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Will the minister take an intervention?

I thank you, Deputy Presiding Officer, for allowing me to resolve my technical issue—so far, so good, but it is early days yet.

I congratulate the member on securing the debate, and I agree with him on the following points. There are huge pressures on the NHS at all levels across Scotland, with specific challenges in delivery in rural areas. In addition, the Covid-19 pandemic still has a residual impact on health and social care, and then there are the demographics, with an increasing number of elderly people—I am one myself, being 81—requiring healthcare.

The Borders has an ageing population, with the fifth-highest proportion of people aged 65 and over in Scotland, and a declining birth rate. If we add together the declining birth rate, young people leaving for towns and cities and older people retiring to the scenic Borders, we see that the ageing demographic can only increase, and there will therefore be more demand on health and social services.

That is the background, but NHS Borders is using innovative processes to tackle those demands. I do not congratulate NHS Borders willy-nilly—in this instance, the board deserves it. There is the hospital at home service, a Scottish Government initiative that has been piloted in the Borders that allows patients to be cared for—as it says on the tin—in their home. It is targeted mostly at older patients with suitable health conditions—with the patient’s consent, of course—and it has an overall 90 per cent-plus satisfaction rating.

We know that people prefer to be at home, if that is suitable, and that recovery is accelerated and their sense of wellbeing increases substantially if they are. It is no wonder—who would not prefer to be treated and supported at home by professionals, with family and friends in familiar surroundings, reunited with the cat and “Bargain Hunt” while lounging on the sofa?

As a result of its success, the region’s health board has been allocated £600,000 from a £3.6 million Government pot. Not only is recovery better, but hospital beds are freed up, as is staff time. The service tackles the spectre of delayed discharge. The virtual-ward model monitors patients in their house, with regular clinical follow-up and access to specialist advice.

In 2023-24, more than 14,000 older patients across Scotland used the service. A new report from Healthcare Improvement Scotland estimates that £14.9 million was saved in “traditional hospital admission costs”, with an estimated further £36.3 million saved in post-hospital care as a result of a reduction in re-admissions. That is more than £50 million in total.

In the Borders, the hospital at home service is currently limited to the central Borders. I have proposed to the cabinet secretary that it could be extended using community hospitals such as Hay Lodge hospital in Peebles. At present, some patients are already discharged to that hospital if it is suitable for them, often as an interim measure, following their discharge from the Borders general hospital, before they return home. With the hospital at home service, some patients could go straight home, which would, again, free up beds and staff, this time in Hay Lodge.

For completeness, I highlight the issue of accessing GP practices, which is, as members know, more complex. Most are private practices—businesses—that are contracted by the NHS to provide certain services, so GPs are not NHS employees. That is why there is such a divergence in how, for example, people can make an appointment.

Nonetheless, I conclude where I began: by broadly congratulating NHS Borders on modernising delivery. That includes its work in liaising with housing associations and reserving key workers’ houses; those key workers include staff in the health service, so that has encouraged recruitment to the Scottish Borders.

All those measures are tackling the delivery of healthcare across that extensive rural area, and I commend them—and commend NHS Borders—to members. I hope that those measures can be replicated, for example in my old hunting ground of Dumfries and Galloway.

I am obliged to the member for taking my intervention.

I am not aware of this—perhaps you can advise me. Does NHS Grampian operate the hospital at home model, which has made great progress in the Borders?

Deputy Presiding Officer, can I go after the next speaker? I am having technical difficulties with my Surface laptop.

There is a model in the Borders called Near Me, which would in fact have dealt with Douglas Lumsden’s issue.

I hope that the member will agree that the demographics in the Borders are extremely challenging, with an increasing elderly population that is living even longer and requiring even more healthcare and social care. That is a huge issue in areas such as the Borders.

Thank you.

The cabinet secretary will be aware that many in the voluntary sector are suffering from the national insurance increase for employers, which is impacting on many charities. Should the United Kingdom Treasury look again at the impact that that has had on the charitable sector?

I congratulate my colleague Kenny Gibson on securing the debate. I am very pleased to speak in support of the motion congratulating the Community Housing Advocacy Project on an extraordinary 25 years of service to the people of Ayrshire.

The charity’s origins lie in the simplest but most powerful of ideas: that everyone deserves access to independent, free and compassionate housing advice. What began with volunteers offering advocacy support has evolved into delivering professional welfare rights assistance, money and debt advice and vital outreach services across the region.

CHAP has shown what it means to put dignity, prevention and empowerment at the heart of community support. It has retained a high level of accreditation under the Scottish national standards for information and advice providers for more than a decade—that is no small achievement. Between August 2021 and July 2025, it delivered more than £10 million in financial gains for its clients. I repeat that: £10 million in financial gains for its clients. That is money going directly into the pockets of the people who need it most—it is poverty alleviated, homelessness prevented and lives stabilised. Importantly, in addition, it is public money saved through early and effective intervention.

I warmly congratulate everyone who is involved with CHAP—its staff, volunteers, trustees and partners. The organisation’s commitment to providing all its services free of charge, despite operating in a funding landscape that is dominated by short-term and non-recurring grants, is testament to its integrity and determination. Few third sector organisations manage to survive, let alone thrive, for 25 years without stable core funding. CHAP has done so because the need for its work is profound and because its impact is undeniable and it succeeds.

However, today’s debate is about not just celebrating one organisation but recognising the principles that sit at the heart of CHAP’s success. Those principles apply far beyond Ayrshire, including in my constituency of Midlothian South, Tweeddale and Lauderdale.

The number 1 principle is prevention. CHAP intervenes before crisis hits, before someone loses their home, before debt becomes unmanageable and before a young person slips into homelessness. Prevention must be the cornerstone of our national approach to housing and poverty, especially as councils prepare for new ask and act homelessness prevention duties. Rural communities in Midlothian and the Borders know all too well that prevention is not just good policy—it is essential when services are stretched and distances are long.

Principle 2 is accessibility. CHAP takes its services into communities, through outreach and partnership, and it goes to where people actually are. For my constituents, those are places such as Innerleithen, Lauder, Stow and West Linton. Access to advice often depends on such a model. We need more organisations, not fewer, to adopt that outward-looking, barrier-reducing approach.

Principle 3 is independence. People who are facing crisis, whether it is financial, house related or personal, need advice that they can trust. CHAP’s insistence on being independent and free from conflict is a core reason why individuals feel safe seeking its help.

That principle is vital across Scotland, especially in rural and semi-rural areas, where anonymity can be harder to maintain and trust is everything. CHAP treats people as citizens with rights, not as problems to be managed, and that sensitive, personal ethos is essential if we are to build resilient communities.

While CHAP’s work is rooted in Ayrshire, the lessons that it offers are national. There is not a CHAP in my constituency, but we have the citizens advice bureaux, which deliver much of what CHAP delivers. Having recently visited our CABs—in particular the CAB in Penicuik—I can testify to that.

Today, we congratulate CHAP on 25 remarkable years. It is there when it is needed, and one cannot say more than that. I commend CHAP, and also—if I may, Deputy Presiding Officer—the citizens advice bureaux in my constituency.

This is the first time in my 25 years in the Parliament that Tourette’s has been discussed. I thank the member for securing the debate in the chamber, and I welcome those in the gallery who are listening to this significant—I would add milestone—debate on Tourette’s.

The main symptom of the syndrome is tics, which can be vocal or motor. They can include whistling, sniffing or clearing your throat, repeating a sound or phrase and occasionally swearing. A person cannot control them—they just happen. The syndrome usually develops in early childhood, and it is even estimated that one in every 100 Scots has Tourette’s. Sometimes it is so mild that it cannot be identified. There is no known cure, but the condition can be managed. Most important of all, I believe, is for the public to be educated to understand the condition so that we can remove the stigma.

John Davidson, who lives in Galashiels, is a constituent of mine who has Tourette’s. I first met John—although he will not remember it; I do not expect to be remembered all the time—many years ago while visiting Langlee community centre in Galashiels. I was there for a meeting and, in the near distance, I could hear shouting and swearing. Like many, I was taken aback, but then I was told, “It is only John,” and that he had Tourette’s. I had heard of it, but I had not encountered it, so that was a first.

Not much is widely known about the condition even now, so it is much misunderstood. People think that it is a sign of terrible rudeness and express their distaste one way or another, but John has worked his whole life to change that. I think that he became a reluctant poster boy for Tourette syndrome when he was just 16. The little-known condition, which had previously been described as “a wild madness”, caused him to spasm, jerk, swear uncontrollably and shout explicit sexual phrases.

To this day, John still works at Langlee centre. He has also been the subject of not a few documentaries, including the 1989 BBC programme “John’s Not Mad”, which enabled him to bring Tourette syndrome into the living room in a way that had never been done before. That approach has continued, turning into a lifetime of advocacy to further publicise and increase understanding of the condition. In 2002, at the age of 30, he appeared in “The Boy Can’t Help It”; and, in 2009, when he was 37, he was in “Tourette’s: I Swear I Can’t Help It”. Latterly, as has been said, the new film “I Swear”, which is based on his life, is a powerful piece of storytelling that reflects not only the challenges that he has faced but his determination and humour.

John has made Scotland, and, indeed, the United Kingdom, a more understanding place—I hope—for people living with Tourette’s.