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I congratulate Brian Whittle on securing the debate. His enthusiasm for sport can be seen, and I enjoyed that.

Like my colleagues and people throughout the country, I watched as our Olympians delivered major success for team GB in Tokyo during the summer and no doubt inspired a generation of young athletes to dream of reaching the very top of their sport. The commitment of our athletes, their coaches and their local clubs throughout the UK is admirable, and the time, skill and effort that are put into developing first-class athletes have undoubtedly paid off this summer. It is worth saying again that our athletes won an impressive 65 medals, which equals the London 2012 total.

Although indoor events took place behind closed doors, the return of the Olympics was much needed for all those who had been looking forward to a summer of sport. The Olympics brought a sense of normality, albeit in the most abnormal of times.

In the excitement of a global Olympic games, I sometimes think that we forget where it all begins for many. It begins at the grass-roots levels in towns and villages throughout Scotland and the whole of the UK, where future Olympians and Paralympians are first introduced to sport, enhance their skills and prepare for a future of success. It is in local communities that future champions develop what will become a lifelong love of sport, and it is local sports teams, such as Nithsdale Wanderers Football Club in Sanquhar, which I visited recently, that allow local accessibility and the opportunity for people to dream of playing for team GB at an Olympics some time in the future. A small games hall in the village of Catrine has championed badminton over many years and given young people the pride of performing in tournaments across the country.

It is a shame that those opportunities simply do not exist for many young people today and that accessing outdoor green spaces or using football pitches or multi-use game areas comes at a significant cost that is too much for many families. Others have spoken about the power that sport has to unite communities, spark friendships, showcase talent and improve mental health. Given that power, it is beyond belief that we do not give sport the recognition that it deserves or prioritise it in the way that we should. Austerity has hit sport hard and has taken it from the communities that need it most. When Governments have a target to reduce public spending, what is hit first? It is community spaces, sports halls and kids clubs, and we know that that disproportionately affects poorer communities.

On the back of Evelyn Tweed’s question, I have a brief question about the length of time that it takes for women to be diagnosed with endometriosis. Women speak to me about the fact that it has been a long journey, and clinicians have acknowledged that they perhaps do not have the necessary expertise. I am sure that this issue will be part of the plan, but it is important that we share expertise among clinicians and that, where necessary, appropriate training is available.

I do not have any follow-up questions on that, convener.

Cabinet secretary, I was heartened to hear your response about dealing with the root causes, which is important in this area. Following on from Paul O’Kane’s questions, I will ask about childhood obesity and approaches to young people’s health. Do you agree that it is important that we get those things right early on so that we can look forward to people having long and healthy lives, and that it is important that we target areas of deprivation in order to ensure that people across all communities have a fair start in life?

I thank Emma Harper for bringing the debate to the Parliament. I was really interested to see the motion on the agenda and to hear Emma’s contribution this evening, knowing about the expertise that she brings to the subject from her role as a nurse and, as I have learned, as a patient.

I also have some experience of working with patients who use insulin. I spent many years working as a dietitian in the NHS and, in my early career, I covered diabetic clinics along with a specialist diabetic nurse and other members of a multidisciplinary team. Diabetes is a condition that patients manage and live with, and I learned so much about the adaptability, resilience and humour of people following a diagnosis of such a life-changing condition. The experience also gave me a lifelong admiration for the dedication of NHS staff and how they build relationships with patients who face having to overcome enormous hurdles during many years of treatment. I give a big shout out to all those staff, from the porters to the caterers, the medical and clerical staff, and particularly to my colleagues among the allied health professionals, which is a group of incredibly dedicated health service workers.

As the motion points out, insulin is one of the greatest medical breakthroughs in history. It changed the lives of many millions of people by changing the diagnosis of type 1 diabetes from a death sentence to a life worth living. Before insulin, it would have been unusual for someone to live past two years after diagnosis, so 100 years of insulin is definitely worth celebrating.

There are so many elements that members could bring to tonight’s debate, including diabetes diagnosis, diabetes treatment, and diabetes as a life. However, in such a short debate, we only have time to raise one or two issues. In the short time I have, I want to talk a little about tackling the inequalities around diabetes care, particularly the link between inequality and diabetes outcomes.

I thank Diabetes Scotland for its briefing, which reminded me of the realities of living with diabetes, particularly for someone who comes from a more deprived background. Although insulin means that type 1 diabetes is no longer necessarily a death sentence, type 2 diabetes is still on the increase, and the day-to-day complications in heart health, eye care and foot care mean that it is an incredibly hard condition to live with.

It is important to acknowledge that living with diabetes can be relentless, and managing it can feel overwhelming. Managing lifelong conditions can take its toll on individuals and their families, so it is important that we, as parliamentarians, acknowledge our role in fighting for services and for every possible advance to be made, and made accessible to all.

The poorest people in Scotland are more than twice as likely to have diabetes at any age than the average person, and once they have the condition, those who live in the most deprived homes are twice as likely to develop complications through diabetes than those who are in less deprived areas. Those stark figures show the reality for so many. Where someone is born and where they live unfairly lays out their future, particularly when it comes to health.

Tackling the root causes of health inequalities has to be key right here in the Scottish Parliament. We need to tackle inequality in income, access to suitable housing, and access to healthy food. We need to acknowledge the role that we all have in the Parliament and we need policies that transfer power and wealth. The great achievements in diabetes care can continue, but we have to work hard in this place of power to ensure that the factors are in place to give economic justice to all.

The briefing from Diabetes Scotland gives us the stark figures. Rates of diabetes are 80 per cent higher in the most deprived communities in Scotland. That is unacceptable and we must act. Let us celebrate 100 years of insulin, and let that remind us that things can change. With the correct structural changes in society, we can head towards Diabetes Scotland’s vision of a world in which diabetes can do no harm.

I, too, thank all the volunteers in the Borders who participated in the great Borders river clean this year and in previous years. I also congratulate Rachael Hamilton on securing a members’ business debate on the issue. It is important that actions from local communities are spoken about and acknowledged in the Scottish Parliament.

More than 400 people from a number of villages across the Scottish Borders have worked together, demonstrating not only the strength of spirit of towns and villages pulling together on a common cause, but also where we need to act to look after the natural environment that we rely on and must take responsibility for.

As members have said, communities in many parts of the south of Scotland are rightly concerned about the environment, littering and fly tipping. Many communities are taking excellent direct action through events such as the river clean, litter picks and the beach clear-ups that Martin Whitfield mentioned. Cleaning our green spaces, rivers and fields undoubtedly has many advantages, from the aesthetic—tourists are attracted to the beautiful towns and villages across the Borders and beyond—to the environmental and educational benefits. It is important to teach people from an early age to respect their environment and understand the damage that is caused by plastics and the overconsumption of goods, which previous generations have undoubtedly succumbed to.

As it aimed to do, the great Borders river clean has brought into sharp focus the scale of the problem that we face. In one weekend, 3,000kg of rubbish was pulled from a Borders river. What a throwaway society we live in. The organisers hope that that shocking figure will raise awareness of the effects of the problem and help to change behaviours and reduce the amount of litter that enters the natural environment. That is very much needed.

Young people across the planet are telling us to act now and are instructing us to take the issue seriously. As a Parliament, we must accept our responsibilities. We must do more and take on responsibility for ensuring that there is legislation and funding to prevent the causes of such environmental problems. We must be serious about having a zero-waste Scotland. We need to use the evidence that we have to move on education, with local authorities responding to the reasons that have been identified, be they socioeconomic problems, barriers to people accessing services or a lack of education to change behaviour.

I end by noting just how important the subject is. I hope that we will return to it in the chamber many times in order to demonstrate that we take it very seriously, as that will be the best thank you that we can offer the volunteers. I once again commend the great Borders river clean and thank all the volunteers.

It is good to be back at Holyrood, making a start on the job that all members were elected to do: to push Scotland forward in building a better future for us all. To my mind, at least, that is long overdue. The Parliament needs to use its time and powers much more decisively and effectively. To do so is our duty not only to those who have elected us, but to the generations who fought to bring power here in the first place.

During the summer, I have been out regularly to speak to constituents. The most common question that I am asked—after “Why are you at the door?”—is a simple one: “What does the Scottish Parliament actually do?” I will be honest: in the first months of my time as an MSP, I have found myself asking the same question. The answer is, in short, “Not enough.”

It is a great disappointment that the Government’s plan and delivery for the first 100 days of government is, as usual, more than underwhelming. Although positive advances that are to be welcomed include an inquiry into the Covid crisis and £1 billion for the NHS, it is far from the radical template for a new country that the manifestos of the two governing parties suggested back in May. In reality, most of the plan is just recycled announcements that were already known.

The long-awaited NHS recovery plan unfortunately contains nothing of note for social care, which is at a catastrophic tipping point. It lacks a meaningful youth job guarantee, and we are still left with little to no detail at all on what is to be done to help people in rented accommodation in Scotland. I understand that that is part of a great many things that we will hear about later in the year—a promise that the public has gotten used to under this Government.

Reform of the rented sector is one of the key public concerns of our age. We often hear positive rhetoric about Scotland’s supposedly progressive approach to housing, but that does not stand up to even the most cursory bit of scrutiny. Although I am sure that many will welcome input from the Greens, it will need to be more than just another voice in the room. We are years behind on these reforms, and if we do not act now, with the added economic costs of Covid, it may be too late to get many renters’ lives back on track.

The saddest fact is that we all know that a great deal of the public do not pay much attention to what goes on in this building precisely because so much is consigned to reports, future plans or one-off payments, with no or little long-term purpose behind them. Perhaps this session will be different and my words of warning will sound hollow. I truly hope that that will be the case. However, if we have another five years of governance in Scotland in which decisions such as doubling the Scottish child payment or saying no to the Cambo oil field are not made, we will be back here again in 2026.

I warn that a greener Scotland should mean not simply having Greens in Government, but actively pursuing radical and transformative change. As noted by the world-renowned climate activist Greta Thunberg today, Scotland under this Government has done little to suggest that it is a world leader on climate change. With COP26 approaching, we could well become caught out in front of the world’s gaze.

Scottish Labour has said that we need to use the opportunity of COP26 to show leadership in tackling the climate emergency and deliver a just transition, with thousands of new green jobs across Scotland. Under this Government, the number of jobs directly in the low-carbon economy is at the lowest level since 2014, and the SNP’s new green jobs workforce academy amounts to little more than a new jobs portal. That is not good enough. Before they publish another plan to keep the press happy, my message to the SNP and the Greens during this important week is simple: you cannot stand up for Scotland by lying down.

This incident is obviously a serious failure that must not be allowed to happen again. I ask my question on behalf of women who had subtotal hysterectomies before 1997. To reassure those women, I would like to press for a date on which the audit of those cases will be completed. How long will it take for individuals affected to be contacted? In cases involving individuals who have passed on due to complications relating to cervical cancer, will their families be contacted?

The Scottish Government rightly recognises that low pay is at the heart of child poverty and that it is an issue that should preoccupy everyone across the country. Why, then, will the Government not commit to paying carers—a workforce that is largely made up of seriously underpaid women with childcare responsibilities—£15 an hour?

I nominate Paul O’Kane.

Paul O’Kane was chosen as deputy convener.