Seòmar agus comataidhean

We debate many motions that thank various workers and groups for their efforts. Although such motions have a place in the work that we do here, the weight of the crisis that affects ambulance availability and the subsequent stress that is caused to patients and front-line workers should hold greater sway than usual.

Although I applaud all of our dedicated staff, I will use my time better in trying to find out why the Government keeps letting them down. My standing here telling paramedics, call responders and technicians how thankful we are for their work will have made no difference if I am back here in a year doing exactly the same, while an unresponsive Government continues to make excuses for the problems.

We cannot change processes, adjust targets and rebrand services and call that reform. It is not. It is a branding exercise, not responsible governance. The key to the whole situation is simple. The Ambulance Service is underfunded, understaffed and lacking in resources: fix that, and we fix the problem.

I cannot stress enough to the Government that chasing targets and small headline improvements over proactive structural reform is not the way to run a health service. It is disappointing that the health secretary wasted his time this week briefing the Daily Record on his statement before informing Parliament, because doing so only further ingrains the image that this is all about expectation management and public presentation.

I do not want to manage the expectations of the woman who was left lying in Ayr town centre for four hours last month as she waited for an ambulance; I want her to be treated and back home with her family. That example is not even one of the extreme ones. Reports of patients waiting more than 40 hours for an ambulance create anxiety and stress throughout many communities, which are well aware that a delay in making it to hospital could, as we know, be the difference between life and death.

At least there is some positive news this week, as Covid rates seem to be declining across Scotland. I believe that we should use any breathing space that that allows us to focus all our efforts on preparing the NHS for the coming winter, and on alleviating pressure on the worst-impacted parts of our hospitals. Instead of doing that work, however, we might have to pick up the pieces from the missteps that have been taken over the past couple of years.

As my party colleagues and other members have mentioned, a concerning clinical backlog needs to be addressed right now that requires new field hospitals to tackle it. That is exactly what we should be doing. I understand that the health secretary has not ruled that out; I would support any steps to achieve that goal. Regardless of how it is reported, it is important for patients and the communities.

Before I close, I reiterate that all the problems—queues of ambulances, lack of beds, overworked staff—are deeply interconnected. We cannot tackle them without addressing the problem of underfunding. The Government has committed £1 billion of investment in the NHS over the next five years. Although some of that investment has gone towards training and recruiting new staff, that process will take almost a decade to bear fruit. In fact, nearly all the funding was already earmarked before May, with a fair amount of previous commitments already having been shelved.

That investment will not be enough. The NHS needs emergency measures to cope now. We see from feelings in the chamber that reports from our constituents suggest that the public wants action, too. After emergency measures, we need to address the problem of long-term planning and the failure to bring in well ahead of time the resources that the NHS requires.

The chamber should deal with the difficult issues, and we should pursue whatever works for the NHS. The strength of Scottish Labour’s motion reflects that intention, so I hope that it will be supported in that spirit.

I thank Michael Marra for bringing this important debate to the chamber.

The increased number of former professional footballers speaking publicly about their dementia diagnoses in recent years has undoubtedly encouraged increased research into the links between playing the sport professionally and being diagnosed with a neurodegenerative disease. The bravery of those former professionals in speaking out means that we can have this debate. Therefore, I encourage the Scottish Government to act purposefully to support professional footballers who are living with dementia and those who are currently playing the sport and might be worried about the impacts that it could have in later life.

Other members have quoted the statistics on the increased link, so I will not repeat them. However, the University of Glasgow found that, although the likelihood of being diagnosed with a disease such as dementia might vary depending on career length, it does not vary depending on the era during which a player played. That confirms that we have made little progress in making the game safer, which is an important point.

The diagnosis of those former footballers relates to an injury caused at work. That is the link. Football is a global, multibillion-pound industry in which a decent career can ensure financial stability for life. However, that was not always the case for footballers who played in the 1950s, 1960s and 1970s. Their commitment to football often only just managed to pay the bills and put food on the table. It is important to note that many professional football players today are not paid the breathtaking figures that we read about in relation to high-profile players. They continue to play football, doing a job—just like the rest of us—that makes them much more susceptible to conditions such as dementia than the average person.

Wider discussion is needed in the football and health communities about reducing the incidence of dementia among professional footballers in the future. As I said, there is a clear link between playing professionally and dementia. It is an industrial injury.

It is in the Scottish Parliament’s power to right a historical wrong, lead the way and classify such incidences as cases of industrial injury. If we do so, players who are affected will be entitled to receive the industrial injury disablement benefit and have the fact that they were injured at work recognised by the state. That would be a small but important step, and it is supported by the Professional Footballers Association Scotland and the GMB. It would go towards helping former professionals who are affected and would be a great step for the future of current players who might be worried.

We can all agree that the personal stories of those former professionals and their families are devastating. Too many lives have already been lost and too many more people will suffer unduly if no action is taken. The Scottish Government has the power to act. In the interests of supporting and protecting our former, current and future professional players, I support Michael Marra’s motion and hope that the Government will do more with purpose before it is too late for many players.

Sorry, Presiding Officer.

This should be a lesson about proactivity rather than reactivity. Let us not wait until something becomes a media scandal before we tackle it. I am not sure that Scotland can take the situation for much longer. We need to deal with it now, because a crisis could become a catastrophe.

Like many members, I have been inundated with requests from constituents who want to return to face-to-face GP consultations. For the most part, people simply want a feeling of assurance from a friendly face. After all, so many of our constituents, particularly older people, receive a great deal of social as well as medical support from their local GP practice. It is understandable that losing that has been a real drain on so many lives.

Given all that, I think that, within the sensible confines of Covid regulations, we should be returning to face-to-face appointments. We do not expect that to happen immediately; the public are simply asking for clarity about when it might happen, and at the moment there is little that I can tell people—I can only calm their concerns.

Equally, I understand why, with Covid cases rising and fears about the approaching winter, many people still have concerns about returning to some form of normality. We must be led by the science and a disciplined focus on utilising the proven methods that limited the spread of cases in the past.

In doing that, we must be clear with the public about what it means. Thousands of people have been patient and have stayed away from the NHS unless they thought that their cases were urgent, but that will undoubtedly mean that serious illness has gone undetected. We have to let people know—sooner rather than later—when they can get back to their doctors. I want to work with the Government on that, as I am sure all members do. We will get the message out, but there has to be some direction from the top.

In chorus with other members, I emphasise the amount of pressure and uncertainty that GPs and practice staff have been dealing with since March 2020. Public criticism of GPs is perhaps due to unclear communication, and the current situation is making things worse. No one should be under the illusion that care is not being provided. GPs, practice staff and their colleagues in wider primary care teams are supporting colleagues in acute care and are administering thousands of vaccine doses. In most cases, GPs and practice staff are working more than they have ever worked, and with that come fatigue, burnout and serious stress.

In a recent BMA survey of GPs, two thirds of respondents said that their current workload is unmanageable, and more than half said that their workload had got worse during the pandemic. In what sense does that suggest that the problem is under control? We seem to have stressed staff, patients who are worried that they will not receive the care that they need and ministers who are unresponsive to people’s plight. If we do not deal with the problem now, it will damage the NHS not just during the Covid period but for years to come.

Let us be honest. Staffing levels in local practices were a concern long before Covid became a part of everyday life. This is just one chapter in 14 years of SNP mismanagement of the NHS. A great many staff expressed concern about staffing levels in the years that led up to the pandemic. Had we listened, we might have a much easier road to recovery now.

I will.

Can the cabinet secretary assure us that the allocation of funds takes into account that the problem of ambulances being unavailable, certainly in my region of South Scotland, has been exacerbated by ambulance crews having to wait at hospitals for record periods of time to hand over patients, and that fixing the problem requires greater staffing and resources at all points of the emergency service chain?

I am glad that the Government is finally instituting the Healthcare Improvement Scotland review that Scottish Labour asked for, but will the minister clarify the terms of the review, when she expects it to report and how far reaching we can expect it to be in order to prevent further instances from happening?

Thank you, cabinet secretary, for your answers so far on treatment and families. I am very keen for us to explore the links with social inequalities, deprivation and poverty. It is important that we understand the commitment from you and the Government to make use of all the powers that we have to ensure that we tackle childhood poverty and housing issues, and to ensure that people have employment opportunities. What are your thoughts on those issues?

Like the cabinet secretary and previous speakers, I wish to mark the heroic efforts of our incredible NHS and social care workers during the Covid-19 pandemic, and I recognise the work that they will no doubt have to continue doing for some time. However, let me be plain: the best way to recognise that heroism is to give staff the pay increase that they deserve. A round of applause is nice, but a pay rise will keep a roof above your head and food on the table. It is of course welcome news that further staff capacity will be added to the health service, which is struggling from years of poor management and underfunding, but the best way to retain staff and make them feel valued is through good well-paid jobs.

BMA Scotland has correctly described the proposed 3 per cent pay increase for medical and dental staff as doing

“virtually nothing to help low morale”

or end serious difficulties with staff retention, and the slightly larger increase for staff on agenda for change grades has been contentious to say the least.

It is clear that the annual difficulties in getting a fair settlement for NHS staff is rooted in the fact that the work of those in the community, hospitals and emergency response is not valued as highly as it should be. In one area in particular, the problem is becoming acute. I could go on for a long time about the problems in mental health services in Scotland, but I have only four minutes.

Members are more than aware of the need to improve mental health services, but a key starting point for any forward plan has to be the recognition of what has gone wrong. However, I do not see that from the Scottish Government. In fairness, it says things but never does anything, which says to me that it does not recognise the scale of the problem.

I remind the Government that the number of children and young people waiting a year or more for mental health appointments is at a record level, and there has been an increase of 115 per cent in that number over the past year. The Government’s target for 90 per cent of referrals to be seen within 18 weeks has never been met—not once. Almost one in four referrals to CAMHS is rejected, and there is little data on what happens to those who are not accepted.

Undoubtedly, successive lockdowns, though necessary, have taken a considerable toll on services and the mental health of many, but we should not pretend that Covid is the cause of those startling failures—it all stems from policy decisions and where priorities lie.

It is a fact that mental health has never been given the precedence that it warrants by the Government. Until that changes, the spiralling decline in the mental health of thousands throughout Scotland will continue.

I, too, congratulate Karen Adam on securing the debate. The Tokyo Paralympics were as exciting and inspiring as ever, bringing an end to a summer of sport in the most remarkable of ways. It was great to see team GB perform so well, coming second in the medal table with an excellent 124 medals, with the 33-strong Scottish contingent contributing 21 of those medals—the best performance by Scots at a Paralympic games since Sydney 2000—and winning medals in 18 of the 22 sports. Team GB highlighted the wide array of talent that we have at our disposal, succeeding at the highest level and competing against the very best. We should be so proud of all our Paralympians for the effort that they and their teams put in during the most difficult of times, and we should congratulate them, as we are doing in this debate.

Our Paralympians are truly inspirational. Many of them faced adversity in childhood or perhaps in later life, but all have overcome barriers that in years gone by would have stopped them from participating in sport. It is encouraging that sport in 2021 is so inclusive. We have a long way to go, but the 2021 games showcased the very best talent, which has come from years of hard work and people often facing numerous setbacks. I believe that more people are recognising the importance of the Paralympic games now than before, and it is crucial that we continue to highlight how vital that breakthrough is to breaking down barriers and tackling stigma.

There is still work to be done. We have to ensure that sport is accessible to everyone. That means making sport accessible to disabled people and ensuring that having a disability does not act as a barrier to an individual’s ambitions or opportunities. More investment is needed in inclusive sport to ensure that no one is left behind and it is the responsibility of politicians, the media and wider society to highlight the positive impact that sport can have. It is our collective responsibility to do that, because, as mentioned in the motion, events such as the Paralympics bring people together—sport brings people together. To undervalue the positive impact that sport has on society would be a mistake.

Ahead of today’s debate, RNIB Scotland set out some key asks, including increasing funding for disabled sport, such as sports adapted for people with sight loss, for example tandem cycling and guided running, and for introductory sessions and classes for more advanced participants. That should remind us that there remains a long way to go to ensure that sport is accessible for people with a wide range of disabilities. Moreover, sportscotland, which has invested around £3 million to support Scottish disability sport since the Rio Olympics in 2016, noted that disabled athletes still face significant challenges that require joint working in order to be overcome.

The Tokyo Paralympics was a celebration of talent, diversity, inclusion and community and we can all agree that it was a joy to watch. As we have all said, it was a joy to see team GB athletes, who with their coaches, families and all the volunteers from local community sports clubs deserve a great deal of credit for making the sacrifices that they have to bring about such success. It is right that we have the opportunity to commend that success. Rather than seeing this debate as an end, it should be a stepping stone towards ensuring that Parliament gives sport and inclusive sport the consideration and investment that they deserve.