Seòmar agus comataidhean

The member will know that members of the corporate body have a responsibility to make decisions on behalf of the Parliament in certain circumstances. Often, that is when an issue includes the security of the Parliament and involves security advice that we receive from Police Scotland.

We had a thorough debate at the corporate body. No member proposed that we hold a vote. We listened very carefully to the arguments that were made. We expressed some of the concerns that have been raised by members, and we were satisfied from the answers that we received that the approach was the correct course of action to take.

Although the pandemic has accelerated it, the collapse of many large retailers in our town centres, including in Kirkcaldy and Dunfermline, was already a feature of high streets across Scotland. They are owned by private companies and investors, but we need a public sector response to the challenge that we face.

The minister mentioned some projects, but what is there to incentivise the repurposing of large units and to support local authorities in their efforts to invest in changing town centres, which I think will need significant investment? Will the public have a stake in the decisions that impact on their high streets and environment?

To ask the Scottish Government how it is supporting the economic recovery of town centres. (S6O-00052)

I welcome this afternoon’s debate, and I am pleased to be leading for Scottish Labour on the issue in my role as shadow minister for drugs policy.

We must tackle Scotland’s high number of drug deaths, and I want to work with MSPs across the chamber to put saving lives and bringing an end to the misery of drug fatalities first, before our political differences.

In the previous parliamentary session, it was rightly made clear that the Government had failed to address a rising rate of drug deaths, and that Scotland having the highest rate in Europe was shameful, a poor reflection on policy makers and past decisions, and demonstrated an unacceptable lack of leadership and complacency from the Scottish Government.

We are at the start of a new session, and recent announcements from the Government, including the MAT standards and the investment to support their delivery, are welcome. Although my colleagues and I will push the minister and the Government to urgently deliver significant and meaningful change—and will hold them to account for the significant challenges in our communities that drive drug use and dependency—I will work constructively and co-operatively with the minister to find solutions that address the health crisis, support the on-going work of the Drug Deaths Taskforce, and examine Scotland’s relationship with drug use, which would lead to a healthier society that values everyone and supports positive choices.

We will support the Government’s motion this afternoon, although I make clear that, although we accept the call for a four-nations summit, it must not be about nursing a constitutional divide that will lead to an impasse.

I wish the minister well in exercising her persuasive skills to present an evidence-based argument, but it is fair to say that it will be a difficult discussion. Making changes to the Misuse of Drugs Act 1971 would take time, but we do not have time to spare in Scotland. The Scottish Government must demonstrate that it will pursue all options in the existing legal framework to advance safe consumption rooms, testing facilities and other measures that can contribute to reducing fatalities and harmful drug use.

Clearly and correctly, the Lord Advocate is independent of Government, but we want to see the justice and prosecution service prioritise public health and harm reduction.

In her statement in March, the minister said that she was determined to “overcome the legal barriers” to establishing overdose prevention facilities, and that a team of officials was

“working to pull together expertise and options.”—[Official Report, 18 March 2021; c 53.]

In closing, I ask the minister to say more about how that work is progressing. Our amendment supports finding solutions in the existing legal framework, and I want that to be demonstrated.

Although the proposal for a UK summit focuses on where there are barriers, I want to recognise what we can do urgently that will make a significant difference. When the MAT standards are introduced, they will be transformational. Their introduction will have the effect of a creating a right to treatment without having to rely on introducing legislation.

The Dundee drugs commission established the need for many of the policies that are reflected in the MAT standards. Given the scale of Scotland’s drug deaths crisis, there should not have been such a delay in their being introduced. We now need to see huge cultural change in services and an increase in rehabilitation capacity—including for mothers and babies—that is supported by investment. We need to address stigma and discrimination through medical intervention and work on mental health and trauma recovery, as well as social and community support.

Commitment to April 2022 as an implementation date means that some people will still fall through the cracks and not receive the treatment that they deserve and need in the coming months. Progress must therefore be accelerated. This year will be challenging. The standards are going to be incredibly hard to achieve but there must be accountability. Our amendment calls for an interim report at the six-month point in order to monitor progress. I recognise that the MAT standards include reporting mechanisms; however, we need robust monitoring of implementation, and clarity over where accountability lies.

There are changes that we can introduce in order to demonstrate accountability. We need the establishment of baselines so that improvement can be measured. The service is patchy across Scotland. We need to know where the gaps are and what ADPs and health boards are doing to address those. The MAT standards recognise the reality of staff burnout and fatigue. We need flexibility in relation to, for example, staff meeting the same-day prescribing target.

What is being done to address the issue of data on drug fatalities? The 2019 figure was the highest annual figure on record, making it the sixth year in a row that that has happened. The next set of drug figures that we receive will be from 2020. That makes it very difficult to model, test and evaluate policy innovation, although I note that the minister has talked about the public health surveillance programme, which might address some of the issues. Covid-19 has shown that we can extract data quickly and in an anonymised format. We need to look at how we can improve data and ensure that forensic toxicology is fully resourced and supported, with issues resolved.

However, there is really good stuff in the MAT standards, and work must be done to raise awareness and expectation. Commitments to assertive outreach and anticipatory care are all positive. In Fife, we now have an alert system for non-fatal overdoses, and we need to look for more options for intervention at key points. Will the minister also look at the expansion of the use of the nasal spray for naloxone, as opposed to an injection? That method is quicker and easier to administer. Taken together, the standards will make a significant difference to treatment and to recovery.

This week, I visited FIRST—the Fife Intensive Rehabilitation and Substance Use Team. Although this is my first drugs policy debate in my new role, I have a long relationship with drug treatment services across Fife, and I thank them for the work that they do in rebuilding people’s lives. They have been at the sharp end of service delivery for many years, and they understand intergenerational addiction, the impact of poverty and trauma, and the need for a culture change in all our addiction services. However, they can also talk about how people’s lives and families can be transformed when they are given the right support and are treated with humanity.

I move amendment S6M-00400.4, to insert at end:

“; considers that the resources of the police and justice system should be focused on supporting lifesaving, public health interventions and believes that all options within the existing legal framework should be explored to support the delivery of safe consumption facilities; notes that delivering the new Medication-Assisted Treatment Standards will require significant service reform; believes that, given the scale of the drugs deaths crisis in Scotland, there must be public accountability and scrutiny over implementation of the standards, and calls on the Scottish Government to report on a six-monthly basis to the Parliament on the progress of implementation and service improvement.”

I very much welcome this debate on women’s health. The creation of a plan that provides a co-ordinated and inclusive strategy for women’s health is overdue, and I am pleased that, in this parliamentary session, the Government is prepared to focus on women’s health and bring together many issues that MSPs and campaigners have pressed it on for many years. It is welcome that we recognise the connectedness of all those issues. Women’s health has been marginalised, unacknowledged and devalued, and there have been, and continue to be, systematic, institutional or societal failures in the treatment, public health messages and support that women receive.

The minister referred to “Invisible Women: Exposing Data Bias in a World Designed for Men”. That book revealed the inequalities of a society that is created for men. The needs of women have been ignored in the planning or design of things from the ridiculous, such as the temperature in our offices, to the dangerous, such as the design of car seat belts. Perhaps that has not been deliberate or malicious, but women have been treated as second-class citizens and given not even an afterthought. That has affected all areas of society, including healthcare.

The author of that book—Perez—highlighted the example of heart disease and its perception as a male disease. The consequences of women facing missed diagnosis and disadvantage in treatment are also addressed in the British Heart Foundation’s “Bias and Biology” briefing paper, which Kenneth Gibson mentioned. It is welcome that the Scottish Government now recognises the specific needs of women with heart disease, but the paper points to inequalities at every stage of a woman’s medical journey and the importance of a much broader rethink. I hope that the women’s health plan will bring that.

The lack of support for women experiencing perimenopause and menopause is gaining a higher profile, which is welcome. There is more open debate and discussion about the symptoms that women can experience, and there is more effort to reduce stigma and tackle shame, which has been driven by decades, if not centuries, of the representation of women as crazy or barren simply for experiencing a natural process. In her book “Perimenopause Power”, Maisie Hill makes clear the broader impacts of menopause symptoms and how they can affect relationships and work performance. The average age of menopause is 51, and the age group of women with the highest suicide rate is 50 to 54. That is a stark fact that highlights the importance of evidence-based guidance and the provision of support, including on the use of hormone replacement therapy.

It is vital that women can access proper support, and routes to specialist care need to be improved. There is only one specialist centre in Scotland for menopause, so the first port of call in most instances is a general practitioner. We must ensure that women are confident that their concerns will be listened to by GPs and that they will not be deterred from asking for help. Misdiagnosis is a key issue in women’s health, and women too often feel that their point of view has been dismissed when they have approached their GP. We must increase the number of available specialists and the amount of training for GPs, reduce waiting times, and encourage self-referral so that access to treatment is straightforward and responsive. We need workplace strategies that better recognise changes throughout women’s lives and how they impact on women’s working lives.

The Health and Social Care Alliance Scotland report on future planning was brought together by the lived experience sub-group of the women’s health group. In the report, women highlight difficulties in accessing services, particularly for some marginalised groups. They say that there was no mention of mental health in the plan, with the focus being on physical health—although I noted the minister’s opening comments on that. Making appointments around work and caring responsibilities is still difficult, the need for GP referrals for specialist services can add a further layer of delay, and requesting female GPs or interpreters can put additional pressure on women who are seeking appointments. We must have clear, accurate and up-to-date information readily available online, including accessible videos in a range of physical locations and in other languages.

I will briefly mention the need for investment in research into women’s health. A woman’s health plan is vital to address inequalities in health provision, to provide standards and deliver expectations for women’s health needs, and to ensure that, when they seek health services, women are taken seriously and provided with choices to enable them to live healthy, rewarding lives.

This has been a broad debate, and there are many areas of agreement. However, I share the concerns that have been raised about this year’s exam programme.

I would like to focus on a few key issues, the first of which is deferral of primary 1 for children who are four and a half years old. The cabinet secretary will know that the legislation on that issue was changed in the previous parliamentary session, after sustained campaigning and evidence from the Give Them Time campaign. The change is welcome, but I make a plea to the Government to bring forward the implementation period for the policy. The current timescale is that it is to be fully introduced by 2023, to allow for pilots and for local authority delivery to be costed. However, there are strong arguments for the need to bring implementation forward, not least in light of the past year in education.

Much focus has been placed on schools this afternoon, but early years education has also been significantly impacted in the past year. Nurseries and early years centres have worked hard to keep in touch with families and children and to provide stimulus and engagement, but young children have missed out on so much opportunity for socialisation and learning. Those who are due to start school at four and a half are already disadvantaged by having only a year and half of nursery provision instead of a full two years. The isolation that children experienced in the past few months strengthens the argument that parents should have the right to continue with a funded nursery place if they believe that that is in their child’s interests.

Implementation of the policy must be brought forward. The argument about whether nursery provision should match the parents’ right to choose whether their child starts formal education once the child is five has been won; the question is when that right will be introduced. I cannot understand why the five local authorities that were chosen to pilot the programme are those that already grant 100 per cent of applications. Meanwhile, constituents across my region have been denied nursery places, or even charged for places in local authority nurseries. That seems ridiculous when the policy is on the brink of change and the principle behind it has already been accepted. Recently, the City of Edinburgh Council announced that it will grant all such requests. The Government needs to stop delaying the introduction of the policy and implement it now, so that the 2021 intake can take advantage of the change.

In the previous session of Parliament, mine was one of the voices that called for an equality audit, following concerns about the impact of the lockdown on school education. The first lockdown exacerbated the educational inequality that already existed. Children and young people from socioeconomically disadvantaged backgrounds faced significant challenges in accessing online resources, children in need of additional support struggled to get that support remotely or at home, and there was a postcode lottery in the type and frequency of teacher support and learning available.

That equality audit was published in the previous session. It looked at the overall experience up to August 2020 and provided an analysis of certain schools up to November 2020. Since then, we have had a further period of school closures. We must have a focus on learning for all young people and an intensification of the support that is available for learning—and that must be a long-term commitment. The impact of the months of remote learning is broad, and we must ensure that the needs of all children and young people are met as education starts to rebuild and recover. We must not accept there being a lost generation because of the pandemic. Investing in our young people’s futures is key to our recovery.

The equality audit showed that learners in better-off families spent 30 per cent more time studying than those in poorer families. The digital divide, access to adequate space and parental support were all factors in the quality of learning. The audit also recognised the impact of the intersectionality of poverty-related disadvantage with other disadvantages, such as additional support needs. We all recognise the efforts that teachers and schools made—other members have spoken about that, and I fully support their views—but we cannot deny the impact of the past year on education.

In the second set of school closures, more structured learning was provided, perhaps because processes were more developed, but there was still a significant impact on the mental and physical health of children and young people. There were also impacts from the disengagement of too many children and young people who need the structure and discipline of the school day, and from the cancellation of exams. The impact of the last-minute introduction of exam assessments on children’s futures is still unknown, and it is causing much worry and concern.

The audit points towards policies and mitigations, and the Government speaks about introducing some of them. I would like greater clarity on solutions. The report talks about youth work and the role of the third sector, the need for smaller class sizes, and increased tutoring and one-to-one learning. We need radical solutions, and we need to be innovative if we are to rebuilt children’s lives and opportunities.

On the exam programme, I would like the Government to commit to a resit guarantee. Can it provide any assurances that the impact of Covid-19 will be taken into consideration in assessments? Other members have raised that issue this afternoon, and I look for clarity on it in the minister’s closing speech. I am concerned that some young people who would otherwise have achieved results through school attendance have been unable to perform in the assessments. They were allowed no study leave, with assessments taking place during the school day, with there often being multiple assessments in different subjects on the same day.

Progress on closing the attainment gap has so far been glacial, and the challenges that we face now, following the experience of the past year, make progress even more difficult to achieve.

In the past few years, it has become standard in high schools for the academic year to start in June, to provide students with enough time to complete the curriculum before the following year’s exams. My understanding is that that is not happening this year. What does that mean for students sitting exams in 2022 and their ability to complete their coursework?

I will close with some comments about further and higher education and the importance of additional funding support for students. The steps to provide extra funding for the extension of courses are welcome, but we must ensure that there is an equitable approach across different circumstances and courses. A key source of funding for students—for many, it is essential—is the employment that they can get during the summer holidays. We must make sure that students who would normally work to support their studies are not prevented from continuing their courses as a result of Covid impacting their employment opportunities. I know that the student hardship taskforce has been looking at that and I would welcome information from the Government on any plans to provide students with tailored support solutions this year.

Can the cabinet secretary indicate when the appeals process will be completed, given the impact that that will have on applications for further or higher education? Student places are dependent on qualifications, so can pupils be confident that they will get their results in time?

I have previously asked the Scottish Government about the recording of data on cases that involve violence during what began as consensual sexual activity. The then justice secretary confirmed that the police and the court do not provide information on such cases and that discussions would take place with stakeholders on how such data could be extracted. Will the cabinet secretary provide an update on related discussions and on any work that will take place to ensure that data on such cases is recorded, so that we can better understand the extent of the issue?

made a solemn affirmation.