Seòmar agus comataidhean

I, too, put on record my gratitude to all who work across our NHS and care sector in whatever capacity.

I now address the Labour motion. It would have more heft if it at least mentioned, if only in passing, the devastating impact of Covid and the years to follow when the NHS throughout the UK and healthcare throughout Europe and the wider world dealt with a raging pandemic and adapted procedures in the face of the virus, which brought what I might term the usual provision of healthcare to a standstill.

The motion also does not recognise that it will take years for recovery. To this day, sanitation is high, mask protection continues and ambulances have to be sanitised after every patient. All that adds to delays, and Covid still stalks hospital corridors. Add to that the pressures of influenza—not mentioned by Labour—which can be very serious and, despite vaccination, is possibly proving more so to some groups of people, including me, because we have reduced resistance after years of wearing masks and sanitising our hands.

Then there is the welcome but extra pressure of the demographic shift, which also went unsaid in the Labour motion. We all live longer, which is a good thing, but age naturally brings additional demands on our health services and care sector. Wherever we look in the UK, the issues remain the same. Indeed, the situation is worse in Wales—where Labour is in government—than it is in England under the Conservatives. I do not say that with even a slight degree of satisfaction—not in the least—but do so simply to put today’s debate into context.

Also for context, I say that, in my 24 years as an MSP—during the Labour-Liberal Democrat coalition and to date—much of the attention has been on firefighting the increased demands on the NHS. Some good progress was made, and I welcome free personal care under the Labour-Liberal Democrats, and, of course, free prescriptions, free school meals for those in primary 1 to primary 5 and the child payment, all of which are interventions made under the SNP Government that are aimed at reducing NHS pressures. In England, it costs more than £9 per item prescribed, and therefore some people who live south of the border are rationing their medication to the endangerment of their lives let alone their health.

The problem is, as it always has been, how to move from the immediate demands, which are exacerbated as I have narrated, to a medium to long-term solution. I therefore welcome this suggestion by the British Medical Association:

“BMA Scotland is calling for a National Conversation with all stakeholders, to take a long-term approach to what we want and expect from our NHS. Only when we fully understand what we need and want from the NHS can proper consideration be given on how we resource it.

The National Conversation, commissioned by but independent of the Scottish Government, would act as a facilitator for a dialogue between the public, health and care stakeholders, Scottish Government and political parties; its purpose is to inform the reform, it must have practical outcomes that are part of a long-term vision for NHS Scotland.

Now is the time to seriously consider what the NHS provides within the resources we provide it with, and ask the difficult questions around what we as a society want from a National Health Service free at the point of need, what we can afford to deliver and how we deliver it. There are no easy answers.”

I agree.

Covid was a wake-up call for all of us to the growing needs of those who receive care at home or in care homes and the varying standard of that care; integrating health and social care; the standardisation of care provision; recruitment and retention; and the expanding use of pharmacies and allied health professional services so that the right treatment is provided at the right time by the right health professional. All of that is not easy, as the BMA stated.

I will come on to resourcing.

During this thoughtful discussion, we should consider the following questions: what is the role of health boards? What should the relationship between GP practices and health board areas be? Should more GPs be directly employed by the NHS rather than in private practice? How much more can technology be used? What should the state provide in the care sector? What kind of workforce do we need and where do we get it when some options are closed because of Brexit? What will be required as our ageing population increases? How does our society afford expensive treatment and drugs? What price do we put on all that, and how do we fund it?

This is the only party-political thing that I will say: as a result of the disastrous and costly funding of public buildings, including in the NHS, using the private finance initiative under Labour, the cost each year to the Scottish Government in repayments to the private sector on NHS buildings alone runs at £250 million, which could have been better spent on services.

It is the job of the Opposition to hold the Government to account, but too often that is with press headlines in mind. Opposition members must offer solutions and, most importantly, credible funding sources from what is virtually a fixed budget, now reduced in value by £1.4 billion due to inflation.

I say to members in the chamber: less heat and more light, please. Turn down the volume on theatrical rhetoric; turn up thoughtful and responsible debate. That is what the Scottish public want.

According to the list on the UK Government website, as of 21 December 2022, there were 41 countries from which the UK does not require medical reports in relation to applications for gender recognition in the UK. I presume that that does not impact on the Equality Act 2010. Can the cabinet secretary advise members why breaching the Equality Act 2010 applies only when the Scottish Parliament, by an overwhelming cross-party majority, merely does what many other countries have done, or will the UK Government’s position result in the UK removing 41 countries from that list?

I am pleased to speak in the debate in support of my colleague Evelyn Tweed and all who have campaigned over the years to highlight cardiomyopathy and the need for defibrillators.

I note that you, Presiding Officer, have taken part in previous debates on the issue. This will be my fifth. The first was in 2001, and the subsequent debates took place in 2010, 2014 and 2021.

I put on record my condolences to Mr and Mrs Ferrier, even while I congratulate them on their fundraising efforts following their tragic circumstances.

I first became engaged with the issue of cardiomyopathy when I met Kenneth and Wilma Gunn, who were then constituents of mine in Selkirk. After their son died from hypertrophic cardiomyopathy many years ago, they established the Borders-based charity Scottish HART—which stands for Heart At Risk Testing—which is also known as the Cameron Gunn Memorial Fund. Since then, over the decades, Mr and Mrs Gunn have worked tirelessly to promote awareness of cardiomyopathy and to encourage the testing of young athletes.

Back then, they were endeavouring to raise the £0.25 million that was required to provide a mobile echocardiogram that could be used at sports clubs and schools to test young people. Cardiomyopathy is a disease that is usually more recognisable under the headlines that we unfortunately sometimes read, such as “Sudden Death on Sports Field”, “Heart Condition Kills Youth” and “Teenager in Mystery Death”.

Cameron Gunn was playing five-a-side football with workmates, practising for a charity game, when he suddenly dropped down dead. He was 19; it would have been his 20th birthday the next day. Young people are still dying in similar circumstances, so I pay tribute to other members of the Scottish Parliament who have raised awareness of cardiomyopathy and of the work of Scottish HART.

Euan Robson, the former Liberal Democrat MSP, first lodged a motion on the issue in 1999, followed by former Labour MSP Johann Lamont in 2001, myself in 2003 and former Scottish Socialist Party MSP Rosemary Byrne in 2004. The issue has huge cross-party support.

I recognise the campaigning by outside organisations that are involved in cardiomyopathy prevention—it has made progress, and all parties have responded to it. Malcolm Chisholm, who was then Minister for Health and Community Care, and subsequently Nicola Sturgeon, met Wilma and Kenny Gunn, and both gave up a lot of time to discuss the issues with them. That shows that, with determination and a heartfelt commitment to an issue that requires attention, ordinary people such as the Ferriers and the Gunns can change things in the Parliament. It also shows that politicians listen, and that there are results.

Following the Gunns’ petition to Parliament, and further meetings with and representations from Kenny and Wilma Gunn and Scottish HART, the then Cabinet Secretary for Health and Wellbeing launched a pilot screening programme, in conjunction with health professionals and the Scottish Football Association, at Hampden park. It involved screening amateur athletes aged 16 or over for life-threatening conditions. The cabinet secretary put in a further £150,000 of funding to extend the screening pilot over the coming years, and the pilot subsequently found 400 youngsters who exhibited risk factors that ranged from mild to serious. Even one life saved is excellent, so the programme was invaluable.

The Gunns also campaigned for the placement of defibrillators in public areas such as large supermarkets, airports, and train and bus stations, and over the years that has happened—there has been movement on that.

I fast-forward to 2021, when I said in the chamber:

“From 1997 onwards, Wilma Gunn and her husband Kenny have been fundraising; raising the organisation’s profile, even in Parliament; and campaigning not only for early testing of young athletes but for accessible defibrillators. Back then, not many people knew what a defibrillator was—I include myself in that. The profile was raised here, with debates and petitions in ... the Parliament, and in 2014 Wilma was deservedly awarded an MBE.

Today, we have defibrillators at many points—in trains, bus stations, airports and supermarkets, and in the Parliament and some workplaces—but Kenny and Wilma ... have not stopped campaigning, and they are keen for even more ... to be distributed. The new ones are easy to use—you cannot hurt the patient by using them. In fact, it is better to use a defibrillator”

than have the patient die in front of you for lack of action,

“as you cannot do any more harm than if you had done nothing. I have practised on defibrillators, in the Parliament and elsewhere, and if I can use them—because I am hopeless”

with anything practical—

“anyone else certainly can. Those invaluable minutes on the defibrillator will mean life or death until the medics arrive. That is especially relevant in rural areas such as my constituency, where paramedics cannot simply arrive within eight minutes.”—[Official Report, 14 December 2021; c 98-99.]

I wanted to take part in the debate to remind members of others who have, just like the Ferriers, through their own tragic circumstances, tried to move the debate forward and tried to bring to the forefront the need for defibrillators, and testing where necessary, to save so many young lives. I congratulate the Ferriers, as I remain forever congratulating Wilma and Kenny Gunn, who are still campaigning after all these years, and I say to them: keep on campaigning, as it does produce results.

In my speech I focused on defibrillators, on which we have come a long way. I just wonder whether we know where they are located. For example, do we know where they are in local authority areas? Could local authorities map where there are defibrillators, so that if somebody is in an emergency they know where to get one?

I refer to the exchanges on the pressures that are on the national health service. I understand that some 2 million people have accessed the flu vaccine—90 per cent or so did that when getting their winter Covid booster—but can more be done to ensure access for those who are eligible? Flu is very serious indeed.

Over the decades, successive UK Governments have used every trick in the book to block the Scottish people’s right to determine democratically their future. The current examples are that the vote in 2014 was a once-in-a-generation vote, that there is no demand and that the Scottish Government should focus on the NHS and pressing domestic issues. I will touch on those as I progress.

I will begin in 1979, with a referendum for an Assembly. Better together was in its infancy, but it managed an extraordinary pairing involving Labour’s George Cunningham, who introduced the rule that 40 per cent of the electorate had to vote for the result to count. The dead and those who abstained were counted as noes. In fact, 51 per cent voted for an Assembly, but that failed the Cunningham rule. There was an intervention by the Tory peer Sir Alec Douglas-Home two weeks before the referendum, promising more for Scotland if it voted no. I know because I was there. We were also too small, too poor and—this is contradictory—because of oil, too greedy. All that and a yes vote still prevailed against the background of a winter of discontent.

Fast forward some years, and Tory-Labour—otherwise known as better together—formalised its partnership and project fear was revisited. One of the main planks of the no campaign was that a yes vote would throw us out of the EU. There was, of course, the vow from Labour’s Gordon Brown: vote no and Labour would enhance devolution. Does that ring any bells? Despite all that, 45 per cent voted for independence.

Twenty-four years have passed since the Parliament came into being in 1999, when SNP MSPs were in a minority. We now have 64 MSPs and eight Green MSPs, all standing openly for independence. That is a majority. The unionists have 57 MSPs. At Westminster, there are six Scottish Tory MPs, four Liberal Democrats, one Labour MP and 45 SNP MPs. However, Westminster blocks a referendum because, according to it, there is no democratic mandate. If ballot box results do not count, what does?

I turn to Brexit. What a democratic affront. Although 62 per cent in Scotland—from Shetland to the Borders—voted remain, we are out. There was no 40 per cent rule then.

The argument that the Scottish Government should focus on current pressing domestic issues—which it is doing—is the very reason why the need for independence is pressing. There has been economic mismanagement by successive UK Governments, which have squandered the oil and gas revenues. Norway saved trillions, but in the bank of UK plc, there is just a huge international overdraft. We have seen Brown’s bank collapse and Trussonomics. The result is that the UK has the highest inflation in the G7, which has led to the right pay demands that we see today. As in the dark days of 1979, now is the very time when Scotland needs independence.

I turn to the Supreme Court ruling that ruled only on the limitations of the Scotland Act 1998. I ask members to read MacCormick v Lord Advocate. Lord President Cooper said, obiter—I hope that I have time for this:

“The principle of the unlimited sovereignty of Parliament is a distinctively English principle which has no counterpart in Scottish constitutional law ... I have difficulty in seeing why it should have been supposed that the new Parliament of Great Britain must inherit all the peculiar characteristics of the English Parliament but none of the Scottish Parliament, as if all that happened in 1707 was that Scottish representatives were admitted to the Parliament of England. That is not what was done.”

In Scotland, the people are sovereign. Charles is King of Scots, not Scotland. Ask the people therefore whether they want Scotland to be independent. Give them that referendum. The reason why it is being blocked is that they would say “Yes, we want to be independent.”

On a point of order, Presiding Officer. I lost my connection. I would have voted no.

I refer to the Scottish Government-commissioned research entitled “The Contribution of EU Workers in the Social Care Workforce in Scotland 2022”, which was published in August. Further to those findings, although I accept that Covid has had its impact, does the minister agree that Brexit has made the situation relating to the retention and recruitment of European Union workers worse?

I will put that in my diary. That is good, thank you.