Chamber and committees

Good morning. It is a pleasure to be back among you but, for the first time, on the other side of the table. In the previous parliamentary session, I was a co-convener of the cross-party group on heart disease and stroke.

I would like to speak in support of James Bundy’s petition on the review of the FAST stroke awareness campaign. I commend James and his family for the fantastic work that they have done to date in bringing this petition to the Parliament and highlighting where we are.

The petition calls on the Scottish Parliament

“to urge the Scottish Government to increase awareness of the symptoms of stroke by reviewing its promotion of the FAST stroke campaign, and ensuring that awareness campaigns include all the symptoms of a potential stroke”.

There were 11,055 reported strokes in Scotland in 2022, which is an increase on 2021. The latest data from the year ending 31 March 2022 reported 3,836 deaths in which cerebrovascular disease, including stroke, was the underlying cause. The current test that is used to assess patients who are suspected of having suffered a stroke is, as we have heard, the FAST test. Although that test can identify most strokes, patients can also present with other less common symptoms. The crux of the petition is those less common symptoms that can occur in some individuals and which can, unfortunately, mean misdiagnosis or delays in treatment. That was very much the case for Mr Tony Bundy, who died at the age of 53.

As you said, convener, in 2021, a systematic review of evidence found that the FAST test accurately detected 69 to 90 per cent of strokes but that, crucially, the test missed up to 40 per cent of posterior circulation strokes, such as the ischaemic stroke that Mr Bundy suffered.

That issue has also been identified by the national advisory committee for stroke, which stated the importance of education for health professionals, including in circumstances where there is a negative FAST test. That is what we are talking about here: education is required for the professionals who deal with these situations.

I firmly endorse the calls from James Bundy and his family for a review of the FAST test, an evidence session with the Health, Social Care and Sport Committee and a debate in the chamber in the future. That would help the family to see how the process is moving forward, because it is clear that, in this circumstance, the test was not fit to identify a stroke. It is important that we address that for the future.

I commend and congratulate the Bundy family on the petition following their terrible loss. They wish to support others in that situation so that this will not happen to other families. I support the petition and I am delighted to be here.

As you identified, how you deliver, manage and measure success is vitally important. Sometimes, that comes down to the data that you use. You will always receive certain data because of the nature of the business that you are involved in. However, some aspects are a little bit more technical or about what the environment has to offer. That might not be as easy to measure, depending on how you progress that work.

How do you make your way through that little minefield so that you can collect the right data that will give you the correct information and enable you to put forward a strategy or idea and set out how far you will go on an issue because of what you have been told? If you are not told about something and you do not measure what is happening, how can you then encapsulate that? You have already said today that you have fingers in many pies. It is about managing things so that the data that you receive gives you the best measurement of the progress that you are making, which in turn gives you the opportunity to succeed.

That has to be the approach. If you are to reach your ultimate goal, you must ensure that that framework is there.

All that comes down to resource and financing. In the strategy, you have given some ideas as to the progress that you want to see and have identified elements as priorities. However, there are also aspects of the strategy that you want to do but might not be able to do because you are constrained by, for example, time, geography or the finances behind that.

How do you balance those elements to ensure that you achieve what you want to and that your strategy succeeds? In some ways, if it does not go as far as it can, it will fail.

Good morning, gentlemen. Mr Paterson talked in his opening statement about a joined-up effort—joined-up thinking is needed about how to manage the strategy. You have touched on collaboration. The effective engagement that you have done is evident in the strategy, and what you have achieved in the past is to be commended.

The strategy requires local authorities to be key partners in the process, because they can provide flexibility and focus and are involved in economic benefits that can happen in a location. However, the strategy does not go into the detail of how HES will improve collaboration with local authorities. Why is that detail not included?

You have identified that there is a skills shortage. However, we have a wealth of talent among volunteers at, for example, men’s sheds, where they bring together individuals who have skills from having worked in a wide range of sectors in the past, which they can pass on to others who come and join them. Have you tapped into the third and voluntary sectors to see what skills they can add to the existing base and hand over to others? Those individuals might have stopped being in the working environment that they were in earlier in their lives, but they still have a skills base that they can hand on to the next generation, which could support many of your organisations.

You have all talked about the ambitions of the strategy, and it is clear that there are ambitions in each of your sectors. However, those ambitions will be realised only if we have the appropriate actions, framework and delivery. In your written submissions, you identify that we have a skills shortage, that there are funding support issues and that investment is required. It all comes down to the plans that each of your organisations has for future investment based on the financial support that is provided over the medium to long term. Squaring that circle is the only way to achieve the ambitions.

You all want to survive and thrive, but it appears that you are at a crossroads. For many of your organisations, the next step could be a challenge. We know that there are already challenges, but the challenges could be bigger, depending on where you take your organisations and where you want them to be. For me, the issue is about financial support and investment in the medium to long term, and what you need to ensure that you can survive and thrive based on the strategy that has been set.

Cabinet secretary, you have talked about the approach that the Government is taking, about competence, about the effects and about some aspects of scrutiny. Those are all valid in the process. How has the Scottish Parliament’s EU law tracker supported the Government’s approach to alignment? Has the Government reflected on that? You have mentioned some sectors and business organisations this morning—how have they managed to co-operate under that process?

One specific area that has been discussed in the past is a Europe that is fit for the digital age. Scotland has ambitions of ensuring that it has the cultural, social and economic benefits of the digital society. Your ambition is to ensure alignment across the sector and across the area. What confidence can we have about assuring personal data and about the law behind that? My basic understanding is that there are still some complexities in achieving that and that it may be difficult to align some of it, depending on the barriers and areas of difficulty that may be approached or received.

You have given us a very honest and stark view of the industry that you all represent and are trying to maintain and sustain. I suspect that, without some of the interventions that you are asking for, the industry or many organisations will be at a tipping point with regard to what might happen next. We have already touched on what might be required to get some financial support. We have touched on the issue of the 90 out of 180-day rule with regard to visas. That would give you some hope, if such areas could be managed and maintained.

What other opportunities do you see, if any, with regard to challenging the situation and where you want the sector to go? The sector is in a dire situation and needs help to progress.

Each of you has talents in your own sector. Are you doing anything collectively to try to make progress or to challenge? We have opportunities here to tackle the Government. Is anyone within your own sectors coming forward with potential solutions? We have heard about some of those this morning, which is really encouraging, but are there others? What are other parts of the world doing in similar situations? Are they doing something that we could support or copy, or does everything have to come from the Government side and from the funding mechanisms that we control here? Is that the only opportunity that we have?

Does anyone else want to add to that?