The next item of business is a member's business debate on motion 775 in the name of Alexander Stewart on brain tumour awareness in Scotland. This debate will be concluded without any questions being put. If those members who wish to speak in the debate please press their request to speak buttons down a call on Alexander Stewart to open the debate seven minutes. Mr Stewart, please. Thank you, Deputy Presiding Officer. I am delighted and grateful for the opportunity this afternoon to lead the member's business debate on brain tumour awareness. In order to set the stage and briefly explain why I strongly feel that something more must be done to increase the awareness of brain tumours, I thought it appropriate at this point to highlight some of the salient issues. Brain tumours are the largest killer by cancer of children and adults under the age of 40 in the United Kingdom. Brain tumours reduce life expectancy by an average of 20 years, which is the highest of any cancer that we currently know of. 971 people in Scotland were diagnosed with a primary brain tumour in 2014, with a total of 475 people in Scotland dying from the disease in 2015.  Brain tumours are one of the four cancers, with a 10-year survival rate of less than 15 per cent. About a year ago, I heard of a tragic situation in my region, and I would like to explain that to you now. Mark Richardson from Dumfirmland, a father of two with an oldest stepson and husband to Shona, who is kindly with us today in the public gallery, and I pay tribute to her for the harrowing situation that she went through, for the tenacity that she has had since that tragic situation and the amount of work that she is now doing to support others in a similar situation. Mark was tragically and suddenly struck down by an undiagnosed brain tumour. It was discovered that Mark had a very highly popular manager with Diageo, and he had consulted a lump the size of a golf ball that had not been diagnosed, and he died at the age of 32 in May 2016. He died suddenly after Shona found him collapsed in the Dumfirmland home. It came to light that Mark had had affected extreme tiredness, and Shona had put that down to his demanding job and having to deal with two lively children. Mark also suffered from neck pain and laterally a bleed on his eye prior to death, but nothing was found even after an eye test. Shona and her friends from Mark's Diageo colleagues together decided that they would have a dinner in his tribute after his passing. That event raised tens of thousands of pounds and also Diageo then contributed a match fund to that event, so £62,000 was raised for the brain tumour charity. To date, in excess of £80,000 has been raised in his memory. That includes many events that the family and Shona have put together. They had a climb up Ben Nevis, where 30 of his family and friends took place in September. Indeed, only a month or so ago, Shona organised a charity walk of between 2.5 kilometres or 20 kilometres, depending on the availability and management of exercise around Loch Leven, accompanied by their sons and 50 of their family members and friends. Brain tumours are currently a cancer of unmet need. The investment that is needed in research to improve diagnosis and find more effective and less-harmled treatments and ultimately a cure has been woefully insufficient in the past decades. Cancer research has done a lot of work and I acknowledge the work that they have done, but progress has not been achieved equally across the sectors.  On 29 October, in Australia this year, they launched their $100 million fund to beat brain tumours. The decision has been taken in no small part to the cure for brain cancer foundation, which has worked hard with the Australian Government to secure that funding. That is encouraging, and the announcement arrives at the same time as the United Kingdom UK brain tumour charity is right in the middle of a five-year planning strategy to invest £20 million across the world in research centres in locations in Germany, Netherlands and indeed Australia. I firmly believe that Scotland can comfortably follow the lead set by Australia, and I would suggest that the work in the third sector funders and brain tumour research come across the world, and we can combat if we work together to achieve some of those. The Scottish Government should work closely with brain tumour charities and deal with the research. We have lots of research that has been done, and many people in Scotland have added to that research. I pay tribute to individuals such as Dr Paul Brennan from the University of Edinburgh on the pathway to adult diagnosis, which is the ultimate goal for the increasing awareness of adult brain tumours in Scotland. The most important fact for all is the patient experience. It has to improve. With everyone having equal access to treatment and care, that should be our goal as we move forward. The Scottish Government must ensure that the brain tumour patient has access to clinical nurse specialists or key workers who carry out assessments on all the patient's holistic requirements following diagnosis with signposts in place to ensure that the patient will receive access and support locally. Patients with a brain tumour should have the opportunity to discuss palliative care with consultants at the point of diagnosis.  I urge the Scottish Government, the brain tumour charities and health professionals to work together to indeed support and protect people through that journey, and that is why we should have some kind of public awareness campaign to educate, to give us information so that we understand what we are dealing with. I pledge that I will do all that I can in this place to fight the corner for the awareness of this devastating disease. We need action, not words. We need commitment from Government. If we can work together, we can achieve together just to support patients and their families. Open debate. Speeches of four minutes are called clear. Do we follow by Edward Mountain? I refer members to my entry in the register of interests. I am a registered mental health nurse who holds an honorary contract with NHS Greater Glasgow and Clyde. I thank Alexander Stewart for bringing this important debate to chamber today. It is welcome that people are now increasingly aware of brain tumours and the devastating effect that they often bring. However, I am sure that we will all agree that we can certainly go further. Over the past two decades, a number of high-profile public figures have been diagnosed with the condition that, in turn, has propelled into the mainstream. In the music world, we witnessed Russell Watson's brave fights over the years with two pituitary tumours.  In the world of politics, we sadly lost the late Mo Molam, who suffered from a malignant tumour prior to her death 12 years ago. Improvements in the prevention, detection and treatment of cancers have seen survival rates double over the last 40 years. However, progress has sadly not advanced equally for all forms of the disease. Brain tumours are often perceived to be a rare condition. However, around 10,600 people in the UK are diagnosed each year and it is our ninth most common cancer. In 2014, more than 800 people in Scotland alone were diagnosed with a brain tumour. As Alexander Stewart has already mentioned, although there are less common, they are less common than other types of cancers, brain tumours are the biggest cancer killer of children and of under-40s in the UK. Depending on where the tumour is found and on the rate of its growth, brain tumours cause a range of different symptoms. Common signs include headaches, sickness and vomiting, people can be prone to having seizures, sufferers can see changes to their senses, particularly with their hearing and sight, and people's behaviour can also change. I hope that this debate will not only raise the awareness for people's understanding, the effects and the symptoms of having a brain tumour themselves, but also help in picking up on such changes in others. Only one in five people with a brain tumour will survive five years, but even more devastating is that 60 per cent of people will die within one year. As well as the low survival rate, 60 per cent of younger people will be left with a significant disability. Unlike many other forms of cancer, for example, the breast, a benign diagnosis of a brain tumour can be equally as devastating as a malignant one. Due to the growth being positioned on the brain, even removing a benign lesion can have a huge and persistent impact on the person. One in four people with a tumour will have sensory loss or lose cognitive functioning. One in three's personality and behaviour will change, while one in two's memory will be impacted. For those who survive brain tumours, many will be sadly heavily affected and may live a poorer quality of life. I am grateful for Clare Haughey's expertise from her own background that has been brought to the chamber today. It has been very useful to me to understand some of those things. I wonder whether or not, in the circumstances that you have described, it is welcome that the Scottish Government is bringing forward a new logical action plan that, hopefully, can begin to address some of the very issues that you are laying out in your excellent speech today. Clare Haughey. I thank Bruce Crawford for that intervention and the absolutely support in the Scottish Government's action on this. The Scottish Government, through its beating cancer ambition and action strategy, and the accompanying £100 million investment over five years, serves as a blueprint for the future of cancer services in Scotland. It will improve the detection, prevention, diagnosis, treatment after care and, ultimately, the survival of people affected by cancer. The £100 million strategy will include £50 million for radiotherapy equipment and to support radiotherapy recruitment and training, £9 million over five years to ensure better support for people with cancer in their families, for example, through linked workers, and £5 million to support waiting times and performance. In addition to that, the Scottish Government has also invested £41 million in the detect cancer early programme, which is targeted at those living in the most deprived areas of Scotland. The continued focus from the Scottish Government on early diagnosis is absolutely vital, and it will make a positive difference. Cancer services have come a long way over the past few decades, but there is much more to be done to reduce mortality rates. Being diagnosed with a brain tumour can be an overwhelming prospect for those affected in their families, so it is vital that we support them from the detection right through to their aftercare. I thank Alexander Stewart for the chance to debate this in the chamber. At the end of every day that I have the privilege to serve in this Parliament, I know that I will go home having learned new facts and figures. Some remain just as that, facts and figures, but some of what I learned become ideas that I am driven to support, to see whether I can build on them to benefit those that I represent. The subject falls within the latter group. I knew little about brain tumours before I was elected. I had not come into contact with anyone with this form of cancer.  Sadly, the treatment of brain tumours is about 20 years behind the treatment of other cancers. One thing is clear is that the 130 different types of brain tumours make diagnosis difficult and sometimes the symptoms are mistaken for other serious conditions, which then delays treatment. The reason why I want to speak in this debate is to highlight those tumours and to ensure that early diagnosis can lead to early treatment. My reason for wanting to do this is simple. Not long after I was elected to Parliament in 2016, I was contacted by the parents of a boy called Robert, who lived in the Highlands, a piper and a biker who had been diagnosed with a brain tumour. His parents would be doing all they could, and he did a little bit of help to get Robert some additional specialist help. I met with them and Robert, and over the next few months we worked together, taking his treatment forward. Sadly, in 2017, despite the support of doctors, Robert lost his fight. The reason why I mentioned the story is because of the importance of early diagnosis. In the case of Robert, his family were initially concerned when Robert struggled with his piping and took him to his doctor. The doctor moved really quickly, and Robert was diagnosed quickly, but that is not the case for all children. While diagnosis times have dropped from nine to six weeks, we need to do more, and we should ensure that that drops further. I know that Clare Haugh has already mentioned the symptoms of brain tumours, but I think that I want to mention them again, because that, I think, will shed light on that. As far as babies are concerned, we should be looking for persistent vomiting, lack of balance, abnormal eye-cont movements, lethargy, abnormal head position and sometimes fiction seizures. In children above symptoms, walking problems, co-ordination and double vision. In teens, the symptoms can also include delayed or arrested puberty and abnormal growth. Ever since I met Robert, I have taken a keen interest in two charities. First, the UK-based brain tumour charity, with whom I hope to promote early diagnosis in the course of the terms of this Parliament. Secondly, a charity called HeadSmart. I would like to encourage all those who get the chance to go on to HeadSmart's website and to do so to look under the stories section. There are nine stories of children there who have suffered with brain tumours. They all make clear the importance of early and accurate diagnosis, and that is what we should take home from this debate. I say to all parents, if you recognise any of the symptoms that I have mentioned in your child, take them to the doctor. To doctors, if you see any of the symptoms that I have mentioned, do not ignore the possibility of brain tumours. I say to the Scottish Government, do all you can to increase the knowledge of brain tumours. I hope that, as a result of this debate, if we do that, it will be a fitting tribute to Robert. I also add my thanks to Alexander Stewart for tabling his motion and allowing members the opportunity to discuss how best to make progress on the detection and treatment of brain tumours and to pay tribute to the memory of all those affected by the cancer. Brain tumours may be the ninth most common cancer in the UK, but, as cancer research UK and the brain tumour charity highlight, it is one of four cancers of unmet need due to the poor survival rate and the all-too-limited improvements that we have seen in the past decade. 60 per cent of people died nos with high-grade brain tumours, tragically died within a year, and only 19 per cent will survive for five years or more. As Alexander Stewart and Edward Mountain showed in their opening remarks, behind the statistics are real lives, real people and real families tragically affected. The number of people affected is on the rise with brain tumour incidents increasing by 16 per cent from 2005 to 2015 in Scotland. Over the same period, the number of deaths as a result of brain tumours increased by 14 per cent. While mortality is increasing at a slower rate than incidents, progress still remains far too slow. Ensuring that brain tumours are detected and treated as quickly as possible is, of course, crucial to improving progress both in the detection and treatment of tumours. However, we know that the identification can be incredibly difficult both for those with tumours and for medical professionals. The symptoms of brain tumours are wide-ranging and nonspecific and they can vary depending on where in the brain the tumour occurs. In fact, 31 per cent of those with brain and central nervous system tumours visit a healthcare professional more than five times before being diagnosed. 37 per cent of diagnoses occur after an emergency admission compared to an average of 9 per cent across all cancer patients. However, as the motion highlights, there has been some progress since 2011. The average diagnosis time for childhood brain tumours in the UK has decreased from 9.1 weeks to 6.5 weeks. Here, we can see the positive impact that targeted efforts to improve early detection and raise awareness can have, and vital work continues to improve recognition and understanding of symptoms in order to further reduce diagnosis time for children and adults alike. We also need to ensure that primary care services in our communities are accessible and adequately resourced. As a common first point of contact on a healthcare system, primary care has a vital role to play in providing early detection, but difficulty access in these services adds an additional barrier to treatment. That is particularly true in relation to people with general and seemingly non-urgent symptoms as are common among those with brain tumours. As well as improving diagnosis for brain tumours, there remains a need to improve our knowledge and treatment capabilities through research. As all speakers have highlighted so far across the UK, brain tumours are the biggest cancer killer of children and adults under the age of 40. Yet, in 2016, less than 2 per cent of cancer research funding was spent on research in brain tumours. Pioneering work on the subject is taking place across the world, and technological innovations are constantly creating opportunities to transform how we diagnose and treat brain tumours. In several Scottish universities, that important work is being done. Dr Nick Leslie at Heriot-Watt is exploring the potential uses of 3D printing in brain tumour models. Dr Brennan at the University of Edinburgh is working to establish why some adults take longer than others to be diagnosed and to understand how brain tumours progress, and at the Edinburgh Cancer Research Centre, a number of teams are working to better understand brain tumours and develop potential new treatments. We must do all that we can to ensure that this vital work has the support and, of course, the funding that it needs in the future. It is also important to recognise the role social care may play in delivering care for those who have or will have brain tumours. The Scottish Cancer Patient Experience Survey found that the proportion of people with brain tumours offered a care package was the second lowest of any cancer type at just one in five. In pallative care, the picture is equally lacking. Research by the brain tumour charity found that the majority of people with the terminal brain tumour diagnosis were not given a choice of end-of-life care options, and almost half felt that they had not been given appropriate information about end-of-life care. In concluding, it is clear that, whether it is improving detection, treatment or care, there is much still to be done to tackle this cancer, which many argue has not had a high enough priority. Thank you very much. Thank you very much indeed, Deputy Presiding Officer. I congratulate Alexander Stewart on securing this important debate and welcome the opportunity to make a brief contribution to it. I also offer apologies to you, Deputy Presiding Officer, and others, due to the fact that the Justice Sub-Community is taking place right at this moment. Myself and Callum Steele have some catching up to do after yesterday's debate on policing, so I will have to leave slightly early. However, I will certainly read with interest the contributions that were made during the remainder of the debate. That is, as others have already said, an important issue. I pay tribute to the work of Cancer Research UK, not just highlighting brain cancer but supporting research into the causes and how it can be treated more effectively. As others have said over the past 40 years, we have seen very welcome improvements in prevention, detection and treatment that have revolutionised cancer medicine and survival rates, but that has not been consistent across the piece. Brain cancer is one of four cancers of unmet need that has been identified quite rightly by Cancer Research UK. Those cancers have a poor five-year survival rate, as others have mentioned, which has seen limited improvement over the past decade. I think that Cancer Research is quite right to prioritise the improvement of both the quality and the quantity of research into those four cancers. That is certainly the view of those involved with the Friends of Neuroward ARI in Aberdeen, a group that deserves our gratitude and support, as do the other campaigners mentioned by colleagues in their remarks. I pay personal tribute to Caroline Critchlow and Caroline Toshney in particular, but they are certainly very well supported by other volunteers in this group. They have done incredible work over the years, raising money for the Neuroward in Aberdeen, but also raising the profile of the issue that we are debating today. Caroline Critchlow is in absolutely no doubt that the main issue is that diagnosis is still coming far too late. There are lots of different brain tumours, and their symptoms, as Clare Haughey outlined, are easily confused with other things, as the tragic example referred to by Alexander Stewart illustrated. There seems to be a reluctance for whatever reason to refer for MRI scans, and as a result, too often people are presenting at A and E by which stage it is invariably far too late. That, in turn, puts pressure on neurowards that tend to be underfunded, and that is because of a wide-ranging nature of the referrals for head injuries, for spinal tumours, MS, MND, Parkinson's, etc. They do not appear to be benefiting from the funding that supports all of those diseases. I am told that the new Glasgow hospital did not include a neuroward in the new build, and I am certainly interested to know the reasons for that decision. Clare Haughey, for a point of clarification, there is a neurodepartment on the site of that hospital. That is helpful and encouraging to know. The underlying problem is that not enough is known about brain tumours. Only 1 per cent of cancer research funding is being spent in that area, an amount that, in real terms, is going down rather than up. That is tragic and rather inexplicable when, as we know and others have mentioned, it is the biggest cancer killer of children and adults under the age of 40. More research, earlier diagnosis and greater awareness. I thank Alexander Stewart for at least helping with the latter of those three, and I hope that we can see much more progress on the first two. In the meantime, I apologise again, Deputy Presiding Officer, to Alexander Stewart, the minister and others, that I will shortly have to leave the chamber to attend the committee. Thank you. It is fine if you want to leave just now, there are some committees sitting. In order to call all the other members that wish to speak in this debate, I am minded to accept a motion under rule 8.14.3 that the debate be extended by up to 30 minutes. I invite Alexander Stewart to move that motion. The question is that under rule 8.14.3, the debate is extended by up to 30 minutes. Are we agreed? I now call Emma Harper to be followed by Iain Gray. I would first like to congratulate Alexander Stewart on bringing this important date to the chamber today. I need to remind the chamber that I am a registered nurse. The operating theatre was one of the areas of clinical practice that I gained experience in. Today's debate is about raising awareness of brain tumour and the effects that the signs and symptoms diagnosis and treatment have on not only the patients but the families of those affected. While researching for that, I was reminded of the terms glioma, glioblastoma, astrocytoma, stage 1, stage 2, stereotactic biopsy, chemotherapy, radiotherapy—all different words that are used in the language of caring for people with brain tumours. I acknowledge that the motion wording says that there are over 130 types of brain cancer. In 2003, while working at Serious Sinai Medical Centre in Los Angeles, I was able to participate in tumour removal surgery that was performed called Awake Craniotomy. Sometimes a tumour is in an area of the cerebrum where the speech centre is located and preserving speech-fallen surgery is an obvious optimal goal. That can be achieved using the specialist technique. I was reminded of the work that I have participated in on reading the motion and doing the research for today. In 2014, 971 people in Scotland were diagnosed with a brain tumour and in 2015, around 475 people died as a result of a tumour in their brain. I also pay tribute to the people, the families and the lives that are affected by brain cancer. One of the most important factors in the successful treatment of a brain tumour is early diagnosis and I am going to focus my time on that. Last year, I was contacted by headsmart campaigns so that I could help raise awareness of the headsmart programme, which has already been mentioned by my colleague Edward Mountain. I was asked to raise awareness using my social media contacts. Headsmart is an internet-based site to help by providing education about symptoms of brain tumour, especially that can lead to an earlier diagnosis, especially in children. I mentioned children, as according to the brain tumour charity, 10 to 15 per cent of childhood brain tumours in the UK are high-grade astrocytoma. It is called a diffuse intrinsic pontine glioma, or DIPG. It is a fast-growing tumour originating in the brainstem and it often appears in children aged only six years old. Children and teenagers, young folks, the symptoms might go undiagnosed until more problematic, as adults may think of some of the symptoms as part of growing up. One description was that a young teacher forgot the pupil's names and her text messages became garbled. Later, she was diagnosed with a brain tumour, so those garbled text messages and not remember the names were associated symptoms. When individual symptoms are connected, action can be taken. The site describes symptoms as persistent or recurrent vomiting, persistent or recurrent headache, abnormal eye movements, blurred vision or double vision. The abnormal eye movement, for example, could be the appearance of a new squint, bulging eye or other eye problems. Problems with hearing and loss of balance in co-ordination, so some of the children described wobbly legs and fits or seizures are also part of the symptoms. The head smart decision support tool for healthcare professionals on the internet sites gives guidance on when to reassure, review or refer and will lead to neurological examination, CT or MRI scan, and as part of the clinical pathway for diagnosis and treatment. There is so much involved in the care, treatment and family support around brain tumour disease, but the recognition and diagnosis at the earliest opportunity is one of the most important aspects of getting the right support and care. The impact of the head smart campaign is that childhood diagnosis time is reduced from 14.4 weeks to 6.5 weeks, so that is a great achievement. I will conclude again by welcoming this debate and reiterating the importance of raising awareness of cancer of the brain. Again, I thank Alexander Stewart for securing this debate today. Thank you. I call Ian Gray to be followed by Ruth Maguire. Thank you, Presiding Officer, and thanks to Mr Stewart for bringing this important motion to the chamber. As we have heard, brain tumours unfortunately impact families and communities the length and breadth of Scotland. Indeed, today's debate was highlighted to me by a constituent who got in touch to share his story of how he tragically lost his son last year to a brain tumour. Two more of my young constituents, Luke Stewart from Trinent and Alex Logan from Preston Pans, have recently been diagnosed with an extremely rare form of malignant tumour, known as DIPG, which is extremely difficult to treat. This form of tumour affects only 20 to 30 children a year in the UK, but we have two cases diagnosed within a few miles of each other. Local communities have rallied round Luke and Alex. Luke was told by the NHS that they could only provide radiotherapy to give him some semblance of equality of life, but he is now receiving treatments in Mexico after hundreds of thousands of pounds were raised to fund a new treatment. He is only the seventh patient in the world to receive the family report that the benefits have been significant, but how hard they have had to fight in order to get them. Alex's family are now fundraising too. Once again, their friends and neighbours are stepping up to play not least at Preston Pans boxing superstar Josh Taylor, who dedicated his recent defence of his silver superweight title to Alex and his campaign in front of a television audience of millions. Although it is welcome that Luke now has access to the treatment that he needs, and although I know that Preston Pans will not let Alex Logan down, we have to put our hands up and say that we are letting them and their families down. They should not have to depend on fundraising to get the treatment that they need and which can help. They should not have to travel to Mexico to find the treatment that they need. As we have already heard, over the past 10 years, survival rates from brain tumours in Scotland have shown little improvement. Brain tumours kill more people than leukemia in Scotland. Deaths have increased by over 15 per cent in the past 15 years. Brain tumours kill more children and adults under the age of 40 than any other cancer. We have also heard that cancer research spending in the UK features less than 2 per cent dedicated to research on brain tumours. That simply cannot be right. It is time that we did better for youngsters such as Luke and Alex. I call Ruth Maguire to be followed by Claire Baker. Ms Maguire, please. I thank Alexander Stewart for bringing this important topic to the chamber today. The debate is fundamentally about raising awareness of the signs and symptoms of brain tumours, and the importance of doing this cannot be overstated. It really is a matter of life and death. I am sure that I was not alone in being shocked by some of the statistics and stories that I read about in preparation for the debate, such as that nearly one third of people visit a healthcare professional more than five times before being diagnosed and that 37 per cent of patients with brain tumours in Scotland went straight to hospital for diagnosis compared to 9 per cent of all cancer patients in 2016. That is because of a lack of understanding amongst both the general public and healthcare professionals, which can mean that brain tumours can often go unidentified and undiagnosed for a long time. When they are finally diagnosed, if it is too late to treat them effectively, the result can be the patient deteriorating quickly and dying. That can and must be improved and, by raising awareness, it can be. That has been proven beyond doubt by the UK-wide campaign Head Smart, which has radically improved average diagnosis times for children and young people. Based on the diagnosis of brain tumours and children guidance produced in 2007, Head Smart is a public-facing campaign that focuses on raising awareness of the signs and symptoms of brain tumours in children and young people. Through educating both the public and healthcare professionals, the campaign has succeeded in saving countless lives and in markedly reducing long-term disabilities. Before 2007, average diagnosis times for children with brain tumours in the UK was 13 weeks. Four years after the publication of the guidance for healthcare professionals, that was reduced, and most recently, average diagnosis times have been reduced to 6.5 weeks. The goal is now to get the average diagnosis time down to four weeks. The campaign so far has demonstrated how much of a difference can be made simply by raising awareness. If we continue to do so, I am confident that we can achieve this goal for children and young people, as well as for adults. As well as raising awareness of what we currently know, another crucial strand in better dealing with brain tumours is new research. I was pleased to read about the pioneering research projects that are currently under way in Scotland at the universities of Edinburgh and Herriot-Watt. I hope that the Scottish Government will capitalise on those research findings in due course, in addition to the action that it is already taking, such as the first Scottish Cancer Patient Experience Survey that was published in partnership with Macmillan Cancer Support last year. The findings of that survey highlighted good practice as well as areas for improvement. Responding to that in September of this year, the health secretary announced the formation of a ministerial cancer performance delivery group to drive forward improvements in waiting times for diagnosis and treatment for cancer patients in Scotland, supported by £1 million of new funding. An additional £3 million was also announced to increase the number of radiology trainees in Scotland by at least 50 over the next five years. That investment, plus continued national awareness raising, will continue to focus our minds on further improving outcomes for brain tumour patients. His diagnosis and treatment still lags behind that of other cancer patients, which can and must be improved. I would like to welcome some of my constituents to the chamber for this debate. I have been contacted by a number of constituents who are living with a brain tumour diagnosis, and their stories have been very effective in highlighting the challenges that people face when fighting that condition and trying to get on with living their lives. I would also like to thank the brain tumour charity and Cancer Research Scotland for their briefings in advance of the debate. Alexander Stewart has highlighted the key issues around the experience of people, the health and emotional impact on them, the difficulties with diagnosis and the lack of awareness of the condition. There are two things that struck me in particular from the briefings. First, the stress that there must be for the individual in trying to achieve a diagnosis. We know that a third of diagnosis comes from emergency admissions into hospital, and also 31 per cent of people have to visit their GP at least five times before a diagnosis can be decided on. I recognise the difficulty that it is in trying to diagnose. I think that that has been highlighted by other members. The condition can also look similar to other conditions. It is relatively uncommon for a GP to come across that condition. I understand the difficulties that there are in diagnosis, but that must be extremely frustrating for the person who is waiting for that diagnosis and their families.  There is need to be more investment. The investment has been inadequate to address some of the key issues around improving diagnosis, finding more effective and less harmful treatments, and ultimately finding a cure. The briefings and other members have highlighted the importance of research that it can make a meaningful difference to people. I have highlighted the work of Dr Paul Brennan and the work of Dr Dirk Seiger, who is looking at particular work around enabling the faster development of drugs to try to treat the brain tumours. There are examples of where treatment is difficult for people to experience and we could see improvements around patient care. Secondly, the thing that struck me is the patient experience through all this. There are models of care from other cancers that we could replicate here. We have clinical and nurse specialists in other areas and we know the benefits that they can provide. They are vital to supporting people. We often recognise that the clinical care and consultant experience that people have there is excellent. It is so important, but when they finish that engagement, they can often feel abandoned. They are dealing with the shock and the stress of having received that diagnosis. They often come up with many questions that they cannot remember. The answer to that is that they have had a short meeting with a consultant, so they have many unanswered questions often.  At that point, a clinical specialist and a nurse specialist can provide some really valuable support and signposting to support people. It is the most prevalent life shortening cancer for children and adults under the age of 40, which must make diagnosis extremely concerning. I would highlight some of the emails that I have heard from constituents. Michelle emails me. She got diagnosed with a brain tumour just over a year ago when she was only 25 and says that her whole life has changed due to the symptoms that come with this horrible disease. She had to give up her job and she had to give up her college course due to being so ill. She is only 26.   I feel that because it affects this age group, we are maybe not as experienced in how to deal with supporting those patients. I think that it is an area that really needs some focus. I was also contacted and it impacts significantly on people's life, their home life. We have often seen parents who have young children being affected. I was also contacted by Elisabeth, who and her husband both work. They claim no state benefits, but they have a young daughter. They were trying to access early nursery care and feeling that the situation that they are facing should have made it easier for them to qualify. They were unable to pay for childcare, which was the situation given that they are both in work and they are not claiming benefits. That seemed to be the answer that they were given about how to deal with this. I think that that situation has now been resolved, but it illustrates how families who are often trying to look after young children, trying to deal with the diagnosis and the kind of challenges that they face. Finally—sorry, Presiding Officer—I just also like to mention that there is an extremely stressful time for people. The stats show that people do not often have the support that they need, and they often do not have enough understanding for their employers or the agencies, which suggests a lack of understanding here and the impact of the condition. That has all been reflected in the emails that I have received. I will finish with Ewan, who also contacted me, who said that another key interest for him was the nature and provision of support, post-operation and the impact on families and their patients is enormous and the challenges last a lifetime, particularly the mental health and wellbeing aspect that we must also give attention to. Thank you. I now call on Aileen Campbell to close with the Government Minister. Seven minutes are there about these. Thank you, Presiding Officer, and I, like others, would like to thank Alexander Stewart for securing this debate. I appreciate all the contributions made from all members this afternoon, and to pick out the professional and authoritative contributions from both Clare Haughey and Emma Harper. The Scottish Government recognises the damaging impact of all cancers, including brain cancer, on individuals, their families and friends. Brain cancer has a devastating impact on younger people, being the biggest cause of cancer deaths in those aged 40 or under. I want to pay tribute to, like many have in Mark Richardson, who was mentioned in Alexander Stewart's motion and also welcomed Shona to the chamber, and recognise that tremendous effort to raise an enormous amount of money in memory of Mark and, again, just to reiterate how sincerely sorry we are for the sad passing of Mark. Edward Mountain, similarly, spoke about Robert and it sounds like he was an incredibly wonderful and talented lad. Again, it was important that Edward Mountain did take that time and his remarks to raise again the awareness of all the signs, especially those signs that may be missed by parents. Similarly, again, Ian Gray, and I appreciate him for raising the stories of both Luke and Alan and Alex, sorry, and while I know that we all wish him well, I also want to extend an offer to meet with Ian Gray about their cases to find out more, if there is anything more that could have been done if that would help. Again, we probably all want to put on record our hopes that both Alec and Luke can have the recovery that we all hope for them. Claire Hawke also mentioned the fact that it is not just constituents that have been impacted by brain tumors, but many notable people like John Hart and Mo Molam. For me, I also want to pay tribute to a teacher at a school in my constituency, Moira Struthers, who recently, untimely and sadly passed away. She was a remarkable woman who, for by being an incredibly popular teacher, was also heavily involved in the community. She volunteered, she raised money and she also did all that she could to help anyone who was in need. I have had many constituents contact me about this debate, all echoing the calls that we have heard about today regarding the need to raise awareness and research, and making sure that Moira's experience can inform the way that we move forward. Clearly, what unites all those stories that we have heard today is a need to do more and to make sure that we redouble our efforts around brain cancer and brain tumours. Before that, I want to outline some of the more national approaches that we are taking towards our cancer strategy. In March 2016, the Scottish Government unveiled its beating cancer ambition and action strategy, which serves as a blueprint for future of cancer services in Scotland. The Government is aware that early detection of all cancers, including brain cancer, is crucial, and the strategy will deliver £100 million of investment to improve the prevention, the detection, diagnosis, treatment and aftercare for all those who are affected by cancer. There is good work, but, as we all acknowledge, the improvement felt in some areas of cancer are not replicated in others, showing that there is still much more that we need to do. Our £41 million detect cancer early programme has increased diagnostic capacity across Scotland, as well as increasing awareness of the signs and symptoms of cancer. Next year's programme, however, will focus on early detection for all cancers. That aims to encourage anyone with any concern or changes to their body to visit their GP. With regard to raising awareness of brain cancer, my officials met the brain tumour charity and headsmart earlier in 2017 to share crucial information on signs and symptoms of brain tumours via our WeC social media channel. I have again instructed my officials to meet colleagues from brain cancer charities to discuss how we can further support awareness messages and also to consider research opportunities. Building on that request that was made by Alexander Stewart for charities, the third sector and Government to work together and work collaboratively. To improve cancer diagnosis, the Scottish Government has also supported the Scottish referral guidelines for suspected cancer, which were revised and published in 2014. Those include a specific section on brain cancer and are intended to help clinicians to identify those people who are most likely to have cancer and require urgent specialist assessment. Those guidelines are due to be reviewed and refreshed next year. Again, that will be assisted through that engagement with those third sector charities and organisations that have a specific knowledge of brain tumours. That will enhance our ability to raise awareness and ensure that clinicians are able to identify people who are most at risk and not caught up in the fact that those symptoms can often mimic other conditions. We all know that, however, where a diagnosis of brain cancer is made, the huge variance in sight and tumour type can make treatment challenging. Clare Hawke was also right to point out the impact of even a benign tumour can have. I welcome the research funding in Edinburgh and Glasgow from the brain tumour charity and also the increased focus from CRUK on less-survivable cancer such as brain cancer, and those centres are carrying out internationally-leading research into many different areas around diagnostic improvements, developmental biology and neuro, regeneration and neuro stem cell biology. Researchers can also apply to the Scottish Government chief scientist office for funding, and applications aimed at improving the diagnosis and treatment of brain cancer would be indeed very welcome. Ruth Maguire and Clare Baker talked about the importance of the patient experience. The first Scottish cancer patient experience survey was published in June 2017 and covered all aspects of the cancer care journey from thinking about that something might be wrong through to the support received after acute care and treatment. Although national results revealed that 94 per cent of people had a positive experience of their cancer care overall, areas for improvement were highlighted. Particular concerns for people with brain tumours included the high number of emergency admissions, provision of care plans, access to information and access to clinical trials. Those findings will assist in identifying where to target future improvements, and I want to see those improvements reflected in the next cancer patient experience survey. Also taking on board the suggestions raised today, for instance Clare Baker, outlined in that real need to have a broader package of support alongside the initial clinical interventions that might have taken place. Members also raised the issue of appropriate palliative and end-of-life care services. The brain tumour charity has highlighted the need to ensure that people with brain tumours have the option of discussing palliative care with clinicians from the point of diagnosis. I am pleased that Scotland already has a very good reputation for palliative and end-of-life care. This year, the University of Bath Institute for Policy Research published a policy note that Scotland is taking bold steps to improve palliative and end-of-life care services and support. We want to ensure that everyone has access to palliative and end-of-life care tailored to their individual needs. Our framework for action on palliative and end-of-life care contains a number of commitments to improve services and to support to help to meet the needs of people and their families. To achieve our aims, we must create the right conditions nationally to support local communities in their planning and delivery of those services. That ethos is at the heart of our health and social care integration agenda, and it is reassuring to see the positive outcomes of that beginning to be reflected. However, to close, I want again to offer my thanks to the members for their contributions to today's debate. We know that we must keep looking to improve how we deliver care and how we can equip ourselves to deliver even better health and social care services in the future. The cancer strategy will assist with that, but it will also require us to work together collaboratively with contributions from people living with cancer, carers, voluntary groups, professionals and professional organisations, and of course our dedicated NHS staff. In memory of Mark, of Moira, of Robert Michelle and all those impacted by brain tumours, we must ensure that their experience informs our actions going forward and that we can make improvements on the life expectancy, the impact, the broader impact on their families. We must make improvements in those areas and we must see the increased research and opportunities that that brings to make the improvements that I think we all seek and want to do so in the memory of all those that have been mentioned today in the debate. Again, I thank Alexander Stewart for taking the time to raise this important debate and for all the contributions and just acknowledge that we want to endeavour to do more to make the improvements that are so necessary. Thank you. That concludes the debate. I suspend this meeting until 2.30.


So in this video, we're going to continue on with our multiple linear regression analysis and at the end of the previous video, we got this residual plot and realized that maybe this isn't the best set of predictors that we could possibly include for our model. And so we're going to, in this video, introduce a way to do a correlation based variable selection. And so so far we've sort of been throwing we through this state variable at the analysis because we thought maybe this is important. But we didn't include any other variables. And when you have a large data set like this, you can try to put through all of the variables at it and see which ones are important. There's so many that at times it can become important to maybe take a step back and see which ones are already highly correlated and then focus on including those variables. So I've already selected down selected a few of these variables so we've got our response variable here, and these are just some explanatory variables that I thought might be important. Note that they're all numeric variables. So the first step is to actually create this correlation matrix. And I'm going to call it core matrix. And we take our selected data set. And we just say, core. And this is the same correlation command that we've learned in the linear regression lesson. It's just not being applied to any single variable, but it's just not being applied to any single variable, but it's just not being applied to any single variable. So that's what happens when we leave it empty. And so we can see that we now have this correlation matrix where we can see where variables are highly correlated to NOX, RGGI, and where they aren't highly correlated. And so what we are going to do is actually plot that to be a little bit more a visual way to show what these variables are. You could easily go through and make your selection just based off of these numbers. Before we can plot using GG plot, though, we need to melt the data set. So GG plot, if you recall, really likes those long form matrices, and this is a bit too wide. So we're going to melt. And it's going to look a little different from our previous melt. For one, we're not going to tell it which variables because we want to melt all of them, but we are going to say to not ignore the index, because we this is currently an index column here and we want it to be included. So don't ignore the index. And then after we melt, we're going to reset index. So we're not telling it what to melt or what to call any of these variables, just saying melt them all, including the index. So if I give you an idea about what this looks like, I forgot my dot melt command. So core matrix dot melt, and then you have the ignore index false and run it that way. So now we can see that our index one variable, and then our variable became all of these column names. So now we can connect variable column or row variable to column variable to the correlation. And then we can plot that using ggplot. And so our data is now core matrix melt. And our GM this is a new GM that we haven't used before is GM tile. Within our AS, we can say x is now index. Now variable. And we're going to fill it based off of value. And these are just these column names up here. And then, just to make it a little bit easier to read, I'm going to add a theme element where I actually change the axis text angle to be 90 on the x axis. So we can run that. And we can see a correlation matrix. And so the correlation matrix dark purple is going to be an okay negative correlation, and yellow is going to be a perfect positive correlation. And so we can see here that there's a block of yellow that are all fairly in green that are fairly correlated with each other we can see some dark correlation here and here. And then we've got a lot of sort of in between stuff around here. But what we are interested in is this RG GI role. And we want to go across here and see, okay, CO2 base is pretty highly correlated. Less so here. Okay, Knox base is good. It's one to one perfectly correlated with Knox RG GI. We've got PM 10 and PM to five SOX start to get some less good correlations here. And then some of the stack things seem to be decently correlated so stack diameter stack height, and so forth. So I'm going to go through and write those down and figure out which ones we actually want to include in our next round of multiple linear regression. So I'm going to create a new variable called results to so that I don't override my original results. And once again using that SMF OLS. So we start with our why data tilde x data. So I'm going to do an OX base, which was important. Plus, CO2 base was important. PM 10 base. PM to five base. So X base. And we still want to keep our state variable. And I'm also going to add in a second categorical variable and fuel type. And then finally minus one. And then we need to tell it our data is DF merged. And we said has const equal to true and tech the fit on to that. So then we can print results to summary. And so we can compare now so if we go back up here we can see our adjusted our squared was 7.761. And now it's 0.786. So we have seen quite a large improvement there. To sort of boot bolster that adjusted our squared. We're still seeing a significant p value. And then we can come in here and now we've got a lot more data. And we can see that in terms of fuel type, the coal category is critical for is very significant for this prediction, which makes sense. We tend to have quite a bit of Knox emissions so it makes sense that whether or not a power plant is coal based or natural gas based or nuclear does have an impact on their knocks emissions. And we can also see what wasn't significant down here so S O X was actually not very significant. So perhaps we could remove that in a third round. We could add more variables so I didn't add any of those stack based variables. The stack height or the stack diameter so perhaps adding those could lead to an improvement. But there are lots of things that you could continue to do to further increase this adjusted our squared value.


Hello and welcome to the session. In this session, we will discuss a question which says that the initial population of a city was 20,000. Later on, with each consecutive year, the population of the city increases by 1,600, write an expression for the population P as a function of number of years M, determine the rate of change and the initial value of the linear function. Now before starting the solution of this question, we should know a result. Now any linear expression is of the form y is equal to Mx plus b. Now this result will work out as a key idea for solving out the given question. Now let us start with the solution of the given question. Now where we are given, what is the description of the function? We are given initially the population of the city was 20,000 and with each consecutive year, it increases by 1,600. Now we have to write a linear expression for the population as a function of number of years. Now here, population is denoted by and number of years are represented by M. Now here it is increasing with years, initial dependence and number of years. Thus it is a dependent variable and number of years which are denoted by M represent dependent variable. Now the change in population is 1,600 people per year. So here, population is increasing at a range of 600 people, the population 1,600 and we have to write a linear expression for population as a function of number of years. And from the key idea, we know that any linear expression is of the form y is equal to mx plus v where x is the independent variable and y is the dependent variable. Now here is the dependent variable and also in n years, the population is increased by 1,600 and required expression p is equal to 20,000 plus 1,600 n. Now here we are putting a positive sign because population is increasing by 1,600 people per year. We can write it as p is equal to 1,600 n plus 20,000. So this is the required linear expression for the population p as a function of number of years n. Now here we have to determine the rate of change and initial value of the linear function. Now in the question it has given that initial population was 20,000. The rate of change in population is 1,600 people per year. Now the initial value 20,000 the y intersects 600 which is the slope. This equation let this be equation 1. So 1,600 is the slope of equation 1. So this is the solution of the given question and that's all for this session. Hope you all have enjoyed this session.