 The final item of business is a member's business debate on motion 7890, in the name of Emma Harper, on where a hat day 2023 will be concluded without any questions being put, and I would ask those members who would wish to speak in the debate to please press the request to speak buttons, and I call on Emma Harper to open the debate up to seven minutes, please. Thank you, Presiding Officer. I am pleased to have the opportunity to lead this debate to raise awareness of brain tumours following the where a hat day on March 31. I thank members from across every party who have supported my motion, allowing the debate to go ahead, and I welcome the minister to our role, because I believe that this is her first member's debate that she's responded to. I also thank the brain tumour charity for its continued work to raise awareness of brain tumours in supporting those impacted by brain tumours and their families in raising vital funds for brain tumour research as well, and I applaud their campaign, the brain that is better safe than tumour, which aims to support the public in awareness of science and symptoms of brain tumours. I welcome Thomas Brafford from the Brain Tumour charity to the gallery this evening. Brain tumours are the largest killer by cancer of children and adults under the age of 40 in the UK, and brain tumours reduce life expectancy by an average of 20 years, which is the highest figure for any cancer that we currently know of. There are a number of brain tumour science and symptoms depending on the type of brain tumour and its location. My motion notes that there are more than 130 different types of tumour of the brain. Some symptoms may be very severe or may not be apparent at all. If you are experiencing science and symptoms that are concerning you, the first step would be to visit your GP to discuss those and they can advise further. Brain tumour symptoms can include headaches that are more severe in the morning and wake you in the night. They are usually different from headaches that you might have had previously and will be persistent and worse than with time. Weakness, loss of sensation or numbness is also a sign of pressure on our damage to a specific part of the brain and can also be manifested through walking unsteadily or lack of co-ordination, ataxia or muscle weakness on one side of the body, which is hemiparesis. Heating loss could be a sign of acoustic neuroma if it occurs only on one side. A speech difficulties may also include the loss of ability to write, speak or understand words. A person may have difficulty getting the words out, which is expressive dysphagia, or they might have difficulty articulating them, which is dysarthria. Other symptoms can include a lack of concentration, confusion, memory loss, disorientation, drowsiness and change in behaviour. While the cost of brain tumours is debated, research shows that certain genetic conditions predispose a person to overproduction of certain cells and exposure to some forms of radiation. In my time in the operating theatre in Los Angeles, I had the privilege of working with a neurosurgeon called Dr Keith Black. Keith Black is now the chair of neurosurgery at Cedars Eye and Eye Medical Centre, and that's where research does continue. He was a pioneer in developing the surgery that we now know as awake craniotomy for the removal of particular brain tumours that occur in the speech centre of the brain. There are some amazing awake craniotomy surgeries on YouTube for anybody that's no squeamish that wants to watch them for demonstrating how far we have come in developing advanced surgery techniques. Around 60 per cent of people diagnosed with a high-grade brain tumour will die within one year and only 19 per cent will survive for five years or more. Brain tumours are one of the four cancers with a 10-year survival rate of less than 15 per cent. My Auntie Jean was one and she didn't survive following a diagnosis of astrocytoma, and she wasn't even 50 years old. We must see this change, Presiding Officer. Early diagnosis remains a unique challenge for brain tumours, with estimates suggesting that up to 64 per cent of patients are diagnosed via an emergency department. That's quite a high number. We must acknowledge that the pandemic has seen many patients face disruption to their care, to clinics, to appointments and treatments such as surgery or chemotherapy. Although the NHS took extensive steps to keep cancer services running, we heard that in most areas in Scotland, surgery for those living with low-grade or less aggressive brain tumours were delayed. Of course, the pandemic continues to have a huge impact on all aspects of our NHS. However, I would like to raise some of the asks of the brain tumour charity. The charity asks the Scottish Government to ensure that everyone diagnosed can access support from a clinical nurse specialist or a key worker, regardless of their tumour type or where they live. For the Scottish Government, it is also asking to drive earlier diagnosis by committing to reducing the proportion of brain tumours diagnosed in the A&E, and by piloting a promising new blood test developed by researchers at the University of Strathclyde in Edinburgh in primary care across Scotland. As soon as possible, to explore its potential to triage those with possible symptoms. To accelerate the access of real-world data for Scottish brain tumour patients, cancer researchers and charities, including through Brian, which is a brain tumour charity's patient-led app. The brain tumour charity is also asking to ensure that brain tumour research and development of treatments and therapies is equitable to that of other cancers. Indeed, it is welcome that the First Minister has given a commitment to ensure that brain tumour detection is improved in Scotland to give people the best possible opportunity of recovery, including through fast-track diagnostic centres, including the one opened in Dumfries and Galloway in my South Scotland region in 2021. Finally, I want to touch on Alan and Annika Johnstone. Annika died on 18 November 2019 due to a short battle with glioblastoma, and I knew Annika. She was kind, caring and compassionate dietician within NHS Dumfries and Galloway. We worked together when I was a clinical educator. She gave me lots of advice for patients with complex dietary needs and she supported me as I was developing training for the nurses. Since she's passed, her husband Alan has raised over £57,000 for the brain tumour charity by walking 214 miles of the southern upland way, while I didn't think I'd be upset. In her memory, he's raised £57,000. That's a challenge that he said was tough, but it's one that, in his words, was easy to compile. Annika went through. His charity fundraising was invaluable for research and development. In closing, I look forward to colleagues speaking. I repeat my ask of the minister and thank Alan for his hugely important fundraising work and following his tragic loss. I also repeat the message from brain tumour research to be better than tumour and to ensure that symptoms are addressed urgently. Diagnose times and treatment of brain tumours have made leaps and bounds in recent years, thanks to incredible achievements in research. This debate gives us an important opportunity to recognise just how far life-saving treatment has progressed and to recognise and thank researchers, medical professionals, campaigners and volunteers for individual work in improving the lives of people affected by brain tumours and their families and loved ones. It's clear that the rigorous national campaign has been made the availability of its support possible, and while awareness of brain tumours is at an all-time high, we must continue to keep this vitally important campaign on the political agenda to build upon our recent achievements. Much has changed since the topic of brain tumours was last debated in this chamber in 2017. Our health landscape has changed dramatically, not least due to the pandemic, which saw charities and voluntary organisations experience a significant loss of income and are now struggling further due to the cost of living crisis. That's why it's critical for us to listen carefully to the policies and recommendations of charities, like brain tumour charity, as well as the lived experience of people affected by this complex disease. Although charities have been leading on the campaign, it's critical for Governments across the four nations to provide much-needed support by treating brain tumour research as a critical priority. Campaigners have been asking for more government support to build research capacity, and I'm delighted that Scotland continues to build its reputation as a hub of transformative world-class research into brain tumours, with institutions like the Brain Tumours Centre of Excellence at the University of Edinburgh leading away. I give my full backing to campaign calls for experts, researchers and charities, including, indeed, for more research funding and importance of early diagnosis. I was pleased to see a Government's announcement on the Scotland's new cancer strategy, which has a potential to be a major milestone for people affected by brain tumours. I have my full confidence that a minister under our new government will use the findings from a cancer strategy consultation to effectively inform the decision-making process. We cannot underestimate the importance of ensuring that the voices of experience of people affected by brain tumours are at the heart of a policy. So many of our constituents are impacted by cancer, and it's critical that we are at the centre of our approach going forward. The Scottish Parliament's Health, Social Care and Sports Committee, of which I am a member, recently concluded, enquiring into health inequalities in which we have heard evidence in health inequality not only contribute to the development of cancer, but also impacts what type of treatment a patient can access and the ability to access support overall. That is an important point raised constantly by the brain tumour charity. We have found that inequalities in brain tumour trials, due to poor health, as well as the cost of implications, present a barrier to patients entering clinical studies. It is absolutely essential that minorities and those living in deprived areas across Scotland are included in the clinical trials to better understand their experience of the current system and what improvements needed to be made. As a motion recognises, the side effects of brain tumour treatment can have a significant impact on persons' quality of life. I am incredibly proud of the array of services that are available across my constituency, including MAG's Fife and the Brain Tumour Charity Support Group, providing invaluable support to people affected by cancer, including people with brain tumours. The introduction of the three early cancer diagnostic centres in the Eshernan, Dumfries and Galloway and Fife to speed up cancer diagnosis are providing GPs with an alternative route to urgently refer patients and are picking up cancer earlier. Patients presenting with nonspecific symptoms can be more difficult to diagnose and some symptoms or combinations of symptoms can have a range of potential causes, not all of which are cancer. Where cancer is a cause, increased time taking to diagnose these patients can often result in poor outcomes. Figures up until October 2022 show that this initiative is working around 60 per cent of referrals going on to be diagnosed with cancer around 20 per cent referred into primary care for non-cancerally treatment. Getting referred for tests to check for cancer is the anxious time for patients and families. These centres provide a clinically safe and effective rapid service to rule out or rule in cancer. The Scottish Health Awards are the most prestigious and recognised awards for those working across NHS Scotland and its partners to deliver high quality healthcare and social care services to people in Scotland. I was pleased to see that NHS Fife's rapid cancer diagnostic service team shortlisted at last year's awards ceremony in the innovation category, much to serve recognition for all their work. In conclusion, changes cannot come soon enough in terms of better outcomes for people impacted by brain tumours and their loved ones. It is reassuring to hear from members across the chamber and to know that we united in shared vision to cure all types of brain tumours and to raise awareness for such an important cause. It is welcome that we have the time in the chamber this evening to discuss the impact of this disease and the importance of research into brain tumours in Scotland and across the UK. Indeed, as mentioned in the member's motion, brain tumours kill more children and adults under the age of 40 than any other cancer, with one in three people knowing someone impacted by a brain tumour. However, despite the prevalence and harrowing impact of this cancer, just 1 per cent of the national expenditure on cancer research has been committed to brain tumour research to this day. Brain tumour research, the charity behind Where I Had Day, is calling for an increase on that national research investment to £35 million per year so that work can continue to find a cure for all kinds of brain tumours. With 16,000 people diagnosed with a brain tumour each year across the UK, our approach to treatment and research must show ambition. I commend brain tumour research for its centre of excellence strategy, which is building capacity in pioneering research through four specialist centres across the UK. It is crucial that research into brain tumours is properly funded so that this valuable work can continue and we can continue to further develop research and treatment here in Scotland too, including building on that centre of excellence model such as at the Institute of Neurological Sciences in Glasgow, which was founded in 1966 and is scheduled for a major new redevelopment by NHS Greater in Glasgow in Clyde. Let's look at the opportunity that that proposed investment could have for transforming research into brain tumours in Scotland as well. Research into the treatment of the tumours is one important aspect of improving the options and support available to people living with brain tumours and other types of cancer. Another crucial aspect is the availability of psychological support for people and their families who have received a devastating cancer diagnosis. That cancer diagnosis is transformative in a deeply distressing way for any time in a person's life, but brain tumours in particular kill more children and young people than any other cancer. A diagnosis at a young age can come with its own unique concerns and challenges. At present, there are two specialist psychologists for young people with cancer in Scotland, in NHS Greater Glasgow in Clyde and NHS Grampian Health Board respectively. With 200 young people diagnosed with cancer every year in Scotland, there is simply not sufficient or equal access to specialist mental health support for patients across the country. I hope that the minister may address that point in her remarks to the chamber later. With 200 young people in that situation, the distress caused is absolutely appalling. Considering the unequal access to support in this context, it is important for us to recognise that as part of this debate, the wider inequalities around the prevalence and treatment of cancer that exist in Scotland. Recent Public Health Scotland data found that the overall risk of developing cancer was 30 per cent higher in the most deprived parts of the country than it was in the least deprived parts. We also know that the most recent data shows that almost one in three suspected people with cancer were not treated in line with Scottish Government's own two-month target in the final quarter of 2022. Indeed, the last time that 62 day target was met was 2012. It is abundantly clear, therefore, that access to support and treatment for people with cancer is not consistent or reliable. In her closing remarks, I would be grateful if the minister could outline her plans for funding brain cancer research for the future but also how she plans to tackle cancer inequalities of today so that everyone in Scotland has equal access to psychological support and treatment regardless of their postcode. I must apologise to Dr Gohani. I was out of my correct order of speakers, so I would now call Sannish Gohani and I would then call Beatrice Wishart, and I apologise also to Dr Gohani. Dr Gohani, up to four minutes please. Thank you, so Labour tried to take minutes earlier, they've managed to do it this time. Thank you Emma Harper for bringing this debate and also for your personal and passionate story. I did of course bring my best pink hat to wear today in chamber but sadly it's not allowed inside so I don't have it but I did show Emma my hat. Brain cancer is one of six common cancers with very poor survival rates and along with lung cancer, liver, esophagus, pancreas and stomach we call these the less survivable cancers as their average five year survival rate is just 16%. Over 9,000 people will be diagnosed with one of these cancers in Scotland each year in a quarter of all cases of diagnosis of cancer. These six cancers account for 40% of all cancer deaths claiming over 7,000 lives in Scotland annually and as a GP I might see up to two patients throughout my whole practising career to diagnose them with a brain tumour. Identifying these one or two patients early is really difficult and that's because early symptoms such as headaches or feeling sick can be really vague and they also have 10 or 20 different explanations. Sometimes patients present with convulsion but the vast vast majority of patients with headaches or epilepsy and they don't have a brain tumour. One of the first things you're taught as a GP is common things are common. In other words we shouldn't jump to brain tumour with a headache because it's more often than not a migraine or simply a headache. But this is of no comfort to those whose symptoms get worse, develop muscle weakness, have problems with balance, vision, hearing or speech. They might lose their sense of smell, become confused or suffer personality change and some may go on to be diagnosed with brain cancer but sadly it is often very late. I spoke to Heather Deary from AIR who went to her GP back in 2008 complaining of fainting chronic headaches and vision problems. Her GP diagnosed migraine then stressed she was a student at the time but a condition worsened and she was at her wits end and 18 months and five different GPs later she was referred to the ear nose and throat team. They found nothing wrong with the ear but thought an MRI would be prudent and that's when her tumour was found. Heather required emergency surgery to relieve pressure on her brain from the build up of fluid and 18 month wait from first presenting to her GP to diagnosis meant it was too late for any alternative treatment to surgery. That surgery came with side effects. It left her with facial paralysis, partial deafness, balance and visual issues, nerve damage, fatigue and muscle spasms. Heather suffers with pain constantly and also for the first three years after surgery Heather had very little in the way of peer support. She just didn't know where to turn yet she is amazing. Heather campaigns tirelessly as a patient advocate to raise awareness of brain cancer and earlier this month received an award for her efforts from the brain tumour charity. What can we learn from Heather's experience and from the experiences of countless others? I can think of an action that would make a difference. In primary care we really need a non-invasive test that flags up biomarkers for brain tumours. This would identify patients who may be at risk and require a referral for medical radiography. If a patient's symptoms persist, GP's are more likely to do blood tests than we are to do an MRI or CT scan given the pressure on radiological departments and most of us in primary care can't actually order and request a CT or MRI brain scan. Brain tumours kill more patients under the age of 40 than any other cancer and more children than leukemia. Brain tumours kill more women under 35 than breast cancer and kill more men under 70 than prostate cancer. We need to get real about research. I would request the Scottish Government to prioritise brain tumour and the other less survivable cancers as a clinical priority. We need a strategic plan for resourcing and funding discovery, translation and clinical research. We also need a robust system of tissue collection, which is in place for cell line isolation and biobanking. The Government should also ensure that access to clinical trials, which is key to developing new brain tumour therapies, is available. I refer members to my register of interest as a practicing NHS GP. I now call Beatrice Wishart to be followed by Jacintain Barth to four minutes please, Ms Wishart. Thank you, Presiding Officer, and thank you to Emma Harper for bringing this important debate to the chamber. I'd also like to thank all those colleagues who took part in the Wear a Hat Day photo call that was hosted for brain tumour research on 16 March and those who came along to the drop-in session afterwards. Raising awareness is so important. Members may be aware of a proposed cross-party group on brain tumours that Jim Fairlie and I hope to develop and I would encourage colleagues to join us. The group would bring together those with lived experience of brain tumours and key stakeholders to try and influence policy and research. We know that every year in Scotland around 1,000 people are diagnosed with brain tumours and sadly around 470 people die each year in Scotland from brain tumours. Brain tumour research is a cancer charity that I hold particularly close to my heart. One of my daughters, Louise, lives with a brain tumour and has done for several years. Following surgery, she continues to receive care and have regular check-ups and thank you to the NHS. Louise has suffered from migraines all her adult life. She'd presented to her GP for about a year with non-specific symptoms, including the sensation of something in her head when she was walking. Following what was thought was a particularly excruciating migraine, she ended up in hospital after a blue light trip to A&E. I thought she'd had a stroke. Eventually, after numerous scans and being flown by air ambulance to Aberdeen, she received the diagnosis of a low-grade brain tumour, a meningioma, which leads me to concerns about how much longer such a diagnosis might take today as the NHS recovery from Covid continues along with pressure on primary care and a shortage of GPs. Emma Harper's motion makes the point that some symptoms can mimic other equally serious conditions, making early diagnosis and treatment more difficult. As a family, we are only too well aware of how fortunate Louise is in comparison with too many other patients. Louise keeps up-to-date with news from the brain tumour research charity, and when she received notification about today's debate inviting people to contact their MSP, she emailed me to ask if she should email me. The manifesto from the charity, entitled Together We Will Find a Cure, calls on the Scottish Government to invest more in brain tumour research to find a cure, to improve patient experience and outcomes, to drive clinical trials in Scotland to bring new treatments from the bloratory bench to patients, provide clinicians in Scotland with more time to participate in research and to drive improvements in patient experience across NHS Scotland. At the Brain Tumour Research Centre of Excellence at the University of Plymouth, they are making progress in helping to diagnose meningiomas through a non-invasive blood test, and that would spare future patients having to undergo invasive surgery. It is that kind of research and clinical trials that could be undertaken in Scotland and would help to improve early diagnosis and find treatments for patients. There has been a historic underfunding of research into brain tumours, with just 1 per cent of the national spend on cancer research allocated to it. Let's work together to support the work of organisations like brain tumour research and brain tumour charities and close the care gap. I also welcome the opportunity to participate in this very important debate tonight and congratulate my friend and colleague Emma Harper for securing it. I also want to thank Emma Harper's constituent, Alan Johnstone, for the tremendous work that he has done to raise awareness of brain tumours and to fund research and development into treatment for them. As members have already indicated, brain tumours are the largest killer by cancer of children and adults under the age of 40 in the UK. Brain tumours reduce life expectancy by an average of 20 years, which is the highest figure for any cancer that we currently know of. I want to see all of those with a brain tumour have the best possible chance of survival and I'm therefore pleased to support where a hot day and the calls from the brain tumour charity, which has been outlined by my colleague already, Emma Harper. One in six respondents to the brain tumour charities improving brain tumour care survey last year had to wait more than six months to get a diagnosis after first seeing a healthcare professional about their symptoms, with one in ten waiting over a year to be diagnosed. While I absolutely acknowledge some of the reasons for this, not least the huge challenges still being felt in our NHS due to the pandemic, we do need to see early diagnosis and early access to treatment. People who display symptoms of a brain tumour should receive a definitive diagnosis as quickly as possible after first visiting a healthcare professional about their symptoms. Unfortunately, there will always be folk who go through accident and emergency to get diagnosis because there will always be folk whose very first symptom is a seizure or something major that requires emergency treatment. However, there are many things that can be done to help drive down the diagnosis times for the majority of folk who experience symptoms of a brain tumour in the future. Simply put, the main benefit of a faster diagnosis is that treatment, care and support can be provided to folk at the earliest opportunity, which could lead to folk living better lives after their diagnosis. I therefore welcome an update from the Minister and the Scottish Government's commitment to improve the time that it takes for brain tumour diagnosis and on when the fast-track cancer diagnosis centre in NHS Grampiwm will be fully operational. When it will report on its effectiveness. Our brain tumours have a very real human impact and I want to discuss the experience of one of my constituents, Suzanne Davis. Suzanne received her diagnosis of glioblastoma and I apologise if I have not pronounced that properly. Brain tumour in 2014 now works with brain tumour research after defying the odds of survival to raise awareness of the disease. She is a mum to two teenagers who were just four and seven when she received her diagnosis. After initially visiting her doctor after suffering from headaches and speech issues and being told that it could be down to her hay fever or stress, Suzanne visited another GP who sent her to the Aberdeen royal infirmary who gave her a CT scan and found a tumour the size of a golf ball. She underwent an awake craniotomy and the operating team successfully removed 95% of the tumour and she then underwent chemotherapy and radiotherapy. She now has an MRI scan every six months and the most recent scan in December last year was stable. In February this year, Suzanne walked 10,000 steps each day to raise funds for brain tumour research and raised a total of £706 and the original target was just £500. I thank Suzanne for all her efforts and wish her every success for the future. I welcome the debate and I thank Emma Harper for bringing it to the chamber tonight. Thank you, Presiding Officer. Were Hat Day is a brain tumour research flagship campaign and it is now in its 14-year. Over the years it has raised more than £2 million. It forms an integral part of brain tumour illness month. I thank my colleague Emma Harper for bringing this important issue to the Parliament today. I thank you for sharing your personal story. As I want to tell the chamber, one of my aunty who is in Turkey at the moment is getting a private treatment for a brain tumour. She is about 30-32 years old. It is also commend the great work of fundraisers. Every penny raised means more important research can be done bringing us closer to a cure. Historically, there has been a significant underfunding of research into brain tumour. In the past 12 years, brain tumour research has provided funding in excess of £15 million to early stage science. Since 2009, it has been doing tremendous work helping to develop the next generation of researchers through its centres of excellence and has campaigned tirelessly to improve the clinical outcome of brain tumour patients. However, more support still needs to be given. As my colleague Emma Harper's motion already mentioned, brain tumour kills more children and adults under the age of 40 than any other cancer. Yet, the national investment in brain tumour research still represents just 1% of brain tumour funding since record begins in 2002. For too long now, brain tumour has been low on the list of priorities. As a result, patients and families are let down. For change to happen, there need to be a strategic plan using joint-up thinking across the pathway of discovery. Translations and clinical research. Government department must start working together. It is crucial that scientists in Scotland are able to access further funding, including National Institute for Health and Care Research funding, in order for them to do their vital work. We must ensure adequate research is being done to make advancement in brain tumour treatment. More investment into treatment of brain tumour is urgently needed so that they can be developed and accelerated and the capacity of our medical research can be expanded. Finally, I would like to say a few words on the importance of Horizon Europe for brain tumour research and the wider research community. The UK Government recently published an independent review of the country's research and development landscape, in which it concluded that the Horizon Europe Association was essential. The review recommended that relationship with EU partners needed to be protected, maintained and expanded. The free exchange of researchers' idea and data with our closest research intensive neighbours is vital for UK wider research, development and innovation. It is vital that Scotland and the whole of the UK have full access to Horizon Europe, the world's largest collaborative research programme. By doing that, we can take great steps to finding cure for brain tumour. I am pleased to respond to the debate and give my first parliamentary speech as Minister for Public Health and Women's Health. Joining this ministerial team is an absolute honour and I am looking forward to working with stakeholders from across the portfolio, including members of this chamber. I would like to give my personal thanks to Emma Harper for bringing this motion to the chamber today. Thank you to all the colleagues who have shared such valuable contributions, highlighting the importance of brain tumour awareness month and some very personal stories. I would also like to welcome members of the brain tumour research into the chamber tonight. As Emma Harper mentioned, Alan Johnson, I would like to give him my heartfelt thanks for the selfless work that he has done to raise funds and important awareness of brain tumours after the tragic loss of his wife, Annika. I have brought a hat with me today. I promise that I won't wear it. I hope that the Presiding Officer will indulge me with this prop. The hat is from Callum's Cabin, an inspirational charity in my constituency on the Isle of Bute. The charity was set up by an inspirational family to support children who are undergoing cancer treatment and their families, and this touches on some of the points that Paul Sweeney raised in his contribution. Callum Spears passed away from an inoperable brain tumour on 16 February 2007, and his parents Duncan and Caroline and his twin sister Jenna started fundraising to fulfil Callum's dream to offer family holidays to children like him on his beloved Isle of Bute. Callum's Cabin now has holiday homes in three locations across Scotland where families can go and spend quality family time together making irreplaceable memories and recharging their batteries. There are also nine flats in Glasgow where families who have to spend a long time away from home when a child is enduring longer-term treatment at Glasgow's children's hospital can stay, a home away from home for families faced with such uncertainty. I'd like to compliment every single person that's contributed to this debate. This is one of the privileges of being elected MSPs to talk about and raise the importance of subjects such as brain tumour cancer. David Torrance spoke about the experience that needs to be taken account of. Sandish Gulhane again referenced research and also Heather's campaign. Paul Sweeney talked about the centre of excellence in research, and Beatrice Wishart again raised awareness with her powerfully personal story. Jackie Dunbar again talked about early-day diagnosis, and Foisal child rate again mentioned the importance of research. We know, as others have said, survival rates in some cancers have improved at much slower rates than others. For brain cancer, the difficult fact is that the five-year age standardised survival rate cannot be robustly estimated because the patient cohort is simply too small. For other more survivable cancers, the average five-year survival rate is 69 per cent. We know that the earlier cancer is diagnosed, the easier it is to treat. That is why we continue to invest in our detect cancer earlier programme. The programme takes a whole systems approach to early detection. It encompasses public awareness, primary care, screening, diagnostics and data. Since launch, positive shifts have been noted. However, the pandemic, as others have commented, has impacted on its progress. Diagnosing brain cancer can be challenging as symptoms are wide-ranging and can often be vague, as Dr Gulhane mentioned. Work is under way to update our get-checked early website with content on brain cancer to ensure possible symptoms are highlighted and the public reassured on next tests. We also launched a new public awareness campaign in March, be the early bird, with the aim of reducing fear of cancer and empowering those with possible symptoms to act early. We are also working to improve the pathways for patients once they have taken the all-important step of contacting their GP. In 2018, the detect cancer earlier programme funded a clinical refresh of eight pathways, including brain cancer, in the Scottish referral guidelines for suspected cancer. That revised guidance was published in January 2019, which supports primary care clinicians in ensuring those with suspected symptoms of cancer are put on the right pathway at the right time. More recently, we have established Scotland's first rapid cancer diagnostic services within existing NHS infrastructure. The first centres are operational in NHS Arran and Ayrshire, NHS Dumfries and Galloway and NHS Fife. They provide access to a new fast-track referral pathway for patients with non-specific symptoms suspicious of cancer. Two further services in NHS Lanarkshire and NHS Borders will be fully operational by June 2023, supported by more than £600,000 worth of investment. With regard to NHS Grampian, as my colleague Jackie Dunbar mentioned, they have not submitted a proposal, however, are working on a regional proposal that we expect to receive this financial year. The Scottish Cancer Network is also developing new national clinical management pathways. Those pathways have been developed in correlation with both health professionals and patients and set out best practice for a cancer patient's care. Initially, three of those have been developed, and given our focus on less-survivable cancers, one of those is for neurological cancers, including brain cancer. In addition to the work already underway, colleagues will be aware that we are developing a new ambitious 10-year cancer strategy to launch very shortly. The new strategy will continue to focus on those cancer types that have the poorest survival. It will take a comprehensive approach to improving patient pathways from prevention and diagnosis through to treatment and post-treatment care. Its vision will be supported by a three-year action plan and will include a commitment to clinically refresh the referral guidelines, including those for brain, and explore the role of decision making support tools in enabling early identification and appropriate onward referral. Paul Sweeney I thank the minister for giving me a welcome to her place in her new role in the Scottish Government, but I would also like to follow up on her point about investment, particularly in relation to the Institute for Neurological Sciences in Glasgow, which is an ageing facility and is long needed for replacement. I just wonder whether there could be an opportunity to build on that investment, particularly with the brain tumor research activities and potentially building that as another UK centre of excellence in this field. Paul Sweeney I thank Paul Sweeney for his kind words and his intervention. I would be very happy to meet Paul Sweeney later after the debate to discuss that and see if we can make any progress. Work to develop a new earlier cancer diagnosis vision in Scotland that will outline the future of the detect cancer early programme is also nearing completion. That vision will form part of a new cancer strategy. While it will focus on reducing later stage disease, it acknowledges that not all cancers have a formal staging system and that includes brain. Additional measures will be considered to monitor progress and improvement in those areas, including diagnoses via emergency presentations. We will continue to work with the less survivable cancer task force of which brain tumor charity is a member to develop practical and impactful actions to support the increased detection of those cancers. If I may, this April is also the first teenage and young adult cancer awareness month. We know that from 2010 to 2019 just over a quarter of the children and young people diagnosed with cancer had a cancer of the brain and or central nervous system. A cancer diagnosis is indescribably difficult for young people and their families to go through. We are committed to making sure that the necessary support for physical and mental health is available to all who need it when they need it. That is why the managed service network for children and young people with cancer was established. Government's commitment to improving services nationally and supporting a consistent approach to care and treatment across the country. In closing, I reiterate to members and those who are watching the debate the Scottish Government's enduring commitment to diagnosing brain tumors earlier for children, young people and adults. I thank all those who give their tireless energy towards raising awareness of brain tumors and for the work that we know must continue to be done to improve survival rates. You can find out more about the symptoms of brain cancer by visiting NHS reform website. If you or anyone you know are worried about those symptoms, please contact your local primary care service for help and advice. Together, we can close the deadly cancer gap and ensure that Scotland continues to lead progress for less survivable cancers. Thank you.