The final item of business is members' business debate on motion 15292 in the name of Gordon MacDonald on Marie Curie's great daffodil appeal. The debate will be conducted this evening by Emma Harper on Gordon's behalf. The debate will be concluded without any questions being put. Can I ask those who wish to speak in the debate to press the request to speak buttons please? I welcome everyone to the public gallery and I know what all you Marie Curie volunteers are like, so can I sit you right at the start? We'll have no clapping, heckling or anything else going on. There'll be time at the end of the debate to show any appreciation that you may wish. I call on Emma Harper to open the debate for around seven minutes please. I'm pleased to have the opportunity to bring this important debate to the chamber this evening to raise awareness of Marie Curie's great daffodil appeal. I'm speaking on behalf of a motion brought to Parliament by my friend and colleague Gordon MacDonald, who is unfortunately unable to be here this evening. I understand that more than 100 Marie Curie volunteers and staff from all across Scotland are here tonight, including the charities new chief executive Matthew Reid. I'm sure that colleagues across the chamber will join me in welcoming them here to their Parliament. I'd like to start by paying tribute to the support that you've given Marie Curie over the past few years, leading members' debates, raising awareness and hosting parliamentary events. I will be doing this this evening also. By the way, Prisidon officer told me that she was out on Saturday in her yellow top hat, collecting for the appeal also, and I wish I was there to witness her son's face. The great daffodil appeal is one of the most iconic and recognised fundraising drives of the year. People all over the country will wear their yellow daffodil badges with a sense of pride that they will be donating money to support Marie Curie, to deliver their world-class palliative care services in our communities, to support their research, to support their campaigning, and to support the information services that they also provide. Last year, my colleague John McAlpine and I hosted a blooming great daffodil tea party in our regional office to raise funds and awareness. Earlier this year, I joined the palliative care cross-party group, convened by my colleague Bob Doris MSP, so that I could learn more about what could be done. Prisidon officer, I thank Emma Harper for taking the intervention and name-checking. She just gave me the opportunity to come to my feet to put on record the wonderful service that the Marie Curie Hospice and Springburn in my constituency does for right across Glasgow, but Emma Harper agreed with me that it is also the Marie Curie community nurses who are invaluable in the city of Glasgow, including in the year 1718, where they supported 569 people at home, and that was 5,459 visits. That invaluable work and dedication that they provide to people who are in real difficult periods in their life. Emma Harper, I thank the member for his intervention. I think that it is great that he is here in chamber supporting his Springburn constituents, who are the Marie Curie nurses, as well as the Springburn Marie Curie hospital. Thank you very much for being here. The services provided by Marie Curie are only possible through the dedication of the many thousands of volunteers, donning top hats, bibs and collection buckets, and braving the ever unpredictable, good Scottish weather every March. As always, the Scottish people are incredibly generous, donating thousands of pounds every year. Whether the daffodil is worn in solidarity or in memory of a loved one, each daffodil tells a story. My story is contained in my 30 years as a nurse. Last year, the daffodil appeal helped Marie Curie care for over 8,600 people living with a terminal illness, as well as her family members, friends and carers. They have a huge and irreplaceable impact on our communities at a time that can be incredibly difficult and challenging for families. We can remind ourselves that the organisation takes the name from the twice-nobel prize-winning scientist, Marie Curie, for her research in radioactivity. Marie agreed for her name to be used for a hospital staffed by women, to care for and treat women with cancer. The hospital was destroyed by a bomb in 1944, which led to the hospital being re-established as the Marie Curie charity. Marie Curie provides care for people with any terminal condition, whether that is terminal cancer, organ failure, heart disease or frailty, and, increasingly, we see people presenting with many different and multiple conditions. They do this across the whole of Scotland and the rest of the UK. They deliver in front-line care services in 31 local authorities in Scotland through nursing and hospice services. Their volunteer befriending service Helper is now reaching out to new areas and caring for more and more people with an information and support service, which now supports over 10,000 people a year UK-wide. Marie Curie is also the biggest funder of palliative care research. With two research leads in Scotland and over 16 active research projects, much of that expertise and knowledge is generated right here. I am proud that the Scottish Government has an ambitious vision that everyone who needs palliative care will have access to it by 2021. That is determination that I wholeheartedly share. The Scottish Government's strategic framework for this action on palliative and end-of-life care sets that out, and it is outstanding to see that progress is already being made. That progress is supported by Marie Curie and others in the sector. I look forward to hearing from the minister on the most recent up-to-date progress that the Scottish Government and its partners are making. It must also be acknowledged that, sadly, despite progress, some people are still missing out. In Scotland, around 43,000 people who die each year need palliative care. Estimates suggest that a quarter of those people still miss out on some or all of the support that they need. We know that those dying with conditions other than terminal cancer, such as dementia, heart failure and frailty, are less likely to access palliative care. Older people lack Asian and minority ethnic populations, as well as people who define as LGBTI, and those who come from our poorest communities are far less likely to get the care that they need when terminally ill and dying. I think that we can all agree that this is not acceptable, and I am pleased that this is being recognised and addressed by a Scottish Government working for the people of Scotland. We know that Scotland's ageing population is something to celebrate, but it means that, in the years to come, more people will be living longer and there will be an increased need for palliative care.  That is 50,000 people that we need to make sure receive the support that they deserve. It is clear that we are going to have to do more to ensure that people get the care that they need now and in the years to come. Presiding Officer, when preparing for this debate, I was pleased to see the wealth of support that Marie Curie provides to my South Scotland constituents. I think that it is worth highlighting some of that important work. Across the NHS, in Frees and Galloway, over 2017 and 2018, there were 4,359 visits made to 542 people and the patients by the regions that there are 31 dedicated Marie Curie nurses. The support from those nurses allowed 72.5 per cent of palliative care patients to die in a place that they chose, which I welcome. Additionally, I am pleased that, across South Scotland, Marie Curie has seven shops raising funds for the charity, located in Ayr, Prestwick, Throon, Lanark, Newton Stuart, Strenwyr and Dumfries. With more than 896 dedicated volunteers, I thank each and every one of them for their efforts to make the lives of others more comfortable. In closing, Presiding Officer, I would like to wish Marie Curie every success for this year's great Daffodil appeal. I would like to thank everyone at the charity for everything that they do to support families across Scotland. I know that compassion, dignity, care, love and kindness that they bring to everyone that they look after and their families can never be covered in a simple thank you, but I want to be clear that gratitude of myself and of this Parliament is here. Marie Curie provides support to her loved ones towards the end of their lives and it is our role as politicians to support them as best we can. We move to the open debate. The speeches of around four minutes, please. Brian Whittle, followed by Gail Ross. Thank you, Presiding Officer. I thank the Government of Ireland's Absence for bringing this debate to the chamber. The first day allows us the opportunity to thank Marie Curie and other organisations for offering part of care for all and all their amazing work that they do to raise awareness of the Daffodil appeal. I was sitting in my office last night wondering where I would go with my speech. I happened to glance to my right and I have some photographs on my wall to make me smile. Do we need to smile in this place sometimes? There is a picture from the mid-90s of a bunch of reprobates in a warm weather training camp, where Tom and McCain was there and Elliot Bunny was there, and at the end of it was a friend of mine, Don Flockhart. He sadly lost her six-year battle with cancer last month at the age of 51. She was cared for in her last few months in the Maricuri hospital in Edinburgh. If you will indulge me a minute, Deputy Presiding Officer, I just want to go in to tell you what a prestigious international athlete she actually was and still holds the Scottish record for the under-15 200 metres that she represented at the Scottish and British level. I remember her humour and her cheek in the warm weather training camps. She was always at something, always playing practical jokes, laughing and generally being a really great company. I will say that she gave me a really hard time about my politics. You lot over there would have loved her. She managed to cram more into her 51 years than most would do in several lifetimes. There is so much I could tell you about her, from teaching English to foreign students in Italy to learning yoga in India. She even assisted Paul McKenna, I found out. She assisted Paul McKenna in teaching him NLP. I just scratched the surface of what she achieved. She had a way of connecting with people and a desire to help people. She once insisted that she work with my middle daughter, with her positive mental attitude towards her track racing and performance. She has been described as a force of nature and she was all of that and more. My thoughts are with her family. I know that they are very grateful to Marie Curie for the care and comfort that they gave to Dawn and her family in her last few months. I am sure that we all have a story to tell. The one thing that strikes me here is how young Dawn was. I am sure that when we consider palliative care, we automatically think of those later in life. As I said before, a positive and active lifestyle can definitely stack the cards in your favour, but it cannot make you immune. The Scottish Government has a vision where everyone in need of palliative care will have access to it by 2021. However, there is currently one in four missing out on that much needed care. Whether that be in a hospice or a hospital, support to stay at home or in a care home, the ask is that the appropriate care is available in line with the health and social care plan. An acute hospital setting is rarely the right environment for end-of-life care, both from a patient's perspective and even from an economical perspective. We are all aware that people are living longer with more complex conditions, not just cancer and dementia. Therefore, we need to map out palliative care requirements of the future in the midst of the budgetary constraints. That is a key ask. One phrase struck me when reading the Marie Curie briefing document that reminded me of the carers debate that we had just last week. I quote, far too many carers of those at the end of life are not getting the support and the need to enable them to carry out their carers role. More carers need to be identified. I am pretty sure that that is the very same thing that we said in this place last week. So, while we get involved in arguments about Brexit and budgets in constitutional bun fights, this debate is an opportunity to remind us that, through the clutter of politics, there are things—every day things—affecting people's life that we can change. Can we all commit to making sure that this is one of them? Gail Ross, followed by Lewis MacDonald. I would also like to record my thanks to Gordon MacDonald for bringing this debate to the Parliament and also to Emma Harper for leading the debate. I would like to say to Brian Whittle what a lovely tribute that was. I would also like to say hello to everyone in the public gallery. Mary Curie gave us a very detailed briefing to members with activities in our constituencies. I would like to thank them for that, but, most of all, I would like to take this opportunity to thank all those working with Mary Curie who provide invaluable care and support to individuals and families, often the most challenging of times. The support provided by Mary Curie is only possible through the magnificent fundraising efforts of countless volunteers. Each march, the Great Daffodil Appeal helps to raise awareness and funds that allow Mary Curie to continue to provide the fantastic support and care to people all over Scotland. I recently joined local volunteers in WIC, collecting for the Great Daffodil Appeal, and the generosity from the local community was absolutely fantastic. I would like to congratulate them on their £952 that they collected, but I must admit that I had a great couple hours just chatting to them and laughing and getting to know them, and I must say that I knew most of them already, being from a small community. That is only one of the groups active in Caithness, Sutherland and Ross that I would like to take this opportunity to thank. In the Highlands, around 2,575 people die each year from cancer, with 1,930 requiring pallet of care. In the last year, Mary Curie nursing team in the Highlands have seen 189 people over 1,403 visits. Even with that impressive level of care being provided, it is still estimated that one in four people miss out on pallet of care at the end of their lives, and that is why I welcome the actions from the Scottish Government in setting out its strategic framework for action in pallet of and end-of-life care. We know that, when asked, the vast majority of people would like to be cared for at home or in their own community, and that specialist in general pallet of care services have a proven record in reducing admissions to accident and emergency, can prevent unplanned hospital admissions and support appropriate discharge into the community. In 2017-18, nearly 88 per cent of those who died were able to spend their last months of life at home or in a community setting. Hospices play a critical role in supporting people to achieve their wishes to spend their last days at home or in the community, and in the NHS Highland area over 92 per cent of people achieved their preferred place of death. Without the support of the third sector, it would be impossible for health and social care partnerships to meet those needs and the needs of those living with a terminal illness. Evidence suggests that investing in pallet of care services can make efficiencies and savings in the wider health and social care system, and the London School of Economics suggests that extending specialist core pallet of care services to those that would benefit could result in net savings of over £4 million. As we mark the great Daffodil appeal this evening, can we both celebrate the hard working commitment of Marie Curie staff and volunteers but also recognise the significant funding that is required to carry out that work and absolutely endorse what Brian Whittle said about the need for us all to come together? I think that that is the perfect setting for us to do so. Lewis Macdonald, followed by David Torrance. Thank you very much, and I too congratulate Gordon Macdonald in his absence on securing this debate and Emma Harper on opening it. As I think every speaker so far has said, Marie Curie has played a vital role in providing pallet of care across Scotland and beyond for many years, and the great Daffodil appeal has become a widely recognised symbol of the support that the charity provides for people with cancer and with other terminal conditions. The pins that many of us are wearing today are not just a way for Marie Curie to raise much-needed funds for its hospices, home care nurses and support networks. They are also a way, in the sense that Brian Whittle is so well illustrated, that they are a way for many people to remember those who have lost the cancer and other illnesses and who benefited in their final days from the expert care of Marie Curie nurses. There is no Marie Curie hospice in Aberdeen, but there are something around 50 Marie Curie nurses working in Aberdeen and across the Grampian area to support people with cancer and terminal conditions, making over 6,000 home visits to over 1,000 people in 2017-18. The helper service run by Marie Curie, which sees volunteers go into the homes of those who are receiving end of life care to provide support and friendship, has also recently been reorganised in our area to cover the whole of the north of Scotland and provides a very valuable service, with nearly 100 volunteers in Grampian alone. A service that is particularly valuable to people in rural areas who are undergoing end of life care support to their families and generally to people who find it difficult otherwise to access the kind of support that they need. Marie Curie is one of the longest-running charities supporting terminally ill patients, but in Aberdeen and the north-east, as in many areas of Scotland, she works alongside other national and local charities. I know, certainly, the Marie Curie people with whom I deal are very keen to emphasise that they are part of a wider family of support for those with cancer. Aberdeen has its own MAGGI centre, providing support and advice to cancer patients, while Macmillan Cancer Support is a regular advice session at Aberdeen Citizens Advice Bureau, as well as running local support groups. Clan Cancer Support works to support cancer patients and their families across Grampian and also in Orkney and Shetland. Cancer patients from the Northern Isles, as those members from that area will know, come to Aberdeen Royal Infirmary very often for cancer treatment. Clan provides accommodation for patients and their families at Clanhaven, as well as counselling and therapy at the purpose of building Clan House in Aberdeen. The family of support for people in those circumstances is very important. Marie Curie nurses particularly play such a key role in providing practical, palliative care to patients with terminal cancer and other diseases. It relies on good will to raise the funds that are required to provide those services. It enjoys huge good will, but it is important for all of us, and perhaps especially for the Government, to recognise that such fantastic voluntary effort cannot do it all on its own. As our population ages, demand for palliative care, as Emma Harper said, is only going to increase, much of that demand will fall on integration authorities, health boards and local councils, all of which face their own funding challenges, perhaps especially but not only in my own region of the north-east. It is vital that the Scottish Government continues to address those issues to look at supporting the effective integration in health and care, as we have debated here on a number of occasions, and to provide the support that the whole sector needs in going forward. Inevitably, Marie Curie will see an increase in demand for specialist nurses, and they will need to continue to receive that support. Let me close by paying tribute to all the nurses and volunteers for Marie Curie who do such vital work in what can be such a difficult area. To acknowledge all those, including yourself, who deliver and all those who support the Great Daffodil Appeal every year, allowing that important work to continue and allowing that role to be played into the future. I thank Gordon MacDonald for securing this debate in the chamber today, allowing us the opportunity to speak about Marie Curie and her annual Great Daffodil Appeal. I would also like to welcome all Marie Curie's staff and volunteers to the Parliament today. Every year since 1986, the Great Daffodil Appeal calls on people across the country to donate and wear a Daffodil during the month of March so that Marie Curie can continue to care for people with terminal illness who deserve the right of high quality, patient friendly and sympathetic care. Marie Curie helps to relieve the physical, emotional and financial stress on terminate ill individuals and their families through her service and support. The invaluable services that are provided allow us with part of care needs to retain an element of independence and control by granting them the option of leaving the hospital and staying in the comfort of their home with a guarantee that they will be cared for by hardworking and compassionate nurses. In fact, 89.3 per cent of patients supported by Marie Curie last year spent the last six months of their lives at home, and a community setting allows 97 per cent of patients to pass in their place of choice. Marie Curie does an excellent job of respecting its patients wishes and its provision of social care, which is no doubt an integral part of palliative care. In fact, Marie Curie in partnership with NHS Fife has been commissioned to provide a variety of nursing, emotional and practical home-based support. Everything from helping patients to manage symptoms to assistance with meals or to a weekly chat. In fact, approximately 4,190 people die each year and 3,140 of these individuals have a part of care needs, being about 75 per cent of those who pass away need assistance. That is why a great daffodil appeal is of such great importance. In Fife alone, a team of 13 Marie Curie nurses conducted 4,062 visits and saw a total of 338 patients last year. Along with a nursing team, 153 dedicated volunteers gave her time to support terminally ill patients and their families across Fife. Marie Curie's defending service, Helper in Fife, is currently supporting 27 families with more volunteers due to begin training. Marie Curie's support in the area is invaluable to countless members of my community and has been and continue to be and be touched by our services. Last year in October, I had the pleasure of meeting with representatives and had more about how we make real life-changing differences in the lives of those who serve. I believe that it is vital for people to be made aware of the services that Marie Curie provides and for them to take advantage of those services if they or someone they know are struggling to care for his or herself as no one should be or have to endure illness or suffering in isolation. My constituency of Gercordia is proudly home to a Marie Curie charity shop. Since its opening, Marie Curie's shop has proven time and time again to enhance my constituency. The shop, run by volunteers, raises awareness for causes, encourages charitable giving in my area and most importantly highlights the organisation's impact on the area. Volunteers are a backbone of Marie Curie and I cannot praise them enough for a fault, then, that Marie Curie would not be able to provide a level of care and support what it does. The Gercordia fundraising group has raised £24,310 since forming in August 2014 and currently has six active members who are taking part in the great Daffodil appeal collections this month. Volunteers deserve our sincerest gratitude and support for all their hard work and dedication. I am fortunate to have the opportunity to join volunteers on many occasions and help with their fundraising efforts. It is an incredible experience to see fellow fifers of all age groups with big smiles on their faces, tins in hands, encouraging and inspiring others to do good in the community. I have seen firsthand how proud and happy the volunteers are to lend a hand and be part of such a worthy cause. Volunteering allows people to give back to a community that is truly satisfying and a humbling experience. That is why I am very much looking forward to offering my help to my local fundraising team once again during this year's appeal and will be joining them during March down in Gercordia High Street. In conclusion, I wish the Marie Curie organisation and all the volunteers who were involved across Scotland all the best in the great Daffodil appeal of 2019. I, along with my staff, will be wearing a bright yellow Daffodil to raise awareness and make a difference, and I will encourage everyone else to do the same. Thank you very much, Presiding Officer. I, too, start by echoing the chamber's thanks to Gordon MacDonald for securing time to debate this important issue this afternoon. We cover many topics in this chamber, but I think that the debates that we have about end-of-life care are some of the most poignant and some of the most profound. I am very privileged to speak in this today. I am grateful that I have been reflecting and listening to other people's contributions. The experience of members across the country is very similar to mine, in terms of the work that Marie Curie does to give comfort and compassion to people in the last and sometimes very difficult hours of life. All told, there are only 23 Marie Curie nurses in the Lothian region, but their reach extends far beyond that. They give out more than palliative care, they give compassion and they give love, not just to people in their final hours but those who love them around them. That speaks volumes to the character of the people that choose that life, that choose that profession. Not everybody could be a Marie Curie nurse. In the time that I have available to me, I want to offer two reflections on events that have happened to me since I spoke in this debate last year. The first was a visit that was organised by Marie Curie to their Frogson hospice in Edinburgh, where a lot of my constituents will spend their last days. It was a familiar place to me because my wife's gran had died there in 2002 and I reflected that to the receptionist at the door when I arrived. She said, what was your gran's name? I said, her name was Brydie, but it was 2002. She said, what do you mean Brydie Douglas? 16 years later, the receptionist still remembered my wife's grandmother with fondness. It was that human interest, that desire to get to know the people in their care and to see the human being and the life story behind them, which really struck with me. The second reflection that I would like to offer is something that happened exactly this time last year. My wife's father was taken into hospital with what was suspected to be a simple bladder infection. He had profound MS, so he was very prone to it, but he became apparent very quickly that this was advanced bladder cancer or liver cancer. It was clear that he would only have weeks if not days to live. The battle then was to get him home. We really struggled with that, as many families do, to make sure that there was an adequate social care package underpinning that so that we could give him his last days at home where he definitely wanted to be. Mary Currie was vital to that. We could not have done that without the Mary Currie nurses coming in to help. In those last six days, from his discharge from hospital to when he sadly passed away, we were able to build a bubble of love and light and happiness around him in his family home with the support of the Mary Currie nurses. They offered so much more than I ever expected of them. I had never seen them in operation quite as I did at Robb's bedside. They taught me to massage a moisturiser into Robb's arms because he was very dehydrated as most people are when they are coming towards the end. It was one of the most intimate experiences that I had with my father-in-law. I taught him as I did it. He taught me how to rehydrate him by putting water to his mouth. Their care stretched far beyond Robb's final hours. It struck home to me that, a week after Robb's funeral, a Mary Currie nurse appeared at the door with a bunch of flowers and a mobile telephone number. That offer of continuing pastoral support, which we have leant into from time to time, put simply, Presiding Officer, they made what could have been a tragic and very sad experience, one that we reflect on with fondness and love. I thank everyone for them. I thank everyone who is in the chamber today for supporting them. I am grateful for the opportunity to debate this in Parliament today. I thank my good friend, Gordon MacDonald, for securing the debate in the chamber this evening. I also thank Emma Harper for leading the debate so effectively. I welcome those who are here in the gallery to support the work that Mary Currie does. It has been very interesting hearing the experience of others around the chamber this evening and their own contributions that they have made to Mary Currie and some of the challenges that they have faced in their own lives. Incidentally, I joined Gordon MacDonald last week in the photoshoot that Gordon had organised, and I thank him for that, too. I also thank him for being able to wear one of those splendid top hats in the yellow that Mary Currie had. I have already had some Mickey taking out of my own constituency in the little folk art photographs that appeared in the sterling observer. However, what I really want to do tonight is to thank the Mary Currie organisation for the incredible work that they do to provide the end-of-life care for people in my constituency. Moreover, I also recognise the role of the many volunteers that they have. I think that it was almost two years ago that I was one of the first MSP to host a Mary Currie blooming great tea party fundraiser. I had held the event in my constituency office at Step in the sterling sterling enterprise park. I should say that it is well attended, mostly by employees from the many offices in the complex surrounding me, but who does not love a good cup of tea, a slice of cake and a good blither? I tell you this story because it struck me that invariably the conversation for those who turned up and attended the tea party turned to what Mary Currie meant to them, and I want to come to that a bit later. First, let me say that the Mary Currie shop in sterling city centre is incredibly well run by a dedicated team of local volunteers. I had the chance to drop in recently as part of sterling's bid to become Europe's volunteer capital and speak to Morag, the shop manager, about how important that place actually is to local people. It's a place that people not only pop in for a wee bargain but also to have a chat with the people who are the volunteers in the shop, and they do a great job, as you might imagine, while having that blither of raising funds on behalf of Mary Currie. Most recently, I caught up with local Mary Currie activists Frida and Jim in sterling's morrison store on Friday. Jim is the area manager, and he was telling me about the varied role he has in the organisation. Frida is a local volunteer originally from Bannockburn, and as someone who has worked in hospitals who has been able over a number of years to tell me her story about how important Mary Currie had been as a service to her. The two of us are handing out those daffodil pins that most of us or all of us are wearing this evening, and it was quite remarkable to see so many people give so generously to the bucket that was there. It was humbling, actually. The work that Mary Currie does means so much to every one of us in this chamber and many across the country and in our constituencies. Most of us will know someone. I think that, as someone who has said this already, we have been through an end-of-life experience. It is not just the patient that experiences this difficult situation but also the family and close loved ones, too. Having the help and advice from Mary Currie's staff to provide has been a real and invaluable lifeline to so many people. The nurses provide free nursing to people with terminal illnesses, one-to-one nursing care, which can be overnight, or even very short notice in a crisis. Just knowing that service is available brings comfort to people who are going through that difficult time no matter how bad it can get, that help is there. I have written this first hand just how much care the Mary Currie nurses provide to people. Let me quickly tell you that story. One of the Mary Currie nurses visited my office to let me know about their work locally. By sheer coincidence, that nurse had been at the end of life carer for one of my staff's mothers. That reunion between those two people, who had been through a lot together, was at the same time deeply emotional as it was joyful. You can see in both their faces just how much it meant that joint experience and meant to them. It was a very moving moment that I will never forget. Mary Currie is a vital crutch to those who are going through perhaps the most difficult event that life invariably throws at us. I thank goodness that organisation exists without it. People in those situations would have a much more difficult time and the families involved would have had a much more difficult time. I am sorry that I cannot be at the reception this evening to join others to celebrate the work of Mary Currie and the blooming great tea party. Before I call Mr Mountain, there are three speakers still to go, plus the minister, so we are running out of time. I am therefore minded to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes. I would ask Emma Harper to move a motion without notice. The question is that the debate be extended by up to 30 minutes. Are we all agreed? That is therefore agreed. I remind members who might be concerned that parliamentary receptions and so on are not allowed to begin until business in this chamber is finished. Can I have, please, Edward Mountain, followed by Maureen Watt? Thank you, Deputy Presiding Officer. I thought that I had just calculated that I had 10 minutes to speak and then you made that comment that I was standing between people in their reception, so I would be mindful of the time. I would like to thank Gordon MacDonald for bringing this and Emma Harper for speaking in this debate. When I met the representative of Mary Currie in December last year, I was so inspired by the care and support that they told me they offered to patients across Sir Highland. The help that this charity provides, I believe, is vital. Last year, 1,403 visits to terminally ill people at home across the region, supporting 92 per cent of people to die in the place of their choice. Let us not forget—I do not forget—that this would not be possible without the huge energy that goes into the fundraising efforts of all those fundraisers. I would like to take this opportunity to pay special tribute to the 14 local fundraising groups in the Highlands who have raised more than £170,000 in 2017 and 2018. That money will go a long way to support loved ones across the Highlands. I also want to thank Gordon MacDonald for reminding the chamber and the Parliament that Scotland still has a way to go in ensuring that everyone with a terminal illness receives the care that they need. As we have heard, 1 in 4 people miss out on the palliative care that they need at the end of life. I believe that we need to do better. I am delighted that the Government is stepping forward to trying to achieve that by 2021. Come on, be bold, do it beforehand. I believe that the clock is ticking for all of us, as far as palliative care is concerned, because we are seeing a rise in the population of Scotland, and this increase in age will mean that there will be an increasing demand. I believe that the issue unites the chamber, as we have heard this evening, because many of us have lost a family member or friend to a terminal illness. I know from personal experience that, without palliative care, our loved ones cannot make the choice where they want to be for their final moments. That is why it is important. I believe that dying with dignity is the mark of a civilised society. I strongly believe that everyone must have the right to die where they want to in the location of their choosing and at home. That is why I think that this charity is so important. That is why I wear the daffodil every year, because people know that we are supporting this wish.  However, every other time of the day and the week, I am very happy to wear it and support it. I can see that that did not go down very well, but I just think that from a rugby point of view, I am not going to wear it. I urge everyone to wear the daffodil and to join the great daffodil appeal in March this year, and to take time to thank all those people from Mary Currie who are helping our friends and family in their last days. We do not have more in what we appeared to have had a wee problem with her button. Can I tell everybody how ever she looks very fetching in that yellow top hat? Therefore, the last speaker in the open debate is Liam McArthur. Thank you very much, everybody. I am happy to step in as a substitute for Maureen Watt. I, too, thank Gordon MacDonald for allowing the debate to take place in Emma Harper for not only stepping into the breach but taking on the mantle that you have so ably carried over recent years in leading this debate. I think that debates in this place always benefit from the ability of members to draw on personal experience. I think that we have heard that very powerfully this evening, notably from Brian Whittle and my colleague Alex Cole. As ever, I pay tribute to the phenomenal work done by Mary Currie nurses, staff, volunteers on behalf of those with a terminal illness and, of course, their families. I think that we should never fall into the trap of being complacent about that and I am fairly sure and confident that we won't. I think that we also need to bear in mind—and the motion indeed reminds us of that—that there are still thousands of people across Scotland in need of palliative care who are still missing out. With an ageing population and annual death rates on the rise, the numbers that are unable to access the end-of-life care that they need will inevitably increase unless steps are taken to address that. I very much welcome the Government's action plan for palliative care and end-of-life care. It does, as others have reminded us, commit to ensuring that, by 2021, everyone who needs palliative care will get it. However, for that to happen, I think that we will need to see a greater priority from health and social care partnerships as well as resourcing from Government. To meet that target, we will also have to address what is, I think, a discrepancy and inequality in access. I think that Emma Harper was absolutely right to point to the fact that, for those over 85, for those living alone, ethnic minorities living in deprivation, there are disparities between those suffering from cancer as opposed to those with other terminal conditions such as dementia, motor neurone disease, heart failure and others who seem to be overrepresented among those who are not getting access to that care. I also, like others, want to acknowledge the efforts of those who are responsible for delivering those services in my constituency in Orkney. As I have said before, this is a relatively new service in the islands, but it has already shown its worth and value. Feedback from those who have benefited from the service remains incredibly positive and, inevitably, as a result, demand is likely to continue to grow. More so than I suspect, the two nurses that are currently operating in Orkney will be able to support. I would hope and expect every effort to be made to enable that demand to be met, working closely with GPs and other relevant services, reflecting the essential partnership between voluntary and public sectors that are so essential in that area. It certainly appears to be strong support within the Orkney community, reflected in the response to the fund-rating heroics of Linda Lennie and her team of local volunteers. I am delighted that Linda is here in the chamber to witness the debate and to attend the reception tonight. In conclusion, I congratulate Gordon MacDonald for enabling this debate to take place. I wish everybody involved in the Great Daffodilif field every success this year and to all the Manicuri nurses, staff and volunteers. I sincerely thank them for the exceptional work that they do in allowing people to die with dignity and in a place of their choice. I call Jo FitzPatrick to respond to the debate for around seven minutes, please, minister. Can I add my congratulations to Gordon MacDonald for securing tonight's debate and to Emma Harper for stepping into the breach and leading tonight's debate? I also thank members from across the chamber for what I think has been an excellent debate with some particularly powerful contributions. I particularly want to thank Alex Cole-Hamilton and Brian Whittle for their very touching contributions, which I think puts it into context about why we all think that the Manicuri is so important. I have to say that the fact that the Great Daffodilif appeal is still going strong after more than three decades is just a fantastic achievement of which the Manicuri staff and volunteers should be rightly proud of. We all agree—I know because we have heard it across the chamber—that the fantastic work that Manicuri in Scotland does is invaluable. It fulfil a role that is vital in supporting those nearing the ends of their lives and also in sustaining a multitude of families and friends around them. Since I have been appointed to be part of the health team, I have been immensely impressed by the range and breadth of the support that Manicuri offers. It was good to hear from across the chamber some examples of that right across Scotland. There are a number of great examples from my constituency in Dundee, in which you can see that Manicuri is a much broader organisation and provides a much broader range of support than perhaps people would traditionally expect of the organisation. The skills, compassion and care that is provided is more important than ever, as the demand for such services is set to increase due to the well-understood changes in our population, which I think Lewis mentioned earlier. We all want a fairer, healthier Scotland, and the Manicuri Great Daffodilif appeal presents a timely opportunity for us to reflect on the challenges that we face in meeting those specific needs and an opportunity to set out the concrete steps that we are taking to address them. Scotland is already a world leader in the field of palliative and end-of-life care, and I am proud of the progress that we have made over the past few years, increasing numbers of specialist staff, improving access to services and through our programme of health and social care and integration, putting services under the control of our local communities. However, there is more to do. The Scottish Government is committed to working with organisations like Manicuri to take forward our shared aim of ensuring that everyone in Scotland who would benefit from palliative and end-of-life care has access to it by 2021. That is an ambitious goal, but one that we fail is within our reach. In December 2015, we published our strategic framework for palliative and end-of-life care. The framework sets out a number of commitments that are designed to improve the quality and availability of palliative and end-of-life care in Scotland. However, to achieve that vision, it is essential that we create the right conditions nationally to support local communities in their planning and delivery of palliative and end-of-life care services to help to ensure that the particular needs of each individual are met. That ethos is at the heart of the health and social care integration. Integration authorities are working with local communities and building on the expertise of organisations like Manicuri to commission services that are truly designed to meet the palliative and end-of-life care needs of their local community. By commissioning services in this way, improvements will be driven through meaningful collaborative partnerships with the palliative and end-of-life care community. Key to the success of the work is the ability of integration authorities power to drive real change. They will manage almost £9 billion of resources that NHS boards and local authorities previously managed separately. This year, that includes more than £550 million of health investment to support integration and social care increased to exceed £700 million in 2019-20. We have also asked healthcare improvement Scotland to work with integration authorities to test and implement improvements in the access to and delivery of palliative and end-of-life care. Data is vital. Without it, we do not know whether people are indeed getting the palliative and end-of-life care that they need. Without it, local communities cannot commission the services needed to support people's care, and care plans will remain hard to share. The data challenge is recognised in our SFA, which contains a commitment to support improvements to the collective analysis, interpretation and dissemination of data and evidence relating to the needs, provision, availability, indicators and outcome in respect of palliative and end-of-life care. A working group is tasked with clarifying the data requirements to ensure that they are valuable for both individuals receiving care and the integration authorities in the planning, commissioning and improving of the local services. Work with NHS information services division ISD, the data group, is investigating a number of areas where data collection and use can be improved. I want to now turn to the values and skills that people need from our health service and social care staff. It is difficult to discuss death and dying, and to do that requires a great deal of personal resilience and compassion. However, developing the skills to have those difficult conversations is critical for having timely and helpful anticipatory care planning conversations. Having those conversations and sharing what matters to the person at the end of their life can make all the difference to how and where they die and the care that they receive. Enabling people to do to be with those who are most appropriate as they approach death is not a simple skill. It calls not just on people's technical skills, but on our own values, life experience and compassion. The locally-focused community work, such as that that compassionate Inverclyde, embodies the ethos of the whole community coming together to support each other with compassion at points of grief, loss and change. Finally, I want to touch on and say a bit about pallative care and end-of-life care research. Over the past few years, the Scottish Government has provided funding to our new well-established pallative care research forum to support maricuri and academic colleagues to undertake work to help us to develop a clearer picture of research and data gaps and to support improvement in identifying people who might benefit from pallative care approaches and co-ordination of their care. That will be helpful in realising our shared vision for pallative care in Scotland. I am optimistic that, through our combined efforts and continued productive collaboration, work towards our shared goals will be able to bring about further innovation and transformative change in pallative and end-of-life care. I look forward to continuing our work with maricuri on the shared aim for many years to come. I also look forward to joining other members in the garden lobby for the maricuri reception immediately after this debate, which is a further opportunity for us all to thank maricuri and their staff, nurses and volunteers for the amazing work that they do for us all. Thank you, minister. That concludes the debate. Can I add my personal thanks to all the maricuri volunteers that are sitting in the gallery tonight? My apologies for being unable to come to your reception. This meeting is closed.


So my favorite story of medical gaslighting was the time that a drain was removed from my leg after surgery as an inside of my leg without any pain medication or anesthetic. The day before the doctors told me this was going to have to happen but not to worry I'd be properly medicated I wouldn't feel anything it would be fine. But I woke up at 7 a.m that next day with two doctors in my room saying we're going to do this now. And when I expressed concern and frustration saying I don't have any medication you said this was going to hurt a lot. I am worried. They told me that they were on a schedule and didn't have time to take care of it so we were either going to get this done or it wasn't going to get done. So it got done it didn't feel great and when I asked to speak with the doctors about this they told me Joe no one ever told you that that was going to happen. We never said you'd have medication for this and honestly you seemed pretty doped up yesterday so I think you're just mis-marrying things and thank god my husband was in the room both times because he was able to step in and be like no no absolutely not she wasn't doped up that's exactly what you said you just lied.