Seòmar agus comataidhean

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?

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—

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.

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?