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I have learned a lot from the discussions, but there is something else that I have been wondering about. In lots of our evidence, particularly the written evidence, there has been discussion about support for patients and staff in this process. Can you say a few words about whether it would be helpful for psychological support, perhaps, to be available to staff and patients involved in the process? Do you think that, before going through the process, patients should have some specific support?

Do you have a view on patients receiving counselling? In your last response, you talked about others assessing what people need in response to the position in which they find themselves.

That is very helpful. Thank you.

I am so pleased that Government time has been given to debating women’s health today. We will support the Government’s motion tonight.

If we have learned anything from the women’s health plan, it is that every target in the next women’s health plan must have attached to it a clear action plan and a pathway to deliver it. Otherwise, it will just be more words to women in our communities. When our population desperately needs action, it is incumbent on us to ensure that we have a delivery plan. I am very pleased that the Government will support our amendment at decision time.

Since the introduction of the women’s health plan, it has always been my intention—and, indeed, the intention of the Scottish Labour Party—to scrutinise it fairly, with the genuine hope that it would be a success and that access to and quality of women’s health services would improve across the country.

As the minister indicated, securing a women’s health champion was a significant step forward, supported by Scottish Labour, in achieving some form of progress for women. I welcome Professor Glasier’s account of what the plan has achieved so far and what she hopes it will achieve in the future. Nonetheless, she and others continue to identify where there are problems and where we must strive to do better.

What we all agree is that women’s health must continue to be a priority if we are to have any hope of getting on top of the backlog of pain and misdiagnosis that so many women continue to suffer.

We will all have had meetings or phone calls with women who are unable to access diagnosis and treatment. As other members have said, we must mention those with endometriosis, in particular. I am sure that other members will cover it in their speeches today, but I note that women have suffered over many years, as there has been an absolute void in service for that condition. I welcome the changes, but there is much more to be addressed in the coming years.

We are all pleased with the achievements in women’s healthcare during this session of Parliament in areas such as the introduction of buffer zones to ensure that women can access healthcare free of intimidation and with the roll-out of the human papillomavirus vaccine as part of our fight to eradicate cervical cancer. I have been desperately pleased to see the progress in those areas.

I also want to mention, as the minister brought it up, the online women’s health platform, through which factual information is now available to young girls and women in Scotland. As we go through our life cycle, we can go back to that at the points when we need it. Professor Glasier spoke to us about that at one of the cross-party meetings that the minister pulled together.

However, it is undoubtedly the case that, in other areas, progress has been far too slow and that health inequalities have deepened and are very real for many people in our most deprived communities. All members have a responsibility to acknowledge that and to scrutinise the Government to ensure that the dial can finally be moved on the issue. We cannot have a debate such as this without understanding that life expectancy in our most deprived communities is falling and is far lower than it is in our most affluent areas. Of course, we are all more aware of the issues around unhealthy life expectancy.

Yes, of course.

I return to my point about unhealthy life expectancy. Not only do our poorest neighbours die younger, they live life in a much poorer state of health for longer. That plays out for women in many ways. They live in poor health, and they care for others in poor health. It is often the case that a heavy weight is placed on the women in our population.

As is the case for other areas that impact directly on women, the issue of rural maternity services has been debated in the chamber many times. However, that has been in members’ time rather than in Government time. The Government’s inadequate response to that cannot be overstated. The health of pregnant women in rural areas is in particular peril, because they are often transported multiple miles at various stages of pregnancy or labour. That must be a women’s health priority in Scotland. Despite the genuine concerns of patients and staff throughout the country in communities such as Wishaw, the Scottish Government has continued with its policy of downgrading key neonatal units at the heart of our most deprived communities. The impact of that on women should be a concern for us all.

In waiting times for cancer treatment, hysterectomies and reproductive healthcare, women in Scotland are waiting far too long to receive the support that they need. We often hear of the lack of training opportunities for staff, which limits development in our services.

Inequality is most pronounced when it comes to cancer screening. As we know, women from the most deprived areas are less likely to attend breast screening—about 20 per cent less likely. The rates of women who are up to date with their cervical cancer screening continue to fall. I am sure that I do not need to remind the Government of the importance of improving those statistics. Many lives will be lost if we do not get on top of that. Again, we cannot debate the issue without some reference to the significant lower uptake of screening by women from more deprived areas.

Although I do not want to dwell too much on this, I cannot contribute to the debate without mentioning the impact of strong cross-departmental working on women’s health services and outcomes. It is absolutely imperative that the Government does better on that. I have raised the issue before in the chamber. All Government departments must see women’s health inequalities as a priority, but there is no clear evidence that that is currently happening—or certainly not in the way that it should.

In many ways, no matter how many iterations of the women’s health plan are brought before Parliament, I argue that a lack of Government willingness to acknowledge its own responsibility plays a big part in the on-going suffering of many women across Scotland. I am glad to hear the minister acknowledge that responsibility here today; that is very welcome.

The lack of urgency from the Government compounds that and it is not unfair to say that the Scottish Government appears to believe that publishing a policy paper completes a task and that it places very little importance on the delivery or outcomes of its plans. We must address that significant issue together. Without serious reform and a change of direction—which we have heard that the First Minister is not committed to—delivery in this policy area will remain largely untouched, and if we debate this again in another three years, we will find the same challenges still being faced by women up and down the country.

Therefore, although the Government will concentrate on the areas where it considers that progress has been made—as we saw in the opening speech—I urge serious caution. The Government is supporting our amendment, which we welcome, and should use that to show that it can be serious about setting out a route to delivery.

I say that because, as all parties will say today, health inequalities still have a stubbornly high impact on women. When it first published its plan, the Scottish Government referred to a British Heart Foundation report that said:

“in Scotland there are inequalities at every stage of a woman’s medical journey”.

As we review the plan and look towards its next iteration, we must ask ourselves whether that has really changed.

The next women’s health plan must set out not only targets but the action plans that will achieve those targets. I look forward to playing my part in making that happen and I know that my party is committed to doing that so that we can change the health outcomes, and the health inequalities, that are seen by women in Scotland today.

I move amendment S6M-15382.2, to insert at end:

“; is concerned by the slow progress in addressing stubbornly high health inequalities experienced by women, and calls on the Scottish Government to ensure that the next plan sets out concisely when and how each of its actions will be fully implemented across Scotland.”

Thank you. I think that some other colleagues have questions around safeguarding, so I will go back to the convener.

I thank our guests for agreeing to speak to us. Much of what I am going to ask about might have been covered but, in the interests of clarity, I will ask my question, which is about the recorded numbers. We know that the Government has to report on anyone who has accessed MAID. Could you give us a sense of where you think the numbers are in terms of what was anticipated prior to the legislation? We see that there was a rise between 2019 and 2022. Have you considered what might have caused that rise? Can you give us some sense of the situation in Canada in terms of the actual numbers? I ask Dr Green to respond first.

Dr Coelho, would you like to respond?

The cabinet secretary will know from public health figures that the gap between our most and least deprived communities remains stubbornly high. Women between the ages of 50 and 70 from our most deprived communities are less likely to attend their routine breast screening appointments and have a 64.2 per cent screening rate, compared to 82.8 per cent in the most affluent communities. Given that I have raised screening inequalities in the chamber on a number of occasions, and given the Government’s commitment to reducing inequalities in cancer screening, will the cabinet secretary agree to bring to the chamber a debate in which he can update us on the status of the equity in screening strategy and allow scrutiny of the Government’s commitment to targeted work in that area?

Professor White, you spoke about training. Are parts of the training about picking up on those elements?