Chamber and committees

Thank you, convener. I do not know whether the collective noun is a suite of MSPs. I thought of a posse of MSPs, but I like your description even better: a galaxy of talent. We will settle for that, convener, thank you very much.

We are joined in the public gallery by Monica Sheen and Colleen Murphy, and by Alfie, who is probably the most well-behaved baby that I have ever seen. They have come specifically in support of this petition and they are joined in that support by many others who simply could not be here today. I also convey apologies from Mark Griffin. You will know that he has experience of the neonatal unit. He had another meeting, otherwise he would have been here today.

Thank you for the opportunity to speak to this petition. I am not sure whether this is the first time that there have been so many MSPs engaged in the same subject at committee, but it shows how important the issue is. The number of signatures collected on the public petition and the Scottish Parliament petition is also significant.

My colleagues and I will set out a number of reasons why the proposed downgrading of Wishaw neonatal unit is unsafe. As you have said, the rationale for downgrading Wishaw and keeping three units open in Glasgow, Edinburgh and Aberdeen is set out in the Scottish Government’s demand and capacity modelling of NICU services. However, the data that was collected for that report on which these critical decisions are being made is, frankly, inconsistent. Different timeframes are used throughout: sometimes data taken over a year is compared to data taken over three years, and there is no rhyme nor reason to it. I understand that the exercise was rushed but it is so arbitrary.

The review that was initiated by the Scottish Government, which we welcomed, acknowledged that the data was flawed, but nothing has been done about it. Therefore, people are proceeding at pace to implement proposals that we know are based on flawed data. I find that astonishing, given that this Parliament and the Scottish Government assert that decisions are all evidence based. They appear to have fallen at the first hurdle here, and there is little wonder that people have very little confidence in the report and its implementation.

The report also fails to give consideration to maternity capacity. There is no analysis or consideration of workforce requirements. Although the report states that workforce data has been collected, the results of the analysis are not included. I have no idea why you would not put such a significant element into the report. I will come back to staffing in a minute.

In 2017, the Scottish Government published the “Best Start” report, which stated that three to five neonatal units should be developed, supported by something like 10 to 12 local and special care units. That is fine. Since then, however, the Government has simply fixated on developing only three. There is no explanation why the number is not five or four. It is our contention and the petitioner’s contention, based on the data and the volumes of people being cared for, that there should be four units in Scotland, and that Wishaw should be one of them.

Wishaw neonatal unit is the third busiest neonatal unit in Scotland. The critical mass of neonates exists within the central belt area. We know that Wishaw neonatal unit accepts the highest number of in-utero and out-of-utero babies, which clearly shows the skill set and the capability in the unit. There are transfers from other board areas all the time. Wishaw was named the best service in the UK last year, information that clearly has been ignored by the Scottish Government.

My colleagues will explain that there are real concerns from staff and patients that level 3 neonatal units in Glasgow and Edinburgh are already facing staffing pressures and will not be able to cope with demand once Wishaw is downgraded. I recently uncovered statistics that show that health boards across Scotland, in particular in the central belt, with the knowledge of the Scottish Government, have cut paediatric and maternity vacancies. Let me stress that the numbers are not frozen, they are not still there; they have simply been cut from the complement of what was required. I therefore worry about safety due to the lack of staff. The staff shortages will also add to pressure on neonatal services and force mums and premature babies to be transferred not to Glasgow or Edinburgh but to Aberdeen. We are talking about the very sickest babies, and just think about the distance that that would involve.

There is clearly appetite and scope for Wishaw neonatal unit to remain in place alongside units in Glasgow, Edinburgh and Aberdeen as part of the best start strategy. I would be grateful if this committee would take this petition on—because I know that you have run with petitions before—and invite the minister or the cabinet secretary to explain why the Scottish Government is ignoring the evidence and putting at risk the safety of mothers and babies at Wishaw.

They were sounds of approval, convener.

Thank you for giving me the opportunity to speak on the petition.

I share many of the petitioner’s frustrations. I think that the petition is born out of frustration, given that the community council has attempted to engage meaningfully with the planning system in Argyll and Bute, sometimes to little notable effect. A useful piece of context that is noted in the petition is the fact that Helensburgh is closer to Edinburgh than it is to many other parts of Argyll and Bute. As members will know, Argyll and Bute is a very rural area that includes 20-odd islands, so it is not without its challenges.

The petitioner’s experience has been that the very reasonable suggestions that the community council has made have been considered by committees of councillors who simply do not have any relationship with or understanding of the community of Helensburgh. Often, those councillors are representatives of rural and island areas, whereas Helensburgh is predominantly an urban population whose travel-to-work area is in greater Glasgow, so there is a different context there.

Let me give you some of the examples where the community council has engaged and that engagement has resulted in absolutely nothing happening. In all the examples that I will give you, the community council did not oppose the application but suggested a different way of doing it or some conditions that should be applied based on its local knowledge.

In the first case, the community council was clear that housing could go ahead on the former Ardencaple garden centre site but that the number of houses was well in excess of the number specified in the local development plan. That was a case of the community council saying “Yes, by all means, put houses there, but not in the quantity that is being squeezed into a very tight site.”

The second example is a care home in the former works depot of Hermitage park, for which one of the community council’s concerns was the scale of the development, which might have impacted on a war memorial that was right next door to it.

The third example is the leisure centre, which is beautiful but is on the pier at Helensburgh on infilled land, which is prone to flooding. The community council therefore had an eminently sensible suggestion of moving the centre away from that area, but it was completely dismissed.

The petitioner is proposing not that community councils take all these decisions over but that their local knowledge is somehow inserted into the planning system, so that we get better decisions that are not about stopping development but about ensuring that it is right for the right place in their community.

I am sure that the committee will have ideas. Writing to the Royal Town Planning Institute or Planning Aid, which will have experience of these types of applications, might be an option.

Absolutely, and thank you for your forbearance in allowing me to come back repeatedly. I also thank the petitioners, Audrey Baird and Fiona Baker, for their determination to see the petition through.

As you rightly said, convener, it has been four years since the petition was lodged. In that time, very little action has been taken by the Scottish Government to prevent the further destruction of our natural historic environment. As we deliberate the petition, the Government drags its feet and time runs out to stop vast monoculture plantations destroying our biodiversity, environment and heritage. One of the suggestions that was made when the petition was last discussed was that the committee could consider holding a debate in the chamber on the petition, because ancient woodland touches every part of Scotland.

In August 2023, the Cabinet Secretary for Rural Affairs, Land Reform and Islands said in a submission to the committee that Scottish Government officials are progressing plans for a new register of ancient woodlands but that it is not possible to provide a timescale for completion. That is disappointing, and it reflects a distinct lack of urgency in so many of the Scottish Government’s actions in this regard.

It is interesting that the cabinet secretary’s submission points to a native woodland survey that was last done in 2014. That survey identified that 5 per cent of native woodlands were non-native species, yet another survey carried out much more recently, the Caledonian pinewood recovery project,

“showed that non-native trees were found on just under 30% of plots per site”.

That is a substantial increase in less than a decade and it should have us extremely worried.

Apparently, the project is doing wonderful things. It is going to remove non-native species from X number of hectares, but what does that mean in real terms? What percentage is that of the problem that needs to be tackled, and has it survived the recent round of budget cuts? There is a lot to be concerned about there, and there is also a lot to be concerned about in the lack of regulatory powers. I am astonished at the complacency in the cabinet secretary’s response, because, frankly, the protections are not adequate.

I will make three small points as I draw to a close. First, in 2022, the committee did some work to test the effectiveness of tree preservation orders. The petitioner’s latest submission asserts that TPOs do not actually protect trees. Trees with TPOs are being felled, then developments are taking place in those localities. We have examples to illustrate that. There is nothing at all in the biodiversity strategy, which is the forerunner to the proposed natural environment bill, to deal with strengthening TPOs.

Secondly, I bring to the committee’s attention a Royal Society of Edinburgh inquiry. Members of the RSE are currently lecturing on behalf of the Royal Scottish Geographical Society to educate the public about all the points that the petitioners have raised in their petition. The forestry mantra of having the right tree in the right place is not what is happening across the country.

Finally, there is the disenfranchisement of communities. Petitioners have often mentioned that communities are absent from dialogue about what to do with trees in their local area and changes in the forestry industry. The example I would cite is in my constituency. At Torr farm wood in Rhu, there was an incident of illegal felling, after which the landowner and Scottish Forestry responded to an event organised by the community council, which I attended. Scottish Forestry promised that it would introduce a revised management plan for that ancient woodland and that it would consult the community council. What we have now, more than a year later, if not two years later, is a fait accompli simply handed to the community council.

I remind members that trees with TPOs were illegally felled. Action is required quickly, because time is running out. Scottish Government action is terribly slow, so we need to urge it on because, at the moment, our ancient woodlands are disappearing because non-native species are taking over, and that is happening at pace. We need action now before the situation becomes any worse.

I thank Dr Sally Witcher for bringing the petition to Parliament. I am one of the co-conveners of the Parliament’s cross-party group on long Covid, so I am well aware of the calls to improve air quality in both health and social care settings and indoor settings such as schools. We have debated the issue in Parliament.

I was interested to read the Scottish Government’s response, because it sets out quite clearly what it is not doing. Covid has not gone away. Just because the Scottish Government believes that nobody is still at risk does not make that true. Those who are immunosuppressed are still at risk of contracting Covid, and we must ask what we can do to protect them.

As I said, Covid-19 has not gone away. The clinical risk continues. There is a direct impact not just on someone’s health but on the economy. Many of the statistics that we have seen in recent times, which show the number of people who are not employed, suggest that there is a problem that we must consider.

We also know that reinfection with Covid-19 increases someone’s chances of developing long Covid, and, as Dr Witcher has said, one in 10 people are likely to get long Covid and suffer long-term symptoms.

The impact on the economy is significant and can be seen in our public sector as well. I recently attended a long Covid group in Inverclyde, and everyone at the table who had long Covid was a front-line worker. Whether they worked in a school or in a health and social care setting, they were the ones without PPE at the beginning, and they have been impacted the most. The issue is having a significant effect not just on the economy in its widest sense but on our public services and their ability to run.

No one is immune to the risk. All of us here could get Covid. Vaccination is now restricted to those over 75 and people who are immunosuppressed. Regular testing has been stopped in health and social care settings, so we do not know who has got it and whether they are passing it on, and the use of face masks and covering is no longer mandatory. That is an issue specifically in health and social care settings; I am not talking about what is happening in the wider population, where we do not even bother to count incidences anymore, so we do not know whether the rate is bad or not to any great degree.

The introduction of improved air quality in health and social care settings would be an important step in preventing people from being infected and reinfected with Covid-19 and suffering the subsequent effects of long Covid. Other things that would make a huge difference include making PPE available to those who work with vulnerable people, bringing back testing so that we can monitor prevalence and direct our response, and supporting people at home.

In her submissions, the petitioner has shown that clinically vulnerable people are more likely to experience poorer outcomes as a result of Covid. They report that they feel that healthcare is unsafe and that action on clean air and the use of respiratory masks in healthcare settings would make a difference.

Of course, we are talking not only about Covid but about other respiratory illnesses. A study in Europe found that people who were exposed to dirtier air spent as many as four days longer in hospital and were 36 per cent more likely to need intensive care treatment. That shows that the petition’s proposal works in relation to other illnesses as well. The research, which was published in the European Respiratory Journal, said that cleaner air brought health benefits that are almost as great as some of the medical treatments given to Covid-19 patients. However, in response to the petition’s call for ventilation systems, the Scottish Government said that health boards should

“use their delegated capital budgets to maintain their estates, replace equipment and minimise risk to patients, staff and visitors.”

That is funny, because health boards are facing enormous budget pressures on a scale that we have not seen for a while, and they are going to be forced to make cuts to their existing budgets, with all capital projects basically halted. Therefore, without assistance and direction to do so, it will be almost impossible for health boards to fund the air filtration systems in hospitals that are needed to make clean air.

Of course, the issue is about not only hospitals but care settings, including care homes and care at home. Vulnerable people surely deserve a level of protection that reduces risk. For example, if someone who is immunosuppressed has carers coming in, PPE should surely be available. The Care Inspectorate’s submission does not really consider that point at all, which is disappointing.

In closing, I will say that, in 2022, as a result of the expertise and learning that they acquired during the pandemic, and their awareness of the importance of good indoor air quality for health, Belgium passed a law to improve indoor air quality in all closed spaces that are accessible to the public. However, we seem not to have learned any lessons at all, and certainly none in relation to protecting those who are most vulnerable or are immunocompromised, and I hope that this petition will start the process of ensuring that the Scottish Government pays attention to what it needs to do.

Convener, you and Mr Stewart have covered most of the detail of what I was going to say, but I will emphasise a couple of points. We would all acknowledge that FAST is a very good awareness programme for stroke, but it could be even better, and that is the essence of the petition. I have to say that the petition is simply common sense, and I am not sure why the Scottish Government is not doing this.

We heard why James Bundy brought the petition to us, and it is a matter of regret that his father died in the way that he did. As we have heard, 40 per cent of ischaemic strokes are simply not captured, and symptoms such as vomiting, blurred vision, confusion and lack of balance should be included in an extended FAST awareness campaign. Convener, you referred to BE FAST, with BE covering balance and eyes.

Therefore, I ask the committee to urge the Scottish Government to conduct a wider review of the FAST approach. We recognise the good work of the FAST campaign but, if we are missing up to 40 per cent of ischaemic strokes, surely the Government should be open to changing the campaign to include more symptoms.

The minister’s response misunderstands that point, but I ask the committee to encourage her to build on the solid foundations of FAST but extend it to include more symptoms so that we can save more lives. I am sure that everybody would sign up to that objective.

I think that we would all describe childsmile as a flagship programme. It was introduced by the last Labour Scottish Government and has helpfully been continued by the SNP.

We are seeing growing inequality, particularly in children’s oral health, between the least and most deprived areas. There was already a problem, but that problem has been exacerbated by Covid and we are now seeing registrations of very young children drop dramatically. Only 25 per cent of children under two years old are registered, which is desperately worrying, given the impact of this issue in later life. We do not think that childsmile has returned to pre-pandemic levels. What are you doing to address concerns about children’s oral health?

We know, too, that there are concerns about adults, so what specific measures are you taking to address inequalities in adults’ access to dentistry?

Speaking more widely about prevention, I very much welcome the fact that the dentists who gave evidence to the committee mentioned prevention with virtually every breath they took. However, they described a funding model that is “high-volume, low-fee” and “disease-centred” and said that they feel they are not able to do the kind of prevention work that they want to. One dentist highlighted the ability to bring together a group of children to do education work on prevention, saying that the fee model did not allow them to do that.

I am keen to know what improvements you will make to enhance dentists’ ability to carry out prevention work, and I would also like to know what the Government will do, at the population level and beyond the touch points that you have described, to improve access to dentistry and ensure that more preventative work is done.

I do not want to put words in your mouth, but what I seemed to hear is that the ability to be more flexible around prevention is not part of the current discussion about fees.

The dentists described the model as preventing them from doing the kind of dental work that I have described. We will need to wait and see what you come up with.