Seòmar agus comataidhean

I, like others, thank Kenny Gibson for lodging the motion. I welcome people to the public gallery tonight.

The motion rightly recognises the immense impact that chronic kidney disease has on individuals, families and our NHS. I declare a slight interest, Deputy Presiding Officer. When I was a teenager, I was going to go through some surgery and had a body scan. Through the body scan, we could not find any kidneys. However, as Kenny Gibson pointed out, the kidney is a secret worker, so I presume that because I am standing here tonight, something is happening in my body.

CKD is one of the most common and resource-intensive long-term conditions in Scotland, yet, as others have pointed out, it remains one of the few areas that does not have a dedicated policy with a real focus. We have heard tonight that that must change, because we know about the scale of the challenge. Thousands of people across Scotland rely on dialysis every single week, while others live with a kidney transplant and many remain at risk of disease progression. That demands action, because dialysis is not a treatment that one can simply fit in around ordinary life—it becomes life itself.

The NHS does extraordinary work, and, like others, I thank the extraordinary doctors and nurses who do that, but the system is under pressure and those with long-term conditions are often the first to feel the strain. For those living with chronic illness, equity means access to the right treatment, at the right time and in the right place, whether they live in the centre of Edinburgh or on a remote island in the Highlands, but we are falling short of that right now.

Rural patients face long and exhausting journeys to access treatment and people in our most deprived communities are 60 per cent more likely to develop chronic illness, including kidney disease, and face a life expectancy that is up to 25 years shorter than that of those in our wealthiest areas. As we have heard from other speakers, ethnic minority patients encounter language and cultural barriers, and disabled people face hurdles with transport, accessibility and advocacy.

The challenges are not abstract; they are lived day in, day out. That is why it is so important that the Scottish Government makes CKD a specific strand in its long-term conditions strategy. I would be interested to hear whether the minister can, in her closing speech, confirm that the Scottish Government is heading towards that and tell us when we are likely to get there.

These are not luxuries; they are necessities. We know what works. Expanding home dialysis brings greater independence, improves quality of life and reduces pressure on hospital services. Increasing organ donation rates saves lives and eases demand. As Brian Whittle said, prevention through early screening in high-risk communities has the power to slow progression and reduce the long-term burdens on patients and the NHS alike.

International examples show us what can be achieved and what we should be aiming for. For example, in Australia’s Northern Territory, mobile dialysis units have transformed care for remote communities, proving that geography need not dictate outcomes. Scotland can, and should, be as bold, but that cannot be done by Government alone. It requires action from doctors, third sector organisations, industry and from patients themselves, whose voices must shape the services that they rely on.

Chronic disease is not only a medical condition; it dictates how you shape your life day in, day out. We need action and I look forward to hearing from the minister.

I welcome the cabinet secretary to her position. A recent report from Shelter Scotland stated that, shockingly, there are more children in temporary accommodation in Edinburgh than there are in temporary accommodation in the whole of Wales. How can our capital city still be in such a crisis a year after we declared a housing emergency, and what will the cabinet secretary do practically to help the City of Edinburgh Council to move on from that situation?

The minister will be aware that the Delegated Powers and Law Reform Committee met on Tuesday. There was no time for the committee to consider a written report on the issue, and there was no opportunity for us to scrutinise the LCM. The Parliament has been asked to approve an LCM that many members have been unable to find the full details of and to ask the appropriate questions about. I appreciate that there has been a consultation with those outside the Parliament, but members in the Parliament seem to have been left behind. Why is there such urgency to get the LCM through today, and why could it not wait until September? Could he also confirm that the approach that has been taken is not good practice and should not be seen as such?

Martin Whitfield will be aware that the legislation that we pass does not last just for the duration of the current Government; it lasts for years to come. I am happy to accept what the minister says, but we do not know how the legislation could be used by future Governments, which might have a very different view. Is Martin Whitfield not concerned that, if there is a Scottish Government policy change, the legislation could be used in a way that would have a damaging effect on young people in Scotland?

Will the member give way?

Is the member arguing that everybody in the care sector should be on £32,000 a year? That is the pay threshold that his party at Westminster is setting for people coming in. We must either increase wages dramatically or we must reduce that figure. We cannot do both.

I am happy to give way, but I think that Christine Grahame was first—my apologies.

I want to begin by recognising, as many members have today, that immigration is a sensitive topic and that we owe it to our constituents to refrain from reckless generalisations. There has actually been a fair amount of consensus across the whole chamber. I suggest that, instead of making such generalisations, we ground our arguments in facts, as Liz Smith and others have done, reflecting the world as it is, not as we idealise it to be or fear that it might be.

In that spirit, I associate myself with the remarks of my colleagues and others when they acknowledged that illegal immigration should not be accepted or—what is worse—encouraged. I fundamentally disagree with Maggie Chapman. Illegal immigration has harmful effects in all the areas that are dealt with by Government portfolios, but especially in social security, which is already at breaking point in Scotland. It is clear that the matter needs to be addressed swiftly and effectively.

We must also admit that the previous Government did not get it all right.

I am grateful to Michael Marra for taking my intervention. One of my concerns with the white paper from his colleagues in London is that it does not recognise that in some sectors, such as the caring sector, there is a massive shortage because of the income that individuals in that sector earn. Is there a danger that people who give valuable care to disabled and older people in Scotland will be cut off from coming?