Seòmar agus comataidhean

I thank my colleague Paul O’Kane for bringing this important debate to the Parliament. I know that, for months, he has been working tirelessly with carers and carers groups to find out exactly what we need to do to improve their lives and those of their loved ones, and I know that, with them, he will continue to fight to get the measures that they need to support them put in place.

It is important to be clear that we are talking about carers who do not receive employment payments. We are talking about people who step in to look after and support a family member, a loved one or even a close friend. Those carers are not employed. Often, they do not see themselves as having that role or job, or as providing an essential service. However, all members in this Parliament know that that is the case.

Carers Scotland tells us that, every day, almost 1,000 people in Scotland become carers. Most carers would call themselves a loving partner, a parent, a child or a good friend, and would not immediately identify with the caring role. That means that they miss out on practical support, which is important. Research found that 97 per cent of carers took a year or more to identify themselves as carers, and 46 per cent—nearly half—cared for a decade without identifying themselves as carers. Of course, that means that carers are missing out on essential financial and practical support. We must all do what we can to ensure that carers understand that they are entitled to such support.

In my life before I came to the Parliament, I was lucky enough to have a job that allowed me to support and work with many unpaid carers. That was a number of years ago, at a time when that care provided by unpaid carers really was invisible. In my early days of working, I do not recall anyone looking at supporting carers or providing services to a house in which mum, dad or gran was providing care and support. Perhaps there was the occasional day service or weekend respite care. I recall families and extended families who provided high levels of care, as well as social and emotional support, to their loved ones—they did so, as carers do now, without question and absolutely willingly.

I am heartened to hear that such carers are fighting back at a system that has forgotten them. That is quite right; as a society, we need to support and value the role that they undertake. The UK and Scottish Governments must be prepared to offer practical, emotional and financial support to carers in Scotland and throughout the UK.

As members have said, we know that approximately 800,000 unpaid carers in Scotland provide care and support to family or friends who are affected by disability, illness or frailty that is associated with age. Care is deeply gendered: in Scotland, as many as 70 per cent of unpaid carers are women.

The current cost of living crisis is being felt more acutely by carers throughout Scotland. In October, Carers Scotland published “State of Caring 2022”, after running a survey of more than 2,000 carers to ask about the impact on their lives of caring and the cost of living. Carers Scotland found that carers were more likely to be in poverty than non-carers and twice as likely to be in poor health.

It is completely unacceptable to have that knowledge but do nothing. In this Parliament, we have a responsibility to ensure that there is change. We must stand up for unpaid carers.

Carers Scotland tells us:

“Carers need financial help and practical health and care support right now to ensure they can make it through this Winter.”

That is an urgent priority. Such support includes increasing benefits by the inflation rate, providing cost of living support to carers and providing an energy payment to people with severe disabilities, to help households to manage the extra costs of living.

I support those demands from carers organisations and I hope that the cabinet secretary can give us some idea of how we can try to meet demands for essential support for carers and their loved ones.

I join all my parliamentary colleagues in marking this year’s world AIDS day.

In closing for Scottish Labour, I also want to take the opportunity to remember those people at home and abroad who are no longer with us, having lost their lives to this terrible disease. The work that we must continue should always be done with them in mind. I refer to Jamie Greene’s reminder that, behind the statistics, there are always people and their families.

The on-going battle against AIDS is a remarkable success story for co-operation on research and development that has had a positive effect, at least here in Scotland, if not all over the world. I will return to Gillian Martin and Richard Leonard’s points.

The Government motion correctly commends the work of those who have ensured that we have vastly reduced the number of HIV diagnoses across Scotland—I have no doubt that that feat will continue for years to come—but the intended goals cannot stop there.

As my colleague Paul O’Kane said, we will support the Tory amendment, which highlights the need for timely access to sexual health services and the importance of ensuring that treatment and prevention strategies are at the forefront of all our policy making.

A number of colleagues talked about the need to look at rural inequality. The minister nodded vigorously when that point was made, and I am sure that she will address it in her closing remarks. My colleague Gillian Mackay made an important point about the cost aspect for people who live in rural Scotland. She also spoke about the sensitivity of a situation in which a person in a very rural community might be worried about exposure before they are ready for it if they need to access services. Those are important points.

I thank Joe FitzPatrick for offering hope from his constituency in relation to where we might go with our work in this area. It is important that we all seek to talk about examples of success.

Many members spoke about stigma, which is such an important issue. This morning on the radio, I heard someone from Waverley Care speak about the need to reduce stigma. Although it is incumbent on the Scottish Government to do something about stigma, all members have a responsibility to act. Along with Waverley Care, we have called for an anti-stigma campaign, and it is great that the minister has said that the Government will run such a campaign.

Emma Roddick painted a historical picture and Brian Whittle mentioned a number of people who, in my lifetime, stood up and were counted. Given the petrifying advertising that went on in the 1980s, which Dr Gulhane and others mentioned, it is so important that we get the campaign right, and I hope that the minister will mention that again.

Scottish Labour shares the Government’s target of reducing transmission to zero by 2030. As my colleague Paul O’Kane discussed, that is why our amendment calls on the Government

“to outline a clear timescale for eliminating HIV transmission in Scotland by 2030 and commit to providing the Scottish Parliament with an annual progress report.”

I hope that the minister will support our amendment, which is about how we get there and make the biggest difference.

I thank my colleague Claire Baker for talking about the various transmission routes that exist and about other action plans that may need to come together to help us get to where we need to get to.

Given the havoc that HIV wrought for so long, it is incredible to think that we could reach the stage where it is under control and, potentially, is no longer transmitted at all. That was unthinkable not so long ago. I cannot begin to imagine the extent of the work and dedication that went into achieving that, whether that took the form of research or people making us aware of the issue so that we pushed and pushed on the facts.

Gillian Martin and Richard Leonard spoke about other parts of the world, where the reality is stark. Scotland and the wider UK have a responsibility to alleviate the suffering that many experience every day. To do that, we must continue playing a lead role in the fight against AIDS for generations to come, passing on to the rest of the world the hard-won knowledge that we have gathered. That begins with pushing against the damaging rhetoric from some quarters saying that foreign aid funding should be reduced. Foreign aid has vast benefits: millions have been able to survive with HIV and to live a prosperous existence in their communities. We have a role across the globe and must not cut our efforts. We heard from Gillian Martin and Richard Leonard about how people in other countries live.

Innovation and research must remain key. The introduction of PrEP has been remarkably positive, as have the focus on prevention and specialist care and the use of contact tracing have. Together, those form a modern and considered approach to tackling the problem. It is important to mention Alex Cole-Hamilton’s request for the minister to speak about some areas—such as Lothian—where there are very long waits for PrEP and about how those will be tackled.

If we can maintain the current trajectory and ensure accountability, we will be going a long way towards improving the lives of thousands of people at home and many more abroad. That can only be good. We can do this. I hope that all parties can work together to make an essential, global difference to HIV and AIDS.

As dispersal areas for asylum seekers expand to all council areas in Scotland, and given that we know the truly terrible impact that hotel accommodation has had on the mental health of asylum seekers, will the minister—in conjunction, I hope, with the Cabinet Secretary for Social Justice, Housing and Local Government—explore the community sponsorship scheme that is run by Reset UK as a means of assuming greater control over the housing of asylum seekers? The Government could thus support improved mental health and wellbeing, given that we know the link between housing and wellbeing.

I will take us back to an issue that was mentioned previously. I have done a lot of work with the allied health professions, which are very keen to talk about early intervention and prevention. Is that about a change in attitude and approach, or should there be something in the bill that would help that happen?

I, too, thank Clare Adamson for bringing the debate to the chamber and I welcome the people who join us in the gallery. On behalf of Scottish Labour, I mark pancreatic cancer awareness month and world pancreatic cancer day, which took place earlier this month.

Raising awareness of illnesses such as pancreatic cancer is pivotal to ensuring early diagnosis and improving the prognosis. Indeed, I consider it important to highlight in the chamber, as I did last year and as others have done, the key symptoms of pancreatic cancer, including abdominal or back pain or discomfort, unexplained weight loss or a loss of appetite, yellowing of the skin or eyes and/or itchy skin, a change in bowel habits, nausea or vomiting and indigestion that does not respond to treatment. Knowing those symptoms and seeking medical advice, even as a precaution, can be life saving or life prolonging and it is key that we continue to support the public awareness campaigns.

I will mention our NHS. We cannot avoid the fact that, in Scotland, we have an NHS that is not always working for patients and staff. An NHS that was founded to be universal, free at the point of need and accessible is, through no fault of our first-class workforce, now struggling daily to survive. We cannot fill the vacancies. We need to be more honest and talk about the reality for patients, families and staff as we face that.

I do not particularly want to labour the point, but I will talk about the reality of inequality in health in Scotland. In the debate on this topic around this time last year, I warned that the Scottish Government had to do more to tackle the widespread health inequalities that, to this day, remain a stain on our society and adversely impact people from our most deprived areas. The reality is that the Government does not show enough urgency in dealing with the problem.

Research released this week by Cancer Research UK highlighted that people who live in deprived areas in Scotland are more likely to get cancer and, tragically, more likely to die. It highlighted that cancer death rates are a devastating 74 per cent higher in the most deprived populations than they are in the least deprived populations. The research also confirms that there are lower one-year and five-year survival rates among the most deprived groups. That is the reality for people in Scotland’s poorest communities. We should all be shocked by it.

It is right that we have such members’ business debates and that we do them in a consensual manner, but I urge the minister to commit in her closing speech to come to the chamber during Government time to set out a clear plan for what has already become a crisis in health inequalities in Scotland. We must take action to address the health inequalities linked to cancer that our country faces.

The most recent data from Public Health Scotland confirms that pancreatic cancer remains among the top 10 most common cancers for men and women. As the motion states, it is the deadliest of the common cancers, which should encourage serious and prompt action even if nothing else does.

It is important that we take this opportunity to highlight the symptoms of pancreatic cancer and to encourage everyone who has even the slightest doubt or concern to seek the medical advice that could be life saving. The decisions that we make as elected members can save lives. The radical and determined fight against health inequalities can make a difference, and I urge members to make time to debate the subject further.

I again thank Clare Adamson for bringing the debate to the chamber and I thank the visitors who are in the gallery.

I wonder whether the convener of the Health, Social Care and Sport Committee would like to add to the committee’s work programme; we should perhaps scrutinise the information that we have heard today.

I realise that I must come to a close. The people of Scotland, the workforce and the health service need the Scottish Government, the cabinet secretary and, if I am honest, back benchers to be much more open about what is actually happening in our health service. We need to look at the cuts that have been made and at what we can do to make a difference. We must ensure that the Government will put up with scrutiny from the Opposition, because good opposition makes good government, and I want the people of Scotland to have a good and fair public health service.

Of course, there was Mike Russell.

I wonder whether the convener—[Interruption.]

Thank you, Presiding Officer.

The fact that so many people were sent out to trash the story made it more real to us, because the Government was obviously concerned. I have had a lot of respect for Bob Doris during my time in the Parliament, but I thought that his speech today was not a fair representation of what is going on.

I see that the cabinet secretary is laughing about that.

We have a change of heart there from the member.