Seòmar agus comataidhean

I thank all the witnesses. There is so much that we could pick up on.

Because of the time, I will just pick up on the notion that we need to go from talk to action. That is very clear—we need to get things done. Are there good examples that we should be looking at in other countries? We know that the evidence is there; it is clear what we need to do. Are there good examples of countries that have taken action and are starting to see outcomes? That question is for David or Kim.

In the wake of the developing situation surrounding the omicron variant, how many individuals in residential rehabilitation have been double vaccinated? How many residents in rehabilitation centres have adequate testing and vaccination services available to them? What is being put in place to ensure that residents get the booster in good time?

In closing for Scottish Labour, I share the sentiment that has been expressed in the debate and I add my voice to other members’ voices.

Not only is violence against women sadly still a major concern in 2021, but it appears to be getting worse in Scotland and around the world. If anyone imagines that it is becoming a thing of the past, they are sorely mistaken. The cabinet secretary and Meghan Gallacher opened by mentioning the shocking statistics, from the UK and around the world, and others across the chamber emphasised them. This is a pandemic.

We know that in the UK this year at least 126 women have been killed by men, or that a man is the principal suspect in their death. How can we look at those numbers and think that there is not a serious problem in our society with the way in which men view and treat women? Whether it is domestic violence, sexual harassment or rampant misogyny, women continue to be the target of far too many men’s terrible behaviour and aggression. I agree with Maggie Chapman that if we cannot understand how serious that is and address the root cause, we do not deserve to be standing here. A big step towards addressing that root cause is exposing those parts of our society that apologise for and normalise the violence. Many of them are key parts of our establishment and seem to think that they are immune to the problem. Michelle Thomson, Pam Duncan-Glancy, Pauline McNeill and Mercedes Villalba talked about that.

There could not be any greater example of the dangers that women face across the UK than the terrible murder of Sarah Everard by a serving police officer, who used his authority to subdue and kidnap her. In the wake of that event, women naturally felt particularly vulnerable and angry. Yet at a peaceful vigil to remember Sarah and to protest the police’s failings in London, officers pinned down and arrested many protesters under Covid regulations. To even consider that a normal or rational thing to do is evidence of stone age thinking by supposed pillars of our society. It was done by the very service that is there to protect us, to women who were responding to one of the police’s own killing a young woman. Who has been held responsible? The Metropolitan Police commissioner continues to be in post, despite those events, while some of the women at the protest have been made out to be criminals. How am I supposed to tell young people in my region—or, indeed, my own daughter—that this is a safe country for women, when that is the headline news and that is the police response? Something needs to change, and it needs to change quickly.

Often the institutional response to what I and many other women regularly see is minimal, to say the least. We have heard from others that Rape Crisis Scotland has highlighted how Police Scotland’s responses to rape allegations are riddled with poor communications, outdated attitudes, and lengthy and unclear proceedings that leave survivors feeling isolated and anxious. Is it any wonder that so few women come forward and report those crimes?

Another issue mentioned during the debate, which is part of the same problem, is the fact that women now feel that they have to boycott clubs and bars up and down the country in response to serious concerns about increases in drink spiking. For years, those concerns have been met only with public relations campaigns and awareness-raising approaches, but how many people are convicted of spiking drinks, or of similar activities, in Scotland—a charge known as “drugging”? Over the past three years, where there is data available, the answer is that no one has been charged, so either all those women are making up the problem or the crime is not being detected at all. If that many men were saying that they had fallen victim to spiking, I wonder whether the statistics would be the same.

Every woman who is a victim of violence must be treated equally and fairly by an establishment that understands, or at least seeks to begin to understand, what they have gone through. That begins with accepting that it is a serious problem that we do not have under control. It means direct engagement with grassroots organisations, health and recovery charities and, as Pam Gosal rightly said, right across, and sensitive to, all our communities. It requires institutions such as the police to open their eyes and ears to what is going on.

I thank Jim Fairlie for his comments about men joining in with the debate and I thank Neil Gray, Jim Fairlie and Alexander Stewart for their excellent and thoroughly worthwhile contributions. We needed to hear them. We need to deal with the sorts of attitudes that we expose young men to, and that encourage a culture of entitlement instead of one of respect—a point that was raised by the cabinet secretary. If we can approach the problem as both a criminal justice issue, and as a societal issue that is mixed in with the way in which some men think it is acceptable to behave, we can begin to tackle it. Until then, it will just be more PR stunts and not enough serious change.

I finish by repeating what Pauline McNeill said: if we want things to change, we need to be brave. All of us need to be brave.

I thank David Torrance for bringing the topic to the chamber for debate. On behalf of Scottish Labour, I recognise mouth cancer action month and acknowledge the crucial work of the Mouth Cancer Foundation and Oral Health Foundation in raising awareness of mouth cancer.

The NHS advises that we cannot be certain what triggers the DNA changes that lead to mouth cancer but makes it clear that smoking and alcohol consumption are the leading causes of the disease in the United Kingdom. That highlights a further need to reinforce messaging regarding smoking and alcohol intake.

I appreciate the task that is ahead of us but, too many times, we discuss in the chamber the impact of conditions and life-threatening diseases that have avoidable causes. We must match our words with definitive action. There are clear links between the intake of the harmful products that I mentioned and life-threatening illness. We must go further in our efforts to reduce that impact.

I welcome the Scottish Government’s plan to create a smoke-free generation by 2034 but we must act with greater purpose and, indeed, urgency to address the prevalence of smoking, particularly in deprived areas, where it is at its highest. Only by doing so will we start to weaken the link between deprivation and serious ill health or, in fact, early death.

In short, much more has to be done to address Scotland’s significant health inequalities. I will continue to raise that point in the chamber, as I am sure members can imagine. I hope that the minister appreciates—I know that she does—that the need for action is urgent because some communities, including ones that I represent in South Scotland, are disproportionately impacted by those factors.

Moreover, a significant problem that we face when seeking to raise awareness of conditions and illnesses such as mouth cancer is a lack of knowledge surrounding the early symptoms and when to seek medical attention. Emma Harper raised that. The NHS advises that the most common symptoms of mouth cancer are:

“sore mouth ulcers that do not heal within several weeks ... unexplained, persistent lumps in the mouth that do not go away”

and

“unexplained, persistent lumps in the lymph glands in the neck that do not go away”.

It is crucial that we highlight those symptoms in the Parliament. I have repeated them so that people are aware of them because, if they are caught early, a complete cure is possible. According to some research, that can be done using surgery alone in nine out of 10 cases of mouth cancer.

The importance of early detection cannot be overstated. It can increase the chances of survival by 50 per cent to 90 per cent. That is why it is crucial that any changes to an individual’s mouth are reported to a dentist or doctor if they remain for longer than three weeks.

We must commend the work of the Mouth Cancer Foundation and other organisations but, more importantly, we must act with purpose to spread their message further and ensure that the symptoms of cancer—of which there are more than 8,000 new cases a year in the UK—are well known and prominent throughout the country.

I reaffirm a key point that I have made in previous debates and that other members have made: despite being under pressure and strain, and despite the difficulties that the pandemic has imposed on it, the NHS is still functioning and people should make contact with their general practitioner and dentist whenever they feel that they need to. The reduction in the early detection of cancers has been one of the most devastating impacts of the pandemic and, as a result, lives will be lost. However, as we hope to turn a corner and continue our progress, it is crucial not only that the Government addresses the urgent cancer backlogs but that people feel that they can come forward.

I thank members for participating in the debate and commend the work of mouth cancer action month.

I thank my fellow members of the Health, Social Care and Sport Committee, who are all here today, for their work on the bill over recent weeks.

I welcome this opportunity to open the debate for Scottish Labour, as our party has been at the forefront of this issue for years. I afford particular recognition to the efforts of the former Lothian MSP Neil Findlay to get justice for the women who have been affected by mesh. He and members of other parties across the chamber recognised early that they were dealing with an unspeakable injustice, and that we simply could not let it pass.

Before I begin my comments on the bill, I want to share my recognition of the women who have campaigned relentlessly to keep the issue on the agenda in Scotland. Their efforts have increased awareness of this serious problem not only here, but across the UK. Their campaigning has meant that, unlike many other people who never receive the compensation that they deserve, the women are close to justice. It is a brilliant story of courage and tenacity, and one of which Scotland should be proud. However, only by saying that we got it wrong in the first place and by rectifying mistakes can we truly embrace that pride. Certainly, we can do so only after those who are out of pocket have the record set straight.

Every member should take time to recognise the efforts of the women, and to reflect on the steps that have been taken to get us to this point—not least, so that we do not make the same mistakes again. We can never celebrate enough serious democratic engagement by the people who are at the sharp end in our society, so I encourage other groups who feel that they have been treated unjustly to come forward. This is their Parliament and it is our duty to help them.

As others have, I want to thank again the women who forced us to listen to them. I thank them for coming forward, I thank them for making us listen and I thank them for sharing their stories. I know that that must have been difficult.

The Health, Social Care and Sport Committee is recommending that the general principles of the bill be supported; my party shares that recommendation. As a member of the committee, I have been impressed with the detail in, and the care that has been taken over, the bill. We can all agree that the general principles are moral and just.

A quick timeframe for getting the bill over the line is necessary, because the women who have been affected by mesh have suffered more than enough. I will be looking for guarantees on that, as we proceed. It is now our duty to make certain that the bill delivers on its promise of fairness.

Although the financial implications might seem to be relatively small, for those who will be helped the bill is worth an unimaginable amount. It represents recognition of their fight and of the fact that they were right all along.

During committee meetings, I was struck by the lengths to which many women have gone in order to get their mesh removed. We have heard some examples of that. For a good number of women, it involved travelling across the world. The committee heard stories of women travelling across the world who had to live in hotel rooms before their operation and after their surgery because they required to stay for treatment. We can all imagine how much, in those circumstances, we would have wished to be home with our loved ones while we were recovering. People did not commit to such steps lightly; as a result, we cannot approach the issue lightly.

That is not to say that there are not concerns that need to be addressed. There has been some recognition of that, but we need greater clarity and it being made plain who will qualify for mesh removal reimbursement and who will not. Throughout the process, I have been contacted by women who find the proposals either difficult to understand or imprecise. We can make adjustments to ensure that no one misses out. That point has been addressed by the convener and the cabinet secretary. A bit of peace of mind can go a long way, so I am glad that we addressed many such worries during the committee hearings, and that we are doing so again in the debate.

We are considering in the chamber some of the hidden complexities that many people who are observing the debate from afar might not have considered. There is a strong case for individuals who had their original mesh surgery done by NHS Scotland, but who were not ordinary residents in Scotland at the time of their removal surgery, being eligible for reimbursement. I hope that the cabinet secretary will reassure us on that, and that the bill will include such a provision.

The last thing that anyone wants is for us to end up with the women again feeling ignored or short changed by the system. I, and others, made that clear to the cabinet secretary in committee, and I have been assured that that will not be the case. However, the Government can equally be assured that any deviation from those expectations will not be accepted by Scottish Labour or the women involved.

The cabinet secretary has committed, quite rightly, to being flexible in determining what costs will be reimbursed under the terms of the bill, but the committee has argued that much greater detail is required—perhaps to be included at later stages—for cross-party support to be gained. However, we have been reassured by the cabinet secretary’s acceptance of the points that have been made by members, so I trust that that will be realised.

Scottish Labour will support the bill at stage 1. However, if the reasonable expectations of the women are not sufficiently met, we will, before the bill can be passed, lodge amendments to ensure that the principles that have been laid out today are delivered.

Again, I thank everyone who has been involved in the bill for their hard work. I look forward to its next stages and to passing serious and life-changing legislation of which we can all be proud.

At the end of June 2021, Public Health Scotland reported that the number of children and young people who had been waiting more than a year for mental health services had doubled since the end of June 2020. Can the minister advise the Parliament what examples of alternative support the Government has in place for those children who are on very long waiting lists or who may have been rejected by the service?

I am interested to hear your view on the digital strategy. You have stated that you look at the strategy in terms of data and what you call IT solutions. Do you think that that is the best way of making progress in that regard?

My second question concerns the difference between the strategic-level thinking in Public Health Scotland and the thinking at the local level, which is driven more by a business-as-usual approach than by consideration of the initiatives and changes that could be put in place in order to benefit public health in general. How can we move that forward?

The minister is aware that for those in our most deprived areas, an equally important issue, which is relevant to supply chains and the food and drink industry, is that of affordable access to sufficient amounts of nutritious food. Can the minister explain why the Scottish National Party and Green MSPs failed to support the progress of a right to food bill at the committee stage last month? What action is the Scottish Government taking to address hunger and food insecurity, particularly in our rural communities?

The Scottish Government’s own 2019 Scottish health survey reported that the number of people in the most deprived areas of Scotland who smoke regularly is more than five times the number of people in the least deprived areas who smoke regularly. Given that there is a direct link between smoking and the increased likelihood of those from deprived areas experiencing ill-health or early death, does the Government think that it is doing enough to look specifically at reducing smoking in our most vulnerable communities?

This is what the Government does time and again. It tries to move the debate away from what we know will solve many of those problems. The trade unions tell us that offering that wage to staff would have a positive result.

As the colder nights approach, we may be in serious difficulty no matter what, but if we start the work now and the Government delivers for NHS staff, we can return to this place in the months and years to come with a sense of achievement.