Seòmar agus comataidhean

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.

Yes, and we would therefore hope that we would be making more progress and fewer reports, and that we would be changing services for the better of the people.

To start to make progress, we need dedicated mental health workers in every GP practice, not just access to one, and a significant increase in mental health spending across the NHS without detriment to other services that are equally under strain. We need the resources. There are not simply possibilities at this point; there are absolute necessities.

If we are to get the country back on its feet, we will be asking people to work hard and rebuild Scotland, but we have to do our bit. We have to work hard for them.

Yes.

That means giving people the world-class treatment that Scotland was once famed for. The cabinet secretary can play a leading role in that, but the Government needs to take action.

To this day, the legacy of mining and the miners who made it happen is everywhere across South Scotland, particularly in my home area of Ayrshire and in Midlothian, which is referenced in the motion. It is not just a legacy that has been left on the earth; it is a legacy of social, cultural and political energy that continues to reverberate. I am speaking in the debate in order to celebrate that legacy and the dedication of the miners who broke their backs for our country. They have not been forgotten by me or by the Scottish Labour Party. I hope that we can, through a bit of common sense and decency, get them the pensions that they deserve. That is not much to ask.

I know that there are people in other parties who would like to think that they saw off the miners long ago. However, although many miners are now retired or, sadly, no longer with us, the legacy of the industry lives on in the solidarity, grit and shared experiences of their communities. It also lives on in the poverty that we have heard about, which is seen in many former mining communities and in the miners’ struggle to achieve financial security for themselves and their families, now that their livelihoods and the highly skilled and well-paid jobs that came with mining have all but gone.

I am disheartened to say that, nearly 40 years after the process began, we are still having to stand up and defend the miners and their families against a Tory Government that simply did not care—a Tory Government that saw destroying the power of the working classes as a priority above all else. Why would we expect anything different now?

It is likely that, over the next six years, the Treasury will earn about £23 billion in real terms from the miners’ pension fund, but the sum could grow as high as £55 billion—all that wealth, and so little of it going to those who grafted for it. There was a time when the Tories claimed to be all about getting Britain back to work and putting a pound in people’s pockets. We can see now whose pockets are bulging from the miners’ money.

Fortunately, we have a majority in Scotland against that callous injustice, and I fully support the call to give the £1.2 billion that is held in the investment reserve to the former miners. After all, it is what they are due.

As is rightly mentioned in the motion, the great work of the Labour Government in Wales serves as a fine example for Scotland to follow, and I have no doubt that attempts to follow it will be supported by almost everyone in the chamber. I only despair that we have had to demand it. The distribution of funds should have been reviewed long ago. I thank Christine Grahame for bringing her important motion to the chamber for debate.