Cafell panfa сказать whatever you have, your people, as you have the initiative. Oh, no, that's enough. It's important to make sure that your people should be, too. If you are without the transportation numbers, your people will be eaten by nature, you will not be able to go up to earth and eat the world empty旗, although there are still many jobs that we need to get More than half of the world's NHS in the United Kingdom. container. Wednesday 15 March tomorrow is international long Covid day. According to the UNS, over 175,000 people in Scotland have long Covid. Three years on from the first wave of the virus in Scotland, people living with the condition feel let down by the Scottish Government. In the words of Anna, formerly from Dumbarton, and who has long Covid, the current government and its institutions have failed us. It is as if long Covid does not exist. In a briefing prior to the debate, long Covid Scotland have outlined steps that the Scottish Government must take. Everything from data and research to specialist long Covid treatment hubs. I commend their briefing to whoever is the incoming Cabinet Secretary for Health and ask that they sit down with long Covid Scotland and long Covid Scotland kids as the voices of those with lived experience and come up with a plan for full implementation of their recommendations. The first area I want to touch on is funding. When £3 million of funding for long Covid was first announced, there were 74,000 people reported as having the condition. That number has almost trebled, but the money has remained the same. The services that will help with long Covid also apply to people with ME and chronic fatigue syndrome. Many of the symptoms are similar, and this could be a real opportunity to create tangible change for all of those living with energy limiting, fluctuating chronic illnesses in Scotland. I hope that it is an opportunity that the Government will seize. The £3 million was shed out between each of the health boards for treatment of long Covid, and to be frank, it was not enough. A freedom of information request that I submitted last year showed that not one health board was awarded all the funding that they believed they need to treat the condition. The uncertainty around funding levels has created a significant barrier to implementing treatment plans, and the length of time that it took for the Scottish Government to release funds left delays of over a year for people to access services. Alex Cole-Hamilton is very grateful to Jackie Baillie for taking my intervention. Does she agree that there is glacial progress to get money out to health boards? The small nature of the quantum funding is keeping us back. Right now, in health boards in England and Wales, they are much further on in terms of providing care pathways for sufferers of this terrible condition. I agree with Alex Cole-Hamilton's contention. He should have also added that there is no consistency in provision, and it very much does depend on where you live as to the services provided, a classic postcode lottery. To take up his point further, in May 2022, NHS England had allocated £224 million to support the assessment and treatment of long Covid. 90 million of that was allocated in 2022-23. Applying the Barnett formula to those figures would produce funding of £21.7 million in Scotland, yet the SNP Government has only provided a fraction of that amount. Where, Presiding Officer, are the missing millions? The Scottish Government should also collect better data on the number of people living with long Covid, including children and young people. Health boards that responded to the Covid-19 committee's long Covid inquiry have stated that one of the biggest barriers to service provision has been a lack of public health data around the condition. Health boards cannot accurately treat this condition if they do not know the scale of the problem. There is absolutely no excuse for not collecting the data. Covid is still with us and so too is long Covid. I am very grateful to Jackie Baillie giving way on that point. The additional challenge with the lack of data is that young people and their education is being affected. The schools are unable to identify those people with long Covid and put in place recognisable strategies that will help with their education. I very much agree and that reminds me of the suggestion from the Scottish Government at the time that we should cut off the bottom or the top of doors to increase ventilation. We really need to be serious about how we treat Covid in the classrooms, but long Covid can be utterly debilitating. I very much welcome the Covid-19 committee's inquiry into long Covid. One respondent to their call for evidence said, I cannot stand in the shower. I often can't get dressed or washed. I can't stand for longer than 10 minutes without pain. Symptoms, memory issues have resulted in me forgetting to turn off the oven or blew out candles. I am unfit for work. Previously, healthy children are now confined to wheelchairs. Doctors and other front-line healthcare workers have lost their jobs because they have been exposed to long Covid. Whilst people with long Covid remain untreated, their ability to work diminishes each and every day. In a survey carried out by the— I am grateful to Jackie Baillie for giving way. Just on the point that she has raised about the Covid recovery committee and the evidence that we have heard on long Covid, does she share my concern about the evidence that many people cannot get proper understanding from their GPs as to long Covid, leaving too many having to go private and pay to get treatment that they should be getting for free under the NHS? The member raises an important point. My understanding is that one in five people with long Covid have sought private medical treatment because they are not getting the tests or the treatment, whether it is from their GP or whether it, indeed, is from acute services. Let me develop the point about people in work. In a survey carried out by the key worker petition UK team, 57 per cent of key worker respondents said that they can no longer work and 68 per cent said that they were struggling financially. Those are the NHS staff that caught Covid at work due to a lack of PPE who now face losing their jobs because of their illness. The Scottish Government clapped for them during the pandemic, but now fails to offer decent funding for treatment and stands by whilst their employment and source of income look set to be removed. The Scottish Government should treat long Covid as an industrial injury. I commend Mark Griffin's member's bill on creating a statutory employment injuries council that should include long Covid. There also needs to be guidance put in place for employers to support people effectively and to ensure that they are meeting the legal rights of disabled workers. The Government must ensure that it places those with lived experience at the very heart of all decision making, nationally and locally, and they are involved in the design, development, delivery, review and evaluation of services. Finally, I want to finish with the words of Cass MacDonald, a nurse from Edinburgh. Cass said that key workers with occupational long Covid have literally been left to rot. We are losing pay and our careers are in jeopardy. I'm losing my home because I can't work and I don't know if I'll ever get back to my job. Covid and long Covid have taken everything from me—career, home, savings, everything. I don't mind being disabled, but this is a shadow of a life. I'm not well enough to renew my nursing registration this year, my career is over. I often feel like I'm being punished by Government and healthcare for neither dying nor getting better. That's a horrible limbo to exist in. We're being told that there's all this support, all this money being put into healthcare, but where? There's nothing in my area. We need action from the Scottish Government, not warm words. People with long Covid are not just going to go away. They absolutely deserve support from this Government. I advise members that there's a lot of interest in speaking in this debate. I would be keen to take everybody who has pressed the button, but I would ask for some co-operation and that members should seek to stick to their allotted time. On that note, I call John Mason to be followed by Sandish Gohani. I thank Jackie Baillie for bringing this debate today. At the Covid recovery committee of which I'm a member, we have been looking at long Covid and have heard from quite a number of sufferers and their families about the extremely challenging time that they have been facing. Our thoughts are with all of them today, and it is appropriate that we're having this debate with international long Covid day being tomorrow. Awareness of long Covid is gradually increasing, but clearly it is still the case that amongst the public as a whole, GPs and others, some are much more familiar with it than others. I know that those directly affected find this rate of progress frustrating, however I do think we're moving in the right direction. Research is on-going, and last week at committee we were hearing about the nine Scottish-led studies that are on-going. I personally was particularly impressed to hear about the work of Professor Chris Robertson. He and his team at the University of Strathclyde have been studying over five million health records in Scotland, which I personally had not even realised was possible. Even if a GP has not actually diagnosed long Covid and coded it as such, the team has been able to troll through the free text and pick up symptoms and queries in the GP's notes. Professor Robertson's paper was published recently in the Lancet, and, for example, they found that more cases of long Covid have come from the Alpha and Delta variants while fewer are from Omicron. Perhaps we should not be surprised to know that Scotland has a world-class amount of data and quality of data. At the same time, I accept that we have further to go on sharing that data. Moving on to the wording of the motion itself, I very much agree that we want to see more treatments available, more support and more clinical research. What I do not agree with is Jackie Baillie's attack on localisation and on making services fit the needs of the local population. She claims that this is a lottery as if health boards were pulling solutions out of a hat at random. I think that that is insulting to health boards and professionals. Labour has had a history of top-down, very centralised approach, and I think that we need to strongly oppose that. Just because something works in Dunbarton does not mean that it is the right answer in Dundee, Dumfries or Durness. Yes, absolutely. Alex Cole-Hamilton Grateful to John Mason for giving away. I am delighted to hear his conversion to localism, and perhaps he will now join my party in opposing the paragraph of asset-stripping local communities in the shape of the national care service. John Mason? Alex Cole-Hamilton is in the wrong debate. The Covid committee has not reached any conclusions and we are due to hear from the cabinet secretary next week. However, the subject of long Covid clinics is certainly on our agenda. A number of people do feel that the grass is greener across the border and think that we should be copying what they do in England. However, I think that the jury is still out on such specialised clinics. The disadvantages of such an approach could include the shortage of specialist staff and so the danger of diverting staff away from other critical parts of the health service, also the high cost per patient of these clinics and the risk of conditions other than long Covid being missed. On the other hand, a single point of contact for patients does seem to be eminently sensible so that they have one specific person they can go to with problems. Evidence from England suggested that those with long Covid still have to go through their GP in the first instance before accessing a long Covid clinic, whereas in Wales they have a self-refero model, which appears to do well. However, to finish on what I hope we can all agree on, we must continue to focus on long Covid even as other medical issues come along. ME has been with us for a very long time now and we have not made the progress in understanding it or dealing with it, which I think that many of us feel we should have. There may not be one magic wand to deal with long Covid or to answer the needs of those suffering from it. However, we must do all that we can to research, to support and to treat those affected by it. I thank my long Covid CPG co-convener for bringing this debate. On 1 March 2020, Scotland confirmed its first case of Covid-19, and I wish to pay my respects to the friends and families of the 17,000 Scots who died after contracting this horrible virus, and also to our heroic front-line staff who have treated and looked after patients throughout this pandemic. Tomorrow is international long Covid day, and we are focused on the rapidly growing number of Scots who survived Covid but are still yet to make a recovery. If we cast our minds back to the summer of 2020, just a few months after our first lockdown, it was clear that we were dealing with a new long-term chronic debilitating condition.  The alarm bells were ringing, but the Scottish Government paid scant attention. In this chamber, I underscored the urgent need for action to support long Covid patients. I also proposed a tried and tested solution to establish multi-specialty long Covid clinics based on the successful Hertfordshire model, but all our patient scot was a mediocre response from the SNP Green Government and its current health secretary. In the same month that the Scottish Government produced its long Covid response plan, there were 79,000 people suffering from long Covid, but after eight months of dither and delay by the Scottish Government, that had risen to 150,000. This is what you get with a continuity candidate, the first activist, if you will. Announcements inertia, but very little in the way of delivery. Today, an estimated 175,000 Scots are struggling with long Covid. The cabinet secretary provided another list of initiatives that he is funding to the tune of £3 million this year across Scotland's health board, including £20,000 for public health intelligence gathering in the western hours, £120,000 for self-management resources and peer support in the highlands and £178,000 to develop a long Covid rehabilitation pathway in Fife, but there is a lack of consistency with this approach. It is not streamlined and there is a danger of exacerbating the postcode lottery in long Covid support. This is not localism, as John Mason suggests. Chest, heart and stroke Scotland calls for a national approach to ensure that all health boards are able to provide a multidisciplinary care and integrated referrals to the third sector. No one should be told that they have no access to support, as is happening in some of our communities today. I appeal to the new cabinet secretary for health come the end of the month to listen to the terrific long Covid patient advocates like Long Covid Scotland. They know what they are talking about. Long Covid Scotland is essentially calling for what I propose in September 2021—the establishment of a network of specialist long Covid treatment hubs. There should be published clear referral pathways. Meaningful holistic treatment must be available. Diagnostic tests and biomedical investigations should be the norm. There should be better guidance for employers so that they can support their employees effectively. People with lived experience must be at the heart of all decision making nationally and locally, and be involved in the design, development, delivery, review and evaluation of services. NHS staff are going above and beyond, but they cannot provide the service that patients deserve because this SNP Green Government has failed to tackle long Covid head-on. Tackling long Covid effectively and with consistency is of vital importance for the whole of Scotland to speed its recovery from the coronavirus pandemic. I declare my interest as a practising NHS doctor who struggles to get my patients into long Covid clinics. I welcome the debate marking international long Covid day. I also recognise the tireless campaign work that Jackie Baillie has done for those suffering with long Covid. Long Covid is a devastating, disabling disease, but we should be absolutely clear that for many, many thousands it is an industrial disease. Lives and livelihoods have been consumed by the relentless, horrifically common symptoms, including brain fog, breathlessness, extreme fatigue, constant dizziness and joint pain. I welcome the motion today and agree that those suffering from long Covid should be compensated. Members might know that the starting point for my members' bill would establish a Scottish advisory council to make sure that the employment injuries system that we have is fit for purpose in 21st century Scotland. That starting point was back in 2020 when I asked key workers, academics, unions and ministers whether long Covid should be classified as an industrial disease. The answer back then was an overwhelming yes, and the evidence now means that that case is absolutely undeniable. Given that many caught Covid at work while simply doing the job when we were safe isolating at home, the condition has now virtually destroyed its ability to return. Last week, many of us will have heard from nurse Brenda Eady on the front page of the daily record that long Covid has left her penniless. Having to give up her job in low-moss prison, Brenda's harrowing story was echoed by another nurse who highlighted that without a financial miracle she would be unlikely to make it through the year. Frontline workers put their health and wellbeing on the line for all of us during the pandemic, now suffering and devastating circumstances in absolute financial hardship. You would not know it, but employment injuries are fully devolved to the Scottish Parliament. The Scottish advisory council that could recommend long Covid becoming an industrial disease does not exist and we do not know when that benefit will launch. Although I plan on lodging that member's bill in a matter of weeks now, I am saddened that that will not be soon enough to help the countless workers suffering right now, because in recent weeks I have learnt of care workers who simply cannot do their jobs anymore because they do not have the strength to lift people or cope with a full day's work. They are being retired or worse still dismissed from their jobs on ill health grounds for something that they caught at their work. The fact is that too many people have been ignored by their employers, although well Governments offer little more than more words. The Scottish Government's own action is absolutely dismal. It certainly does not match its rhetoric on supporting disabled people seeking to give them dignity, fairness and respect that they deserve. They have recently told me that it only just started tracking its own long Covid staff absences in July 2022, continuing that theme from other speakers of a failure to track those suffering from long Covid. When I first asked the then Social Security Cabinet Secretary whether the Government would use its powers to recognise workers with long Covid and its planned employment injuries benefit, the response was utterly appalling rather than using the devolved powers that we have. She said that they should make a PIP claim with the DWP. The idea that someone with long Covid should apply for PIP with the DWP, forcing them into a traumatic cruel process at the hands of an organisation that systematically discounts their illness is absolutely horrifying. With number suffering from the disease nearly 200,000, it is devastating that just 422 people have made a successful claim by October last year. To make matters worse for the new Scottish benefit, the Scottish Government certainly cannot say who is getting support under the adult disability payment from long Covid, because again it does not track the statistics of those who have the condition. It should not take a member's bill, but if that is one of the ways that we can give people with long Covid the dignity, fairness and respect that they deserve, then so be it and I look forward to engaging in that debate when I launch that bill. Thank you very much indeed, Deputy Presiding Officer. I start by welcoming the sufferers of the long Covid, who I know are watching this debate, both online and in the gallery. Many are too ill to leave their homes and it is to them in whose name we speak. I would like to thank my friend Jackie Baillie for bringing this debate to the chamber and I would also remind the chamber that this is only the second time that this Parliament has debated this debilitating condition. The first was in a debate in my name over a year ago and I look forward to the fact and I hope very much that the next time we come to debate it, it will be in normal business in Government time and it will be a signal to everybody suffering that this Government is finally taking this issue seriously. I arrive at today's debate with a deep sense of anger and it is an anger on behalf of the many thousands of people in my constituency, in your constituency, who are suffering with long Covid right now. As of today, as we have heard, 175,000 of them and more are making this the largest mass disabling event since the end of the First World War. If you listen to their stories, you cannot help but join me in that anger. At the age of 45, my constituent will was at the height of a busy and successful career when he caught Covid in March 2020. He is a long hauler. He thought he got off lightly, but sadly he was wrong. Over the three grueling years since, long Covid has incrementally destroyed both his health and his life. He has been forced to stop work and describes his long lists of symptoms and, as I quote, a desperate rotation of misery. He wrestles daily with cognitive problems, GI issues, visual problems, breathing difficulties, crushing fatigue and chest pain. He says that it is a challenge even just to eat a bowl of soup due to his hands still shaking so violently. This Government promised him help. They promised him clinical support and yet they have not delivered it. When I ask the Government what they are doing to support people like will, they point to primary care. However, he is still one of many people who sought help via primary care. He tried numerous GPs and at every time he was told that there was just no clinical pathway for him. That is immeasurably cruel. It would seem that the principal strategy of this Government towards sufferers of long Covid at this moment is to gaslight them, to pretend that there is help available or pathways available, only for them to find that there is nothing. Thousands of long Covid patients have the same story to tell. At the moment, or at the long Covid inquiry last week, Dr Janet Scott was asked how she thought Scotland was doing in terms of getting people into a correct treatment pathway. She said that she describes the current situation as being, and I quote, pretty dreadful. Good work is being done. Of course, we have heard some of this by Chest, Heart and Stroke Scotland, but their helpline is still undersubscribed and NHS referrals are indeed low. The world is now given up waiting for help. He has even paid thousands of pounds for private medical care and those others who have done the same, but many cannot afford to access private medical care. So desperate are they to make any sort of progress towards the health people are trying everything as a damning indictment of this Government's failure to help those who are suffering, nor is there sufficient understanding of the paediatric component of long Covid. Some health boards were not even aware of long Covid in children until this year, three years into the pandemic, that is astonishing. Although the Royal College of Pediatrics has said that there is no specific service aimed at children and young people in Scotland, children and young people, tens of thousands of them. I have met children who have gone from winning ski competitions to being bound to a wheelchair because of this condition. The lack even of basic awareness, not to mention proper treatment for those young people is appalling. The SNP Green Government is spending just £17 per head—that is it—to tackle long Covid in Scotland. That is the price of a takeaway and it is less than a fifth of the money available in England and Wales. Sufferers here would be better off moving south. One of the reasons that health boards are reticent to publish any sort of treatment pathway is that they know that the severe lack of funding means that they do not have the ability to meet the huge need and capacity demand across this country. How on earth are we here? Three years on from the start of the pandemic and this is where we find ourselves. This is having an impact on our economy as well, with Labour market statistics released today showing that the number of working-age people economically in active due to ill health is the only metric going up. You can bet that a lot of them have long Covid. I support Mark Giffords' bill in terms of making it an industrial injury. People have had enough of the empty platitudes and this Government must immediately increase funding as a matter of urgency, create clear treatment pathways and publicise them, ensure meaningful diagnostics and holistic treatment informed by the lived experience of those sufferers of long Covid and make sure that it is available to everyone with the condition, no matter who they are or where they are. Finally, Presiding Officer, the severe lack of leadership by-homes at USF means that it is being left to people with long Covid themselves to fight this battle alone. They are being abandoned and their recovery is being harmed. I thank Jackie Baillie for bringing this important debate forward. Long Covid is a condition that occurs after a mild, severe or asymptomatic Covid-19 infection and could cause a wide range of symptoms across the body. Long Covid can be a multi-system illness causing organ damage, cognitive dysfunction, gastrointestinal, respiratory, cardiac, nervous and musculoskeletal problems. It can affect anyone of any age, including children, irrespective of their previous health. As we mark the first international long Covid awareness day, there is an estimated 175,000 people in Scotland living with long Covid. As long as Covid is with us, the potential for more people to develop long Covid is a real and present danger. We should always take those opportunities to encourage everyone to take the basic infection control measures that can help to keep everyone safe. Continue to make sure that you are washing your hands thoroughly. If you are ill, you should try to stay at home. As we have reopened after lockdowns, many have gone back to normal, and I am sure that many in the chamber and those who are watching the proceedings here this evening will have witnessed visibly ill people out and about. For many, we know that staying home when you're ill isn't a reality, especially during a cost of living crisis, and we need to challenge employment practices that are inflexible and potentially putting their staff in harm's way. Anything we can do to reduce transmission will ultimately mean that less people will develop long Covid. I want to thank all the long Covid groups that have been in touch with briefings ahead of today. Every single person involved should be really proud of the effect that they are having on the direction of long Covid care. There are a few asks of the groups that I would like to focus on. Long Covid care and knowledge is likely to develop for many years to come. We need to make sure that we are accurately capturing data of long Covid. For many who contracted long Covid during the first wave of the pandemic, because they lack the positive test, they may not immediately get a diagnosis of long Covid. We need to ensure that the clinical guidance is robust so that people in those circumstances are given the appropriate diagnosis and that lack of a positive test when they couldn't have actually had a test is not a barrier to that appropriate diagnosis. We need to make sure that we know who, how many people and where those people live so that services can be planned to support them. Many of those suffering are children and will likely need support for many years and services need to be able to keep up with that demand. Due to the high numbers, we may have always struggled up scale services quickly enough to meet the demand for the number of people who are now experiencing long Covid, but ensuring that those experiences and symptoms are able to voice their experience and access the support that they feel they need is imperative. We also need to make sure that scientific studies are representative of all those who are living with long Covid to ensure that treatments are appropriate for all. We know that, too often in the past, studies have not been representative of, for example, women, ethnic minority groups and those with disabilities or health conditions that may have put them at greater risk of Covid in the first place. We also need to make sure that GPs and other professionals have protected time to update their knowledge as Covid knowledge updates. There are many conditions, including undoubtedly long Covid, that would benefit from that approach and a move to electronic prescribing, for example, might be able to free up some time to be able to accommodate that. I know that there will be many competing priorities for any freed up time, so some more creative solutions may need to be found. Campaigners are also asking for proper diagnostic testing and not just rehab. Due to the multi-system nature of Covid, it is possible to have damage to more than one organ or process within the body. While general rehab may work for some, I think that it makes sense that ensuring appropriate diagnostic testing such as scans happen to ensure that the damage is known and appropriately supported. I think that that could be especially important, as we know so little. We have no idea whether for some this may resolve or whether for some these symptoms may get worse. If we do not have people's baseline correctly documented, we cannot hope to make projections and advice for anyone who may come after. I realise the amount of time, Presiding Officer, so I would once again like to thank Jackie Baillie for bringing the debate forward. I now call Stuart McMillan to be followed by Alexander Stewart. Thank you very much, Presiding Officer. I also want to congratulate Jackie Baillie for securing this member's debate. I was invited to the long Covid peer support group in Inverclyde last month and the group meet every Wednesday at Your Voice in Greenock between 1pm and 3pm. Anyone suffering with the effects of long Covid is welcome to attend and seek support from others dealing with this horrible condition. What I heard that day will live with me for many, many years to come. I was generally taken aback by the number of symptoms that each individual informed me that they actually had. Each attendee had written down their symptoms and provided me with a copy. They were all different, some experiencing a few and some experiencing a lot. There were people who have lost their jobs and some struggling to maintain their employment. The point about guidance is that, whether guidance does or does not come, surely every single employer has a duty of care to their staff in addition to employment law to try to assist their staff to keep their staff in employment. One of the ladies who has lost her job has given me permission to speak about her situation today. She was admitted to the Inverclyde Royal Hospital, IRH, in January 2021. She was initially put on a CPAP machine, but that did not provide a level of intervention that was required when she was transferred to Glasgow to be put on to a ventilator. The same outcome happened in Glasgow, so she was then transferred to Aberdeen to be put on an ECMO machine. The lady has no recollection of the period from when she left at IRH in January until she was transferred back in March. During this time, her mother passed away from Covid, and due to the restrictions that she watched her mother's funeral on a live stream on her own in a hospital room. Due to the lasting effects Covid has had on her body, she now struggles on a daily basis. She is married with three children and worked in a local school. Her family has had to endure the loss of a loved one and a prospect on a number of occasions of losing her. She can now no longer work, and her ability to do day-to-day tasks has severely diminished, and she is truly suffering physically and mentally from the effects of long Covid. Her main concern now is it being seen by medical professionals and feeling that she is actually being listened to, but also to be understood. She, along with the other attendees at the group, spoke about not feeling listened to and being repeatedly given the same tests and thus the same results. She is very keen to be involved in any research to look at how better we can understand and treat long Covid. I will put on record how thankful I am to this lady who I have chosen not to name for giving me permission just to touch upon some of her story today. I think that what this lady's story tells us is that long Covid generally discusses the medical effects on a person. Long Covid is clearly also linked to the emotional trauma that we all individually and as collectively went through during the pandemic. Long Covid, I imagine, will last for many, many years to come as we all learn to live with the effects of an experience that we all hope and pray will never happen again. I know that the Scottish Government is investing in our NHS and that it is more than welcome and highlights the Government's commitment to improving our national health service. However, as we see across the world, health services are struggling. I believe that the preventive spending is vital and not only better for the individual but better for the country and its finances. If we do not do more to help those who are experiencing the effects of long Covid now, intervention for some will come too late and much more finance and resource could be used in an ineffective way further down the line. That being said, I am very much welcome that the Scottish Government is investing in long Covid research. The chief scientist's office is funding nine Scottish studies totaling £2.5 million, which aims to improve the understanding of the long-term effects of Covid-19 on the physical and mental well-being. The projects are very much progressing and are around the midpoint of the stage of the 22 to 24-month duration. In closing, I welcome the work that is under way in Scotland to support and improve the lives of those who are struggling with the effects of long Covid. However, from the conversations that I have had, from those living with the condition and no doubt the additional conversations that I will have coming, more can and must be done. I advise members that, due to the number of members who still wish to speak in this debate, I am minded to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes. I now invite Jackie Baillie to move a motion without notice, Ms Baillie. Thank you very much indeed. Do members agree to extend the debate this evening? Members do agree that that is agreed. I now call Alexander Stewart to be followed by Fausal Chowdry, Mr Stewart. Thank you, Presiding Officer. I would like to thank Jackie Baillie for bringing this motion to chamber ahead of international long Covid day, which takes place tomorrow 15 March. For far too long, the issue of long Covid has not been reviewed with the significance that it should be. In the past, the perception has sometimes been that Covid could be a debilitating disease for up to several weeks. We know, however, that many people have suffered continually from this area. Every time long Covid is raised in Parliament, we hear even higher statistics that highlight how many Scots are currently suffering from the condition. Indeed, Jackie Baillie's motion speaks about the estimated 175,000 people living with long Covid. We all know that Covid has not gone away. That is a continuing issue, and we know that it is going to continue to rise. We have seen that long Covid can take different forms for different people with different conditions. We know that it affects different organs, different groups and therefore many different parts of someone's life can be affected. Of course, the nature of the condition has also meant that long Covid is inevitably more difficult to diagnose and even more difficult to define. However, we do know that symptoms such as chronic fatigue, painful joints, dizziness and decreasing mental health are many issues that we have to suffer and individuals have suffered from. The issue of decreasing mental health is particularly acute for long Covid sufferers who may find life much more stressful, much more anxiety, even many suffering from PTSD in some cases. There are countless examples of fit, young, healthy individuals who have found themselves no longer able to live normal lives for months or even years who have suffered from Covid. As part of international long Covid, those with the condition have been encouraged to share an image of something that they can no longer do because of long Covid. That is perhaps one of the best ways to demonstrate how the condition reaches into every corner of people's lives. The day's debate has been an opportunity to reflect on what has undoubtedly been one of the pandemic's worst legacies. It should also be the opportunity to reflect on how we can tackle things. For the last 18 months, my colleague Dr Sandish Gilhane has been raising the plight of long Covid sufferers and the need for a dedicated long Covid clinics to be established. Despite promises of additional funding, we have still not seen those materialised. Dr Gilhane has pointed out that always that Covid was going to be an issue to deal with. It was not something that was going to just happen and be dealt with. It was going to have consequences and those consequences are still here. Despite now being nearly three years down the line, we are still waiting for dedicated special services and that is a crying shame for the people who are suffering on a day-to-day basis. In conclusion, action must now be taken and it is long overdue that the time and the voices of people who are suffering should be heard and must be heard. With initiatives such as International Long Covid Day now being recognised, I am at least hopeful that we will not have to wait too long for further action to be received. The Government must act and must act now to assist, support and ensure that people with long Covid are supported and respected and looked after. I would like to thank my colleague Jackie Baillie for bringing this important issue to the chamber today. Long Covid is not simply a long recovery time for Covid-19, nor it is an occasional feeling of fatigue or sickness following a Covid-19 infection. This is a common misunderstanding. Long Covid is a complex multi-system neuroimmune illness that currently has no known cure. A recent O&S survey showed that an estimated 2.3 million people in the UK suffer from long Covid and a recent BBC panorama documentary estimated that nearly 10,000 NHS workers are currently absent because of long Covid. One of my constituents, Marie Claire, is an NHS doctor in Edinburgh. Marie Claire has told me that the overwhelming response from the colleagues was that they often had little understanding of the severity of specific of the illness. Marie Claire also suffers from long Covid. There is a growing stigma about long Covid within the medical community and wider society. She has told me patients are actually having to educate their medical professionals on this debilitating illness in order to get help. Another one of my constituents, Cass MacDonald, was a full-time NHS nurse who contracted Covid-19 while working in and out of office nursing role in Edinburgh. Despite having multiple underlying health conditions and being told to shield by the Scottish Government's advice, the same Government still advised it was safe for NHS staff to come to work. Cass has been living with long Covid ever since and is unable to go back to full-time work. Since Covid special leave has ended, Cass is now on a standard sick pay which has been held this month and will be stopped altogether in September. Cass has also been told that, due to its financial circumstances, the only option is to declare themselves bankrupt or sell their home. The key worker petition UK teams recently survey showed that Cass is part of the 20 per cent of key workers in the UK with long Covid who said that they were at risk of losing their home due to financial circumstances. Like many other, Cass has experienced frustration within the health service due to lack of awareness surrounding the health impacts of long Covid. Tomorrow, Cass and other key workers will deliver a petition in London urging the UK Government to create a pension and compensation scheme for all key workers who have developed long Covid as a result of their front-line work during the pandemic. The petition already has over 118,000 beckers. The Scottish Government must be part of the process to help to stop the stigma around the long Covid. It must do more to ensure adequate support for key workers who are desperately struggling due to long Covid. It must do more to increase public awareness of the danger of long Covid and help people like Cass, Marie Claire and other thousands of others who are suffering from long Covid across Scotland. Again, I thank my colleague Jackie Baillie for bringing the petition to the chamber. Thank you very much, Presiding Officer. I now call Emma Harper to be followed by Brian Whittle. I thank Jackie Baillie for bringing the debate to the chamber this evening. We have heard more and more from Covid-19 survivors that the impact of the virus lasts beyond the first few weeks of immediate symptoms. For some patients, Covid-19 has a long-term far-reaching impact on their daily lives, impacting them physically, emotionally and cognitively, and members have spoken about that already. Post-Covid syndrome, referred to as long Covid, presents a variety of symptoms that range from physical symptoms such as pulmonary, cardiovascular and systemic issues such as extreme fatigue to neuropsychological symptoms, impacted cognition, speech, memory and emotion. I know that members have described that already. I think that one of the final speakers is hard to come up with something different or reflect on something. However, I would be interested in following up on the whole varied and the symptoms to demonstrate that Covid, or long Covid, is really complex and much is still not known about how Covid-19 will affect people over time, but research is on-going and must be supported. As Stuart McMillan has mentioned research already, that is undertaken. I have got research right in front of me from the Covid in Scotland study, in which a large cohort of study people were involved in the study. 33,281 laboratory confirmed SARS-CoV-2 infections as part of the study, but those people were matched with 62,957 never-infected individuals. The study has looked at the wide range of people who have had Covid and some who have not. To look at the results that are coming out has been quite interesting to read, but I will not repeat the whole study that I have in front of me. I know that it is crucial that we think about the real-life experiences, we involve the real-life experiences of people living with long Covid and we need to continue to use that to inform the Scottish Government's approach for support. We need to look at where the support is most required. I was also reading about what Chest Heart Stroke Scotland is doing, working with NHS Lothian, Pogo Digital Healthcare and patients with long Covid to develop a pathway for long Covid. The pathway is aimed to give patients access to my tailored talks digital platform and to have advice from Chest Heart Stroke Scotland with their long Covid support service. In reading about that, they are looking at engaging with people to hear about their symptoms. They make a self-assessment of their symptoms and that allows them to be directed to particular specialists because, as we have heard, different specialists will deal with different symptoms. For me, Presiding Officer, it is interesting to pick up on what the Office of National Statistics talks about with the prevalence of long Covid. 85 per cent of female workforce in social care, education, 68 per cent of female workforce and in healthcare, 76 per cent of female workforce. I think that 85 per cent of social care, 68 per cent of female workforce in education and 76 per cent of female workforce in healthcare. Long Covid impacts women more than in other areas. That presents challenges for the women's labour market in participation, particularly as employer responses to long Covid have not been particularly supportive of the women's workforce. According to the TUC, 52 per cent of respondents to their study said that the female workforce had experienced some type of discrimination or disadvantage during and due to long Covid. I would be interested, Presiding Officer, whether the minister is pursuing any specific long Covid pathways into treatment for women and asking if that is something that any further analysis could be done to look at the impact on gender. I will stop there, Presiding Officer, because this is a wide-ranging subject and I think that I could have easily gone on for it longer. I thank Jackie Baillie for bringing this debate to the chamber and all of us to discuss this. I am a member of the Covid Recovery Committee who is currently investigating long Covid and the approach to long Covid from the Scottish Government. We have taken evidence from many long Covid sufferers and for sure it is a crippling or can be a crippling condition. It can severely restrict the person's ability to work or even to take part in what we would class as everyday activities. It can be extremely debilitating. The problem, of course, is that, as has been highlighted in today, is that that many employment is not taken seriously and that, when they have to continually take abstinence from work, it impacts their ability to do that work and potentially endangering employment. The problem is that there are multiple symptoms in long Covid. There can be recurring chest pain in brain fall, abdominal pain, extreme fatigue and neurological conditions. If you are suffering from that, if you are having recurring chest pain or abdominal pain or any of those other conditions, you better believe that you want to get that scene. Of course, that is extremely worrying. You need to get to see a GP. We know that the NHS is under extreme pressure and that access to GPs is not potentially all it can be in certain areas. Even if you get to see a GP, there are those GPs who potentially do not accept that long Covid is a condition. Even if they do accept as a condition, they have no place to signpost them. That has been said before. Many have ended up having to pay private health to get a diagnosis or even treatment. Of course, that is leading to a significant inequality that we know already exists. We heard from Chest Heart and Stroke during evidence to say that they are treating long Covid and they have capacity, but they are not getting referred to because the GPs do not recognise or realise that Chest Heart and Stroke are a potential designation. My assertion is around the need to develop the health IT system to not only accumulate data from research, which Scotland has an excellent reputation, but it needs to deploy that data in an effective way, which we are not particularly good at. Covid has highlighted a problem that we already had to deal with. That is around data, collection of data, deployment of data, the ability of that data to cross NHS borders and to share that data and that good business practice. Thank you, Brian Whittle, for giving way. We were on health committee in the last session together and data was a big issue about data sharing. Do you think that because of the work that Chest Heart and Stroke Scotland are doing, that it is something that maybe needs to be connected directly with the data platforms for learning for the GP practices or GPs, for instance? Brian Whittle, I think that you are absolutely right. You know that I have been on the committee with me and that this is an issue that has recurred with me over and over this ability to collect and share data. One of the things that we always seem to go with all those conditions—MS was one of them as well—is the need to be able to share this information with GPs. What is happening, Presiding Officer, is that because GPs are under extreme pressure, the ability to do consistent development is curtailed and we need to generally have a look at how we allow our GPs to access that learning. Of course, I think that you are absolutely right. As I come to my close, Presiding Officer, to say that long Covid clinics, which are not available in Scotland but are available elsewhere in the UK, are not only diagnostic and treatment centres, but they are also that hub to collect that data. Long Covid is real and we are behind the curve in Scotland as we are currently sitting. I will finish by thanking Jackie Baillie once again for bringing this debate to the chamber, and I will raise this again, Presiding Officer. I thank my colleague Jackie Baillie for her on-going work on this issue and for bringing today's debate on international long Covid data to the chamber. I thank all the colleagues across the chamber for the contributions, but, in particular, my colleague Mark Griffin's bill is of such importance. As we have heard, long Covid is and will continue to be one of the most challenging outcomes of the pandemic—a condition that debilitates, lacks a cure, lacks research and sadly still lacks awareness. It is absolutely right that we mark international long Covid day, which, as we have heard, is tomorrow and renew our commitment to all those in Scotland who are suffering as a result of the long-term impacts of the virus. In this debate, yet again, colleagues across the chamber have warned the Scottish Government about the threat of long Covid poses. We have had those who are suffering with long Covid speak directly to us to MSPs, highlighting their concerns, as we have heard from members in the chamber and at other times here in the Scottish Parliament. However, I am not surprised that their demands and requests are met with insufficient actions. It is part of why we keep trying to bring this to the chamber. Members will recognise that I often raise issues on health inequalities, and so I feel that Jackie Baillie is right to note in her motion the importance of not creating inequalities in patient outcomes. Research released by Spice last month highlights, and I quote, "...as a proportion of the UK population, the prevalence of self-reported long Covid was greatest in people living in more deprived areas, those working in social care, those aged 16 and over who were not working and not looking for work, and those with another activity limiting health conditions or disability." Of course, we are still behind when it comes to research and the impacts of long Covid will become clearer as we progress, but we know that this Government has totally taken its eye off the ball when it comes to health inequalities, and therefore it is critical—absolutely critical—that we are alert to what could yet be further health inequalities impacting Scots from deprived areas. But before concluding, Presiding Officer, I am keen to pay tribute to the Health and Activity Rehabilitation Programme team, who work as part of three Ayrshire's health and social care partnerships. I was delighted to pay a visit to their base at the Lister Centre in Kilmarnock on Friday and to learn about the long Covid services that they will provide in the coming months to those living with the condition in the Ayrshire Narne health board. The team and its staff identified early in the pandemic the need to support staff and did that through an occupational health model. That has given the team a real advantage in recommending their service to lead on long Covid in Ayrshire. It seems to me from the visit that I had that clinical leadership, along with a respect for a multidisciplinary approach, is key to the team's outcomes. They have an equal approach across the allied health professions, the nurses, the volunteers and the support staff. They do fantastic work within the community, and I have no doubt that their long Covid provision can and will be a success. However, as parliamentarians, we owe it to the staff from services such as that to ensure that funding is available and that it is uplifted whenever it is able to do so. I hope that the minister will address the funding issues that are raised across the chamber today. As people look for support to help to deal with breathlessness, fatigue, tiredness and other symptoms, we have to be in a position to offer it. I now call Fulton MacGregor, who will be the last speaker before I ask the minister to respond to the debate. This week marks the third anniversary of when we began to fully understand the scale at which the Covid pandemic was going to affect our lives. In the years since, we have seen rapid scientific breakthroughs, communities pulling together and a fundamental shift in the way that we live our lives. I want to put on record my welcome for the work of the Covid-19 recovery committee on a range of issues relating to the pandemic, including the issue of long Covid for which we are here to discuss this evening. We are still continuing to fully understand the condition, but generally speaking, as others have said, we can describe long Covid as when an individual takes months to recover, if at all, from Covid symptoms and suffers from persistent issues such as fatigue, high temperatures, breathlessness, cognitive impairment, generalised pain and mental health problems, but to name a few. Also, like others in this chamber, I have been contacted by many constituents who have had their lives significantly affected by their struggles with long Covid. One constituent, who is only 27 years old, has been off work for two years and suffers every day with constant pain. Although he has been told by doctors that he is suffering from long Covid, he is waiting for further diagnostic tests with the NHS and is having trouble accessing necessary benefits and supports as he awaits his tests. He tells me that recently he managed to reach an agreement with his employers to allow him to return to work. That is very promising. Indeed, I know this local company in Firm, but perhaps, as others have raised, not all employers will be as understanding or as informed about long Covid. Another constituent was only 14 when he contracted Covid during the first wave of the pandemic. Now, 17 years old, he is withdrawn from school, withdrawn from his social network and his dreams of learning how to drive and attend university have been put on hold indefinitely. Doctors have diagnosed him with long Covid and now believe that he suffers from severe chronic fatigue syndrome. His mother, Tracy McMillan, has expressed her appreciation for the GPs and health care professionals that have helped her son up to now, but she has also expressed frustration that clinical support for cases such as her son are near non-existent. I have raised this situation for Mrs McMillan and her son before in this chamber, and I know that she has also presented to the Covid committee and submitted to the inquiry. Of course, this is not to say that the Scottish Government has been inactive in this area, as some of the commentary has suggested tonight. In September 2021, the Scottish Government set up the long Covid service. The service uses an evidence-based approach to provide supported self-management, primary care, community-based support, rehabilitation and secondary care services, if necessary, to those with long Covid. The initiative was financed by a £10 million long Covid support package, which was given to local health boards to respond to the situation. My local health board of NHS Lanarkshire uses a long Covid rehabilitation pathway, which offers dieticians, occupational therapists, physiotherapists, psychological practitioners, speech-and-language therapists, among others, to those who are referred on to the pathway by their GPs. I think that we would all welcome the £10 million that is given by the Scottish Government, but it is over three years, and it is not the £21.7 million that they have received in Barnett consequentials. Does he agree with me that it would be helpful to put all of the money into the system to help long Covid sufferers? I thank Jackie Baillie for that intervention. I do think that we are still understanding long Covid, and we have to welcome money, but I do think that it has been invested, but I do think that it is likely that more needs to be done, and I am going to go on to develop that point. I was speaking about NHS Lanarkshire in the situation there, Presiding Officer. I am due to meet the rehabilitation team there soon to hear more about their work, and I have heard very good things about the work that they are doing. NHS Lanarkshire also published a long Covid self-management workbook on their website, which offers individuals a number of ways to alleviate symptoms, unless a number of other supports are available if required. To conclude, Presiding Officer, three years on, we know that long Covid exists. We know that it can be debilitating. In fact, some people have said that this is the pandemic after the pandemic. We know that people suffering from it experience a wide range of symptoms. Local health boards have protocols in place to provide some aid, but a much greater investment is needed in order to provide support in cases such as those of my constituents that I mentioned earlier. As well as providing health assistance, we must make sure that the social security network does not allow anyone suffering from long Covid to slip through, and I will finish on that point. I now call on Minister Marie Todd to respond to the debate around 7 Minutes. Thank you Presiding Officer, and I'm very pleased to respond to this debate on behalf of the Government. I hope to respond to many of the points that have been raised and set out the Scottish context, and again reiterate our commitment to supporting people with long Covid. International Long Covid Day tomorrow is an important opportunity to reflect on the impact that Covid-19 has had and continues to have on those adults and children who experience persisting symptoms. Those symptoms can vary considerably in their presentation and impact from person to person and can have significant effects right across many areas of life. I want to take an opportunity to pay tribute to our dedicated health and social care and third sector staff across Scotland who have been working tirelessly since the beginning of the pandemic to support people with long Covid. Unfortunately, as has been mentioned by many in the chamber, at present there are no broadly effective treatments for long Covid. The recommended approach in clinical guidance is to provide treatment where possible for specific symptoms or support to help people to manage them. This is being supported in Scotland through local primary care teams who will conduct tests to investigate symptoms to provide direct support or access to other services. They might also include the third sector community rehabilitation, mental health services and, for a smaller proportion of patients, further investigation of specific complications delivered in a specific specialty clinic or hospital setting. Alex Cole-Hamilton I am very grateful to the minister for giving way. That is what it says on the tin. That is what the Government has said for the best part of 18 months now, but it is not what is happening in real life. I said in my remarks that the Government is gaslighting victims and sufferers of long Covid by suggesting that there are treatment pathways that do not exist. What does the minister have to say to them? I am absolutely, I find it quite insulting that you are using that term in the chamber. There is no intention to gaslight patients. However, from listening to those who have been impacted by long Covid, it is very clear that healthcare support and services have not always met their expectations. We also know that finding the right support can be particularly challenging when people have multiple symptoms or a complex presentation. That is why this Government has established that £10 million long Covid support fund that aims to increase the capacity of existing services, supporting those with long Covid. One moment, it aims to develop those into more clearly defined local pathways and it aims to provide a more co-ordinated experience for those accessing support. Thank you very much and I am grateful to the minister for giving way. Research from SPICE has identified that £21.7 million in Barnett consequentials has come to the Scottish Government as a result of NHS England treatment for long Covid. Where is that money gone? I am sure that Jackie Baillie is aware that we spend more per head of population on health than any other UK Government. We have more GPs per head of population. Spending in Scotland is 10.6 per cent higher than England. I put to Jackie Baillie and others who have raised the point of services being better in England. RCGP Scotland's written response to the Covid-19 recovery committee inquiry on long Covid stated that we note that the English clinics have been hugely expensive for the number of patients treated and that most treatment involves rehabilitation and symptomatic care, so it does not differ significantly from what is in offer in Scotland other than it is significantly more expensive. Give me one moment to proceed. We have made an initial £3 million available to NHS boards and partners over this financial year and a further £3 million will be allocated over £23.24 million. The clinical guidelines, so all of you in this chamber, and I would presume that Dr Sandish Gilhane is already familiar with evidence-based guidelines, but the clinical guideline produced by Sine, NICE and the RCGP notes that one model for long Covid service organisation would not fit all areas. That is why we are supporting the NHS boards to develop those tailored models of care delivered by teams with knowledge and expertise of their local populations. For example, between May 22 and January this year, NHS Lanarkshire's long Covid rehabilitation pathway, as mentioned by my colleague Fulton MacGregor, has directed over 580 referrals. That pathway delivers a single point of access for assessment and co-ordinated support from services, including physiotherapy, occupational therapy, psychology, dietetics and speech and language therapy, depending on what is most appropriate for a person's needs. NHS Highland, where I live, which spans the largest geographical area of all of the Scottish health boards, covering 41 per cent of the country's landmass, has developed a long Covid pathway delivered by a virtual team quite rightly. That includes occupational therapy, physiotherapy and staffing to support assessment, rehabilitation and co-ordination. That pathway has had approximately 100 referrals since going live in September 22. I will give way. Brian Whittle. I am very grateful for the minister for giving way. Perhaps we have reflected in the fact that Ayrshire and Arn do not have any pathway for anybody with long Covid, except for those who work within the health board. You will be delighted to hear that six health boards have long Covid pathways up and running, NHS Greater Glasgow and Clyde and NHS Ayrshire and Arn have indicated that their pathways are expected to open later this month. Elsewhere, other boards are working extremely hard to conclude recruitment processes and have to find long Covid pathways in operation as soon as possible. We have established a national strategic network to ensure initiatives that are delivered by boards are robustly evaluated, helping to spread that best practice in learning as quickly and effectively as possible. However, there is still a great deal to be learned regarding long Covid, which is why we are contributing to the worldwide research effort to better understand the condition. Our chief scientist of us is funding nine research projects investigating the longer-term effects of Covid, totaling £2.5 million. Initial findings from a number of them have been published in peer review scientific journals. More broadly, our CSO research funding schemes are open and I have to be absolutely clear that applications on long Covid are welcome. Ventilation was mentioned earlier in the debate. We know that that can make an important contribution to reducing the risk of transmission. Expert advice from bodies, including SAGE and the Health and Safety Executive, indicates that air-cleaning and filtration devices such as HEPA filters are not a substitute for efforts to improve ventilation in order to mitigate against the risks of Covid. We are taking forward the recommendations of our ventilation short-life working group, which aims to raise awareness of the importance of ventilation, increase technical skills and improve air quality in buildings. Lastly, as I close presiding officer, it would be remiss of me not to recognise the work of the Covid-19 recovery committee and the work that it is currently undertaking and the wealth of information that it is amassed from academics, healthcare practitioners and, most importantly, people with lived experience of this condition. This is a brand new condition and yet in Scotland we have already done a great deal. We have issued national guidance, we supported research into the condition, we have established a fund to support the development of services, set up a national strategic network to ensure learning between NHS boards and the sharing of evidence into long Covid. I recognise that that would be no comfort to individuals who are suffering and who are finding it hard to navigate care, but it is really important that we are dealing with a condition that we are still learning about. All of that has been done within the context of an NHS under immense pressure as a result of the pandemic. There is one final thing that I want to correct before I close and I find myself obliged to correct just one of Alec Cole-Hamilton's inaccuracies and that is that this is actually the third time that this Parliament has debated long Covid. The last time we debated it was in May last year in Government time. The Government remains committed to drawing upon the best available insight and evidence to inform our evolving approach to supporting people with long Covid and we look forward to engaging with the Parliament on this issue. Thank you minister. That concludes the debate and I close this meeting.