And then I can hide the data tab by clicking on the data tab, right click and hide it. I could do that to this data tab, right click and hide it. I could do that to this data tab, right click and hide it. And then I want to be on something other than a graph when I go to print it to check it out. File tab, print, and then I'm going to use the Qt PDF printer. It's free. I'm not advertising for them, but that's just what I'm using to make a PDF out of it. I'm going to choose the entire worksheet instead of just one page. And then if I scroll through this, I've got all of my reports that I can print out on one worksheet. And I have more flexibility now to put those graphs in there as well.


One of the eight universally recognized rights of the consumer is the right to redress. This means the right to a fair supplement of just claims. It includes the right to receive compensation for misrepresentation for the provision of truly or unsatisfactory rules or services.


What is very important for particularly from the point of view of the students and those who are undertaking courses in migration research and migration studies is this it is a standalone chapter although it is built upon 2018 WMR one need not refer to that 2018 volume it is self-contained in itself and so at one place itself it provides all the sources and all the material all the data for for researchers convenience.


There are definitely some significant differences between being a military family and a civilian family. We move every two to three years. With the length of time that I've got in service, you know, we're about a year and a half, not even quite two years every move. It's kind of hard to move from place to place a lot, but it's fun to have new adventures all the time. It's not easy, but it's kind of fun getting to see all the new places. This is the reason they are so good at school or so good at being flexible. I get to meet a lot of new friends and new people that grew up in different environments, and so I think that's pretty important. It's really made them really aware of that giving back aspect, and it's about that public service in a different fashion. Regardless of what it is, where we're at, what we're doing, family is always at the forefront.


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Hi everyone and thank you for joining me today. We're going to be talking about energy monitoring and energy benchmark tests and various GitOps architectures and looking at flux and Argo CD as well. I'm Niki Manoledaki. I'm a software engineer at Weaverx and I'm also a maintainer of open GitOps and a contributor to the environmental sustainability tag of the CNCF. My co-presenter Al Hussein wasn't able to make it today, unfortunately, but we'll hear from him in the video in the in the video in the presentation. So the cloud's carbon footprint. There are a lot of numbers out there trying to estimate what this is. But it's difficult sometimes to find a reliable source that will give you a definitive number, which is also a guess that is always changing and it's going to be growing continuously in the next years as well. But the International Energy Agency, the IEA, has some numbers about data centers and data transmission networks where each account for one to one point five percent of global electricity usage, which is about three percent. There's other numbers that measure the ICT industry as a whole to be around four percent. But yeah, so in the diagram that you see here, you also see, you know, a larger diagram of global net zero targets and what that has to look like, net zero being a reduction of 90% or more of greenhouse gas and other carbon emissions, where 10% only can be offset. So the 90% reduction cannot be through offsets. And so let's go a little bit deeper in this conversation on energy and carbon monitoring and optimization in the cloud native ecosystem. There's some drivers and markets in the market such as net zero. A lot of companies have these in place and other sustainability targets. So that means reducing the energy usage and carbon emissions of your infrastructure. There's performance optimizations to be gained from energy efficiency as well as cost savings. Also, you know, encompassed by the term FinOps, where you can deduce that if you reduce your resource utilization and cloud usage through cost optimizations, that may be a proxymetric for sustainable metrics. And there is also regulatory drivers in the US, the Security and Exchange Commission, the SEC, has an upcoming rule called the Climate Disclosure Rule, which will require publicly traded companies to report on their carbon emissions. Scope one, scope two and scope three. That's direct, indirect and embedded emissions. And in the EU, there's already been a law that's passed and is going to take 18 months to be implemented. And that's the Corporate Sustainability Reporting Directive, or CSRD. That's going to also require companies, especially publicly traded, large companies to report on their carbon emissions. And if you want to hear more about this, the Green Software Foundation, which is part of the Linux Foundation, has a great podcast called Environment Variables. Amazing name. And one episode is on the legislation aspect of this and how it will impact the tech industry and the cloud industry and cloud users as well. So there's a lot of community momentum at the moment in the CNCF. There's the Environmental Sustainability Tag, which meets twice monthly and you're very welcome to come and contribute and learn. And there's also in the GitOps working group, we have the Environmental Sustainability chapter or subgroup, where we actually this talk came out of that. And you're also very welcome to join us if you would like to do more of the test that we're going to be talking about here. And last but not least, there's, well, there's the Green Software Foundation and that I'm going to talk about more in a minute. And the Project Silver, which is a new project by Linux Foundation Europe, which is focused on telcos and how to measure and reduce the energy consumption of especially 5G architectures using cloud native software. So about the Green Software Foundation, let's go, let's zoom in a little bit deeper as well before we get into why energy benchmark tests matter. The Green Software Foundation has been working on the Software Carbon Intensity Index, the SCI, which they're in the process of of making into an ISO standard for measuring the energy consumption and carbon emissions and as a rate of a software component. So there's a formula that they have put together with various variables such as energy consumption, carbon emissions, embedded carbon, and all of this per rate. So per rate of something such as this could be an API request, it could be a reconciliation like what we were going to see in this in a minute. So that's really important for comparing the software intensity, the carbon intensity of software. There are many open source tools available for measuring energy consumption as well as the hyperscalers have some offerings as well for measuring carbon emissions through carbon dashboards. These offerings are very limited. There's definitely an issue with data granularity, like you can't necessarily on AWS, for example, you can't set a tag and view your carbon emissions via a tag. You see your entire infrastructure. You can't see by region, which is helpful, but you can't really deduce a single EC2 instance what it consumes, for example, which is what we need. And there's a three month lag. So if you, whatever you're running today, you're going to have the carbon emission of it in the three months from now. But it's helpful for the long term reporting. And in the open source side of things, there's still a lot of guesstimating, but Kepler is what we're going to look at today. It's an EBPF based tool. So it's Kepler stands for Kubernetes based efficient power level exporter. And it's a great acronym as well. And it's a Prometheus exporter. So it looks at your kernel syscalls. That's the EBPF part. And it looks at various components, such as it uses the Rappel for energy data aggregation, and also other components that are in the kernel to aggregate all of that and provide energy consumption in joules. Joules is a metric for energy. Joules over time is watts. So if you look at joules over, for example, two hours, you're going to get the watts equivalent, which you can use with a carbon coefficient for a given electricity grid to get, to multiply that with that coefficient and get the carbon emissions for your software. And so, yeah, EBPF for monitoring is really cool. And it's a growing topic as well. And so in Prometheus, what you end up having is this Kepler container joules total, which is amazing. It's magic. So the test environment setup for these tests have included Ubuntu and Arch Linux. So very painful. I was using Arch for this. It hurts a little bit sometimes. But trying to do this on a Mac was very difficult, even in a VM. It doesn't help. Yeah, it's, it's challenging. But on Linux, it's much easier. We used Minicube to create the cluster environment with CPU count of four. And three is also possible, but it did run out of, yeah, compute power sometimes and crash my machine multiple times. But we then use Prometheus, Grafana, and then the magic, the secret sauce Kepler to measure flux and Argo operations. So idle GitOps dashboard number one over two hours, we can see the flux system namespace and the Argo CD namespace without anything, anything to reconcile. So just idle. We can see that Argo CD is consuming slightly more energy consumption at a base level. And we can also see that the flux system, the flux has some spikes. Now any guesses as to what that may be caused by customized controller. Yeah, very close. So you see those spikes. And so, yeah, there's a little bit of a different pattern that we can already see. Now my co-speaker, Al Hussein will present a little bit more about the benchmark test in the architectures. Thank you, Nikki. Hello, everyone. Today, I would like to take you through the experiments scenarios we conducted to evaluate the energy footprint of a set of GitOps architectures and patterns, which are first, we examine the concurrent deployment of a sample application with Argo CD and flux. Next, we compare the power consumption of deploying applications from a mono repo versus a multi repo approach. Moving on, we explored the impact of using a standalone cluster versus a happen-as-poke or multi-cluster setup for Argo CD. And lastly, we vary the reconciliation interval comparing a three-minute interval with a 30-minute interval. For each of those, our long test starts with having the GitOps tool in an idle state for the first 15 minutes to ensure a stable starting point before deploying an application. After another 15 minutes elapsed, a code change is introduced to trigger an update, followed by a rollback after 15 minutes. At the end of the hour, the application and the GitOps tool get deleted. Now, let's dive into the architecture of the first scenario, in which we aim to evaluate the energy footprint of deploying the GitOps sample application to a mini-cube cluster, using both Argo CD and flux simultaneously, but to do different spaces. There is a rise to independently deploy and manage the application using the set tools. The power consumption in the flux namespace remained relatively consistent throughout the hour, hovering around 0.1 watts. However, there were periodic spikes observed approximately every 10 minutes or so, which could be potentially attributed to flux internal operations, such as synchronizing with Git repo history or checking for changes in the application's configuration. On the other hand, within the Argo CD namespace, we observed a different power consumption pattern. Initially, the power consumption started just below 0.1 watts, however, after approximately 15 minutes, there was a spike when the sample application was deployed. Furthermore, after another 10 minutes, the power consumption in the Argo CD namespace increased to 0.3 watts and remained at that level for the rest of the hour. The sustained increase in power consumption in the Argo CD namespace may be linked to the ongoing activities performed by the Argo CD application controller. The analysis of all namespaces reveals interesting insights. Notably, the cube system namespace exhibits significantly higher power consumption compared to the other namespaces, which can be connected to various system components and processes that are essential for the functioning of the Kubernetes cluster, such as kubelets, kubroxy, and other control plane components. On the other hand, the GitHub's tools demonstrate much lower power consumption. Similarly, Kepler itself also shows lower power consumption, which suggests that its overall footprint is relatively minimal. In our second experiment scenario, we focus on comparing the energy footprints and impact of code repository strategies, namely monorepo and multirepo. For the monorepo approach, we deploy both guestbook and pod info sample applications from a single Git repository. This means that all necessary configuration files and charts are stored in a single Git repository. In contrast, for the multirepo approach, we deploy the sample applications from two separate Git repositories. Each application has its own dedicated repository containing its hand charts. It appears that there is not much of a change in the power consumption between the two approaches. The power consumption in both our Gostidian flux system namespaces remains relatively consistent, regardless whether the applications are deployed from a single or multiple repositories. This implies that the choice of repository strategy does not seem to have a significant impact on the power consumption when it comes to deploying applications following a GitOps model. Our Gostidian repository seems to have peaks when there is an update to the code in the Git repository, which happens around every 15 minutes, which is the sleep time that we have set in the experiment script. While ARGO CD application controller is the one most of the power consumption is attributed to. In our third experiment scenario, we investigate and compare two architectures, standalone, a single cluster, and Haban spoke for multiple clusters architecture with ARGO CD. In the standalone approach, we deploy a sample application to a single cluster, specifically a mini-cube cluster where ARGO CD is installed. In contrast, the Haban spoke approach involves deploying the same application to multiple clusters, two AKS clusters besides the mini-cube cluster. We utilize ARGO CD's application set feature for this purpose, which allows us deploying and managing the applications across multiple clusters. In the case of multiple clusters deployment using the Haban spoke architecture, it appears that ARGO CD consumes close to twice as it does when it deploys to a single cluster. The increased power consumption in the multi-cluster scenario can be linked to factors inherent to the Haban spoke architecture. Managing deployments across multiple clusters requires additional resources, resulting in higher energy consumption. Regarding flux, Niky will explain why it's not included for now. Over to you, Niky. Yay, thank you, Alhusein, who is definitely here among us right now. Thank you, Niky. Hello, everyone. Okay, so why did we not include flux in the single cluster versus multi-cluster experiments? Primarily due to time constraints, but also because doing so the equivalent would be to use, for example, cluster API. Cluster API, if this is new to you, is a way to create a management cluster and then create a bunch of workload clusters that kind of copy what is happening in the management cluster. So you can manage a fleet of clusters that way, and it's also very GitOps compatible because you can configure everything with manifest in a Git repo. So cluster API and flux is a great combination of tools to use together, but part of why I could literally not run this on my local machine because it's very resource intensive. I had just like Lenovo ThinkPad 13 to work with and using the cloud would, for example, require using cluster API for Amazon, the Amazon provider, which works with EKS. And full disclosure, I was previously a maintainer of EKS CTL, the CLI for EKS. And I've been researching which AMI, the image for the node to use, like the operating system that would be the most ideal for running Kepler on the cloud. Which is, it's very challenging again because of the EBPF constraints and you need your kernel headers to be exposed in a read-only secure way. And you need C groups V2, and so you really need quite a lot of configuration in order to run Kepler on the cloud, and it hasn't been done yet. But yes, the last reconciliation scenario that we tested was trying three minutes versus 30 minutes of reconciliation interval. And the results for that were like slightly, I'm not sure if it's what we expected for flux. For Argo, you do see a decrease. So there is some optimization there for flux, not so much. And actually what we realized is that we were testing the reconciliation for specific resources, like Git sources and Helm sources. But this is not the same as brick-conciling everything according to these intervals. And Kings and my colleague had made a really good comment that sometimes optimization are not that and they may actually be misconfiguration. So we have to be really careful with that so that optimizations don't stop us from using a tool in the most optimal way. So other GitOps architectures that we want to try, like I mentioned before, is to use it with Cluster API to run it on EKS. And pull-based versus push-based reconciliation would also be really interesting to try. So some of the challenges and lessons learned. The operating system is an EBPF portability, something that is very challenging and it's quite well documented. I recommend this article by folks from Pixie who also work with EBPF on the challenges of deploying EBPF in the wild and accommodating various different operating systems and how difficult that can be. So, like I mentioned before, we used Linux machines and MacOS is pretty challenging. The Kepler does support VMs, but it's still, I've tried with kind, I've tried with Minicube, I've tried with VirtualBox and no luck so far. Hopefully one day. That would make the DevM much easier for Mac users, otherwise you need to also have a Linux machine. Resource limitations, like I said, the test environment for running all of these tools and all of these operations can be really intensive. Again, DevEnvironment is a challenge for this. And our machines, like we had to try all of this so many times because sometimes we just had Kepler not returning any data and the GradFinal dashboard was literally just five dots, so we couldn't really show you that. And our system often became unresponsive and we had to start over and so it can be really difficult. And cloud limitations, so we really should be trying all of this in the cloud, right? Currently there's no support for EKS, if there is interest in doing that or solving for any of these challenges, please do contribute to the sustainability subgroup of OpenGitOps. And lastly, oh, but Kepler is supported by OpenShift. Kepler is a tool that is developed by Red Hat and IBM primarily, so there is support for OpenShift. And some statistical limitations is that we need way more data points because we can show you a couple of examples or averages, but ultimately we need way more data points so that we can have actual information that has been tested on different environments hundreds of times, ideally, and for much longer periods of time as well, so that we can have a better picture of what the energy consumption of the software is. So you can try it yourself. There is, if you scan this QR code or go to visit this page, you will see scripts for how to run all of this yourself. And we are planning to move all of this work to the OpenGitOps organization on GitHub very soon, so that's going to be something that you can also help to maintain and spread the word and contribute to and measure whichever tool you are building or maintaining using, etc. And lastly, the Environmental Sustainability Tag of the CNCF is going to be meeting on Wednesday around 12.45 outside of SustainabilityCon's room, very targeted room location. But if you're interested in talking more and joining the tag, you're very welcome to join us there. And also attend some SustainabilityCon talks if you're at OSS in the next days. And if you scan that other QR code, you can see more talks about flux happening these days. I don't know if there's time for a question or any questions. Yes. No, we didn't compare the energy consumption for different ways of setting up your customization, but that's a really interesting test to do as well. And I don't think it would be too difficult if the difficult part is setting up your test environments. But after that, you can really measure anything that you want. Okay, so the question is if flux was intended to be more energy efficient from the get-go, given that the data shows that flux has a lower energy consumption. I don't think that it was necessarily intentional. I don't think that we had this data before now to be able to measure things. But there have been, I know there's been some performance improvements very recently. So maybe that played a role. We haven't tested different versions before those optimizations and after, but that would also be really interesting to be able to share that kind of information. Thank you. I understand that they're there. So the question is if we tested get-sub modules, we haven't tested that. What you see is everything that we've tested in the past about for this talk. But that's another use case that would be really interesting. And I hope that we can see more features being tested before they're released in that way to also be able to show that the consumption is low compared to some that might double or triple your consumption and hopefully that becomes a test for the future. Yeah, so I don't know if this was picked up. But the question is if sustainability can become a topic that is as important as, for example, security and if it can become part of the test that we run, the auditing that we run on our software. There is a lot of demand creation being created right now around sustainability in the cloud-native ecosystem. There's a lot of questions and it's very new to a lot of people. So we're still doing a lot of education, a lot of awareness. And there's also sometimes sustainability can be kind of a buzzkill sometimes because it sounds like something that you do out of, for what, right? And actually there's so much that's been shown that improving sustainability can reduce financial costs so we still have to kind of link those together to people. There's also regulation coming that's going to require those metrics of whether this is a goal or not. And I've seen a lot of reports that are saying sustainability is in the top five for the years to come. So I hope so and maybe we can make sustainability or measuring the SCI part of the graduation process. I think that would be really interesting for the CNCF. Yes, I think we're out of time by four minutes but there's three questions and I don't know, maybe we can have these questions afterwards. Sorry, I would love to but we're a little bit behind. Thank you.


and then trying to pay it as late as possible without incurring any fees and being able to take advantage of discounts if you can and without angering the people you're doing business with, your vendors, right? So that would be when you enter a bill. Now when you enter a bill, if you're on an accrual type of system, then the bill form is another term that is different than the term you might hear normally. You might say, I got a bill from the utility company or something like that. If you got a bill from the utility company, then you might just pay the bill with a credit card or with a cash payment. In that case, it's a bill in normal terms, but it's not a bill that you entered into QuickBooks as a bill. Because for QuickBooks, the bill form means that you're increasing accounts payable. So if you got a bill and you paid it with a check or you paid it with an expense form or you paid it with a credit card, you paid the bill, but you didn't enter a bill form into QuickBooks because you didn't go through accounts payable. On the other hand, you might also call that bill from the utility company and invoice. I got invoiced by the utility company. Notice the invoice and the bill are the same type of document. It just depends which side of the table that you're on. So you can actually use them interchangeably in normal context. But when you're entering stuff into the software, the bill means that ultimately you're going to be paying someone else and the bill form more specifically means that you're entering the bill into the system, increasing accounts payable, so that you'll then have to track the stuff that you owe and then pay the accounts payable at a later time. So that's going to be a little bit more complex of a process. And then if you have inventory, then that throws another kind of wrench into the system. So if you have inventory, now you're purchasing, let's say we're going to be purchasing guitars later and we sell guitars. So if we purchase the guitars, we might have a purchase order that we're going to enter into the system. The purchase order is a form that's different in that it doesn't actually have a financial transaction behind it. It's just a request and it's different than what you might think of or we might think of when we order something from Amazon, like I order something if I buy a guitar online, I haven't got it yet, but I have to pay it when I buy it from the online store. Unlike if you have more power as the purchaser in a business situation, if you're purchasing a thousand guitars from China or something, then you might be able to, because they're manufacturing it or whatever, I don't know, then you might be able to request the guitars before you actually pay for them, which would be great. So then you could request the guitars, they ship them, you see if they're good, and then if they meet the qualifications and then you pay for them. So in that situation, the purchase order is the request form. And then when you receive the stuff, then you would enter the bill at that point in time. The bill would come in the box of guitars or whatever, and then you would enter the bill. So those are the different kind of formats. So we'll practice in the first month of data input, or we'll go through all of these forms one by one, and then we'll do a practice problem and look at it more on a cash-based system for the first month and an accrual-based system for the second month. But when you're setting up your system, that's what you want to ask. You want to say, am I on a cash or an accrual basis? Oftentimes you don't have a choice as to be on the cash or an accrual basis because it will be somewhat dependent on the industry that you're in. So you have to say, am I on a cash or an accrual-based system in the industry that I'm in? And then how can I set up my system to be as easy as possible? If I could just pay my bills as they come due by just taking it out of the checking account, then I might just be able to depend on the bank feeds. That would be great. Or depend on the credit card feeds. That would be great. If I'm using checks, then I want to make sure that I do a full service accounting system, enter the checks before they clear the bank so I can track the outstanding amounts. That's the point of the checks. You have to do that for the checks. Or do I need to do the accounts payable process? Now if I see that over here in our system here, notice here's all the forms. If you're on a normal cash-based system and you're doing electronic transfers, you'd be entering expense forms. What do expense forms do from a journal entry standpoint? They increase the expense account typically, although you could be purchasing like equipment or something like that, an asset account. And the other side is going to decrease the checking account typically. A check form, QuickBooks Online differentiates from the expense form. They're going to be similar, except that the check form has a check number on it that will be dealing with it, but the journal entry will in essence be the same. The bill is going to be the form that specifically means that you're increasing accounts payable. It's not coming out of the checking account. It will be coming out of the checking account later when you pay off the accounts payable, but the bill for the purpose of QuickBooks means we're going to pay something, but we're going to pay for it in the future. The pay bills is a specific form that's basically just another type of check or expense form, meaning it's going to decrease the checking account, but it's going to be specific to paying off the bill form. And that'll give you like an added piece of information that's kind of a check that was used to pay off the bill form. And we'll talk about each of these forms in more detail in future presentation. The purchase order is that request type of form. And then we have these forms that we'll also talk about a little bit more detail later, a vendor credit, a credit card credit. And then when we print the checks, if you enter checks, then you'd have to print the checks. And then we have an add. You can add a vendor down below. So we'll take a look at each of these forms in more detail. We'll analyze the journal entries and we'll look at the impact of those journal entries on the financial statements.


That concludes general questions, the next item of business is First Minister's questions, and at question number one, I call Douglas Ross. Thank you, Presiding Officer. First Minister, should he convicted rapist ever serve time in a woman's prison? First Minister. Presiding Officer, can I, of course, point to the fact that some matters that we will discuss in this session of First Minister's questions are subjudice? However, issues raised are operational matters for the Scottish Prison Service, and given understandable concerns that have been raised, it's important that I do address them. So I want to take some time, Presiding Officer, to set out the situation and answer Douglas Ross's question directly very clearly. Firstly, in general, any prisoner who poses a risk of sexual offending is segregated from other prisoners, including during any period of risk assessment. Secondly, there is no automatic right for a trans woman convicted of a crime to serve their sentence in a female prison, even if they have a gender recognition certificate. Every case is subject to rigorous individual risk assessment, and as part of that, the safety of other prisoners is paramount. Finally, in general terms, and perhaps most importantly, I heard the chief executive of rape crisis Scotland say this yesterday. I don't see how it's possible to have a rapist within a female prison. So let me be very clear. I agree with that statement. Bearing in mind what I've just said about the importance of individualised risk assessment as a general principle and presumption, I think that statement is correct. Termining now to specifics in the case that has been in the media in recent days, that risk assessment is under way. As in all cases, the Scottish Prison Service won't wait until an assessment is completed if they think action is required more quickly. Now it would not be appropriate for me, in respect of any prisoner, to give details of where they are being incarcerated. Given the understandable public and parliamentary concern in this case, I can confirm to Parliament that this prisoner will not be incarcerated at Caughton Vale Women's Prison. I hope that that provides assurance to the public, Presiding Officer, not least to the victims in this particular case. I appreciate that response from the First Minister, but this rapist is in there now. He's in segregation in a woman's prison at the moment, so I'm unsure what the First Minister is trying to say when the reality is that this double rapist, this beast is in a woman's prison right now. We think that it's wrong that a rapist is sent to a woman's prison.  Given what the First Minister has just said and given he is currently in Caughton Vale, does the First Minister believe that it's possible for a rapist to be held in a woman's prison as he is just now and not be a threat to women? I think that Douglas Ross should have listened more carefully to what I said. I have a responsibility, Presiding Officer, even standing in this Parliament, to be mindful of issues around safety and security of everyone. What I said in relation to this specific case, I made some comments in general that I think should give reassurance to the public, but in relation to this case what I said, and I'm going to repeat it, the risk assessment is under way. However, as in all cases, the Scottish prison service will not wait until an assessment is completed if they think action is required more quickly. This prisoner is not going to be incarcerated in Caughton Vale women's prison. In terms of the interim situation and how the situation that you have said there is going to be achieved, I have to be mindful of allowing the Scottish prison service to do their operational job and to do that properly. I will go back to one of the things that I said in general. This applies to any prisoner, regardless of whether they are trans or not, regardless of whether they are in a male or a female prison. If any prisoner poses and is considered to pose a risk or gives rise to any concern about sexual offending, that prisoner is segregated from other prisoners and that applies during any period of risk assessment. I think that I am being very clear to Parliament in light of public concerns, but I am also allowing having regards to important issues of security and safety to allow the Scottish prison service to undertake their operational responsibilities in relation to an individual case. First Minister, you just have to be clear with people. Can you confirm that a double rapist is currently being held in a woman's prison? That is the situation. Let us hear what the former governor of Caughton Vale prison, Rona Hodgkis, has said about this. I am absolutely clear about the fact that they should be in a male prison.  She continued, it is a red line, I would not have crossed. The double rapist only decided to change gender after he was charged by the police. It took the threat of jail for this criminal to decide to change his gender. That is not a coincidence, that is a conscious decision. The First Minister is hiding behind the Scottish prison service, but they are a Government agency that is accountable to SNP ministers. All that really comes down to is what ministers decide. They had the power to prevent this happening and they still have the power to change this in the first 72 hours under rule 191A of the Scottish prison service rules. Above asking where he currently is, was there any ministerial involvement in the decision to send this rapist to a woman's prison? Before that 72 hours expire tomorrow, will the First Minister personally intervene and remove this double rapist from Caughton Vale? The matter is not going to be incarcerated in Caughton Vale. Either short term or long term. There is an importance of allowing the Scottish prison service operationally to give effect to what I have just said, and that is important to stress. Those are operational matters for the Scottish prison service. The very fact that I am standing here and addressing them, and I think that most people listening to what I am saying right now will understand fully what I am saying. I am not to use Douglas Ross's phrase, hiding behind anyone. I am setting out very clearly that I agree with the comments of the chief executive of rape crisis Scotland yesterday when she said, and I repeat, I do not see how it is possible to have a rapist within a female prison. It is of course right and proper that there are individualised risk assessments done on every prisoner, and that is important, but I agree with that statement. What I have said is that short term or long term, this prisoner is not going to be in Caughton Vale, but it is important to allow the Scottish prison service operationally to give effect to the decisions that they have taken. I am sorry. I have asked this three times now, so I am going to ask for a fourth and final opportunity that I have. Where is this double rapist at the moment? Is he currently in a woman's prison here in Scotland, First Minister? Yes or no? I am sorry, all of this stuff about the Scottish prison service. This is the rules that the Scottish prison service has to work to. Rule 15.1 about the allocation of prisoners does allow ministers to intervene. Ministers could have intervened before now, and rule 19.1A gives 72 hours for this to be challenged. That expires tomorrow, and we heard nothing from the First Minister about what she is going to do about that. We have warned for months that violent criminals, just like the sex offender, the absolute beast that we are discussing today, would try to exploit loopholes in the law and attack and traumatise women. The problem, as we have said all along, is not trans people, the problem is violent offenders. Before the SNP's GRR bill has even come into force, rapists are currently exploiting the current laws. We shouldn't make it any easier for them to attack women. Nicola Sturgeon has seemed to reject that the fact that he is currently there isn't a risk to women. I can't agree with that. Will the First Minister go to Cortamvale? Will she personally explain to the women there who are sharing their prison with a double rapist why, on earth, her Government is allowing them to be in a cell next door? I think that if Douglas Ross was actually listening and was paying attention to the facts of what I'm saying out, he would know what I'm saying. What I'm saying is firstly, the Scottish prison service is in the process of giving effect to the decision it has taken not to incarcerate this prisoner in Cortamvale. Before the 72-hour period expires that Douglas Ross has referred to, my expectation is that this prisoner will not be in Cortamvale prison. That, to most people and to people who are reasonable, would be a very clear explanation of the situation. There are, of course, very, very small number of trans women who are currently in prison custody. In fact, many of them are in male prisons. There is no automatic right for any trans woman to serve their sentence in a female prison. That is subject to robust risk assessment. That is right and proper. To be fair to Douglas Ross, he made this point, and it is an important point. We must always be careful when we are having these exchanges that we do not even inadvertently suggest that somehow trans women pose an inherent threat to women. Predatory men, as has always been the case, are the risk to women. However, as with any group in society, a small number of trans people will offend. Where that relates to sexual offending, public concern is understandable. That is why the systems that the prison service has in place already are robust. As I think I am setting out here in this individual case, those systems lead to the right outcomes. 2. Anna Sarwar 3. Tomoromarks Holocaust Memorial Day, where we remember the 6 million Jews who lost their lives and other victims of Nazi persecution, and the victims of genocides in Cambodia, Rwanda, Bosnia and Darfur. Every day in politics we see division, but today we stand shoulder to shoulder in the face of anti-Semitism and all other forms of prejudice and hate. We unite to say never again, but we can't be complacent. We still have a long way to go to create a more equal and more peaceful world. Last week, one in three people waited more than the four-hour standard in A&E. There is a continuing crisis in Scotland's accident and emergency departments, a crisis caused by decisions made by this Government over the past 15 years. Patients are waiting longer for care than ever before, and we know long waits cost lives. Can the First Minister tell the chamber how many people waited over 24 hours in A&E in the last year? I associate myself with Anna Sarwar's comments about Holocaust Memorial Day. This week, of course, we do remember all the victims of genocide. That is important, but it is also important on this occasion to rededicate ourselves to the fight against prejudice, hatred and intolerance, and I know that we are all united in that endeavour. On the specific figure that Anna Sarwar has asked for, I suspect that he is about to give it to me, but if he doesn't, I will provide it to him later. The situation in our accident and emergency departments remains very acute. There is significant pressure on the NHS generally and on emergency care in particular. However, we are at this stage seeing an improving situation. Since the start of January, for example, waits over both 8 and 12 hours have fallen by around 40 per cent in each. There is work still to do. We are supporting the NHS in that work, but we are hopeful that we are seeing the severity of the winter crisis start to abate and that we will see further improvements over the week to come. Anna Sarwar, I know the number and she should know the number too, because it impacts on people across this country every single day. The answer that the First Minister was looking for is 6,362 people waited more than 24 hours in A&E last year. In 2019, that number was 48. Let me repeat that. 48 people waited more than 24 hours in 2019. In 2022, that number increased to 6,362. Some waited even longer. 1,356 people waited more than 36 hours in A&E and 390 people waited more than 48 hours. That is two whole days waiting in A&E.  Staff are burnt out, patients' lives are at risk and A&E doctors are telling us that 36 people could die due to long wait this week alone. So what is the First Minister doing right now to prevent these unnecessary deaths this week, next week and in future weeks too? I've set out in recent weeks the actions we are taking, the investment in the winter plan, investment in additional interim care beds, for example, and other support for the national health service. Long waits, whether in accident emergency units or in any other part of the NHS are unacceptable. They do have consequences, which is why we work so hard to reduce and eliminate long waits in the NHS. Of course there is always something missing from Anna Sarwar's questions, important though these questions are, when he compares figures from 2018 to now, and that of course is a global pandemic that we have been dealing with in the intervening period. That said, it remains the priority to tackle waits in our national health service, which is why we are cautiously optimistic, although not complacent, about the improvements that we are seeing in accident and emergency units. The latest weekly figures, for example, show four-hour performance up to 6.7 points on the previous week. As I've said, we are starting now to see significant declines in the percentages of people and indeed in the numbers of people waiting over both eight hours and 12 hours. However, there is still a lot of work to do to support staff. One of the things that we have done here in Scotland, which has not been replicated in England or Wales, where there is a Labour Government, is offer staff the best possible pay increase that we can on average 7.5 per cent here in Scotland, compared to 4.5 per cent where Labour is in Government in Wales. Listening to that response from the First Minister, I can understand the anger of staff and patients. This is what one nurse told the daily record this week. Patients are not angry at the NHS but with the Scottish Government. The First Minister and the Cabinet Secretary need to speak to these patients. The Scottish Government does not see these patients as human beings, as someone's mum or someone's dad. This is about human life, each and every single one of these SNP MSPs constituents whose lives are at risk every single day. It's not good enough for the First Minister to keep making excuses or to talk about Covid, because demand on A&E is actually down by nearly 120,000 people compared to 2019. Fewer people are using A&E, but waiting times are still longer than they've ever been. Scotland's NHS is at breaking point and things are only getting worse on Nicola Sturgeon's watch. The longest ever waits at A&E. Patients waiting hours in ambulances to even get into A&E. 7776,000 people, one in seven Scots on an NHS waiting list and record-breaking delayed discharge. Our NHS, our patients and our staff deserve so much better than this. So why should people across Scotland continue to accept the unacceptable from this SNP Government? Every single patient seen on a national health service is a human being and, frankly, it demeans Anna Sarwar's argument to suggest that any of us don't think that that is the case. Anna Sarwar is responsible for what he says in this chamber. Nobody else is responsible for what Anna Sarwar says in this chamber. Second point that I would make, Anna Sarwar asked me in his previous question what action the Government was taking. He then pointed to reduced demand for accident emergency services. That is actually because of the action that is being taken. The ambulance service see and treat, so that so many more patients now get seen and treated without ever having to go to a hospital. NHS 24, the work that it is doing to reduce the tendencies at hospital or admissions to hospital. That is an example of the actions that we are taking having an impact. Lastly, I take responsibility as the health secretary for NHS Scotland every single day of the week. Anna Sarwar's argument seems to be that this is all uniquely down to the SNP. I know that he doesn't like comparisons, but if he is going to make that argument, then I am afraid that they are inevitable. If it is all down to the SNP, then why is it that in the latest film months that we have statistics for, A and E performance in Scotland is 6.2 percentage points better than it is in Wales where Labour is in government? The fact of the matter is that pressure on the health service is intense. In Scotland, England, Wales and Northern Ireland, we are dealing with that pressure. In many respects, those who work so hard across a very fresh in Scotland are doing a better job than we find in many other parts of the UK. To ask the First Minister what the Scottish Government's response is to reports that dozens of people living in Scotland with no recourse to public funds are being made homeless and forced to sleep rough on the streets or in cars. Stopping people who are facing destitution from accessing support when they need it most is unacceptable and, I think, shocking. It is disturbing in the extreme that the UK Government's no recourse to public funds policy prevents local and national government from providing support to people and it remains the biggest barrier to eradicating rough sleeping in Scotland. Immigration and the no recourse to public funds policy are entirely reserved matters. We have repeatedly raised the devastating impact of those policies. We will, however, continue to work with COSLA to improve access to support and services for people who are subject to those policies as far as we possibly can within devolved powers. No one should be made homeless, forced into destitution or have their human rights infringed regardless of their immigration status. The UK's immigration system and NRPF policy in particular prevents people accessing essential safety and lifeline services in times of need. Lack of provision and support risks leaving some people open to modern slavery and exploitation. In Scotland, the Ending Destitution Together strategy seeks to ensure that those with no recourse are protected as far as possible within devolved powers. Can the First Minister say what has been done to ensure that as much support as possible is available and that people make use of that support? Can she tell us how information, including about nationalities, is being collected on how many people with no recourse are homeless or at risk of being homeless? I thank Maggie Chapman for raising the issues. Information on the number of people at risk of homelessness will be collated via on-going engagement with the third sector and local authorities. As I said in my previous answer, we will continue to do all we can within devolved powers, including funding, support and advice services. For example, we have provided over £900,000 since 2020 to ensure the operation of winter support in Edinburgh and Glasgow, which is open to everyone. COSLA has also produced guidance to ensure people subject to the no recourse to public funds policy, supported to access services available to them and updated guidance will be published later this year. It is, however, critical that the UK Government changes this no recourse to public funds policy so that we can act to support everyone in Scotland at times of crisis regardless of their immigration status. John Mason To ask the First Minister what the Scottish Government's response is to the second round of the UK Government's levelling up fund allocations in Scotland. First Minister We fundamentally disagree with Westminster Government making decisions in devolved areas. Of course any additional funding is welcome, but this should be devolved through the Barnett formula, just as we were promised that EU funding would be devolved after Brexit to allow Scottish ministers and councils to make decisions about its use. The fund overlooks Scotland's distinct economic needs, and the latest awards show that many remote, rural and sparsely populated regions are being ignored. I am further disappointed that UK ministers decided, after bids had been submitted, to consider which local authorities had received funding in the first round, meaning councils in Scotland wasted money, time and effort bidding for funds that they were no longer eligible for. The evidence is clear that the so-called levelling up approach means that Scotland is losing out. John Mason I thank the First Minister for that answer, and it seems that less well-off areas like Glasgow have lost out in round 2 and were possibly misled as to the bidding process by the UK Government. Does she share my opinion that a levelling up fund should be targeting the poorer areas? Surely it has to be either levelling up or geographical spread, it cannot be both. First Minister Yes, John Mason is absolutely right, and I share his concern that Glasgow and other council areas in Scotland with high levels of deprivation have lost out. Of course, if the Scottish Government had been given control of the funding, which would have been the correct and sensible course of action, we would not have taken the competitive dash for cash approach favoured by the UK Government. The UK can, of course, still choose to devolve funding to Scotland for our share of the remaining levelling up funding, and we would be happy to discuss that with them. If this is not just our view, the Tory mayor of the West Midlands described this as another example of Whitehall's bidding and begging bowl culture, and he said that he cannot understand why the levelling up funding money was not devolved for local decision makers to decide on what's best for their areas. I completely agree with that. Question 5 Jamie Greene To ask the First Minister what steps are being taken to tackle unethical and illegal dog breeding in light of recent reports of high-value extreme breeding programmes operating in Scotland. First Minister The recent BBC programmes on illegal and unethical dog breeding paint an alarming picture. The Scottish Government is actively working with a number of government and key stakeholder organisations, including the SPCA and Police Scotland, to disrupt the activities of those involved in the unlicensed puppy trade. New animal licensing regulations were introduced in 2021 covering the breeding and selling of dogs to tackle the growing issues linked to puppy farming. We intend to consult on the potential licensing of other activities, including canine fertility clinics later this year. Furthermore, several puppy campaigns have been run over the past few years to highlight the cruelty of the trade, to raise public awareness and provide advice on how to buy a puppy safely. Jamie Greene I thank the First Minister for that. Anyone who saw the BBC disclosure programme, which I commend to the chamber, will be anything but horrified, disgusted and as angry about this as I am. This is a multi-million-pound pet industry which has been fuelled by consumer demand for designer dogs. It's been run by organised crime and it's a pet industry based on nothing but greed. Those dogs are now more valuable to criminals than drugs, I'm afraid to say, and those are dogs that often result in tragic consequences and the loss of life. It's happening right here, right now, in Scotland. Can I, first of all, ask why there are so few prosecutions for illegal dog breeding here in Scotland relevant to the number of incidents reported? Secondly, what specific legislation is the Scottish Government willing to bring forward to crack down on illegal and unethical breeding and selling? That includes closing any loopholes on co-ownership of dogs. Will this whole Parliament now send the strongest possible message to those involved in this disgusting trade that we will not put up with your cruelty anymore and if you break the law you will pay a heavy price for it? I absolutely agree with Jamie Greene's right to bring these issues to the chamber. This behaviour is despicable, is illegal and unethical and people who engage in it should expect to face the full force of the law. Jamie Greene asked me about numbers of prosecutions. As he understands, prosecution is not a matter for ministers' decisions about prosecution. They are matters for the police and the prosecution authorities. I will ask law officers to write to him if there is further information that they can helpfully provide. I indicated in my previous answer that having introduced regulations in 2021 we do intend to consult on the potential licensing of other activities later this year and that will give everyone across Parliament the opportunity to contribute to that consultation. I welcome that exchange and, further to that, I welcome the Government's support for my welfare of dogs bill shortly to be introduced, which will require, if passed, prospective dog owners to rigorously consider fully the welfare of puppy in all aspects, including the breeding before buying. Does the First Minister agree with me that, if that leads to educated demand, the supply of puppies, crudely bred, will reduce and cut off the vast profits that are already referred to, which go to criminals who care nothing for the welfare of the puppies, seeing them only as fashionable marketable commodities? Yes, I very much agree with that. That is a point that is very well made. We have to consider the issues of supply and demand and, of course, the interrelationship between them. I very much welcome any and all proposals that support animal welfare and I take the opportunity to applaud Christine Grahame for all her hard work over a long period of time to bring forward the legislation that she refers to. I look forward to the bill's imminent introduction, which I understand will raise much-needed awareness on the responsibility of owning a dog and I am sure that the bill will have strong support from all parties right across the chamber. To ask the First Minister what steps the Scottish Government is taking to increase uptake of the HPV vaccine in light of warnings from Joe's Trust that girls in the most deprived areas of Scotland are missing out. First Minister? Firstly, Scotland has the highest uptake rates of the HPV vaccine across the four nations, but we want to go further and increase uptake particularly in the most deprived areas. Therefore, from 1 January a simplified one-dose schedule was introduced for all those eligible up to their 25th birthday and we anticipate this will further increase uptake. One-dose HPV vaccine uptake is currently 91.5 per cent for girls in S4 and 88.4 per cent for girls in the most deprived areas. We have provided over £400,000 to Joe's Cervical Cancer Trust to support their campaign work on screening benefits and my officials will also be happy to work with them along with Public Health Scotland and health boards to understand how we can maximise uptake rates in areas of deprivation. The creation of a women's health campaign provides a further opportunity for issues of this kind to be promoted and addressed and indeed I am delighted to announce today the appointment of Professor Anna Glaesier as Scotland's first women's health champion. Professor Glaesier will be key to driving improvement in women's health and helping address the inequalities that have persisted in women's health for far too long. I welcome the announcement from the First Minister that it is, however, 18 months later than originally intended. The World Health Organization target for fully vaccinating girls against HPV is 90 per cent, but the latest figures for Scotland last year show that only 77 per cent of girls in the most deprived areas were fully vaccinated. The World Health Organization also recommends that 70 per cent of women are screened, but again women from the most deprived areas are less likely to take part in screening programmes with uptake only reaching 63 per cent. We have the tools in Scotland to end cervical cancer but the Scottish Government are not using them.  Will the First Minister commit to addressing this as a matter of urgency and set out a clear plan in the next month so that cervical cancer can be eliminated in Scotland? Of course we do have a women's health plan that addresses these and many other issues. I think that we were the first part of the UK to have a women's health plan and of course Professor Glazier will now have the key task of driving that forward. Those are really important issues but I do not think that it is the case that the Scottish Government is not using all leavers in relation to HPV vaccine uptake. As I said earlier, Scotland actually has the highest uptake rates across all of the four UK nations and we have recognised that we need to do more and are doing more through, for example, the simplified one-dose schedule. We are seeing the benefits of that. Since vaccination of girls started in 2008, the number of cases with pre-cancer cells identified in that population at cervical screening has reduced by almost 90 per cent in comparison with rates in women who were not vaccinated. We will continue to take these important steps to improve the health of girls and women in this respect and in all other respects as well. Can I draw the attention of the First Minister to the experience of a constituent of mine who informed me that they were told to make an in-store purchase ahead of using a pay-point facility to top up their energy meter? Paypoint have confirmed to me that this should never happen and paypoint have contacted the business in question. Does the First Minister agree with me that, while the vast majority of pay-point vendors are professional and provide an important service, that were unacceptable practices such as what I have highlighted moments ago, that this should be reported swiftly and acted upon and that this experience highlights the barriers and vulnerabilities faced by many on pre-payment meters? I do very much agree with that. I would echo Bob Doris' concerns and what he has said in response to those. I am obviously also aware of issues of this type and would urge people to raise their concerns with an advice agency and with their energy provider to get the necessary advice and support. I think that it is incumbent on the UK Government because this is a reserved matter to take more action on pre-payment meters. Forcing people onto them, particularly for very small amounts of debt during winter, makes matters worse for people, not better and is more likely to increase debt and leave people unable to heat their homes. I would urge the UK Government to respond to that and to listen to the calls from many and ban energy companies from being able to force people onto pre-payment meters. Falkirk Council is considering closing four school swimming pools and one public pool to make ends meet. I have had numerous emails about this and it boils down to council funding cuts from this Government. Does the First Minister agree with me that closing swimming pools is a retrograde step and what does she intend to do about it? Council budgets are not being cut. The draft budget for this year proposes a £570 million increase in the local government settlement. Of course, had the Tories had their way and we had seen tax cuts for the very richest in our society, council budgets would have had to be cut. Thankfully, we did not follow conservative advice in that regard. Finally, we are still in the budget process. Here is an offer to the member to all on the Tory benches. We work in an effectively fixed budget where we can increase revenue by asking those who earn the most to pay a little bit more to help public services. If the Tories contrary to their actions south of the border, but if the Tories want to see more money for councils or for anybody else, tell us where within the draft budget we should take that money and we are happy to have a conversation. I know that the First Minister will share my horror and the horror of this chamber at the safety of those children and unaccompanied children in Scotland making that assurance that that has been delivered here, regardless of which authority is providing the accommodation. Is she aware of any similar instances of those reported in England occurring in Scotland and what can she provide an update on what steps the Government is providing to ensure that unaccompanied children are being moved from hotels into secure accommodation? I do recall the question that was asked before Christmas. I will write to the member with any update I can give him in terms of actions being taken by local councils here in Scotland, supported where necessary and appropriate by the Scottish Government to address those very real concerns and include any information councils have about unaccompanied children here in Scotland. In relation to the general issue, I think that everybody must have been deeply shocked to hear this week the revelation that 200 children have gone missing when they should have been effectively in the care of the home office. What perhaps is even more shocking than that is how little attention there seems to be paid to this. If a child here in this country goes missing, there is rightly lots of attention. That should be no different in the case of those unaccompanied children here. Children, while they are here, are our responsibility and we should care for them, we should love them and we should make sure that they are looked after. I will respond to Paul Sweeney's question in relation to local authorities here, but I hope that all of us across the chamber can unite today to demand for everybody, but particularly for children, much more humanity in the UK Government approach to immigration and asylum. Liam McArthur Men's Sheds in communities across Scotland provide a place for men to meet, to socialise and to pursue hobbies, but increasingly it is recognised that they make a tangible difference in tackling isolation, loneliness and mental ill health. That is why Men's Sheds commands strong cross-party support right across the chamber and why more than 40 MSPs recently wrote to the Deputy First Minister expressing concerns about proposed funding cuts. Will the First Minister guarantee that our Government will protect the core and development funding for the Scottish Men's Sheds Association to allow this invaluable public health movement to be maintained and expanded? The Men's Sheds movement does fantastic work and I would associate myself with the comments that Liam McArthur has made about the work that it does and the impact that it has. My understanding is that there has been discussions with the Government and offer of financial support has been made for the next financial year and I will ask the Minister concerned to write to the member with more detail and indeed to make that known to Parliament generally. I am very concerned on the reports of potential reduction in teacher numbers, especially with regard to Glasgow. Can the First Minister reveal what action the Scottish Government can take to protect teacher numbers? The Government will act to protect teacher numbers. This Government has a commitment to increase teacher numbers and councils are being given additional funding specifically to deliver that. It would not be acceptable to me or to the Scottish Government to see teacher numbers fall. I can confirm therefore that the Government does intend to take steps to ensure that the funding that we are providing to councils to maintain increased numbers of teachers actually delivers that outcome and the Education Secretary will set out more details to Parliament in the coming days. In a spate of crashes on the A96, two weeks ago two people were seriously injured, last week three people were hospitalised and just yesterday two more were hospitalised. A P&J poll showed 93 per cent of respondents demanding that this road be dualled and Gillian Martin MSP wrote persuasively at the weekend, we must duall the A96 for safety, equity and environmental reasons. However, it is reported that no final result will be given to the Government. The final decision on dualling has been or will be made perhaps for years. So First Minister, how many more accidents and injuries will it take before her Government listens to the people of the north-east, stops the delaying tactics and delivers on its decade-old promise to duall this appalling road? First Minister, my thoughts go to everyone who sustains injuries on our roads and indeed to anyone who is bereaved through accidents on our roads. The Government's commitments in terms of dualling and upgrading the A96 stand, of course there are assessments and reviews, not least environmental assessments and reviews underway as is right and proper and the Transport Secretary will keep Parliament updated as appropriate. Pauline McNeill The West of Scotland is the industrial heartland of Scotland with a heavy concentration in Glasgow city region that has 57 per cent of the worst 15 per cent of areas of multiple deprivation. However, an excellent bid, the Clyde Green Freeport, was not supported by the Government even though the bid fully made the criteria in tackling deprivation and boosting manufacturing. It is important to note that eight local authorities supported the bid as a central requirement for submission, not an easy thing to pull together, but yet the successful bids were on the east and none on the west. If the First Minister is satisfied with how she would justify those decisions, would she outline what the plan is to compensate Glasgow and the wider city region? I Clyde community, so it should also be involved in the bid. It is also important, because I realise why the bid was rejected, but for a full transparency we need to see the reasons why the west of Scotland did not have any designation of a Freeport designation for whatever, I do not know the full implications of being a Freeport, but it did concern me as a member of the Glasgow city region that there is no report in the west of Scotland. A number of very high-quality bids were submitted, including the one that Pauline McNeill refers to. Those were assessed in line with the published criteria, and this was a joint decision-making process between the Scottish and the UK Governments, and the successful bidders were announced two weeks ago. I understand the disappointment on the part of the bids that were not successful. It does not mean that the bids were not high-quality, but successful bids had to be selected. The Scottish Government is committed to continued work with unsuccessful bidders and the regions that they were bidding for to look to see what we can do to support them, deliver on their ambitions and objectives for the future. The 27 January is Holocaust Memorial Day, which marks the anniversary of the liberation 78 years ago of Auschwitz-Drominka, the largest Nazi death camp. Does the First Minister support the great work that is done by the Holocaust Educational Trust and our schools and others in teaching successive generations of our children about the atrocities that saw over 6 million people murdered, slaughtered, including, of course, 6 million Jews and many other minorities? Does the First Minister agree that this educational work is essential so that we never, ever forget the lessons that atrocities and oppression must be fought wherever they occur? I associate myself wholeheartedly with Fergus Ewing's comments on Holocaust Memorial Day. Indeed throughout the year I am very proud that the Scottish Government strongly supports the excellent work of the Holocaust Educational Trust to enable young people across Scotland to continue to learn from the atrocities of the Holocaust as we challenge the oppressions of the present. I know that some members will have the privilege this week of hearing directly from the trust's young ambassadors about the impact of Holocaust education in their lives. That is a privilege that I have had in previous years. Indeed, I had the opportunity a few years ago with the trust to visit Auschwitz and that was one of the most profoundly moving experiences of my life. I think we all agree that education has a key role to play in building a society that actively challenges discrimination, hate, intolerance and prejudice in all of its forms and advances equality. We should do that all year round, but Holocaust Memorial Day every year gives us the opportunity to rededicate ourselves to that very important responsibility. That concludes First Minister's questions. The next item of business is a member's business debate in the name of Fergus Ewing. There will be a short suspension to allow those leaving the chamber and public gallery to do so before the debate begins. If I could ask those leaving the public gallery to do so as quickly and quietly as possible as we proceed to the next item of business, which is a member's business debate on motion 7477 in the name of Fergus Ewing on Holocaust Memorial Day 2023. The debate will be concluded without any questions being put. I invite members wishing to participate to press their request speak buttons now or as soon as possible. I invite Mr Ewing to open the debate for around 7 minutes.


We are here with Joe Chiani, the founder of the Patient Safety Movement Foundation. Good evening, Mr. Chiani. I understand that... Oh, thank you. I understand that you have been awarded the 2023 Robert Elworth Patient Safety Leadership Award. Many congratulations to you. Can you please share with us what sorted you and this journey to eliminate preventable harm in healthcare? Absolutely. Basically, first, I want to tell you, it's been because of people like Dr. Robert, we were dead, we are where we are, and it's a great honor to receive this award in his name. What prompted me to take action was a 2011 study that came out of AHRQ. I think, no, it was out of the OIG looking at Medicare patients and the number of harms. And I was shocked that the numbers seemed to be approaching 200,000 deaths a year. This over 10 years after the original article that was the seminal work called Eris Human by Institute of Medicine that suggested we're losing 48,000 to about 100,000 people a year to medical errors. And at the time when that article came out, I knew a lot of incredibly talented and caring people jumped in to do something. And I thought, great, it's going to get fixed. But when I saw that study, I realized it hasn't been fixed or at least not fixed enough and that it isn't just something for experts to attempt to fix. If it's going to get fixed, it's going to take everybody. It's going to take the village. It's going to take all stakeholders, not just doctors and nurses and patient safety experts, but people making medical technology, engineers, executives, people in regulatory regulating us like the FDA, like the Joint Commission, as well as maybe even more importantly, patient advocates, those who are the North Star for us to all remember what we're here for. So that prompted me to try to put a summit together and hoping that if the summit works out, we might have a movement. And so the first summit was January, 2013 and in the first break, I realized we had started the movement as not just hospitals made commitments to zero, but met tech companies made a pledge to share their data so that hopefully AI and expert systems can be used to detect deterioration before it's too late. That's wonderful. That actually brings me to my next question. You are celebrating your 10th summit this June. Do you still feel that the zero preventable farm goal is available as possible? I do, I do. We made a bold goal of zero by 2020, which we did not attain, but that's the only goal. Really, it can't be one, it can't be 10,000, it's gotta be zero. And the more I've learned, the more I realized it can be done or at least get close to zero. There are many preventable debts that have evidence-based practices associated with them that if implemented, human errors don't become medical errors, don't become harmful or fatal. And I know of one hospital who implemented all these evidence-based practices and for six years, they achieved zero preventable debts. So if one can do it, if all of us do it, we can get there. That's great to hear. What collaborations do you hope to see in your future or even long-term? Well, I believe the collaboration that is missing is really the one that hopefully can be done by those who control the purse for healthcare. I think whether it's in the U.S., it's Medicare or out of other countries, whoever is paying for the healthcare, they need to step up now because the choir is with us. We need everybody else to join this movement. And I think to do that, they could use the fact that they're paying for healthcare, or at least in our country, over half of it to demand every hospital implement evidence-based practices, demand every hospital report their harm quarterly in a public way. And I think those two items can get us pretty close to zero. What do you envision as the future of healthcare? I believe we can get to a healthcare system that not only provides everyone access to healthcare, but it's a system that's dignified and it's safe by design. I also believe this push towards home, monitoring people at home, telehealth, telemonitoring, I think can hopefully create a safer place, a more dignified place for people to get most of their care. Now, they still have to go in for their procedures, but there's no reason they need to go wait to see the primary physician and then wait to get more testing done. And then after their procedure, stay any longer than they need to. Once the ICU care period is over, step down can be delivered at home. And we are embarking on many initiatives at Massimo, my company that I started before I started the Patient Safety Movement Foundation to hopefully provide some of those solutions. Especially recently, we hear a lot about AI. I wanted to ask what rules do you think AI and technology will play in the field of healthcare and patient safety particularly? I think AIs can get rid of areas of a mission. I think from here on, areas should be of areas of coal mission. There's a lot of good thing that computers are really good at. And there's a lot of things they're not good at. One thing they're good at is keeping track of data. It can be for hours or it could be for decades. So if we can have patients data flow to these AI based systems, whether it's while they're in the hospital or even their information from physician office visits to the technologies they'll have at home, I think AI can help warn clinicians of impending doom. I think about Rory Stoughton who died of sepsis. He'd fallen in the gym, scuffed his arm and unfortunately, he died of sepsis. But before he died of sepsis, his parents took him to see his primary physician's office. And for his weight and size, his heart rate was really high. When he didn't get any better, he was still complaining about leg ache and throwing up. They took him to the ER. They did the blood work. His white blood cell accounts were high. Now imagine at that time you had AI based systems that would have noticed a high heart rate, the high white blood cell account. It would have sent a warning to the clinicians, maybe to even Rory's parents that, hey, it could be sepsis. Doesn't mean it definitely is, but at least they will not just rule that out. Unfortunately, they assumed it was food poisoning or stomach flu and Rory is not with us today. So AI I think could help a lot. Definitely. Well, this was a great conversation. Thank you so very much for your time, for sharing your insight and expertise and also your vision with all of us. Thank you. Thank you for this honor. Thank you. I hope we can collaborate all of us together until we're at zero and we continue collaborating to keep us at zero. Thank you and many congratulations again on your award. Thank you so much, Sanat.


There's so many aspects of our life that we have little to no control over and this is especially true when it comes to traumatic experiences. But no matter what, we have a choice. No matter how much pain we feel, we have a choice. And the sooner we realize that, that is when we start taking back our power, all right? So in this video covering the Jesse Smiles and Gabby Hannah situation, we're gonna be talking about trauma, forgiveness, and recovery. What's up, everybody? This is Chris from the Rewired Soul, where we talk about the problem, but focus on the solution. And if you're new to my channel, my channel is all about mental health and sometimes what I like to do is take different topics going on in the YouTube community and try to see what we can learn from them to improve our own mental and emotional well-being. So if you're into that stuff, make sure you subscribe and ring that notification bell. And if you're not yet, follow me over on Instagram and Twitter at the Rewired Soul. All right, so yeah, for those of you who don't know me, hi, my name's Chris. I am not a licensed therapist, but I am somebody who is like most of you watching this video right now. I am somebody who has experienced a lot of trauma in my life, all right? So your trauma might have been not as bad as mine. Some of you might have had traumas that were way worse than anything I have ever been through in my life, but here's the thing. I understand that pain and that suffering and the confusion and the anger that comes along with that trauma, all right? And that's what we're gonna be talking about today and I'm gonna be sharing some of my experience of how I've been able to overcome it and the things I still do in my day-to-day life, all right? So if you're not caught up on the Jesse Smiles and Gabby Hannah situation, I've done two videos on it. You can check out the info card or down in the pinned comment below, all right? So let's talk about this and the best thing that I know how to do is share my own experience.  She is sober now. She just actually celebrated 14 years sober, but for anybody who was raised by an alcoholic or a drug addict, chances are you had some traumatic experiences, all right? I'm not gonna share every experience I've been through, but like this time of year, the holidays always get me remembering things from when I was a child because I would always visit my mom during the holidays because my dad was raising me and holidays were a nightmare for me as a kid. I'm talking about five, six, seven years old. When my mom drank, she became homicidal and suicidal. I remember Thanksgiving dinners or Christmas Eve's where she was threatening to stab one of my other relatives. And as a child, that's not something most kids see, right? I remember times when my mom was drunk during the holidays, locking herself in the bathroom, threatening to kill herself. You know what I mean? These were very traumatic for me. Aside from that, when you have a parent who's addicted, it's common to be just put into very not good situations. I'm a father now and I look back at some of those things and I'm very grateful that I'm sober now. So I'm not putting my son in those dangerous situations. But these are all things that make me wanna hold on to this resentment. And basically my mom got sober and during the time she got sober, I became addicted to alcohol and drugs and things got really bad. And one time, because my mom never came out to Vegas to visit me, but one time she came out to visit me here in Vegas. And we didn't really hang out that weekend, but before she left, she wanted to meet up and have breakfast because she needed to talk. And I'm like, okay, whatever. So of course, being the alcoholic I was, I said, hey, there's this bar across the street and it's Vegas, so they're 24-7. We can get breakfast, I can get my drink on, you know, whatever. So we go there, I meet my mom there, one of my favorite little pubs here in Las Vegas and I get an omelet and I start drinking. It's like eight o'clock, nine o'clock in the morning, right? And my mom sits down and she makes amends to me. She apologizes to me for everything she's done. She was probably a year or two sober at this time. Now, something I wouldn't figure out until years later, but some of you already figured this out, she was actually doing her ninth step, which is making amends, right? And I was like, okay, whatever, right? Because something I talked about in my video from yesterday is I am somebody who can hold onto a grudge like you wouldn't believe, right? So I didn't forgive her, like I said to her, yeah, I forgive you, but I had so much anger and resentment from the things that happened to me during my childhood and I blamed her for my addiction, okay, like I'm not gonna dive into the studies and science of it, but you are very likely to develop a substance abuse problem if you were raised by somebody with a substance abuse problem. That and or you'll date somebody with a substance abuse problem, right? So I blamed my mom for how terrible my entire life turned out. So years later, seven years ago for me when they had an intervention and my mom's trying to get me sober, I was screaming at her because all of that anger and rage and resentments were just built up inside of me and I was like, this is your fault. You're the reason on this way, right? And thank God I got sober, but just because I got sober doesn't mean I forgave her. Just because she helped save my life doesn't mean I forgave her. I had so much anger and rage towards her, all right? Because of what happened during my childhood and so many other things. And that is when I had to start working on myself too. It's one of the reasons I started first working on my anger because it was causing me a lot of problems, but through working with a sponsor and having a support group and just getting some clarity, like you guys, I saw some comments and I had some people reach out to me in all my last video about Jesse Smiles and Gabby Hanna about like, you can't just let this go. You can't let this go. And like I said, like we have a choice and I came to realize that I had a choice. I had a choice, all right? It was no longer on my mom, I was an adult. I had a choice if I was going to hold on to the past. It was my choice and what helped me greatly was once I put it in that perspective, now I either choose to hang on to it or I choose to figure out a way to let go of it, right? Or at least, at least try to start healing from it, okay? We are always presented with two opportunities. We are in control, okay? And that's what I realized. And I looked at my two options, right? I hang on to this thing that is making me angry, resentful, miserable, right? Or at least try to figure out a way to heal from this thing and let it go, all right? Something that I always try to teach people is forgiveness is not this act of letting someone off the hook. Forgiveness is letting ourselves off the hook. As soon as I started forgiving people, my life started getting better. It's this weird paradoxical situation that we get in where we refuse to forgive somebody but we're only hurting ourselves, right? Like, it doesn't make any sense when we look at it from a logical state. You know what I mean? And this is just the prime example of trauma and forgiveness, right? Like, I've been through a lot in my life, a ton in my life. I had plenty more experiences that happened throughout my years growing up and in my addiction. I wasn't living the best life and everything like that. I've had friends turn on me, backstab me, you know, girlfriends cheat on me. Just so many things, right? And one thing is I started accepting that things are gonna happen, right? People are gonna do bad things to me. This is something that's gonna happen. But I try to look at every single situation and I promise you this will help you too. Try to look at every single situation and remember that I always have a choice, okay? So like I said, your trauma might not be as bad as mine. Your trauma might be a lot worse than mine. But I want you to start thinking about what do you have control over, okay? You have the choice on whether or not you wanna hang on to that resentment, okay? And like I mentioned yesterday, ask yourself, is that helping you become the person you wanna become or is it hurting you, all right? Like what value is it bringing to you? Look at that thing, look at it like it's in your house. Has anybody watched that show on Netflix with the woman who like tidies everything up? Is it called Tidy Up? I don't know, right? But I haven't even watched it but I've heard the philosophy, right? Does this thing bring you joy? No, boom, it gots to go, right? Same thing with everything else in our life, those feelings, those emotions and everything like that. And I don't in any way mean to try to make this sound like a simple process. This is something I've been working on for years, okay? I have a therapist as well who I work on this stuff with. I've had sponsors, I have a support group, right? But I get to make the choice of how much effort that I put into my healing process, all right? So the last thing I'll say is if you wanna hold on to that anger, if you wanna hold on to that resentment for the things in your life, if you wanna do those things, that is 100% your choice. But at the end of the day, when you rest your head to go to sleep, always remember that you made that choice, all right? Although you may have had no choice whatsoever in what happened to you, like what I was talking about, like especially childhood trauma, we had no control over that. But today, we have a choice, all right? So I want you to ask yourself, what choice are you going to make today? Are you gonna hold on to it, or are you gonna start working towards the healing process? All right? But anyways, that's all I got for this video. If you like this video, please give it a thumbs up. If you're new, make sure you subscribe and ring that notification bell. And a huge, huge thank you to everybody who supports the channel over on Patreon, as well as everybody who supports the channel by buying my books over at therewiredsoul.com and my merch and all that other good stuff. And if you guys ever have topics or you just need someone to talk to, like I'm starting a mental health support community, but feel free to email me or DM me anytime, all right? Thanks again for watching. I'll see you next time.