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A recent Audit Scotland report on alcohol and drug services recommended that the Scottish Government increase funding to tackle alcohol-related harm by mid-2025. However, the budget indicates that those services received a real-terms funding cut. How does the Scottish Government respond to Alcohol Focus Scotland’s assessment that

“the budget in its current form is ... lacking in the ambition and determination needed to tackle Scotland’s alcohol emergency”?

While you were speaking, the opportunity for people who are in training to go to the islands came to my mind. Do you think that more could be done in that regard so that people see the benefits of the work that is done there, and also the lifestyle, which they might be interested in?

For me, as a member of the Health, Social Care and Sport Committee, our inquiry into remote and rural healthcare painted a sobering picture. Patients who live in such areas face unique challenges in accessing healthcare, so I welcome the debate, which will enable us to have an open and frank discussion about the harsh realities that are experienced by so many Scots who live in those areas.

The oral and written evidence that the committee received only reinforced what we—and, I believe, the Government—already knew: that remote, rural and island communities experience greater inequalities in accessing healthcare when compared with communities in urban and central areas. The fact that someone lives in a remote and rural community should not limit their access to basic and specialist care. Why do cancer patients in remote, rural and island areas receive less specialist care? Why are maternity and gynaecology patients in such areas forced to travel long distances to give birth and attend appointments? Why do communities that have a particularly high elderly population have problems in accessing palliative care and support?

To address those issues and the others that members across the chamber have mentioned, the Government needs to be honest about how bad the situation is for many people in Scotland. The challenges to do with staff recruitment and retention are a major issue across the whole of Scotland, but they are particularly hard felt in rural communities, as we have heard. Even a small number of vacancies can cause huge challenges in running services safely. A lack of suitable training and development opportunities, unattractive pay and conditions, and a lack of access to affordable housing act as significant barriers.

The Government must work with trade unions, local government, professional bodies, training providers and NHS boards to discuss opportunities for creating better training, living and transport flexibility. “Cross-portfolio” does not just mean talking about it—it means actually delivering results across portfolios.

I also urge the Government to consider apprenticeship opportunities—perhaps that is what the cabinet secretary discussed earlier—for healthcare workers across our professions. At a meeting that I held last week, the British Dietetic Association conveyed its willingness to engage with the Government on that and to discuss how greater flexibility could be worked into the system to promote better uptake of apprenticeships in healthcare roles. I wonder whether the cabinet secretary will respond to that in his closing remarks.

Many professionals have raised the issue as a way of recruiting and retaining excellent staff from diverse backgrounds. However, despite what the cabinet secretary said in his opening speech, there seems to be a difference on the ground. Things do not seem to be moving very quickly.

I want to go back to childsmile—I know that it has been mentioned, but I have a question for the minister. I have no doubt that she agrees that we should be doing something about the stark health inequalities in dental health, in particular among children. We know that 60.1 per cent of children who are living in the most deprived areas have no obvious dental decay, in comparison with 83.6 per cent in the least deprived areas. That is a marked difference.

The minister spoke of some good work that is going on. However, I have a frustration with many of the things that we talk about, and in this case with the preventative approach for young children in deprived areas in particular. If good work such as childsmile is going on, why are we unable to target that work and share it across different areas so that we can start to make a difference and ensure that the inequality figure gets smaller?

I want to come back on something that Mr Ferris said. I am familiar with Marmot’s work and with the issue of universalism and targeting. We should not just love to get oral health better but see it as our responsibility to get it better because, until we target the inequalities, there will be difficulties across Scotland. I appreciate how much work has gone into improvement, but we need to see ourselves—I refer to MSPs and the people who are in charge of the relevant section—as having a responsibility to take a targeted approach.

You touched on the cross-portfolio stuff, minister. That is really important if we are to get over the line in tackling health inequalities. Thank you very much for your time.

To ask the Scottish Government what its response is to the reported review of more than 1,000 CT scans, in light of concerns regarding the quality of assessments made by a consultant radiologist. (S6T-02241)

I welcome the immediate action that was taken. However, I seek further clarity on how the discrepancies were allowed to happen, which health boards have been affected and when the affected patients can expect to be notified.

That is very helpful. I am sure that the cabinet secretary recognises that such errors impact on public trust and confidence in the Scottish national radiology reporting service, which is relatively new, having launched in 2020, and the situation has arisen during a time when we seem to have regular scandals in the NHS. How will the Government ensure that lessons are learned and that similar errors do not occur in the future?

I thank Kenny Gibson for bringing this topic to the chamber.

I applaud the fine work of the Communication Workers Union—the CWU—on the matter, as it continues to boldly stand up for its members against the Post Office’s decisions, which are causing, as we have heard tonight, serious stress and concern for many families just before Christmas, while they are working hard to keep postal services moving. To add to Liam McArthur’s point, I note that they are busy throughout the year.

As we have heard, the decision to close the remaining 115 Crown post office branches across the UK was taken without prior consultation of trade unions, and the CWU informs us that it has not even been given sight of the strategic review document that led to the decision. That is unacceptable.

Furthermore, the decision was deliberately leaked, as we have heard, in order to get ahead of any press or official scrutiny. Post office workers were waking up and reading about the potential end of their jobs in a newspaper or watching it on television. I reiterate that that is simply unacceptable.

Ten of the Crown post offices are in Scotland, where the sector is already heavily depleted, which has left many communities without direct access to a post office. The branches, which are often the larger ones, are a lifeline for many people. However, more local post offices have been closed than most can put up with, and most sometimes struggle to find a place to do business or sort out personal affairs.

Crown post offices provide many services that are not easily accessible and available elsewhere. That is a valuable thing during a time when the high street is being cut to the bone. The decision to close branches is needless and exacerbates existing problems.

Why is it that we have spent the past decade or more stripping out post offices, thereby losing their utility and incredible community links? Has that made the country better off? Have we heard that the decisions to do that have led to greater modernisation and more stable employment? No, that is not what we have heard. It has led to an enormous amount of legal fees and to consultants raking it in, while ordinary working people suffer—as is often the case.

The current decision would decimate the post office network across the UK and will lead to 1,000 jobs being lost, including many in Scotland.

Every week, I, too, speak to constituents who are desperate for a service like the one that the post office used to provide. Not only was the post office an important utility for business and families, but it provided a community hub with staff who would take the time to offer genuine help.

I fear that we are approaching the days when post offices will be quite rare. I have no doubt that workers and the trade unions will be standing against the decision, and I will, of course, be supporting them and their rights. This is no way to treat the people who have shouldered the burden of pressure that has been placed on post office workers for many years. The review must be reconsidered, and I will support the CWU in its work alongside the workforce.

I again thank Kenny Gibson for bringing the matter to the chamber.

I thank my party colleague Paul Sweeney for bringing this important debate to the chamber and everyone at Marie Curie and its partners for producing their vital report.

Everyone deserves as pain-free and peaceful a death as possible, surrounded by those who love them, in a place that comforts them and where they can make choices. However, as with so many things across the course of our lives, the process of death is influenced by the poverty and inequality experienced by so many.

That poverty is the root of the injustice that permeates our society and that is sustained by so many from cradle to grave. I simply cannot accept that, which is what has driven me to speak in today’s debate and in others on the subject. We must do more to end the situation in which so many people have so little while a few have so much. With the inequalities surrounding death so prominent in our national debate, there has never been a better time for the report, or for this debate.

At every stage of a person’s life, including death, poverty is an anchor on their ability to live as others do. I have met constituents who spend much of their final years of life worrying about how they can afford to leave their families behind or even about whether they can afford the care required to sustain a moderate quality of life until the end. The truth is that some in our society are worried about avoiding paying tax on second homes that they want to pass on to their children while others are worried about whether they can afford even the cost of a funeral. That is not a just or fair society.

According to the report, 17 per cent of those who died in 2023 in my home area of East Ayrshire did so in poverty, with 23 per cent dying in fuel poverty. Figures vary across my South Scotland region, but are not drastically different, which means that almost one in five people are struggling to heat their home or to put food on their table. Those people are often aware that, sadly, they are soon to pass. Can members imagine the mental and physical strain that that sort of pressure puts on a person and on their family? I think that we can all agree that nothing could be worse.

We have heard today that simple things, such as needing to make adaptations to a house, can be a luxury for people who are unsure if they can even afford to feed their own family. That is simply unacceptable. I will be clear: I believe that we need not have an economy that works only for the rich; rather, we should have one that ensures that everyone in society has the means to live and die in dignity.

We live in one of the richest countries in the world, but, in 2024, many among us experience constant poverty. From the cradle to the grave, that is all that they have known or will ever know. We must all accept that truth, although it is as unacceptable today as it was many decades ago when the welfare state was transformed by serious Government intervention. I believe that we require a similar revolution in practice and in thinking to address the problems that I, and many others in the chamber, have highlighted today. I call on everyone to think of that and I call on the Scottish Government to respond to the points raised by my colleague Paul Sweeney and others. We must look to ensure that we eradicate poverty in this country, which, as I stated, is one of the richest in the world.