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I am keen to come to Alan Sutherland in a moment but, Johanna Dow, what increase will non-domestic customers see in their bills?

I turn to Alan Sutherland for the view of the Water Industry Commission for Scotland. I asked Douglas Millican about the fairness of the charges. What is your view?

You mentioned the Scottish ministers. I have looked back at what the Cabinet Secretary for Net Zero, Energy and Transport said about the price increase. Back in February, he said:

“every pound raised is re-invested in our water industry.”

Many customers will therefore be wondering why you have £500 million in cash reserves. I know that you will be able to give some explanation for that, but have you looked at what more can be done to support customers? Clearly, you understand that many people in Scotland are struggling to afford household bills, regardless of their expectations of quality of service. Can you say a little more about the reserves? From reading some of the papers, my understanding is that they sit at about double what they would normally be. Can we expect that to continue in the coming years, or will you use those reserves in any way to help customers with their bills?

Are the price caps fit for purpose? Are they appropriate? If the maximum charge is based on the consumer prices index plus 2 per cent and if inflation is about 11 per cent—which might increase—will that still be the best approach?

I know that it is never polite to talk about people’s salaries and remuneration, but I will put this question to Dame Susan Rice, because it would not be fair to put it to the officers. I just want to get this on the public record.

There has been a lot of interest in the bonus structure for senior officials. We are talking at a time when members of the public are struggling to afford the absolute basics in life, including water charges. There has been mention of considering efficiencies. Is there any on-going reflection or review of the bonus structure for Scottish Water officials?

We heard in the opening statement that there is little sign of inflation or the cost crisis slowing down. I will ask my questions in that context.

My first question is for Douglas Millican. Is it fair to hike up household bills by 4.2 per cent during a cost of living crisis?

Given that my initial questions were about fairness and the assessment of fairness, it was important to take the temperature on that issue.

I have the privilege of being a co-convener of the cross-party group on chronic pain, alongside Rona Mackay and Miles Briggs. Like them, I am grateful to our force-of-nature volunteer secretary Dorothy-Grace Elder and to all CPG members, past and present, for their invaluable contributions.

Colleagues might know that the group was established in 2001. It has always challenged this Parliament and the Scottish Government to improve the lives of people living with chronic pain. That robust challenge and scrutiny are needed now more than ever.

A debate in Scottish Government time that is focused on the practical steps that will be taken to reduce waiting times, improve patient pathways and tackle the issues affecting the workforce is long overdue and, indeed, welcome. I am slightly disappointed that the Cabinet Secretary for Health and Social Care is not here today. I know that he has been engaging keenly with colleagues, but I hope that he will be made aware of what is discussed today.

I thank the minister. I think that we are all keen to make the most of the time in the chamber today.

We know about the long delays and the postcode lotteries that colleagues have mentioned. Those issues predate Covid-19 and Ms Todd’s time in office as well.

We all have to welcome the implementation plan, but—as colleagues including Bob Doris have, reasonably, said—we need to test it out and make sure that it will work. As colleagues have said many times today, the issue is affecting one in five people in Scotland, which is 800,000 people. We recognise that not everyone’s experience will be the same. Everyone’s needs will differ, as will their perception of pain, even among those with the most severe pain.

Unfortunately, what brings our pain community together is the long waits for care and treatment. We know that they are unacceptable. I know from my own casework and freedom of information requests that in my Central Scotland region there are patients who have waited in excess of three and four years for steroid injections, when the recommended treatment time is 18 weeks. We have constituents who are supposed to get their injections six months apart who have waited two years. Some have had to go private when they cannot afford to do so. We know that the issue has exacerbated health inequalities right across Scotland.

As colleagues have said, and it is in the Labour amendment, this is not just a process issue to gather numbers for the sake of it. For patients who require on-going care and follow-up appointments, data collection is really important. It gives people a rough idea of when they might expect to get an appointment, so that they can plan their lives—holidays, annual leave, special occasions and so on. It allows Parliament to scrutinise the workforce plan and make sure that we are putting resource into the right places. Action 6, I think, in the document talks about data. That is fine, but I would say to the minister that it is quite vague. I hope that in her closing remarks we will get a firm commitment that brings us closer to what patients, as well as the workforce, are actually asking for.

Finlay Carson mentioned Liz Barrie, who lives in East Kilbride and is a former nurse and a constituent of mine. She is no stranger to the Parliament, as she has been very outspoken, and she is very courageous. Because Liz worked in healthcare, I think that she feels even more passionately about the issue. I give a content warning here. Colleagues have talked about the impact of pain on mental health, and Liz has said:

“I have contemplated suicide and overdosed on pills in the past because the situation is so bad.”

That is not unique, but it is one example that I will leave with colleagues.

Others have said to me, “You would not expect a family pet to have to wait two years for pain relief”, so why are our constituents having to wait years? Those constituents include Liz, who is a former nurse, and so many others who have had to beg, borrow and steal to get the funds for private treatment during the pandemic, because chronic pain services were completely shut down in many respects and were one of the last services to be remobilised.

Some patients, including some of my constituents in Lanarkshire, travelled to Doncaster because they were in unbearable pain and agony and some of them were feeling suicidal. They went to England and paid for their own treatment, travel and accommodation. The previous health minister said that they could probably get that money back, but they have not received a penny. It is not fair, and I hope that the Government will still try to address that.

Time is short, but I have a couple more things to say. Self-management has been talked about and it is important, but when people are given leaflets and told to go and walk their dog or do a bit more exercise, we have to remember that those recommendations are not appropriate for everyone. We have to avoid being ableist. What about people with disabilities who cannot do those things? What about people who do not have the income to do some of the recommended activities?

I also feel that the issue disproportionately impacts on women, and Ms Todd also has responsibility for the women’s health plan. Endometriosis is a chronic pain condition that it takes women eight and a half years on average to get a diagnosis for. The Government has a brilliant commitment on that, but again we need to know that there is a plan to bring down that time.

Chronic pain can be debilitating, but added into the mix are the impacts of Covid, the cost of living crisis and, for those who live in Lanarkshire, a health board in a code black situation. We need to give people hope, not through our warm words but through action. I agree with colleagues that there is lots of good stuff in the implementation plan, but we need the resource to ensure that it will work, and we need the data.

We have heard today that life is far from normal for people who live with severe chronic pain; it is unbearable. Are we getting a firm commitment from the Government on the reasonable request that data be published on patients who require follow-up treatment, so that we can get sustainable services, transparency and some certainty for patients?