Chamber and committees

Orders not to attempt cardiopulmonary resuscitation—often called DNRs, or do not resuscitate orders—have been in the news. That has created fear, because there is a feeling that some use has not been consensual. I have looked into this, I know that families instinctively want to save their loved ones and want them to have as long a life as possible, but DNRs can also prevent harm and distress. A lot of people do not understand how distressing resuscitation procedures can be. Are we looking at the public message about people having kind, compassionate and comfortable deaths, rather focusing on the use of DNRs, which involves a fear factor? What are we doing to improve that?

Thank you, minister; and thank you to Marion, too. There is not much at all in what you said that I could disagree with.

We know that the women’s health plan is not all encompassing. I am thinking of conditions such as menopause, hyperthyroidism and even endometriosis, which I have suffered from. The number 1 point that we must address is that women are dismissed and disbelieved, as we have seen with the mesh situation.

When I was suffering from endometriosis, it took more than 10 years to get a diagnosis, as has also been the case for so many others. The disease was really severe and I have had several operations. I have a daughter and, like every parent, the last thing that I want is for her to go through the same thing. She is getting to the age at which she might be affected.

Great training is provided in medical school, but how do we propose to change the deeply embedded attitudes to women who present with health issues? A lot of the time, the attitude comes from the top. It is not just male doctors or consultants who are the issue; females can be just as bad. In my experience, the same dismissal of and disbelief in what we say has been apparent in relation to not only women’s health issues, but to our children’s health issues. How will we tackle that?

What Tricia Meldrum said is interesting. There was comment about the pandemic leading to the delivery of the Christie recommendations “at scale”. What lessons can be learned from that in terms of policy approaches?

That is great. I am a councillor on South Lanarkshire Council, so I was delighted to hear the positive comments about the collaborative work on education that the council has been doing.

I am sure that we all agree that we want our children to have the best start in life and that the provision of 1,140 hours of free early learning and childcare has been a bit of a revolution in Scottish childcare. Previously, only 412 hours of such childcare was available, and I know as a parent of school-age kids that it would have made a huge difference to me to have had those nursery hours available.

Although the pandemic delayed things by a year, it was an incredible achievement to get that rolled out. Around 97 per cent of children get 600-plus hours and 87 per cent get the whole 1,140 hours. The Scottish Government has committed to providing wraparound childcare for before and after school and to expanding early years education for all two-year-olds. How should the evaluation of the expansion to 1,140 hours inform future policy making in the area?

Thank you very much for all the answers that we have had so far. It has been really interesting to hear the comments about data, the sharing of good practice and local issues and challenges, but I think that, quite often, all of this comes back to the ability to properly reflect all our children’s strengths and skills, not just the academic achievements, and to deliver the policy ambition on the ground. How does all of this knit together and join up with the move to put vulnerable citizens at the centre of decision making and involve them in that process?

Thanks very much. That is really helpful.

I want to ask about the team making decisions and whether the best care and treatment available can be delivered within the specialist service. Is that completely down to the team? What choice will women have in relation to onward referral?

What health professionals will be part of the multidisciplinary team? How wide will that go, depending on women’s needs?

That is great. I thank you for the huge amount of compassion that is coming through today, which is incredibly important to the women. I hope that that will be reflected in the decision-making process, when we come to that point.

If women are unhappy with decisions about eligibility or cost reimbursement, what processes will be available for them to make a challenge or ask for a review?

It is good to hear that, although you do not think that an appeal process will be necessary, it will be there to reassure women that there is some comeback, if it is needed.