Seòmar agus comataidhean

I thank my colleague Jackie Baillie for her on-going work on long Covid and for bringing this debate an international long Covid day to the chamber. I thank colleagues from across the chamber for their contributions, but in particular I want to mention the importance of my colleague Mark Griffin’s bill.

As we have heard, long Covid is, and will continue to be, one of the most challenging outcomes of the pandemic. It is a condition that debilitates, lacks a cure and lacks research and, sadly, it is one about which people still lack awareness. It is absolutely right that we mark international long Covid day—which, as we have heard, is tomorrow—and renew our commitment to all those in Scotland who are suffering as a result of the long-term impacts of the virus.

In the debate, yet again, colleagues across the chamber have warned the Scottish Government about the threat that long Covid poses. People suffering with long Covid have spoken to us as MSPs directly to highlight their concerns, and we have heard from members during discussions in the chamber and at other times in the Scottish Parliament. However, I am not surprised that their demands and requests have been met with insufficient actions. That is part of the reason why we keep trying to bring the issue to the chamber.

As members will know, I often raise issues on health inequalities. I feel that Jackie Baillie is right to note in her motion the importance of not creating such inequalities in patient outcomes. Last month, the Scottish Parliament information centre released research that highlights that

“As a proportion of the UK population, the prevalence of self-reported long COVID was greatest in ... people living in more deprived areas, those working in social care, those aged 16 years and over who were not working and not looking for work, and those with another activity-limiting health condition or disability.”

We are still behind on research, and the impacts of long Covid will become clearer as we progress. However, the Scottish Government has totally taken its eye off the ball on health inequalities, so it is absolutely critical that we are alert to what could be yet further such inequalities that will impact Scots from deprived areas.

Before I conclude, I am keen to pay tribute to the health and activity rehabilitation programme team that works as part of the health and social care partnerships in Ayrshire’s three local authority areas. On Friday, I was delighted to pay a visit to its base at the Lister centre in Kilmarnock to learn about the long Covid services that it will provide in the coming months to people living with the condition in the NHS Ayrshire and Arran area.

Early on in the pandemic, the team identified the need to support its staff, which it did through an occupational health model. That has given the team a real advantage in recommending its service to lead on long Covid in Ayrshire. From my visit, it seems to me that clinical leadership and a respect for a multidisciplinary approach are key to the team’s achieving its outcomes. It has an equal approach across allied health professions, nurses, volunteers and support staff, and it does fantastic work in the community. I have no doubt that its long Covid provision can and will be a success.

As parliamentarians, we owe it to the staff of such services to ensure that funding is available and is uplifted whenever possible. I hope that the minister will address the funding issues that members from across the chamber have raised. As people look for support to help them to deal with breathlessness, fatigue, tiredness and other symptoms, we must be in a position to offer it.

I just want to support Alexander Stewart. If the Children and Young People’s Commissioner has indicated that there may be more that we can do, it would be useful to explore that to its end point.

I support what members have said and I want to make the important point that, in the time that I have been in the Parliament, there have been a number of debates and committee discussions about the issue. Now, it is about us seeing what action is being taken. Getting that information from those organisations would be helpful and allow progression to the next stage, which is important for such urgent matters.

That is a relevant point. We should raise that with the Government as something that it must make sure that it monitors in its cancer plans.

I declare an interest, as a registered landlord.

MSPs have stood up and stated on many occasions the absolute importance of keeping guards on trains, maintaining safe and regular buses and ensuring that transport hubs are sufficiently staffed for the benefit of all. Whether it is to ensure that the public are protected, to ensure that people with disabilities can get on and off safely or to warn of developing hazards, those calls all have a logical and necessary reason.

A key reason why those calls have been made so consistently is that we need to ensure that those who use trains, buses and boats feel safe and unthreatened while travelling. Of course, more often than not, when we speak of that we are, sadly, focusing on women. We still live in a world where women do not always feel safe when using public transport. As we have already heard, a survey by the Office for National Statistics suggests that nearly half of women in Britain feel unsafe using public transport alone after dark.

Whether cases involve catcalling or women being pestered or whether they go as far as all-out sexual assault, the number of cases where women have been made to feel isolated and exposed by the behaviour of men on public transport is concerningly high. We have all heard horror stories, today and at other times, or have experienced them ourselves. It is worryingly common that women’s complaints are not taken as seriously as they should be. It may no longer be socially acceptable to insinuate that a woman was at fault—as was regularly claimed when I was young—but there are still plenty of ways in which women’s concerns are diminished, while emphasis is put on women changing their behaviour instead of the men who carry out the harassment.

All women have been told at one time or another that they should not get on board this or that bus, or that, if they are travelling on a train at night, they should bring someone else with them. Although people who say that mean well, it belies the fact that, in 2023, we still accept that there are no-go areas for more than half of the population of the country. The implication is that men are born with an entitlement to roam and travel that women can enjoy only in the company of men they know. Some may scoff at the way in which I have characterised that, but it is absolutely true, and it is reinforced by the fact that men who harass women on public transport often simply get away with it. They get on with their day, oblivious to the damage that they have caused, and yet, for the woman, her right to feel free in public has been severely damaged. In some cases, women will never get on a particular bus or train again. Their life has been limited by the selfishness of others. We must not put up with that. We must all agree that the actions suggested in the report and in previous debates in the chamber require to be addressed urgently.

Like others, I was shocked to learn that, in a survey of its ScotRail-employed members last year, the National Union of Rail, Maritime and Transport Workers found that more than 80 per cent of ScotRail women workers had been subjected to violent or antisocial behaviour at work in the past year. Of those who had been subjected to those behaviours, 80 per cent were lone working at the time. That is absolutely shocking. Those workers should not have to put up with that sort of treatment. As a democracy and a functioning society, we simply cannot let that behaviour go on without treating it with the seriousness that it deserves. Further, and perhaps just as important, we should not be making decisions that only worsen the problem. It appears, at times, that we do so without thinking.

What can be done or, better put, what cuts should the Government not implement if it is to take the issue seriously? I was glad to hear the minister’s remarks about considering the points in the report, and I would like more information on that. Making cuts to ScotRail’s ticket office opening hours exacerbates the problem. Elderly passengers, in particular, still prefer to speak directly to someone when buying their tickets, and they often rely on the ticket office’s knowledge to plan their journey. Planning a journey is an important part of feeling safe, so that support is absolutely necessary. The ratio of people in our country who are past retirement age and who use public transport skews significantly towards women. Like so many other cuts that are made without thinking, the proposal to cut ticket office opening hours will disproportionately harm women.

As we have heard, cutting bus routes and leaving isolated stations and trains without sufficient supervision inevitably leaves many women in a vulnerable position. As my colleague Neil Bibby mentioned, the number of late night bus routes that are disappearing is very concerning, not only because those bus routes have gone but because of the number of women disproportionately affected because they often work in roles that finish after dark and have no other means to get home. We know that employers are often not sympathetic to those concerns.

Finally, we must keep guards on trains and adopt a zero tolerance approach to those who are caught harassing women—or indeed anyone—on public transport. If someone cannot use railways and roads with respect and decency, some limits should be put on their freedom and not on the freedom of the women who are being harassed.

In the interests of time, I will try not to repeat points that other members have made. As my colleague Paul Sweeney stated, Scottish Labour supports the aims and objectives of eating disorders awareness week 2023, with this year’s focus on eating disorders in men.

To better understand these complex mental illnesses and put gender stereotypes to bed, it is right that we applaud Beat for launching the UK’s biggest survey to date on men’s experiences with eating disorders. I acknowledge the work that has been undertaken on raising awareness and bringing people with lived experience together, and on advancing the care of people with eating disorders.

As we heard, the statistics are stark. I will not go over them again, but we know that, tragically, one in four people who experience an eating disorder are men, and one in five of those men report never having discussed those struggles, which is shocking. That acts as a reminder to us all that eating disorders are prominent and serious. Eating disorders still have a taboo around them that means that men in particular feel that they cannot speak out.

As Beat has indicated, it is essential that we take seriously our role as members in raising awareness, fighting for funding for research and scrutinising the Government in delivering the full implementation of the 2021 national review of eating disorder services, which includes 15 ambitious recommendations. Like other members, I would be interested to hear the minister’s response to the review. I hope that the minister will answer some of those points in his closing remarks, particularly the group’s conclusions from September 2022, which recommended a national eating disorder network. When will he oversee the implementation of those recommendations?

Furthermore, the 2021 national review of eating disorder services highlighted a lack of training and education on eating disorders for healthcare workers in Scotland. I spent many years working in the NHS as a dietician as part of the allied health professions team, so I know only too well the importance of raising awareness of those conditions and disorders and of training future healthcare professionals.

It is clear from members’ speeches that we all take the issue very seriously. The research work and contributions made by charities, experts and others are important, but there is more to do. With cross-party support, which we seem to have in the chamber today, we can work together and address the concerns of individuals, charities and others across the country. I look forward to hearing the minister’s remarks on the issue.

Our population is, on average, becoming older with each passing year. We must come to terms with the increased prevalence of dementia and related illnesses. Dementia can be a harrowing diagnosis and one that many of us dread, but we can do a lot, including providing people with dignity. Currently, unfortunately, we are not near that standard.

An issue such as dementia requires serious attention from the top of Government, yet the headlines that dominate are about the internal war that is going on in the SNP and the flawed national care service plan, which is not worthy of the name. In politics, and as politicians, we must do better. We must seek to discuss the issues that matter to people in their everyday life: health, education, care and communities.

Three national dementia strategies have been published since 2007 and a fourth is planned. If we take a close look at the previous plans, we see that a great deal has never been realised, including effective local delivery plans and key commitments on post-diagnostic support. We can also see the effects of those broken promises in the day-to-day care of patients and the toll that it takes on those who look after them.

To tackle dementia, we need a well-funded care service with well-paid carers. There is no getting away from that. My party repeatedly calls for a decent pay rise for social care workers.

The challenge that we must face up to is to provide care for people where and when they need support in a way that works for them. I am well aware that that is easier said than done, but launching strategy after strategy is not a substitute for serious action. I am very concerned that we are two years into this session of Parliament and there has been little of the latter.

I want to briefly mention the developing international evidence base that highlights the benefits of allied health professionals’ early interventions, supported self-management and rehabilitation as a means of supporting people to live well with dementia for longer.

Despite all the innovative, creative and evidence-based work, it is evident that access to allied health professional services remains inconsistent and challenging. At times, they are simply not available. More must be done to raise the profile of and to improve access to those essential AHP services. In relation to dementia services, access to AHPs is most definitely a postcode lottery.

Since the first dementia strategy was published 13 years ago, delayed discharge has become a huge problem, leaving a lot of dementia patients in a state of distress and prolonged discomfort. In many areas, people are victim to a further postcode lottery, in which their experience of provision might be vastly different from that of someone just a half-hour drive away. Will the new strategy solve the problems, or will it just play lip service to them? The public are perfectly justified in asking those questions.

Many of us will know of a friend, family member or colleague who has been diagnosed with dementia and will have witnessed the intolerable toll that it takes on them and their families. Would it not be some support for them if the Government delivered on its commitment to remove all non-residential care charges? Using the delayed national care service plan as an excuse for inaction on that is just not good enough.

Let us give people something to be positive about. Let us give those who care for people with dementia a wage that they can build a life on. Let us take some of the cost of care away from those who can barely afford it. Let us stop the postcode lottery.

We are not asking for much. We are just asking for the Government to live up to its own commitments.

I thank members of the committee and all those people who contributed to what is an important and, indeed, timely report.

As we have heard, our town centres should be the beating heart of our communities. However, as the report notes, for too long they “have been in decline” due to a lack of investment, but also to a change in habits, with people becoming more inclined to go to shopping centres and retail parks and to shop from the comfort of their home online. It is not realistic to suggest that we would be able to reverse those trends entirely; indeed, it is not realistic to believe that change is not required because people will, in time, return to town centres.

We need town centres that are adaptable, vibrant, diverse and modern. We need town centres that meet the needs of individuals and families in 2023; that are consistently underpinned by community and togetherness; and that are supported by a determination, as the report mentions, to rebalance

“the cost of doing business in town centres”

compared with

“out of town”.

I cannot contribute to the debate without mentioning a vital relationship that is highlighted in the report, which is the important role of local government in improving our town centres. Across Scotland, we have a vision for what our town centres ought to, and could, look like to meet the needs of a modern Scottish population. However, for those dreams and visions to become a reality, they need funding—local government and local councils need funding.

It is therefore beyond belief that, year after year and budget after budget, the SNP cuts the budgets of those who provide the local services on which so many rely.