harms event where I listened to a very personal testimony, which highlighted to me the stigma and embarrassment that that individual experienced. He made it clear that it is a public health issue and it should be treated as a public health issue.

I note Clare Adamson’s and Ben Macpherson’s comments about football and the unique social role that football clubs play in our society. I often say that football is on the front pages, the back pages and the centre pages of our newspapers. I note the round table on football that Ben Macpherson has highlighted and I will speak to Ms Todd about his suggestion about including gambling as a topic there.

In July 2024, Public Health Scotland published a briefing on gambling and suicide that outlines some of the work that the Scottish Government is doing with Public Health Scotland to tackle the issue. I also note how important cross-parliamentary work is.

I welcome the introduction of a statutory levy on the gambling industry that will provide much-needed funding for the hidden issue. I have been in written dialogue with Baroness Twycross about the levy, and I note Ben Macpherson’s suggestion about engaging with Ruth Davidson. The levy is a significant step forward. The expectation is that Scotland will receive a fair allocation of funding for treatment and prevention activity this year. I look forward to working with the Welsh and UK Governments on that.

Improving health and reducing health inequalities across Scotland remains a clear ambition for the Government. In order to tackle the mounting challenge, the Scottish Government and COSLA, in collaboration with wider partners, are developing a population health framework to take a cross-Government and cross-sector approach to improve the key building blocks of health. The framework will consider what action can be taken to mitigate the socioeconomic drivers of ill health in order to build a Scotland in which our places and communities can positively support health and wellbeing. The work that we are doing on gambling will directly support that framework.

I look forward to working with the Parliament and more widely on the issue in the coming year.

I recognise the work that Stephen Kerr has been doing with the Bundy family, whom I had the privilege of meeting last year to listen to their experience.

As a result of that, I have had numerous conversations with colleagues. I have also visited the NHS Lothian thrombectomy hub, where I learned at first hand how the east of Scotland thrombectomy service works and discussed with clinical and service management the issues of sustainable delivery, staffing levels and equity of access.

As I said in my first response, work is on-going to establish the most effective means of further expanding access to thrombectomy to maximise the number of patients who are able to benefit from the treatment.

The Scottish Government is committed to the sustainable expansion of the thrombectomy service. Work is on-going to align the governance and delivery of thrombectomy with similar national programmes and to establish the most effective means of achieving that with national health service colleagues.

Our focus remains on maximising access and ensuring that as many people as possible can benefit from thrombectomy. Procurement for a national artificial intelligence imaging tool is under way. Once that is implemented, it will support increased access to that important procedure.

On 6 February 2025, the Scottish Government published a suite of documents for implementation by NHS boards that were produced to support the aim of improving maternity and neonatal care in Scotland. They are the product of a co-development approach that has drawn on the expertise of our clinical and third sector partners. We are currently developing a robust process for monitoring progress towards implementation. A report will be published in the coming weeks that will summarise responses from all NHS boards on implementation of the recommendations in “The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland”.

The SAER is a review that is carried out by experts into what went wrong and why. It is there to create a fuller picture of what happened and what changes need to be made as a result. SAERs are learning and system learning exercises that are incredibly important. The revised framework that was introduced by HIS includes a template for boards to use when reviewing SAERs. It also includes a new learning summary template that will be published on a new online community of practice once completed.

I agree that we have to ensure that we get the right support for our staff who work in NHS maternity units. As I highlighted in one of my responses to Stephen Kerr, one key thing that the Scottish perinatal network highlighted was the importance of staff psychological safety. As I said in my response to Meghan Gallacher’s question, I very much support the work that NHS Lothian is doing to ensure that its staff get the right support to carry out their roles, which are incredibly important to all of us who live in Scotland.