The next item of business is a member's business debate on motion number 1360 in the name of Sandra White on a welfare conditionality study. This debate will be concluded without any questions being put forward. Would those members who wish to speak in the debate please press the request-to-speak buttons as soon as possible? I call on Sandra White to open the debate. Around seven minutes, please, Ms White. Thank you very much, Presiding Officer. I thank the researchers at Glasgow University and their partners across the UK who have collaborated on the welfare conditionality research, funded by the Economic and Social Research Council. The project, which is looking at conditional welfare in the UK, started in 2013 and will finish in 2018. This motion highlights the first wave of those findings. I also thank the media who covered the research, particularly the daily record, for highlighting the human costs of this particular conditionality research, which shows that as well. We are looking at too many areas. How is it affected with conditionality in changing the behaviour of those receiving welfare benefits and services? Are there any particular circumstances in which the use of conditionality may or may not be justifiable? The findings are undoubtedly a stark reminder of the complete and utter failure of the UK Tory Government to provide meaningful support to those who need it. I give members a snapshot of the findings. Sanctions often came as a shock without warning. Many of the interviews of those believed that they had been compliant. Loss of income through sanctioning was usually disproportionate. For example, having no money for food for a whole month because of being five minutes late for an appointment. There were variations in expectations of different job coaches contributing to mistrust in the system, which was often viewed as deliberately designed to catch claimants out so that they could be sanctioned. The material impact of sanctions, both in terms of short-term crisis and long-term pay-off of debt, can result in renteriors, eviction threats and homelessness. Very few cases were sanctions worked at all. The issues that interviews said prevented them from finding work are not helped by sanctions. The high number of sanctions is still caused by DWP administration errors. The poor implementation of easements and flexibilities for particular groups—for example, homeless people and lone parents—is something that we should pay particular attention to. The level of awareness in this particular group is very, very low, and there is a discrepancy of support, which is neither intensive enough nor tailored enough to be effective in helping people to overcome barriers to work. One of the most galling findings from the report is the fact that sanctions do nothing at all to help people to find work. The running theme behind examples of people getting into work was the availability of appropriate support rather than the threat of punishments. The research demonstrates that the very foundation of the sanctions regime is flawed. The fact is that people, by and large, want to work—they do want to work—and in many cases have long histories in employment before their circumstances changed. I have no doubt that members across the chamber all have many cases of constituents who have fallen victim to the sanctions regime and have sought their advice and support. The report highlights many cases, and I would, if you are indulgence, take the opportunity to highlight a few to put into perspective the reality of the situation for welfare service users. In the word welfare, I really do not like it at all, and I try not to use it, but that is what the report does use. Take, for example, a man in his 50s, made redundant, could only find part-time work relying on universal credit to top up his wages. Prior to universal credit, he would have had the opportunity to apply for working tax credits, would have been free from conditionality. In his own words, that is how he has described his interaction with the system. The first moment that I walked into the job centre, I felt criminalised. You looked down upon to me, it was as if I was signed up to a prison. This man's problems did not end there. It was a long delay in receiving the universal credit payment, as well as administrative errors, which resulted in three months of rent-a-years. He requested that his housing element of universal credit be paid directly to the social landlord, but that did not happen. He had taken to court over the rent-a-years that he had accrued, and now he feels that everything is looming over his head and is suffering from depression and anxiety. One lady who is disabled said that it is demeaning, condescending, painful and damaging and that it actually makes your disability worse. A man who had a history of paid employment until an accident prevented him from working has had to manage his treatment and hospitalisation for on-going problems, while being sanctioned for not replying to a letter that was sent while he was in hospital. He said that it was a very hard time that he went through not coping on the illness that affected your daily life, but he has also affected that somebody has just clicked a button and just stopped my benefits. He stopped that wee bit of income that was coming in. He took it away and gave me this telephone number that was to phone my local council. They may be able to help me. Unfortunately, ring the council. You don't qualify because you're not getting this type of benefit. That research clearly illustrates that the sanction regime is dehumanising, ineffective and pushes people into destitution and reliance on foot banks, often no fault of their own. The Tory Government approach to benefit claimants is to resume guilt and to punish disproportionately. Not only does this fail to help job seekers find work, but it puts many people in the position with a simply penniless. We in this Parliament have an opportunity to shape services that fits the needs of users than the one box fits all approach of this Tory Government. I welcome the commitment from the Scottish Government that participation in work programmes will be voluntary. Our social security system must be person-centred, must treat people with dignity and respect at every stage of their journey into work, focusing on developing their skills to fill their employment potential. However, we all know that the Scottish Parliament will take over responsibility for employment programmes and some responsibility for social security related to disability to be devolved. However, the UK Government remains entirely responsible for some decisions, and in particular those that include decisions over claimant conditions and sanctions. I would hope that the minister would reply or touch on that particular aspect of it in his summing up. In summary, what kind of society do we want to live in? One, will we protect and support those who need it, or one, will we actively work to demonise those in need? I will always opt for a society that will protect, support and nurture. The Tory Government must halt the sanctions until an immediate review of the claimant conditionality and sanction regime has been carried out. For the sake of all our citizens, I would hope that they would do that. We move to the open session. Speeches of four minutes, please. Adam Tomkins will be followed by Neil Bibby. Thank you very much, Deputy Presiding Officer. I congratulate Sandra White for bringing this debate on a very important matter to the Parliament, even if I didn't agree with everything that she said in her remarks a few moments ago. I would like to start with some facts. First, sanctions are and always have been an important part of our welfare system, and it's right that they are in place for those few who do not fulfil their commitment to find work. It prevents abuse in the system and it creates fairness for taxpayers. Second, sanctions affect only a tiny number of claimants. Only about 2 per cent of job seekers are sanctioned and a quarter of 1 per cent—I don't have time to take interventions this evening, I'm afraid—and a quarter of 1 per cent of ESA claimants are sanctioned. That's to say, 399 out of every 400 claimants of employment and support allowance are not sanctioned at all. Third, the UK has a far less strict sanctions regime than that operating in most European countries. Indeed, there are only seven EU member states with a less strict regime than that operating here. If we are out of line with the European average, it's because we are more lenient than others, not stricter. I would like to point out that the Scottish Government's expert working group on welfare, a group that produced a report in 2014 about what social security would look like in an independent Scotland, argued that there is a general acceptance that receiving benefits will inevitably imply some form of conditionality. That report stated, and I quote again, that the social security system of an independent Scotland would be based on positive conditionality with expectations on individuals as well as the state. It's far from clear, Deputy Presiding Officer, how such—I don't have time to give away, I'm afraid, Minister this evening—it's far from clear, Deputy Presiding Officer, how such conditionality would be any different from the reformed and vastly reduced sanctions regime in operation now in the United Kingdom? Getting people into work is a good thing. I think that we now all recognise that work, for those who can, represents the best route out of poverty. Getting disabled people into work is a good thing, which is why I welcome the fact that there are 360,000 people with disabilities in work now in the United Kingdom who were not in employment two years ago. However, I recognise that the disability employment gap remains far too big, which is why we, on those benches, have a commitment to Harvard—a commitment that I have invited Scottish Government ministers to join in the past but which, sad to say, they have yet to take up. This is an opportune moment to be debating those matters. Just this week, the UK Government published its work, health and disability green paper. The green paper makes plain that a higher employment rate is good not merely for the economy. It's vital, too, to the health and wellbeing of our citizens, including our citizens with disabilities, which is why it matters, Presiding Officer. It really matters that the disability employment rate is even lower in Scotland than it is in the UK as a whole. I've already said that it's too low in the UK, but it's even lower in Scotland, where only 42 per cent of people with a disability are in employment. We hear a lot in this Parliament about dignity, fairness and respect, but I ask this. How is it treating disabled people with fairness and respect to subject them to a welfare system that parks them on benefits, tells them they're not fit for work and denies them the dignity of employment? That's why I applaud this week's green paper, because, as did Mark Atkinson, chief executive of scope, and as did, to be fair, among many others in the House of Commons this week, Dr Ailey Whiteford MP speaking for the SNP. I applaud the green paper because, in its very opening paragraph, it understands that the disability employment gap is one of the most significant inequalities in the UK today and is indeed an injustice that we must address. But it's not all about work. The final point that I'd make is this. The social security system must do everything it can to move people off benefits and into employment, but at the same time it must also support those of our fellow citizens who, for whatever reason, genuinely cannot work. That's why it's important to record in closing that spending on disability benefits has increased since 2010. It went up by £3 billion in the last session of the Westminster Parliament, and in this session £50 billion will be spent in the United Kingdom on disability benefits. That's more spending on disabled people every year of the current Parliament than was the case when the Conservatives came to power in 2010. Can I just say if people refused to take interventions that I wouldn't expect them to go over their speaking time, even in a member's debate? Please, Mr Bibby, to be followed by Claire Hawke. I welcome the debate this evening and congratulate Sandra White on bringing forward her motion. I was delighted to sponsor a briefing event in Parliament in September, which presented the interim findings of the ground-breaking research on sanctions and conditionality. I know that some of the members in the chamber this evening attended that event, and I'm sure that they would agree that it was a very helpful and informative briefing. It was organised through the welfare network run by Policy Scotland at the University of Glasgow, and I want to thank again Dr Sharon Wright, Professor Peter Dwyer and Professor Sarah Johnson for their very helpful presentation on the research that was conducted by academics from six universities across the UK. I'm sure that members across the chamber will agree that there is an increasing awareness of the impact of sanctions and conditionality on constituents and their family. That research is particularly useful in helping to place the individual cases that we hear about in a wider context. Although research focuses on conditionality that is reserved, there are important implications for this Parliament in considering how we operate the new social security powers now under the Scottish Government's control. As the motion highlights, the study found universally negative experiences of sanctions, linking continued receipt of benefit services to mandatory behavioural requirements, has created both, as Sandra White said, widespread anxiety and feelings of disempowerment among welfare service users. It's already been mentioned by some of the other key points that the study raises. For example, Saxons often came as a shock without warring with many of the interviewees who believed that they had been compliant. The loss of income through sanctioning was usually disproportionate to the so-called crime. Sandra White said, for example, that having no money for food for a whole month sometimes came as a result of being just five minutes late for an appointment. In the research, there were very few cases where sanctions actually worked. The running theme behind examples of people getting into work was the availability of appropriate support rather than the threat of punishment. That's what this research has been telling us. Yet, warringly, there was a view that the system is designed to catch claimants out so that they could be sanctioned. Those are real, serious concerns from some of the most vulnerable people in our communities. It's vital that we not only listen to them but learn from what is being said by the people who know the welfare system the best, those who rely on it. All too often, debates on welfare become arguments of facts and figures, but what the study does so effectively is to highlight the human consequences of welfare sanctions and conditionality. I know that Adam Tomkins said that he believed that there were very few people involved. However, that research shows that the 481s welfare service users' participants in the study significantly 134 were in Scotland, and some of the cases from our communities highlighted truly shocking examples of the consequences of sanctions. One male welfare user in Scotland said, "...my daughter could not attend school for two weeks. I didn't have any money for that. You have to give her some money every day for some lunch and for a bus." Barnardo Scotland, in the briefing ahead of this debate, highlighted the difficulties experienced by another parent. She was 10 minutes late for an appointment because of an unforeseen incident with one of her children.  She was without money for four weeks and was unable to buy fuel cards for her gas and electricity meters or feed her children. Those examples alone should set alarm bells ringing for all of us about the consequences decisions can have on the very people our welfare system is supposed to protect. Members will be, of course, aware of the new film, I, Daniel Blake, which highlights the devastating reality of far too many people who need our support but are simply not getting it. It is encouraging to see such a film shining a light on those experiences. I think that the more people are aware of those circumstances, the better. Presiding Officer, I want to conclude by thanking again all those involved in this important study. Its findings should serve as a wake-up call and make the Tory Government think again about the damage that their welfare policy is doing. Due to the number of members still wishing to speak in this debate, I am minded to accept a motion. It would be under rule 8.14.3 that the debate is extended by 30 minutes. The motion is moved on to Clare Haughey to be followed by John Finnie. I thank Sandra White for the debate and welcome the findings of the welfare conditionality study. The findings support the views of many members across the chamber that, for too many users, the welfare sanctions system is draconian, dehumanising and ineffective. The study illustrates that the linking of the receipts of benefits to mandatory behavioural requirements is too often a very blunt instrument that creates anxiety and feelings of disempowerment among service users. The detrimental impact of sanctions is not only financial, but material and emotional, and in addition can have serious health repercussions for the individual. Many users do not understand the reasons for the sanctions that have been applied to them. Poor communication, as well as health and personal circumstances of the service user, can lead to unfairly imposed sanctions, and many sanctions are subsequently overturned on appeal. However, that is not an easy process and the impact on users waiting for their appeal can have devastating consequences. From my constituency of Rutherglen, a young man in his early twenties living independently eight years ago suffered a severe orthopedic trauma. That led to several major surgical interventions to rebuild his limb. He was also diagnosed at the same time with severe epilepsy. He was therefore simultaneously under the care of two senior consultants who both individually confirmed his inability to work long-term. Forced to attend an at-hose assessment, his leg in plaster and using crutches, he was deemed fit to work due to his ability to use his fingers to text on his mobile phone. That was used to reduce the required qualifying points, and his benefit was withdrawn. No regard was given to the medical evidence from his consultants. This ridiculous decision was overturned on appeal, but that process took nearly six months. Had it not been for the intervention of his parents, he would have been out in the street and starving. As it was, they were able to assist, but the short-term financial impact on them was not insignificant. Thankfully, he was able to get the support of his family, but many young people in similar circumstances are not so fortunate and can end up in severe debt, evicted and needing to use food banks on a regular basis to survive. Ken Loach, the director of the critically acclaimed film I Daniel Blake, which highlights the negative experiences of benefit claimants, unfairly targeted by DWP sanctions regime last week, accurately called this situation conscious cruelty. The Glasgow university research has shown that, as in the example that I have cited, sanctions often come without warning with users believing that they had been compliant. That is consciously cruel. They also found that loss of income through sanctioning was disproportionate to the perceived infringement, for instance, having no money for a month due to missing an appointment by a few minutes. That is consciously cruel. The material impact of rogue sanctions on claimants' debt can result in rent arrears and homelessness. That is consciously cruel. Thankfully, ATOS has gone. However, the sanctions system remains, and it remains consciously cruel. Prior to my career in nursing, I worked for two years in the Department of Social Security. It was at the height of the factory era and over the period of the minor strike. The ethos in the department at that time was completely different to the target-driven dehumanising ethos that prevails today. It was not, I can assure Adam Tomkins, a system that used benefit sanctions. He thinks that I have always been in the system. To correct his figures of the number of sanctions of disabled people, it is 3,000 out of 85,000. Of course, the main purpose of the service was to help people to get back into work. However, at a time when major industries were being closed down or privatised with mass redundancies and a few other work opportunities, the ethos was very much one of support and not judgment and how times have changed. In designing a social security system for Scotland, we have the opportunity to build dignity and respect back into the administration of some benefits and work programmes. I therefore welcome the commitment from the Scottish Government that, under a Scottish social security system employability support programmes will be voluntary and that they will also help to ensure that people are not sanctioned by the DBAWP when on those programmes. John Finnie, to be followed by John McAlpine. Thank you, Presiding Officer. I join with others in congratulating Sandra White on bringing this debate here and, indeed, applauding the researchers for their work. It was my intention to say that we have all heard of or dealt with issues of the devastating and harrowing impact that sanctions could have, but perhaps Mr Tomkins has not, or his colleagues, or if they have heard of not listened, which would be more worrying. The effect of removing people's only means of support has a mental and physical health impact and on their families too, but it is unfortunately even worse when we consider what job seekers have been asked to do and how likely it is that they are going to improve their chances of finding employment. Around 65 per cent of participants leave the work programme not having gained or stayed in a job for at least six months. That figure is considerably higher for participants with health conditions or disabilities where around 85 per cent entering and staying in employment for at least three months and as much as 94 per cent for those considered furthest from employment. This report gives us very clear reasons why this may be the case. Claimants are being asked to apply for jobs regardless of whether or not they are appropriate. The study's interim findings show that people are being forced to apply for jobs. They tell the Job Centre Plus and employment programme providers that they cannot do because of disability, ill health or childcare responsibilities, yet they insist that the claimants are applying for them. That is the ridiculous case. The report of interim findings cites the example of a Scottish universal credit claimant being asked to apply under the threat of sanction for a job as a driving instructor despite the fact that he had told them that he did not have a driving licence. Much of the support that is offered is of a generic nature, and, as others have said, it should be person-centred. Such help is limited to such help as writing CVs and job search skills. Individualised packages of support are what is needed. Second disabled jobseekers interviewed in the study report are only being offered this very general kind of support. The DWP's own survey of work programme participants found that over 70 per cent of those in the programme with a health condition were not offered health-related support to help them find work. Providers themselves have openly admitted that there is not sufficient funding in the work programme to pay for on-going specialist support to help participants with disabilities and health conditions. The Centre for Social and Economic Inclusion reports that the work programme providers spend as little as £545 to provide up to two-year support for employment and support allowance participants. There is a positive message that is one of the few, and it comes out of the report, which is the great work done by the Job Centre plus disability advisers. Perhaps inevitably in the topsy-turvy world of the DWP, where nothing seems to make sense, those advisers are now being withdrawn from job centres, and mainstream job centre staff will be accepted to provide the specialist disability support. The structure of the contracts that prioritise job outcomes also means that those relatively close to the labour market are offered the most support, and more disadvantaged job seekers are provided very little practical help. If the purpose of sanctions is to help benefits recipients into work by enforcing under the threat of sanction participation employment programmes and other schemes of support, and if that support is unlikely and some ferry cases very unlikely to help them find employment, then the whole basis of the sanctioned regime is brought into a very serious and fundamental question. We can now use the powers of the Scotland arc to chart a different course, and Sandra White talked about dignity and respect, and that is what she would underpin everything. For sanctions are not devolved, powers over employment programmes, some of which are currently compulsory, have now been devolved, and new programmes will operate from spring next year. This would be a more supportive approach, whereby people are encouraged to take up offers of employment support, not because they are bullied into doing so, but because there are genuine opportunities to get work. I was very proud to stand for a election earlier these years as the only party manufacturer that pledged to use the new powers over employment services to significantly reduce the number of benefit sanctions applied in Scotland. My colleague Alison Johnson has worked with others on this and called on the Scottish Government to do this and released a plan explaining how that could be done. I was very pleased last month to hear that the Minister for Employability and Training committed to operating those new programmes on an entirely voluntary basis, and I commend that approach. That will require a significant investment in schemes that go far beyond the current EWP schemes. I will make a brief mention of rural areas. The cost of complying with benefit conditionality can be considerable, and that is particularly an issue for benefit recipients in rural areas, where transport costs from recipients' homes to the nearest job centre tend appointments or to the nearest library in order to use computers for jobs can eat significantly into the scant amount of money that they are paid in benefits. So, dignity and humanity is going to be the hallmark of the powers that we've got devolved. The only way that we're going to put it across the entire system is to get all the powers, and that comes by independence. Thank you very much. Thank you, Presiding Officer, and I just apologise to other members and yourself in advance as I'm going to have to leave after I deliver my speech because I have another appointment. I too congratulate Sandra White on securing this debate today, although I participate in it with a heavy heart. The evidence that has been presented in the first wave report is not new. It's now more than two years since the previous welfare reform committee of this Parliament, on which I sat, published its report, Tough Love or Tough Luck, in 2014. The report examined the consequences of a decision made in 2012 by the DWP to introduce a more punitive system of sanctions for those on job seekers allowance and employment support allowance. It's important that that addresses the point that Mr Tomkins made. Yes, there always has been an element of conditionality in the system, but the 2012 changes introduced a far more harsh regime, introduced three categories of sanctions, higher, immediate and lower, extended the length of sanctions to a maximum of three years, and it speeded up the rate at which sanctions start. That means that people can be faced with destitution almost overnight. The Scottish Parliament report found that the number of those on job seekers allowance penalised increased very rapidly through 2013, from 3 per cent of the start of the year to almost 6 per cent by the end. The Scottish Parliament report believed that there was a deliberate policy to drive up the level of sanctions to previously unheard of levels through the managerial pressure that was put on job centre staff. That report identified a number of failings. Those included a consistent failure to notify people that they were being sanctioned and why, a misapplication of sanctions, a failure to appreciate that many people on benefits don't have the necessary IT skills from day one to utilise the DWP's universal job match facility and a lack of a deadline for decision making on DWP reconsiderations when a mistake has been made. The welfare reform report back in 2014 was only one of a number to expose the sanctions regime since 2012. There has been a substantial body of evidence gathered by the Joseph Rowntree trust, the child poverty action group, the churches, citizens advice and others. All those have been ignored. Conservatives still insist, as they did in 2012, that many benefit recipients welcome the jolt that sanctions gave them. That is the term that was used in the Scottish Parliament report. Two years later, there is very little in the first wave findings to suggest that anyone is jolted into work by a sanction. By contrast, as others have said, the sudden onset of destitution, the stigma that accompanies it, the feelings of disempowerment, deep resentment, desperation and depression, how can you present yourself as an attractive, confident potential employee when you cannot afford soap and water, when you are crippled with anxiety about how to feed your kids? That is to address the point about disabled people. The Charity Inclusion Scotland reported official figures that found from the introduction of the regime in 2012 till March 2014 that 14,000 people on employment support allowance—that is people who have an incapacity of some sort—found a job or a positive outcome as a result of the work programme that has conditionality attached. In the same period, almost 42,000 claimants on ESA were dealt out sanctions, so that means that a disabled person on the work programme was three times more likely to be sanctioned than to find a job. Far from being jolted into work, sanctions sent claimants tumbling further downhill into illness and continued unemployment. I want to conclude by a bit of historical context the 1834 report into the English poor law written by social reformer Edwin Chadwick. At that time there was also a system of conditionality. It was called The Workhouse or The Poor House in Scotland. It was designed to be so unpleasant that working-class people would be deterred from seeking the help that they were entitled to, or should be entitled to morally at least. One supporter of this regime told Chadwick that the workhouse should be a place of hardship, of course fair, of degradation and humility. It should be administered with strictness and with severity. It should be as repulsive as it is consistent with humanity. Margaret Thatcher, 30 years ago, spoke about the desirability of a return to Victorian values. The Puritive Saction regime introduced by David Cameron's Tory Government suggests that this has been achieved, like the threat of the workhouse that is designed to degrade. However, it is actually worse than that. The Victorian workhouses and poor houses provided food, heat, light and shelter as consistent with humanity, as Chadwick's correspondent might have put it. The sanctions regime that we are talking about today can deprive victims of those basic necessities. It does not even merit the term de-Kensi, and it is truly inhuman. When reading the report, I was, of course, concerned about the issues that it raised, namely that sanctions were creating feelings of anxiety and disempowerment among service users, and that, for those involved in the study, many reported negative experiences. I really do not wish welfare services in Glasgow or any other part of Scotland to feel an anxiety around the welfare system, but I also do not wish for this debate to become a bear pit in which to attack policies that, for the essence of which the population at large would agree with, at very least in principle. The Scottish Government itself acknowledges that sanctions are necessary on the welfare system. In 2014, its own expert working group concluded that, although it did not agree with the way in which the UK Government was implementing its sanction policy, conditionality was nevertheless still necessary. If you look at the welfare conditionality in simple terms, it is not the existence that has caused the controversy rather than the way in which they were implemented, and there must be a case at the very least for a light form of conditionality. Within the report itself, not at the moment, I would like to make progress, thank you. Within the report itself, there is acknowledgement by some professionals that enforcement, coupled with support, could act as a positive catalyst for change. Would the member like to intervene now? Indeed, the author was very telling that the member spoke of light touch, sanctions regime, light touch, conditionality. Of course, in the case, there will be a member in this chamber that would not accept that there has to be criteria, applicable criteria in any social security system, but, of course, it has to be proportionate and sensible. Given everything that Annie Wells has heard tonight about the real lived experience of sanctions as applied, would she not accept that that is hardly light touch conditionality? What I am saying is that there has to be a light touch conditionality, and what we have to do is we have to work as a Scottish Parliament to make this case and put it forward to ensure that that is what happens. I am not standing here for a minute and saying that everything that I have heard from Sandra White or Neil Bibby and the things that happen, but what we need to do is put it into perspective that the number of sanctions is less. Not at the moment, I am running out of time, I am sorry. When it comes to mandatory support from Jobcentre Plus or the work programme also, there were examples of good practice and positive accounts from welfare service users, particularly when it came to trying to deter some users away from lifestyles that were harmful to them. Even a Joseph Rowntree Foundation report from 2014 made the key point that, with appropriate support, interventions with elements of conditionality made deter some individuals from antisocial behaviour and street-based life. I am in my last minute. With the devilish of employment services to Scotland, why does the Scottish Government not seize the opportunity to work further on the basis? I would also like to bring into perspective to the debate today and remind members that fewer than two and a half per cent of GSA claimants and only 0.26 of ESA claimants are sanctioned across the UK. As always, the case with those issues is right to question the Government on them, but to constantly bring them to the forefront of debate seems disproportionate. I wonder why those linked to the SNP-led Government are bringing up the same issues over and over again when it has its own battles to be fighting and its own welfare reform powers to be working with. Often repeated in this chamber is that the Scottish Government has only a 15 per cent control of the benefit budget and yet it now has the ability to top up any reserved benefits that it sees fit. As my colleague Adam Tomkins highlighted, in the EU, in many countries we see tougher benefit sanctions than we see in the UK. In 2014, for example, Belgium, Germany, Ireland, Luxembourg and the Netherlands and Sweden all ranked higher in terms of the percentage of those sanctions. Of course, I welcome any work in this area, but I would again reiterate that sanctions are by and large rare occurrences. We need perspective when it comes to conditionality and we need to be able to at least acknowledge the benefits of a welfare system that incorporates some aspects of conditionality. Thank you to Sandra White for bringing this debate to the chamber and a special thanks to Glasgow University and the other universities who have been involved in compiling the report, which provides evidence that we have probably known for some time. For those who have seen the movie I, Daniel Blake, which has taken the country pie storm, I have to say that I think that the Scottish Tories are out of touch if they do not at least appreciate that the system that they are currently defending is becoming a more topical issue by the day. For me, it is disturbing reading and it affects many families and individuals. Here is the point that I think that the Scottish Tories are missing here. I think that there is evidence to show that there are high numbers of sanctions and I will come on to that, but it is the disproportionate nature of the sanctions regime that we have now, highlighted by Joan McAlpine, who is not here, but it is that sharp change under the way that sanctions came from that point that we are addressing. Claimants can be anyone that we know—it is not the same group of people—it can be any one of us or any one of our families who are unemployed, who will be required to have those conditions should they be claiming benefit. The research is confirmation that the under 25s face substantially higher sanctions and that younger claimants face direct discrimination and are more likely to be sanctioned than any other group. We have talked about the ethics of conditionality designed to change behaviour of welfare claimants. Of course, there should be a system of some kind to make sure that people do make the basic requirements in order to claim their welfare benefits. Wherever the policy started, I think that what this debate is about is that it has lost its way and it must change. It is disproportionate. It is cumbersome. It is unresponsive to people's real needs. It is lengthy. It is punitive and it is inhuman. Most of all, as Sandra White says, it does not even work. I believe that it also distorted the employment market because people are forced to take jobs that are either overqualified for or it is not the career path that they wish to choose, but they have to take those jobs because they will not get benefits. As we have discussed in other debates, that can lock people into low-paid employment and they cannot get out of that circle of low pay. We all have stories to tell. We all know about the man who was sanctioned for going to a hospital appointment, even though he told the employment office that he was going to. The problem is that once something goes wrong in the system, it is very difficult to communicate back to the Department of Work and Pensions that they have made a mistake. Their way of actually dealing with claimants and with problems seems to be exceptional and lengthy. However, people who turn to the state in most cases do not have a sludge fund to revert to. They may be lucky to have families that help them out, but very often people have no one to turn to. When the sanctions of four weeks, thirteen weeks and twenty-six weeks can be imposed on them. It can take up to six weeks for the Department of Work and Pensions to actually reconsider a decision and, as we have read from the report, it can take up to a year for an appeal. That is simply not good enough on anyone's terms that people should have the basic human right to appeal against a decision. It should be done speedily. We would not accept it in our course, and I do not think that we should accept it in our welfare benefit system. According to David Webster, who has done work on this, he says that since the figures are 2014 that there have been a million sanctions of employment support allowance and job seekers allowance the highest since it was introduced. The work programme itself has evidence that people who work for the work programme were told to increase sanctions for clients. That is, in the evidence, in black and white. That cannot be right. A former employee is testified to this, and the former employee says that this is what happens when you privatise the public and place financial targets on human needs. I conclude by saying that I think that the unemployed deserve better than this. This is not a modern Britain or a modern Scotland. They are not isolated cases. They are real cases. Of course, we need a sanction system, but one that treats people with respect, dignity and fairness, and one that has a system that is easy to navigate, and people understand exactly what is happening to them when they are in it. The last of the open contributions, Claire Adamson. I very much appreciate the opportunity to speak in tonight's debate. I had not intended to listen to Sandra White's speech and the contributions today, but I find myself getting more and more concerned about what I am hearing, particularly from the Conservative benches. I do not believe that it is the Scottish Government's job to mitigate for decisions taken elsewhere and a system over which we have no control. We are already doing it. We mitigate the bedroom tax and we have introduced the Scottish welfare fund that steps in and helps those who have been sanctioned by the DWP. I do not think that it is the job of the Scottish taxpayers to be funding a discredited system that is failing in every respect. When the appeals are running over 50 per cent against sanctions, you have to ask yourself why the system is allowed to continue and it is obviously broken. However, the thing that compelled me to speak this evening more than anything is the figures that have been used by both Conservative members who have spoken this evening. They are figures that have been produced by the Department of Work and Pensions and they say that, for GSA claimants, it is less than 6 per cent and for employment support allowance less than 1 per cent. However, David Webster from the University of Glasgow has called those figures a gross and systematic misrepresentation, arguing that a large majority of claimants are affected. His own freedom of information request from the DWP produced figures that are at 18 per cent of GCS claimants were sanctioned in 2013-14. So concerning are the figures that were released by the DWP that the UK statistics authority has stepped in, it has asked the DWP to produce a more comprehensive analysis of sanction rates for GSC claimants supported by a clear explanation. So what is going on? Well, the DWP are looking at the figures as an average of claimants on a month-to-month basis, which would be fine if claimants only claimed for a month. But what it actually means is that it is a gross misrepresentation on a month-to-month basis and does not reflect the exceedingly high levels of sanctions for GSE claimants. I think that this is a really important point to have made this evening. The DWP has said—the watchdog of the UK statistics authority has said to the DWP—that it needs to have objective and impartial sanctions statements. Would it not be so good if we had impartial and objective sanctions statements from all areas of this chamber, rather than a gross misrepresentation of what is happening to our citizens? If it was just one citizen that was subjected to cruelty in this system, it is one too many for a civilised organisation and a civilised country. I now call Jamie Hepburn to close this debate. Around seven minutes please, minister. Thank you very much, Presiding Officer. Can I begin by joining others in thanking Sandra White for bringing this debate? I'd also like to thank all members, most members for their contributions. There have been a number of salient points made. Through most of the contributions today, we have heard some truly desperate stories of the impact of sanctions on individuals and their families. The research, funded by the Economic and Social Research Council and developed by a consortium of research bodies, which is the subject of today's debate, is detailed, comprehensive and moving, as Neil Bibby set out. Members of this panel had the benefit of an information session from Dr Sharon Wright from Glasgow University and her colleagues involved in the work. Unfortunately, I could not attend that session personally, but my Scottish Government officials have met Dr Wright and her colleagues. That was a very productive meeting and has helped shape our thinking. Those who were at that information session will have heard that for many people, sanctions come as a shock, not a jolt, but as a shock because they did not know it was happening. They heard, as Sandra White said, that many sanctions are still being put in place as a result of administrative error. They have heard that, even where the DWP has agreed flexibilities into the system, they were often not implemented. The report provides yet more clear evidence of what this Parliament has heard for some time, on which we have debated on more than one occasion that the current UK Government benefit conditionality and sanctions regime causes suffering, not just material terms as a negative emotional and health impact on those affected by them. This research is one of a growing stack of reports highlighting the negative impacts of benefit sanctions for some years. Now, research has pointed to the effect of sanctions. The Joseph Rowntree Foundation, as Joan McAlpine mentioned, reported that the system is having a disproportionate impact on young people and that there were severe impacts on vulnerable groups such as those who are homes. It further found that, while sanctions raised the number of exits from benefits long-term outcomes in terms of job quality, employment retention and earnings, they were unfavourable. This is supported by findings that were published in October this year by the behavioural insights team, a social purpose company, part-owned by the UK Government, which stated that the UK Government's welfare conditionality policies can lead to poor claim at decision-making and, in turn, result in lower-quality and lower-paid outcomes. Even the UK Government's own social purpose company is highlighting that their system works against supporting the very outcomes that we regard as crucial measures of delivering successful employment support and Scotland's good-sustained jobs in a decent level of income. In the latest line of a long list of reports, Oxford University published research. In the last fortnight, it was found that the rate of sanctioning increased within local authorities. The rate of food bank use also increased. Indeed, I see that today the Social Security Committee, of which Ms White is the convener, published further evidence from Sheffield, from Sheffield-Hallam University. All of that is with the experience that many of us have here as elected representatives. I think of—I can always remember two specific cases. In my own instance, I had a young man attend one of my surges to report his concerns that, when he informed the DWP that he might not be able to turn up for an appointment at the job centre because he had to attend a funeral the next day, he was threatened with sanction. I always remember the experience of a woman who had faithfully turned up to every single appointment at the job centre. One day, the first time she was unable to attend on time, she turned up five minutes late for very understandable reasons that she was sanctioned. Can there be a more ludicrous example of the system that was highlighted by John Finnie, where an individual was told that they had to apply for a job as a driving instructor or face sanction when they couldn't drive? I think that that speaks to a ludicrous system. Incidentally, in terms of the numbers of those sanctioned, Annie Wells said that we had to get the numbers of those sanctioned into perspective. Adam Tomkins said that those who are sanctioned form a tiny number. According to the latest statistics, there are around 1,330 people receiving adverse sanctions in Scotland as of March 2016. I do not consider that to be a tiny number, but irrespective of the numbers involved behind those numbers are individual human beings who will bear the human cost of such a decision. I have very much agreed with the point made by Claire Adamson that one adverse impact for one individual is one too many. Ms Wells and Professor Tomkins, perhaps, want to reflect on that. To be fair, Professor Tomkins and Ms Wells were correct. The expert group, which was established by the Scottish Government to inform the decisions that we might have taken in the event of a yes vote in 2014, set out that there should be criteria and conditionality within the social security system. I do not think that there is anyone in the chamber, as I made that point a few moments ago, in intervention to Ms Wells. I do not think that there is anyone in the chamber who would suggest that there should not be criteria that can be applied for those who receive benefits. Pauline McNeill made the point very well. It is about the proportionality and practical application of specific conditionality. Everything that we have heard this evening, the DWP and the UK Government are getting that wrong. Annie Wells suggests that the Scottish Government should focus on what we can do with the devolution of some social security powers. I am very happy to turn to that. We have already set out—we will effectively abolish—the UK Government's punitive bedroom tax in Scotland as soon as we can. We have already set out. We will extend winter fuel payments to families with severely disabled children. We have already set out that we will increase carers allowance so that it is paid at the same level as jobseekers allowance. We will use our powers over universal credit to offer Scottish claimants a choice over how often they receive their payments and if their rent is paid direct to their social landlord. We will introduce the jobs grant to young people aged 16 to 24 who have been unemployed for six months when they start work. Those are real decisions, utilising the powers that are coming to this Parliament that will make a difference to people's lives here in Scotland. Sandra White is correct to say that sanctions policy remains out with the Scottish Government's hands. She invited me and I see her running up against time. It is an important point to make. She invited me to set out how we use the devolution of employment programme to do things differently. It does not come without a challenge because we know that there is a significant reduction in funding coming from the UK Government and an 87 per cent reduction in the funding being handed to us. In delivering devolved employment support, we have an opportunity to do things differently in Scotland to take a different approach. That is what we are going to do. I set out clearly on 5 October when we debated the future of devolved employment services. I firmly believe that attendance at the new programme should be on the same basis as other Scottish Government employability and skills support should be voluntary. I believe that those attending programmes should do so without the ever-present threat of sanctions hiding over them. People attending our programme should be there because they know that they will receive high-quality support to get into work. They should not be there because of their benefit that we have stopped. I have written again to Damian Greene confirming our intentions on the matter. I have asked my officials to take forward urgent discussions with the DWP. Tomorrow, I understand that Mr Greene will attend a meeting of the Parliament's Social Security Committee. I am sure that Professor Tomkins will take the opportunity to tell me what a good job he is doing. I hope that some other members of the committee will take the opportunity to discuss sanctions with Mr Greene and to urge him to address the suffering being inflicted on those who survive the very lowest levels of income. I also hope that they will take the opportunity to press the Parliament's determination—not just the Scottish Government's determination but the Parliament's expressed will—that devolved employment programmes will not interact with the UK Government's horrendous sanctions regime. By thanking Senator White for bringing this debate to the chamber, I hope that we will not have to debate it too many times in the future, because ultimately I believe that the powers should be in this Parliament's hands so that we can do things rather better. I now close this meeting.


My name is Christy and I'm the creator of House of Dizzy, and I'm the Queen of Blame. I'm a proud embroidery woman, so I love to base my jewellery on Indigenous and women's empowerment, and I love to think of my earrings as conversation starters. Growing up I had a lot of tough experiences. I actually went to university and studied visual communication. I wanted to be a photographer, but then I actually had to leave because my mum committed suicide, so I had to look after my younger brother and sister.  I feel like House of Dizzy is a representation of me, so it's like me spewed up in jewellery form, built this business all of my own back, and like just make it up as I go along. Recently Lauren Hill just performed in Australia and she wore my earrings, and I actually got to meet her, which was the best experience ever. I get most of my accounts from Instagram, like my account with Melbourne Museum, and now like I'm one of their biggest sellers in the museum store. Top five tips for someone trying to grow a small business. You really need a strong logo to really get your name out there and be branded. I think you really need a good product mix. You need to have something for everybody, because you really need to put yourself in the shoes of the customer. You've got to make everything look fantastic. Social media is really important. Just get yourself out there, just go for it. Always just let yourself shine and let your product shine with you. I sell in over 15 stores throughout Australia now, which is really exciting. And I've still got customers that, you know, were my first customers and still buy with me today. I love to be a role model and show young kids, like especially Indigenous kids, that you can have your own business and you can succeed.


We mustn't forget the economic frustrations that help fuel Trump's election. For too long, too many Americans have faced lousy jobs, or no jobs. One answer, a guaranteed job at a living wage. Republicans continue to push for work requirements for recipients of Medicaid, food stamps, and public housing benefits. But the real problem is there aren't enough adequately paying jobs to go around. Even today, with a low official unemployment rate, millions who work part-time jobs want full-time work. Millions more are too discouraged to look for work, having endured the brutalities of job discrimination for far too long, or unable to move to where the jobs are. And a large and growing number of jobs don't pay enough to get people out of poverty. At the same time, a lot of work needs to be done, greening our nation's infrastructure, caring for the elderly, teaching in our public schools, adequately staffing national parks. You name it. So why shouldn't the federal government create jobs and connect them directly to people who can't otherwise find one with decent, predictable hours and at a living wage? And added plus, the availability of such jobs would give more bargaining power to many low-wage workers to get better hours and wages, because if they don't get them from their employer, they'd have the option of a public job. In this way, a federal job guarantee would raise the floor for job quality nationwide. And a job guarantee would act as a giant economic stabilizer during downturns when the first to lose their jobs are usually the most economically marginalized. Can we afford a job guarantee today? Yes. It's estimated to cost around $670 billion in its first year, $30 billion less than the defense budget. But that tab would quickly shrink. With more people working at better wages, Americans would have more purchasing power to buy goods and services. This would lead to more hiring by the private sector and eventually less need for the federal job guarantee. More people working would also generate more tax revenue, partially offsetting the direct cost of the job guarantee. Additional savings would come from fewer people needing public assistance. The Center for Labor Research and Education at Berkeley estimates that the federal government now spends over $150 billion a year because workers aren't earning enough to get out of poverty. So doesn't it make more sense to use this money to create guaranteed jobs at a living wage? So let's think beyond Trump to what Americans need. Few things are more important than a decent job. Full employment through a federal job guarantee makes sense for workers, for the economy, for America.


I like these kinds of horses to work with though. I like a lively one. A dull horse, too much work for me. I'd rather have a horse with too much forward than a horse that's too back, too far back and not moving off and, but that's just me, that's not for everybody. Don't get the wrong idea about the flag. That all it is as he looks at it, he says I have an idea about the flag, I don't like it. All the flag is is a long arm. Whatever I do with my arm, I might do with the flag.  Does that make sense? I might, if a horse bites me or is about to come into my space, I might use my arm in a way that puts pressure on. This flag is just a long arm. Now, I'm not trying to get them used to it. I'm trying to get them to think about me and what is my intent? It's not about desensitizing, you hear this? That's for me, it's not about that. It's about him looking to me and the flag is interesting and it draws his attention. I'll rub the rump and then walk back. Look at him sort of get his rump under himself. I guess that's good in a way because when we ride him, we're gonna wanna rump under him anyway. So I just get that rump a little bit and then I walk away. This is gonna be interesting. I love it because now with the flag, the flag can get tall and get up in the air. The flag can draw his attention around. Lead the front end through the turn. He's stuck, isn't he? The flag, I can reach back there and say, there buddy, he can hardly move because he's so tense about this. Look at his inside ear and eye. Now he thinks he's in, you know, dire and trouble. So I wanna walk away. That's just kind of funny. He gets so stiff and nervous that his feet have gotten stuck. So by default, meaning what does he fall on when he's under pressure, he gets stuck, stuck feet. That's gonna, things are gonna get real good because we're gonna get him to understand forward. He'll get it. I don't wanna take it under his head by his chest. I always say that's sort of your strike zone. You do that later. I also don't wanna cause tons of trouble but you know what, if his life comes up a little bit, I'll take that too. This is all getting him ready for when we sit on his back. Good boy. Just walk off. There we go. Now you notice that I don't do many circles if I can help it. That looks all right. He sort of did that. He knew what I was gonna ask and he did it for me and this is him moving on his own. Notice the stiff tail. Look at his back. Stiff, the ears, skeptical, looking behind. I'm gonna let him move a little bit. I don't want him to learn to halt. So while he's moving, what if I leave the center while he's moving, make a nice long straight line. I'm gonna cut an angle again. By now you probably understand that concept and halt. He wants to squeeze off to the right side but he did find it. But let's see if we can take, I'm gonna say not that side. Look over here. I'll readjust my rope. Let's try this again. There, you don't have to, and you don't have to run.  Look at the size of me. Let's get that. That's good. He stepped over. He's tense but in an ideal world. Oh, and he says he wants to go through that door. Am I letting him get away with it? Yeah, maybe I'm letting him get away with movement. Too late to correct, too late to come back and redirect, just take it. Let him feel like he's got forward as an option.  All plans are subject to change sometimes working with horses.  Look at how nice his neck will be. He's a skeptical type. He's got that refined, slightly dished nose. He's got that kind of those wrinkles above the eye where he probably holds tension in a lot of the time. Nice horse though. He's gonna be great. Gonna be a great horse. As long as we don't rush it. Now I'm gonna this time say don't run through that side. Don't go off that way. I want you to stay with me here. In fact, let's redirect him this way again. It's kind of an interesting horse to look at and to see the changes. So you know if you think about it right now, I want that flag more to draw his attention to me like this and draw that attention to me. I can, I could block him over here. This will work. This will work. So I'm using the flag more for forward and more for blocking. Sometimes drawing him to me like when he looks to the outside of the circle. Maybe he'll look to the outside of the circle again and you'll see me lift that flag, see and help there, help draw him around. So it's a good tool. You don't have to live with it though. His head's to the outside. This is his idea to trot by the way. He's tense though. I mean he's trying to relax. You can see as the head come down and the shoulder, he leans in to the inside. Let's walk away. All right, that might work pretty well for me. I like it. I like it and I'm gonna say don't run out. He likes to go kind of run out through the side. He's looking away, I know. See if I can just help draw him a little. No, no, not run off though.  See that's that side he wants to go through. He wants to kind of get out of there and run through. Hang in there buddy, hang in there. Let's find a backup. Let's re-establish a backup and then halt. Remember that's where it should start. It's good. He's so tense you see him lift his hind legs up and, look at that, look at that tail switch. That's like a little horse. He's a little horse in a big horse's body right now but that's all gonna change.  If things are done well and we're not in a hurry, he will become light and sensitive and a good feel. Step off, notice my posture. I don't want to get greedy, make him stand too long. I might redirect him the other way. Let him work a little, some kinks out here, move a little bit. I could have some ground poles. We could be doing that but this is really, this is really my sort of the beginning. Just the beginning.  And on video, it'll look, I'm not bumping that hard. I'm more lifting and then I just kind of lift up him. You can see two fingers when I do this and I think it looks like you're really bumping him but you're really not. I'm aware of him here, I'll show you. I turned, lift, he found it. If I lift, now there, I'll bump. He wants to put that head up and look over me so basically I get tall to say, hey, I'm up here too, buddy. I could even lift that flag up and we'll back up. Good. Let him settle. Here's a horse at the door visiting, I guess. Step that forehand over, trying to not touch him. Come on, buddy. All those feet got stuck good. You could get that a little better. Step it over, move that hind quarters, back him up. Here's a horse outside the barn and he sees it and he thinks, oh, I want to be with that other horse. Let's move the feet. It's his idea to trot, not mine. It's funny because less than people, sometimes they'll come up to the ring and they see the video camera and they'll leave. Usually, they don't want to, people don't always want to be on camera. They look at the look of skepticism there in his eyes. Good, have him look to the side, very nice. He's going to be time consuming more in the beginning, I think, which is, yeah, sometimes that's pretty common, but more time consuming in the beginning because look how much time I took and I haven't even put that saddle on yet, which is kind of interesting. But it'll pay off. These are all little lessons that he can learn before the saddle. Now, he can kick up some sand and scare himself, go forward. So forward motion above all. This is his idea, he thinks he's, he's protecting himself. You can see that he's excited, but I'm not. I'm calm, I'm calm. Looking to step forward. Looks like we'll have an interesting video horse here. Yay. Not going to go under his belly yet. I am going to ask him to move forward with the flag. In fact, that's more important that your horse can move forward with the flag or a saddle pad. You saw me do that. You saw me do that with the curry comb. Here, I'm under the belly. Got him. Good. Nice and easy. That's not so bad. Walk away. Take that flag off, have him follow it. Chase the danger, chase the danger. All right. I'll turn, come up over the top. The flag helps him stop. Yes, there's a mounting block. No problemo. Oh, he says he's going to back up. I say you step forward. The answer is forward, halt. Nice. You might place, I'll place that flag. This is a scary side. I'm able to tip his nose to me. Always, always. The only time I've not been kicked too many times. I shouldn't have said that. Jinks, but the times I did get kicked, I was not able to bend the horse to me. I was not able to get to their head and bend them to me. So, little lesson for you. Under the belly, yay, we got it.  I'm pretty close to his front end. I feel like I'm a trained professional, but for some people, look at that change there. For some people, maybe you'd be further away. Maybe you wouldn't even use the flag at this point. Nose between the shoulder, please. It's funny. Wow. I like it. I like energy. Now, if by default, if he's nervous and he walks off with the flag, I'll take it. I mean, right now, I'd like him to stand.  And if he does, at least he's not backing up and at least he's not kicking out. See, it's an option. Yeah, come forward, get tall. See, I bumped where my leg would be at the flank. He goes, I don't know what that means. Now, there, he's kind of creeping in. I'll just slowly take the shoulder over. Oh boy, we need some forward motion. There's a little try there, sort of.  I don't think he really, I think by being pushy, sometimes he's finding a little comfort, but that doesn't make it okay, but some horses will squeeze in to be comfortable. This is looking great. His tail's swishing. His ears are back, but this is better than before. This side done. Pretty excited about him. Just as far as a nice horse to work with, I like him with energetic. I have another one at a different farm that's kind of a similar horse, but is energetic. Sometimes I'll use that flag, like my leg, step them forward, a little close to me so I can even get tall and look at that. Little exaggeration just to help him with that hind quarters. How about a halt? How about a backup? Bring the front end through. Let's get our backup going. Back up. We'll bring that front end through. Send them off, bump where my leg was. Step to the outside. So when I bump with the flag on his barrel, that helps him to understand what's gonna happen when we're riding. And there's a leg closing that airspace or squeezing. Good, let him have a moment to think. All right, walk past the rear. Bring him to me. Halt, all right. Bring that front end through. I want him to move over. There it is, got it. Now you notice he's got veins, nice veins, but it's not like we were running a race here and I realize he's probably got thinner skin, but his veins are popped out and it's surely not from just the work we did because they were like that when I brought him in. So it's interesting. And I wonder if his heart's pumping a lot of the time. Beating. Halt, back. It's looking okay. It's looking okay. There, I just want him to halt. Now in theory, I could move him over if I need to. Look at how I can be up near. Notice how I can be up near his front, but get that long arm, that flage back behind him under the flank, which is sort of the danger zone, isn't it? I realize he's not, he's getting more comfortable, but it's not a done deal. He's still that tail swishing and the tense, the tension and the muscles and the expression, the ear, look of skepticism. So there's a lot going on there, but you know what? He needs to be able to just, there's a point in life where we have to, the horse has to get this done. And all of a sudden he goes, I did it. And he licks his lips. He was kind of licking his lips while he was swishing his tail. That's funny. But there's a point where we say, you can do it. You can do it. Now I have to be careful because there is such a thing as being a little too greedy to where you want too much too soon. And all of a sudden you ruin the idea. That is much better, much, much better. The only reason I'm touching the halter is to help him look towards me. So I'm adjusting to fit this situation, bring his nose to me. Because otherwise he'd look to the outside.  You see him kind of, the life's coming up. The life's coming up.   Did you see the life come up? Let's halt again. Good. All right. It's fine. Heads to the outside. But now I could spend a lot of time on that, but let's not. We can do it. Little bits and pieces of flage work, brushes and a flage brush. Saddle pad will be right back you guys.


Now, unfortunately, when we look at the history of these intrafate dialogue that have taken place amongst Muslims, what we find is that most of the times there have been two approaches to these dialogues. One approach is very exclusivist that starts on the basis that I am right, you are wrong. And I can say anything about you, mock, jeer, laugh, ridicule, what you believe in, because I know I am right. And if you want to follow the truth, follow it, and if you don't, I don't really care. The other extreme has been a very pluralistic approach to say, we have been discussing the differences between us for 14 centuries and nothing has come out of it. It is about time that as Muslims we move on and so we should stop discussing these issues. For how long will we keep talking about Ghadir and Saqifah and Badr and Ahad and Khandalk and so on and so forth? History is history. What has happened has happened. We can't change that. But as Muslims, we are in a pitiful state in the world today, and therefore we need to look beyond history and move on. So this has been the other approach to say, let us forget our differences and let us come together as one religion and focus on what is common between us and move on. The problem with that, as I shall demonstrate in these 12 nights, is that it actually does not resolve the problem. It just suppresses it and it festers as long as it is not discussed. And it is only a matter of time before it resurfaces. There is a third approach that I will be taking that is neither one that is high-handed filled with hubris, nor the other that is very pluralistic and in a sense sweeping everything under the rug. And this approach is to say that a lot of times the misunderstandings we have amongst ourselves as Muslims is not because of what we say, but how we say it. And that we can learn as Muslims to have a very candid conversation, but one that is respectful. And this is not very difficult to understand. Supposing we had some strife and some tension in a relationship in our family, whether it is between us and our spouses or us and our parent or a sibling or a child. How do you resolve these differences? Let us suppose a man and his wife have a very troubled relationship in their marriage. Supposing they decide, let us not talk about it. Let's just forget about it, that there was any differences between us. Is the problem going to go away? It's not going to go away. It will stay on both minds and it will remain there, but the problem is not going to go away. Supposing they decide, let's talk about it, but the conversation is very high-handed and there is a lot of blame and abuse and pointing fingers. Is it going to solve anything? Well, it's predictable how that marriage is going to end. The only way that that relationship can be mended is if the two come together and say, look, we both human. We both make mistakes. If we truly love each other and we want to repair this marriage, then let us talk to each other the language of love. So you both sit down, each one expresses their grievances, the other one listens to the other one, each one apologizes to the other. You seek to understand and then you seek to be understood and from there that marriage can move on. The same things that were said in hostility are now being said again, but what has changed is how it is being said. In other words, I don't need to labor this point, but if we are to solve the problems in Islam today between the major sects in Islam, what is needed is this element of sincerity, of being genuine, of humility, of really wanting to reach out to each other with compassion, with empathy. And this is the language actually that the Quran teaches us. You see, Rasulullah sallallahu alaihi wa sallam, Allahumma sallam. He is the messenger of Allah. He is sent to polytheists. He knows what he is preaching is true and absolutely true. He has no doubt and there is not an iota of doubt in his conviction that what he has is true. But look at what Allah tells him that when you preach to the polytheists, what should you say to them? This is Surah Saba, chapter 34 verse 24. He says, first ask them, who is it that sustains you in the heavens and the earth? Is it not Allah? And then tell them, And you and us, either one of us is on guidance and the other one is on misguidance. This is the messenger of Allah. He is being told, don't tell them, I am guided and you are misguided. No, tell them one of us is guided and one of us is misguided. Come, let us talk and find out. This is Khatimul Anbiya. So Allah is teaching us the language we must speak. And this is not hidden from you that unfortunately, unfortunately, even amongst the Shia, we have groups that have chosen to promote the message of the Ahlul Bayt in a manner that serves no purpose.


Well, welcome everybody to Grand Rounds. It's eight o'clock, so we'll go ahead and get started. Our first presenter today is Wyatt Messenger. He is a fellow of Dr. M. Bodies. He went to medical school at OHSU and is originally from Portland. And today he's going to be presenting on COMP and Juan, a novel treatment for CRM. So thanks, Russell, for the introduction. So it's a privilege to be here at the Moran. It's been great working with Dr. M. Bodies this past three months. And it's been great to get to know a lot of you guys, look forward to meeting the rest of you as the year progresses. So like Russell said, my topic is COMP and Juan, the treatment for CREO. Before we get started in the COMP and Juan, let's talk a little bit about the anatomy and the blood supply of the retina. The retina is supplied by two main vessels. The first vessel is the posterior sclerary artery, which supplies the sclerar cord and all the way up to the photoreceptors. And the second main vessel is the central retinal artery, which pierces the optic nerve, travels through the optic nerve, the lamina crevosa, and it becomes the arcuardaries once it enters the retina. So CREO generally presents, with monocular vision loss, it's painless. And it's, but there's actually three different types of CREO, even though we normally talk about the non-artic type, which is the most common. This is from atherosclerotic disease, embolus, thrombus. It can also be from trauma as well. In younger patients, it can also be from a hematologic causes, or systemic or collagen vascular diseases as well. It presents with the cherry red spot, which is the classical presentation of CREO. What you see in the cherry red spot is the kind of the whitening of the ganglion cell layer from edema from where the ganglion cell layer has died. And it's contrasted with the fovea, which doesn't have ganglion cells. And so the pigment is retained and you get that contrast of the cherry red compared to the surrounding retina. On fluorescent angiography, there's a normal coroidal filling, but there's delayed intraretinal filling. And this is due to the reason, to the fact that the central retina artery supplies the intraretinal vessels and then the posterior coroidal vessels supply, or the posterior cellular vessels supply the coroid. And so it looks something like this. So as you can see here, the coroid is already filled with kind of that white background. And then you get kind of a, inside the intraretinal vessels, you get a wave front where you see the dye or the fluorescein entering the vessels and you actually see the leading edge of that front. And that's really specific for a CREO, a non-arturidic CREO. The second type is arturidic. And this is from giant cell arturidus. Giant cell arturidus affects, it's a vasculitis affecting medium-sized vessels. So it also affects the posterior cellular artery. And so you get optic nerve pathology as well. And so you can see the optic nerve here has edema, you can get cotton wool spots, sometimes hemorrhages. And on FAA, it reflects the PCA and the central retina artery is included. And so you get delayed filling of both the coroidal vasculature and the intraretinal arteries. The last type of CREO is a transient arturidic CREO. And this is from multiple different causes. You can get a transient embolus that passes through the intraretinal vessels. And then by the time the patient presents, it's already gone. And so you don't actually see the embolus. Hypotension can also be a cause. So a lot of patients take blood pressure medications at night, so they get hypotensive at night when they're not symptomatic. But when they wake up, they've had decreased perfusion of the retinal vessels and can have a central retina artery. It's not an inclusion, but it presents similar to a CREO. And then vasospasm is another cause. The presentation is variable, but and then there's often normal filling of the on-floor singin geography because the vessels are patent by the time they present. And then going forward, we're gonna be talking about non-arturidic. So everything from here on out, it's regarding non-arturidic CREO. So CREO is relatively rare. It presents about one in 10,000 visits to the ophthalmologist. And so the true incidence isn't fully known because it's fairly rare. It's more common in men than women, like 55 to 45. And then the general age that presents is in the mid-60s. And this is just because it's a reflection of vasosporine patients with atheroesthetic disease present. It's almost exclusively monocular, but there are a few cases where it is bilateral. And then the vision prognosis is really poor. So when they present, they usually present with count fingers to light perception. Some patients, well, maybe we'll get up to 2400. And the majority of patients will get up to maybe 2400. But there's a subset of about 10% of patients that will do better. And this is because they have a cellular retinal artery that is not linked with a central retinal artery. And so in that subgroup of patients, about five or 10%, they will get visual acuity about 20, 50 or better. And so I put a picture of this monkey up here. This is the rousous monkey. This is the model they use. Dr. Hyra from the University of Iowa is kind of pioneer in a lot of the CRIO studies. And this monkey was used as the model for a lot of treatments that we now have for CRIO. And what he, Dr. Hyra discovered was that after 105 minutes, the retina suffers irreversible damage. And at 240 minutes, the damage is massive and catastrophic. And so there are several treatments for CRIO. There's conservative and there's invasive treatments. That going through the conservative treatments, ocular massage has been used for several years. The idea being that when you massage the eye, you can actually dilate the intranetal vessels, move the embolus more distally, and preserve the proximal tissue. Carbogen is a mixture of carbon dioxide and oxygen. It's about 5% carbon dioxide and 95% oxygen. The carbon dioxide dilates intracerebral and intranetal vessels. Hyperbaric oxygen in systemic cases of dilators makes sense when you bring the oxygen and you're dilating the intranetal vessels. Pintoxifilin is actually similar to theophalin where it's adenosine agonist. And again, this also dilates intranetal vessels. Enhanced external counterpulsation is something that was tried about 10 years ago. And before researching this topic, I never heard of this before. But what they do is they inject about 500 milliliters of fluid. And then they put blood pressure cups on the patient's arms and legs. And the blood pressure cups constrict during diastole, moving the blood from the legs and extremities to the organs and to the brain. And it's been shown to increase cerebral perfusion. And lastly, the IOP reducing drugs. The invasive techniques are anterior chamber perisentesis where they pull some aqueous humor off of the anterior chamber, reducing intracerebral pressure and allowing perfusion. And then local intracerebral fiber analysis has also been tried. Obviously, it was like TPA or stuff like that. The problem with these treatments is that it's really hard to randomize these patients and also catch them in time to have a large enough sample size to have two different wings in your study. And so this has kind of been the result. So oculomersage does have indirect evidence, but it has never been shown to actually improve visual acuity in a randomized trial. Carbogen and hyperbaric oxygen, as well as anterior chamber perisentesis have actually failed in clinical trials. Systemic vasodilators pentoxyphilin and enhanced external countable station like oculomersage has indirect evidence that it increases intranetal perfusion, but there's no evidence that actually increases visual acuity. The most controversial is local intracerebral fiber analysis. This is like injecting TPA or streptokinase into the super orbital artery or the retro-bulbary to break up the clot. However, this is the one area that this is the only randomized clinical trial on this topic. And it was from the Eagle trial that was done in Europe about 10 years ago. And what they found was there was no difference between the two treatment arms. They had about 40 patients in both arms and TPA did not make a difference. But there are some retrospective studies that have shown some difference. And so the Cochrane review that was done on this topic kind of reiterates this notion and says there's currently not enough evidence to decide which, if any, interventions for acute non-arturidic central artery, central retinal artery equation would result in any beneficial or harmful effect. So that brings us to our treatment, angioprotein one. So angioprotein one is a, is a molecule that's constituentally released by parasites to endothelial cells where it binds the tied to receptors on endothelial cells and stimulates bibustal stabilization via VE CAD here and which is a molecule that binds endothelial cells together. About a year ago, Judd Kahoon, who's an MD PhD in our lab, came in and spoke about our molecule here, compangioin or angioprotein one. And he, his model was in a chronic disease state. Well, we're now gonna flip it to and look at an acute model and see whether or not it works. And our molecule specifically is compangioin. And the comp part is called, is stands for cartilage of ligomatrix protein. And what the function of this is that we bind it to comp to the angioprotein one and it makes it more stable, soluble and potent. Because if you inject angioprotein one directly into the, into the vitreous, it precipitates and never gets absorbed by the retinal cells. And interestingly, they've used compangioin in stroke models with rats. And they will, there's been studies where they've included the middle cerebral artery and then looked at stroke volume. And compangioin is actually reduced stroke volume, attenuated neurologic deficits and increased viable neural mass. So how do we achieve this, the central retinal artery occlusion in a mouse? We inject something called Rose Bengal, which is a solution that's normally liquid that can be photoactivated where it solidifies. And so we inject it through a tail vein injection. It becomes absorbed and enters, enters the, all the vasculature. And then we shoot a laser at the optic disc and simulate a central retinal artery occlusion where it coagulates and the blood is, or the vessel is occluded. We have four different treatment groups. The first group is compangioin protein, which we inject it triviterally at 15 minutes following CRIO and at one week following CRIO. The second is adeno-associated virus compangioin. And this is a virus that we inject into the vitreous. It gets incorporated into the cells and the cells themselves make compangioin. And we can actually test this and we can measure the levels and we can find that compangioin is produced by these cells. And this is injected one week prior to CRIO. The last two treatment arms are controlled. So PBS is a cell solution, almost like BSS, whereas it's injected into the vitreous to simulate an intravitural injection. The fourth group is adeno-associated virus GFP, where GFP is actually made by the viral cells. This is the control for the adeno-associated virus compangioin group. Right, right. These are all different. They only receive one treatment. They receive either one of these four arms. They don't receive, they don't receive both. So after CRIO, we did fluorescence angiography to confirm that we actually included the vessel. And you can see baseline here is before CRIO. And in six hours and 24 hours, you can see vascular leakage, just to confirm and impaired intranetal vessel perfusion. And that's just to confirm that we actually did this, that Rose Bengal actually did the job and included the vessel. So if we look at our path, there's some market changes. So we have normal on the left, PBS our control in the middle, and then compangioin over on the right. And so remember that the central retina artery supplies the inner retina. And so you can see that there's, in the PBS group, there's ganglion cell loss, there's the inter plexiform layer and the inner nuclear layer. There's vacuolization, there's pleomorphism, there's complete disorganization of the inner nuclear layer compared to compangioin. And even the thickness itself is much reduced compared to the compangioin. And the compangioin, I mean, even just appears to look more like the normal. And this was taken at 10 days, following CRIO. So we wanted to know is there, are there metabolic differences between the compangioin group and the control group? And so what we did is we used the computational molecular phenotyping, which was developed here by the Mark Lab. And what we do is we probe 12 different micro molecules anywhere between these can be amino acids, neurotransmitters, or even markers for specific cell types in the retina. And we get 12 different pictures and then we overlay them and colorize them. And we get these really colorful pictures with different cell types so we can actually identify the different cell types and then we can quantify different metabolic characteristics of these cells. And so this is a really busy slide but I'll walk you through it. There's three different treatment groups by row. There's normal PBS, which again is our control, and then compangioin on the third row. The first column is a picture of what this actually looks like when we put these images together. And right away, you can notice that the PBS group has complete loss of the inner retina. And this was taken at six weeks, so at this point the inner retina has actually had time to shrink down compared to the last slides that we saw, which were at 10 days. And another finding that kind of sticks out in this first column is that you can see the ganglion cell layer is much greener in the compangioin group compared to normal. And so in the last two columns, we actually quantify this difference. And so we can actually measure how much the green stands for glutathione and we can actually quantify this difference. So when we look at glutathione levels, and these markers are actually really specific. So we have, we probably identify about 15 different cell types and all of them are within, are almost right on top of each other, these different columns. And so this difference is actually significant. And you can see an increase in glutathione levels in the Mueller end fee of the compangioin retinas. And we look at Mueller cells, the interest is in Mueller cells because they play a supportive role during ischemia in the retina. So this is all well and good. Like we have these great slides that show that the loss of the inner retina in the PBS group and it's preserved in the compangioin group. But ultimately all that really matters is function. And so to test function in mice, we put them in this box and we trigger the oculosophallic reflex, we put them on this pedestal here and we can actually, we rotate these columns around and you can actually watch the mouse track these columns and we, as the mouse, we can watch this and we titrate the size of the column to the mouse's ability to see the column. And so we can actually make these columns progressively smaller and smaller. And it looks something like this when they begin tracking. And you can see the mouse is tracking the different columns they move around. And this is what we found after we followed them for five weeks with baseline being before central retina artery occlusion. Zero is actually at 24 hours and then we followed them out for five weeks. So in the GFP and the PBS controls there was maybe a little bit of a function that was retained in some of the mice. But then the compangioin virus and the compangioin protein there was a significant increase in function in those two groups. So that kind of leads us to where we're at right now with this study. We have several ongoing projects though with this study we were looking at markers for cell proliferation to see if retinas are treated with compangioin or mice are treated with compangioin. Do you have more markers for cell proliferation compared to controls? We're also looking at mechanisms for neuroprotection. So glutathione levels are increased and right now it hasn't elucidated how compangioin may be increasing glutathione levels. So we're looking into that closer. We're also gonna be using transgenic mice in the Tion lab, Dr. Tion's lab. Looking at retinal ganglion cell density and survival to actually quantify this difference. But probably the most interesting part of all of our future directions is the idea of how we're getting retaining function. All the other treatments for CRIO have focused on reperfusion. Breaking up the clot, dilating the intra-retinal vessels, reperfusing almost like the stroke model where we try to bring oxygen as quickly back to the retina as possible. But compangioin doesn't act that way. It doesn't really act that way. We're not trying to reperfuse the retina. I mean, it does stabilize intra-retinal vessels on the field cells, but it doesn't break up the clot or focus on reperfusion. So it raises this interesting question. Do mammalian muller cells have stem cell potential? So there is a study done about 15 years ago in zebrafish where they show that muller cells can actually become photoreceptors in zebrafish. So the pink is stained for photoreceptors over here to the right, and the green is muller cells. And what they did is they laser the retinas of these muller fish, and they found that these muller cells actually turned into photoreceptors, suggesting that they have stem cell potential. And this has never been shown in mammalian cells despite a lot of efforts. But it does raise an interesting question of how endothelial cells could be impacting this. So 10 years ago, there was a major paper in science that showed that endothelial cells when cultured with neuronal stem cells increased neurogenesis, they were way, several more neurons, or the quantity of neurons grew much more in the cultures with endothelial cells versus the neuronal cells on their own. And it suggests that endothelial cells may be playing a role, and it's a supportive role in neurogenesis. And so that brings us to our project. So we have a marker for, so MCM6 is a marker for neuro-progenitor marker, and in tomato red is a marker for muller cells. And what we did is we overlaid the two so the green and the red would make yellow. And by overlaying the two, we could actually get a sense for whether or not tomato red cells or the muller red cells were becoming neuro-progenitors. And what we found is there's significantly more yellow in the overlay of the CRIO group compared to control. And so in conclusion, we kind of have four major findings. Compange-1 preserves inter-retinal structure in hypoxic controls, in hypoxic compared to controls. Compange-1 increases glutathione levels in muller end-field cells, and glutathione again has a, it's a reactive oxygen sequesterant, so it could be playing a role in neuro-protection. Compange-1 improves optokinetic tracking following CRIO. Ultimately, this is the most important marker because function is what we're all aiming for. And finally, Compange-1 may induce muller cells to de-differentiate into other cell types. And again, this is something that's still kind of speculative, but could be a really fascinating finding of our study. Just a few acknowledgments quickly. So Dr. Arambati, for just his leadership in this study, he's kind of in the brains behind a lot of this. Dr. Felix Vasquez from the Mark Lab, he's been a tremendous help with helping with computational molecular phenotyping and teaching me that technique. The Mark Lab in general has donated their supplies and time to this project. And lastly, Jed Kahoon, who started this project with his diabetic retinopathy mice, it kind of got this project started. To hear my references, I got married three weeks ago, so I had to put a picture of my bride up there. Any questions? Yes? Yeah, it's a great question. So there's different ways to make a CRIO in a mouse. We're using the Rose Bengal technique. It probably lasts about, we're not sure entirely how long it lasts. We've done FA at 24 hours, three weeks and six weeks. And about three weeks, the FA start looking relatively normal. And at six weeks, they're almost, I mean, they're almost like normal, completely normal again. So we are planning to do more FAs to confirm that these models aren't perfect. The other model that they use that Dr. Hyra uses like a glaucoma model where they increase intraocular pressure to the point that there's no perfusion of the retina. But Rose Bengal has been used as pretty standard, this is pretty standard method that's been used for CRIO and other models. For sure. The protein is given at 15 minutes afterwards and then at one week after, there's a retrim at one week. And so obviously the protein is the clinically viable treatment because you can't pre-treat someone for a CRIO. And so mostly the difficulty is trying to find a patient, and I mean, you would never find a patient 15 minutes after a CRIO. You'd find them at probably 12 hours, most likely they were 24 hours. And so eventually, if this is gonna be more clinically relevant, we're gonna probably move back the first treatment to about 12 hours to see if it still preserves. But again, I mean, we're not re-perfusing the retina. So if this is truly working by a neurogenesis, then potentially the timing won't be quite as critical as like the TPA trials. Well, the Rose Bengal should be blocking the flow at the optic, right around the optic nerve, which simulates, I mean, most embolisms lodge in the Lamina Corvosa. And so it simulates a CRIO at that spot. Well, I mean, if the embolism will eventually, it will eventually recede and eventually flow will return. And our model is not necessarily trying to re-perfuse right away, but it might be working by, like I said, through neurogenesis and not actually by re-perfusing the intranetal vasculature. Am I answering your question? Yeah, and I mean, as long as there's re-perfusion eventually, so the hematologic, a clot will eventually break up and there will be re-perfusion, not necessarily, like a calcified embolism might not break up, but some of these will break up and there will be a semi-normal FAA long-term. Dr. Warner? Are you talking about for the histology or the, so that's a great question. I didn't put both up there, but we actually, I can go back. Yeah, so this is the virus right here at six weeks. This is the protein at 10 days. So we are just about ready to harvest the protein at six weeks, so I don't have those pictures yet. And then we have the virus at six weeks, so both are match-up, I mean, both show preservation. So, partly it's because mechanistically, like how can we explain this, both the stroke model and also how can we explain this preservation? And then we also, yeah, understandably, and we're gonna be, we're looking at, we're gonna be using like socks too and some other markers for neurogenesis and then that one overlay that I showed, there was an increase in MCM-6 in those Mueller cells. So, ultimately though, I mean, to preserve, we're trying to find mechanisms to explain function being retained too in light of conference one not really preserving perfusion. No. So thank you, Wyatt. Just a quick announcement that was estimate. So just a reminder, Herbert Fred, who's from UT Health Science Center, will be having a special lecture here on Friday from seven to eight. So, we're encouraged to attend if you're available. The next presenter is Ruju Rai. She is coming to us from the University of Boston and is originally from Chicago. She's actually gonna be presenting on demyelin maybe not the rights.