 The next item of business is a member's business debate on motion 9742 in the name of Richard Lockhead on world cancer day 2018. This debate will be concluded without any questions being put with those members who wish to speak in debate. Press the request to speak buttons now. I am going to say some of what I call Richard Lockhead to open the debate. I currently have nine members, as well as Richard Lockhead and the minister, to speak in this debate. This will require a motion without notice. I am reminded to accept a motion under rule 8.14.3 to extend the debate by up to 30 minutes. Can I invite Richard Lockhead to move that motion, please? The question is, will the debate be extended by up to 30 minutes? Are we agreed? That's agreed. I also say that I have to be very strict with members as the Parliament resumes at 2.15. We have crisp four-minute speeches. After all that, I now call Richard Lockhead to open the debate. Mr Lockhead, seven minutes, please. Sunday is world cancer day, which has taken place on 4 February each year since the year 2000. It was founded by the union of international cancer control that has over 950 organisations across 150 countries working to reduce the global cancer burden. Members in this country include Cancer Research UK, whom I wish to thank for the input to the debate. I also thank members for signing the motion and for being here for this debate today. Anyone who has not experienced cancer themselves will certainly know a loved one, friend or neighbour who has had cancer. A cancer diagnosis is devastating and daunting for those affected and their families. After being diagnosed with breast cancer, my wife described the feeling as a falling off a cliff and an experience that she doesn't expect to recover from, but then the treatment plan falls into place and you start to pick up the pieces of your fractured life. However, with tremendous support from the NHS and others, many people get through the experience of diagnosis and treatment. Even in the most difficult of times, there are of course moments of surrealism and humour. One of my abiding memories is my wife suddenly handing me the dog clippers that were lying around the kitchen and asking me to shave her head as she was fed up with the clumps of hair falling out as a result of chemotherapy. I can safely say that I had never thought I would see the day when my wife would ask me to shave her hair off with dog clippers of all things, and I can also safely say that I am not cut out to be a barber, but at least now today we can look back with a smile. I want to pay tribute to all the people and organisations who are there to help cancer sufferers and their families in their hour of need. Organisations such as Macmillan Cancer Support, which offers practical, emotional and financial support to many of the 220,000 Scots living with a diagnosis. Colleagues regularly table parliamentary motions, recognising efforts of individuals, groups and businesses that do remarkable things to fundraise for charities and research. In my constituency of Murray, we have many groups doing their bit, such as the Fabulous Children's Charity, Logan's Fund, which aims to try and win back some of the childhood loss to time in hospital. We have a new charity, Abby's Sparkle Foundation, established as a legacy to 15-year-old Abby Mayne, who left us on Christmas day after opening her presence along with her mum Tammie, dad Russell and brother Cameron. She held on for her favourite day of the year. Abby was truly remarkable and inspirational and continued to live life to the full, following her diagnosis at the age of 10. She sparkled and she spread sparkle to others. At the Pact service in Elgintown Hall this month to celebrate Abby, who is a talented and outgoing cheerleader, there was a performance by her friends in All Stars Cheer and Dance, and there was plenty of sparkle with singing by family and friends. Abby's mum, a family friend, told me how Abby named the charity, created the logo and said that she wanted to raise money for hospitals and stuff. The community is now rallying round, organising coffee mornings, soups and sweets and collections and sponsorships, and the Elgin academy is organising a talent show. I am delighted to report that more than £11,000 has already been raised to spread Abby's sparkle and help other children. Well done, Abby. It is a very difficult but powerful statistic that one in two of us will be diagnosed with cancer at some point in our lives. While cancer death rates have fallen by a fifth in the past 20 years, the number of cancer cases has increased. Many cancers are not preventable or curable, however four in ten cancers are preventable by not smoking, maintaining a healthy body weight, or not abusing alcohol, or eating more healthily and enjoying the sun safely. That is why the prevention agenda is so, so important. Scotland and this Parliament have led the way with the smoking ban and minimum unit pricing for alcohol. We must continue to deal with those challenges, especially when we read in today's news that alcohol is a factor in 3,700 deaths in one year, but we must now focus a lot more on food, especially if we are serious about being a good food nation as well as a healthy nation. Cancer Research UK quite rightly wants to raise awareness of the fact that obesity is the second biggest preventable cost of cancer after smoking. I welcome the consultation that closed this week's on proposals to tackle junk food advertising and action on food and healthy eating. I know that the Government alone cannot solve what is a very complex issue, and it is not just about the food that we eat. However, it is now time to act. Being overweight is linked to 13 types of cancer, including some of the most common cancers, such as breast and bowel. According to polling, only a quarter of Scottish adults are aware that being overweight would cause cancer, or could cause cancer. It is reported in today's press that people underestimate the level of obesity in Scotland, so those findings have to be a wake-up call. That is all against the backdrop of our rates of obesity being the worst in the UK and one of the worst in the OECD countries, with 65 per cent of adults and 29 per cent of children being overweight or obese. That does not just cost lives, it costs the NHS an estimated £600 million a year. Given the difficulties as a country that we have in achieving our dietary goals and saturated fat and sugar consumption or fruit and vegetables intake, it is quite clear that Parliament now needs to act. That is why it calls to tackle the issues that lead to overconsumption of unhealthy food and must be heeded if we are serious about improving our diets and reducing cancer rates. It is no wonder that polling is found at two-thirds of Scotland's support restrictions on multi-pi, multi-bi promotions, with 9 out of 10 parents believing that supermarket promotions impact on what we buy. 67 per cent of Scotland's adults are encouraged to buy more unhealthy foods, as they say, because of what multi-bi offers. That literally is a killer fact. I know that I am as guilty as anyone else when it comes to being tempted by multi-bi deals, and I take home more unhealthy foods than I intend to when I walk into the supermarket, when I leave the supermarket, and I am just as guilty as anyone else. According to Cancer Research UK, 110 tonnes of sugar that is equivalent to 4.3 million chocolate bars are purchased on promotions in this country every day of the week. Multi-bis are intended to persuade customers to spend more, but usually that means to eat more. Public Health England found that price promotions increase the amount of food and drink that we buy by a fifth. And let's not forget that that also contributes to the UK's food waste mountain as well. So given the challenges that we face as a nation, we need our retailers and industry to help, not hinder our efforts to tackle obesity and in turn cancer and other health issues. And World Cancer Day is a chance for all of us to reflect what we can do and to make a pledge and take action. The risk band that we are encouraged to wear today and the next few days for World Cancer Day on Sunday represents unity. So in closing, I hope that this Parliament and Government can unite on the compelling case for action and that the public can unite with us, the politicians and the private sector, including our retailers and food and drink industry, along with voluntary organisations and charities, can also unite around this agenda. If we can do that united, then I believe that we can fulfil the aspirations of the Scottish Government's cancer strategy, which says, beat cancer with ambition and action. Thank you. Thank you, Mr Lockhead. As I said earlier, I'm afraid that it has to be a strict four minutes in speeches. I call Tom Mason to be followed by Kenneth Gibson. Mr Mason, please. Thank you, Presiding Officer. I can take this opportunity to thank Richard Lockhead for bringing forward this motion to discuss something that, despite great work by healthcare professionals and the third sector, affects too many people across Scotland. Advances in technology and increased awareness mean that cancers can be detected much earlier than previously, and we see from survival rates that, for some, the disease is not death sentence it once was. Yet, as I know from my own experiences, for all the distance we have come, we have progress still to make. When I was treated for prostate cancer, where excellent progress has been made, everybody referred to my treatment as my journey. Presiding Officer, normal journeys can be an adventure, sometimes even exciting, and, eventually, most return to where they started. With cancer treatment, returning to the same place is not achievable. In my case, I'm not sure that I can call my journey exciting, but it certainly was an adventure, and I certainly did not return to where I started. There are always lifelon side effects, many of which can be unpleasant and debilitating. We must ensure that there is a good balance between treatment options in terms of the intrusive effects that they have on patients and the quality of life both physically and, most importantly, mentally. Deep clinical depression is sadly not unusual. I'm concerned that we have lost focus in this particular respect. In an ideal world, preventive action would ensure that such treatments are not needed in the first place. We already have referred to diet and smoking, and I think that this is a great avenue to explore. The upcoming diet and obesity strategy gives us a real opportunity to change lives and maybe save lives, so it is incumbent on all members to engage with that to determine our next steps. We need to make sure that such information is widespread as possible so that people can make informed, positive and healthy choices. However, it is also important to consider the scientific community in this debate. Sadly, all the lifestyle changes in the world wouldn't eradicate the disease in time, so it is vital that we support our scientists and researchers as they continue their commendable work. For example, this week, I attended a reception for Beyond Cancer Medicine, highlighting DNA mapping technologies. From the evidence on display, Scotland is very much in the forefront of the research, but we need to do more in the way of strategic planning to fix some fragmentations in current funding systems. I think that greater leadership on this issue would be a long way to realise what undoubtedly is potential. Finally, we must always remember the families that cancer affects. Behind every statistic is a story and often one of hardship and loss. We must endeavour to support them through those challenging days. The fight against cancer goes on and we have work still to do. Treating cancer will always be difficult journey, but it is one made up of many steps. Each will have its rewards and often disappointments. We only know which by moving forward one step at a time until we reach the end of the journey. I would like to take my thanks to Richard Lochhead for bringing this debate forward. I am much all-concerned on this very best for the world cancer day this week and on Sunday. I congratulate Richard Lochhead on bringing this important issue to Parliament today. Half the population will be diagnosed with cancer at some point in their life, and it may be safe to say that everyone in the chamber will have at least one personal connection to the disease. Indeed, my twin sister was diagnosed with breast cancer, very aggressive breast cancer, some eight years ago, and had to be operated on within 48 hours. She has since made a full recovery. Although significant progress continues to be made in cancer death rates in Scotland have fallen by a fifth over the last two decades, 87 people are diagnosed every day. As we mark world cancer day this Sunday, 4 February, it is important to consider what more can be done especially to prevent cancer. Cancer Research UK highlights that 40 per cent of cases could be prevented by positive action, including not smoking, eating a healthy balanced diet and maintaining a healthy body weight. As Richard Lochhead said, obesity is a single-base risk factor for cancer after smoking, being linked to 13 types in total. That includes some of the most common cancers, including breast and bowel, and some of the hardest to treat, such as pancreatic and esophageal. Yet only one in four Scots is aware that being overweight could put them at risk of cancer. That is particularly concerning. One considers that Scotland's levels of obesity are the worst in the UK and we are among the heaviest nations in Europe. In fact, only 35 per cent of Scottish adults are of a healthy weight, while 29 per cent of children in Scotland are overweight or obese. Therefore, it is vitally important that awareness is raised to emphasise that more can be done to reduce the preventable cancer instances in Scotland. Of course, Scotland has led the way on prevention in many areas, pioneering the smoking ban and minimum union pricing. Thanks to legislation-increased understanding and research, we have come a long way in the fact to reduce smoking, although there is still some way to go. Changes in attitudes since the smoking ban emphasised that altering societal behaviour is entirely possible, even in the short term. In the same way, we should rethink the way that we look at our diet. A healthier future, action and ambitions on diet, activity and healthy weight is the Scottish Government's strategy document that aims to reduce public harm associated with poor diet and the excessive consumption of food and drink, high in fat, salt and sugar, thereby reducing the risk of developing cancer among other conditions. A consultation on the strategy has recently been launched. In this year of young people, we must focus more than ever on giving children the best possible start in life. As such, the upcoming strategy represents a chance to introduce measures that will have a profound impact on our lives and those of future generations. After all, an obese child is five times more little to become an obese adult, placing them at further risk of preventable cancers. If current trends continue, rising numbers of overweight and obese adults could result in 670,000 avoidable cases of cancer across the UK over the next 20 years. As it stands, the future may not be the bright one that we hope for for young people, but it is fully within our power to change that. It is important to improve Scotland's health, regardless. Not every instance of cancer can be prevented through a change in diet and lifestyle. Genetics may play a part. In such cases, early detection is the intervention that is required to ensure successful treatment. We must therefore also stress the importance of screening programmes. Cervical screening saves around 5,000 lives in the UK each year, as in 75 per cent of cases, cervical cancer can be prevented if treated early enough. Similarly, bowel cancer, the third most common cancer in Scotland, is curable in its early stages. In fact, 9 out of 10 people survive the disease if detected and treated early. Cancer is the biggest killer worldwide, but research has helped to double survival rates in the last 40 years. Funds raised from World Cancer Day 2018 will help even more people to survive by supporting thousands of scientists, doctors and nurses to accelerate progress in the fight against over 200 cancers. Debates such as this raise awareness of how to reduce preventable cancers, helping those working with dedication to reduce the prevalence of cancer and to inform the lives of all those who are affected by it. I call Anas Sarwar to be followed by Tom Arthur. Thank you, Deputy Presiding Officer. I, like others, start by congratulating Richard Lochhead for bringing forward this important debate. I also put on record my thanks to all the organisations that are involved in cancer advocacy. Too many to name, but all doing an important job in raising awareness of cancer. Advocacy and lobbying of parliamentarians or of government being the support mechanism for those who may have been sadly diagnosed with cancer or those who are involved in fundraising or the research involved in trying to defeat cancer altogether. I want to repeat some of the statistics that were mentioned by Richard Lochhead just to emphasise the point. One in two people are diagnosed with cancer at some point in their lives. Almost 32,000 people are diagnosed with cancer every year. The shocking statistic that almost 40 per cent can be prevented if people make different life choices around alcohol, around diet, around activity and around safety in the sun. I reflect on conversations with my own constituents and one particularly close constituent of mine who I regard as a friend who lost his brother last year to cancer. He said that when someone gets cancer it is not an individual that suffers from cancer, it is a family that suffers from cancer. That is a really important point because all of us will be touched in cancer in different ways, either directly through individual diagnosis, through a direct relative or indeed a close family friend. That is why it is in our interest to take cancer head-on in an attempt to defeat it. We have rightly focused on smoking in the past and the impact that smoking has on the incidence of cancer. We have talked about the impact of alcohol and there is still so much more work to do around the impact of alcohol in terms of tackling cancer rates. Right now, we are focusing on obesity and I want to commit my party's focus to work closely with the Government to make sure that we can have a obesity strategy and policy framework in place so that we can challenge us head-on. I think that that needs to look at things that Richard Lochhead has mentioned around portion sizes, promotions, advertisement, availability and access of healthy foods, the responsibility that companies have on making sure that not just unhealthy foods are affordable but that healthy foods are affordable too and how we promote healthy foods amongst children in particular so that we can have a fundamental cultural change. Those are all challenges that we all need to focus on. In the past minute and a half that I have, there is clearly a link between inequality and diagnosis, inequality and treatment inequality and survival rates. How we can create that positive cancer pathway framework to give people the support that they need once they get cancer is extremely important. We have a good example of that in terms of the cancer journey that was a partnership arrangement between the health board and Glasgow City Council, and it would be interesting to hear from the minister how that cancer journey could be developed right across the whole of Scotland so that we can benefit communities across the country. We still have issues around the speed of diagnosis, pressures on our NHS, pressures on our workforce, how we can have speed of diagnosis and how we can then have speed of treatment, because there is clearly a link between diagnosis and treatment speed to survival. All I would say in closing is that this is something that goes beyond party politics. This is in our human interests and I will love Scotland to be at the forefront of defeating cancer so that we can be an example to the rest of the world too. Thank you very much. Mr Sarra, I call Tom Arthur to be followed by Alison Johnston. Mr Arthur, please. Thank you, Presiding Officer. I am grateful for the opportunity to speak in this debate. I would like to begin by thanking and congratulating my colleague Richard Lochhead on securing this important debate and also to recognise what I thought was an incredibly powerful contribution and to thank Richard Lochhead for sharing his personal experience. Often in politics, we can debate on things in the abstract and it is particularly with cancer to hear these very powerful human testimonies. Under scores, the job that we have in this place in representing our constituents and working to improve the outcomes for people who are diagnosed with cancer. It has been touched on the fantastic contribution that volunteers have made in charities and it was one individual that I would like to mention is my constituent, Sean McBain, who is originally from Tory, I believe, up in Aberdeenshire. Sean was diagnosed with cancer of the tongue when he was 20 years old and he successfully managed to go through treatment and to overcome and get to a stage where he is cancer-free, but for anyone that would be a particularly devastating and very frightening diagnosis to have. Last year, Sean raised, at my last count, over £4,000 for the Teenage Cancer Trust, because for a year, for every week, he wrote and recorded a song. I thought that that is a very powerful story illustrating someone to be diagnosed with cancer and then to get to a situation where they are raising thousands of pounds for the Teenage Cancer Trust. It is certainly an inspiration for me and I was very pleased to have the opportunity to recognise Sean in a parliamentary motion that I tabled last year. Two of the main themes that have come up are prevention and treatment. I would like to touch on treatment briefly, first of all. I had the privilege of hosting a round table in Parliament earlier this week beyond the cancer medicine that Tom Mason made reference to. It was a very powerful set of presentations. Indeed, we often have debates about the NHS in this place, but some of the work that has gone on in our hospitals is absolutely world-leading, cutting-edge. To hear from the clinicians and oncologists first-hand, some of the work that has been done in mapping, in data pathways and in diagnostics is really incredible, but there was a particular example that I found very compelling. That was the use of car-tea cell therapy. If I recall correctly, the way in which the work is an immunotherapy harnessing the body's immune system so that the body itself can overcome and defeat the cancer. The way that it works, as I understood it in this particular instance, was taking a modified HIV virus which then allowed the car-tea cells in the immune system once it was introduced to recognise the cancer cells that it was not previously able to do and to destroy them. It triggers an incredibly powerful immune response. It is not a therapy that can ultimately require people to be intensive care, but it can also have incredible results. However, I thought that there was something incredibly powerful in that. If we think about where we were with HIV diagnoses 20 or 30 years ago, and now it is a condition that has become a chronic, manageable health condition, and we are now using the HIV virus to defeat cancer, I think that that is an incredible story and testament to the incredible work that our researchers and clinicians do. The final point that I would make is on prevention that has already been touched on. We have the problems of an obesity-genic society, and as members recognise, we are all guilty of milltie buys. We are all guilty of not necessarily taking enough care of ourselves. The points that Annas Sarwar made about inequality are very important. I think that there is a relationship with fair work, because when people are low-paid and unstable work, they are more liable to poorer qualities of food, and they also have irregular eating times as well, which can all contribute to that. However, I just want to again commend Richard Lochhead for bringing his debate to the chamber. Thank you very much. I call Alison Johnstone to be followed by Alec Cole-Hamilton, Ms Johnstone, please. Thank you, Deputy Presiding Officer. I, too, would like to thank Richard Lochhead for bringing his debate to the chamber, marking world cancer day. For stressing the rule that the new diet and obesity strategy could play in preventing cases of cancer, I think that it is fair to say that, over the past few years, a great deal of work has been done in this Parliament and beyond to raise awareness of the links between cancer and obesity, and today I will reiterate the Scottish Green support for strong regulatory measures to tackle our obesity-genic environment, including restricting irresponsible price promotions on very unhealthy foods and limiting advertising. Those necessary steps were proposed in our 2016 manifesto, and I really welcome the cross-party consensus on many of those issues. Recently, the mayor of London has taken the decision to ban fast food takeaways from opening within 400 metres of schools. I believe that we need to see similar action here in Scotland. Many local authorities have struggled to put licensing restrictions in place, and I would be glad to hear how the Government plans to support them through a review of Scottish planning policy. We need to help schools and local authorities to create healthier environments for our young people now, urgently. Last year, I addressed a range of people in education and school food provision at a conference that was focused on improving school meals, and I heard how frustrated some of the people involved are when they work really hard to improve the quality of food in school, only for pupils to choose cheap fast food from a nearby takeaway. Developing a truly healthier environment is crucial, including, obviously, more opportunities for our young people to be active during the day, walking and cycling safely. Many other factors underlie levels of obesity in Scotland. Last week, Gail Ross led a timely debate on adverse childhood experiences. Preparing for that debate, I looked back at some of the original research from the US on the impact of adverse events in early life. Researchers identified a significant relationship between adverse childhood experiences and obesity. We heard more this week in health committee from witnesses on this very issue. Dr Vincent Follity came to the conclusion that, for many people, some kind of trauma marks a starting path to obesity. Clearly, there are many pathways to obesity, and I am not, for a minute, suggesting that that is relevant to all obese people. Two thirds of people in Scotland are overweight, and everyone is different. However, there is evidence that chronic stress has a long-term impact on people's general physical health. In some cases, that may include people's weight. Tom Arthur made the point about those on low income with irregular work. I wonder whether we need to develop a more psychologically informed to weight management, too, as we have done for other targeted health interventions. I would be interested in how the diet and obesity strategy will engage with the emotional and psychological aspects of obesity, as well as its impact on our physical health. I think that a key challenge here is for public health professionals to find a way to deliver public health messages that address damaging patterns without stigmatising people's weight, because stigma only damages people's health. In many cases, it makes people less likely to seek help and support. Some research from the US indicates that obese women are less likely to attend age-appropriate cancer screenings, so none of us wants anyone to face additional barriers to diagnosis. I would be glad if the minister could pick up on that issue of stigma and speak about how our NHS is able to support all people who want to lose weight. The Government's cancer strategy states that occupational exposure to cancer-causing chemicals is responsible for nearly 4 per cent of cases in the UK. Of course, occupational health and safety is reserved, but I would like to know what action we could be taking here. Of course, the strategy does not touch on the impact of everyday exposure to environmental pollutants, and there is evidence linking exposure to hormone-disrupting chemicals, carcinogens and other substances. I am closing now, but I would like to point out that, again, this February, I am taking part in sugar-free. It is an initiative. You can go on and find it online. I did it last year, and I am hoping that this year it might be a little easier, but it is well worth doing. Thank you very much. Well done to let me know that you were closing. You saw the look in my face. Alex Cole-Hamilton followed by David Torrance, Mr Cole-Hamilton, please. Thank you, Deputy Presiding Officer. I begin by adding my thanks to Richard Lockhead for bringing this very important debate to the chamber this afternoon. I wish Alison Johnstone all the best for that desperate challenge of sugar-free February. In the teeth of the First World War, Wilfred Owen described the mechanised slaughter of places like Passchendale and the Somme as being obscene as cancer. I have always been struck by that description of the disease. Cancer is obscene. It is indiscriminate. It hides sometimes in plain sight. As we have heard, it devastates families and friends. Our policy response needs to capture every aspect of the cancer journey that people experience. It needs to tackle causes and prevention. It needs to look at treatment. It also needs to cover research and, indeed, patient choice, particularly around end-of-life care. If we think about that policy response, it really has to begin with prevention. As we have heard in several excellent contributions this afternoon, 40 per cent of cancers could be prevented if we take appropriate lifestyle choices. The chamber has taken public policy decisions that are shaping lifestyle choices around the smoking ban and, more recently, the extension of that ban to smoking in cars, which was originally brought in by my friend and colleague Jim Hume, in the minimum unit price thing for alcohol, which, when it starts to bed, we will see a marked difference in alcohol-related cancers. It is an obesity that we have the most to do. A lot of members have touched on that, not least Alison Johnstone. 65 per cent of adults in this country are overweight and that costs us £4.6 billion makes this a national health crisis. Early diagnosis is also key. We could give those 31,000 people who are diagnosed with cancer every year a fighting chance if we caught it early. However, we see stigma around particularly things like cervical screening and the embarrassment that is related to it as an inhibitor of getting people that critical early diagnosis. Access to treatment is important as well. I think that the tone of this debate is not such that I would make hay with cancer treatment waiting times, but they are unacceptably long. However, there are elements of good practice out there as well. I point to the health boards that regularly capture the reasons for missed waiting time targets and then decide mitigating strategies about how to stop such delays happening again. I would like to see that rolled out across each of our 14 territorial health boards. Research is vital, absolutely vital. In the summer recess, Alison Johnstone and others and I went to the Cancer Research UK research centre at the western general in Edinburgh and absolutely astonished by the research going on there. However, I was really struck by the fact that the vast majority of research fellows at that institution were from European countries outside of the United Kingdom. That obviously underscores the impact of Brexit that that could possibly have. I want to close my remarks by focusing on end-of-life care, because I think that that is a really important dimension to this debate. I visited just on Friday, in fact, at the Marie Curie hospice, and I was struck by the compassion and dignity that is afforded to the patients who receive exemplary care in those very difficult final days of life. It ties very much, I think, into that philosophy—that new way of thinking that was brought in by Catherine Calderwood, the chief medical officer around realistic medicine—that when credited with the facts about your condition, people make grown-up choices about the decisions that they need to take in terms of end-of-life care. That speaks to my values as a liberal about offering choice in the end. I think that we need to do more to extend that choice and identify a humane and dignified way for people to exit this life in a way that we perhaps do not currently do. All of those people in Marie Curie, in the research and in the care that our patients receive in oncology departments around the country deserve the thanks of a grateful nation. Cancer is obscene, but by unifying as we are to doing this afternoon, we stand a greater chance of making sure that it is not the scourge of our society that it currently is right now. Thank you very much. I call David Torrance, who is followed by Alexander Burnett. Mr Torrance, please. Thank you, Presiding Officer. I would like to take this opportunity to thank Richard Lockhead for securing this debate in Parliament today to mark world cancer day. On 4 February, we must join the world in uniting to fight against cancer, the biggest killer worldwide. In 2013, 32,000 people in Scotland were diagnosed with cancer. Mr Lockhead was sent an increase of 12 per cent in 10 years. Day estimates that a number will increase to 40,000 a year by 2027. That means that 110 people are being diagnosed every day. Cancer can affect every person and produces a great burden on patients, families and society. However, in line with the aims of world cancer day, it is important that we recognise that many of the cancer related deaths can be avoided. There is a huge amount of funding going into research regarding the link between lifestyles, behaviours and cancer. Smoking, obesity, diet and physical activity are the most well known. Two thirds of Scotland's population has excess body weight and are physically inactive. As a result of instances of bowel cancer, they are higher than in any other European country. There are several preventive steps that we can take to detect cancer early programme and set out ambitious programmes, recommending improved informed consent and participating in national cancer screening, working with GPs and promoting referral and efficient use of NHS resources. The overall picture is generally positive. Cancer mortality rates have reduced over the last 10 years. Over the last 20 years, we have seen improvements in the survival of almost all cancers. However, we face a great societal problem. It is well known that health inequalities are a result of underlying inequalities in relationships to power, money and resources. That affects the opportunities that are available for good quality jobs, education and living standards. As a result, individual life experiences can have a great impact on a healthy life. Recent evidence has shown that cancer is the most prevalent and the most disadvantaged areas in Scotland, since it has been 30 per cent to 50 per cent higher. It is especially high for people who are doing the ages of 45 and 74 living areas of deprivation, where they are most likely to die of cancer. It is imperative that we close the gap by developing methods of effectively meeting deprived communities' needs, promoting health information, addressing lifestyle changes such as smoking, undertaking research that explores how social demographic and social economic information is collected within local health services, and seeking behavioural change. Relationship between deprivation and cancer is extremely complicated, but there are some clear differences. In 2005, 29 per cent of adults in manual occupations were smokers, compared to just 19 per cent of those in non-manual occupations. The result showed that premature deaths from lung cancer among unskilled workers is five times higher. I am proud that the services that are available in Cercodi and wider Fife area are special for those who are relating to providing support with people who have been diagnosed. Maggie's Fife provides practical support by educating people and managing stress, encouraging exercise of hair loss support, to name just a few. Her cancer support specialists are adequately trained in providing patients and families with inspiration as they run workshops on how to better understand cancer and treatment and taking on active role in recovery. It is crucial not just to promote prevention of cancer but also to make sure that initiatives are in place for those currently diagnosed, providing them with warm and welcome spaces, talking to children about cancer and returning to work and everyday life after treatment. While we have made progress, cancer remains to be the main clinical priority of the Scottish Government. We will continue to work in partnership with NHS Scotland, Cancer Research UK and Better Cancer Care, whose leading research has facilitated better policymaking. Based on the recommendations, we are able to make better decisions and to set out key priorities to make and mark differences of what is affected by cancer. In conclusion, I would like to welcome the recognition of world cancer day and will continue to raise awareness of the issue both inside and outside this chamber. Thank you very much, Mr Torrance. I call Alexander Burnett, followed by Emma Harper. Thank you, Deputy Presiding Officer, and I join everyone else today in congratulating Richard Lockhead for achieving cross-party support and bringing this debate marking world cancer day 2018 to the chamber. As we have heard from all the speakers today, everyone in this chamber has been affected by the hardships of cancer, whether it was first-hand or by seeing someone else go through it. Cancer will be diagnosed in one in two people during their lives. Cancer does not discriminate and anyone can get it, regardless of their age, gender, background, race or circumstances. But almost 40 per cent of cancer cases can be prevented through early detection and by preventative precautions. I would like to take this opportunity to focus on the impact that prevention can have with cancer, as was pointed out and following the theme of Alex Cole-Hamilton. If we, as elected members, should achieve anything today in this debate, it is to raise awareness of the already well-known fact that prevention is key. Everyone should take positive action within their lives to help to minimise their chances of getting cancer. The education of children is the best way to keep them safe and healthy and will help future generations to avoid the risk of getting cancer. Tobacco is the largest cause of cancer. It is linked with as many as eight different types of cancer and 19 per cent of all cases in the UK. For tobacco users, the best step is for them to seek advice from medical professionals about how to quit using tobacco and to set a good example for the younger generations. On that note, I am pleased to say that it has been over a year since I gave up smoking. For people who are not tobacco users, the most preventable cause of cancer that they can fight is obesity. An estimated 9 per cent of cancer cases are caused by poor diet and little exercise. The introduction of a healthy diet, including fruits and vegetables, and the maintenance of a healthy body weight is one of the best prevention. Skin cancer is the most common type of cancer and is easily the most prevented. Taking the right precautions to stay safe while in the sun, self-checks, regular doctor visits and cancer screenings will all help to cut down cases and keep you up to date on cancer prevention methods. Education on prevention measures is the best way to overcome this horrible disease. It has such a negative impact on so many lives, taking steps to help prevent it. It is well worth the change in lifestyle. Many of us I know take on interns and I asked one, currently with me, to help with the research of this debate. She had a personal story that she agreed to share with us. When I was younger, my mother had breast cancer. I remember being very afraid of it, getting it as I grew up. I have a higher risk of getting breast cancer because both my mother and grandmother had it. Unfortunately, my paternal grandmother also recently passed away from colon cancer. I practice prevention measures to minimise my chances of getting cancer because I know of a hardship that goes hand in hand with it. Although her personal story has so much sadness, there is a huge positive in that it is great to see that the meaning of prevention is getting through to the next generation. For that, we must be hopeful. Thank you very much. I call Emma Harper to be followed by Liam McArthur. Mr McArthur will be the last speaker in the open debate. Ms Harper, please. First of all, I congratulate my colleague Richard Lochhead on securing this important debate. I will wear my unity wristband to raise awareness ahead of our February 4, which is Sunday. I would like to remind members that my register of interest reflects that I am a nurse. I have worked in the operating room in post anesthesia care with patients undergoing treatment for a variety of cancer surgeries from face biology and, of course, breast cancer, from which my wee sister is on a positive path. Richard Lochhead's motion mentions positive actions such as not smoking. Here in Parliament, I convene the cross-party group on lung health. That involves working closely with the British Lung Foundation and Chest Heart Stroke Scotland, who do important work, encouraging smoking cessation as part of the fight against lung cancer. Lung cancer accounts for one in 16 of all deaths across the UK and more than one in five of all cancer deaths, so quitting smoking is the single most effective means of reducing risk for lung cancer. If there is anyone out there that still smokes, I would tell you to stop now, please. I would also like to pay homage to the many cancer charities and organisations that help to raise awareness and support people also. Cancer impacts all of us, and I would like to focus on one specific challenge facing many of my constituents who have been diagnosed. I was contacted by constituents raising concerns about cancer pathways in the south west of the region soon after I was elected to the south Scotland region. In Scotland, services to rural areas are organised using cancer pathways or managed clinical networks, MCNs. Unfortunately, some of those organisational networks have been structured so that referral hospital is not the nearest cancer centre to the patient's home. I accept that. In Wigtonshire and Stranraer, there are serious concerns surrounding the distances that some people are required to travel in order to receive treatment, including radiotherapy and chemotherapy. NHS Dumfries and Galloway is connected with NHS Lothian as part of breast and prostate MCN care pathways. That means that transport of patients in the south west postcode DG9 to Edinburgh means many, many hours of travelling for every journey. More than 300 miles is around trip. That is 300 miles when you are nauseated, unwell and potentially exhausted. I made contact with NHS DNG health board in an attempt to seek clarification on the pathways as they assure me that pathways are being revised. I know that cancer pathways are complex depending on what type of cancer is being treated and that patients need to be able to attend where optimal treatment will work best. I really feel for the patients in Wigtonshire who have to travel the extra distance. I have been informed verbally that the pathways are changing, so I would like to ask the minister if she could help me to engage with NHS leadership in DNG so that she can help to inform me about the best up-to-date pathways and processes so that I can help to communicate with the constituents in the south west. My goal is to work with NHS Dumfries and Galloway and to help to support the patients as well. Alex Cole-Hamilton spoke of the cancer journey. My concern is for the actual journey of travel for treatment and I would ask for support again for this from the minister. I am raising those concerns so that my constituents know that I support them in the best outcomes. Again, I thank Richard Lochhead for securing this debate and sharing his personal experience ahead of world cancer day, which is Sunday, February 4. Thank you very much. I call Liam McArthur, the last speaker, then we move to the minister. Thank you very much. I also then my thanks and congratulate Richard Lochhead. Not just on securing the debate but I think the very eloquent way he drew on his and his wife Fiona's direct experience to set the scene so powerfully. Debates like this always benefit from people from MSPs being able to draw on personal insights. Given the prevalence of cancer, it is no surprise that this fascinating debate has benefited in that way. The figures that everybody is referred to are truly staggering—whatever progress we have made in terms of diagnosis, treatment and care over recent decades—and the progress has been highly impressive. Research in Scotland continues to be world-class, as my colleague Alex Cole-Hamilton pointed out. Nevertheless, the challenges that we face remain immense. It bears repeating that one in two people will be diagnosed with cancer at some point in their lives. Well over 31,000 are diagnosed each year in Scotland alone yet 40 per cent of all cancers could be prevented, not by some medical breakthrough as yet unknown, but through changes in diet, lifestyle, increased physical exercise, decreased alcohol consumption and cutting out smoking altogether. Others have covered very well the steps that we can take collectively to help to encourage and support the shifts in behaviour that we need to see. In the short time available to me this afternoon, I simply want to highlight some of the excellent work that is done by those who support individuals who are affected by cancer. I know that they exist in every community across the country and I pay tribute to them all, but I want to draw particular attention to the work of Clann in my constituency. As well as operating the Clann house, a first-class facility and absolute godsend for those from the Northern Isles who require to be an Aberdeen for specialist treatment. Clann is also highly active in Orkney. The local group, led by the incomparable Karen Scott, do fantastic work in raising funds for and awareness of cancer, but they also do so much more to support not just cancer sufferers, but their families, their friends, their work colleagues, and I think that this was a point very well made by Anas Sarwar about the wider impacts of cancer. Over the last five years, Clann cancer support in Orkney has run a fortnightly health walk, offering exercise and companionship. Nutrition workshops encourage a better approach to diet to help to reduce stress. There are regular yoga and meditation groups, as well as relaxing crafts and art groups. Complementary therapies, including reflexology, reche, secom, and shiatsu, are available on clinical hypnotherapists who work with individuals to identify coping strategies to help them through what others have referred to as the cancer journey. Given the vital importance of peer support, there is a monthly period leather and a twice-monthly women's group for women who have or have had a cancer diagnosis, and a men's group is similarly facilitated. My father had a cancer diagnosis a few years ago. I know the support that he received from Clann, including somewhere to stay in Kirkwall on route between home in Sandy, and treatment in Aberdeen, was utterly invaluable. Clann helped to provide reassurance and reduce stress at what was a particularly anxious time for him and the rest of the family. For that alone, I am grateful beyond words. However, I know that Clann is doing day in and day out for so many people in Orkney and Shetland who are affected by cancer. I thank Richard Lockhead for bringing this debate to Parliament and for allowing me to put on record my gratitude to Clann and all those who provide similar support across the country. I now call Aileen Campbell to close with the Government Minister seven minutes, please. I also thank Richard Lockhead for securing this important debate. Richard spoke about cancer and so did Anna Sarwar about being something that we can all be impacted by. I certainly pay tribute to Richard for his candid address describing the brutal impact of a cancer diagnosis and what that can mean, and the way in which he described how his wife felt about a cancer diagnosis feeling like falling off a cliff. I also want to thank him for telling us as well about Abbey, clearly a special lass whose legacy of sparkle and of raising money to make life better for the others is truly inspiring. Similarly, many other members—Alexander Burnett, Kenny Gibson, David Torrance and Tom Arthur—who described the inspiring work of young Sean, also made powerful and personal and emotional testimonies, and for that I am very grateful. Also, Liam McArthur spoke about the fantastic work, phenomenal work that Clann does. I know from my own Shetland connections of the impact that it can have, the transformative impact, the very special place that it plays in many people's hearts in the Northern Isles and how much phenomenal fundraising goes on to support that. I also like the idea of that P.D. Blether. I want to highlight a really innovative bit of work that a young woman in my constituency is doing. She is offering free facials for people who go for their smears as well, so there are lots of really innovative exciting things that people are doing, recognising the need for us to embrace that preventative approach to tackling cancer. It is fitting that we should have this debate in the build-up to world cancer day, a day intended to target misinformation, raise awareness and tackle the stigma that is so often associated with cancer. All those things are important for those who are currently affected by cancer, but also crucially to help to reduce the number of people from developing cancer in the first place. I echo Richard Lochhead's call for our fellow members of Parliament to wear the unity band, which I am pleased to be wearing today. It is a sign of support and solidarity and also helps to raise crucial funds for the work of Cancer Research UK. I echo Richard Lochhead's calls for unity that we need to tackle many of the issues that are identified in his address and others this afternoon, a unity of purpose to get our nation healthy and to prevent the devastation of this disease. The Scottish Government is determined to play its part in tackling cancer and current projections produced by Cancer Research UK tell us that, one in two people in the UK born after 1960 will be affected by cancer. We need to work to reduce those figures over time and, in addition, ensure that the support is in place to help those who are affected by the disease. We recognise that significant progress has been made over the last 10 years, with the overall cancer mortality rates having fallen by 11 per cent. However, we also recognise that more needs to be done to reduce the risk factors associated with cancer. That is why our £100 million cancer strategy, Beating Cancer, Ambition and Action, sets out our ambitions for the future of cancer services in Scotland, improving the prevention, detection, diagnosis and treatment and aftercare of all those affected by cancer. We also recognise the need to turn that ambition into reality. As Richard Lochhead notes in his motion, smoking is the largest preventable cause of cancer that we know of. Our efforts on smoking rates have been bold and remarkable progress has been made today, illustrating that when we take an ambitious Scottish approach, regardless of the political party that is championing that, we can ensure that there are real intangible improvements. Just one in five adults in Scotland now smoke and the number of 15-year-olds who smoke regularly has dropped by more than two thirds in the last decade to be the lowest levels since surveys began. I am glad that Alexander Burnett is one of those who have stopped smoking to contribute to those statistics. That is very welcome progress towards achieving the goal of being tobacco 3 by 2034. Similarly, this Government has shown boldness around tackling Scotland's relationship with alcohol. Today's report from NHS Health Scotland, The Burden of Disease, shows exactly why that effort must continue. It is also right that a large focus of today's debate is on diet and obesity. Due to the cost to our NHS, the cost to our economy and most importantly of all the human cost of poor health and wellbeing that is caused by obesity. Like Alison Johnstone and Anna Sarwar, I am appreciative of the clear consensus across the parties in recognising the need to take bold action on that. Over the past 15 years, progress towards meeting our national dietary goals has remained stubbornly challenging. Recent Scottish health survey figures show that, in Scotland, two thirds of us are overweight or obese and one in five children are at risk of being overweight or obese. Of great concern is that this particular health problem is more marked in our most deprived areas where the obesity rates for children can be substantially higher. As others have noted, excess weight is directly linked to a number of different types of cancer, including bowel cancer and breast cancer, which are two of the most common types. While I recognise and recognise that Alec Cole-Hamilton describes cancer as being indiscriminate, unfortunately we do know that inequality exacerbates poor health outcomes and means that we need to do what we can to prevent that happening. Cancer Research UK predicts that, if current trends continue, the rising levels of obesity could result in 670,000 avoidable cases of cancer in the next 20 years. It is a challenge that we need to tackle head-on. In response, we have committed to tackling the issue, which is why we published a bold plan for improving diet weight and activity for Scotland. That consultation has recently closed and I am grateful to everyone who contributed to that. A growing body of evidence points to the action that we must take to make a real and tangible difference to people's lives, communities and the country as a whole. I am grateful to Obesity Action Scotland, Cancer Research UK and others for their important work in that area. It has set the scene with evidence and authority about what we need to do. Richard Lochhead spoke about us needing to take the chance to reflect, as we have legislated, on a good food nation what that means. We need to pause and make sure that we ensure that that approach that we are taking in Government around the good food nation chimes with approaches that we are taking in our diet and obesity strategy. We need to improve the food environment because it is one of the biggest changes that we need to see in Scotland to help us tackle obesity. The reality is that many of us find it very challenging to make healthy choices in an environment in which food and drink is high in fat, salt and sugar is cheap, widely available and heavily promoted. The odds are stacked against most shoppers. We have data showing that 35 per cent of all food and drink purchases in Scotland is on price promotion. That is double that of Germany, France and Spain. We know that high fat salt and sugar food is far more likely to be brought on promotion compared to those healthy alternatives. Therefore, consistent with our programme for government, the new strategy proposes action to restrict the promotion of food that is high in fat, salt and sugar. However, there is always more that we can do, and we will do, to protect children from exposure to junk food advertising. That is why it is disappointing that the UK Government did not take the opportunity to extend current restrictions on broadcast advertising before the 9pm watershed. However, I reiterate and underscore that the appreciation of the cross-party support in this chamber is to engage with MSPs regarding their views on what we do in Scotland. Further points, Presiding Officer. I want to make very briefly Anna Sarwar commented the work of the Improving Cancer Journey initiative. I can confirm that, within the cancer strategy, consideration has been given to this and the learning that we can get from that. Emma Harper also, I want to thank her for outlining the challenges of rurality for some of her constituents in her area. Again, I am happy to facilitate dialogue between herself, myself and NHS Dumfries and Garrelwy. Furthermore, I want to point out the contribution from Tom Mason, who I think articulated the need for furthering the CMO's approach, which is realistic medicine. That person centred engaging and properly recognising and listening to what people are telling him. That was a point that Alex Cole-Hamilton made in his remarks. In conclusion, Presiding Officer, I want to take time to thank everybody who has taken part in this important debate. The Parliament is best when it works together across those political boundaries united by a desire to create a better Scotland for us all. Regardless of the bumps that we will know that are encountered along the way on this journey, if we succeed, then we stand to gain the biggest prize, a healthier, happier and fairer Scotland. Thank you. That concludes the debate. Nice to spend this meeting until 2.15.