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The cabinet secretary will be aware of the trial involving NHS Grampian, a local energy charity and an energy innovation hub. The health board has identified at least 300 people who require assistance with their energy bills because of their serious ill health and related requirements.

I have a constituent who is at home on life-support equipment, and their monthly bill will rise from £347 to £624 on 1 December and to over £1,000 next year. Does the cabinet secretary consider that other health boards should follow NHS Grampian and consider such interventions?

To ask the Scottish Government when it last met NHS Lothian and NHS Borders. (S6O-01599)

I thank John Mason for his rubbish question. [Laughter.] Apologies—I thank him for his question on rubbish. I also thank my colleagues for their efforts in segregating materials for recycling. We achieved a recycling rate of 81 per cent in 2021-22, which is a significantly higher rate than most public sector bodies achieved.

I do indeed accept that. The OBR has also said that Brexit’s impact on the economy is now “adverse” over the medium term, to the tune of 4 per cent of gross domestic product. This is massive self-harm. Not a week passes without cries of protest from traders, truckers, farmers, hoteliers, care homes, scientists and even performing artists. Trade bureaucracy has soared. Every exported cow needs a veterinary certificate and unskilled labour has dried up, and all of that is impacting on the UK economy.

Public opinion has now swung dramatically against Brexit, with just 32 per cent still in favour and 56 per cent regretting leaving. When there are rumblings in the Tory ranks about Swiss-style deals and mutterings from the Confederation of British Industry about the need for changes to rules for migrants to enable them to work here, we know that even the Tories who are wedded to the ideology of Brexit—Rishi Sunak is right up there—can no longer delude us that Brexit is just the ticket. However, Rishi Sunak has to keep his party together, foremost especially the uber-Brexiteers, who include himself—and to pot with the rest of us.

Although the Bank of England, in its November monetary policy report, says that the major contributor to current levels of inflation is the global increase in gas, and therefore energy prices, it also highlights the impact of

“Non-energy tradable goods prices”.

Those are driven partly by global factors, such as the bottlenecks in international supply chains since the pandemic and disruption that is linked to the Russian invasion of Ukraine, but also by costs associated with Brexit.

To quote from The Guardian,

“To state the obvious, the war in Ukraine and pandemic-related supply issues are sending prices soaring across the world, but what gives Britain a particularly pronounced problem—which forecasters say will endure into the immediate future, while inflation in the eurozone starts to fall—is Brexit. Our departure from the EU has weakened the pound, which increases the prices of imports, and adds to companies’ costs. Post-Brexit limitations on foreign workers are also hitting firms’ bottom lines, as are problems with the UK’s European supply chains ... Adam Posen, an American economist and a former member of the Bank of England’s monetary policy committee, said that 80% of the explanation for Britain’s higher inflation was bound up with Brexit and its endless complexity. It amounted, he said, to ‘a trade war the UK declared on itself’.”

While living standards are under immense pressure around the globe this year as a result of record inflation, in particular in food and energy prices, officials said that Britain would suffer more as a direct result of leaving the EU.

There is more bad news. Even before the economic disaster that was Truss, it is estimated that, between 2016 and 2021, Brexit cost the UK £31 billion. The equivalent for Scotland is £2.5 billion. For Scottish Borders Council, that is £53 million, and for Midlothian Council it is £43 million.

Keir Starmer is no help, battered by his past flip-flops on the subject, and rejecting any easing for a single market, in which he is not in line with public opinion. Neither are the Liberal Democrats. For them all, Brexit is done and dusted and we must make what we can of it.

In 2014, we were told that a yes vote for independence would see us thrown out of the EU. It is ironic, is it not, that we were dragged out, despite 62 per cent voting remain, and by a party that currently holds only six Scottish seats. That lie will not fly again. Already, support for independence is on the rise as the Scottish people see the inadequacies of UK economic policies. Tomorrow, we will learn of the UK Supreme Court judgment. However that goes, I know that, sooner rather than later, Scotland will regain its independence. Brexit was the final straw.

Let us start at the very beginning: the European Union referendum vote in 2016. The vote across the United Kingdom was close, rounded up to 52 per cent voting leave to 48 per cent voting remain. In Scotland, the figures were 62 per cent voting remain and 38 per cent voting leave. Interestingly, by way of an aside, Northern Ireland voted 56 per cent remain.

In Scotland, every constituency voted remain, including in the Scottish Borders and Midlothian. That was in the face of an aggressive and ill-informed campaign blaming the EU for all ills and promising not just the infamous side-of-a-bus £350 million a week for the national health service, but more. We were promised that being tariff free would mean that bureaucracy would be cut, but was it? There is increased paperwork—for example, truckers need import and export declarations, security declarations and other paperwork for their shipments. New infrastructure is needed at ports to deal with queues and to check loads, and there are vast lorry parks.

The trading world was to be our oyster, despite the fact that even Barack Obama said that the UK would be at the “back of the queue”, which is where it is, and where it has stayed. There were no favours waiting for the UK. The one new deal, with Australia, has infuriated farmers and was even criticised by George Eustice, who was then the Secretary of State for Environment, Food and Rural Affairs. The reality is that most British trade is with Europe, and Brexit has crippled it.

We were promised that migration would be under control, as the UK “took back control”—more of that later, as it impacts on our economy. The UK then cut itself off from its biggest trading partner, the EU, where 40 per cent of its exports went, and for what?

The answer is: for the highest inflation among the G7 countries, which is currently running at 11 per cent, with food inflation at nearly 17 per cent. With regard to how UK inflation compares with inflation in other nations, recent analysis from the Financial Times shows that the rate of consumer price inflation is higher in the UK than it is in other devolved economies. It rose to 11.1 per cent in October 2022 in the UK, in comparison with 10.4 per cent in Germany, 7.7 per cent in the USA, 6.2 per cent in France and 3 per cent in Japan. A member of the Bank of England’s monetary policy committee noted, in a recent appearance before the Treasury Select Committee, that Brexit has added 6 per cent to UK food prices.

Yes, Covid had a price tag, and the war in Ukraine is having an impact on the UK economy, but Brexit is why it is doing so badly. Even before Brexit, the economy was weak, after nearly a decade of Tory government. If we add in Covid, Ukraine and Trussonomics, that is a heady mix for failure. That is bad enough, but when we add in the basic ingredient, the Boris Brexit, that explains much more.

Members should not take my word for it that Brexit has had a devastating impact on the UK economy. The Office for Budget Responsibility predicts that the UK will suffer the sharpest decline of any European nation, with a drop in growth of 1.4 per cent in 2023. That can be compared with small independent countries that are similar to Scotland, such as Ireland, which will see their economies grow by around 3 per cent next year.

I apologise for not taking an intervention from Edward Mountain in my speech, which I had to cut considerably.

I respect what Edward Mountain says. Will he address the issue, which is whether Brexit has contributed to high inflation across the UK?

The Auditor General for Scotland said that there has been a 30 per cent increase in capital costs in Scotland directly as a result of Brexit. Can the minister advise us how that will impact on extending the Borders railway line through Hawick and beyond?

I send my regards and best wishes to my former colleague Dorothy-Grace Elder, who has campaigned without pause on the issue of chronic pain since at least 1999.

I will start on a personal note. Like more than 19 per cent of the Scottish population—I now suspect that that is an underestimate, although it is not the Scottish Government’s fault—I have chronic lower back pain. Some days it is worse than others, but it is always there and has been for some years now. Sitting at my computer during Covid made it worse—Finlay Carson referred to that issue—and one day my back simply froze and I had to take bed rest. I mentioned the matter to my GP and was told simply to take painkillers, which I do, and I carry them with me always. Like many, I self-medicate and, in fact, the painkillers have now become more essential than my reading glasses.

That is nothing compared to the level of pain that other people have day in and day out, but it has given me a taste of what it must be like to be in severe and constant pain without relief. You wake up and take for granted that there will be pain. It affects every aspect of moving, including walking and housework. Gardening, which is always a pleasure, takes its toll, and movement is restricted. You adapt to what you can and cannot do. Standing is painful, so even as I speak my back is painful. The pain affects personal relationships. Fortunately, now that I live the single life, only the cat has to hear the constant refrain, “Oh, my back!”

That said, it can also affect the family unit. Partners are sometimes supportive and sometimes impatient. Who wants to hear someone always complaining? We therefore need to have more spaces for those with chronic pain to talk to one another, knowing that those who are listening are in the same boat. It all helps, and it may take pressure off those who are living with people who have chronic pain.

For many people, the situation is far worse than it is for me. The key message—I note that the Scottish Government is approaching the issue in the right way—is that treatment, management and availability must be directed by the people who are suffering from chronic pain in all its varying forms. Any delivery must also be person focused, because each person suffers differently and handles pain differently, physically, mentally and emotionally. Of course, some people simply lose their employment. For them, there are financial consequences.

I note that training for NHS staff is to be increased, which I welcome. Actually, I would extend that to GPs and their staff. Some doctors’ receptionists, acting as gatekeepers, are not always sympathetic. Before I get a lot of emails about that, I point out that I said “some”.

In preparation for the debate, I had a look at online help. I have to say that, when I went on to the NHS 24 self-help guide, I found that it does not do what it says on the tin. After ticking the various boxes on the online questionnaire, it simply told me, “There’s nothing seriously wrong with your back.” Well, that was not any help.

A better website was the NHS self-management site, which has exercises to help with lower back pain. I confess that, until I prepared for this debate, I had not looked at that; I will try some of the exercises. However, if I did not know about it, a lot of the public will not be aware of it. I suggest a public information campaign to alert people such as me who have back pain to those exercises, which might just help—it is worth a try. In the meantime, I suggest to others that they try it.

I also want to focus on early intervention and to encourage those who are silent about their chronic pain to identify themselves. As we know, the adapting that I referred to might well lead to further deterioration in physical and mental wellbeing, because it passes the pain buck to other parts of the body, such as the legs and neck.

Although I welcome the plan, I want actual delivery on the ground. That is the test, at national and local level. I note the minister’s response to Jackie Baillie on resource allocation. It is in the interests of all—those who are suffering, many of whom do so in silence, their families and those who live with them, as well as society at large—that the issue is dealt with.

Plans are the easy bit; the test, of course, is whether we make life that bit easier for those with chronic pain, whatever the level, and I put myself at a very low level compared to others. I know that the minister recognises that point, but it will be the test.

I say to Maggie Chapman that I agree that the majority of people know their own minds—and I have met some of them. Many people have been living in a different gender for a long time before they ever apply for gender recognition. That is the majority, but there are other people who will be transitional and will need a period of thought. I am looking at the balance. For those who already know and who have already been living in a gender for years, a three-month period will be nothing, because they can demonstrate that they have been doing it for years. The same applies to 16 and 17-year-olds, with regard to the six-month period in advance and the reflection period.

However, there are people for whom I want to have just a little safeguard, and particularly 16 and 17-year-olds. In no way does that take away from the autonomy of the individuals. I have met parents of a child of 10 who knew that they were really a girl—he transitioned to a she in primary school. I have talked to people in both directions about the issue before I lodged my amendments. I want to have something in law that works for as many people as possible and that provides safeguards. That is the reason that I would give to Maggie Chapman. We cannot take away all protections and safeguards.

I am not sure whether you want me to move it at the beginning, but—