Seòmar agus comataidhean

I thank Paul Sweeney for his intervention; I absolutely will come on to that point. Those services are important and we should build on them, and the social deprivation element must be part of our discussions.

I think that we can all agree that people of a young age in particular are at a point in their life where they should have positive years ahead. Even when people are 55, that should be a time for them to be excited about the next stage in life, but the condition can make the basics of life intolerable. Dr Chetcuti explained to me that he believes that, sadly, the lack of services for those patients means that many people live a life of poor quality or lose their life far sooner than they should.

The reasons that people end up with the condition are complex but, essentially, ARBD is caused by a person regularly drinking or binge drinking much more alcohol than the recommended limits, which, over time, can, if untreated, cause irreparable damage to the brain.

The brain damage is often caused by a lack of thiamine, also known as vitamin B1, which the brain requires in order to work properly. Absorption of thiamine while drinking alcohol to excess is one cause, but we know that those with serious dependency often have chaotic lifestyles, and that can result in poor dietary intake, which exacerbates the lack of thiamine.

It was reporting on the use of thiamine in treatment that made me realise how important it was to raise awareness of the condition and argue for better services. That treatment should be achievable, but people need knowledgeable clinicians and specialist services to support them. There is evidence that if excessive alcohol consumption is stopped and thiamine intake is increased, around 25 per cent of people can make a full recovery and 50 per cent of people can make a partial recovery. However, the reality is that, as a result of a lack of services to raise the profile of ARBD and its treatment, those opportunities are being missed. That is an important point.

As my friend Martin Whitfield said, it is often younger people who are affected, and they can experience poor quality of life. Care home beds for them are very expensive, and that poor quality of life continues because, once someone is admitted, it is difficult to get the expertise to support them and get them home. The evidence shows that we can change that, and it is important that we talk about that in Parliament.

I know that time is tight, Deputy Presiding Officer, but we cannot have a debate on the subject without mentioning the root causes of alcohol misuse, the link to poverty and deprivation and the role of Government in policy development. I acknowledge the Government’s role—as the Minister for Public Health and Women’s Health will know—in progressing minimum unit pricing. However, I hope that the minister might, in her closing remarks, respond with regard to future movement on the introduction of evidence-based population-wide measures around availability and marketing of alcohol products. With those measures, we would see population-level changes in alcohol intake, resulting in a change to the drinking norms in Scottish society. That is the reality.

In my final minutes—I promise, Deputy Presiding Officer—I return to services for people who are currently suffering from ARBD. The reality is that services are at risk of diminishing rather than expanding. I believe—as I hope that I have shown tonight—that we need to take the subject seriously. I hope that the debate is merely the start of a conversation in the Scottish Parliament. What high-quality service provision currently exists for those who are suffering from ARBD, and how does the Government ensure that funding for those services continues and that there is funding to open other services in Scotland?

We must talk about national treatment standards and how we ensure that there is a referral pathway for the condition to the services that provide care.

I will stop there, Deputy Presiding Officer.

The minister previously stated that the Government continues to explore other avenues, alongside self-sampling, that may improve the uptake level of cervical screening programmes, including consideration of better use of digital technology and more personalised communication. Can the minister give any further update on the detail of that?

I thank my colleague Jackie Baillie for moving her amendment 100 and speaking to her other amendments in the group. I hope that members will support those amendments. I particularly agree with her comments on sectoral collective bargaining. That has been an important part of discussions with the minister and others, but it is important that we get those measures in the bill.

I am happy to speak to the amendments in my name in the group, which seek to strengthen fair work principles in the bill and embed human rights. Amendment 107 seeks to ensure that international workers who are employed in social care shall enjoy all the rights and benefits of United Kingdom status, the social care sector and fair work in care. The amendment would require the Scottish ministers to create a fair work charter for internationally recruited workers, along with statutory guidance on

“the application of the code of practice on ethical commissioning ... and regulations on ethical procurement ... to the delivery of fair work for international workers.”

Amendment 108 would place a duty on the Scottish ministers to prepare and publish guidance on

“continuous improvement in the arrangements for fair work in the social care sector.”

The guidance would apply to all relevant public authorities and contracted providers and would be subject to review in each three-year period, with revised guidance being issued or a statement being laid before Parliament setting out that a revision was not needed.

Amendment 109 would create standardised

“acts and omissions of a contracted provider that constitute a reportable breach of contract in relation to fair work standards”,

which would be reported against. The intent is also to provide for remedies when there are breaches, including contract termination, and to create a standard approach to managing, reporting on and publishing information on breaches.

Although I appreciate that the measures that are set out in amendment 107 may be addressed elsewhere in legislation, I believe that the amendments strengthen the fair work principles in the bill, and I am interested in hearing the minister’s response to that.

Amendment 110 seeks to ensure that contracted providers comply with the labour relations requirements that are referred to in amendment 105. Amendment 110 would also make the victimisation of social care workers on the grounds of trade union membership or trade union activity a breach of the measures in amendments 100 and 101, which have been lodged by Jackie Baillie, on the founding principles and social care duties.

The purpose of amendment 111 is to maximise the realisation of human rights for service users and workers in the social care sector by providing regulation-making powers and a duty to make regulation to achieve that purpose. Amendment 111 would require that such regulations include provision to cover financial transparency, control over profit, control over tax avoidance, sanctions for tax evasion, expansion of public and not-for-profit social care services, and establishment or designation of a care finance regulator. Human rights should be embedded in the bill and amendment 111 would significantly strengthen the bill in that regard.

Amendments 112 and 113 would create provisions for monitoring and reporting on fair work. Amendment 112 would create a common standard of fair work indicators with monitoring and reporting of those indicators to enforce fair work standards.

Amendment 113 would place a duty on Scottish ministers to publish an annual report on fair work in care in Scotland.

I urge members to support the amendments.

Given the minister’s comments, I will be happy to work with her, so I will not move amendment 107.

Amendment 107 not moved.

Amendments 108 to 114 not moved.

I thank my colleague Jackie Baillie for moving her amendment 100 and speaking to her other amendments in the group. I hope that members will support those amendments. I particularly agree with her comments on sectoral collective bargaining. That has been an important part of discussions with the minister and others, but it is important that we get those measures in the bill.

I am happy to speak to the amendments in my name in the group, which seek to strengthen fair work principles in the bill and embed human rights. Amendment 107 seeks to ensure that international workers who are employed in social care shall enjoy all the rights and benefits of United Kingdom status, the social care sector and fair work in care. The amendment would require the Scottish ministers to create a fair work charter for internationally recruited workers, along with statutory guidance on

“the application of the code of practice on ethical commissioning ... and regulations on ethical procurement ... to the delivery of fair work for international workers.”

Amendment 108 would place a duty on the Scottish ministers to prepare and publish guidance on

“continuous improvement in the arrangements for fair work in the social care sector.”

The guidance would apply to all relevant public authorities and contracted providers and would be subject to review in each three-year period, with revised guidance being issued or a statement being laid before Parliament setting out that a revision is not needed.

Amendment 109 would create standardised

“acts and omissions of a contracted provider that constitute a reportable breach of contract in relation to fair work standards”,

which would be reported against. The intent is also to provide for remedies when there are breaches, including contract termination, and to create a standard approach to managing, reporting on and publishing information on breaches.

Although I appreciate that the measures that are set out in amendment 107 may be addressed elsewhere in legislation, I believe that the amendments strengthen the fair work principles in the bill, and I am interested to hear the minister’s response to that.

Amendment 110 seeks to ensure that contracted providers comply with the labour relations requirements that are referred to in amendment 105. Amendment 110 would also make the victimisation of social care workers on the grounds of trade union membership or trade union activity a breach of the measures in amendments 100 and 101, which have been lodged by Jackie Baillie, on the founding principles and social care duties.

The purpose of amendment 111 is to maximise the realisation of human rights for service users and workers in the social care sector by providing regulation-making powers and a duty to make regulation to achieve that purpose. Amendment 111 would require that such regulations include provision to cover financial transparency, control over profit, control over tax avoidance, sanctions for tax evasion, expansion of public and not-for-profit social care services, and establishment or designation of a care finance regulator. Human rights should be embedded in the bill and amendment 111 would significantly strengthen the bill in that regard.

Amendments 112 and 113 would create provisions for monitoring and reporting on fair work. Amendment 112 would create a common standard of fair work indicators with monitoring and reporting of those indicators to enforce fair work standards.

Amendment 113 would place a duty on Scottish ministers to publish an annual report on fair work in care in Scotland.

I urge members to support the amendments.

I thank Emma Harper for bringing this important debate to the chamber again this year. I also welcome the guests in the public gallery—it is great to have them here.

Like other parties, Scottish Labour supports the aims and objectives of eating disorders awareness week 2025 and its goal to raise awareness of how eating disorders can affect anyone. I ask people who need support to seek it, if they can, as the motion says, by contacting their GP surgery, or by phoning the Beat helpline or contacting that organisation through its website.

In seeking to better understand these complex mental illnesses and abolish stereotypes, I thank Beat for its survey, which shows that four out of five respondents

“thought that greater public awareness would make them feel more comfortable to talk about their eating disorder.”

That is an important point, and we in the chamber can contribute to that awareness.

We know that eating disorders affect not only the person with the condition but their friends and family, who can become carers and are often forced to watch their loved one struggle with that battle. Having open conversations can relieve the stigma for families, too, so it is important that we ensure that we have those conversations and reduce the stigma to allow the discussions to continue.

Is the cabinet secretary confident that all health and safety workplace regulations are being complied with and that all public bodies have single-sex toilets clearly marked as male and female? In her answer, I ask her to give us evidence of how that data was collected and, if it is not available, to commit to obtaining such information.

I thank the member for that intervention—it is a very important point. As the parent of a teenage daughter, I am concerned about some of the things that we see on social media. We all have a responsibility to talk about that so that we can address it.

As we have heard, eating disorders are not uncommon: one in 50 people in Scotland, and many people across the wider UK, are affected by them. We know that, tragically, the impacts can be fatal, and that is why we must raise these issues whenever we can.

I also highlight the issue of age at diagnosis, because that can sometimes be misunderstood. We know that most eating disorders develop during adolescence; however, there are cases of eating disorders developing in very young children and in adults, including examples of adults who develop such disorders well into their later years.

That might be shocking but it acts as a reminder to us all that eating disorders are prominent and serious across our whole population, and that they still have a taboo surrounding them. We know that that is particularly true when men are involved and they feel that they cannot speak about it. Again, that is very important for today’s debate.

As Beat has indicated, it is essential that we, as MSPs, take our role seriously. We need to raise awareness, fight for funding for research and scrutinise the Government’s delivery of full implementation of the plans for eating disorder services. I know that other members have asked the minister to respond to that.

One of the review’s recommendations was to establish a national eating disorder network to oversee implementation of the Government’s plans, and its terms of reference were published in July last year. The network is responsible for co-ordinating training and research implementation, along with improving links between primary and secondary care services. I am very interested in that point. Members will know that I worked in the national health service as an allied health professional, so I am aware of the importance of training and the link between primary and secondary care. Professionals in the network often discuss the importance of training and how we should ensure that people are aware of and can spot the various conditions or build-up across the spectrum to ensure that we can signpost and have appropriate resources.

I am aware of the time, but I want to make it clear that I have been impressed by the speeches in the chamber tonight. I hope that we can continue to have this conversation, because that is what tonight’s debate was about.

I thank the committee for inviting me to attend the meeting, because, as members know, I have previously spoken on the issue, and I want to ensure that people are fully aware of the extent of the situation involving people who have undergone the mesh procedure.

I echo the points that have been made by Katy Clark and the petitioners in their submissions to the committee. I support their point about the lack of data on the number of patients who are experiencing complications as a result of the use of mesh. It is concerning that we do not know whether we are capturing that data, which is important. The submissions highlighted the fact that the data that is currently being relied on is inconsistent, incomplete and often outdated. We should all take that issue very seriously. I will not repeat the point that the convener made about that, which was well made. It is clear the minister has taken the issue seriously.

Although the Scottish Health Technologies Group report is interesting, there is good reason to think that the data sets that it used are, as one of the petitioner’s submissions highlights, “narrow and incomplete”. Action could be taken to look at that.

In addition, the absence of follow-up data is worrying. We do not know whether any follow-up work is being done, although a commitment has been made that such work will be done. The full extent of mesh-related complications is also worrying. Given that complications might not be immediately apparent after surgery, could we have a system in place that would allow us to look at that?

I echo the points that Katy Clark made, and I request that the committee keeps the petition open and perhaps writes to the Government regarding a review of the current data sets, so that we can continue to support the work of the petitioners.

The rate of patients being seen within four hours at accident and emergency departments in Dumfries and Galloway is the worst on record. Although we understand the immense pressure that NHS staff are under, lack of capacity has led to treatment taking place in areas that are unsafe, inappropriate and undignified. Last week, I asked the cabinet secretary whether the Government would commit to publishing regular data on the care that is taking place in inappropriate settings, but he failed to address the issue of data altogether. I ask him again: does the Government intend to publish regular data on corridor care?