Seòmar agus comataidhean

Thank you, and sorry for interrupting.

Given that we are engaged in scrutiny of the proposed national care service, I thought that yesterday’s reports about a two-tier national health service were quite alarming. I seek the committee’s advice on whether we should seek clarification on some of that, as it very much links in with the work that we are doing. I seek clarity from the committee on that.

Okay.

Excuse me, convener. If we have finished the evidence-taking session, I wonder whether I might bring up an issue with the committee.

Yes. We took evidence about inspections yesterday from people who work in the field. We know about the importance of going in and seeing how services are performing. There was talk about joint inspections during the pandemic. What were the benefits of that? In relation to the bill, would it be beneficial to look at who is inspecting services, and how and why?

Yes.

I would like clarification of whether there are hurdles that Suzanne McGuinness feels could be overcome to get mental health into the bill, and whether she feels that we will not be able to get mental health services in the bill.

I have lodged amendment 117 primarily to reflect the numerous expressions of concern that I and many others have heard regarding the bill’s content. What I want to say first of all, though, is that, although I agree that many people are in favour of the bill’s spirit and intent, I feel that some details regarding practicalities and protections in getting a gender recognition certificate, particularly for younger people, have been overlooked.

Given that the Government has expressed its view that the minimum age for applying for legal gender recognition should be reduced to 16, it is my view that, should the legislation be passed, extra provision must be in place to support 16 and 17-year-olds, and they must be able to request that support, should they make this decision. Many young people will be reaching a time of change in their lives, becoming independent, moving away from home, beginning full-time work or starting university or college courses. For that reason, it would be preferable for a young person who seeks support in obtaining a gender recognition certificate to have guaranteed access to confidential and quality support.

Similarly, many people in that age group, particularly the youngest, are likely to be living at home and might experience difficulty in communicating their decision to direct family, leading to a sense of isolation and helplessness. That is well documented in the evidence that has been collected. Assistance can be provided through free and accessible advice that helps young people understand the practicalities of their decision and their options for the path ahead. It might also give the young person support to work with their family at a stage that is most helpful to them. Where challenges exist, the support could come from a family liaison officer, who could assist with communication. In all cases, wellbeing support ought to be available from a professional and trusted source to protect the mental health and wellbeing of young people who request such support during the process.

I ask the cabinet secretary to set out the Government’s position on the points that I have raised in amendment 117. The support must be universal and confidential if it is to succeed, and I feel that it is absolutely necessary in order to help young people during a period of particular need. Amendment 117 would give reassurance to young people and their families that balanced and universal support would be available if required and that any support would have the young person as its focus.

I am really interested to explore the key—[Inaudible.]—of profit in social care that was mentioned at the start of the evidence session. I am very impressed with the STUC report, and I suggest that all committee members read it. I hope that it is part of our evidence. Could Roz Foyer and all the other witnesses suggest what key aspects of that we should consider? I know that most of the trade unions contributed to that work.

My question might have been answered, but I will go back to it, if you do not mind, Mary Alexander, to clarify the point about sectoral collective bargaining. Are you saying that we know the steps that are needed to put that in place so, if we embed it in the bill—although we want to get it done before then—it would help us to progress the introduction of the national care service in a better way with the staff?

I thank Emma Roddick for bringing this important debate to the chamber. I hope that she knows that I greatly admire her honesty on the issue and the way in which she champions it. Although we may have some political differences, I find her contributions in the chamber to be excellent. I have heard from many people that she works very hard throughout her region.

It would be welcome if, in the future, mental health were debated in the Government’s debating time, as that would show the Government’s commitment to improving mental health services in Scotland. I do not think that the minister will be surprised by my adding that the scrutiny of services is key to how we improve them. Perhaps the minister could come back to that in his closing remarks.

There are few more important things than the mental health and wellbeing of the population, and there are few more important places in which to remove the stigma surrounding mental health difficulties and discussions surrounding them than the workplace. We spend much of our time in the workplace, and we should feel safe and secure in it and able to open up, if we require to do so.

That is why it is important that we listen to the words of some of the organisations that have done excellent research. See Me, as mentioned in the motion, the Royal College of Psychiatrists and Unison the trade union have consistently called for greater action on mental health matters and on taking mental health matters seriously in the workplace.

In general, the impacts of the Covid-19 pandemic are well known, including the economic impact, but the impacts on the mental health of the Scottish population are perhaps not always what comes to the front of people’s minds.

SAMH produced an excellent report that included the comment that, during the pandemic,

“people reported feeling like a burden and anxious about adding to the pressure of the health service by asking for help and support.”

It is significant that, even though we were putting out the message that health services were open, people thought that they should not approach those services with mental health issues. It is sad that people felt that they should not come forward to ask for help with mental health.

We have to remove the stigma. Struggling with mental health does not make an individual a burden, but our reluctance to talk about mental health in the workplace and in wider society shows how much further we have to go and highlights how badly we are letting people down, including our own colleagues, who desperately need to talk at times, but can be made to feel that it is uncomfortable or inappropriate to do so in the workplace. That is not good enough.

Moreover, we must look at the pressures on our mental health workforce in Scotland, for which the Government may have responsibility. Unison in the Scottish Borders has called on the Scottish Government to deliver a staffing strategy that will alleviate at least some of the significant pressures facing our health and social care workforce on a daily basis—pressures that undoubtedly will impact negatively on the mental health of those workers.

It is important that we talk about the workforces that we manage, and yesterday marked a historic moment as nurses in every health board across Scotland, including over 92 per cent of the Royal College of Nursing members who voted in my area of NHS Ayrshire and Arran, supported strike action. We note that much of what the workforce is talking about is to do with the pressures in the workplace.

That decision has been taken by a national health service workforce who for years have worked in an understaffed and underresourced service and been underpaid and undervalued. They have now said loudly and clearly that the pressures of working in the NHS at this time, including the pressures on their mental health—as has been well reported—are too great for the pay, terms and conditions that they receive from the Government. The RCN, the wider trade union movement, and those workers have my full support in that, and I hope that they also have support from other members who are in the chamber.

The Royal College of Psychiatrists, which gave us a briefing, believes that mental health should be treated as highly as winter pressures on the NHS—that is how important the issue is. We must remove stigma. I again thank Emma Roddick for bringing the debate to the chamber.