Can you hear me now in the chat online? Thank you. Yes, we can hear you now. Thank you. Okay, so basically the activity for today is if you can write whether you have been using entropy in your research in your projects and if yes, how. And once we have it ready you can then get sticky to the ball. Okay, if there are some contributions in the chat, I will read them. Okay, that's also possible. Okay, so you can discuss some field of study for it. Great introduction of trash trees. Have to do this one. This one is as yesterday. Yes, I know that yes, yes, and the other one was the version assumption about processing. And it needs a computer instructions to mutual information between two courses. Using the ring was like your production. I don't know for perspective purposes. I just found out to this. Oh, there was a thing to this. Okay. Yes. Yeah, I know that paper. That's pretty nice. And it's using the maximum to be principal in research and systems and value. Okay. The information through the Internet. Yes. Great. So mentioned my application so I, if you look at my, my publications, more than half of them is summarized entropy. So, so that's why I'm giving lecture now. So in statistical physics information theory, econophysics analysis, image processing getting many, many applications. I see, you know, this thing. Good. So, um, sorry, I didn't pay attention. I don't know if, if you were going through this statement in the information theory course, but when I was thinking how to name this new discovery measure of missing information. John von Neumann replied to him, you should call it entropy for two reasons. In first place, your answer to function has been studied in statistical mechanics under that name so it already has a name. In a second place and more important, nobody knows entropy really is so in a debate you will always have the advantage. So I think that's also the, like the main team of this talk to see if it has some meaning and if we, at the end, know a little bit more about entropy. Yes. So basically, the maximum entropy principle has been introduced by by Jane so interestingly he was the first one who was singing about a connection between statistical mechanics and information theory. And this is the famous paper in 1957, where he says like that this maximum entropy principle as an inference principle so as a statistical principle of statistical estimation gives the correct answer or like is consistent with the results in statistical mechanics because by maximizing it you get this by maximizing entropy with some constraints, you get the results that you know from thermodynamics so you also have the second first second law and everything so he was the first one who really found out that there is information content in thermodynamics and these two entropies up to this Boltzmann constant because one is one so the information to be smashed in bits the thermodynamic entropy is measured in joules per Kelvin. So this Boltzmann constant is this constant that that joins them and stuff like very complicated function of them is just constant that that is that differs these two. Okay. So, so the maximum entropy principle as we know it from the courses on statistical mechanics is that we have a set of constraints that are constraints in like in terms of linear constraints so automatic means. And then you can formulate it as a theorem or just as a principle that given the set of constraints the best estimate of the underlying property distribution is the one that maximizes the entropy functional subject to the constraint so it means that it's the constraint optimization and for that and we use this Lagrange functional so this method method of Lagrange multipliers. And that of course, you can use the maximum principle not only with the linear constraints but with some other types of constraints, but then we it will be very hard to interpret the constraints in terms of me because typically the energy of the system is like an automatic mean. So you can do that but then it's hard much harder to interpret the thermodynamic interpretation of entropy. Basically, if I say, if I take this general approach. So I take methods of large multipliers, then it means that I maximize this function s minus sorry for this double minus alpha, which is one large multiplier times the normalization constraint because we are in the property simplex. So this is a set of multipliers. So this is easy to take the partial derivative, and then I get this steady s over dpi minus alpha minus the sum of lambda k i k so you see that this that the property distribution is now only contained in this partial derivative and rest due to the linearity of the constraints doesn't contain them. So then in case I can write this as some function that is invertible for PI, then I can invert this function and then we see that there is a general so could let you on the structure of the terminomics where the Lagrange function has the terminic interpretation so it's the entropy minus the beta times the if the constraint is the energy so it's minus beta times energy. And we know that the beta here plays the role of the inverse temperature so then this is called massier function or this minus beta times free energy. So it means that the Lagrange function doesn't only serve as a tool, but it has a physical meaning. Of course provided that this can be done but very often we will study only cases where this inverse can be done. And now I will go through the examples from yesterday because we calculated the entropy but now the question is what is the what is the related distribution that you get to see that the different distribution gives you different distributions with very different results so these are three cases that are notoriously known. That is the Maxwell Boltzmann entropy which gives you the Boltzmann distribution so this e to the so is the exponential of minus energy over the temperature. This gives you this one over exponential minus one and Fermi Dirac gives you this one over exponential plus one so here one has to be very careful because there is the only difference is this plus minus one, but it's a major difference. And if we look at the distributions for this, this is in terms of and which is the average number of states. So we see that, and this is the, the, this transfer of energy so it's basically the energy minus the chemical potential so it's kind of effective energy. And I try to move it here. No, you're not. It doesn't, it doesn't matter. So then you see that while the Fermi Dirac is bounded then the Maxwell Boltzmann or the Boltzmann distribution and also Einstein goes to infinity but they are slightly different. Sorry, can you repeat what the information is explaining that. So, so this is the, the average number of particles so let's say the number of particles is the, the average energy times the total number of particles because in the case we have the discrete levels of energy states so in Fermi Dirac we have one is zero one in the other we have 123456, etc. And is the average number of particles in a certain state? In a certain, in a certain state. Okay, yes. And that this what you don't see is the, the energy over the temperature so E over KT. Okay. And now to something more interesting. Now for the structure forming systems. If you, so this is the entropy so yesterday, just remember that this is written in this is curly piece which is the probability that normalize is not that some of the Pi is one but some of the J Pi J is one. And then we have the energy and we can calculate the maximum distribution which is open like the Boltzmann distribution so there is this pre factor and to the J minus one over J factorial and then we have something minus beta epsilon Pi. Here the difference is that normal Boltzmann distribution there will be only alpha without any J. So the J is different for different J, which makes us the normalization condition to look like this so this J, ZJ, ZJ is this partial partition function times E to minus alpha J is equal to one. And if you think about it, this is the polynomial equation and E to minus alpha, because this E to minus alpha J. The polynomial equation is the order of largest possible molecule, which means that if you have largest molecule bigger than maybe three or four, there is no analytic formula for this because there is no analytic formula for solutions of polynomial equation of order five and higher. So it means that this is probably one of the reason why Boltzmann also didn't like go forward because he couldn't at that time without computer solve the normalization constraint. You can do it numerically of course but this is one of the small disadvantage. From this we can calculate the average number of molecules because the Pi J is just the number of molecules of the given state. And what you find out is that the free energy that is basically again the U minus DS can be written in terms of minus alpha over beta. And that appears if you consider the Boltzmann entropy, so the free energy is minus alpha over beta. Here's additional term minus M over beta. So then you'll see that this approach that you take the partial that you take the partition function. And then from this you calculate all the quantities is here different because you have to basically all five to say would be the logarithm of the partition function, you will, you will, you cannot just come up, you have to basically solve for it. So this is this is this is the difference here. So in some cases the partition function might be quite difficult to calculate and then it's maybe easier to calculate just either partition function or some other quantities that then can be used to get the final result. So I have some questions to this. Okay. Then I go to the case of Charlie's entropy because for the case of Charlie's entropy. So what the reason why it was introduced is that the maximum distribution is q exponential I showed yesterday so it's basically this one plus one minus q x to one over minus q. So it's like kind of power all. So it's the this transition between exponential and our lower tails, which can be found in many data. So one of the motivation can be that this is something that can be used for fitting data. And here one small thing that is necessary to mention also regarding the, the partition function is that so we know that in both some case you can write the distribution. It doesn't matter. So that you can write either e to a minus alpha minus beta epsilon i or you can write it ups e to the minus beta epsilon i over the partition function, which is why you can do that is because it's exponential so of course the exponential exponential of the sum is the product of exponential so then basically you can take out this alpha and make make it as a pre factor. Here it's not possible in general so this p star p a star it's the exponential of alpha plus beta epsilon i is not generally equal to exponent of minus beta epsilon i over this some kind of partition function. These are two different two different distributions if you really put in the numbers you see that these are two different distributions. However, in this case, you can derive this kind of interesting identity that the q exponential of the x plus y can be written as product of exponentials, but then one of the arguments must be rescaled to this number so basically what you can then find is that you can rewrite the alpha plus beta epsilon i if q exponential as a product of this exponentials but then this beat up, which would be the temperature then changes and you have something like a like a renormalization group of this temperature so now the question is whether the what is the real temperature so whether the beta tilde or whether the beta is this one over key. And this is this is still a little bit unclear. Sometimes people call itself propellant temperature but it's maybe a good sign of the fact that the temperature is not always easily related to the background multiplier so that the relation might be in certain cases a bit more complicated. And this must be always shown again so for each type of different entropy, the relation between the thermodynamic potentials or thermodynamic variables and Lagrange multipliers must be really discussed. Okay. And now, now we go to a bit advanced. Because the other examples where path dependent processes. So basically, now we ask what is the question what is the most probable histogram of a process that has length and and some parameters theta and case the histogram and now the property distribution of finding this histogram. You know that PK given theta. So basically the most probably histogram is the, the minimum of the over all possible histograms of this should be maximum so maximum argument of this PK given theta and very often and we've seen it also yesterday that this can be rewritten as the as the as the two terms so this is the the multiplicity of the histogram, and then the probability of a microstate that belongs to that histogram. And what you can see then that by taking the logarithm, then this logarithm of this PK given theta is basically equal to logarithm of WK. So this is our entropy. And then the algorithm of this GK theta. So this is, this is this probability of finding this histogram given the parameters. And I hope I think that in the lecture on information theory, you came across to this term cross entropy so then the, the, this S well is the relative entropy so divergence. For a public library, you know that you can write it as the entropy and cross entropy, then we'll appropriate science. This is very often the case also for the generalized entropy is. Not always so we will see that in our cases, we can find such a nice structure and not then really the log W plays the role of entropy, and the log K cross entropy plays the role of the constraint so because it contains this prior probability distribution, and we will see that it naturally gives us the constant. So basically, if I take the cross entropy, the ordinary one so if I have shown entropy and public library version then, then basically this cross entropy is minus sum of P a look qi value qi are the probabilities. And I can say, okay, let's think or let's consider that these prior probabilities depend exponentially on the energy. So I basically put in the on the Boltzmann distribution of the prior distribution. And then what you what you see is that this cross entropy is basically beta times average energy plus the logarithm of partition function which is the free energy. So, basically then I get, get this nice little, little relation between the public library versions entropy and cross entropy. And of course, the, for the case of party pendant processes, the constraints might not be of this form because then the prior distribution of the, observing the histogram might be different and this is what we see in a minute. And the case is that for for the multiple multiplicity of trajectory histogram so we have so this is the SSR processes so we have shown that in this case entropy is this entangled entropy. And if you consider that after each run we drive a ball to random state with probability qi, then basically we can think about what is the probability of the histogram in the following way. But once we jump, then after this first step only available space is the states below so so here's shown by the screen line that the first time all the lower states one to nine are available. If we jump to five, then basically this the subspace that is available to us is just from one to four. And this means that if you little bit think about the, what is the probability of observing this histogram is that by probability of particular sequence, each visit of a state that is not a ground state contributes to the probability of the next visit to a state, the next state with a factor one minus qi and this qi is the sum, the spark will some of the states that are below this given state. And only if we get, if there is this one, we get the renormalization factor since the process restarts, and then we can throw it again so by really thinking about this little bit one can see that this probability of something is to come K is the qi to right over this big qi minus one to k i. And then by taking the regular approximations to take any logarithm and and and using sterling formula, then you can show or even here, you don't have to use the ceiling because there's no factor loss.  And if we then assume again that the prior distribution is the is the Boltzmann distribution so we say that the probability of of the starting depends on on the energy kind of. If we get the height of the of the stair, then basically we get the following relation that basically the cross entropy is the beta times the average energy times beta times something that is called this F. And this is the average sum over the partition partial partition function where the partition function goes only from one to some state. And basically take all these steps where I go from one to one, one to two, one to three, one to four, one to five, because these are all this partial partition function that are available for a state that that is not the ground state. So, then, if you do the I don't have it here. I don't know why, but then basically if you do the maximum entropy distribution principle. And basically take the entropy and maximize with this one string. What you get is, I'm sorry. This is the piece that with the P star I is then little qi over big qi. And if you crack in that qi is formed, then what you get is that the PI is proportional to one or I don't exist so but we didn't say that the qi is are the goals when distribution. Yeah, so yeah so so in that case it would be for the very high temperature so this is the limit of beta goes to zero. But in case if it's not that case, then of course you get that this is the e to the minus i over some j to i minus one j. And interesting way now, if you do it for a large number of steps, and this is something that is not doesn't have so much difference it almost always look very similar to this steps law. Isn't the denominator sum to one? No, I don't know because this is, this is, no, it's not sum to one, because this never really just for i minus one. Okay, this PI, this is not a full partition function, it's this partial partition function. And with each state it increases. So, that's why, and you can show very easily if this epsilon, the distribution of the energy states is not too wild, and it's this distribution effectively is very close to this slope so there is some universal class, and because of this slow driving. So, honestly, it's different between the energy levels is somehow exponential or something like that. And very often you get distribution that is very close to the steps law. And log log scale looks like a line so this is very often seen, and this might be explanation for many of these power law distributions because then what you see is that the power distribution is obtained because of this really asymmetric between driving and relaxation. Sorry, I didn't add this slide to this. I will add it later after the talk so that you can see it. The point earn, this is kind of interesting because, and now I will not go to the detail because it's kind of technical. So we see that the point earn is this this log of PI. And then you can find the, in a similar way that is cross entropy. And then we can say, let's, this is kind of complicated let's look at the case where we sent into infinity. So then we have this minus log PI. And then we have this, again the same term so qi log PI. It's the opposite so because no before we had the PI log qi, but now we have qi log PI plus log qi. And if you calculate the maximum entropy distribution. It looks like that basically the PI is the normalization constant times qi minus gamma. And this is kind of interesting because this. If you think about it, this cannot be satisfied to the boundary solution so they are three scenarios so either the optimal distribution is the private distribution. Or it's this kind of, it's called winner takes it all because then because if you do the maximization, you find that basically the derivative, the partial derivative of the large function cannot be zero, which means that it must be the corner solution. The corner solution is either one or zero. And in that case only one can be one and the rest is zero. So in the end is really the winner takes it all so it means that if there is some depending on this this initial. So the qi is initial ratio or initial property of the boss or the number of the frequency of the boss in the turn, then basically by drawing and drawing what you effectively get is that you will add more and more balls of the same color and then most almost all the balls are of this color that that means. So interesting enough is that in that case, even the maximum to be distribution doesn't give us the, the interior solution of the property simplex. So that's that's very interesting here. So that's that that was that was the examples. Now I just want to briefly say something about the principle. So what we've seen is that effectively maximum to be principle can be seen as a special case of the principle of minimum related relative entropy so basically we minimize this this school book library divergence with respect to some distribution and basically this is how we can encode the constraints in our case and and if there is if the divergence can be written as a sample entropy and cross entropy, then we get this, but in information to remember generally I think you've discussed it already a bit. But you can see us really minimization of the divergence here of course we have the edit value of the present of terminal potentials but in general it's just basically, for example, having priors from the models or measurements and we have posteris from parametric family and then we know the parametric optimization and then the advantage is that the relative entropy is defined for discrete and continuous distribution so you know that when doing like continuous entropy so replace the sum with the integral you might get into some troubles because basically the entropy, the continuous entropy is then might be negative, or might not be so well behaved. The reason is that basically you can see the entropy as a special case of divergence, but you take the prior as the uniform distribution in this case. And of course, since the uniform distribution doesn't exist in the continuous case, like if you have a continue number of states so if you go from minus infinity to infinity, then you need to choose other prior distribution. So, it's nice because it connects information theory terminus and geometry because from there, this can be used also to calculate a thermodynamic length in these things. Now I want to talk a little bit about the generalization of the maximum entropy principle maximum in divergence principle if you have a like process where you don't have only states but you have the trajectory so you can basically define something that is called caliber which is the trajectory version of entropy so you take the probability of observing the trajectory. Maybe for you interesting is that you can write entropy production in terms of this caliber so it's the divergence and it's divergence between the full probability of the forward trajectory and the backward trajectory, hope that you've seen this with the introduction to stochastic thermodynamics so this is quite useful so you see that there is this connection. And I recommend this paper principles of maximum entropy and maximum caliber and statistical physics. This is in review some other physics so you can find many applications of this. The good thing is that with the caliber you can have many, like much richer structure of constraints. But for example you can say, I have a constraint in the sense that I can't I basically say, this is my number of transitions from state I to stage eight. I say this is average number of transitions. And what is the distribution and then what you see is that with the, what you can easily show that with the maximum caliber that the process that maximizes the caliber is basically Markovian because this joint probability can be written as the product of transition probabilities from one day to the other. So basically the Markovian process is maximized the caliber, it is given constraints so this is kind of nice thing to see. Then I sort of do a bit like your information is about the number of positions. Yes, yes, exactly so now you want to collect the position rates for the. And you want to infer the probability of observing trajectories. Okay, because it's so by counting the probabilities. It's not a very clear whether the system is Markovian or whether like it can be just you know, the result of the more complicated Markovian process where the memory. And if you use the principle of maximum caliber and just say these are my constraints, and you find out that the process that maximizes the caliber is the Markov process. Okay. Okay. So we know they're only gonna say is a number is information over the number of transitions. Okay. And then you recover that basically. Yes, that the trajectory distribution is Markovian. So basically the joint probability is product of probabilities of these two point transitions. Okay. And then, here I just mentioned I don't want to go to too many details there are other extremely principles in thermodynamics, sprig of genius principle of minimum enterprise production principle of maximum production for living systems, and they are kind of controversial. They are also their Wikipedia page they have also their page on this assignment project, maybe can be interesting to you to go through it and to read it. And the last thing I wanted to mention is that basically the maximum can be seen as the inference tool because the maximum principle in physics consists of two steps. The first step is to calculate the distribution, and this is really just the statistical inference method. And the second is plugging the distribution back to entropy and calculating the exact number of entropy and use it to calculate free energy and all these things. And this really the second steps connects us with the thermodynamics. And what we can find out is that for each mark for each distribution that we obtained by this maximization procedure. There can be exist a whole class of entropy some constraints that lead to same distribution, but generally front thermodynamics. And then of course the interpretation of the Lagrange for me just in terms of these German I mean quantities can be different. So, that's kind of interesting and here too. Maybe it is examples so basically, like, since the maximum entropy principle maximizes the entropy, then if I take basically increasing function of that entropy that gives me the same distribution right. Because maximum of a function and maximum of an increasing function of that function is the same doesn't change anything. But if you do the calculation, then of course the Lagrange parameters will be changed. Here in that case, is that that it will change the Lagrange parameters, but not the ratio. So there is some, I would say calibration invariance of that. But the important thing is that each of these change leads to different thermodynamics because if you really want to plug it back to the entropy. And all the function of the entropy is will give us generally different numbers so this is for example the case for for the relation between Lagrange multipliers of size entropy and ready entropy. Both of them give us the key exponentials, but their Lagrange parameters are different. So we can calculate it, and you see that this is something is one over Q is something that we saw on the previous slides when I said, of course, when I mentioned is self-referential temperature. So there was this Q exponential of something to one minus Q. This is exactly this, this factor. So we see that that now this factor comes from the fact that the maximum size entropy and maybe not ready, because since the rainy entropy is additive, then it's extensive and then the temperature is intensive while the size entropy is non extensive. It means that the temperature is non intensive so it really changes with the size of the system so that the energy can be extensive again. And then, okay, I didn't the other example doesn't matter. That's all I think that you are for today tired enough. If you have any question or something you can ask now otherwise. That's it. Yes, because the rainy entropy can be written in terms of like this one over Q, the logarithm, this logarithm of size entropy. And although they give the same distribution is to exponential, then these large multipliers are different. So by plugging in back to the entropy, the same distribution to different you get basically different relations between the large multipliers and the, for example, the temperature or free energy or something. Here the free energy is the same because the alpha over beta, this ratio remains the same, but the temperature changes. Something else. Sorry, could you keep the reference for this paper which they were. Yeah, they were. And they find that this this process. Sorry. If you will mention the number of positions and the process was right. This is this paper that maximizes the energy. Yeah, isn't this paper review modern physics by Steve present the guys. Yeah, it's quite long, but yeah, so is it in this paper I recommend reading. Okay. Maybe I mean maybe some very nice questions like that. I mean, why, why the probability distribution that distracts the system should minimize the actual. It's a postulate right so it's an axiom to tomorrow we go to this axiom approach. It's kind of is related to the second law of German I mean it's because the entropy production must be positive so you can then relate it to the case that it can only decrease and at the end of like in the time limit. You end with distribution that is maximum and that's why the entropy should be maximized. So this is vaguely the connection but of course, it's not so easy and doesn't work in all cases but this is the general idea that. Also, if you were discussing this age here and it is basically related to entropy this is that that the process the typically the market process goes towards as it relaxes goes towards the distribution that maximizes essentially. Okay. Just just yeah. No comment so I think that's it and enjoy the evening. Thank you.


Luis, thank you very much for Jesse to being such a strong partner of Green Digital Action track here at COP28. Why is it important for you? Well, you know that we at Jesse we think that the power of partnerships is extremely irrelevant if we want to move an agenda and being part of this coalition is something extremely important because up to now we have been working somehow each one in its own way and we have not been achieving much and having this coalition now in place allows us to bring everything together, allows us also to make a much higher impact, call the attention of policymakers. We need to bring the ICT dimension into the COP conversation, into the climate conversation and this can only be done through partnerships and through collaboration and that's why you know we are very proud to be part of this coalition together with the ITU. So thank you very much for working with us, Luis. Thank you. Thank you so much.


Hi everybody, Joe for jaspyscasebreaks.com coming at you with an 18 team random number block randomizer That's how it works right there Featuring a lot of teams and that unlocks pick a team 31 coming up in the next video. These are the teams that are involved right here From the priciest to the least priciest Big thanks to this group Thanks to this group for buying their spots straight up and congrats to the winners of a few spots in that filler There are the numbers right here. Let's go. Let's roll it. Let's randomize names and numbers six and a six twelve times one two three four five six seven eight nine ten eleven and 12th and final time Got Michael down Richard six and a six a full twelve times for the numbers one two 11 and 12th and final time after 12. We got five down at eight All right, Michael with five Patrick with seven Robert with nine and Nestor with zero and one So usually I say zero gets any and all redemption for those 18 teams including one-of-one redemptions But Nestor you already have you also have one so that works out You'll get live one-of-ones as well Aaron with six Patrick with four Jay with three Robert with two and Richard last Mojo with eight let's order these numerically and I'll see you in the next video for the break itself Jasper's case breaks.com. Bye. Bye


Jesus God well, I think it's pretty clear as a matter of fact. I think it's mandatory to believe so However, there are people that are just not going to accept it and how does the old saying go a man convinced his will is to not Convincing so this particular video is not for people who are still fighting This is for people who believe that Jesus is God and we're just like for the validation of it in In Greek there are rules just like in English just like in Spanish in the language There are rules to the grammar and so there's one particular rule that we need to look at that also Helps approve to solidify that Jesus is God This rule is called the Granville sharp move. Maybe you've heard about it Maybe you have not but who Granville sharp is he lived in the time of slavery in the late 1700s early 1800s He was an abolitionist but what he is most known for is this particular rule He is believed to be self-studied or self-taught and in his self-studies one of the things that he discovered Was this particular rule now? There are other elements of the rule that probably aren't true But there's one particular element of this rule that is true. So before I go to that let's go ahead just kind of give a Brief synopsis of this rule and let me just put on the screen so you all can read what it really is The rule is as follows When the cognitive chi that is in the English the word and Connects two nouns of the same case Either the substance is now the substantive can be a noun or something that kind of operates in place of a noun can be an Adjective or participle and so when you have two nouns Separated by and it will refer to the same thing if the substantive are both singular meaning it's personal Not relating to a thing and also it's not a proper name So just just having that understanding this seems to work a hundred percent of time now I have not come across any examples where there are not although there are some debated texts where People might have debate whether this is a proper noun or not but if it's just it but if it's understood that this is a Noun that's not proper or a substantive that is not a proper name that is singular And that is personal or then this rule follows one hundred percent of the time So let me give a couple examples that I think are pretty easy And no one's going to really debate these issues and that is one in Romans 15 6 So that with one accord you may with one voice glorify the God and father of our Lord Jesus Christ now We understand that the God and father That is relating to the same person now this rule this Granville sharp rule is in place So let's go over to it here. We have God feon and so we have the rule where a feon is the substantive Here's a Kai and then Patera which is also a substance so we have two nouns both of these are singular separated by the Kai and so here we've got an example of Granville sharps rule where both of these nouns refer to the same person so God and father That is the same person. So that's one example, and it's not too controversial. No one's going to disagree with that Let's give another example in in 2nd Peter 1 1 Simon Peter a bond servant and apostle of Jesus Christ. So here we've got let's go over here to the Greek Doulas, which is the first substantive Separated with the Kai next in apostolos. So we have this word both of them into the same gender Apostolos and Doulas both a singular both personal and they're not a proper name So we understand it without much debate that Peter is a apostle as well as a bond servant Referring to the same person Peter the bond servant Peter the apostle same thing That's an example where there's not very much controversy to it However, there are examples where there is some controversy. How about Titus 2 13? looking for the Blessed Hope and The appearing of the glory of our great God and Savior now This is where the controversy will come in for those who do not want to accept that Jesus is God And so here we have feu and to tear us both of these are Substantives separated by the Kai both of these substances both of these nouns are one singular both personal Both of these also neither are a proper name And so they both fit the definition and so what does this state and this is why it can be controversial for those who don't believe that Jesus God that literally God and Savior is Jesus Christ. So Jesus Christ is the great God and Savior but if we who understand this can look at this we see one proof by the grammar and It gives us an idea as to who is the one that's working in us and who has died for us now If we go back to that same example in Peter Not only do we see that Peter is an example being a bond server and apostle does example We drop a little bit further down in that very same verse We'll see it again relating to Jesus to those who have received a faith of the same kind as ours By the righteousness of our God and Savior Jesus Christ. So let's see that rule is also in place here where our God To Fayu so here we've got the first substantive Separated by Kai and then to tear us as well. So we see it again our great God and Savior now in this case You might have a modifier such as our which is fine. That doesn't interfere with the rule at all And so you can have a modifier Before this again, that that's not an issue. But here we've got a clear example just like we had the first part of 2nd Peter 2 1 1 the latter part of 2nd Peter 2 1 1 where Peter is The bomb servant and apostle no problem there the same rule has to be going to be consistent follows that So too is Jesus also our God and Savior so This where it becomes it should be clear that just in following the rules Obviously these people spoke the language they understood it and there are rules to whether you even understood the rule Not obviously the rule was not named the Grandville sharp rule It's just that he stumbled across this rule. It's been tested and proven to be true So again, if you've got a substantive which is a noun could be an adjective Participal anything that is a noun or in the place of a noun or represents a noun if it's singular if it's personal meaning it's not a thing and If it's not a proper name if those two substantive are separated by the word Kai or and Also these two being in the same gender well, then it fits the rule It makes the point 100% of time now This isn't the only rule also that makes the point that Jesus is God as a matter of fact One of the classic examples that we've covered all the time is John 1 1 in the beginning was the word the word with God And the word was God and because you've got these two Substantives here, which would be Lagos and Phaos, which is word and God Trying to figure out which one is the noun and which one is the predicate nominative Well, the order dictates this in this case That is the subject would be the first noun in this case would be the word and then the predicate nominative would be the The following the second now in this case would be God and what it's predicate nominative do it describes the category the class of What the noun is which is the word the word is and what category would class it is God So there's plenty of rules that we can use the site or there are enough rules I have to say that we can use the site to determine that Jesus is God But just the plain reading of the text as well because remember there is one Lord And the Bible tells us in Deuteronomy that the Lord is God Moses meets the Lord. He's called angel the Lord the Lord and God and he's also called I am and Jesus says that Unless you believe that I am you shall Die in your sins and then if you do not confess that Jesus is the Lord whoever calls by the name of the Lord So it's pretty clear again. This is not to try to convince a Unitarian someone didn't want to hold to this it's not for them This is for you guys who understand the truth Who have had your hearts changed and you're growing in the grace and knowledge just further proof Further validation that Jesus is Lord amen


The final item of business is a member's business debate on motion 11352, in the name of Sue Weber, on charitable hospice care to meet future need. This debate will be concluded without any questions being put, and I would ask those members who would wish to speak in the debate to please press the request to speak buttons, and I call on Sue Weber to open the debate around seven minutes please. Thank you, Presiding Officer. It really is a privilege to be able to bring this debate to Parliament this evening. Not that long ago, back in November, I hosted a roundtable on the dying and the margin study from Mary Curie and the University of Glasgow on behalf of my colleague Miles Briggs. It was heartening to see such strong cross-party support at that meeting, and I'm delighted to see such strong representation from across the chamber today as well. Ahead of this debate, I've been working with Hospice UK, Mary Curie, St Columbus Hospice Care to really understand more about the key issues hospices are facing in particular the problems surrounding funding, and I want to thank them all for their support in preparing for this debate today. So why are we here? First and foremost, the funding of hospice care is unsustainable. Hospices are facing an expected deficit of £16 million this year due to statutory funding not keeping pace with historic and recent spiralling costs, in particular the cost of matching the NHS pay awards to remain fair and competitive for their staff has been highlighted to me. With the demand for palliative care increasing and the health and care system under significant strain, the support that charitable hospices provide has never been more crucial and critical. Hospices provide vital support to GPs, district nurses, care homes, hospital teams and social care, through training and education, specialist clinical expertise and strategic leadership. Hospices bring over £60 million of charitable funding into the local health and care system each year, so let's not hide away from the fact that they lessen the demand on our statutory services by reducing emergency admissions, reducing the length of stay in hospital and supporting people to stay at home, therefore worth every penny as they provide significant value for money. The harsh fact is that the number of people needing palliative care in Scotland is predicted to rise by 20 per cent by 2040 and the care that they will need will be more complex, further adding to the pressure already on the already overstretched NHS. Charitable hospices are a key part of a cost-effective solution to those pressures, but they can only do this if that funding is sustainable and they are sustainable. Hospices are struggling to stand still, let alone invest in and be responsive to the future challenges that we are facing. Current funding arrangements do not support hospices to grow and innovate with their services. Here in Scotland there are 16 charitable hospices, 14 for adults and two for children and young people. St. Columbus Hospice Care and Mary Curie Hospice Edinburgh, along with Mary Curie's hospice care at home teams, provide hospice care across Lothian, and in November I had a very informed visit to the Mary Curie Hospice at Fairmalhead. I am actually ashamed to say in all the years that I have been in on this world and living in Edinburgh that is the first time I have been there. In 2022-23 around 8,815 people died in the Lothian region and 90 per cent of them had a pallid of care need. Across the region 4,060 visits were made to the 672 terminally ill people by the Mary Curie hospice care at home team. Mary Curie Hospice Edinburgh and Lothian service supported a total of 1,690 patients through their inpatient, outpatient and community and day therapy services. I really think that a lot of people have a preconceived idea of what a hospice is care and what a hospice is all about. They just see a building, they think that it was a building with rooms and beds and people being there to die. But this cannot be further from the truth. Most of Mary Curie's work is done in the community with the majority of hospice care delivered beyond the hospice buildings out in people's homes and in the community. They are giving people the option to die with their friends and family in their own homes supported by teams of experts. Mary Curie has a fast-track team that helps people with tasks such as washing, caring and showering as they get close to the end of their life and, crucially, keeps them out of those acute hospital settings. The team is essential to keep people in the right place and offers family support to relatives. I would also like to touch on the work of St Columbus Hospice care in Edinburgh. In March 2023, they began a trial of a groundbreaking new virtual ward service. The first hospice in Scotland to roll out a development of this kind as far as we have been made aware. This new service across Edinburgh and East Lothian provides patients and families with an alternative model of care and allows patients to be fully cared for in their own homes or in places of residence towards the end of life. The care and expertise provided by the team allows patients to remain at home with a very high level of support that would otherwise require inpatient hospice or hospital setting care. The cost to health and social care service of caring for people in the last year of their life is vast. Almost one in three people in Scottish hospitals are in their last year of life. 95 per cent of people in Scotland use the NHS unscheduled care services in the last year of life, representing a total cost of nearly £190 million. That is why hospices are so crucial. Hospice care providers made over 1,000 and 23,000 visits to people's homes to deliver vital care and support in 2022-23. As I stated earlier, hospices provide vital support to GPs, district nurses, care homes, hospital teams and social care through their training and education specialist clinical expertise and strategic leadership, and that they also bring over £60 million of charitable funding into the local health and care system each year. Earlier this week, the Minister for Public Health and Women's Health attended a round table on hospice funding. Rather disappointingly, I heard the minister open the meeting by saying that the hospice sector's call for remedial funding to address the £16 million deficit that the sector is facing over the next three to five years is unaffordable. The minister also said that that meeting was the start of the discussion and that today's discussion will feed into other meetings due to be held soon. However, there is no clear timeline for next steps. I hope that this debate today will go some way to shape the minister's thinking and get the minister up to speed with the invaluable role hospices have within our society as our population ages and the needs of people have as they approach the end of their lives become increasingly complex. In conclusion, I think that we can all agree that a new national funding framework for hospice care is vital to ensure the on-going sustainability of this sector and to allow charitable hospices to continue the sport the NHS and provide the high quality palliative care to people in the Lothian region and across Scotland. I now call Stuart McMillan to be followed by Miles Briggs. First of all, I would like to thank Sue Ever for bringing this important debate to the chamber. I wanted to speak today as our given hospice is based in my constituency and I'm sure that almost every family in Inverclyde has had some connection to the hospice either through a relative or a friend over the years. A local hospice is loved and respected by the community and it's a facility for everyone, no matter their financial situation. However, the last few years have brought many challenges to our given hospice, but also every hospice across the country. The pandemic affected their ability to fundraise, but the past year has been extra challenging due to the exorbitant energy increases and the impact that the NHS pay awards have had on their finances. I regularly highlight both the positives and also the challenges that my Gwydian and Inverclyde constituency faces. However, Inverclyde has faced economic and social challenges for many, many years, meaning that we have lost many of the larger businesses and a population has now shrunk to just over 77,000 people. As a result of the pool of organisations in people, the hospice can seek donations from has decreased. Therefore, our given hospice gets created with a range of fundraising events. The organisers of the year, like the 12 Days of Kiltmas, which the chief executive and myself are currently doing, so we're in the kilfer 12 day straight, starting on St Andrew's Day last week. Today is day 7, and there is a just given page if anyone is interested. They also organised the ever-popular Ergymwn Hospice Ball, they organised fire walks, sky dives and Christmas appeals, and local actor Martin Comson, who is one of their ambassadors, currently features in their campaign for funds to upgrade one of the rooms for family members to stay overnight. However, as you can see, their fundraising team is busy all year round, and those activities help the hospice to engage with the wider community. While that is positive, it is clear that the funding model for hospices needs to change. With each hospice across Scotland receiving a different percentage of public funds to help them to deliver services, there is no parity in the sector. Consequently, Scottish hospices have come together to work collectively on this, which I wholeheartedly welcome. I also know that the financial situation facing the Government is tough. Just this afternoon, we debated the fiscal framework, with a wide variety of political points being raised by all sides of the chamber. This debate does not need to follow in that vein, but the hospice's letter sent to the minister dated 20 November was clear and highlighted the situation that Scotland faces as well as it asks going forward. One of the most important questions for me is about the future, but I also believe that we need to have that wider discussion and find a solution to the longer-term funding situation for all of our hospices. That should hopefully provide a more stable operating position for hospices so that it can focus on what they need to do. However, the hearing needs to be addressed. I do not profess to have all of the answers, but I would suggest that consideration is given to looking at the overall health budget to see if there is any underspend that could be utilised. I know that this is tough. The recent letter by the Deputy First Minister to the Parliament's Finance and Public Administration Committee outlined the desperate financial situation that Scotland faces in the year and also for future years. The minister spoke about the closing comments in the previous debate. This is going to last for up to 10 years and potentially more. I attempted to find any resource to help what will be challenging to say the least, but I do urge the minister to look again at the budget. With Scotland's growing age of population, the demands for hospice services will only grow. Not every person at the end of life will want to go to a hospice, but the delivery of high-quality palliative care will only increase, including in the community. There are other excellent organisations and agencies who deliver those to us, but we have to face the fact that demand for hospice care will only increase in future years. That is why a fairer funding model to ensure the stability of our vital hospice sector is needed. I thank my friend and colleague Sue Webber for securing this important member's debate this evening. I would also like to put on record my thanks to organisations that have provided very helpful briefings ahead of today's debate, but I also thank them for the services that they provide across Scotland. Perhaps more importantly, the love and support that they give to families at the most difficult time anyone can ever imagine. From the age of seven, I have known and valued the contribution that hospices make to people when they need them and when their families need them. I say that because the final memories I have of my mum was seeing her in the hospice and leaving her to go in a charitable fund run, and I remember the kindness and care that the staff took not only to myself, but my family members following her death. Throughout the time that my mum and family needed hospices services, they were there for us. That is why I make no apology throughout the time that I have been lucky enough to serve in this Parliament to advocate for our hospices across Scotland, because we need to make sure that they succeed. We have already heard some very important speeches about why that is. Marie Curie's briefing for this debate I think really starkly outlined the fact that 60,000 people across Scotland will be needing hospice services in a community setting. That is something, a 20 per cent increase, is something that we need to start planning for and funding as a country. For taking intervention, I appreciate that there is no other Lanarkshire MSPs in the chamber tonight. I just wanted to ask if you would agree with me to promote the fantastic work of St Andrews Hospice based in Erdre and the fantastic work that they do for patients and fund raising all year round. Absolutely. I think that for all of us when we think about the hospices and all of us probably have been invited to visit our local hospices, you just see the amazing work they are doing at the most difficult time, but also the routes that they have in our communities as well. I very much welcomed the work in the last Parliament that was undertaken by the Government with Chaz and lobbied ministers to help to deliver that parity of funding for children's hospices. As a country, I think that we expected to see that. I very much welcomed the agreement that was signed, which provided approximately £30 million over the five-year period, which has now come to an end, to help to fund children's services for children with life-limiting conditions and the support services that their families needed as well. I am sorry to say that the reality did not match the delivery and, indeed, the agreement for 50 per cent of funding only amounted to about 30 per cent of statutory funding from the Scottish Government. Adult services in Scotland are in a more difficult position today with the average hospices receiving around 25 per cent of costs for statutory services. We need to see things change. I think that one of the issues that we have seen, and I know that this has been raised in previous debates, but the integration of health and social care and the creation of integrated joint boards has also seen a postcode lottery develop when it comes to funding our hospice sector, and that urgently needs to change as well. I very much welcome the constructive meetings that I have had with the Minister to date on those issues. I think that it is really important cross-party-wise that these are taking place, but we need to see, as has been raised by other members, some real action, firstly to put hospices on an even keel to address the deficits that they are facing, as has been raised by the NHS agenda for pay settlements, has placed an additional £16 million cost on the hospice sector, and that is something that they need urgent support to make sure that they can retain the staff. We do not want a staffing crisis to be the next part of the problems that they face. As Stuart McMillan outlined, an equal partnership going forward and a new funding framework is really critical. I think that that is something that all of us will agree tonight, but how Government can make that a reality is now important for a minimum of 50 per cent of costs to delivering core hospice services. It used to be a chief executives letter, I believe, but moving towards what that looks like in the future is something that the sector is crying out for. I hope that the minister can really take on board as the key ask from this debate. Moving towards making sure that we have a dynamic funding mechanism to support future needs, we know from all the briefings what that will look like, and our NHS will not be able to meet that demand. Our hospice sector has to be ready to do that. Finally, to conclude, the founding principles of our NHS was to build a health service from cradle to grave. Without a hospice sector, we will not have that. For people who are accessing palliative care and their families, that would be not only a tragedy, it would be completely unacceptable. We know that many hospices are already using their reserves to fund core services. That is not sustainable. I really do hope that the minister will take from today's debate the pressing need for a new deal for our hospice sector, the cross-party support that exists for that, and that we can work together to make sure that we can deliver for people when they really need it. Let me start by thanking Sue Webber for bringing this debate to the chamber. I want to put on record my thanks for hospices across adult and children's services for the vital palliative end-of-life care and bereavement support that they provided to over 20,000 Scots over the last year. Chaz, of course, has Robin House in Baloch in my constituency, truly a place of joy for the children and their families that use their services. I have constituents that have been cared for by St Margaret's Hospice in Clydebank, and I know of the fantastic work undertaken by Mary Curie and the Prince and Princess of Wales hospice in Glasgow. There will be many more besides. I debated whether to spend my four minutes waxing lyrical about the essential and excellent work that our hospices do across Scotland, but others have already done so. Elequence is out the window and straight talking is the order of the day. The minister should expect nothing less. Our hospices are struggling with rapidly rising costs. The round table held yesterday with the minister was an opportunity to address that, especially before the budget, but it was an opportunity that the minister failed to take. Where was the commitment to a minimum of three-year funding in the funding framework? Where was the national monitoring and oversight? Where was the provision to match NHS pay awards and the need to ensure pay parity? All of that is entirely missing from the framework. The minister has a leadership role to play, which I think she would acknowledge. Getting everyone together at the round table, partnership working and local collaboration is, of course, constructive, but, as Sue Webber said, opening the meeting by telling hospices that their call for remedial funding over the next three to five years to address the £16 million deficit that the sector is facing is unaffordable, frankly, is wholly unacceptable. The Government has reallocated money for their independence referendum, and I welcome that, but you have a constitutional futures division, which eats up £2 million a year in staffing. Over the next five years, that would be £10 million, more than halfway to what is needed by hospices, and surely a better use would be to give this money to them. The additional costs that I refer to arose in part because of the Scottish Government's actions giving a wage rise to nurses in the NHS. Nurses in the NHS deserve every single penny, but so do nurses working in hospices. If hospices cannot offer the same, then nurses will leave, unfortunately, for better pay. It is irresponsible for this Government to shrug their shoulders and say that there is nothing that they can do. Again, Minister, this is about leadership. We know that, for every pound of statutory funding invested into hospice care, there is a saving to the taxpayer of £6 for children and £4 for adult hospice care. However, that is only possible if hospices are sustainable and treated as equal partners with more than just a passing nod from the Government of the significant financial contribution and risk that they undertake. The Scottish Government cannot, with all due respect, afford to watch another area of the health and social care sector descend into crisis on its watch. It must be involved in workforce planning, action taken on remedial funding in the budget, and there needs to be a clear funding framework. Let me make a final point. I have been around so long, I remember things. In the 2016-21 strategic framework for action on palliative and end-of-life care, the then cabinet secretary, now the Deputy First Minister, said that the strategic framework outlines the areas where action needs to be taken to ensure that, by 2021, everyone who needs palliative care will have access to it. That strategic framework has come and gone. The palliative care strategy was promised in the programme for government in 2021 to be developed and published over one year. That has come and gone and it has not been delivered. Minister, where is the commitment to hospices and palliative care, because, to be frank, we have yet to see it? I thank Sue Webber for bringing this important debate to the chamber. I speak in this debate, having spent 14 years working as part of the nursing team at the Smargrup Scotland hospice in Clybank. I also make my contribution as a member of the CPG on palliative care, and I said that Scotland has so many excellent hospices that provide around-the-clock care. Marie Curie, the largest third sector provider of hospice care services in Scotland, supported almost 8,000 terminally ill folk in 2022-23. Over 30 years, families across Scotland, caring for a child with life-limiting conditions, have been able to turn to Scotland's only children's hospice service, CHAS. The Smargrup Scotland hospice, where I used to work, was founded in 1950 and was the first hospice in Scotland. Since then, they have provided medical support to patients who face complex care needs but also provide spiritual, psychological and social support for patients too. That comprehensive approach ensures that individuals receive the care that is right for them at their time of greatest need. Every year, they touch the lives of approximately 1,800 people and do so with compassion and dedication. My time in the Smargrup Scotland hospice team was incredibly rewarding and a real privilege, but it was also immensely challenging. Caring for patients with advanced life-limiting illnesses and complex care needs is not easy and it is an incredibly emotional job that requires resilience and empathy. The care that you provide extends well beyond just the patients themselves. You get to know and care for families and friends of the patients too. You act as a level support for them during what, for some, is the last few weeks or months that they will have with their family and friends. My sincere and eternal thanks go to St Margrup Scotland hospice team, led by Sister Rita as chief executive. They have touched the lives of so many, including myself, and continue to provide the exceptional care that we would all hope for, should we or a relative need it. I completely recognise that all our hospices are facing challenges with funding at this time, as the woodenations make up a large part of their funding and, due to the cost of living crises, I know that many are unable to donate, and that is a real challenge. I welcome that the Scottish Government is currently developing a new palliative and end-of-life care strategy. The strategy will, I hope, aim to ensure that everyone in Scotland receives well-coordinated, timely and high-quality palliative care based on their needs and preferences, including support for their families and carers. Alongside that, the wider commitment from the Scottish Government for the national care service will ensure a level of high-quality social care across Scotland. That will oversee the delivery of care, improve standards, ensure enhanced pay and conditions for workers and provide better support for unpaid carers. It is important that the legislation works in partnerships with providers of palliative and end-of-life care to ensure that the bill recognises and responds to the growing need for palliative care across our community. Hospice care in Scotland will continue to have involving needs, as I have already mentioned, and I am glad to see the Scottish Government recognise that. Hospices play a crucial role in Scotland's healthcare system. They do not just provide medical care, they are a source of compassion and support for patients in their final stages of life, and they offer stability and reassurance for their families and friends, too. Those are core values that underpin our hospices, and I cannot thank them enough. I am delighted to be able to speak today in this very important debate in the motion in the name of my colleague Sue Weber. Scotland's ageing population means that more people will need palliative care in the years to come, and it is therefore vital that we ensure the financial viability of hospices and the third sector delivery of that care. To put this into context it is estimated that by 2040, 60,000 people will die with a palliative care need, which represents a 20 per cent increase in demand. People dying with more than one terminal condition will have increased by over 80 per cent. Two thirds of all deaths in Scotland will be in a community setting such as people's own homes, care homes and in hospices. We know that people in the last year of their lives are significant users of unscheduled care with nearly 500,000 service contracts across Scotland, so services must be available 24-7. That is why hospices and third sector partners are so important. The reduced pressure on unscheduled care services, which cost the NHS, is staggering £190 million a year for those in the final year of their life. I note that financial constraints placed on charitable hospices to match NHS pay awards, making it impossible to operate for financial security, forcing the sector into a £16 million deficit for this current year. I note the need for a new national funding framework for hospice care to ensure the financial stability of the sector. However, I would like to focus my remarks on CHAS. I am privileged to have Rachel House and Cynross in my region and I know that everyone will be aware of the fantastic work that CHAS does to support families and patients. For over 30 years, CHAS has been Scotland's only children's hospice service, although it works diligently towards ensuring no-one should face the death of their child alone. It provides world-class emotional, practical and medical support from when the child's condition is diagnosed right the way through to bereavement or transition to adult services. I have visited Rachel House and the whole surroundings are perfectly arranged to make what is a very difficult time as comforting as possible. Just look at some of the testimonials to truly see how amazing this service is. As one parent said, the death of a child is indescribably devastating and we will always be grateful to the entire CHAS team. I cannot imagine getting through those days, weeks and months without their support. Unfortunately, the need for their service provided by CHAS has never been higher. According to the latest figures available, there are more than 40 per cent more children who may die young in Scotland and there is no evidence that that number is dropping. However, CHAS is facing undue pressures on a budget deficit this year of £2.3 million. That is largely due to the unavoidable cost burden of trying to match NHS pay awards in an organisation where staffing costs represent 75 per cent of their expenditure. Having to ensure that the charity remains competitive within this specialist care market leaves the charity little option to do all that can to match the comparative grade levels within the NHS. However, CHAS does not receive any additional statutory funding when NHS awards are made leaving them at a massive disadvantage. That is even more significant when you realise that 70 per cent of the charity's income is raised through the amazing generosity of the Scottish public. The stark reality is that the Scottish Government funding to CHAS is declining. In 2016, the then Cabinet Secretary for Health and Sport committed to pay parity between public funding for children and adult hospitals at 50 per cent of agreed costs. Unfortunately, that was actually 30 per cent. As another parent asked of the Scottish Government, investment is needed. This service is a vital service for those who will lose a child due to chronic illness. Put the needs of our precious children as a priority. Please. I urge the Scottish Government to meet its programme for government commitment to sustainably fund ensuring that CHAS continues the excellent work that they provide for Scotland's terminally ill children and their families. I thank my colleague Sue Webber again for bringing this issue to the chamber. I now call Rhoda Grant to be followed by Bob Dorris. Ms Grant. Can I congratulate Sue Webber for securing this debate? Hospices are essential to end of life care. Unfortunately, they are not available everywhere. We first need to make sure that everyone has access to high-quality pallidive care, be it in a hospice, be it at home or be it in hospital or another setting. They need to have choice as to where that care can be accessed. It can depend on someone's life-limiting condition. They need information to make an informed decision and an understanding of what their needs may be and how their care can be delivered to enable them to have a good death and where that care needs to be delivered if it requires specialist care. Most people want to die at home, and that should always be the starting point. We have a right to a home birth, but we do not have the right to die at home. There seems to be a hierarchy of end-of-life care, where patients with cancer tend to get better quality of end-of-life care, as opposed to those with age-related illnesses, such as dementia and organ failure. It is hard to understand why, but it needs to change. We need to make sure that everybody has the same rights and abilities to end-of-life care. Others have said about hospices struggling financially. That is the case with many charities that depend on NHS funding. Highland Hospice, which is an amazing organisation in the Highlands, receives approximately 25 per cent of its funding through statutory funding, and the fund raises for the other 75 per cent of its costs. That, in comparison with Roxburgh House in Aberdeen, provides much of the same care. It receives 100 per cent of its funding because it is an NHS facility. I do not think that any hospice is looking for 100 per cent funding, but there needs to be a narrowing of the gap between NHS hospices and those independent hospices. Highland Hospice is really revolutionising how end-of-life care happens. It has an end-of-life care together project that it is running with NHS Highland, with million cancer support, connecting carers, maricuri, Highland senior citizens network and Scottish care. It is all those people working, organisations working together, that have enabled the development of the service. They have a 24-7 helpline for agencies and families who are looking after someone who requires end-of-life care. They are looking at a palliative care response service. That has been rolled out in Inverness, but hopefully it will be rolled out further. That is providing palliative care at home. It helps to cut costs to the NHS by preventing hospital emissions. It is very important to deliver the service that the final year of life is pre-planned, so that services can be put in place and ready for when they are required. It is important that the stops are pulled out to make sure that people have the death that they would wish, and that their families are witness to that, because that helps with the grieving process. I touch on wider funding, not just for hospices, but in my region there are many community groups that provide support to older people and people with life-limiting and chronic conditions. Many of those groups have not had an uplift for decades. They cannot continue to provide the services that they do, and they are going to fail because of underfunding. That means a loss of community care that is provided by the voluntary sector. It will mean more hospital emissions. It is a false economy because hospitals are not geared for that kind of care, and it costs more. It is not good for the patient and it is not good for the family, so we need to invest in end-of-life care in the same way as we do at the start of life, and then need to have equal importance. I want to thank Sue Weber for securing this evening's debate on the future need of charitable hospice care. It provides an opportunity to discuss some of the matters that have been part of my consideration for some time now, and my capacity is cross-party group community of the palliative care group within this Parliament. The palliative care is personal to us all, first and foremost. As an elect representative, I am fortunate to have a maricuri hospice in my constituency at Stalp Hill, and as a son, I was humble to have St Margaret's hospice in Clydebank looking after my father with great care, love and compassion in the last few weeks of his life. Hospices are not silos. They are a vital part of the fabric of our community, offering a range of wide supports and are actively involved in a broader range of palliative care support, not least of all with many hospices delivering a model of care often described as hospice at home. Such services will only grow in importance with the requirement for palliative care set increased by 20 per cent by 2040 and with an older and freer population more generally requiring increased care needs. Yet resources for the sector are badly stretched and we have heard about the funding gap of £16 million that has been identified. We have to be expanding the hospice movement, not seeing it contract. It is clear to me that there needs to be a new funding model developed to support hospices. We need to better understand our relationship with the NHS, with health and social care, be that helping to reduce the frequency and impact of unplanned admissions to hospital for those in the last year of life, or the relationship with delayed or unsafe discharge from the acute sector when those approaching end of life could otherwise be at home, or the relationship with hospices and public models of social care is delivered or procured through the network of Scotland's health and social care partnerships, such as the round table that was held just the other day. It is fair to say that there is a variety of funding models, various service level agreements across the country and a varied level of public funding being invested across 32 local authorities to support hospices or hospice at home services across the country. Variable models lead to variable outcomes, or various levels of service on offer across Scotland. Funding and provision of services are often inconsistent. Any national care service that we develop must help to secure appropriate, dignified, sufficient and equitable provision of pallid of care right across the country. I have met hospice UK, with Mary Curie and the Minister herself to discuss many of these issues. It is often said that death is the great leveller, but by that point it is too late. In public policy we must ensure that the end of life is that great leveller for us all. With two thirds of people's eternal illness relying on benefits, we can see that that is not necessarily always the case. It is not a level playing field. Perhaps by looking at NHS Agenda for Change Pay Settlements, such that we have heard earlier, there could be an expectation that hospities will be given funds to help match that pay award, rather than drawing or shrinking reserves. Challenging, I know, but we could move towards that. Perhaps the next NHS pay settlement, as a matter of course, could look at the financial impact on the hospice sector as a fundamental before agreeing any pay offer. I would like to see funds for hospices linked to Agenda for Change in the future. I do not think that we can move to 50 per cent agreed core cost funding, but that has to be a target that we have to get there. None of us are naive about the funding predicament of this Parliament, but we have to move in that direction. We do need longer service level agreements with health and social care partnerships and a clear line of accountability when health and social care partnerships say that they are delivering what they have been told to deliver as part of any national model. Hospices say that that is simply not happening, so that must change. Finally, on closing, there is huge cross-party support in this chamber for all of this. We all agree that there has to be a new national funding settlement. What none of us know is how that is going to be funded. We have said to Jackie Baillie and others that that is where we have to come together as a Parliament and not play party politics. That is far too important, Presiding Officer. Thank you, Mr Doris. Due to the number of members who wish to speak in this debate, I am minded to accept emotion without notice under rule 8.1 and 4.3 to extend the debate by up to 30 minutes. I now invite Sue Webber to move emotion without notice. I'll do it, George Adam. Moved, Presiding Officer. Excellently done, Ms Webber, if I may say so. The question is that the debate be extended by up to 30 minutes. Are we all agreed? That is agreed, and I now call Sharon Daryf. Thank you, Presiding Officer. I thank Sue Webber for bringing such an important debate to the chamber. Today I want to highlight the critical role that Ayrshire Hospice plays in my region and highlight how a charity like that can make a significant difference in providing compassionate care for those in need when they need it and relieve pressure on the NHS. I met Tracy Flynn, chief executive officer of Ayrshire Hospice, earlier this year. Tracy is passionate about Ayrshire Hospice and giving the best care to all those in the community. The Ayrshire Hospice goes beyond cancer care with a dedicated community team covering the entire region. Its availability 24-7 not only serves as a lifeline to families in moments of crisis but also prevents unnecessary strain on the NHS by reducing emergency admissions. In addition to their comprehensive cancer care, the hospice offers a range of services including respite and response, bereavement counselling, living well service and more. She emphasised the importance of effective collaboration between the hospice and community hospitals. It is clear to me and crucial to acknowledge how a well-functioning hospice like the Ayrshire Hospice has immeasurable cost savings for the NHS, but hospices are facing a challenging landscape. Only just over a third of hospices' income comes from statutory funding, with hospices having to fundraise the rest. Hospices, as it said earlier, are facing an expected deficit of £16 million this year, largely due to the cost of matching the NHS pay awards and to retain their key specialist staff. They need to match those pay rises. The Ayrshire Hospice is one of three Scottish hospices who are funded directly from their health board and not from the health and social care partnerships. They have received just under 50% of funding from NHS Ayrshire Narin, which falls short of covering pay awards. They must award those independently to retain and recruit clinical staff. Hospices seek a new framework for funding that will provide future guarantees and that the pay awards are passed in full and in a timely manner. That new framework could ensure that funding reaches hospices directly, preventing a widening gap between hospices and the NHS. They also wish to remain independent, but to innovate and support palliative and end-of-life care that is fit for the future, they require more sustainable funding. Tracy's dedication has fostered strong relations with NHS Ayrshire Narin and I am pleased to hear that the new hospice is well on track to be opened in autumn or winter 2024, but not all hospices are as fortunate. I previously raised those issues with the Minister for Public Health and Women's Health in the chamber and I would like to take this opportunity for thanking Jenny Minto for meeting with myself and Tracy Flynn in the Parliament. To conclude, we need to commit to supporting our hospices, guaranteeing that individuals in need can access high-quality care. Our hospices play a crucial part in the healthcare system as the demand for palliative care is increasing and it is predicted to increase by 20 per cent by 2040. With the NHS under significant strain, the importance of the support provided by charitable hospices has never been more important. I would like to thank whoever MSP for bringing this motion and this debate to the chamber. Everybody here for their thoughtful contributions. I have listened very carefully and with much interest to what everyone said. I think that everyone's comments illustrate the invaluable nature of hospice care and support that we have in Scotland. It is something that is close to my heart as well as members that I have spoken directly with understand. I have taken the last six months to try to visit and meet with as many hospices across Scotland. What has really struck me about all those visits and meetings is the breadth of care and support that hospices provide across our amazing country. As Sue Weber said, hospices are more than simply a building. I think that that is something that we all need to reflect on because I think that many people just assume that that is what they are. As Rhoda Grant highlighted, Highland Hospice has got an amazing partnership with a number of organisations in Highland and are doing similar work to the work that Sue Weber highlighted that is happening around the Edinburgh area. I would also like to thank Hospice UK and Marie Curie for their helpful briefings ahead of this debate. Most important of all, I would like to thank all those who work in hospices across Scotland for delivering such high-quality palliative care and end-of-life care services, often under very difficult circumstances. Sue Weber's motion makes clear how vital hospices are in delivering this high-quality palliative care and end-of-life care for people and their families. It also reflects the challenges that we face in developing our palliative care and end-of-life services to meet the needs of our ageing population. As others have said, Hospice UK estimates that the number of people needing palliative care in Scotland will increase by 20 per cent by 2040. That is why we need to create the right conditions nationally to help to ensure that our local palliative and end-of-life care services, including hospices, have the support that they require to meet that need. I would just like to continue if that is okay. I will maybe take one later. Scottish hospices are very well placed to help to address those challenges, given their expertise in providing vital support to people and their families, as well as supporting other health and social care services and teams delivering palliative care and end-of-life care. I thank the minister for taking that intervention. When you were out visiting the various hospices, I was at Marie Curie and Famelhead. They mentioned a pilot that has been recently in England, where their NHS 24 equivalent has a direct button to press for those families at home in those out-of-tower settings to access advice quickly, rather than waiting in those often lengthy queues with NHS 24 to then get a district nurse out. Have you considered some sort of innovative solutions like that to try and help those people? I thank Sue Weber for that intervention. I think that that has been what I have been trying to do, is going around and listening to hospices to hear what they have done. Sharon Dowey supported and discussed what is happening in Ayrshire, and there is lots of innovation around there. As I referenced earlier, Rhoda Grant talked about what Highland hospices are doing with their phone lines, and there is also St Margaret hospice in Marie McNair's constituency, who spoke to them about the ambulance service that they are doing. Yes, we are looking at all of that, and it is understanding the breadth of services that hospices are providing, so I have been trying to learn and listen about that. However, in planning for the future, we must be cognisant of the challenges of the present. I understand the financial pressures that hospices face, and I have shared with Scottish hospices the financial challenges that we, as a Government, face. As Rhoda Grant highlighted, there are differences across the sector, which is something that I am looking at. On 17 August, as many people have said in their speeches, I wrote to the Scottish Hospice Leadership Group and Hospice UK to inform them that, unfortunately, their request for £15.5 million was not affordable, given that the Scottish Government is facing the most difficult financial situations in devolution. My reason for sending that letter was to have that level of honesty with them, to be able to start the discussions, which I think was incredibly important. I think that it is also important to reflect that it is the responsibility of integration joint boards, including locally elected representatives, to make informed decisions on how best to resource services, including hospice services, to meet the needs of their local communities, given the budgets under their control. However, I have also been clear that we are keen to support the hospice centre where we can, and as many have referenced yesterday, I met representatives from Scottish Hospices and health and social care partnerships to discuss the challenges that hospices face in more detail. We shared a draft national framework to support a more consistent approach to local governance, commissioning and resourcing between integration joint boards and independent hospices. It was clear from the discussions that there were some very strong relationships between health and social care partnerships and independent hospices, but that we all need to do more to promote and support those relationships, and that includes local authorities, health boards, health and social care partnerships and Government. I think that both Bob Dorris and Sharon Dowey emphasise the importance of that collaboration. I welcomed the very open, frank and honest discussions that we had yesterday, and we agreed on the need for more clarity about roles and responsibilities nationally and locally in relation to strategic planning for palliative care and also more specifically commissioning hospices services. One of the health and social care partnerships yesterday said that they would be bringing this discussion to their meeting next week. I think that that is a positiveness. We have raised the issue, we have got health and social care partnerships to listen and hoping that it has raised up their agenda. We have also got a specialist palliative care meeting on 12 December and more meetings in the new year with health and social care partnerships. There was, I think, yesterday a welcome from the hospices and health and social care partnerships that we were able to have this open dialogue. I have asked my officials to reflect on those issues further, in particular through the development of the new framework guidance. We are also developing a new palliative care strategy, which prioritises work to address leadership responsibilities and accountability for all palliative care across a complex landscape of partnerships and relationships. I hope that that will be published in 2024. I agree with Rhoda Grant. Yes, I will. It is just to give—2024 is long. Can you give us an indication of when? Because they have already been waiting two years for this. I would love to give an indication more. I will go back to my officials and get the date, but I know it is next year, so we are working hard on that. It is something that I want to see driven through. Basically, because, as Rhoda Grant said, people need choice, and that needs to be the right choice for them. The overarching aim of the strategy is to ensure that everyone who needs it receives well-coordinated, timely and high-quality palliative care, care around death and bereavement support based on their needs and preferences. That support should be available to anyone who needs it, regardless of age, illness or socioeconomic background. I reflect on what Ross McCall was talking about with Chaz and the importance of the care that it provides. When I visited, there was a sibling who was there still getting support, and that is very important. As I said at the recent debate on dying in the margins, being diagnosed with a life-limiting illness is undoubtedly one of the most challenging things that a person can go through. No person or their family should have to worry about their finances at such a difficult time. That is why this Government ensures that adult disability benefit applications from people with a terminal illness are fast-tracked to provide them with the support that they are entitled to as quickly as possible. It is also important to reflect the importance of the dying in the margins and in the debate to ensure that we are talking about death to allow people to start planning. I thank all those working in hospices for the commitment and dedication that they show each day, often in extremely challenging and upsetting circumstances. I finish by offering my personal thanks for all that you do and also for the debate that I think is incredibly important.


In August 2017, Malaysia became the first country in the world to issue a compulsory license for sofas buvir, a breakthrough medication for the treatment of patients with hepatitis C. Sofas buvir, sold under the brand name Sovaldi, has been patented by Gilead Sciences. The decision to grant compulsory license for sofas buvir and make it available in government hospitals was made by Ministry of Health of Malaysia after efforts to include the drug in the medicine patent pool and price negotiations with the patent holder were unsuccessful. Compulsory license is one of the flexibilities provided to countries under TRIPS agreement whereby a government may allow someone else to produce a patented product or process without the consent of the patent owner. This may be invoked adhering to a set of conditions such as national emergencies, other circumstances of extreme urgency, public non-commercial use and anti-competitive practices. Exceptions are made under certain circumstances provided these are clearly set out in a country's national patent law. The use of compulsory license for sofas buvir in Malaysia has enabled increased access to the drug for treatment of hepatitis C at about US$240 for 12 weeks treatment compared to a whopping US$71,000 the cost of Gilead's patented version. This step and the resultant scale-up of hepatitis C treatment in public hospitals is expected to benefit nearly 5 lakh patients in Malaysia. Earlier in 2004 Malaysia had become the first country in Asia to use this flexibility following the adoption of the Doha Declaration on TRIPS and Public Health in 2001. And also after prolonged failed price negotiations Malaysia issued a compulsory license for HIV AIDS medicines patented by GlaxoSmithKline and Bristol Myers Squibb. This step had reduced the average cost of treatment per month per patient from US$315 to US$58. It had also helped the government increase treatment capacity from 1500 to 4000 patients by reducing cost of three patented medicines. As a result of the issuance of compulsory license, the average cost of treatment per patient per month fell by 68% to 83%. However, with yet another historic step of granting compulsory license for sofas buvir in 2017, Malaysia has come under severe pressure from pharmaceutical companies and their political allies. There has been continuous intimidation by the US industry and government since 2017. It must be noted that compulsory licensing serves as an important cost-containment measure against the exorbitant patented medicines. Moreover, it opens up competition among holders of compulsory licenses bringing the price of a product down, while the patent holder may continue to receive payment in the form of royalty from the compulsory licensee. Thus, although riddled with implementation issues due to commercial and political pressures from corporate patent holders, compulsory licensing still stands as a legitimate means to address public health concerns.