Seòmar agus comataidhean

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 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.

I am pleased to open the debate on behalf of Scottish Labour to discuss an issue that touches the lives of many families across Scotland. It is vital that we look at what more can be done to improve miscarriage and stillbirth care, so that the next generation does not suffer the same dismissal that perhaps many women have suffered before.

I thank the minister and her officials for the collective way in which they formed the motion. We all want to support and progress the issue to ensure that the care that women receive only improves over the coming years.

At this stage, I welcome the framework, but I am sure that the minister will expect there to be scrutiny from members on how actions are delivered. It is fair to say that some elements of care are delayed, and we need to treat the situation with some urgency.

Let me, like other members, acknowledge the deep emotional toll that miscarriage and stillbirth take on individuals and their families. It is a grief that is often unspoken, and it is crucial that we recognise the profound impact that it has on the many women and families who, sadly, require access to such services.

Although I hope that stigma around miscarriage has reduced, let us not forget that it persists. To address that, we in the Parliament must do our part to talk about it, as the minister and Brian Whittle said, and to work out a way to rectify and improve the care pathway for women who have to travel it. Therefore, I thank all the members who will speak in the debate or who have stayed in the chamber to listen.

I express my gratitude to all NHS staff. We know that the kindness and expertise of staff is at the heart of our NHS. I am sure that, like me, other members from across the chamber hear from patients time and again about the care that they receive in the NHS. In the brief look that I have had at the document, I see actions around supporting staff, which is extremely welcome.

My party welcomes the recommendations from The Lancet’s miscarriage matters series and supports the staff who continue to work on improving miscarriage care across Scotland following those publications. We welcome the progesterone pathway and, of course, support the graded model of care.

We must ensure that the “Delivery Framework for Miscarriage Care in Scotland” can be fully implemented across all NHS health boards to improve the pathway for women. I have seen the goals in the framework. However, we know from the scoping exercise that not all NHS boards routinely or equitably—even across individual boards—provide the same service for patients, which is an important point. Perhaps in the minister’s closing speech we could get an idea of how that might be monitored, so that we can progress it. We should keep a tight look at the framework as we go forward.

Every case of miscarriage or stillbirth is a devastating tragedy for the parents and the wider family. We know that people face many unfair and avoidable inequalities when attempting to access health services, due to financial or geographic differences, which can significantly impact on pregnancy and infant mortality. Inequalities are a barrier for many families, and it is our responsibility to ensure that services recognise that and have firm policies in place to ensure that all services are provided with that in mind. I will look at the framework in that regard. We know that people from our poorest communities access services less readily or much later than more affluent families. Addressing that must be part of any Government strategy.

Disparities due to geography remain far too prevalent; I do not think that it is unfair of me to say that. We talk in the chamber about the journeys that patients have to make, and I am sure that members recognise that issue. In Scotland, we have pockets of extreme rurality. We must seek to workforce plan and have the skills available to attend women, rather than the other way round. I will look at the framework to see how we ensure that that is embedded in what we do.

I am very aware of the time but, like Brian Whittle, I want to touch on the devastating psychological impact of miscarriage for women and the wider family. Psychological services should be available to ensure that people have care right through afterwards. People will perhaps have seen the Engender briefing, which highlighted that such services were not available during the Covid period, which really affected people. There was definitely a link with women not having their family support around them at that time. Should there be any time in the future when we need to think about how we provide services, it is absolutely clear that women require that support.

I wanted to touch on the space that women have, although I do not have a lot of time left. My colleague Monica Lennon has done so much work on that, and she will possibly touch on it. I again thank everybody for coming along and speaking in the debate.

I thank everyone in the chamber for their contribution to this crucial debate. I believe that we can have constructive debates to push for change where we are in agreement. It is important to acknowledge, as Sue Webber did, where we need to push further. We all understand that things can be delayed, but it is our responsibility as the Opposition to highlight those areas.

Some really important cross-party work has been spoken about. Monica Lennon mentioned her work with Tess White on the placental growth factor test for stillbirth. That work was thoroughly worth while, and I thank them for doing it. It shows how the Parliament can work best with Government.

Jackie Dunbar spoke about being there for people. An important part of what we are discussing is that people need support from family and friends, and we have a responsibility to ensure that that support is part of the framework.

I am keen to mention Brian Whittle, Fulton MacGregor and Bob Doris, who each made a point about breaking down stigma, and I thank them for sharing their stories. I think that everybody in the chamber appreciated that.

Douglas Ross made a suggestion about the meeting that the minister has offered. An important part of the minister’s speech was to say that we can work together, but we need to have space in the Parliament to do that. Douglas Ross and I are keen that the minister moves forward with that suggestion.

I will allow Monica Lennon and Beatrice Wishart to decide among themselves whose constituency Louise Caldwell is a part of. Louise’s contribution cannot be overstated, and her efforts show that campaigning by people in their communities can have a real effect on us in the Scottish Parliament. Campaigning can move mountains; it can make such a difference to people. There is no denying the crucial work that is being done to have spaces for people who experience pregnancy loss so that they can recover and have the care and support that they so desperately need.

An important point was raised about funding for tailored support and training so that we can get tangible outcomes for people. I am sure that the minister understands that we will be looking for that in the framework as we go through it, now that it has been produced.

We all agree on the important point of the graded model of care, which provides a comprehensive pathway. As we go through the document, we will be able to pull out those individual bits.

We know from the scoping exercise national overview report that there are inconsistencies across health boards. I have had only a brief look at the documents, so I hope that that will be addressed in a way that ensures that we can identify outcomes.

Gillian Mackay spoke very well in her opening speech about the organisations that we know do such great work with the NHS. The one that springs to mind is Sands, which operates in her area.

In conclusion, we all need to work together on this issue. I thank the Scottish Government for bringing the debate to the chamber, and I hope that we can move forward in a way that ensures that people get the best outcomes in this area of care.

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?

I thank Elena Whitham for securing this important debate and congratulate her on her speech, which sets out the direction that we should all support in Scotland. I am very supportive of the motion, and I welcome SHAAP to the public gallery.

Excessive drinking of alcohol poses a significant public health challenge globally. However, the Scottish culture of high alcohol consumption levels and binge drinking has created what can only be described as a crisis. We need to be honest about that if we hope to reverse the current trajectory and help people, families and communities. It is our responsibility in this Parliament to do what we can to support those communities.

Office for National Statistics figures released only yesterday reveal that alcohol-specific deaths in Scotland have reached a 15-year high and that our country continues to have the highest rate of alcohol deaths in the United Kingdom. As we have heard from Elena Whitham, inequality is embedded in Scotland, so some of the problems with alcohol feel almost built into the lives that people are going to have. We have to be honest about that and seek to change that direction.

Although rates have remained steady compared with 2022, Scotland still has some of the highest rates of alcohol-related harm in Europe. Not only does harmful drinking impact people’s physical and mental health, but, as we have heard, it has a profound antisocial impact and can be detrimental to individual and societal wellbeing. It affects us all, so it is the responsibility of all of us to do something.

We are here today because, as we have heard, there is a strong link between alcohol and criminal behaviour. The “Alcohol (In)justice” report, which we are discussing today, expertly highlights that and provides crucial insight into the extent to which alcohol can fuel violence and criminality, and how we can respond to that.

As we have heard, the number of people with alcohol use disorders is disproportionately high in the Scottish justice system, compared with the rest of the population. A reported 63 per cent of people in prison have an alcohol use disorder, and almost half of those people are possibly dependent on alcohol. The report also highlights findings from the 2019 Scottish prison survey, which found that 40 per cent of prisoners who were surveyed

“reported being drunk at the time of their offence”.

The link between harmful drinking and criminal behaviour is clear. I emphasise that we must work together not only to provide better support for those who are suffering from alcohol problems, but to tackle the root causes of alcohol dependency and alcohol use disorders. It is important that we take that public health approach. By offering treatment and support to people who come into contact with the criminal justice system, we can do some of that work and provide individuals with the opportunity to recognise and address alcohol use disorder.

I have heard a little about the Glasgow alcohol court, which I hope to visit at some point. I hope that the cabinet secretary will agree that some of its positive approaches, which we have heard about, are useful. Intervening in that way would not only improve the health and lives of the individuals affected; it has the potential to reduce reoffending rates, thus helping to alleviate the immense pressures that we feel across Scotland and in the justice system.

Economic and social disparities are also prevalent factors in an individual’s choice with regard to alcohol, as I and others have mentioned. We know that the risk of alcohol-related harm is greater for those who are most disadvantaged in our society. It is important to make the point that they are often the people who are very hard to support; they do not readily come forward to services, and therefore we have a responsibility to go to them and see what we can provide.

I welcome the steps, such as minimum unit pricing, that the Government has taken to address alcohol harm. However, does the Cabinet Secretary for Justice and Home Affairs agree that we need to do some cross-portfolio work on this matter? I have asked the Minister for Public Health and Women’s Health for an update on the delivery of alcohol market reform. If we work together on those issues, we might see beneficial outcomes.

I am aware of the time, so I will close there. I thank members for their contributions, and I particularly thank Elena Whitham for securing this important debate today.