Seòmar agus comataidhean

Thank you for the information that you have provided so far. Leading on from Paul O’Kane’s question, I am interested in ensuring that information is provided to any women who do not know about the scheme or about how to apply to it. We must ensure that that information is very accessible and that women feel at ease in applying, should they have to do so. Has any work been done on that?

In closing the debate for Scottish Labour, I thank my colleagues in the Parliament, all of whom made significant and interesting contributions to the debate. It is always useful to hear about successful projects across Scotland, so I thank members for sharing those stories.

We must also face up to the reality of what is happening. I think that members would agree that Michael Marra described very well the reality for people in Dundee.

When we talk about problems with substance misuse and related mental health problems, we are really talking about people who have, for one reason or another, slipped through the net. Where there should be adequate support to get them back on their feet, there has been little more than a promised appointment that never comes. Only recently, we heard that 31 per cent of calls to the NHS 24 mental health hub go unanswered. We can only imagine how many of those people will immediately give up and seek other ways of coping. This is the story that I hear time and again all over my region, and I know that many other colleagues have heard the same: “I want help but I can’t get it. I’ve been waiting for months just to see someone or even speak to someone.” We can do better than that, and I think that there is broad agreement here in the Parliament, among ministers and others, that we must now do whatever is necessary to pull Scotland out of this nosedive.

However, let us not talk about this in the abstract. We need to be honest with the public and say that addressing the issue will require greater investment and a much longer term approach—two things that the world of politics is often poorly prepared to deal with. Although I welcome the investment mentioned by the cabinet secretary, let us be honest and accept that it is not enough.

We know that the problem of people simply not being able to get the help that they require is widespread in Scotland. As I and others have noted in the chamber today and in previous debates, the number of children and young people waiting a year or more for mental health appointments is at a record high. We should not then be surprised that, for those living with substance misuse, that problem is just as prevalent. We need to find more sustainable ways to get people the care that they require in the community and directly connect the problems of poverty and substance misuse through meaningful policy.

Poverty and homelessness are included in the motion as a consideration but, for me, they should be the core of the debate. If we do not seriously tackle the low-pay, high-debt, exorbitant-housing-costs society that we have built, reliance on substances to deal with that pressure will only get worse. The minute that someone is made homeless or put on the cusp of homelessness through unaffordable rents, their health—mental and physical—will rapidly deteriorate. If that person has already been exposed to a damaging relationship with dangerous substances, it is obvious that they will be at risk of going further down that road, yet little is done to give immediate support to such people and offer them the counselling and respite that they require to follow a different path. Any expense that we incur by increasing counselling and outreach services will be saved many times over by ensuring that people’s health is protected and their homes are secure long before the problems arise.

Scottish Labour believes that we must begin to look at this now. As described by Michael Marra, drug misuse and associated mental health difficulties have spiralled out of control. The conclusion has to be that the issue should be a top priority for every Government, not just here in Edinburgh but in London, too. It needs to remain a priority for a long time to come. There will be no overnight fix, and if we can shift the narrative towards treating this as a health crisis and focus on solutions that are centred around support and prevention, it will change the lives of thousands in Scotland for many decades to come.

I refer to the Scottish Labour amendment in Claire Baker’s name, which I hope will be supported at decision time this evening. The amendment rightly highlights that the number of people staying in hospital due to drug-related mental health problems is on the rise, and further points out that we are not doing enough to make sure that those who need support are being referred to community-based services so that we can address the root causes of their problems. In order to do that, we must more cohesively link together each service and considerably expand the number of outlets that there are for people to seek support from.

The root of all of this is the continued poor funding of mental health services in Scotland. They remain underresourced and blighted by unacceptable waiting times. If we are to change approaches towards community support, and change the disparity in funding for those services, we can shift the trajectory of the debate. Without doing both of those things, headlines may change but lives will not.

I thank Clare Adamson for marking the significance of malnutrition awareness week by bringing the debate to the chamber. Our elderly, who are the most vulnerable in our society, are at the greatest risk of malnutrition that is caused by undernourishment. It should concern all of us that one in 10 people who live in the UK is malnourished or at risk of being malnourished. Others have mentioned that figure, which Eat Well Age Well Scotland has suggested could be an underestimate.

That devastating and potentially underestimated figure will be a shock to many who think that a rich country such as Scotland could not experience such problems. I worked in the national health service for years—I have mentioned in the chamber before that I was a dietician—and I cannot stress enough that the problem is real. However, of all the social and economic challenges that we face in Scotland, we hear little about the challenge of malnutrition. It is described as a hidden problem, and Eat Well Age Well has argued that, although malnourishment is preventable and treatable, it often goes undetected, untreated and unrecorded.

As others have said, we must do more not only to highlight the existence of malnutrition in Scotland but to look at the causes and what we can do to reduce the number of people who live in such circumstances. A lack of public awareness and a lack of Government attention will only lead to an increase in the numbers of those who are malnourished. In turn, that will increase pressure on national health services, which are already under significant strain.

Given that we know that those who are malnourished are more likely to use health services and the health service’s resources for lengthy periods, I ask the minister to take malnutrition very seriously, and I urge the Scottish Government and colleagues to act with purpose to address an issue that we know exists but which is rarely spoken about. I ask the minister to act to protect those who are malnourished and need support and to protect our NHS, which already faces serious challenges.

Scottish Labour has offered solutions to many of the causes of malnutrition in our country. In response to social isolation, we have set out a comprehensive plan for universal basic services, which would strengthen communities and support those who have experienced loneliness by offering services and resources that are backed up by serious funding for local government.

Moreover, to support those who are forced because of the decisions of Governments here and at Westminster to choose between heating and eating, we pushed for the introduction of a right to food bill—led by my colleague Rhoda Grant—to enshrine in law a right to sufficient and nutritious food. Unfortunately, the SNP and Greens kicked that into the long grass at committee stage a matter of weeks ago. It is absolutely right that we talk in the Parliament about malnutrition awareness week, but we do little to support those who are malnourished and little to support health services and the vulnerable if we do not back up our words with action.

The Scottish Parliament has the power to deliver radical action, to enact the change that we all want and to raise awareness, which we all know is needed. Covid will undoubtedly have exacerbated many of the issues that we have discussed, such as food poverty, food insecurity and social isolation. Malnutrition awareness week is an opportunity for us to propose impactful change to stop a trend that has for too long discriminated against the elderly and vulnerable.

I thank you, Presiding Officer, and other members for allowing us to discuss this important issue. I again congratulate Clare Adamson on lodging the motion and so enabling us to participate in malnutrition awareness week 2021.

The minister will be aware that the uptake rate of cervical screening tests in Scotland’s most deprived areas is 63 per cent, compared with 74 per cent in the least deprived areas. That is totally unacceptable health inequality that leaves women from deprived areas at greater risk of developing serious health conditions.

What is the Scottish Government doing to encourage more women from deprived areas to attend their appointments, and will the minister outline today a timescale in which the Scottish Government expects to have closed the alarming gap?

World mental health day 2021 carries particular significance, with people from nations across the globe facing a pandemic that puts restrictions on our daily freedoms, limits our contacts with friends, family and wider society and continues to cause many of us to lose loved ones.

For our young people, the pandemic has been especially difficult, because for months at a time they have been without the educational interaction that sustains much of their daily lives. SAMH highlighted:

“Covid led to a 55% reduction in referrals to Child and Adolescent Mental Health Services ... at a time when children and young people needed more support than ever.”

It went on to state:

“Many children and young people feel that they have been at a point of crisis before they seek help.”

We cannot stand by and watch as young people struggle. A functioning mental health service would actively offer help, be in communities and educate people about the signs of mental health difficulties and when to seek support. We must properly utilise the expertise of groups such as SAMH that know the struggles that many face, and start dealing with the silent pandemic.

As we come through the Covid pandemic in Scotland and look towards recovery, we must be prepared to enhance mental health services with greater funding and resources. That starts with the creation of more posts to support those who are struggling with mental health problems. However, this is a global pandemic and, as the theme of this year’s world mental health day is mental health in an unequal world, the United Kingdom and Scottish Governments must be prepared to support other countries coming through the pandemic. That starts with supporting vaccination programmes across the globe and, as soon as possible, bringing an end to the pain that many continue to face daily. The UK may be making progress now, but no country can expect to progress fully from the pandemic and its impacts, including on mental health, until every country has equal access to medical assistance.

Health inequalities in Scotland predate the pandemic. When I met SAMH recently, it explained that the mental health crisis predates the pandemic. The failure to address waiting times for adult psychological services and CAMHS services predates the pandemic, too. The pandemic has exacerbated the problems that we collectively face and has exploited global inequalities—inequalities that we must all do more to address. We do ourselves and our services no good if we pretend that those problems are new.

The often alarming figures, which mental health charities across Scotland have highlighted for today’s debate, should be a wake-up call to ministers that there is no excuse for undervalued and underfunded services; nor is there any excuse for not giving mental health policy the priority status that it demands and deserves. Words do us no good when they are not backed up by action. I plead with the minister and the Government to listen to members, understand the figures and act—act to save lives and improve services for those who desperately need them.

I welcome world mental health day, the awareness that it raises and the focus that it puts on education, understanding and the need for investment in services across the globe. We know that those living in deprived areas, with less access to public services and facilities, and to outdoor green spaces, are more likely to experience mental ill health, so it is crucial that, in our endeavours, we do all that we can to address health inequalities whenever we find them and create a fairer mental health service that supports everyone who needs it.

Scotland has a chance to lead the way; indeed, it has the power to lead the way. Let us use world mental health day 2021 to revisit strategy and deliver for the people the services that they need so much.

“Progressive” is a word that is thrown around by Governments of all stripes to justify a wide variety of reforms, many of which are anything but. True progress means a world in which homelessness is a chapter in a history book, not a daily reality. True progress means paying people a wage that is more than barely enough to keep their heads above water. True progress is people’s right to food being enshrined in law; the rest is window dressing. “Progressive” is a badge that Governments like to wear on the world stage and a topic that they like to fill parliamentary time with, because it says something about how they wish to be seen, regardless of how far from reality that may be.

I welcome any opportunity to consider the values that we should encourage in Scotland. I will start by recognising that, although the Scottish Government might be progressive in relation to one of the harshest Tory Governments in living memory, that does not hide the fact that, when it comes to standing up and being counted on pay, public service investment and infrastructure development, it is sorely lacking.

I will take the opportunity to reflect on our shared commitment to internationalism. I congratulate the Government on that sentiment, but I do so with a word of caution. We have to encourage future generations to believe that people working together in common purpose is the only hope for a world free from climate catastrophe and desperate greed. However, seeking to do so through the lens of exceptionalism—by which I mean suggesting that Scotland is uniquely enlightened—is not the way to go about it.

Nevertheless, the Scottish Government has correctly derided Downing Street’s decision to slash overseas aid. That decision was made to send a signal to a reactionary part of Britain that we will return to a cold-hearted view of the world in which anything that we put in must be paid back double. That is not progress; that is stone-age thinking. However, we should expect that from the Tories; beneath the buffoonery of Boris Johnson, the UK Government is committed to redistributing wealth from the poor to the rich and rewriting the history of our role in creating global inequality.

I ask the Scottish Government to learn from that example and ensure that we do not do that. For all the positives that are no doubt plentiful in our history, Scotland’s role as part of the UK in spreading war, injustice and intolerance around the world is just as potent and regrettable as any other part of this island. Let us recognise that, so that we can move forward.

To be an example to the world, you have to govern with consistency, and that starts with the basic principles of holding to commitments and respecting the will of the people. What does it mean, as stated in the motion, to “promote democracy” when the Scottish Government continually pushes for a referendum because it did not like the answer the first time? Implicit in that disregard for democracy and in the motion is the suggestion that Scotland is different and that we stand apart from a callous UK and a tough global north, but there is no truth in that. Those are the stories that nationalists tell themselves in every part of the world. We do not need to do that to be progressive. We do not have to create a “them and us” narrative. We simply need to reset our priorities and start going after the profiteers and the privilege that damage us all.

The next time that we discuss the issue, perhaps that can be the focus, rather than the vague advert for an imaginary Scotland that few who live at the thin end of the wedge would recognise.

There seems to be general agreement that we must treat drug deaths in Scotland as a public health issue, not a matter of law and order. I think—I hope—that somewhere among members on the Tory benches, there is an understanding of that. In order to progress and pull our country out of the spiral, we will need to maintain that understanding, and my party will support measures to do so.

I am sure that my parliamentary colleagues will have noticed that, since Scotland re-established its Parliament in 1999, there has not been a parliamentary session in which drug deaths were not a serious concern for the constituents whom members are committed to represent. However, the seriousness with which the Parliament has treated the problem has only recently got anywhere near the level that is required to tackle it. Having seen some examples of other countries that have worked miracles to put a stop to deaths multiplying annually, we are now slowly waking up.

The Lord Advocate’s recent statement is simply realistic. It is not anything that the average person on the street would not understand as necessary. Drug abuse and its effects are not hidden away any more. We all see drug abuse, but far too many just want to keep it at arm’s length. Equally, the Lord Advocate’s intervention has had the positive effect of keeping the issue in the headlines during a time when, naturally, there has been a considerable focus on other health issues. That attention is sorely required.

Prior to Covid, a reform that was getting considerable attention—in no small part due to the great work of my party colleague Paul Sweeney—was safe consumption facilities. They are not an ideal solution, nor one that I particularly envisioned having to support, but over the years, it has become obvious that the scale of the problem in Scotland is well beyond slogans and awareness campaigns. We need to treat the issue with the same seriousness with which we treated the pandemic, and providing safe facilities to prevent death has been proven to work. That is one example of the direct and meaningful approaches that we need to take at all levels of health policy, policing and education. However, it requires serious funding.

In my region, NHS Ayrshire and Arran is experiencing the second highest rate of drug deaths in Scotland. Much of the work falls on the shoulders of community health workers, hospitals and the police, who are overworked, underpaid and left with resources that are stretched to breaking point. Undoubtedly, councils and health boards see the problem as a priority, but they simply do not have the funds to tackle it all the time. We need to expand community resources and improve access to residential rehabilitation and treatment to get on top of the issue. Part of that involves giving the police the time and training to support any reforms that take place, and not forcing through a new model with little consideration of those on the front line.

The police officers whom I have spoken to will be relieved to hear that a more pragmatic approach is now being taken on drugs, because it frees them up to do the policing that they joined the force to do. Included in that should be proper training, so that officers are prepared to respect the use of naloxone to prevent overdoses, as the minister mentioned.

The debate does not have to be about who can show themselves to be the toughest on people with serious addictions. If it becomes so, that is just about politics, not progress.

Poverty is at the heart of the issue. Although I fully endorse all the measures that I have mentioned, the biggest reform that we could push through to end the crisis would be to remodel our economy and society so that it does not have built into its architecture acceptance that the vast number of people should simply be left to struggle in desperation while others have more wealth than could ever reasonably be required.

To ask the Scottish Government what measures it has taken to address the consequences of the reduction of universal credit and any potential impact on child poverty. (S6O-00216)

As the cabinet secretary stated, all parliamentary parties, except the Tories, agree that this cut is shameful and it must be reversed. However, we must also recognise that, here in Scotland, we can mitigate the worst of the effects and help to tackle child poverty in particular. Will she therefore immediately use the powers that we have in Scotland to double the Scottish child payment, and will she commit to investigating doubling it again to meet the desperate need that we have in my region of South Scotland and across Scotland before we see instances of child poverty reaching desperate levels?

Scotland in 2021 should not require many of the services that Fulton MacGregor mentioned in his motion and in his speech. Decisions by the Scottish Government and the Conservative Government in Westminster have made it harder for people to get by and have ensured that fewer families are in stable well-paid employment. That means that more children live and grow up in poverty. The poverty that is associated with purchase of school uniforms is a direct impact of political decision-making. Families are being let down, so we must act with purpose to deliver the real radical change that is required to improve livelihoods and life chances.

The motion suggests that we should welcome the SNP-Green Party coalition pledge to introduce statutory guidance for schools to increase use of generic items of uniforms in order to reduce costs. I support any progressive steps to make buying school uniforms easier and less expensive for low-income families. I know the pressure that is felt by some parents to buy for their children items such as new school uniforms, when it is not really an expense that they can afford.

In 14 years of government, the SNP Government has taken the Tory cuts, multiplied them and passed them on to local communities, so I hope that I can be forgiven for being sceptical about the likelihood of the SNP-Green coalition taking the necessary steps to support our lowest-income families and communities. I hope that tonight’s debate will prove me wrong. I hope that the members who have spoken here will stand up and be counted on the issue.

In response to the need that has been created by political decision making, it has been encouraging to see so many groups and individuals in our communities doing all that they can to help parents to provide uniforms for children, whether that be in the form of donating directly to families or setting up uniform banks where uniforms can be handed in and collected by families. Communities are pulling together to help to alleviate the pressure that is put on their neighbours by poverty that is associated with purchase of school uniform and other items. That has been truly positive and has continued throughout the pandemic.

South Ayrshire School Clothing Bank in my area is a fine example of such work. It is run fully by volunteers, with a mission to ensure that every child is able to go to school in clothing that is just like that of their peers’, which the clothing bank believes can help their ability to learn, socialise and develop key interpersonal skills. However, I stress again that it is shameful that it has come to that. Although community intervention is welcome and the work of volunteers is admirable, the correct policies would have to be put in place to ensure that it is not needed.

With regard to local government, this year, despite more than a decade of cuts to its budget, Labour-run North Lanarkshire Council became the first council in the United Kingdom to introduce a clothing and footwear grant for nursery children. That is an example of a council doing what it can to give children the best start in life. It is clear to me that if such action was to be replicated across Scotland, our young people would start off with the best of benefits.

It is devastating that poverty that is associated with purchase of school uniforms exists in Scotland, and I agree with Fulton MacGregor that schools can and should do more to make generic and less expensive uniform items more accessible to parents of the children who attend. Having an exclusive supplier of expensive uniforms might work for a school, but it does not necessarily work for the low-income families whom it serves. I would welcome regular reviews of such arrangements.

The issue that we are debating today has much deeper causes—namely, fundamentally flawed policies that have failed the people who are most in need. To alleviate poverty that is caused by a host of factors, we must be more radical in our politics and stand up for those who have been let down by austerity and cuts. Only by doing that will we deliver the change that we truly need.