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Good morning. Maree Todd spoke about the fact that things are much more difficult for people in more deprived areas. We need to be honest with ourselves about what happens in those communities. Less funding is going to local government. In local communities, people are able to access more affordable and more local activity rather than just sport. If we are absolutely honest about wanting to get people more active, is it important for us to send the message that we have to resource local communities, particularly in more deprived areas?

Another thing that some of the professionals talked to us about in evidence, and which we hear about time and again, is the move towards prevention and how we are trying to improve that area of our work, particularly for people in deprived communities. Do you think that we are doing enough in Scotland to move the model of prevention for these health difficulties that are causing such inequality?

I am interested in how we address the inequalities that we see. We have talked a wee bit about sport, but I am thinking about access to services across the board. Does either of the ministers have a view on how we could improve that?

I thank my fellow Scottish Labour colleague, Jackie Baillie, for bringing her members’ business debate to the chamber. I could not be here today and not speak in it.

The theme of world cancer day 2022 is “close the care gap” and it is about understanding and recognising the inequalities in cancer care around the world. I am sure that members will agree that I am not shy about raising in the chamber the inequalities in prevention, care and access to treatments.

Health inequalities in Scotland and across the globe are very real. For many of the most marginalised in our society, the chances of getting cancer and the experience of the outcomes of cancer are worse because of factors and circumstances that are beyond their control. Acknowledging and dealing with the root causes that blight many of our communities is key to reducing cancer and cancer inequalities.

Across Scotland, we know that the most deprived populations have worse experiences and outcomes than those in the least deprived areas. Recently, of course, the Covid-19 pandemic has shone a light on health inequalities and their devastating impacts. The pandemic has impacted our lives in so many ways, and one of the most concerning impacts has been the reduction in cancer diagnosis at an early stage. Staff shortages, pressures on the NHS and long GP waiting times are among a whole host of factors that have contributed to figures that Cancer Research UK recently called “devastating”. In Scotland, we have to act with purpose to reverse those concerning factors, resume early detection and give those who have cancer the best chance of life.

In the short time that I have in the chamber, I want to mention cervical cancer. Yesterday, I met a nurse from Kilmarnock who has many years of experience supporting women with health screening and family planning. She talked me through aspects of women’s health and factors that may hamper people from coming forward for screening. Cervical cancer is one of the most preventable and successfully treated forms of cancer if it is detected and diagnosed early and managed effectively. It is essential that we in this chamber battle to ensure that screening services are accessed and accessible. In my discussions last night with Nurse Kenyon, it was clear that encouraging women and explaining the procedures to them is important. If they understand their bodies and what is happening, they are more likely to attend. We should encourage everyone who meets the criteria for screening to ask questions. Our wonderful NHS staff are more than happy to walk people through what will be happening to them and the associated benefits.

Once again, I bring to members’ attention the health inequalities that underpin survival rates for cancer. According to Public Health Scotland, there are links between increasing deprivation and poorer survival rates for cancer, as we have heard in the debate. It is unjust and unfair that that remains the case in 2022. Much more work needs to be done to address the clear health, social and economic inequalities that mean that a person’s postcode can result in a stronger or weaker chance of survival from deadly diseases.

I know that everyone in the chamber wants to see improvements in the awareness of and outcomes for cancer. I thank members for their contributions and for their work. I thank Jackie Baillie again for bringing the debate to the chamber and I applaud world cancer day and the work of Cancer Research UK. I hope that we go on to work as hard as we can to eliminate cancer from society.

I thank Rona Mackay for bringing the debate to the chamber.

The impact of adverse childhood experiences on individuals’ lives can be scarring, devastating and long lasting. Memories of childhood often stay with us, but, for many, those memories are not ones to look back on fondly.

As we have heard from others in the debate, poverty, abuse, neglect and other ACEs cause significant mental and physical difficulty for people in our country and they can also impact on an individual’s personal development.

However, in understanding more about ACEs, it is important to note that research conducted across the UK tells us that adverse childhood experiences are more likely to be experienced in areas of high deprivation. That highlights yet another devastating health inequality in our country, which needs to be addressed with purpose.

Moreover, as outlined by Public Health Scotland, an ACE survey of adults in Wales found that, compared to people with no ACEs, those with four or more ACEs—as has been mentioned—are more likely to have been in prison, develop heart disease, frequently visit their general practitioner, develop type 2 diabetes, have committed violence in the past 12 months or have other health-harming behaviours.

That is deeply concerning to us all, and I consider it important that the Scottish Government conducts a similar ACE survey with adults in Scotland to ascertain whether the impacts are similar, given that Public Health Scotland has advised that there could be a similar prevalence in the Scottish population.

However, we have to be absolutely clear that ACEs should not define an individual’s life or stop them from being successful or content. It is crucial that support is in place for children, young adults and adults to come forward and talk about their experiences. There can be no room for stigma in those discussions, and it is important that such support is accessible, free and comfortable for those who come forward.

The fact that adverse childhood experiences occur for children during a period of innocence and the unknown makes the impact that bit more significant. That is why I fully support calls from the 70/30 campaign to reduce incidence of adverse childhood experiences by at least 70 per cent by 2030, as we have all agreed in the chamber tonight.

That is not only an achievable target but a necessary one. It is one that we must meet if we are to be proactive and deliver for those who have experienced such events. We must invest more in early years. We must place more focus on addressing health inequalities. We must conduct research and analyse data to ensure that there is the most up-to-date information, where it does not exist already, to allow us to take actions that are underpinned by solid evidence.

In this chamber, I regularly call on the Scottish Government to do more to eradicate poverty. I do so because failure to act equates to a failure to stand up for those who, for whatever reason, struggle in life and need us to stand up for them in modern society. Adverse childhood experiences link closely to poverty and inequality. Therefore, to be effective in our endeavours, we must address the root causes. Doing so allows us to support those who are growing up in the most deprived areas today, and it allows us to hope that we can reduce the number of people who have an adverse childhood experience in the future.

The debate is important because it reaffirms the view of us all in the chamber—I have heard this from every speaker, and it is a matter that we all care about—that we must discuss this issue and address it. By working together, we can progress. My hope for the future is that no child will suffer adverse childhood experiences and that they will all grow up happy and content in their lives. We, as parliamentarians, can help that to happen.

I have found the evidence really useful, but I am particularly interested in finding out how we can encourage young people from poorer backgrounds to take part in sport and other activities that use green spaces. Some of the earlier comments about local services and local government funding were therefore music to my ears.

What are the barriers for young people both in and outwith schools with regard to accessing sport and other activities? What do we as parliamentarians need to do to break down those barriers and give people, particularly those from poorer backgrounds, the opportunity to take part?

That would be great.

No, that confirms some of the work that we need to do, which is helpful.

Endometriosis is a painful and often debilitating condition that requires high standards of care and treatment. Commitments in the women’s health plan are, of course, very welcome, but can the minister outline what investment the Scottish Government will be making in endometriosis research? Will she commit to regularly updating Parliament on progress, given that we know just how crucial research will be in better understanding the causes, in developing better treatments and, ultimately, in finding a cure for endometriosis?

On behalf of Scottish Labour, I thank everyone who has contributed to this necessary debate.

As others have noted, the reforms in the bill have come about as part of a lengthy and considered response to reasonable worries expressed by those who were so unfairly treated. Scottish Labour warmly welcomes the agreement by all parties that securing adequate reimbursement is fair and just and expresses our regret that anyone could be left in such pain and distress for so long.

Gillian Martin rightly indicated that the Health, Social Care and Sport Committee will be keeping an eye on the progress that the bill provides for women. As Emma Harper reiterated, this is not the end of the committee’s work. We have much more to do in reassuring women that we can have a world-class service in future.

We thank all the women who shared their stories again and again. Craig Hoy made that point well.

I thank Paul O’Kane for reminding us of the work that was done before this session of Parliament. I can only imagine the work that happened beforehand. We thank Jackson Carlaw, Neil Findlay and Alex Neil in particular, as well as all the committees that worked to bring the bill to this stage. It has been long awaited and we thank all those who worked on it over those years.

Scottish Labour fully supports the overall aims and principles of the bill and wants to see it in place as soon as possible. As many members have said, far too many women have gone through traumatic experiences since having mesh fitted. It is right that the Scottish Government should cover any related costs and it is imperative that the bill moves forward quickly after we—as I hope we will—agree to it at decision time.

The bill includes travel and hotel accommodation costs. We are assured from the bill and the guidance that it will cover all the cut-off dates and the evidence to review if someone is refused payment. The cabinet secretary indicated that someone has been appointed to administer the scheme. That is all very welcome.

We need the legislation now. I am glad that we are getting on with the job. I reiterate my party’s position: we support the bill. We will, of course, continue to scrutinise the Government to ensure that the bill is fit for purpose and to see how the Government will raise awareness so that women know that they are entitled to reimbursement. If we cannot adequately inform people of what they are entitled to, we cannot be surprised when they fail to take up that offer.

Scottish Labour hopes that the debate will give the affected women reassurance that we will move forward. I thank everyone who has contributed today.