 I encourage members who are leaving the chamber to do so as quickly and as quietly as possible. The final item of business is a member's business debate on motion 917, in the name of Claire Adamson, on UK malnutrition awareness week 2021, malnutrition in older people. This debate will be concluded without any questions being put. Would any member wishing to participate in the debate please press the request to speak buttons now or as soon as possible? I call on Claire Adamson to open the debate around seven minutes, Ms Adamson. Thank you very much, Presiding Officer. It's indeed a privilege to bring this debate to the chamber this evening and I want to thank all colleagues who supported the motion and those who will be speaking this evening. I want to give my thanks to Food Train and its Eat Well, Age Well initiative and for their tireless advocacy of rights-based policy making and better outcomes for older people in Scotland. Food Train was set up to help older people with access to food. The organisation has been developing services for 25 years to help people to eat well and age well. Food, company and feeling safe and cared for have been top priorities of the people who have used Food Train services. Through Food Train, service users have been given timely and invaluable insight into the issues that we are discussing this evening. Indeed, further insight into the issue of malnutrition has never been more necessary. The impact of this issue on older people within our society is one that is frequently under-recognised. There are real concerns that the pandemic is compounding the problem, particularly in terms of isolation, which I will come on to cover later. One in 10 older people in Scotland are at risk of or living with food security issues. Approximately 103,000 older people over the age of 65 in Scotland are at risk of suffering from malnutrition. Research from projects such as eat well, age well indicates that even those sobering figures may be underestimated, as many as 30 per cent of older people could be at risk. That should give us pause for thought and determination for action. Tackling this problem requires understanding it and its many facets. Food Train has been championing the message of, let's build the picture. This message is urging everyone working in community settings to uncover the true prevalence of malnutrition and the challenges facing older people in eating well. Malnutrition is largely preventable and treatable through screening and early intervention. Eat well, age well has produced a toolkit that includes clear tips and really simple tools to help to identify individuals who could be at risk of malnutrition. Most malnutrition occurs for people living at home, yet rates of malnutrition in the community for those living at home—older people in particular—are less well known in comparison to reported rates during hospital admissions or care home and residential care settings. Building the picture, understanding the extent of the problem and recognising its causes, causes it to be multifaceted and is essential that it steps to ensure that we overcome the challenges that malnutrition is taking. Last year, I was fortunate to attend the launch of the joint report from the Eat Well, Age Well and the University of Glasgow. Titled at Exploring House, hold food security and malnutrition risk with psychosocial indicators of healthy ageing in place. The report highlights the financial barriers which are typically the focal point of research and policy into food insecurity. However, for vulnerable older people in Scotland, food poverty and food insecurity are not the same thing. In Scotland and across the UK, there are stark inequalities in the ways people age and experience of ageing. Those inequalities manifest in deprivation and poverty, but when it comes to malnutrition in older people, policy makers must recognise that this is only part of the picture. Older adults are at risk of malnutrition, an increased list of lower wellbeing and social isolation and a perception of lack of control over their lives. The findings of the report revealed correlations between food insecurity and early indicators of malnutrition risk with poorer wellbeing and social connectedness. Researchers were clear that supported access to food is crucial in breaking that link. Those in receipt of food-trained services were more likely to say that services helped them to feel in control of their lives. It becomes clear that malnutrition is of much more than poverty. Food, eating it, preparing it and sharing it is inextricably linked to the physical and wellbeing of all of us. Food is intrinsic to a person being in control of their lives and plays a key role in that feeling of social connectedness that is crucial for older people across Scotland. Building a sense of empowerment across our national policy and integrating it into community settings is therefore key to addressing those very complex, faceted issues. As outlined by Dr Kate Reid, the report shows that inequalities experienced by older people are not simply attributed to financial barriers but further through a diminished sense of social and cultural capital. That point is key because that concept is more nuanced than a lack of finance and it can make those problems harder to detect. That is why we must embed those concepts into our policymaking on malnutrition and it is why raising awareness and investing in training, screening and the sport around malnutrition is essential if we are to address that problem. To emphasise, those are not Covid-19 problems. Those challenges have been underlined and exacerbated by the pandemic but we cannot view malnutrition in older people through a narrow lens. Our society has recovered from Covid and must galvanise systemic and sustainable change. We know that Scotland is ageing. The over-75s at the fastest growing age group in Scotland and the proportion of those aged 75 plus is expected to rise by 79 per cent over the 2065 years from 2016 to 2041. That is a present demographic challenge but it delivers a unifying objective for policy makers and legislators. We must build a fairer Scotland for older people. We must ensure that challenges faced by older people such as food insecurity, loneliness, access to health and social care are met with a compassionate and rights-based governance. The Scottish Government has consistently shown its commitment to advancing the human rights agenda. It has set up a national task force on human rights and remains committed to incorporating the United Nations Convention on the Rights of the Child into domestic law. To make the challenges of an ageing population, the Scottish Government strategy, a fairer Scotland for older people, a framework for action, outlines priority actions to tackle the barriers to a positive older age identified by the older people's strategic action forum. Malnutrition has been specifically identified as a key issue affecting older people, and a national commitment was made to tackle malnutrition in a fairer Scotland for older people. However, too many older people in Scotland are at risk and there remains a dearth of public awareness around that problem. Malnutrition regularly goes undetected, unsheated and recorded, and it can be overshadowed by public health methods used for focusing on other diet-related issues. We must better understand the problem and continue to gather essential primary data through research. We have to recognise at policy level the nuanced difference between food insecurity and food poverty. We must invest in training in malnutrition for health and social care professionals to improve confidence and knowledge in screening and providing support. We must support community initiatives that address social isolation, given that that is a key factor in malnutrition. By investing in long-term systemic change, we can empower older people to feel in control of their lives and we can sport older people to eat well and to live well. We can build a fairer Scotland for older people, founded on the principles of dignity, respect and compassion. I welcome the opportunity to speak in the members' debate today and highlight the excellent work of food policy organisations such as FoodTrain and All Volunteers in organising a very successful UK malnutrition awareness week. I thank the member for bringing that motion forward. I believe that malnutrition impacts the poorest and most vulnerable citizens the most. Good quality meals do not have to be expensive, but you have to have the access to that food and have the ability to put things together to make a nutritious meal. Access, ability and education being absolutely key. Access to affordable food is not something that anyone in Scotland should have to worry about, but sadly that is not the case. Often those in our most deprived communities have less access to fresh produce and in turn healthy meals. Their options are restricted by the shops available in their local areas. Driving to the large supermarket a few miles away is simply not an option for many elderly people due to them having to give up driving for various different reasons. Getting to a large supermarket where the offering is greater and in many instances significantly cheaper is sometimes a non-starter if you no longer have the ability to drive, as supermarkets are not always on a convenient bus route. For example, for me to get to my nearest large supermarket by bus would entail me having to take two long bus journeys just to get there. That would be well over an hour all in, but in my car it takes me less than five minutes. During the Covid-19 pandemic, it was only made worse when travel was discouraged and lift-sharing was not permitted. Constituents tell me that they were reliant on their small local shops rather than having access to the bigger supermarkets where access to fruit and veg is significantly cheaper and easier. In my constituency of Aberdeen-Donside, food bank use has increased significantly over the past five years, and many elderly families and individuals have become dependent on emergency food parcels. I would like to take this opportunity to pay tribute to the brilliant efforts of a charity within my constituency. In order to help the most vulnerable to access food in a more dignified way, a local charity CFine, in partnership with Fersan's Unfountain Community project, Fairshare UK, and funded by the Scottish Government, established the Woodside Pantry in the Woodside Community Centre in Aberdeen. The pantry scheme provides food for its members at a token price, allowing those on a low income to pick the produce themselves in a shop-like environment, and the items in the pantry are weighted by value, making sure that all members equally receive meat or fish, fruit and vegetables, and ambient food every week. Malnutrition harms the most vulnerable in our communities, whether it be the elderly who simply cannot travel to access affordable food or young families who cannot afford nutritious food to feed the whole family. Obesity and starvation are two sides of the same malnourished coin. We must strike for better education, better access to food and better lives for those vulnerable individuals and families in the areas that we represent. I am delighted to be able to participate in Clare Adamson's business and motion this evening and pay tribute to her for the work that she has done. It is right that we acknowledge UK malnutrition awareness week. This condition, which is also known as undernutrition, has been noted as a substantial public health issue, with one in 10 older people in Scotland being at risk of or living with. The national records of Scotland's latest mid-population figures suggest that almost half a million people in Scotland are over the age of 75 and can be affected by this issue. As my party's shadow for equalities in older people and with a personal experience of working in the sector, I have a good understanding of the disadvantages, effects and the causes, but it is very important that we also understand some of the reasons behind this whole process, because it affects the person, the family and the carers. There is no doubt that the Covid-19 pandemic has had a terrible adverse effect on the older population among whom loneliness and isolation have grown massively during the pandemic. It is with the issue in mind that we have to focus on malnutrition but also on food insecurity, a subject that has been highlighted in the chamber many times before. We cannot lay the blame completely at the door of the pandemic, because many organisations individuals have been highlighting the issue through the care sector and the third sector. It was back in January 2019 that I spoke in this topic in the past in this chamber, when we were tackling some of the issues of social isolation and loneliness for the older generation. At that time, I was very supportive of the publication of the Government and the strategy that it came forward at that stage. I was also at pains to emphasise that the whole idea of this public health concern needed to be addressed and needed to be given the support, the financial support and the acknowledgement that it was a problem within many sectors and many people within our communities. It is a matter of urgency that we tackle this issue as we go forward. I pay tribute indeed to BAPM for highlighting that everyone should be looking at and everyone should be trying to find out. Their campaign, the ask to look and listen campaign, is vitally important. We have already heard tonight about the food train, and the food train is a phenomenal expectation of taking on board and trying to support individuals. I have that within my constituency in areas of Clackmannanshire and Stirling, and that has been a lifesaver for many individuals in the sector. As I said, it was back in 2017 that the then public health and sports minister, Stirling Campbell, talked about the new diet and obesity strategy, and that, as I said, is something that we have to consider in the wider context of access to food. The diet and obesity strategy also brings together malnutrition, especially within our older population. As I said, BAPM has identified, and we have talked about the Eat Well, Age Well campaign, which are vitally important. Those organisations deliver meals to hundreds of people across communities, right across Scotland. In conclusion, access to nutrition, especially within our older and vulnerable population, and even when they are being hospitalised or living in a care home, is of a major concern. Also, when they are discharged back home, it is causing major concerns. Access to affordable food is also a area that requires further attention, and that has been talked about through the social renewable advisory board. We all have a duty of care to look after our constituents in support and provide, because by doing that, we will inform and give opportunity for food and good choices of nutrition. All of that will help us to assist and stop putting adverse strain on the community, health and social care within our constituencies and regions. I thank Clare Adamson for bringing this important member's business debate to the chamber. The issue of malnutrition is something that must be addressed, especially within our older people. We must ensure that older people have access to the support and resources that they need in order to eat well and not be socially isolated. Covid-19 exposed and exacerbated health inequalities and isolation in Scotland, and we must work to alleviate those issues. We have made progress with our young people. I was the minister who initially took through legislation to pilot free nutritious school meals for P1 to P3s, which has now been extended to P4 and P5 pupils in January, in addition to the free school holiday meals that are being rolled out. However, more work must be done for the older and more vulnerable members of our society. I recently met Food Train Westlodian, who is doing excellent work in not only ensuring that our older people are fed and fed well, but to tackle loneliness and isolation. Throughout the course of the pandemic, they have responded to unprecedented demand and have supported 300 people across Westlodian by providing up to 125 shops per week. The work that they do tackles both malnutrition and isolation. I would like to take that opportunity to highlight one of their innovative and highly successful services, the Eat Well Buddy service. Food Train Westlodian identified that many members needed additional support to complete their shopping order, and they have created a buddy system, which provides older people with a volunteer who will talk through nutrition, suggest different snacks and meals and provide company and connection to the community. The outcomes of the service include a decrease in social isolation and an increased consumption of fresh produce, fluid intake and the number of meals eaten each day by people using the service. Additionally, Westlodian Food Train is in the early stages of an innovative partnership with The Larder, who is a food enterprise organisation based in Livingston. The partnership will have an impact on malnutrition as well as social isolation by providing two key services, a supper club that would involve taking members to The Larder's catalyst kitchen once a week for a home-cooked meal and social interaction with an additional aim of increasing intergenerational relations. The partnership will also provide ready meals, working with a focus group of older people to discuss menu, meal size and cost. It is envisioned that those meals will be cooked by The Larder and offered to customers instead of ready meals from supermarkets. Those meals will have higher nutritional value and will be cooked locally. Those two services are just a snapshot of what Westlodian Food Train does to work with our older people. The third sector is leading the way in ensuring that our older people are fed well and are not alone. Like Food Train, other third sector organisations are coming up with innovative ways to tackle the issues of malnutrition and social isolation. Going forward, we must ensure that our third sector is probably funded and resourced in a sustainable and long-term way. We must work to ensure that everyone in society has access to the support and resourcing that they need to allow them to have a nutritional diet and remain connected to the people and community around them. The call for action in the if not now when report to ensure that everyone can access nutritious, culturally appropriate and affordable food must be viewed as a priority and we must work together to achieve that. Mrs Hyslbar, we will be followed by the final speaker in the open debate, Stephanie Callaghan. Four minutes, Ms Mocken. Thank you for marking the significance of malnutrition awareness week by bringing this debate to the chamber. It is the most vulnerable in our society, or elderly, who are at greatest risk of malnutrition, caused by undernourishment. Indeed, it should concern all of us that one in 10 people living in the UK are malnourished or at risk of being malnourished. A figure that others have mentioned, Eat Well, Age Well Scotland suggests, could be an underestimate. This devastating and indeed potentially underestimated figure will be a shock to many who think that a rich country like Scotland could not experience those problems. However, as someone who has worked in the NHS for years in the past—I have mentioned in the chamber before I was a dietician—I cannot stress enough that that problem is actually very real. Yet, of all the social and economic challenges that we face in Scotland today, I would argue, Deputy Presiding Officer, that malnutrition is one that we hear very little about. Described as a hidden problem, Eat Well, Age Well argue that, although preventable and treatable, malnourishment often goes undetected, untreated and unrecorded. We must do more, as others have said, to highlight not only the existence of malnutrition in Scotland, but also to look at the causes and what we can do to reduce the number of people living in such circumstances. A lack of public awareness and indeed a lack of Government attention will only lead to an increase in the numbers of those who are malnourished, which would in turn increase pressure on national health services. That is already under a significant strain. Given that we know that those who are malnourished are not only more likely to use health services, but also more likely to use health services resources for lengthy time periods, I would ask the minister today to take malnutrition very seriously and urge the Scottish Government and colleagues to act with purpose to address that issue. We know exists, but it is really spoken about. I am asking the minister to do so to protect those who are malnourished and need support and our NHS, which faces serious challenges already. However, I would argue that Scottish Labour has offered solutions to many of the causes of malnutrition in our country. In response to social isolation, we have set out a comprehensive plan for universal basic services that would strengthen communities and support those who have experienced loneliness by offering services and resources, which are backed up by a serious lack of funding by local Government. Moreover, to support those who are forced to choose between heating and heating because of the decisions of Governments here in Westminster, we, led by my colleague Rhoda Grant, pushed for the introduction of a right to food bill that would enshrine into law a right to sufficient and nutritious food. Unfortunately, the SNP and Keane Greens kicked into the long grass committee stage a matter of weeks ago. It is absolutely right that we talk about malnutrition awareness week in this Parliament today, but we do little to support those who are malnourished, little to support our health services and the vulnerable if we do not back up our words with action. It is radical action that the Scottish Parliament has the power to deliver with. It has the power to enact that change that we all want to see and raise the awareness that we all know is needed. Deputy Presiding Officer, Covid will have undoubtedly exacerbated many of those issues discussed in the chamber this evening—food poverty, food insecurity and social isolation. Malnutrition awareness week acts as an opportunity for us to propose impactful change and to drop a trend that has for too long discriminated against the elderly and the vulnerable. I thank other members in the chamber for discussing that very important issue, and I congratulate Clare for bringing it forward so that we can participate in malnutrition awareness week 2021. I thank Clare Adamson for bringing it forward to the chamber. It is sobering to be taking partner debate in malnutrition, and, as we head into her second winter of the pandemic, malnutrition awareness week is especially important and poignant. The pandemic has highlighted the fragility of our food systems, placing previously food secure adults at increased risk of malnutrition. Social isolation and loneliness have peaked, increasing the risk of more Scots, particularly elderly, becoming undernourished. That increased risk is not theoretical, but demand for services from organisations such as Food Train has increased 51 per cent since the onset of the pandemic. Although most Scots are familiar with the risks around obesity, large numbers of undernourished older Scots remain invisible to most of us. Malnutrition can no longer be a taboo topic. We need wider discussion around this public health issue to help to tackle the root causes of malnutrition head-on. As food insecurity among older people is multifaceted, our holistic civic response must connect all the elements. Faxes such as reduced mobility, social isolation and general frailty have been exacerbated by the pandemic, and many of the levers to respond to poverty still rest with the UK Government. However, the challenges cannot be used as a cover to do nothing. We need to move forward with a programme of preventative actions that start making a positive difference now. A recent report by Glasgow University and partnership with Food Train made recommendations that included community screening for early signs of malnutrition, embedding malnutrition into basic health and social care training and investing more in community initiatives that address social isolation such as befriending, which a few have spoken of already. From my perspective, the key overarching basis that we need to respond to malnutrition among older people is to ensure that we all recognise the critical way that food connects people. For example, an older person may struggle to eat alone after losing their partner and befriending groups and other community responses can offer really critical support. Some older people become less physically mobile during the pandemic and reluctance to go out when Covid cases remain high can lead to poorer eating habits, with risks of malnutrition accelerating as mental health and general wellbeing to take their rates. By educating us all on the importance of strengthening connections for older people, we reduce the risks of older people becoming undernourished. Food Train's pilot worksheets to raise awareness of those older people at risk from malnutrition and help them back to health could become an example across Scotland. Only by taking a truly collaborative partnership approach involving NHS, local government, third sector and housing organisations can we create the necessary environment to prevent malnutrition. Beyond the moral imperative of ensuring everyone has access to wholesome nutritious food, there is also an economic imperative. People suffering from malnutrition are twice as likely to access GP services, three times as likely to be admitted to hospital and the place for their strain in their NHS. Identifying malnourishment early and taking positive action reduces unnecessary strain in their NHS and council care services through reducing, for example, falls, as well as mental health issues caused by isolation. In closing, I would like to widen the discussion on food insecurity and commend the Scottish Government on its plan to make food banks the last port of call. This uplifting plan is yet another example of Scotland setting a different, more dignified approach to supporting people at a time of crisis, from that being pursued by Westminster. There is no doubt that this wider focus on food insecurity by the Scottish Government will ensure that malnutrition among older people is no longer a heart-breaking and invisible bite on our society. Our older people deserve so much more, and the right food is a human right that must not and will not be denied. I want to thank Clare Adamson for raising the important issues, part of Malnutrition Awareness Week, which took place earlier this month. The role that food plays in our society is often underestimated. Food connects us all, nourishing mind and body. It brings us together. Malnutrition and dehydration are often hidden issues in our communities, which makes it even more important to raise awareness of this issue. Malnutrition Awareness Week is a valuable opportunity to raise awareness and understanding of the issue, and to consider further action. I had the privilege of speaking at an event organised by EatWell AgeWell project as part of this year's programme. Let me be absolutely clear that malnutrition is wholly unacceptable. Without doubt, more needs to be done to better support older people to access healthy and nutritious food in ways that suit their needs. There is really good work under way through our funding of food trains, EatWell AgeWell project and meal makers. We are continuing to support vital work to lead on the prevention, detection and treatment of malnutrition in Scotland and to tackle social isolation among older people through meal sharing. The work of FoodTrain and others in supporting older people to shop, eat well and socially connect is absolutely invaluable, as many have said in this evening's debate. I recognise the efforts that benefit so many older people and which provided a vital lifeline during the pandemic. Older people are at particular risk of malnutrition. We published the framework of Fairer Scotland for older people in 2019, which committed to working with health and social care partnerships and others on actions to ensure that malnutrition is identified, managed quickly and effectively. Of course, over the past 18 months, older people have been significantly impacted by the health, economic and social harms from Covid-19. Although Covid-19 has delayed the progress of the work, it is even more important than ever that, as we rebuild and remobilise our health and social care services in Scotland, we ensure that older people are placed at the centre of the recovery and to focus on a preventative, joined-up approach to healthy ageing in older people. As we move forward, we will remobilise our efforts. I am announcing today that we will convene a short-life working group to develop a framework for the prevention of malnutrition and dehydration. Back in March, the Cabinet Secretary for Health and the Cabinet Secretary for Social Security and Older People published a statement of intent setting out our commitment to develop a new strategy for older people's health and social care in Scotland. That builds upon the great foundation that is created by a fairer Scotland for older people, which I mentioned earlier. We are now engaging with older people and the organisations that represent them to co-produce a draft strategy that we plan to publish for consultation in early 2022. Following the recommendations of this year's review of adult social care, we committed to bringing forward legislation for a national care service in the next 12 months. That consultation is under way and gives us an opportunity to consider how a new national care service can best support older people to eat and drink well. We have also accepted the review's recommendation to remove charging for non-residential social care as soon as possible. Our proposals in the national care service consultation to reform integration joint boards will also seek to strengthen integration arrangements that were initially legislated for in 2014. Reformed integration joint boards will be better placed to provide high standards of care for older people using those services and provide better support and training for the workforce in the sector. That brings me to our health and social care workforce. We know that recruitment and retention of staff has been challenging, even more so during the pandemic, and further work is under way to develop longer-term improvements to the social care workforce, including better terms and conditions and improved training and development opportunities. We hope that that will improve the experiences of the workforce and, in turn, that will improve outcomes for older people who are served through social care. I want to touch now, as many others have, on the issue of food insecurity. We have made the eradication of poverty a national mission, and that includes tackling food insecurity and ending the need for food banks. However, I know that food insecurity for older people is not only linked to poverty, but it is also linked, as others have said, to broader issues of access. Loneliness and social isolation are strongly associated with malnutrition, which is why projects such as food trains and meal makers are so important. We continue to support food responses that maximise dignity while also being aware of just how vital food is for our sense of belonging and wellbeing. Earlier this month, we introduced our good food nation bill to Parliament. It places duties on Scottish ministers and certain public authorities to produce plans of their policies on food and to set out what they will do to make those plans real. As part of that, we are exploring options to expand the Food for Life programme, which we currently support within the school setting, so that more food that local authorities are providing for our children and older people not only supports them to eat well but is locally produced and sourced. At the heart of our approach is a commitment to make Scotland a good food nation. We want everyone in Scotland to have reliable access to nutritious, locally sourced, locally produced, good-quality food. Without doubt, I recognise that there is still much more work to do. I welcome the opportunity that the debate has given me to set out some of the actions that the Government is taking to ensure that all older people in Scotland have the resources and support that they need to eat and drink well. I want to thank Clare Adamson again for this motion, which the Government supports. Thank you very much Minister. That concludes the debate, and I close this meeting of Parliament.