 The next item of business is members business debate on motion 15009, in the name of Mark Griffin, on Marie Curie and Macmillan cancer support, getting it right for carers supporting someone at the end of life. This debate will be concluded without any questions being put, and I would ask those who wish to speak to press the request to speak buttons. I call on Mark Griffin to open the debate for around seven minutes please. I am grateful to members who, in supporting this motion, have made this afternoon's debate possible. I am also grateful to Mr FitzPatrick for his interest in the issue today. Over the Christmas period, nearly 100,000 people in Scotland will have spent their time caring for someone with a terminal illness. It is estimated that each year approximately 40,000-46,000 people in Scotland with a terminal illness will pass away. It is tragic that, for some, that may have been their last Christmas together. It goes without saying that, even if you try to cherish every last moment with a loved one, the impending loss can cause anyone to grieve before that person passes. On top of that heartbreak, the person caring for their loved one has a new demanding experience requiring them to get to grips with the terminal person's condition, their decline and the public services that they come to rely on. They face new problems every single day, and it is the time when carers need the most help. It is precisely when society and the NHS should be stepping in to provide intensive help for all involved. Getting it right for carers, supporting someone at the end of life, is an important report. It highlights the problems that are faced by carers, especially those looking after someone who is terminal ill and approaching the end of their lives. I want to thank Mary Curie and Macmillan for their work on that, particularly I want to thank the research team Susan Swan, Emma Cardiff, Richard Mead of Mary Curie, as well as Macmillan, the Scottish Government carers centres and especially the carers who took part and shared their very personal stories. Regardless of the time of year, out of love and kindness, carers dedicate themselves to friends and relatives. They save the NHS billions. They thrive in their roles and enhance the quality of life for those they care for. We know that many carers will experience ill health themselves. The impetus behind the carers act, which has now been implemented, attempts to respond to that sorry reality. Exhausted physically and emotionally, frightened and unsure, some carers are sadly overwhelmed by the demands that are on them. The report highlights that caring for someone who is terminal ill can be complex, highly demanding and at times all-consuming. Many carers will watch as their loved one gets support, while they are rarely asked about what help they need. One carer told researchers underlining the desperation that I did not even think, where can I go for help? It is perhaps just one example, but the report cites many more. Another told them that it is the bashing your head against the brick wall. It is going from crisis to crisis. Another one said that I started seeing myself as a carer when I was taken into hospital one night with a suspected heart attack because I was so stressed. Carers need support to help them to care. Of course, when they do not have that support, when that support is not there, they put their own health at risk. It is vitally important that councils and Governments ensure that adult carer support plans or young carer statements are requested and agreed. I hope that the minister will be able to say today how many plans have been requested and completed. With the support of Maricuri, I attempted last year to amend the social security bill to ensure that carers get their allowance fast-tracked, alongside the benefit for someone who is terminally ill. Like that, the fast-tracking of the plans for carers of terminally ill people could make the difference for some carers getting support in time or not. I hope that the minister can say when that fast-tracking will come into force. The report makes clear that the mental and physical stress of caring and beginning to lose someone impacts hugely on their ability to grieve after bereavement and their long-term quality of life. The chance to talk about their role, getting peer support or having a break from caring, whether that is a day or just a few hours, is all referenced as being vitally important to improve that situation. 2018 also saw the introduction of the carers allowance supplement for low-income carers. That financial support is a start on the journey on recognising the contribution of carers. I was delighted to support and improve that measure to protect it from inflation. Although I have been critical of the Government's decision to leave carers allowance in the hands of the DWP for now, those powers must be used with the backing of carers. That is precisely why I have begun asking carers how long that financial support should continue once they care for person passes or they go into a hospital long-term. In both cases, the carers who have given so much to care for their loved one are expected just to return to a life that they had before caring, with no support and no financial assistance, almost as if someone can automatically just pick up their job where they left off. If we are ambitious with the new powers, those are changes that I hope we can make for carers in this Parliament so that there is less financial stress while caring too. One of the most intriguing parts of the report is the difficulties that we encounter in identifying carers. Many people see themselves not as a carer but rather as a mother, a husband, a son, a sister, a friend or sometimes a neighbour. As a result, they do not ask for help or even think that they are entitled to help because they do not consider themselves a carer. They are just doing what they would expect of themselves for someone that they love. It is clear from the Marie Curie and Macmillan study that there are too many missed opportunities to identify those carers. Fundamentally, the research shows that when carers are identified and get support, it makes a huge difference. We need to do more on that identification so that plans can be in place and a carer's own health is supported. Whether it is GPs and district nurses, social care staff, third sector workers, loved ones, family members and friends, everyone has a part to play. I hope that the minister can say how across Government and communities we can better identify carers for people who are terminally ill to make sure that they get the support that they need. Caring for someone at the end of their lives will be one of the most difficult and challenging experiences for people and families to face. People decline quickly and, as it does, the carer needs support to be increased rapidly. Those last stages of life are painful and tragic. Carers struggle to keep up with the loss physically and emotionally, but we can step in to help them through. It is important that we help them through, and that report shows the areas in which we must focus, and that support to improve the lives of carers. I look forward to hearing from other members and the Government's response to that report. We will move on to the open debate. I have quite a few speaking requests. I ask members to go no further than four minutes in their contribution. Bill Kidd, to be followed by Brian Whittle. Thank you very much, Presiding Officer. I start by thanking Mark Griffin. That is a hugely important topic, and bringing it for debate here to the Parliament is something that is really required. I would like to thank both Mary Curie and Macmillan Cancer Support for their joint report on getting it right for carers. It is an important, complex and emotive subject, and it is crucial that the debate brings increased awareness of carers rights. The carers charter outlines a carers right to an adult carer support plan from the given local authority. The process of identifying a carer's needs through the plan should happen as quickly as possible. That means that support is provided when it is needed. Two aspects are particularly important for ensuring a swift provision of support. The first is identifying carers, and the second is increasing awareness of their rights. The report recommends that identification is everyone's responsibility, and it highlights GPs and district nurses as professionals well placed to do so. The presumption should be that a patient with eternal illness has a carer looking after them. Early identification can lead to health professionals proposing an adult carer support plan, or to the carer directly requesting that plan. The carers charter promotes both routes towards receiving support. In Glasgow Annie's land, we are particularly appreciative of the work done by Macmillan in providing support and information to carers and patients at the Beats and Cancer Centre at Gartnavel. Services such as that can sign post carers rights to people amidst an emotional and difficult time. Marie Curie has also provided significant support to people with facing this situation of caring for a loved one with eternal illness. In 2017-18, Marie Curie volunteers visited families more than 10,000 times to provide face-to-face support. That, we can all agree, is an incredible and very valuable effort. In the final stages of the care for persons life, the carer is rightly focused on how they can best support their loved one. In this very difficult time, the physical and emotional needs of the carer can often, however, be put to the side, as was mentioned by Mark Griffin earlier. There can often also be an increased financial burden on carers, particularly if they have had to stop working. The report highlights that if the carer has unmet needs, then there may be a detrimental effect on that carer. In the last three months of the care for persons life, a carer will be looking after their loved one for an average of 70 hours a week and will often have poor sleep patterns. The combination of the different factors can often, for example, lead to carers becoming more susceptible themselves to viruses and other illnesses. The report warns that unmet carer support needs could potentially lead to a breakdown of care and to greater complexities in the healthcare provision required. Quick provision of support for carers is pivotal. It can avoid the breakdown of care and treats family carers with the dignity and de-care themselves that they deserve in a difficult time. Identifying who is a carer is and assessing the needs quickly is a key part of enabling quick provision of support. The report thoroughly evidences this and support for carers increases. We need to get the message out about what their rights are and how they can access them. It is my hope that this debate goes some way in achieving that. Brian Whittle, followed by Monica Lennon. Thank you, Deputy Presiding Officer. Can I start by also adding my congratulations to Mark Griffin for securing time in this chamber for what Bill Kidd has said as a debate and an important topic? I am delighted to have the opportunity to contribute. I think that many of us in here will have some experience in this when family members or friends approach the end of life. My grandmother died from cancer in the Isher hospice some years ago and the care that she, my grandfather and my family received helped as immeasurably with that difficult time. My grandfather also died not long after in the care of another hospice from accelerated dementia. Prior to entering into the hospices, the family gave as much support as we possibly could. I was really lucky at the time because my grandparents didn't live too far from me and I was involved in sport and it allowed me to drop in every single day. My father was self-employed and he also had that certain amount of flexibility allowing him to spend time every day with my grandparents. I recognise that this is not necessarily a situation available to all families. I wonder how my grandfather would have coped firstly with my grandmother's situation if her health deteriorated and then his own health had the family not been close by and able to help and then finally receiving the very best of care from the hospice. The truth is, as pointed out in the Maricuri and Mellon Cancer support report and in Mark Griffin's motion, too many people do not receive this kind of dignified support as the approach at the end of life. A quarter of people miss the palliative care and the need according to the report, leading to that accelerated deterioration of their condition. Crucially, though, the support for the carers and their health is not often considered. The pressure there under balancing their lives, often with families to care for while caring for terminally ill relatives, is all too frequently overlooked. I have often said in this chamber that we need to consider the health of our healthcare professionals as they care for us and that very same ethos should be applied to those who are caring for someone else with a terminal illness. If we do not ensure that the carers themselves are looked after, then they will be in danger of falling into ill health to the detriment of both them and those that they are caring for. We need to recognise that there is a huge pressure on the carer as they manage the decline of a relative and recognise the stress and worry associated with the thought of what will happen if something happens to me. That is where primary care should have a big role to play across the chamber. I think that there is an agreement. There needs to be a shift from secondary care into community care. That is a very good case in question. GPs and district nurses should be able to firstly identify those in a caring role, and they should also be able to self-refer. Secondly, and crucially, they should be able to direct them and their families to the help that they need. It is about communication, it is about developing a system that is easy to access and to utilise. Technology will inevitably play a key role in developing such a system that you have properly enabled will potentially help to prevent the need for some GP appointments and hospital visits. In that respect, it is not necessarily just about increasing investment every time, it is about better utilisation of resources. GPs are under increasing pressure, we know, so in developing those systems, we must always ensure that they are designed to take the burden away from the GPs as well, making them easy to access and to use. The outcome is the end-of-life care that allows the patient peace, dignity and respect. For the carers and family members, the breathing space to keep that stress at bay and allowing the family and the patient quality time together. I put on record our thanks to Mary Currie and Macmillan Cancer Support for bringing us that report and to all carers, professional or otherwise, who deliver palliative care and comfort in the most trying of circumstances. Understanding and identifying those who are carers and being able to signpost them to the help and support that they require. That is what we are debating today. I thank Mark Griffin, first of all, for being a tireless champion for carers, but also for securing this important debate today, which I know is close to the hearts of many people across Scotland. I fully support the motion and commend Mary Currie and the Macmillan Cancer Support team for their report, highlighting the needs of people who are caring for loved ones towards the end of their lives. I thank them for the briefings that are provided for this debate. In central Scotland, the parliamentary region that I share with Mark Griffin, over 7,000 people need palliative care every year. Countless friends and relatives in loved ones are involved in providing care. As others have said, caring for carers is hugely important. I am grateful that, in my area of Lanarkshire, carers have the support of 45 nurses and 94 volunteers through Mary Currie and the wonderful services of Lanarkshire carer centre and others. Lanarkshire carer centres have many times pointed out to me that meaningful conversations with carers can really make a difference and help people who are supporting loved ones towards the end of their life. Elsewhere in our region, there are 57 Mary Currie volunteers in Fort Valley and six nurses. That support is invaluable. As Bill Kidd had mentioned, the Carers Scotland Act 2016 places a duty on local authorities to prepare appropriate plans for carers. However, Mary Currie and Macmillan support findings reinforce the complex nature of identifying carers, because, as Mark Griffin said, many people care out of love and they do not see themselves as being carers. It can be difficult to get support to carers. When people who are carers reach out for help, because our health and social care system is so stretched, it can mean that the system is not always joined up and people do not get the support that they desperately need. Support must be available quickly, as a decline towards the end of life and death can often be swifter than expect. Bill Kidd has powerfully warned that the breakdown of care is a serious risk, so I will be interested to hear the minister's response to that. Other groups that I have met, including Together in Dementia every day, tied, talk about when someone has died that there is not enough bereavement support for carers. I would like to hear what the minister and the Government are doing to address that. When a terminal diagnosis is communicated to a family, it turns everyone's lives upside down. Others have talked about the financial impact, which can only make a bad situation even worse. People are having to take time off work. There are travel costs, additional costs of getting to hospital and so on. There is a big role for employers here. Employers can help to prevent families who are affected by terminal illness from falling into crisis. The accredited care positive scheme can give carers flexibility to deliver care at home. The GMB trade union of which I will declare that I am a member and the TUC have the dying to work campaign. That urges employers to offer greater employment protection to workers who are diagnosed with terminal illness and who want to carry on working. I am eager to work with the Scottish Government to see what we can do in Scotland to get behind and to implement some of the measures throughout the dying to work campaign. In conclusion, caring for a loved one towards the end of their life is often described as a privilege. There is love at the heart of the debate as Mark Griffin's motion conveys. Carers carry out such an invaluable role for their families, but it is really important that we do not allow carers to become isolated and lonely and miss their own urgent medical appointments and put their own health at risk. I am grateful to Mark Griffin for the debate and I look forward to hearing the minister's response. I thank Mark Griffin for bringing this important debate to the chamber. I am very pleased to be speaking on it. In an unpredictable, ever-changing world, Marie Curie is a constant reassurance like a big comfort blanket that gives people the knowledge that they or a family member or friend will have choice and dignity in the event of a terminal illness. In 2017-18, Marie Curie nurses cared for 32,692 people in the UK. The combined work hours of over 2,000 nursing staff members reached 1.2 million hours of work that was funded by the NHS and by charitable donations. Last year, Marie Curie invested £3.3 million in pallidative care research. Over 4,000 people were involved in research studies that were funded by Marie Curie or carried out by their researchers. There are Marie Curie fundraising groups in my constituency in Bishop Briggs Kirkntillach, Lensie and Bearsden, and there are just some of the 85 groups in Scotland doing fantastic work. However, the latest research from Marie Curie—I thank them for their briefing and Macmillan Cancer Support—is found that too many people caring for someone at the end of life are going unidentified and unsupported. They rightly highlight that carers supporting someone at the end of life without support are at risk of falling into crisis and a breakdown of care can follow. Carers need to be identified early and it is everyone's responsibility to identify them, not least GPs, social workers and district nurses, and signpost them to Marie Curie so that they can have at least a break, even if just for a few hours. Financial support and advice are also vital for them to be aware of. Alarmingly, the Carers UK 2017 survey found that the number of carers identified by GPs had fallen in the past three years, with only 9 per cent of carers reporting that their GP knew that they were caring for someone. Marie Curie is a household name. The problem is that carers often do not see themselves as carers, as Mark Griffin and others have said. They see themselves as mothers, sons, brothers and friends doing what they can out of love so that they do not self-identify as carers are asked for help often to the detriment of their own health. Physical care can require a level of fitness and strength, which is increasingly difficult for carers to provide, especially with the ageing demographic of today's carers. Isolation, combined with sleep deprivation and not always being free to leave the person that they are caring for, can have significant impact on their mental health, feeling of loneliness and wellbeing. Carers should know that Marie Curie is always there to step in and help them for their loved one with tenderness and professionalism. Another aspect of the charity is that it is always at the forefront of the ever-changing needs of society, and working with MND Scotland led a campaign for a fair definition of terminal illness to be included in the final social security Scotland act. The new definition bases the decision on clinical judgment, removing the last six months of life restriction currently used by the DWP. They are now working to help shape the accompanying guidance. Marie Curie nurses give people with a terminal illness choice and dignity. Put simply, they are a fantastic charity. They make it possible for people faced with a terminal illness to have the choice to die peacefully in their own homes surrounded by the people they love. None of us know when or if we will need the support of Marie Curie nurses, but we should all be eternally grateful that, if we do, they will be there. I, too, would like to thank Mark Griffin for bringing this important issue to the chamber today and also Macmillan Cancer Care and Marie Curie for their on-going work and for this particular research. There are almost 800,000 unpaid carers, including young carers, in Scotland, and we know that they play a hugely valuable role in providing care, support and love to friends, family and neighbours in a whole variety of circumstances, which are often extremely challenging ones. As Mark Griffin described so well, caring for someone at the end of their life can be especially difficult, as the report by Marie Curie and Macmillan Cancer Support highlights. Caring can be hugely rewarding but also physically and emotionally demanding, and often all the more so when the cared for person is needing the end of their life and often more intensive and complex carers required. That is why I share the concerns expressed in the report and echoed by members today that we are struggling at times to identify carers in this situation. The report and the motion today emphasise the importance of primary healthcare professionals in identifying carers, but the report also reveals that in the past three years the number of carers identified by GPs has fallen, and only 9 per cent of respondents to the carers UK 2017 survey reported that their GP knew that they were caring and offered extra support to fit their caring role. We know that demands on GPs have never been greater, but we need to increase awareness of recognising the carers role amongst all professionals and wider society. Difficultie in identifying carers is especially worrying in the case of young people. My reading of the section of the report on young carers is that we simply do not know how many young carers are caring for relatives at the end of their lives, and I would be grateful if the minister could address that in closing. I would also like to draw attention to what the report says about the support needs of carers after the person they have cared for has passed away. Caring for a loved one at the end of their lives can be all-consuming. We might experience guilt bewilderment, the loss of identity and the loss of purpose after the death, and the support for carers in that position is not always what we would all want it to be. The report says that there was a general sense of being abandoned once the person had died, and many carers spoke of a sadness in the lack of professionals who offered condolences. In contrast, those carers who attended support services after their loved one had died spoke of the benefit of those services and of the benefits of being able to access peer support during that time. I would also like to mention the excellent work that is going on among over 40 organisations and individuals who are involved in the good life, good death and good grief initiative, working to encourage all of us in Scotland to be more open in the way that we discuss death, dying and bereavement. Before closing, I would like to focus on what the report found in relation to financial pressures on carers providing end-of-life care. The opportunities that we now have have been mentioned with the devolution of carers allowance. The survey conducted for the report found that many of the carers were unsure of what financial support they were entitled to, with one saying that they did not even know what carers allowance was. That is consistent with figures from Turn to Us, which suggest that across the UK, £1.3 billion of carers allowance to owed to more than 400,000 people goes unclaimed every year. That is at a time when costs can be incredibly high. Obviously, with so much going on, it is understandable that some of the carers were not able to find the time to claim or did not know that they could claim. Raising awareness here is absolutely key. I would ask the minister to consider whether there might be scope to pay additional assistance to those carers who provide particularly intensive and demanding forms of support, such as caring for people at the end of their lives. Carers perform a highly valued role, often in difficult circumstances, none more perhaps when the person being cared for is coming to the end of their lives. We cannot thank them enough, so it is vital that we reflect the importance of their role by offering the support that they need, both while they are caring and after. The report shows that we are not always doing that at the moment and that needs to change. I start by echoing the thanks that has been offered to Mark Griffin for this important debate and for the report published by McMillan and Marie Curie on getting it right for carers supporting someone at the end of life. Their voices are very important in any issues affecting end-of-life care, and I also want to recognise the longitudinal commitment that Mark Griffin has shown to issues like that. There are also debates such as those that offer us an opportunity, as parliamentarians, to pay tribute to the unpaid carers that support countless people in our country. They are the bedrock under which all of our health and social care strata is built. Without their support, everything would collapse, and I am not being overly dramatic to say that. They do so out of a sense of duty and of love for the people around them. We often, as policy makers, exploit that love because we could not match that care in any kind of public policy offering that we could come up with. My mother-in-law was one such carer. She never thought of herself as that. Her husband, Rob, was diagnosed with MS at the age of 41. For the last 20 years of his life, he spent much of that time confined to a chair. She had never really suggested that she needed help. We all assumed that Rob and I were enjoying quiet enjoyment of their life together. Until one day, she confided in me that she had to flag down a passing motorist when Rob had had a fall and she had been too unable to lift him herself. At that point, we realised that she needed a bit of extra support. That is the quiet dignity that is so commonplace for our unpaid family carers. They would not seek it otherwise. They believed that it was their time. Last time, Rob went into hospital with an infection. It became apparent very quickly that he had a very aggressive form of cancer and something that was going to limit his time with us just to a matter of days, if not weeks. The staff in the hospital were excellent. The care that he got in the hospital was excellent, but it was a noisy place. It was a place where he was without his home creature comforts. Getting him home, because it was clear that he was beyond the reach of medical care, was our number one priority. We came up against a very complicated landscape that people who are caring for loved ones in that situation find all too commonplace. The fact that there was not a health and social care package that could be delivered to him in the home meant that his departure from hospital was delayed. It was only after our insistence and the fact that two of his offspring were GPs that the health and social care partnership agreed to release him to our care, and thankfully they bolt in some support later on. However, it was very much Marie Curie nurses who were the cavalry in that situation. I do not think that we could have offered Rob those last six days in a quiet bubble of love and light and happiness were it not for their support. They taught us very basic humanitarian things that you would not think of associated with the end of life care about massaging moisturiser into Rob's arms, because his skin was dry and it gave him comfort and companionship. That support did not end with Rob's passing. If we were to choose the manner of our passing, I would choose something like that, Presiding Officer, because those nurses gave him that dignity and that comfort. They continued to support our family. They arrived days later, days after the funeral, with a bouquet of flowers and a private mobile telephone number, through which they could be contacted. It was a level of support that I never expected, but for which I am eternally grateful. They are also supported by other organisations, such as Cruise Bereavement, who are there to offer after life support to carers left behind. Let's remember, and the report states this, that 11,000 people who die in this country don't get the end of life care that they need. One in four miss out on palliative care. Supporting those around them is absolutely vital to improving those vital last days. That starts with identification. Only 9 per cent recognise the fact that they are carers or reveal that to GPs. That is even worse for young carers, too. We need to do more as a Parliament for each of those individuals, because behind each of those individuals is the opportunity to offer some of our most vulnerable citizens the right and the opportunity to have a dignified and comfortable death. Stuart Stevenson, followed by Annie Bells. Let me thank Mark Griffin for the opportunity to debate this important subject and, equally, to thank Macmillan. I do so in a personal capacity as a family, as so many others have benefited over the years from support from Macmillan in terminal illness. It is worth saying that, as the person who is statistically closest to death than anyone else who is present, death is the last great taboo. Therefore, we often do not engage with the idea of death and the necessity of preparing for death in a way that would support the person who is departing and those who care for them to an adequate extent. That lack of recognition is part of it. I take a minor observation that the one thing that has not emerged in the debate, which surprised me, I must say, is the role of faith communities in supporting families with terminal ill people. The visit from the priests, from the pastor, from the minister, from an elder of a church can often be an important part of the support before death, but also in the bereavement process that Mark Griffin and Monica Lennon referred to after death. As a GP's son, I am aware of the conventional view of bereavement that there are five phases and that, basically, it lasts six months. It is important, as Monica Lennon and Mark Griffin said, that there is support for people in that phase. It does not matter how unexpected the death may be or how long anticipated it is, it is a shock when it happens and the bereavement support for the carer is very important indeed. Of course, modern medicine has created particular problems in that regard. First of all, people survive a diagnosis of a terminal condition much longer than they used to. They may survive with comorbidities, people with many different conditions, with a complex set of needs and a complex range of support that is required from medical profession. We create a problem, in a sense, for the system of supporting carers. We expect more of carers through that comorbidity and we expect longer support because of generally longer survival times after diagnosis. Therefore, this whole issue has become more important than it ever was. We cannot start to help people to understand the process of death, the process of bereavement, early enough. It is one of the reasons that may sound quite trivial, because it is quite important for children to have pets because it confronts for them in their lives the idea that nothing in life is actually forever because pets tend to die. That is true of us, as it is for our pets. Therefore, I hope that this debate makes its own modest contribution to engaging us with the idea that death is normal and natural. Indeed, it is important that we move out of the way to allow the next generation to come through. The study that Macmillans has done is a very valuable contribution to understanding the pressures on carers and perhaps the support gaps that we now need to address. As a rural MSP, I, in particular, point to the difficulties in reaching people in rural areas and identifying carers. They are more likely to be non-identified and lack support in rural areas. Once again, Presiding Officer, we can never thank Macmillan too much. I do so again. In order to allow our last speaker and, indeed, the response from the minister, happy to accept a motion without notice under rule 8.14.3 to extend the debate by up to 30 minutes, I invite Mark Griffin to move a motion without notice. The question is that the debate being extended by up to 30 minutes. Are we all agreed? I am very pleased about that. That does not give licence to Ms Wells or the minister to talk for 30 minutes. I am very grateful to have the opportunity to speak in today's debate and, like others across the chamber, I too wish to thank Mark Griffin for bringing this topic to the chamber, as well as Mary Currie and Macmillan cancer support for their efforts in creating this report. One of my most memorable experiences on MSP was a visit that I made to the Young Carers Festival in West Linton in 2017. Although people I met weren't all caring for someone with a pallid of illness, it nevertheless brought home just how all-encompassing caring for a loved one can be. Although the children and young people that I spoke to made no complaints about the situation that they were in, it was evident that personal sacrifices had been made and their lives were noticeably more difficult than their peers. Particularly when we look to those caring for someone nearing the end of their life, a time that can be emotionally exhausting and for some completely unexpected, it is vital that we do all that we can to get the right support in place. The Scottish Health Survey estimated in 2016 that there are over 788,000 people caring for a relative friend or neighbour. Although it is difficult to determine how many people are caring for someone with a pallid of illness, we know that there are approximately 40,000 to 46,000 deaths of people with a terminal illness in Scotland every year, and across the UK, around one in 12 carers are caring for someone with a terminal illness. The main issues that are noted by the report are that carers are not being identified, sometimes not at all and for the many not early enough. Because of that, carers are not being supported, with the consequences being a lack of good care, co-ordination or no support at all. Often the path into a caring role can be a gradual one, with many people believing that they are simply carrying out a social role that is expected of them. As many others have said, carers do not see themselves as such because of the business of the role and because for many it is an evolutionary process. The report by Marie Curie and McMillan notes that there is a clear need for health professionals to empower carers to self-identify. That could be a simple intervention such as leaflets in GP waiting rooms or a public awareness campaign. As Rona Mackay alluded to, by empowering carers to self-identify, there is a greater chance of support plans being put in place. To be proactive in that process means that carers can receive financial as well as physical and psychological support. Notably, the report highlighted a lack of knowledge amongst carers when it came to accessing services to meet their needs. Many carers felt hindered by poor communication between health professionals and by not having a central point of contact. With the juggling demands of carers, many of them still work. It is extremely important that care is carefully co-ordinated in advance, with a central professional who can take care in times of crisis if needed. Moreover, the report also highlights the need for respite. With 23 per cent of carers citing that they do not know how to get a break, that needs to be prioritised. For many carers, sleep deprivation is a major issue, and time away from the caring role provided people with the opportunity to maintain their physical and emotional health. To conclude today, I would like again to thank Mark Griffin for bringing this topic to debate. The experience of the death of a loved one is difficult enough to care and nurture someone right to the point of their death even more so. For this reason, I welcome the publication of the report, and I ask that the calls made be duly acted on. I want to start by adding my congratulations to Mark Griffin on securing this important and timely debate. It is really valuable to hear from members across the chamber, highlighting particular pressures on those caring for people with terminal illness, and I particularly thank the members who gave some of their own personal experiences, particularly Brian Whittle, Alex Cole-Hamilton, Stuart Stevenson and others. I am really grateful for the opportunity that this debate provides for us to have a discussion around some of the priorities for supporting people who are caring for people at a time with a terminal illness. I also want to join others in welcoming the research in the report from Marie Curie and Macmillan Cancer Support. It is a very valuable piece of work, and I think that it goes further than the slightly narrower focus that we have particularly commissioned them to take out. The Scottish Government funded the study to inform our work in developing forthcoming regulations on priority timescales for identifying the needs of carers of people with terminal illness. I think that Mark Griffin asked about the timescale for taking that forward, and it is an important point. While I will cover it later in my speech and I may do it again, I will try to cover it now just to confirm that we will be consulting on regulations in the coming weeks, and I will talk later about how we have got to formulate the regulations that we will be consulting on. It is also worth emphasising that this research was carried out before the new rights under the Carers Scotland Act was put in place last April. That act put in place a system of carers' rights to make carers support more consistent and personalised individual needs to help protect carers' health, wellbeing and sustained caring relationships—a number of the points that were made by members across the chamber. Those rights now extend to all carers so that they can access support earlier in their caring journeys. As highlighted in our programme for government, we are working to embed those rights for Scotland's 790,000 carers as an on-going priority. We are talking about the number of 790,000 carers. Alison Johnstone asked if we knew the number of young carers who were caring for people at the end of their lives. We estimate that there are some 44,000 young carers in Scotland who are preventing and providing care. As far as I am aware, we do not currently have the figures in terms of what proportion of those carers are providing care for people with a terminal illness, but I think that, as the carers act beds in, it is likely that those numbers will come forward. If the number is available, I will try to come back to the member on that, but I am not sure that it is as yet. Across the Government, there are a number of pieces of work that gel with the carers act, so we also intend to improve carers' social security benefits, accelerate the integration of health and social care and reform social care to make sure that it is fit for the future. Those are all actions that should help the overall experience. We have also heard about the importance of making sure that carers can access support early. As Bill Kidd said, a key aspect of our work in helping carers to be aware of their rights to support and how to access that support. Our charter summarising carers' rights under the act is now widely used across Scotland, and there are a series of practical what-to-expect leaflets by the Coalition of Carers in Scotland. Advice on carers' rights is also accessible through the information and advice services that are now required in every local area. Mark Griffin, Brian Whittle and Monica Lennon all mentioned the importance of carer identification. That is an important theme in the report, and it is key to getting it right for carers. A main factor in that is that staff who come into contact with carers can identify them as a carer and help them to access support. We are supporting local staff training and awareness in a number of ways, including funding and an excellent ebook produced by the Scottish Social Services Council and on-going work with national carer organisations and NHS Education Scotland. Rona Mackay and Annie Wells talked about empowering carers to self-identify, but we absolutely have to make sure that the information is there so that people understand their rights and feel empowered in that way. It is also important to mention the new duty to involve carers when people are discharged from hospital, which is an excellent opportunity to identify carers at an early stage. Annie Wells mentioned short breaks. Alongside carer identification, the report highlights the value of breaks from caring, and under the carers act authorities must now consider whether support should include a break from caring. We are continuing to fund non-statutory short breaks fund, which was spent £26 million on since 2010. The motion and the report highlight the need for co-ordination of support, which is central to the new carers support plans and young carers statements, which are at the heart of the carers act. All carers now have the right to one of the plans to identify their own personal outcomes and individual needs. They also provide tailored information about support available locally, future care planning and what support the local authorities will provide. Mark Griffin asked about the numbers of support plans and young carers statements that had been requested. That is information that we have asked from local authorities. We have asked for the first six months figures, so they are not yet available. We are requesting them and we will make sure that members see those figures when they become available, because that will be a test about just how awareness of the carers act is filtering across the country. While scrutinising the carers bill, the Parliament decided that carers of people with a terminal illness should have priority access to those plans. That will require legislation. As I said earlier, we commissioned the report from Macmillan and Maricuri to inform that work. We have been working with organisations on proposals for the regulations that we are about to publish for consultation in the coming weeks. Local authorities and health and social care partners tell us that they are already prioritising those carers, but we want to have regulations to ensure that they receive support quickly and without compromising the quality of support or creating unnecessary bureaucracy. Monica Lennon asked me about bereavement support. Under the carers act, every local authority's area of care information and advice services have to provide information and advice on bereavement and support for carers. That is one of the things that, as the act is implemented, we need to make sure that that is happening and that is the experience on the ground, because that is what is very important. To close, I want to acknowledge the contributions from across the chamber and also the excellent work of Macmillan and Maricuri. Most importantly, I want to acknowledge the contribution of carers looking after loved ones with a terminal illness. I want to reiterate the commitment to doing what we can to make sure that they can access the support that they need and deserve when they need it. Thank you.