Seòmar agus comataidhean

Like other members, I thank the committee and the clerks for preparing the stage 1 report on an important piece of legislation. It is helpful for those of us who are considering the bill but were not part of the committee that the report was so well put together.

I support legislation that would actively seek to support debt management strategies. The convener, Claire Baker, set out well the contributions that the bill could make. I do not think that I have read anything that suggests, or spoken to anyone who suggested, that some of the proposals that other members have talked about have ever been seen as open to abuse rather than positive steps.

Scottish Labour will support the bill at stage 1 at decision time, as we agree with its general principles and aims. The introduction in legislation of a mental health moratorium is welcome. It is right that people who are suffering from poor mental health are provided with the greater protections that members have spoken about. Having read the stage 1 report, the evidence and the SPICe briefing, along with having discussed the matter with members of the committee, it is clear to me that that would be a positive and welcome step.

Scottish Labour is also supportive of the proposed two-stage approach to the moratorium period, with an open-ended first phase that would allow an individual to focus on recovery from a serious mental health condition rather than exacerbate the problem with continuous debt worries. Prioritising the mental health of the individual in such situations is paramount, as other members who have spoken to people with lived experience have said. We believe that we have found common ground with the Government on that.

As members know, citizens advice bureaux across the country provide high-quality debt advice free of charge to people in their time of need. A witness from one of them said:

“We must recognise that, when someone has a mental health crisis or when their mental health is so bad that they need to take time out and pause, that is not the time to think about their debts.”—[Official Report, Economy and Fair Work Committee, 25 October 2023; c 9.]

We ought to listen. That means not only establishing the moratorium in legislation but explaining how it will operate in practice. Some of the questions that members have asked the Government so far have related to that.

On that point, I find myself in full agreement with the committee’s recommendations. As Daniel Johnson mentioned, Scottish Labour shares the committee’s concerns about the lack of detail on how the moratorium will operate in practice and its view that there must be sufficient time to scrutinise detailed proposals. That would be helpful, as many other members have said. The bill leaves a lot of detail to be laid out in regulation. Those regulations should be provided in draft form before stage 3.

I appreciate that, in his letter to the committee responding to the stage 1 report, the minister acknowledged the committee’s concerns and suggested that he will seek to address them. I look forward to his comments on that. However, it is important to note the evidence given by South Lanarkshire Council, which noted:

“It, therefore, is not clear, at this point, who will be able to use a Mental Health Moratorium, how an application will be made and what effect it will have or how long it will last.”

Clarity on that would be helpful for people who will have to deal with the situation. There is undoubtedly a concern. The Scottish Government has set out a well-intentioned and well-supported proposal, but where it lacks detail, it is fair to say that there is still a fair amount of work to be done to address the concerns that the committee, other stakeholders and members in the chamber have raised.

Furthermore, eligibility in relation to the moratorium is another clear area where we believe that the Scottish Government ought to revisit its position. As it stands, only those who are receiving compulsory treatment would be eligible for a mental health moratorium. I know that a couple of members mentioned that, and they are far more familiar with the exact wording, but my understanding is that the approach is thought to be not proportionate to the scale of the problem. I agree with the committee’s proposal that the criteria should be widened. Going back to a statement that I made earlier, I think that it would be helpful to use clearer terms so that people understand it. I also understand that there has never been any evidence from other areas that the moratorium has been widely abused, so I think that it would be helpful and that it could be managed well.

As the minister noted in his response to the stage 1 report, early indications from the consultation suggested that support for some areas of this legislation is not widespread and there are concerns about the entry criteria. It is welcome that the minister has recognised those concerns and will move forward with them.

In calling for an extension of eligibility, we recognise that that would require an expansion of debt advice services. As other members have mentioned, it is all very well for us to recognise that we might want to change the legislation, but we know that debt advice services are quite stretched. Those who work in the debt advice sector are already working to capacity. They must be given the training and support that are required to properly deliver the reforms as they come through the different stages and are passed in the Parliament.

Citizens Advice Scotland believes that there should be more partnership working across mental health and money advice services, and a lot of members would agree with that. That could be achieved by embedding money advice services in mental health settings or by working closely with local community teams and groups. An important part of any legislation is how it works in practice. The community-based approach can be applied across various disciplines and to tackle various issues, but I am strongly of the opinion that this is a key area in communities and that those most in need would feel the benefits.

The points about the uprating of the allowances that were mentioned by the convener are quite important. I do not have time to go into them, and I am not on the committee, but from reading about it in the papers, I think that it would be important for the Government to look at that.

In concluding, I reiterate my party’s support for the general principles of the legislation. The key aims of the bill are well intentioned and are shared across the chamber. We have identified that stakeholders broadly support it. I hope that the minister will address some of the issues that have been raised by the committee and by members in the chamber today. I again thank the clerks and the committee for the stage 1 report.

Can the minister set out timescales for the introduction of the ban and what the associated repercussions are expected to be if the ban is not complied with? How will the Scottish Government work with shop owners and others who sell such products so that they can safely dispose of their stocks?

Comrades in the gallery and members in the chamber, we have heard that few people in our recent history have made themselves heard on the national stage and truly altered the course of history. They are people we can call titans of the working class, and Mick McGahey is certainly one of them.

To this day, McGahey remains a respected figure across the political left and a feared adversary across the political right. He was a man who stood against injustice, exploitation and corruption wherever it was evident around the world. He was a lifelong communist, a proud Scot and a trade union leader who worked with everyone he could to achieve tangible improvements for his class.

He remains an inspiration to the many who have since followed along the path of socialism. I never met him, but people in my home town of Mauchline and surrounding areas and villages certainly did. His socialism is a path that many people from my area have followed or hold a lot of respect for. Only recently, I spoke to former miners in Cumnock who met him and who were out on those picket lines with him. Many of them said to me that, although they might not always have agreed with McGahey’s line in the disputes of old, they still possess tremendous respect for a man who always remained consistent and steadfast in his defence of them.

He is an important part of our working-class history, and we should commemorate him here. I shudder to think what he would have had to say about the Tory Government’s egregious attacks on the rights of workers to defend themselves from exploitation, which are going on today. I imagine, however, that he would have said, “Stand firm and fight.”

He was a man who not only stood for what he believed in but advocated passionately for those who were worse off than him, and he committed his entire life to giving voice to the voiceless and resisting the vested interests of the people at the top. I can think of few figures more fitting for a memorial in this Parliament, which he did so much to build, creating a sustainable foundation for Scotland.

McGahey, and people who knew him, always knew that there was never going to be a simple day on which victory occurred and progress took hold. He understood that it would be a process of struggle and conflict that led to brighter days ahead for his class. Part of that was about securing the right of the Scottish people to have devolved powers in a Parliament of their own. It was to be a working-class Parliament.

We owe his generation a great deal for holding fast in that pursuit and for holding that reality. I very much doubt that he would be a great fan of the self-congratulation and endless delay that goes on in the Parliament now, but he would be proud, nonetheless, that voices and opinions of a varied and experienced mixture of society flourish in this building. That is part of the legacy of what he fought for and championed as democracy, particularly a democracy that reflected the unique views of working-class people in Scotland.

I thank Richard Leonard for bringing the debate to the chamber and members for their participation. I hope that we see the likes of Mick McGahey again.

Previous research into community hospitals in Scotland found that,

“Despite the range of primary and specialist care services offered at the community hospitals, staff and management in both settings felt that the potential for local provision had not yet been fully realised.”

What specific work is the Scottish Government undertaking to ensure that our highly valuable community hospitals realise their full potential in delivering for local people?

I have a personal interest in this important topic, having many years ago trained as a dietician and met many mothers and babies over the years. It is also an area that Labour members before me have championed, and I cannot speak about breastfeeding in the Scottish Parliament without mentioning the world-leading legislation that was introduced to the Parliament by my friend Elaine Smith. The Breastfeeding etc (Scotland) Act 2005 makes it illegal to stop a mother feeding her baby under the age of two by breastfeeding or bottle feeding in premises where the public have general access. I am absolutely sure that that legislation has contributed to the improved rates of breastfeeding that are mentioned in the Government motion.

I start in agreement with the Government—I emphasise that Scottish Labour fully supports its initiatives to improve breastfeeding rates in Scotland, and I agree that closing the inequalities gap is paramount. Breastfeeding plays a big part in improving health over an entire life. I will take the intervention from Rachael Hamilton.

Thank you very much for that intervention. It is a very good point—time passes and we perhaps forget some of the legislation that has been passed when we could be making sure that people in our communities are aware of it. Funnily enough, I was at a women’s group earlier today over lunchtime, and I spoke about the 2005 act and how we make legislation work for people in their communities, so that intervention is relevant to me today.

To go back to speaking in general terms, children get one chance at childhood, and it is incumbent on us all, whether we are family members, members of the public or politicians, to do what we can to get it right for every child. From when a child is born, we should ensure that they have the chance to flourish and improve their health and wellbeing over their entire life—I think that all members agree that we should encourage that. At that wonderful moment, we also have the chance to improve the life of the mother. The long-term health benefits of breastfeeding are well documented. It is an amazing opportunity, and the Government must ensure that its approach to breastfeeding champions that fact.

It is clear that improving breastfeeding rates in Scotland would help to improve the health of babies and mothers and reduce inequalities in health, which is why this is such an important debate. Because there is such strong evidence that breastfeeding benefits both mother and baby, there is great value in the Government committing to invest in policies that support and promote it.

Public Health Scotland is clear that breastfeeding provides the best nutrition for babies and young children and supports children’s health in the short and long term. We have heard that breastfeeding reduces children’s risk of gut, chest and ear infection and leads to small but significant improvement in brain development. Breastfeeding benefits mothers’ health, with strong evidence that it reduces the risk of breast and ovarian cancer and some evidence that it may also promote maternal health and healthy weight and reduce the risk of type 2 diabetes.

The benefits of breastfeeding for both baby and mother are recognised across the world, and it is important to note that that includes high-income countries such as Scotland. At times, that can be questioned. It is perhaps easier to understand the benefits in less developed countries, but western society can overlook the fact that there are clear benefits. UNICEF UK is absolutely clear that increasing the number of babies who are breastfed could cut the incidence of common childhood illnesses, which would not only benefit that individual but could, it estimates, save the NHS across the UK up to £50 million each year. It is interesting that breastfeeding rates in comparable western countries, with similar population sizes and demographics, show that it is possible to dramatically increase rates with political will and a supportive breastfeeding culture. That means that continued investment and commitment from the Government is entirely sensible.

Comparing results can be difficult as many nations across Europe gather details in slightly different ways, but analysing the approach that is taken in countries with positive changes in rates helps to establish what can be done to introduce breastfeeding friendly initiatives. Over the past decade, UNICEF UK has complimented Scotland on its work in this area, highlighting marked improvements in breastfeeding rates, and particularly the rise in breastfeeding at six months—one of the studies that I looked at showed a rise from 32 per cent in 2010 to 43 per cent in 2017. Those results highlight the positive impact of national infant feeding strategies across Scotland, including supporting maternity and community services in Scotland to achieve baby-friendly accreditation—I will come back to that later in my remarks.

The latest figures show that two out of three—66 per cent—of babies born in Scotland in 2022-23 were breastfed for at least some time after birth, while 37 per cent were being breastfed at 10 to 14 days. However, it is thought that the increase in that figure was mainly due to mixed breast and formula feeding.

Although all improvements are welcome, we need to acknowledge that progress is slow and merits strong scrutiny from the Government to ensure that it is committed to on-going improvement. We also need to make sure that the data is easily accessible and user friendly. It is not easy to find like-for-like figures, but such information would be helpful when we are trying to support such initiatives and work constructively with the Government on the issue.

Current guidance recommends that babies should receive just breast milk for the first six months—we have heard that sometimes we are not very good at achieving that—and that solid foods should be introduced after that but that children should continue to be breastfed up until their second birthday or for as long as the mother and baby wish. In Scotland, we have some of the lowest breastfeeding rates in the world and we know that many women are stopping breastfeeding before they want to. We have a responsibility to make sure that that does not happen. As legislators, we must ensure that women have a real choice to breastfeed should they wish to do so.

As I have mentioned before, there is good evidence that interventions can work to improve breastfeeding rates. That is why Scottish Labour lodged its amendment today: to highlight the need to ensure that women have all the levers in place to support breastfeeding. Health visitor services are key to that. We are hopeful that the Government will see the amendment in the way in which it is intended: to nudge it to make commitments to support vital health visitor services across Scotland. Scottish Labour is concerned by reports that health visits for mothers and babies are being reduced due to staffing pressures. The amendment calls on the Scottish Government to guarantee that families are able to fully access the service.

I spoke to several women in preparation for today’s debate and every single woman mentioned to me that there was strong support in the hospital but an absence of support once they got home. If we want to support women to breastfeed—particularly to exclusively breastfeed—we need to have longer-term support, which is something that health visiting guarantees. I acknowledge that a more comprehensive approach is needed, as mentioned by the minister and Tess White. If we do not accept that, in reality, there are funding restraints and that sectors such as the NHS and the third sector are being stripped of funds, we are not doing the debate justice. To make such initiatives work, we need to have in place good training and provision for our health service workers and longer-term funding for the third sector.

I am conscious of time, so I will close by reiterating Scottish Labour’s support for a real choice for mothers to breastfeed. We support the legislation that is in place in Scotland and the schemes that are aimed at ensuring that breastfeeding is embedded in our communities and businesses across Scotland. We hope that the Scottish Government will address the issues that are raised in today’s debate to make breastfeeding a reality for all the mothers and babies who wish to breastfeed and would benefit greatly from it.

I move amendment S6M-11935.1, to insert at end:

“; is concerned by reports that health visits for mothers and babies are being reduced due to staffing pressures, and calls on the Scottish Government to guarantee that every family is able to fully access the Universal Health Visiting Pathway, which consists of 11 home visits to all families, including eight within the first year of life and three Child Health Reviews between 13 months and four to five years.”

I agree with the Government and with all the other parties across the chamber by emphasising that Scottish Labour fully supports initiatives to improve breastfeeding rates. I wish that I could mention every member who has spoken, but I do not write quickly enough to have noted them—or perhaps I cannot read my writing.

I thank everyone who has contributed to this important debate, which has been excellent, with members having the opportunity both to speak and to welcome interventions. The contributions have been varied, which is beneficial when debating such issues.

I thank the minister for her contribution and her acknowledgement that Scotland should and must do better. It is helpful if we acknowledge that we really want to improve and that we challenge ourselves to change the breastfeeding rates in Scotland.

I also thank the minister and other members for congratulating mothers, families and communities on the contribution that they have made to the change in breastfeeding rates and to the change in cultural norms around breastfeeding. Many members have spoken about the change that we have made in our communities in terms of supporting mothers to feel comfortable breastfeeding. We have so much more to achieve, as everyone acknowledges. As I have said, that is an important point.

It is clear that improving breastfeeding rates in Scotland would help to improve the health of babies and mothers, and to reduce health inequalities. Many members have spoken about that. Therefore, today’s debate is significant in the context of health inequalities. We must continue to make progress on breastfeeding, and we must have a relentless focus on tackling inequalities, as members of all parties have mentioned. Indeed, Scottish Labour is strongly of the view that closing the gap in inequalities in this area is paramount, as breastfeeding plays a big part in improving health over an entire life, and every child deserves that opportunity.

Emma Harper mentioned targeted interventions. I agree with that. If we are to ensure that that happens, we need the Scottish Government to have a laser-sharp focus on how we fund, promote and encourage practice and policy.

I thank Rachael Hamilton for reminding us, in her intervention, that legislation is only as good as its implementation and how our communities find that it works for them. It is impossible not to thank her for the personal nature of her speech—the Presiding Officer referred to it as a “tutorial”. Helpfully, that led us to explore why women who tell us that they would like to breastfeed sometimes give up. That is an important point for us to bear in mind when thinking about what we are doing here in the Scottish Parliament: we are trying to set the scene to allow people to have a choice. Many members have mentioned the need for people to have a choice.

Alex Cole-Hamilton’s experience perhaps did not quite paint the same picture as Rachael Hamilton’s, but it was important, as it highlighted the role of fathers and other family members.

I take the opportunity to add that the points on perinatal health are very important. I did not pick that up in my opening speech, but I hope that the minister will make a few comments on the topic in her closing remarks.

Stephanie Callaghan made a personal contribution in which she spoke about the joy of supporting others to meet their goal of breastfeeding. I have met and spoken with many peer supporters. Many members have spoken about the peer support model and the need to ensure that it is funded and gets the support that enables it to continue. It will be essential that we see the data on the review that the minister mentioned.

Karen Adam is still standing after having six children. It was lovely hearing her pay tribute to all parents, whatever they choose to do. Many members mentioned that point. Claire Baker put it very well in her remarks when she spoke about every journey being different. Our job is not to place the onus on women; rather, it is to provide a supportive environment. I think that everyone who has spoken in the debate has made the point that it is for us as legislators to get the environment right to provide that choice.

The minister made extremely important points about marketing practices. Although I did not have time to raise the topic in my opening speech, it would be useful to hear more about how we ensure that there are tight marketing controls.

The minister and others noted the worrying cost of formula milk, which is causing distress to mothers. I know that my colleague Monica Lennon has raised that topic in questions to the Scottish Government. Claire Baker made a very important reference to affordability and the need for a consistent approach in ensuring that best start allowances meet the needs of families who choose to feed formula to their babies.

Tess White raised the important role of midwives and the pressure that they are currently under. It is important to promote the profession as a good career option, but also to retain the staff who are currently in the system, as their great expertise and knowledge are so important. We know that that is a problem, and Scottish Labour will support Tess White’s amendment at decision time.

On similar lines, I hope that the Government will support the Scottish Labour amendment, which recognises the pressures on the health visitor service. Michael Marra, who has been approached on the issue, illustrated how stretched health visiting services are in his area, but we know that that is not the case only in the Angus area. As he said, we do not want a postcode lottery, and we do not want that situation to become the norm. Having guaranteed health visitors is so important for this issue and many more.

Having spoken to women who have been committed to breastfeeding, I know that it is the vital support at home that really makes the difference. Every single one of the women I spoke to in preparation for this debate mentioned that there was support in the hospital but an absence of it once they were at home. That is an important issue. If we want to support women to breastfeed, and certainly to exclusively breastfeed, we need to provide long-term support in the home, and health visitors are vital to that.

Scottish Labour will support the Government motion. I hope that the debate encourages us all to work together to further improve the rates among all mothers and babies who wish to breastfeed.

Given the importance that the First Minister places on the issue, I ask him to acknowledge that access to in-person sexual health services is often limited, particularly, as was mentioned, in rural areas. Even in more urban areas, clinic times can be limited to one session per week, and NHS Inform indicates that workforce pressures are causing operational hours to be changeable. Given all of that, what additional investment has been made in sexual health services to ensure that face-to-face appointments can be provided appropriately when requested?

This issue is perhaps the one that I hear most about from constituents across South Scotland, and that is why it is essential that it is given fair hearing here today. Whether people live in rural or urban areas, are young or old, have a long-term condition or are seeking new advice, worries about NHS waiting times are a constant. It is described to me as not just waiting but languishing on NHS waiting lists. That is not my description but that of patients and constituents in all our communities. I expect that every one of us here has or knows someone who is waiting and experiencing that.

Put simply, our constituents want to know what can be done to stop our NHS being put under such constant pressure. Although they are sympathetic to the fact that waiting times are a reality of any health service, some of the extended waits that people are having to put up with are simply unheard of. There are 7,000 Scots waiting for more than two years. I was not going to bring this up, but in the cabinet secretary’s contribution he kept referring to other nations. In Scotland there are 7,000 people waiting for more than two years, and in England there are 227. It is not helpful to continue to go over those figures. People want to know what is happening.

In Scotland, it is at the point where it has become commonly accepted that there are certain operations and treatments that people might have to wait years for. In some cases, that wait can shorten lives and cause unmanageable stress.

Is that really what we came to this place to do? As lawmakers and elected representatives of our communities, we have to understand that the people who are telling us this are not just statistics moving from one column to another; they are real people with complex lives who are in constant limbo because they simply do not know when they will receive the treatment that they require.

As we have heard, under the SNP Government, 80,000 people and their loved ones are living with anxiety and, in many cases, pain for more than a year while waiting for planned care, because the Government is not getting it right. Those people view commitments that the Government has made as a personal promise, and time and again, they are seeing that those commitments amount to just words. That is not acceptable, and I implore those who have the power to change the trajectory not to say, “Look over there—it’s someone else’s fault,” or, “We’re not as bad as someone else.” That does not do justice to our constituents.

The Government should look at the NHS’s long-term investment and infrastructure needs in Scotland, be honest about delays on national treatment centres and reset the programme clearly. The cabinet secretary mentioned only a couple of the national treatment centres and did not speak about some of the other projected centres. We need to ensure that our workforce is secure and that we move away from the damaging and expensive reliance on agency workforce. That has been a thing under the SNP Government, and it needs to address the issue. Our job is to hold the Government to account, and I ask it to address that.

I have sympathy for any Government that has to put up with the constant undercutting of public services that is led by the Conservative Government in Westminster, but our job in this place is to deal with what we can do, and the Scottish Government can do things. Therefore, on behalf of my constituents, I say: let us be clear about what can be done. The Government has been in power for 17 years and should deliver its promises on staffing and national treatment centres. The staffing crisis is making commitments such as the one on the national treatment centres impossible to deliver.

We must do what we can. I make a genuine request to the cabinet secretary to feed back appropriately on the issue, so that we can feed that back to our communities and our constituents. Cabinet secretary, let us push forward into the new year with a serious plan and not even more empty promises.

I thank Brian Whittle for bringing the debate to the chamber as members’ business. I always seek to offer recognition to workers and staff, so I join Brian and others in doing so.

The justice service is under enormous pressure, with increasing numbers of prisoners in the estate. Many prisons in Scotland are in a poor state, and much of our prison estate is extremely old, so it is nice, today, to be able to look at important examples of good practice that might help prisoners and their wider families.

I pay tribute to prison officers and staff in the prison service—the profession is often overlooked. Prison officers have a complex job, which their pay does not reflect, and yet, across the prison estate, we see them working with others to secure a positive future for the prisoners they support.

When researching for the debate, I found a comment that was made by Wendy Sinclair-Gieben, who is HM chief inspector of prisons for Scotland. She said:

“If we bring people into prison and do nothing with them, we will release them back into society angrier than they were when they came in. That is not appropriate. As a person in the community, I would like to think that the Prison Service is working with those people to reduce the risk when they leave.”—[Official Report, Criminal Justice Committee, 9 November 2022; c 1.]

That statement, which was made during a pre-budget scrutiny meeting, stood out to me as someone who is not an expert in this area. We know that many in our prison population are there due to complex social issues, as has been mentioned by other members. Perhaps people are reoffending or are at risk of reoffending because, on the whole, we do not support them in the way that we should.

There is strong evidence that prison, when used as a vehicle to care, support and rehabilitate, helps to return individuals into the community with a purpose for their future, which is helpful for them and their families and communities.

In doing a little bit of research, I found an approach in which there are seven pathways for helping prisoners not to reoffend. The pathways are helping them with accommodation; helping them with their attitudes, thinking and behaviour; helping them with their relationships with their children and families; helping them to deal with things that are important issues in society currently, such as drugs and alcohol; assisting them in entering education—Brian Whittle mentioned art—training and employment; looking at finance, benefits and debt, and helping them with those aspects as they transition back into the community; and, very importantly, helping them with their health. In my reading of the good work that is going on at HMP Kilmarnock, the organisations that are mentioned in the motion and the prison staff are seeking to cover all those pathways.

However, overall, the reality is that, although we have progressive policy in Scotland, we tend to have a punitive culture, and, to some degree, the attitude that can come across is, “We’ve always done it that way.” Sometimes, there is cultural reluctance to change, and all of us can be guilty of that. When we are changing such large organisations, doing so can be difficult.

The prison and justice services have been firefighting for some time—I think that even the Government recognises that. There is a backlog in the courts, and there has been overcrowding in the prisons, never mind the impact of the pandemic.

I do not have much time left, so I will mention the collaborative rehabilitative approach that is taking place at HMP Kilmarnock. We would all wish to support that and the work of the visitor centre, which liaises with local groups to ensure that prisoners, when they return to their communities, have the opportunity to make that work. Like Brian Whittle and others, I hope not only that that approach continues at Kilmarnock in the years ahead, but that it can be seen as the way forward and one that we can replicate more widely across the prison estate.