Seòmar agus comataidhean

I, too, take the opportunity to welcome Patrick Harvie and Lorna Slater to their new jobs. I am sure that they will have every success in them.

I welcome the debate on the first 100 days of this session of Parliament. While Covid cases continue to soar and our NHS is placed under increasing pressure, it makes sense to reflect on what has been achieved in the first 100 days and how much further we have to go before the pandemic is behind us and our health service can fully recover.

Although the Covid crisis is by no means over, it is never too early to begin learning lessons from the pandemic. I am therefore pleased that the Scottish Government has taken steps to establish a public inquiry. The Covid crisis has left thousands of people with long-term health effects and many have tragically died. We have witnessed this terrible virus devastate care homes, put our loved ones in hospital and change the way in which we live our lives. The Government’s handling of the pandemic must be thoroughly scrutinised so that we can establish how Scotland could have better prepared and ensure that we are in a better position to handle future pandemics.

It has been almost 18 months since the first Covid case in Scotland, and, during that time, healthcare staff have gone above and beyond to protect us from the virus while continuing to deliver emergency and routine care. Staff are exhausted and demoralised, and, as we make plans to help our NHS recover, we must avoid placing extra pressure on them. The NHS recovery plan must be accompanied by clear messaging from the Scottish Government. Ministers need to be honest with the public about what level of service the NHS can provide while it recovers and about how long the public will be expected to wait for routine treatment. It cannot be left up to already overburdened staff to deliver that message.

Just last week, a GP wrote to me about the negativity that practice staff had faced when explaining to patients that they could not access general practice in the way that they used to, saying that staff had often been in tears. The GP said that comments in the media when the plan was published about GPs opening up for face-to-face appointments were unhelpful. General practice has always been and remains open. Throughout the pandemic, GPs have held face-to-face appointments when clinically necessary. Due to rising patient demand, GPs are having to triage patients so that the most urgent cases are seen first. The reality is that that will continue for some time. We need to see leadership from the Government on that issue, and a public information campaign that clearly sets out how people can expect to access health services in the wake of Covid.

In order for our NHS to recover, recruitment and retention must be prioritised; attractive pay and conditions will be key to that. We know that some clinicians and trade unions have expressed disappointment at the proposed pay increases for NHS staff. The chair of the British Medical Association Scotland, Dr Lewis Morrison, has said that the 3 per cent pay uplift fails to address years of pay erosion and does virtually nothing to address low morale.

As we work to help our NHS to recover, another major focus of this Parliament will be social care reform. The Scottish Government’s consultation on a national care service has now been published, giving people the chance to have a say on how the service should be shaped. This is an historic moment, when we have the chance to transform the way in which people access social care, to improve choice and autonomy, to deliver greater recognition of unpaid carers and to design an ethical commissioning process, to name a few. That will be some of the most important work that we will undertake in this session of Parliament, and I look forward to working with colleagues across the chamber to ensure that we have a truly human rights-based, person-centred service.

There is also much work to be done to improve our existing public services in the wake of Covid. Rail strikes are growing across Scotland—swift resolution is needed, because we risk serious disruption at COP26, when hundreds and thousands of people will be travelling to Glasgow. Abellio has a duty to its staff and passengers to resolve the situation. It is a problem of the operator’s own making and one that it has an obligation to fix. Scottish Greens are strongly supportive of moves to bring ScotRail entirely into public hands. Discussion of what a people’s railway will look like when the franchise is taken over by the state needs to start now, and that should include consideration of how we achieve timetables that work and reduce journey times rather than increasing them.

This is the year of COP26, and this Parliament’s response to climate change is rightly under increased scrutiny. The citizens assembly on climate change has produced groundbreaking recommendations and given the people’s consent to transformative change. We must rise to that challenge. In response to last session’s climate change plan update, the Environment, Climate Change and Land Reform Committee set out a series of recommendations. It is vital that we see a meaningful response to those in the run-up to COP26. While reflecting on the past 100 days, it is worth stating that the next 100 days will also be crucial. Our ambitions and decisions in the run-up to COP26 can make a significant difference for generations to come.

I extend my condolences to everyone who has tragically lost a loved one to drug overdose.

As others have said, we need action now to prevent further loss of life. In June, a majority of MSPs supported my amendment to the Government’s motion on drug-related deaths. That amendment called on the Scottish Government

“to investigate, as a matter of urgency, what options”

it had, within the current legal framework,

“to establish ... safe consumption rooms”.

Will the cabinet secretary provide an update on what progress has been made on establishing safe consumption rooms as part of wider harm-reduction strategy and treatment options?

I welcome the First Minister’s commitment to continue to provide support to those who are eligible if they are required to self-isolate. However, given that the latest figures show that only 24.2 per cent of people who are aged 18 to 29 have received two doses of the vaccine, many in that group will be unable to take advantage of the exemptions to self-isolation requirements and will therefore be the most greatly affected by those requirements. Will the First Minister consider extending self-isolation support to those who are not yet, or who cannot be, double vaccinated, so that they are not unfairly penalised?

I thank everyone who has been making a sterling effort during the pandemic.

Out-of-hours GP services have been particularly affected because workload pressures within in-hours general practice are impacting the availability of GPs who work in out-of-hours services. There are serious concerns among GPs about the ability of services to cope with demand, with patients who attend out-of-hours services being asked to wait for an appointment with their normal GP. What immediate additional support can be provided to out-of-hours general practice so that it does not buckle under the strain?

I am grateful to have the opportunity to speak in today’s debate. Scotland currently has the highest rate of infections among all the UK nations. Yesterday, we recorded the highest daily number of cases since the start of mass testing. Despite the incredible success of the vaccination programme and the very welcome lifting of restrictions, it is clear that the pandemic is not over and that, unfortunately, emergency legislation is still very much needed.

According to the latest data, only a quarter of those aged 30 to 39, and less than a fifth of those aged 18 to 29, have received both doses of the vaccine. Our young people are still vulnerable and there is significant evidence that people in those age groups are now driving infection.

The delta variant is moderately resistant to vaccines, particularly in people who have received a single dose, and people infected with delta are around twice as likely to end up in hospital as those infected with the alpha strain. We need to continue to support people to isolate when they are infected and encourage them to engage in regular testing. We are not out of the woods yet.

I am pleased that Jackie Baillie’s amendment was agreed to and I hope that it addresses the concerns of those in the care home sector. As we all know, the pandemic has been an extremely difficult time for care services and it is vital that they have the support that they need to recover from Covid-19. Given that the Care Inspectorate has responsibilities for regulation and inspection of care services, it will play a vital role in supporting care homes to deliver the best standard of care possible.

Like others in the chamber, I regret that the scope of the bill could not be widened so that we could assist those who will undoubtedly be affected by the on-going pandemic but who are not protected by the provisions that are currently contained in the coronavirus legislation. I agree whole-heartedly with Pam Duncan-Glancy’s comments yesterday that a provision that instructs local authorities to recommence care packages and respite care would have been a welcome inclusion in the bill.

In addition, the Scottish Greens have long called for self-isolation payments to be made universal so that everyone is supported to isolate and no one is forced to choose between isolating and paying their bills. Yesterday, Pam Duncan-Glancy mentioned her desire to include that provision in the bill, and I am pleased that Labour supports it. I look forward to continuing to engage with parliamentary colleagues and the Scottish Government on those issues after the bill has passed.

There are some provisions in the coronavirus acts that I would like to see continue after the pandemic has ended—for example, those provisions that relate to student residential tenancies and the restrictions on giving grants to businesses that are connected to tax havens. Students now have the same rights as other tenants and that should continue after the legislation expires. Likewise, ensuring that there were no coronavirus bail-outs for firms that use tax havens was a welcome step during the pandemic, but I believe that we should push further on that issue and end legal tax avoidance permanently.

I will conclude before I completely lose my voice. Although I know that everyone in the chamber would prefer that emergency legislation was not necessary, the state of the pandemic in Scotland necessitates that the bill is passed. I am grateful to those members who have engaged with the Scottish Greens during the process and I look forward to continuing to work to ensure that the people of Scotland are protected from the effects of this terrible virus.

I, too, extend my sympathies to all of those have been affected and their families.

The minister states that the risk of cervical cancer is low and that cervical screening is the best protection against cervical cancer, but many women’s confidence in the programme will have been undermined by today’s announcement, particularly when we are hearing more about how women’s health problems are being missed, ignored or misdiagnosed. What urgent action will the minister take to restore confidence in the cervical screening programme and encourage women to continue to attend their appointments?

In relation to amendment 18, I have engaged with Scottish Care, which has serious concerns about the impact of the continuation of the reporting provisions on the Care Inspectorate’s ability to carry out its other obligations and provide support to care services. I absolutely agree with Jackie Baillie that, given the situation that we have had during the pandemic, we have to have some form of overarching reporting and accountability. I would be grateful, therefore, if the cabinet secretary could commit to working with the Care Inspectorate and perhaps other parliamentary colleagues to bring something back at stage 3 that would not only reflect both sides of the issue but ensure that the Care Inspectorate has the ability to discharge its duties effectively and continue to improve standards of care.

The Scottish Greens will support amendment 30.

The latest workforce statistics show that there are more than 4,400 nursing vacancies in Scotland and that a fifth of the workforce is over the age of 55. We urgently need to improve recruitment and retention of nurses if we are to maintain safe levels of care. Does the cabinet secretary recognise that pay and conditions will be essential to ensuring that the NHS has the nursing workforce that it needs and to the implementation of the Health and Care (Staffing) (Scotland) Act 2019, which has been delayed due to the pandemic?

I, too, thank Bob Doris for bringing the debate to the chamber. Yesterday was global MND awareness day, so I am grateful to have the opportunity to speak in the debate.

I pay tribute to MND Scotland and the late Gordon Aikman for their incredible efforts to secure better care for people with MND, and it would be remiss of me, as an avid Scotland rugby fan, not to mention Doddie Weir’s foundation. The Gordon’s fightback campaign raised more than £500,000 for MND Scotland to invest in vital research. As the motion states, it aimed to

“double the number of MND specialist nurses”,

guarantee MND patients a voice and outlaw care charges. Given the conversations that are taking place on the establishment of a national care service, it is right that we pay tribute to Gordon’s work.

One of the defining characteristics of motor neurone disease is how rapidly it progresses. As we have heard, the average life expectancy is just 18 months from diagnosis. That is why it is so important that people with MND can access the care and support that they need, when they need it. They cannot be placed on a waiting list, because they simply do not have the time to wait, but too many people do wait. People with MND are being forced to cope with their rapidly deteriorating health without the care that they need while statutory services struggle to meet demand.

The motion refers to the

“fast-tracking of terminally ill people for ... social security benefits”.

That would ensure that people with MND would not have to wait months to receive the benefits that they are entitled to. As the motion notes, however, we still have far to go before people with MND can access all the support that they need equally and fairly. MND Scotland is calling for people with MND to be fast tracked for access to housing and social care services so that they are not left without support for weeks, or even months, while their condition deteriorates.

Long waiting times can have a devastating impact on people with MND and on their loved ones. While people with MND are waiting to be allocated a care package, unpaid carers are often required to step in and care for them, with little or no support. That can impact on the physical and mental health of carers, who may struggle to cope with providing care that should be delivered by social care services. Too often, unpaid carers are used to fill gaps of care and, according to Carers Scotland, that has been exacerbated by the pandemic. Many carers have had to significantly increase the hours of care that they provide, and nearly 400,000 people have taken on a caring role for the first time. We need to recognise the value of unpaid carers and ensure that they have access to the training, equipment and respite breaks that they need. The Scottish Greens would also like to see the introduction of health checks and access to flexible healthcare appointments for unpaid carers.

The Scottish Greens want to see a national care service that is person centred and based on human rights—one that recognises the specific needs of individuals, including those with rapidly progressing conditions such as MND. MND Scotland is calling for a national care service that prioritises carers and recognises that, due to the rapid degenerative nature of the disease, people with MND require fast-tracked access to care and anticipatory care planning. People with MND often face further delays when trying to increase their care packages or gain access to 24-hour care as their condition deteriorates. Conversations about the level of care that individuals will need in the future must take place early, so that they do not face further waits for essential care when they begin to experience paralysis.

Early planning for housing adaptations must also take place. People with MND can wait months for adaptations, such as wet rooms and stair lifts, or be forced pay for them themselves. In 2021, it is unacceptable that people with a terminal illness are paying thousands of pounds for the adaptations that they need to help them to live with their condition. Adaptations can help people stay out of hospital and maintain their independence for longer, and help carers to look after them safely. Ensuring that people with MND are fast tracked for such adaptations and that the process is simplified will be an important step in reducing delays and improving care.

The motion states that we must “help find a cure” for MND, and that must be the ultimate goal. However, in the meantime, we must urgently improve MND care so that no one with this devastating illness is left waiting for the help that they need.

Dignity, which we all hope to maintain, is something that drug addiction has robbed from many, that the criminal justice system has eroded and that the continued lack of reform of the Misuse of Drugs Act 1971 will suppress for many.

Drug deaths have been rising year on year in Scotland. Since 2014, Glasgow has faced the largest incidence since the 80s of HIV, which has affected people who inject drugs. Scotland has the highest number of drug deaths in Europe, and the war on drugs has categorically failed.

David Liddell, the chief executive officer of the Scottish Drugs Forum, said:

“Scotland’s drug problem has its roots in the harsh climate of 1980s deindustrialisation and the economic and social impact in the subsequent decades. Other countries chose a more interventionist approach by which the state created alternative employment and opportunity during these changes. This was not the policy in the UK. The consequence of this ongoing approach is a large and more entrenched drug problem nationally.”

[Interruption.]

The member’s colleague did not give way, so neither will I.

Communities were robbed of their dignity through not being supported after their industries collapsed. As a result of a lack of intervention, second and third generations are suffering from addiction and complex trauma.

We know that, often, those with addiction have low incomes or no income and have issues in accessing a wide range of services, such as income support, NHS treatment and housing, as a result of a vast range of issues, including those that are not related to their addiction. Those who manage to access treatment experience stigma, particularly in relation to medication.

We must ensure that support for those who experience addiction is person centred and holistic. Ensuring that the trauma that may have been the catalyst for their addiction, or any other acquired trauma, is addressed properly is essential to addressing the issues that dominate their lives.

We have to ensure that being drug free is not a condition of treatment. We would not require someone with lung cancer to stop smoking before we started treating them, so why are we insisting that, after a lengthy wait on a waiting list, someone must be drug free before being treated? Often, drugs are a coping mechanism and trauma is the real issue. Behaviour policing should never be part of our approach to rehab; it should be about maintaining dignity.

There are wider impacts that also need to be addressed, including housing and how we engage with people who may have had negative experiences when accessing services in the past. Stigma is an enormous issue in relation to accessing services. I hope that we can work with the Government and local government agencies to ensure that we remove that judgment of those who require help.

The Misuse of Drugs Act 1971, which is about to have its 50th anniversary, is out of touch and should rightly be out of time. The briefing provided by the Transform Drug Policy Foundation notes that the Home Office’s independent review of drugs, led by Dame Carol Black, has been explicitly prevented from addressing the overarching legislation.

It is very clear that this is a health crisis. Health is devolved to the Scottish Parliament and powers over drugs legislation should also be devolved to ensure that a more compassionate approach is taken than that taken by the UK Government.

I turn to the substance of my amendment. Portugal decriminalised possession of all drugs in 2001 and in 2019 it established its first mobile safe consumption room. Drug-related deaths in Portugal have been below the European Union average since 2001 and the proportion of prisoners sentenced for drug-related offences has fallen from 40 per cent to 15 per cent. Rates of drug use have remained consistently below the EU average. The facilities primarily aim to reduce acute and direct harm by preventing overdoses from happening and, when they do happen, by providing intervention, and by ensuring that needles are not reused and that no one puts themselves in a dangerous or vulnerable position.

During the election campaign I had the pleasure of meeting and occasionally debating alongside Peter Krykant. Peter is a fellow Falkirk bairn and runs the mobile safe consumption room in Glasgow. He documents on Twitter his experience of running the service and the great work that he does. One of his most distressing posts is about a young woman—given our debate this week on women’s health, the post is particularly relevant. The young woman did not want to come inside the van to inject herself for fear of being arrested. Instead, she went down the nearest close, pulled her trousers round her ankles and sat on the ground, which was full of broken glass, animal faeces and dirty water. What have we done for her dignity? Without Peter to keep an eye on her, anything could have happened.

We have the ability to start today to make a change. I encourage all parties to support my amendment. Let us take a stand today to restore people’s dignity and support the fantastic work of people such as Peter.

I move amendment S6M-00400.3, to insert at end:

“; considers that safe consumption rooms are an important public health measure that could reduce drug deaths and deliver wider benefits to communities, as they have done elsewhere; condemns the UK Government’s refusal to support trials in Scotland and urges it to reconsider, and calls on the Scottish Government to investigate, as a matter of urgency, what options it has to establish legal and safe consumption rooms within the existing legal framework.”