Chamber and committees

Sizeable changes could be made to Grangemouth in the next few years. The community has lived beside an oil refinery for the past 100 years, and its sights, sounds and—often—smells are very well known. The options in project willow and the decommissioning of the refinery leave the community with uncertainty about what living in Grangemouth and the surrounding area will be like in the years to come. How will the Scottish Government ensure that the community is well engaged on and informed about the changes that are likely? What will the Government do to ensure that there is not a detrimental impact on the lives of people in the community?

Agreement of the operating principles of the delivery vehicle is one of the key issues in the next steps portion of the paper, to avoid a situation in which a project is set up, benefits from public investment, extracts profit and then leaves workers in the lurch when conditions change. What is the timescale for agreeing the operating principles? How will unions and workers be involved in agreeing those principles? What will the Scottish Government do to ensure that any funding comes with the appropriate strings, so that we see the projects that we want to see, with terms and conditions for workers that will last?

As I begin to wind up on behalf of the three committees, I echo the cabinet secretary’s sentiment and send the love and best wishes of the chamber to Christina McKelvie.

I am pleased to have the opportunity to close this important debate on behalf of the Health, Social Care and Sport Committee, the Criminal Justice Committee and the Social Justice and Social Security Committee. As we have heard, the three committees have undertaken joint scrutiny of the issue of tackling drug deaths and drug harm, and I thank all members of the committees for their diligent work thus far. I also thank all members from across the chamber who have taken the time to contribute to today’s debate, and I echo much of the sentiments that have been expressed.

I also want to thank everyone who contributed to the people’s panel report, which provides a comprehensive overview of the current landscape of drug services and the issues facing service users and their families across Scotland. The report has highlighted the crucial role that individuals with lived experience play in driving change across Scotland, and I am pleased that the recommendations in the report have mostly been welcomed and agreed by the Scottish Government. I hope that that work will provide a strong foundation for change, and I look forward to scrutinising forthcoming policy actions on the back of that important and comprehensive set of recommendations.

On that point, I take the opportunity, on behalf of the joint committee, to offer my sincere condolences to anyone who has lost a loved one to drugs. I also commend the bravery of all those with lived experience who have taken the time to share their ideas and experience with the committee throughout the process, in particular the participants in the people’s panel, whose testimonies and commitment to collaborative working have set an excellent example and helped to highlight the benefits of participative democracy.

The issue of drug harm and drug deaths has blighted Scotland for far too long, and it is incumbent on all of us in the Parliament to work together to mitigate the damage done to individuals and families, with the ultimate goal of saving lives.

This debate and the work of the people’s panel are strong examples of cross-committee collaboration, which I hope will be emulated in the future. For such a complex and nuanced issue, working collaboratively is essential if we are to make progress, and the cross-sectoral nature of the significant challenges that we face in tackling drug deaths and drug harm necessitate such collaboration.

It is clear that there is no quick or easy fix when it comes to tackling drug harm and drug deaths in Scotland. However, what is clear is that progress needs to be measured, and the Parliament will play a key role in ensuring swift Government delivery on the many points that have been raised in the report and in the chamber today.

In her intervention on Collette Stevenson, Emma Harper mentioned anti-stigma training for those who work outside of drug and alcohol services. That is hugely important and reflects some of what we have heard in informal sessions of the Health, Social Care and Sport Committee. Many of those who spoke to us noted that it was not always drug services that they first got help from. Ensuring that all services are trauma informed is hugely important.

Audrey Nicoll, Stuart McMillan, Carol Mochan and Alex Cole-Hamilton mentioned awareness raising around naloxone and increasing the number of people who are trained to use it. I hope that, in addition to increasing the number of people who are trained, the Government is looking at how to train as diverse a group as possible to ensure that everyone who might interact with those who use drugs has the confidence to be able to use naloxone.

Maggie Chapman and the Cabinet Secretary for Health and Social Care, as well as others, referenced the work that is going on at the Thistle in Glasgow. We should collectively pay a huge tribute to the staff there, who, contrary to some of the coverage of the site, are doing a phenomenal job.

Alex Cole-Hamilton and others mentioned nitazenes, and Emma Harper mentioned the current warnings in Dumfries and Galloway. I hope that we can see progress on drug checking soon. Elena Whitham was entirely correct about the need to roll out more safe drug consumption facilities across Scotland.

From my perspective as a member of the Health and Sport Committee, the debate and report have been useful in highlighting the importance of ensuring that everyone is able to access the services that they require. I echo the points that the convener raised in her opening speech. It is essential that a collaborative approach among all relevant public bodies is in place to tackle the crisis. A single point of access to specialised services would go a long way to reducing the stigma that is associated with accessing assistance for service users and their families, as would ensuring that GDPR-compliant information sharing agreements are in place to allow more streamlined assistance for service users.

It is vital that front-line services and third sector organisations that play a crucial role in tackling drug harm have certainty about funding to allow for long-term planning. I, too, am grateful for the Scottish Government’s commitment to strengthen that and I look forward to ensuring that initiatives such as the drugs mission funds and the fairer funding pilot have the intended effect of providing those services with the assurances that they need.

As Turning Point Scotland highlighted in its response to the people’s panel report, there has been a notable shift in public opinion and growing support for a health-based approach to drug use. That is most welcome, and I share Turning Point’s hope that that shift in attitude will be the impetus that is needed to create a system that is focused on support rather than punishment when it comes to tackling the drugs crisis in Scotland.

I thank the conveners of the Criminal Justice Committee and the Social Justice and Social Security Committee for their opening speeches and for highlighting the recommendations that come under their committees’ remits. I share the sentiment that they expressed about, and the commitment to continue, our collaborative approach to scrutinising future policy, which, by necessity, will cross into various remits.

As evidenced by the people’s panel, which has provided an excellent road map for progress with the report, it is essential that we all work together to tackle the crisis. Only through cross-party and cross-remit working can we ensure that services are to the standards that are required for service users.

I again thank everyone who contributed to today’s debate. It has been an open, honest and frank discussion. I share the commitment made by members across the chamber to ensure that promises made by Government in the wake of this important report are delivered swiftly and efficiently for the people of Scotland.

All the money that has been announced for Grangemouth is absolutely welcome, but trying to get money out quickly does not always mean that that money gets spent in the correct projects for the area. At the Grangemouth community council meeting last Thursday, 120 people were in the room, asking about the industrial future of Grangemouth and wanting to resolve some of the disconnect between them and industry. How can the cabinet secretary implore people to resolve that disconnect as well as ensure that projects are value for money and will support both skills and the local community?

The testimony from people at Skye house is horrific. I hope that the Government is supporting those who went through that, and that it is ensuring that they get the mental health support that they deserve.

Although NHS Lothian and NHS Tayside were not covered in the “Disclosure” programme, will the minister ask those boards to look into practices at their in-patient units to ensure that any issues in relation to care standards are properly investigated and resolved, and to ensure that the issue is not more widespread?

The report from The Promise Scotland says that

“some people, some organisations, and some systems are not yet doing enough, and this risks the country as a whole failing to deliver the promise.”

What is the minister doing with the organisations that are not doing enough, and across portfolios, to ensure that individual intransigence in organisations is not risking the Promise as a whole?

I thank the First Minister for providing advance sight of his statement and I welcome the £25 million that has been announced.

However, the closure still poses the risk of a huge potential loss of skilled workers from the area, and there is still concern about the impact on small businesses in Grangemouth that are reliant on the refinery workers for their business. Can the First Minister outline what extra support could be made available to support some of those small businesses as they adapt? Will the Government consider proposals for the use of the £25 million for projects at sites around Grangemouth that are outside the Ineos compound?

Throughout the debate, many members have mentioned the various sectors of the economy that will be impacted. I will leave the intricacies of elasticity, among other things, to Liz Smith and Michelle Thomson, but I believe that the immediate impact on the health and social care sector is particularly stark and warrants highlighting.

As has been mentioned throughout the debate, the Labour UK Government’s employer national insurance contribution changes represent a substantial financial and operational burden for third sector organisations and social care providers across Scotland. Workforce costs already account for the majority of expenditure in the sectors, which leaves little room for them to contend with those further increases.

The rise in employer national insurance contributions is especially unsustainable for smaller providers and for those with high staffing requirements, many of which are already operating on extremely tight margins. The direct results of the changes could lead to real risks of service reductions, staff lay-offs and closures, which will further jeopardise the care sector, which so many people rely on and which we should all be fighting to fund better and stabilise.

Scottish Care’s analysis points to the fact that the changes to national insurance rates that were announced in the UK budget will create additional financial burdens on independent care providers in a dangerous and inequitable—which is not easy to say at this point on a Monday—way. Scottish Care has outlined the potential for care homes to close as a result of the change. The people in those care homes still need care and places have to be found, which is putting more burden on an already stretched system. If care homes close, it will cost the public sector more to find places for those people.

Labour trumpets its increased block grant to the Scottish Government, but what use will that be if we end up having to find emergency care places as a result of the decision? The Health and Social Care Alliance Scotland—the ALLIANCE—alongside other third sector organisations has raised serious concerns about the financial strain that is being caused by increased national insurance contributions. It has signed a joint letter to the Chancellor of the Exchequer, following a survey of its organisation members that found that 85 per cent are worried about the additional costs, with 62 per cent fearing service cuts, 82 per cent being concerned about financial stability and 71 per cent expecting recruitment and retention challenges. Many have called for exemptions or increased funding to offset that burden.

Meanwhile, data from the Scottish Council for Voluntary Organisations estimates that the change will cost third sector organisations in Scotland £75 million next year, which further threatens the sector’s ability to deliver essential services.

The list does not stop there. The Coalition of Care and Support Providers in Scotland expects not-for-profit providers within its community alone to face an additional £30 million bill next year, due to the rate increase and threshold reduction—costs that it cannot afford and has no clear way to cover. In recognising the urgent need for action, the CCPS has also written to the chancellor, calling for full exemption for public service social care providers. It warns that, without that, the consequences will be devastating. That could very soon lead to the loss of vital community-based support, which will increase the strain on the NHS and the Scottish Prison Service and put a heavier burden on unpaid carers, many of whom already struggle to balance employment with wellbeing.

The Labour UK Government’s failure to recognise and account for the impacts of the changes on social care and third sector organisations raises further concerns about the lack of value being placed on social care, and about awareness of the perilous state of the sustainability of the sector. The Nuffield Trust estimates that the employer NIC changes will cost independent sector social care employers in the region of an additional £940 million in 2025-26. It also points out, most notably, that the Government seemed to be aware of those consequences.

An initial table that was published by the OBR on its economic and fiscal outlook included £5.5 billion provision for compensation for ENICs for public sector employers and adult social care. However, that was later revised through the removal of any mention of adult social care and reduction of the allocation to £4.7 billion. Officials have not yet explained the £800 million reduction, but, based on independent calculations, it appears to reflect an estimate of the ENICs change’s financial impact on adult social care. That strongly suggests that the UK Government understands the sector’s vulnerability but has chosen not to provide the necessary support. Alarmingly, major adult care provider failure is listed in the national risk register, which warns that such failures could severely disrupt care for those who depend on it. Without urgent intervention to stabilise the sector now, it could be decimated.

Many members have mentioned this afternoon how hopeful they were at the end of the Conservative Government and their disappointment at the mess that the decision has caused. Alex Cole-Hamilton, Lorna Slater and Kevin Stewart, among others, mentioned the other options that are available to the UK Government, none of which it seems even to have considered.

A few members mentioned the impact on hospices. Given the charitable nature of hospices, we are passing a burden back to them to raise money from people in their communities to plug the gap. That points to the effects that many members have warned of beyond the immediate rise in ENICs. Their needing to raise more money to plug gaps in services is a horrendous situation for charities to be in.

Today, the Scottish Greens call on the UK Government to, at the very least, fully fund the increase in employer national insurance contributions for commissioned services and arm’s-length external organisations. The additional costs will place significant strain on vital services and the organisations that deliver them, many of which are already operating under extremely challenging financial and operational conditions. Those providers have an unsustainable burden, with many already grappling with the consequences of having very little funding and of Brexit and its devastating effect on staff retention.

If the additional cost of ENICs is not addressed, it not only will compromise the ability of those organisations to maintain the services that people rely on but could also lead to cuts, closures and reduced quality of services. The consequences of that would be far reaching, impacting on the most vulnerable members of society and further exacerbating existing challenges in our health and social care systems. The UK Government must act now to ensure that those organisations are fully supported, thereby safeguarding the essential services that contribute to the wellbeing and support of our communities.

It is very clear that the UK Government has abandoned the workers at Grangemouth. The workers are rightly angry that both Governments have left them to the will of a billionaire who would rather play fantasy football than look after his workers. The decision has the potential to devastate the town that I grew up in, and I am angry on behalf of all of those workers. With the greatest of respect to the cabinet secretary, I note that anything that might be generated by project willow, and by others, is potentially too far down the road to solve the immediate and urgent issue facing us.

I have not yet lost hope that the Scottish Government will meaningfully step in, save the jobs and ensure a sustainable future for the site. Will the cabinet secretary now step in to address this increasingly urgent situation?

I begin, as others have done, by acknowledging the deep and often unspoken grief that miscarriage and stillbirth bring to women and their families. I thank midwives and their teams across Scotland.

Despite it being a relatively common experience, miscarriage can be profoundly isolating, especially for those without the support that they need. The emotional, physical and psychological toll can be immense yet, too often, those affected suffer in silence. There is a reluctance from many to talk about their loss, especially when that loss is early. I am sure that many members have spoken to family and friends who have had a throwaway comment such as, “At least it was early,” which definitely prevents people from being truly able to speak about their loss.

Good miscarriage care goes beyond medical treatment. It requires compassion, clear information and a shift in societal attitudes to ensure that no one faces the experience alone. I welcome the opportunity to discuss what Scotland is doing well and what we must do better to improve care and support for those affected. I thank the minister for securing the debate.

Scotland has taken important steps in improving miscarriage care, recognising that compassionate support is just as vital as clinical treatment. The national bereavement care pathway has provided much-needed guidance to healthcare professionals, helping to ensure that those experiencing pregnancy loss receive sensitive and appropriate care. That initiative has encouraged a more standardised approach in reducing disparities in how miscarriage care is delivered across the country. The pathways have been developed together with several pregnancy and baby-loss charities, royal colleges, a wide range of healthcare experts and an advisory group of women and men who have experienced loss.

The funding by the Scottish Government is vital, and it is delivered in partnership with Sands. The important role that Sands plays in supporting families affected by miscarriage and baby loss cannot be overstated. In my Central Scotland region, its local support groups cover the Forth Valley and Lanarkshire health boards and provide a safe and understanding space for bereaved parents to share their experiences and to receive comfort from those who truly understand their grief. Those groups, which are run by dedicated volunteers, offer peer support meetings, remembrance events and advice to help families to navigate the tricky situations that they are in. The presence of such compassionate support networks is invaluable in ensuring that no one feels alone in their grief.

Although it is undoubtable that progress has been and continues to be made, there is still much work to do. Too many women report feeling dismissed or unsupported when experiencing miscarriage, particularly in early pregnancy. We must do more to ensure that healthcare professionals receive adequate training to provide informed care. Access to miscarriage support remains inconsistent across Scotland. In some areas, women are left waiting for treatment or are forced to navigate a fragmented system. Steps have been taken to mitigate that, but we must double down on efforts to ensure that every woman, regardless of where she lives, can access timely and comprehensive care.

As has been mentioned, the psychological impact cannot be overstated. Although some support services exist, many women and families struggle to find the counselling and mental health support that they need. We must strengthen links between miscarriage care and mental health services. Without accurate and comprehensive data, it is difficult to identify gaps in care. I acknowledge what the minister has already said on that. We must continue to listen to those with lived experience and to ensure that their experiences shape improvements.

Although we have made significant strides in supporting those affected by miscarriage and stillbirth, the effort is far from over. It is imperative that we continue to work collectively with healthcare providers, policy makers, employers and society at large to break the stigma surrounding pregnancy loss. It is only by ensuring access to consistent, compassionate and high-quality care that we can provide solace to those families who grieve.