Seòmar agus comataidhean

I thank Clare Adamson for bringing this important debate to the chamber. On behalf of Scottish Labour, I am proud to highlight the importance of pancreatic cancer awareness month, and of marking world pancreatic cancer day tomorrow.

Pancreatic cancer is truly one of the most aggressive cancers and is perhaps, sadly, the deadliest common cancer in our country. It is a cancer that often brings an abrupt end to the lives of the people whom it targets. In my local health board, NHS Ayrshire and Arran, it has killed between 50 and 70 people every single year for the past decade. That is 50 to 70 more families being devastated year after year.

A close family friend died from pancreatic cancer many years ago and I am sure that today he will be thought of by so many people, including my parents and family, who have some very fond memories of him.

The Covid-19 pandemic has impacted our lives in many ways, but one of the most concerning impacts has been the reduction in levels of early cancer diagnosis. Staff shortages, pressure on the NHS, and long general practitioner waiting times have, among a host of other factors, contributed to figures that Cancer Research UK calls “devastating”.

Admittedly, the context of there being a global pandemic has impacted on the ability of health services across the world, but in Scotland we must act with purpose to reverse those concerns, resume early detection and give those who have cancer the best chance of life.

However, it is absolutely devastating that, even after diagnosis and treatment, many of the people who are diagnosed with pancreatic cancer are not given that chance of life, due to their symptoms not being noticed or treated with concern until too late. Therefore, it is important to highlight again that the

“key symptoms of pancreatic cancer include abdominal or back pain or discomfort, unexplained weight loss or a loss of appetite, yellowing of the skin or eyes and/or itchy skin, a change in bowel habits, nausea or vomiting, and indigestion that does not respond to treatment”.

Just as important is that it be made very clear to the public that the NHS is—even although it is under strain and is still suffering from staff shortages—open and accessible, and that if a member of the public has concerns, it is better to have a medical examination than to wait until it is too late. The importance of public awareness of the symptoms and of the fact that treatment and examination are available, should people need it, cannot be overstated. Everyone in the chamber would agree that any person who is concerned should go and seek treatment.

As Clare Adamson rightly mentions in her motion, despite the fact that some progress has recently been made, the survival rates for pancreatic cancer have remained stubbornly similar for far too long, so it is incumbent on all of us to do more, to act and to raise awareness of this awful disease in order to help people to secure the early diagnosis and treatment that can be so vital to their future.

As I often do, I want to bring to members’ attention the health inequalities that underpin cancer survival rates. According to Public Health Scotland, greater deprivation is linked to poorer survival rates from cancer. We must strive to do something about that. It is unjust and unfair that that remains the case in Scotland in 2021. Much more work needs to be done to address the clear health, social and economic inequalities that mean that a person’s postcode can make the difference between their having a stronger chance and their having a weaker chance of survival from the deadly disease.

I thank the organisations, which many members have mentioned, that have done so much work to raise awareness of pancreatic cancer. The value and importance of their work cannot be overstated; as parliamentarians, we must do all that we can to support them.

As we continue to make progress in our recovery from the Covid-19 pandemic, as we hope we will, the Scottish Government needs to ensure that its priorities include addressing late diagnosis and focusing on early intervention. It must also do more to tackle the widespread health inequalities that, to this day, remain a stain on our society and adversely impact people from our most deprived areas.

Again, I wish all those who are involved in pancreatic cancer awareness month the very best, and I thank Clare Adamson.

It starts with pay, wellbeing measures and workforce planning, not spin.

Does the member acknowledge that there were staffing problems before Covid and that it is not just Covid that has caused those problems?

Is the cabinet secretary aware of concerns about the Covid passport scheme not being enforced rigorously or consistently at large sporting events such as football and rugby matches? How will the Scottish Government address such concerns, to allow the Covid passport scheme to have its desired impact?

For me and most of my constituents, this is a simple issue. It is about doing what is right to help an NHS that is struggling to keep its head above water and it is about making sure that we have well-trained and well-looked-after staff who are supported to give the best care in the world. I do not want this to become a party-political issue—I do not think that the issue would benefit from that—but the Scottish Government must step up.

I worry that, going into winter, we will see a repeat of the capacity crisis that we have seen year after year in Scotland and elsewhere. That is undoubtedly exacerbated by the Scottish Government’s failure to properly engage in serious workforce planning. That is not a new problem, nor is it, as some spin would have us believe, a problem that is caused solely by Covid. Warnings were in place long ago, and many of my colleagues who sat in the previous session of Parliament will make the same points that I will make today.

As Jackie Baillie indicated, Labour members will support the motion on removing the cap. We must remove that cap on funded places for front-line medical students, but we cannot do so without additional investment for our first-rate medical schools and the capacity to deliver foundation places to all graduates on the completion of their degrees. That is basic common sense, and I believe that it is achievable with the correct political will.

The problem is generally applicable across the medical fields, as Jackie Baillie indicated. I have repeatedly raised issues in the Parliament around the need to increase the number of trained pharmacists in Scotland. Without moving away from the purpose of this debate, I want to make that point again. There is a staff shortage emergency in the NHS in Scotland, and we have to be honest about that.

Beyond the vital need to get more high-quality front-line staff into our NHS, we need to take care to look after those who are already putting in incredible shifts day after day. Margo Cranmer, the chair of Unison’s nursing sector committee, has described Scotland’s nursing team as “stressed and exhausted”—that has already been mentioned, but I thought that it was worth stating that again. She went on to say:

“Substantial investment in extra staff and changes to their working lives are essential.”

Staff retention is nowhere near where we need it to be, and I view maintaining a satisfied workforce as a top priority for any service that wants to tackle the challenges that lie ahead. I do not think that, in all honesty, we can say that that is where we are in Scotland at the moment.

We have all spoken to constituents and representatives of medical NHS staff who have no end of stories about the strain and pressure that they are under. I want to give them something to hold on to, not just a few headlines or motions of thanks. Therefore, as well as lifting the cap, let us get a long-term pay deal that seriously reflects what health groups and trade unions are asking for, and offer a working-time review to every staff member considering retirement, which will give us the opportunity to offer more flexible working arrangements and retain staff for longer. Staff are fed up with being a secondary consideration.

At the heart of all this is low pay, which is a mistake that the Government makes again and again. We are supposed to be designing a transformational national care service, but the Government has still not committed to a wage of £15 an hour for social care workers. The NHS recovery plan that was presented to Parliament a few weeks ago was equally full—

My question is about rights for care home residents. We know what happened during the pandemic. Does the minister feel that the opening up of care homes to visitors provides adequate access for family and friends to ensure the wellbeing and health of residents?

The minister briefly mentioned CAMHS, which is very important for young people and their families. We know that waiting times have been quite long. I wonder whether you can give us some information on three aspects relating to CAMHS. The first is waiting times, which you have touched on. We need to get it right for people by getting waiting times down.

Secondly, there are a number of rejected referrals to CAMHS. The Government has acknowledged that and has said that more work needs to be done. What can be done for those young people?

The third aspect relates to unmet need. We know that when schools were closed because of Covid there was a drop in the number of referrals to CAMHS. Medical staff have identified that young people might have missed a window, so we should ensure that they get any support that they need at this time.

I want to ask a wee bit more about unmet need. Do you have a plan? Have you spoken to any organisations about what we might do to identify young people who have been missed?

I thank Emma Harper for bringing this important debate to the chamber—as she often does with so many conditions. On behalf of Scottish Labour, I welcome world COPD day, which takes place tomorrow, and I recognise this year’s theme of “Healthy Lungs—Never More Important”.

The prevalence of COPD in Scotland and, indeed, globally should cause all of us concern. As Emma Harper has mentioned in her motion and in her speech, the increasing prevalence of COPD means that it is estimated to become the third most frequent cause of mortality worldwide by 2023.

I consider it important, in order to stop that worrying trend, that the causes are understood and highlighted. It is well known that smoking is the most common cause of COPD, being the leading factor for nine out of 10 cases, according to NHS Scotland. That means that around 90 per cent of COPD cases can be tracked back to a single cause, which highlights for the Parliament where action must be taken to address the trends that we are currently seeing.

In 2018, the Scottish Government set out plans to create a smoke-free generation by 2034, protecting those born from 2013 onwards from the adverse impacts of smoking. I and Scottish Labour support that move. I hope that, in the longer term, it will address what will be an even more challenging condition.

However, we need more action now to protect those living with COPD. The condition is another of those that disproportionately impacts the poorest in our society. Sadly, it is another example of where the Scottish Government is falling short when it comes to addressing health inequalities. “The Scottish Burden of Disease Study, 2016: Deprivation report” highlighted that COPD was one of the “leading causes” of ill health or early death in Scotland’s poorest communities.

Indeed, in 2019, Action on Smoking & Health (Scotland) reported that more than five times the number of people in the most deprived groups smoke compared to those in the least deprived groups. That highlights a clear link again in Scotland, where poorer people in Scotland’s most deprived areas are more likely to suffer from health conditions such as COPD and are therefore more likely to have their quality of life reduced further.

However, the inequalities are not limited to smoking. The Health and Safety Executive suggests that working in construction, textiles, factories and welding are also linked to increased chances of getting COPD. In each of those places, there are low-paid workers, often from more deprived areas, and if they are already smokers they could be at further risk of facing significant health difficulties in the form of COPD.

Chest Heart & Stroke Scotland reports that people who are living with long-term health conditions such as COPD are at greater risk of readmission to hospital if they are not supported to manage their conditions and they have high levels of loneliness, isolation, and poor mental health. It is therefore right that Emma Harper highlights the need for greater focus on COPD care, and I believe that such focus should include taking the advice of organisations such as Chest, Heart & Stroke Scotland, as well as considering programmes such as their hospital to home support service, which offers direct post-diagnosis support.

COPD is another condition that highlights and exacerbates the already significant health inequalities that Scotland faces. I welcome the fact that the motion refers to health inequalities underpinned by smoking, air pollution and poor quality of housing, but we cannot accept that our ability to debate health inequalities in this Parliament should be limited to members’ business debates.

Where I live in Ayrshire, the rates of COPD are among the highest in Scotland. In 2018, NHS Ayrshire and Arran had the highest proportion of people living with COPD in Scotland. This debilitating condition causes ill health at home as well as long stays in hospital with repeated readmissions. In representing the south of Scotland, I have to ask the Scottish Government to take health inequality seriously. It is incumbent on the Scottish Government to lead a debate on the health inequalities in our country and to be held to account for its record on addressing them. In doing so, we might take some purposeful steps towards helping the tens of thousands of people who are being disproportionately affected by conditions such as COPD as a result of deprivation. We can and must do more to help those communities.