Seòmar agus comataidhean

Will the cabinet secretary set out the breadth of subjects that currently exists in Scottish education, and will she say what impact colleges, community campuses and virtual education have had on the provision that is available to pupils?

I am listening carefully to what Paul O’Kane is saying. He mentions child poverty. He knows where I am going here—the issue of the two-child benefit cap. Will he join me in calling on the Chancellor of the Exchequer to review that in the upcoming budget?

Prisoners on remand make up around a quarter of the prison population, which seems an unacceptable level. Will the cabinet secretary expand on the steps that have been taken to improve alternatives to custody for those who are waiting to go to court?

I asked the Cabinet Secretary for Justice and Home Affairs about the high number of people being held on remand in our prisons, and I will ask the Lord Advocate a similar question: is she content that all 2,000 or so of the people who are currently being held on remand are a risk to society?

I put on record my entry in the register of members’ interests, as I hold a bank nurse contract with NHS Greater Glasgow and Clyde. I thank all the members who supported the motion to allow the subject to be debated.

The debate is particularly timely, as this month is liver cancer awareness month. We know that 90 per cent of liver disease is preventable and that, if it is diagnosed at an early stage, damage can often be reversed and the liver can fully recover. Tragically, however, in the United Kingdom as a whole, there are more than 10,000 deaths each year as a result of liver disease, and there has been a fourfold increase in death rates over the past 50 years. Mortality rates for chronic liver disease in Scotland have increased by 80 per cent in the past three decades, and they have increased by 16 per cent since the pandemic.

Back in May, I sponsored the British Liver Trust’s love your liver roadshow at the Scottish Parliament. It was fantastic to see more than 20 MSPs, including the Cabinet Secretary for Health and Social Care, attending the event.

Liver disease is closely linked to health inequalities. The main risk factors for chronic liver disease are alcohol use, obesity and viral hepatitis, all of which are most prevalent in our most disadvantaged and marginalised communities. Liver disease mortality rates are now five and a half times higher in the most deprived areas, and individuals from those areas are more likely to develop, be hospitalised by and die from liver disease than those in the most affluent areas.

However, Scotland is rapidly making progress on early detection to tackle those inequalities, as nine of the 14 health boards are now implementing fully effective pathways for earlier diagnosis of liver disease. People from the Camglen area of my Rutherglen constituency often access services from NHS Greater Glasgow and Clyde. Between 2003 and 2022, the board saw the largest fall in liver disease deaths—48.6 per cent—across all health boards. Challenges persist, however, as 251 people in the board’s area sadly died from chronic liver disease in 2022.

Nonetheless, Scotland is leading the charge in developing and rolling out new diagnostic technology to accelerate the earlier detection of liver disease. For example, the intelligent liver function testing pathway, which was developed by the University of Dundee, uses an automated algorithm-based system to further investigate abnormal liver function test results in initial blood samples from primary care. There has also been some local innovation, with FibroScan technology being piloted in Glasgow city to target those who are at highest risk in addiction services, which enables rapid referrals to specialist care to take place.

One reason why those innovations in tackling liver disease are so important is that liver disease is the biggest risk factor for liver cancer—it is present in between 80 per cent and 90 per cent of liver cancer patients. Alarmingly, liver cancer is now the fastest-rising cause of cancer death in the UK, with a survival rate of just 13 per cent. Sadly, as a result of barriers to earlier detection, liver cancer has seen the largest increase in mortality rates of all cancer types in Scotland over the past decade.

To tackle that crisis, Scotland has broken ground through the publication of a dedicated 10-year cancer strategy with a specific focus on improving outcomes for liver cancer as one of the six less survivable cancers. Tackling it demands that we look upstream at earlier detection of underlying liver disease—through the initiatives that I described—and at prevention. We all know, of course, that prevention is better than cure. As such, I welcome the Scottish Government’s consultation on advertising restrictions on food and drinks that are high in fat, salt and sugar, which are disproportionately marketed towards children and vulnerable groups. That is hugely significant, given that up to 40 per cent of children with obesity are now estimated to have fatty liver disease.

In addition, given that alcohol is responsible for the majority of liver disease deaths in Scotland, I am delighted to report that the increase in minimum unit pricing for alcohol took effect last week. Evidence from Public Health Scotland has shown that minimum unit pricing is highly effective in tackling alcohol-related liver disease, reducing health inequalities and, ultimately, saving lives. In fact, it is estimated that the policy has, on average, saved 268 lives and averted 899 hospital admissions each year.

In closing, I pay tribute to the British Liver Trust for all its work to raise awareness of liver disease, including through its love your liver roadshow. A continued focus on prevention, and on the early detection of liver disease, is essential to save lives, and the British Liver Trust’s efforts to end liver disease should be commended.

I refer members to my entry in the register of members’ interests. I hold a bank nurse contract with NHS Greater Glasgow and Clyde. What additional support is the Scottish Government providing to health boards to implement its winter planning?

I thank you, Presiding Officer, for giving me permission to leave the chamber before the end of the debate. I put on record my entry in the register of members’ interests, as I hold a bank-nurse contract with NHS Greater Glasgow and Clyde.

I congratulate Stuart McMillan on bringing to the chamber this important members’ business debate. In recent years, aesthetic procedures have exploded in popularity, with many clinics popping up on our high streets offering services such as dermal fillers and Botox. While some of those treatments may seem minor, the use of fillers and neurotoxins such as Botox involves medical procedures that can cause serious harm if they are performed incorrectly.

I will share the words of one of my constituents, Suzanne, who owns Pristine Aesthetics. She is a registered nurse, and she runs a regulated clinic in my constituency. She says:

“As nurses we pay high fees to our regulators Health Improvement Scotland, and we work tirelessly to give safe effective care to patients. However we are constantly undermined by people doing short courses to inject people with cheap products purchased online. There is no deterrent, no safety net, or information on this for the public.

As nurses we have high standards and strict protocol on infection control and safe practice. It takes years to train and mould a nurse with the appropriate skill and ethics. The amount of dangerous places in this area is utterly frightening … this is poor unsafe practice.”

Healthcare professionals such as my constituent Suzanne must complete extensive education and clinical training before they can be licensed to perform injections and other procedures. Licensed aestheticians—I knew that I could not say that word properly—who may perform laser treatments, for example, typically complete more than 600 hours at an accredited training centre. However, there is currently no legislation in place to prevent an unqualified member of the public from purchasing materials online, completing a weekend seminar or online course and promoting themselves as qualified to inject clients, regardless of their actual level of knowledge, skill or experience. Worryingly, a 2021 survey of plastic surgeons revealed that 63 per cent of respondents had reported seeing patients with complications, damage and disfigurement after receiving treatments from unqualified injectors.

My constituent’s concerns are reflected in responses to a previous Government consultation on the subject, with almost 98 per cent of respondents agreeing that there should be further regulation of the industry to reduce the risk of physical and psychological harm and the associated cost to the NHS when something goes wrong. As one respondent put it,

“It’s easy to train to deliver these injections, it requires far more expertise to reverse or manage complications. Anyone who cannot manage their own complications should not be delivering these treatments.”

One cosmetic doctor who was interviewed in the press described what she called

“a concerning trend among teenagers to pursue ... ‘tweakments’ to achieve a look that is often completely unrealistic and unattainable”,

driven by “online beauty standards” and filtered images. That chimes with the findings of Girlguiding’s recent “Girls’ Attitudes Survey”, which revealed that over half of girls aged 11 to 21 said that they wished that they looked like they do with social media filters.

In Scotland, there is, effectively, what my constituent has described to me as a “two-tier system” currently in place. Health practitioner services, which are regulated by Healthcare Improvement Scotland, must take into account the physical and psychological wellbeing of the patient or client when considering a course of treatment, including their age. There is currently no ban on under-18s receiving treatments from non-medical prescribers.

The announcement from the Minister for Public Health and Women’s Health that there will be a new public consultation on the topic is an extremely important step towards ensuring that the treatments, which are increasingly popular, are as safe as possible. New regulations will of course have to be introduced with care and consideration, not least to avoid undue difficulties for reputable small businesses and to ensure that unscrupulous providers are not driven underground. The consultation and the continued work of campaigners to raise awareness of areas of concern in the industry will be key to ensuring that regulation will be as comprehensive and effective as possible.

The Scottish Government has stated that it wants to ensure that the procedures

“are delivered from hygienic premises by appropriately trained practitioners, applying recognised standards and using legitimate products.”

Those are sensible goals, which the public should rightly expect to be pursued.

I refer members to my entry in the register of members’ interests: I hold an NHS Greater Glasgow and Clyde bank-nurse contract.

The national treatment centres are playing a key role in bringing down waiting lists in Scotland, but it is of considerable concern that the opening of new centres has been delayed as a result of the United Kingdom Government’s cut to Scotland’s capital budget. Will the cabinet secretary join me in calling on Labour members in the chamber to join us and press their colleagues at Westminster to reverse that cut as a priority, so that that work can be progressed?

The SNP Government’s decisions on income tax since the devolution of powers are estimated to have raised around £1.5 billion more in 2024-25 than would have been raised if we had had UK rates and bands. That vital funding can be used to support our public services and deliver the Scottish child payment. Does the cabinet secretary share my concerns about the impact that it would have on our ability to support our public services and tackle child poverty if we were to follow the Tories’ ill-judged plans for tax cuts?

On a point of order, Presiding Officer. It did not look as though my app had connected, but it has now told me that I did vote yes.