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The cabinet secretary will know from public health figures that the gap between our most and least deprived communities remains stubbornly high. Women between the ages of 50 and 70 from our most deprived communities are less likely to attend their routine breast screening appointments and have a 64.2 per cent screening rate, compared to 82.8 per cent in the most affluent communities. Given that I have raised screening inequalities in the chamber on a number of occasions, and given the Government’s commitment to reducing inequalities in cancer screening, will the cabinet secretary agree to bring to the chamber a debate in which he can update us on the status of the equity in screening strategy and allow scrutiny of the Government’s commitment to targeted work in that area?

I thank Clare Adamson for bringing the debate to the chamber. On behalf of Scottish Labour, I mark pancreatic cancer awareness month and world pancreatic cancer day, which, as we have heard, takes place on 21 November.

Raising awareness of illnesses such as pancreatic cancer is absolutely pivotal in ensuring early diagnosis and improving prognosis. During my three years in the Parliament, Clare Adamson has truly played her part in that regard, and I thank her for doing so. In one of the very first debates in which I participated, I shared my story of a close family friend’s experience. I have been here for other such debates in the years since, and I appreciate how often Clare Adamson brings the issue to the chamber.

The key point that I will make is that the situation is urgent. Others have mentioned the reasons why, which I will go over, but we must make advancements in the treatment options and address the health inequalities in what is often a very late-diagnosed condition. As we have heard this evening—it is worth saying it again—80 per cent of people with pancreatic cancer are diagnosed at a late stage and more than half of people die within three months of diagnosis. We can see why much needs to be done to raise awareness of symptoms and that the Government has a huge responsibility to ensure that the national health service is in a position to encourage and support research efforts and to do important work around early diagnosis.

We know that there must be urgent changes to funding in Scotland for research into pancreatic cancer. Many of the briefings make that point to members, and I am sure that the minister will have heard that, too. I hope that she will respond to that point in her closing remarks.

As the motion states, the £600,000 of funding for early diagnosis and treatment is very welcome, but we must have confidence that there will be more and continued funding of the research part of the NHS. I read the briefing notes on that, and I noted that the importance of research to advancements in treatment cannot be overstated. I thank all the researchers and, of course, the patients and families who participate in the research and contribute to that life-saving and valuable work.

I also thank the various organisations that have contacted me and other members ahead of today’s debate with their briefings. They highlight the sheer scale of the challenge that we face and the fact that we must move forward with some urgency on pancreatic cancer care.

Like Miles Briggs, I ask the minister to respond on the potential closure of the national service that is known as the Scot HPB national care pathway. From what I have read in the briefings and in other papers, there does not seem to be any commitment after March 2025. It is important for us to understand what the Government is considering. The concern is that, if the service reverts to regional guidance, regional variation will reappear and health inequalities will continue to worsen, because funding is precarious.

Members will know that I repeatedly raise the issue of health inequalities in the chamber. We know that those in our most deprived communities are more likely to get cancer and, tragically, to die from it. I know that we all agree that that is absolutely unacceptable, so I ask the minister to consider whether we can do anything to make that situation better, because if we can, we should do it. I hope that the minister and the Government are making successful decisions on that point.

I thank Clare Adamson and other fellow members who have contributed to the debate.

Given the story that we have just heard, and the fact that, since 2020, no data has been published on breast reconstruction waiting times following mastectomy, will the First Minister commit today to ensuring publication of good-quality data on such waits as soon as possible, so that we can properly see the relevant trends?

To ask the Scottish Government what its response is to the reported view of the Royal College of Emergency Medicine that its winter planning is “not doing enough” to support accident and emergency departments as they approach their busiest time of year. (S6T-02142)

According to the care homes census, one in five care homes has closed since 2014, which means that there are 18 per cent less care homes than there were a decade ago, while demand is going rapidly upwards. Many more are likely to close over the coming years. That is the root cause of hospital overcrowding: people have nowhere to go. Cabinet secretary, is it not the case that the Government has lost control of social care?

Public Health Scotland recently revealed that levels of delayed discharge from hospitals reached a record high in August, which is one of our warmest months. The Royal College of Physicians has said that that should be a cause for huge alarm. Does the cabinet secretary think that hospital staff will gain any confidence from the Government saying the same thing it says year after year?

The World Health Organization estimates that more than half of children in Scotland have tried alcohol before they turn 13. What progress is the Government making on the issue? Will the First Minister commit to pursuing policies, with some urgency, that deliver an alcohol-free childhood?

The minister will know that people in the most deprived areas are seven times more likely to end up in hospital due to alcohol-related conditions and that certain hospitals serve a disproportionate number of such areas. Is anything being done to provide extra support for those hospitals, specifically for accident and emergency departments, which are reportedly dealing with an increase in the number of people presenting who are at risk from serious alcohol harms?

I thank Tess White for bringing this important issue to the chamber. I, too, welcome it being Scottish women and girls in sport week.

I understand that many people feel strongly about the topic, which is why it requires the attention of Parliament and should come to the chamber floor for debate. In my speech, I want to try as much as I can to show that I believe in a sports provision that is fair, safe and allows everyone to have an opportunity to compete and enjoy a whole variety of sports. I also want to describe my constituents’ views as far as I can.

I am contacted regularly about the issue by constituents and people outside my South Scotland region who are on both sides of the debate. Primarily, the feedback that I receive is that a great number of women feel that their voices are not being heard when it comes to sport and the inclusion of women in sport. I think that we can all agree that that is not acceptable. We have to hear those voices, and it is our responsibility in the chamber to ensure that that happens.

I do not profess to have all the answers, but I can say with certainty that there is a need for more research and for individual sports to be allowed more time to make decisions on how we discuss the matter and make progress. We cannot rush into altering the fundamentals of competition without carrying out due diligence. Millions of people take sporting competition very seriously, either actively or as spectators, and it would be remiss of the Parliament to simply dismiss women’s concerns about transgender people’s engagement in sport. We have to take time to listen and to learn.

We all surely agree that sport must be safe and as fair as possible. That is what we teach children from a very young age, and it is the spirit of, for example, the Commonwealth games, which will be coming back to Scotland in a couple of years. Transparency and a logical approach to fairness and harm avoidance are required.

As others have mentioned, the Equality Act 2010 includes an exemption that allows us to act in relation to sport. Sports leaders have also made comments that have been referenced by members. The performance director of British Cycling has said that this could be

“the single biggest issue for Olympic sport.”

In athletics, Seb Coe has said that the issue is making women’s sport “very fragile”. It is therefore very important that we make progress.

When I speak to constituents, overall, they accept that there are some cases in which someone who has transitioned could compete alongside others of their gender, but we should be clear about what that should look like. When it comes to high-impact sports and ones that feature frequent contact, there are legitimate concerns about long-term health effects and a blanket approach being taken. As we have heard, in sport, someone who has experienced puberty as a male has a significant natural advantage, so much more consideration has to be given to those cases.

Let us not forget that it took many decades to get the public to take women’s sport, including women’s athletics, seriously. We owe a debt to the women who built those foundations, so we should be serious when making decisions about what we do.

As I said, I do not pretend to have the answers, but, as parliamentarians, we must listen to the experts and be open minded when concerns are raised. We cannot have a knee-jerk reaction. It is not good enough to make political points. I hope that, by our speaking up today, some people out there will understand that parliamentarians are listening and that we can take action on the issue.

I, too, thank Rona Mackay for her commitment to fetal alcohol spectrum disorder and for bringing this important debate to the chamber to mark international FASD awareness month. As others have said, it is vital that the Parliament has an opportunity to talk about the issue, raise awareness and call for continued action to support interventions. As parliamentarians, we have a responsibility to look at how we reduce the prevalence and impact of FASD in Scotland and support those who live with it.

As we have heard, it has been estimated that about 3.2 per cent of Scotland’s young people live with FASD. That figure is stark when we consider that, as the motion states, it is the most common preventable neurodevelopmental condition in Scotland. The evidence from the University of Glasgow, which members have mentioned, suggests that the prevalence could be higher than we previously thought, with about 42 per cent of babies having been exposed to alcohol in pregnancy and 15 per cent showing signs of exposure to high and frequent consumption.

As has been stated, FASD is preventable, and the UK chief medical officers have made it clear that alcohol and pregnancy do not mix. They recommend that the safest approach for people who are pregnant or are planning a pregnancy is not to drink alcohol at all. That will keep the risks to the baby to a minimum. Drinking alcohol at any stage of pregnancy risks the development of a neurodevelopmental disorder, and it is important that people understand that.

However, I want to make two points in that regard. First, more than a quarter of women in the United Kingdom are unaware of that advice not to drink alcohol. Secondly, it is estimated that 45 per cent of pregnancies in the UK are unplanned. What do we do about that? How do we make sure that that information is available to young women who are planning a pregnancy and to those who do not know that they are pregnant?

Clearly, there is an important piece of work to be done to ensure that the messaging is clear for women throughout their life, so that they get that information. We have a responsibility to make sure that our pre-conception strategy is such that people get that information.

Another important point is that binge drinking—consuming lots of alcohol in a short period of time—is thought to bring a particular risk of FASD. We know that, in Scotland, there is an element of binge drinking among women. We in the Parliament must use the opportunity of this debate to talk about the wider approach to an alcohol strategy for Scotland that seeks to change our problematic relationship with alcohol.

Alcohol policy needs to be a range of measures, formulated and implemented by the Government and other public bodies, that are designed to prevent, improve or treat the health and social problems that are associated with problematic alcohol use. Given past commitments from the Government and the minister, I hope that, in her response to the debate, she will discuss the public health measures on which we might be able to improve and move forward, and the pace at which we might do that.

As I draw my remarks to a close, I thank all colleagues for the discussion. We must seek to get the best support for those who live with FASD, and we must seek to improve diagnosis and support. However, prevention is key and, in Scotland, we know that we need to move forward with that. I thank all my colleagues for contributing.