Seòmar agus comataidhean

I thank Gillian Mackay and the campaigners at Back Off Scotland for bringing this vital issue to the Parliament.

My colleague Monica Lennon has, unfortunately, had to withdraw from the debate. She sends her full support for the spirit of the motion and the work that has gone into highlighting the issue. Members know that Monica has shown firm commitment to the needs and rights of women, and I am pleased to pass on her message.

For some people, abortion is a difficult political issue and most people make their case respectfully and constructively. However, a very vocal and influential minority do not. Standing outside a clinic that is committed to helping people in dire need and shaming those people for seeking help is bullying, no matter how well meaning someone thinks that they are.

Those who seek to oppose a woman’s right to make her own choice are not a new quantity by any means. For decades and centuries, an ever-decreasing section of society has felt it incumbent on it to police women’s decisions and indeed their bodies. Fortunately, due to the efforts of so many brave individuals, that grip has loosened, in our country at least, to the point of being almost non-existent. However, I can only say “almost”, because it is still there, and this debate is about a current pernicious example.

For Dani Garavelli’s fantastic piece on the phenomenon in The Scotsman, she spoke to those who have experienced such intimidation, and they reflected on how uncomfortable it made them feel during an already difficult time in their lives. The discomfort is not solely reserved to them; it is also felt by those who work in the clinics, who are left feeling vilified and forgotten by the authorities, despite simply wanting to do their jobs.

As we have heard, these vigils, as the organisers call them, take place regularly in the health board areas where 70 per cent of women in Scotland live. It is difficult to quantify just how many women will have encountered them, as many will prefer to keep quiet. The groups behind these vigils are often funded by highly questionable US-based pressure groups with a history of homophobia, sexism and indeed racism. Why are they being allowed to intimidate women at a point in their lives that is always difficult, but for many is absolutely necessary? I can only imagine that, if the same sort of intimidation was happening to men, we would not need to have this discussion, as it would have been dealt with long ago.

Well, enough is enough. We all understand that a law is not currently in place to prevent such instances of intimidation, but that needs to change. I fully support Back Off Scotland’s call for the enforcement of 150m buffer zones around the clinics. I understand that other organisations will be fearful that that could curtail the right to protest in other instances, but there is no reason why legislation could not be introduced that reflects those nuances and does right by those who seek vital healthcare.

The women behind Back Off Scotland have first-hand experience of the issue. I was glad to hear that they have met Maree Todd to discuss it, but I am not surprised to hear that they came away with little more than reasons and excuses why it cannot be done or why it would be difficult to do it at this time. That is not how government should work. We cannot pass the buck on the problem and hope that it will go away. Equally, we cannot simply fob it off on to local authorities, which are already overburdened.

More and more people are becoming increasingly aware of the practice and we will soon get to a point, through the commitment of campaigners such as Back off Scotland and others, where the Government has no choice but to carry through. Why wait until then? Introducing legislation as soon as possible would alleviate the distress of so many women, and especially those who are already in vulnerable circumstances with little in the way of a support network.

Let us push forward and move beyond this very necessary members’ business debate. Members’ bills can take years to go through and are often unsuccessful. Let us make this a priority for the Parliament. It would certainly be a legacy that we could all be proud of and one that future generations would thank us for. Let us be brave. I ask the minister to do the right thing, and to do it now.

The Scottish Government has committed to halving childhood obesity by 2030. Can the cabinet secretary outline what steps the Government is taking to make community sport more inclusive, accessible and affordable for families who cannot afford the expensive cost of participating in sport, to ensure that sport plays its rightful role in meeting the targets that the Government has set out?

That is helpful. Thank you.

It is really important that we are clear with the women—the people who describe themselves as in-betweeners—about what we mean by entering into arrangements. Having spoken to some of the women, I think that any movement towards going for that surgery was quite a trauma to go through, so we need to be clear.

To go back to Jackie Baillie’s point, in the previous evidence session, we heard that we are not clear about when people might have the option of going to Dr Veronikis. It did not seem clear in the previous session when that date might be settled. A small number of women are involved. Can we be clear with them, please? It is very important for those women to be able to move on.

My question is probably also for Dr Jamieson. I am interested in the clinical nurse specialist role. I have read that, in other services that have such a role, it can be quite successful in developing patients’ confidence right through the care pathway. How will the role work, and how early will the women meet a clinical nurse specialist to go through the information?

I have a question about the third option, which has been referred to a couple of times now. I have to say that I am unclear about the timeframes, but are you clear about them? When will we get an answer to that?

I thank Collette Stevenson for bringing this important issue to the chamber.

On behalf of Scottish Labour, I welcome world menopause day, which was marked on 18 October. It is vital that we take time to recognise the importance of raising awareness of the menopause and how it can impact women’s health and their day-to-day life, and—crucially—to highlight what we can do to tackle the stigma that still surrounds the menopause.

As the motion states, around 400,000 women in Scotland today are of menopausal age, and most of them will experience symptoms that are wide ranging and often distressing. Our role in the Scottish Parliament is to ensure that their experiences are not stigmatised, but are spoken about openly and freely, and that adequate support is put in place to support them in all aspects of society—at home, in public places and in the workplace.

My call for such support to be put in place is addressed not only to councils, the Scottish Government and places where support can be offered to women with relative ease. Although interventions such as the excellent policy brought forward by Collette Stevenson that we heard about earlier, are very welcome, I also call for support for every woman up and down the country who experiences menopause symptoms, including women who work in industries where a path to securing such protections may not be clear and for those who do not feel comfortable going to their employer to discuss such concerns.

It is important to discuss Scotland’s significant health inequalities and how they link, and will continue to link, to women’s experiences of the menopause. The motion states—correctly—that employers should be flexible with women who feel that their ability to work has been impacted by symptoms linked to the menopause, and that they should be treated with dignity and respect in the workplace. That must mean a minimal expectation of allowing flexible and/or home working and of giving time off where necessary.

As we have heard, in recent years, we have made significant progress in improving provision relating to women’s health in Scotland’s workplaces. However, we can still go further, including by being more open in our discussions about the menopause and offering greater levels of protection than already exist.

In Scotland in 2021, we must accept that we fall way below the standards when it comes to addressing health inequalities. Time and again, it is the poorest in our communities who suffer the consequences of inaction—those with low incomes and debt and those who, at this time of year, have to make the incredibly difficult choice between feeding themselves and their families or heating their homes.

The health inequalities in our country are one of our greatest challenges. Women in low-paid and precarious employment may want to take time to attend their GP or a primary care service relating to the menopause, but they simply cannot afford to do so. Those who are working in male-dominated sectors might want to explain their difficulties to employers, but do not feel comfortable doing so. In the worst cases, those who have the most severe symptoms might want to take time off work but either cannot afford to do so or do not feel that there is adequate support to do so.

Decisively resolving those issues is within the power of the Scottish Parliament. Inequalities in health, particularly in employment practices more widely, do not reflect the Scotland that we want to live in. However, that is the Scotland in which ordinary people struggle through and live. We must do all that we can to bring health solutions closer to home so that those who need them most, such as women who are experiencing menopausal symptoms, can get relief and support without having to visit a hospital or go to the GP continuously. That starts with addressing stigma about women’s health, tackling health inequalities more widely, and ensuring that workplaces are suitable for the needs of such women.

We must push on with increased purpose to create a just and compassionate society that recognises that, for generations, women have largely been left to struggle needlessly, and that that must change. As we have heard tonight, it has to change now.

The cabinet secretary’s statement should be welcomed. Scottish Labour will take time to consider the range of recommendations that are made in today’s report. The cabinet secretary rightly states that the process will not be a quick one. Will he say when he expects to complete consultations with relevant stakeholders and to bring draft legislation to the chamber? Will he give more detail about who he expects to consult as part of the process? Will he include patients and their family members as well as those with a genuine interest in making NHS trusts work on behalf of local communities?

Thank you for the information that you have provided so far. Leading on from Paul O’Kane’s question, I am interested in ensuring that information is provided to any women who do not know about the scheme or about how to apply to it. We must ensure that that information is very accessible and that women feel at ease in applying, should they have to do so. Has any work been done on that?

In closing the debate for Scottish Labour, I thank my colleagues in the Parliament, all of whom made significant and interesting contributions to the debate. It is always useful to hear about successful projects across Scotland, so I thank members for sharing those stories.

We must also face up to the reality of what is happening. I think that members would agree that Michael Marra described very well the reality for people in Dundee.

When we talk about problems with substance misuse and related mental health problems, we are really talking about people who have, for one reason or another, slipped through the net. Where there should be adequate support to get them back on their feet, there has been little more than a promised appointment that never comes. Only recently, we heard that 31 per cent of calls to the NHS 24 mental health hub go unanswered. We can only imagine how many of those people will immediately give up and seek other ways of coping. This is the story that I hear time and again all over my region, and I know that many other colleagues have heard the same: “I want help but I can’t get it. I’ve been waiting for months just to see someone or even speak to someone.” We can do better than that, and I think that there is broad agreement here in the Parliament, among ministers and others, that we must now do whatever is necessary to pull Scotland out of this nosedive.

However, let us not talk about this in the abstract. We need to be honest with the public and say that addressing the issue will require greater investment and a much longer term approach—two things that the world of politics is often poorly prepared to deal with. Although I welcome the investment mentioned by the cabinet secretary, let us be honest and accept that it is not enough.

We know that the problem of people simply not being able to get the help that they require is widespread in Scotland. As I and others have noted in the chamber today and in previous debates, the number of children and young people waiting a year or more for mental health appointments is at a record high. We should not then be surprised that, for those living with substance misuse, that problem is just as prevalent. We need to find more sustainable ways to get people the care that they require in the community and directly connect the problems of poverty and substance misuse through meaningful policy.

Poverty and homelessness are included in the motion as a consideration but, for me, they should be the core of the debate. If we do not seriously tackle the low-pay, high-debt, exorbitant-housing-costs society that we have built, reliance on substances to deal with that pressure will only get worse. The minute that someone is made homeless or put on the cusp of homelessness through unaffordable rents, their health—mental and physical—will rapidly deteriorate. If that person has already been exposed to a damaging relationship with dangerous substances, it is obvious that they will be at risk of going further down that road, yet little is done to give immediate support to such people and offer them the counselling and respite that they require to follow a different path. Any expense that we incur by increasing counselling and outreach services will be saved many times over by ensuring that people’s health is protected and their homes are secure long before the problems arise.

Scottish Labour believes that we must begin to look at this now. As described by Michael Marra, drug misuse and associated mental health difficulties have spiralled out of control. The conclusion has to be that the issue should be a top priority for every Government, not just here in Edinburgh but in London, too. It needs to remain a priority for a long time to come. There will be no overnight fix, and if we can shift the narrative towards treating this as a health crisis and focus on solutions that are centred around support and prevention, it will change the lives of thousands in Scotland for many decades to come.

I refer to the Scottish Labour amendment in Claire Baker’s name, which I hope will be supported at decision time this evening. The amendment rightly highlights that the number of people staying in hospital due to drug-related mental health problems is on the rise, and further points out that we are not doing enough to make sure that those who need support are being referred to community-based services so that we can address the root causes of their problems. In order to do that, we must more cohesively link together each service and considerably expand the number of outlets that there are for people to seek support from.

The root of all of this is the continued poor funding of mental health services in Scotland. They remain underresourced and blighted by unacceptable waiting times. If we are to change approaches towards community support, and change the disparity in funding for those services, we can shift the trajectory of the debate. Without doing both of those things, headlines may change but lives will not.