Seòmar agus comataidhean

With reference to my colleague Claire Baker’s amendment 94, I feel that it is important to raise the serious concerns that many parents have raised with me, and which young people have, regarding this section of the bill. That is especially the case considering how poor the current support for young people is in this country, despite the fact that they are perhaps the group in greatest need of support. It is essential that young people can access the same level of psychological and social support as any person before making such a decision, and I do not see that that support is available at all.

In amendment 94, my colleague quite rightly asks for a pause to this section of the bill. As she has highlighted clearly and very well, that would not prevent 16 or 17-year-olds from socially transitioning. I cannot think of many pieces of transformative legislation that would be passed before something as important as the Cass review had published its conclusions. Although the review is not focused specifically on NHS Scotland, it clearly has great relevance to Scotland, and we should have the opportunity to consider its findings before we change the age.

That answer is disappointing, but I cannot say that I am surprised by the news that the appointment will not be made before Christmas. In June, the First Minister promised that the appointment would be made during the summer; in September, the Minister for Public Health, Women’s Health and Sport told me that the announcement would be made very soon; and, in October, the Cabinet Secretary for Health and Social Care advised that the appointment was imminent.

Given that health inequalities disproportionately impact on women from deprived areas, that women’s health matters are not being considered and treated with respect in the workplace, and that diagnosis rates for cancers that specifically impact on women remain stubbornly high, we need a women’s health champion—we have needed a women’s health champion—timeously. The First Minister knows that the delay is unacceptable. Will she commit to personally ensuring that the appointment is one of her first actions in 2023?

Absolutely. I knew that the member would have visited the Usual Place, which is an experience that all members should have. It has a very high success rate and it should be supported.

The value of Unison’s initiative is clear and it shows the power of a union to raise such important issues up and down the country. I thank Unison and other unions for their support and work to preserve and protect disabled workers. I join Pam Duncan-Glancy in asking disabled workers to join a union. Finally, I repeat my thanks to Pam Duncan-Glancy for allowing us to debate the issue and keep fighting.

To ask the First Minister, further to her commitment in June that a women’s health champion for Scotland would be appointed in the summer, whether such an appointment will be made before Christmas. (S6F-01648)

I, too, thank my colleague Pam Duncan-Glancy for bringing this important debate to the chamber. I know that she has worked tirelessly throughout her career on this cause, and that she will continue to fight for disabled workers and alongside the trade unions that represent them. If there is one thing that I know about working in this place, it is that Pam Duncan-Glancy has plenty of fight.

Unison’s year of disabled workers is a year-long campaign across the UK to improve the working lives of disabled people. As we have heard, the campaign was developed in Scotland following a motion from a Scottish branch, which was then rolled out as a national campaign and supported by the wider trade union movement. That is a real achievement by the Scottish branch. I congratulate Unison on its initiative and on its work throughout the year. Its work to find ways to support and celebrate the diversity of workers in the workplace shows unions at their best.

Before moving on, I must mention the scale of the problem, which my colleague Paul O’Kane spoke about. Unison has provided us with a briefing on the detail, and it is important to know the detail to understand the changes that we need to make. The situation is clear: in Scotland today, disabled people are less likely to be in employment, education or training; they are more likely to have low or no qualifications at Scottish credit and qualifications framework level 4; they are less likely to have a degree or equivalent qualification; they are more likely to be in part-time employment; they are more likely to face additional barriers; they are less likely to work in higher managerial positions; and they are less likely to work in professional occupations. I do not think that any of us is shocked by that, but we should be, because it is absolutely unacceptable.

In my life before coming to the Parliament, I was lucky enough to have a job that allowed me to support and work with many disabled people, the bulk of which was working with adults with learning disability. That group of people inspired me, motivated me and taught me a lot about life, and I am ever grateful for the time that I spent working in that area. I mention that because, looking back, it strikes me just how few of the people who I supported had paid work. That is a sad and unnecessary situation, when I consider how capable, reliable and keen to work those people were.

I am saddened that the employment rate for people with learning disability across the UK has fallen to a low of just 4.8 per cent. It is shocking that only 4.8 per cent of a group of people who are motivated, reliable and want to work are in employment. People with disability have the right to work and it is incumbent on the Government to ensure that the world of work is a welcoming and suitably adjusted environment. The Equality Act 2010 offers a range of protections to disabled people, but workplace discrimination still affects many people across the UK. We must all do more.

I recently visited an impressive social enterprise in my region called the Usual Place. When I clicked on its website, a message said:

“Did you know ... we are a Disability Confident Leader with 70% of our staff force having a disability”.

That is a claim to be proud of. I invite everyone to visit the Usual Place, which provides a cafe, shop and conference facilities that are truly excellent. I recommend a visit. It is in a beautiful setting and has excellent staff and tasty food. The preparations there are about providing real experiences for people.

Emma Harper (South Scotland (SNP) rose—

I will take an intervention from Emma Harper.

The cabinet secretary will know that I agree that austerity has been the key driver of inequality. I have been positive about what has happened with the Scottish child payment, but a lot of organisations say that we need to go further. Does he agree that we should be going further at this stage?

I thank all my colleagues on the Health, Social Care and Sport Committee for the work that they put into the report, and I thank all those who gave evidence to the committee on the reality of health inequalities in our communities.

I am pleased to open the debate on behalf of Scottish Labour. My party and I fully support the recommendations of the report; indeed, I would go further and say that it is essential. We recognise that the issue of health inequalities is one of the most significant political issues that we can address in the Parliament. To allow health inequalities in Scotland to have such a detrimental impact is to prevent our country from growing, progressing and improving. Health inequalities hold back people and communities and, if the Parliament fails to recognise the scale of the challenge, they will hold back a nation.

Before I move on, I must speak about the scale of the problem that we face. In Scotland, women from more affluent areas are more likely to attend screening appointments than women in our most deprived areas. Suicide rates and cancer rates are higher in our most deprived areas than they are in our most affluent areas. As described in a recent report from the University of Glasgow, the gap in life expectancy between the most and least deprived areas has actually worsened. That is shocking and it should worry all of us in the chamber.

That gives a picture of a country whose Governments are letting it down and where the poorest pay the price of neglectful governance. I therefore welcome the recognition in paragraph 354 of the report, which states:

“The Committee considers that policy action to date has been insufficient to address health inequalities and therefore concludes that additional action is urgently needed across all levels of Government to resolve this.”

No one can speak about health inequalities without condemning the policy of austerity. It was widely accepted and acknowledged in the evidence that was given to the committee that austerity drives health inequalities and causes undue harm to our most deprived communities. The current attack on the poor by the Tories must be addressed if we are ever to make far-reaching changes to address health inequalities in this country.

Along with other members on the Labour benches, I will continue to fight Tory cuts and attacks on the poor. We will do that not only by attacking the abhorrent record of the Tories in power, but by highlighting the positive impact that a Labour Government could make in this country. However, the reality is that my job in this place is to ensure that the Scottish Government is meeting its responsibility to our citizens, and it is this Government’s responsibility to do all that it can to change the downward trajectory.

There are a lot of things on which the Scottish Government must act. If it fails to do that, it will let down many people who would benefit greatly from serious reform. In Parliament, we regularly hear plenty of warm words from the cabinet secretary and Government ministers, but we do not see enough action to seriously tackle health inequalities.

Having said that, I am confident that, with the right approach and good will, we can take into account the testimony of the experts who came to the committee. We heard from them about important matters such as access to safe and secure housing; whether we are efficiently using our housing stock; embedding community link workers in all our GP surgeries; maximising welfare; and eliminating barriers to employment. Those are just a few of the issues on which there are very necessary recommendations in the committee’s report—which, despite being far from exhaustive, is a positive step in the right direction.

The Scottish Government can and must do more. It is undeniable that we are facing economic challenges due to national and international pressures, but now is the time to stand up rather than hide behind excuses. It is perfectly clear—we received a detailed plan on the issue from the Scottish Trades Union Congress this week—that there are significant levers that the Scottish Government can use to increase pay, especially in the public sector. That is the most obvious and impactful contribution that we could make to improve economic outcomes and, with that, reduce health inequalities.

Roz Foyer, the general secretary of the STUC said:

“This isn’t a question of ability, it’s a question of ambition and political will. I’m fed up listening to the Scottish Government playing the Westminster blame game. Simply being better than the UK Government isn’t good enough.”

Roz Foyer is right. That is not good enough; that is a low bar with which to make a comparison. We in Scotland can do better.

I remind Parliament that the solution to health inequalities lies largely in widening opportunities and increasing the provision of services so that they reach every community in the land regardless of wealth or whether someone benefits from a postcode lottery.

We all accept that inequalities are complex and multifaceted, and they cannot be solved with a single policy or initiative. Health inequalities are everybody’s business. I support the committee’s call for cross-party and cross-portfolio engagement on the issue. If that can move us one step closer to eradicating health inequalities, which is what the report intends to achieve, my Labour colleagues and I will work with all parties to deliver that change.

Will the member take an intervention?

Can Craig Hoy touch on how austerity affects communities? There are lots of reports on the issue; a recent one from Glasgow is clear that austerity is driving most of the health inequalities that we have.