 Felly, y dyfodol y gallu ymlaen i'r cyfrifod i gefnigol y Debyg Llywodraethol yn y ffordd dros, yn ei ffordd i gael Ysbytyd, yn y ffordd i Gwниldaeth Edward Mountain o Stomer Care in Scotland. Mae'n dyfodol i'r cyfrifod i ddod eich gael y cyfrifod i', I invite members to participate to press the request to speak buttons now or as soon as possible, and I invite Edward Mountain to open the debate around about seven minutes, Mr Mountain. Thank you very much, Presiding Officer. It's a real privilege to stand in this chamber to talk to this motion and in doing so fulfil both a promise and a challenge. In 2002, I promised to try and highlight the importance of being aware of bowel cancer, and I also committed to raise stoma awareness. Last summer, I was challenged by Brian Devlin, who sadly couldn't make it here tonight, to do something to promote a greater understanding of stomas in the Scottish Parliament. Hopefully, today, I'll be doing both of those, and I'd like to thank all the members across the chamber that signed my motion allowing that to happen. At lunchtime today, Presiding Officer, a group of ostomotes set up from the Parliament to walk to the top of Arthur's Seat. They did so to trumpet loudly, there is little they can't do. Presiding Officer, when we were planning today, I had to use all my skills to stop a parachute drop by some of the more enthusiastic ostomotes who thought it would make a great display. Ostomotes are quietly getting on with their life and the life that their bags give them. Tonight, our debate will be watched by lots of people within the chamber and also by ostomotes and other and their friends, and I'd like to welcome them all this evening. Some of them face considerable challenges to be here tonight, but they're a tough lot. On a daily basis, they handle much more unpleasant things than most of us have to. Presiding Officer, our lives are a journey, and sometimes those journeys have bumps in the road and diversions. When we reach those diversions, we more often than not have to embrace the root change. Not to do so can be a disaster. It was on 28 January 2022, the day before my operation, a string of people visited me. One nurse came in with more purpose than the others. She clutched a large bag and a black marker pen. With little explanation, I was told to remove my top. I was made to stand up, sit down, lean forward, lean back, breathe in, breathe out and a heap of other exercises. Then off came the pen lid, and a large black spot was marked on my tummy. I was told that that's where my stoma would go, and it would be a perfect fit, and it was. Not my surgeon's choice, but the choice of my stoma nurse. Tonight, I want to praise our stoma nurses. They are key to good stoma care, and we need to bring more of them into the profession. We need them now more than ever. There are over 20,000 ostoments in Scotland, and many of them have trouble-free stomas. Some do not. Yes, I will give way. Can we have Mr Cole-Hamilton's microphone, please? We got it now. I am very sorry to derail the wonderful momentum of Edward Mountain's excellent speech there. I speak for the whole chamber when I salute your bravery, Edward Mountain's bravery, both in talking about his own stoma experience and bringing light to the challenges, as he describes them, of those people. Many thousands of Scots who face life with a stoma, but don't let it in any way conquer their endophatic ability. Does he recognise that we still have a long way to go as a society to tackle the stigma of stomas, to recognise access to things like lavatories in public for people with stoma bags so that they can go to the shops and go to cinemas and go to bars with confidence? Will he again join me in saluting not just the work of the Stoma nurses, but everyone in the Stoma community, including those companies who produce the stoma kits? I welcome that intervention, because there is a stigma, a stigma from perhaps people who may be having to face a stoma and for those people who don't know anything about it. I can honestly say that the day before my operation I knew little or nothing about stoma care. In fact, I've been a typical male ostrich and buried my head in the sand. It was my wife who googled and found out everything about it. I refused to let her tell me about it, but as I came to know more about them, I realised just how normal they could be. So, going back to where I was, where the trouble-free stomas, there are some ostomates that don't have trouble-free times. Some have leaks and sores and they struggle to get the help that they need. That's why I want to call tonight on all health boards in Scotland to collaborate through a national once-for-scotland approach to ensure best practice to deliver the highest quality care. As part of that excellent care, we should be offering an annual check to all those that have a stoma. It is clear that some won't need this option, but there are some that will, and we should remember that while stomas can stabilise, equipment does change and improve, thus a review can make things better. Prior to this evening, MSPs received a colostomy bag. There's a huge range. One size can be cut to fit all, but there are subtle differences. In those differences that make the difference in many cases, and there are some 15 or so companies that bring their skills to designing and making the bag. But there is a danger that in future that we might go down to having one bag maker and supplier, and I would encourage everyone, including stoma nurses, to consider the full range because it appears that not to do so would not be making the best use of technology. I'm looking forward to hearing contributions from other members, but before I do so, I'd like to make a plea. Five asks that are being asked and promoted tonight and hopefully promised by the Government that the reception can be delivered by the Government at very low cost, and I believe that we all can support them. However, I think that there's one thing that we can champion, and this comes back to what Mr Cole-Hamilton said, Presiding Officer. When we go into a building, I would urge every single member of this Parliament to ask the simple question, does the disabled toilet have a shelf? It is a strange question, and the answer is they should have. Why? Well, if you want to change a stoma bag, you'll need a variety of equipment, replacement bags, possibly scissors and mirror, wet wipes, a disposal bag, and perhaps even a stoma collar. If there isn't a shelf, Presiding Officer, the only option is to lay them out on the floor. Not great and certainly not hygienic. A simple shelf costing a few quid could change all of that. So, I'd like to start the ballrelling tonight, Presiding Officer, by asking you if you know whether the Parliament's disabled toilets have shelves. Presiding Officer, thankfully, you're not going to— Sorry? Yes, I would take an intervention. Christine Grahame, on behalf of the corporate body, I suspect. I am, actually. I can't speak on behalf of them, but I am a member of the corporate body. But before I say that, can I say I find this a very emotional speech to listen to, and I commend you from my heart, Edward, for speaking in that way and bringing it to the chamber. But as a member of the corporate body, I've listened to what you've said, and we will have something done about it. Even if it wasn't through the chair, Edward Mountain. Well, Presiding Officer, that's one of the things that would make my evening. Because I did ask, actually, this Parliament whether they would fit shelves over a year ago. And the latest thing was they're still thinking about it. Well, if the corporate body through Christine Grahame are going to promise tonight, I think there may be some other members of the corporate body that might have to be considered. But, you know, let's go for that. But it's not just this Parliament where there's a problem. What I would say to you is, for example, NHS Highlands disabled toilets don't have a shelf, and I bet they're not the only health board. So we have a way to go. And this Parliament, by putting shelves in, if that's what they decide to do, could make a real change and lead the way. Frankly, Presiding Officer, I think I've said enough. I have the greatest admiration for all in the Stoma world. Those that make the bags, those that fit the bags, those that wear the bags, and those that look after those people that are indeed wearing the bags. But my greatest admiration is for those that wear them, proving every day that they are no different to anyone else. And whatever the challenges that they face, life is for living. I look forward to hearing the rest of the debate. Thank you, and congratulations, Mr Mountain, even if you have exposed divisions within the corporate body. We now move to the open debate. I call first Emma Harper to be followed by Alexander Stewart. Around four minutes, Ms Harper. Thank you, Presiding Officer. I welcome the opportunity to speak in this short debate, and I congratulate Edward Mountain on securing it. And I welcome everybody to chamber here this evening. I recognise the work that the member has done, both to raise awareness of Bill Cancer and Stoma Care in Scotland, and to champion Stoma Care for the people across Scotland, including hosting the reception this evening. Unfortunately, I won't be able to attend the reception because I'm chairing a cross-party group, but I wish you well at your event. I also remind members that I'm a registered nurse, and during my time in the operating theatre, I assisted in many cancer and stoma creation surgeries. I know that stomas can be created for a number of reasons, such as Crohn's disease, ulcerative colitis, and when I worked in Los Angeles, even as a result of trauma inflicted on people by stab wound injuries. Not all stomas are permanent. I'm sure I will. Thank you for taking the intervention. I also thank Edward Mountain for bringing this to the debate, and being so honest and forthcoming in his speech about his own experience. I am a co-covener of the cross-party group on inflammatory bowel disease, and one of the things that resonated with me from Edward's speech was about the different sizes of stoma that were required, because the thing that we haven't yet talked about is for cancer patients that can be life-saving treatment, but for Crohn's and colitis, it's life-changing, moinly, and that can affect a lot of young people and children. We just have a thought about how they are impacted in terms of stigma, in terms of facilities and schools and everything else that's already been mentioned. Okay, thanks. Thank you, Clare Adamson, for that. I think that it is absolutely important, so in my experience, I've looked after children who have had stomas created, and I think that it really is important that we highlight stigma associated. Actually, to pick up on the point that Edward Mountain talked about the disabled toilets in this place, the ones on the fourth floor where my office is, they had a table during Covid, but now there isn't a table, and actually that would be really simple just to return a table while they're working on the shelf issues. So I absolutely support that ask that Edward Mountain has made here in chamber this evening. I wanted to pick up a wee bit about screening and bowel screening. It's now quicker and easier to do with one wee small sample to send instead of the three samples that was previously required. I know that people who are diagnosed earlier, 14 times more likely to survive bowel cancer, and bowel cancer is one of the main reasons of what we are stomas are created in the first place. The screening test is offered to people between the age of 50 and 74. I was interested to read that the latest screening uptake stats for Dumfries Gallow in the Scottish Borders are as follows. 60,677 people in DNG were invited for their screening tests, and 38,070 were screened. That was an uptake of 62.7 per cent. So that's gone up on previous years that have been noted. And also for the same period in the Scottish Borders, 47,389 people were invited and 30,944 were sent in their samples. So their uptake is slightly better than DNG, so there's a wee bit of competition there. 65.3 per cent uptake. So those are good figures, but obviously we need to improve those figures. For the fact that we're discussing this and raising awareness in chamber today, about the importance of screening is really important. And I know that our time is really short, but yes, I think I'm almost out of my time, though. Douglas Lomstone. I thank Emma Harper for taking the intervention. She mentions the figures. It was almost like a third are actually getting the test, but are not actually doing it. Does she have any ideas of how we can try and increase that number to get nearer to 100 per cent? Emma Harper. Yes, sure. I think obviously there needs to be work to be done to continue to raise awareness of the importance of screening. And partly that's what is helping us today to talk about that. I'm sure there is work that will be taken forward again to just continue to raise awareness of the importance of screening, so not even just screening for Bill, but for other screening that we're doing. The final thing I wanted to touch base on, presiding officer, was just mentioning the Stoma Care nurse specialist, because if we didn't have them, there would really be challenges for people to hear about how Edward Mountain has described the black marker dot on his abdomen. I've seen that being taken forward for people and sometimes people, you can see how well informed they are and other times they need some real good support and information. So the Stoma nurse network in Scotland, I think, should be absolutely valued and supported because they are doing a phenomenal job. And so, presiding officer and closing, I want to thank Edward Mountain again for his courage in bringing this debate forward. And all the people who work in Stoma services, I think, should be basically recognised for doing a fantastic job and encourage everyone eligible to ensure they take up their screening invite. Thank you. Thank you, Ms Harper. And I call Alexander Stewart. Would you be followed by Gordon MacDonald? There are only four minutes, Mr Stewart. Thank you, everybody. Presiding officer, I'm very grateful for this opportunity and I'd like to commend and congratulate Edward Mountain on his courage in bringing forward this member's debate this evening. I'd also like to apologise to you, Deputy Prime Minister Edward, the minister and members because I have to leave after my contribution and I won't be able to attend your event because I'm hosting one myself in the building, Edward. But my thoughts are with you. I echo the debate's motion and I'd like to put on record my sincere thanks and commendation to all dedicated professionals involved in the care of those living with Stoma. It really is a change of life for these individuals and they do that with courage on a day-to-day basis and, as I say, they have to be congratulated on how they manage that process. But they are supported by a network of individuals and nurses and they also are worth our weight in gold and give support to individuals daily. These individuals, by the very actions, also give much needed support, comfort and reassurance every day to individuals. And we've already heard that some of them have to deal with the trauma of leaks within their bag or how they manage that, where they can change it, how they can be developed. All of that is a major issue on a day-to-day basis for some individuals, Deputy Prime Minister. And I know that the reassurance that we have in teams that are there supporting Stoma nurses and within my own region, we have teams within the Forth Valley Royal Hospital and also Perthwell and Firmry, and I know the work that they do supporting individuals in the community the length and breadth of those areas. And it is an expensive issue and it has become, Deputy Prime Minister, we cannot look away from the processes that are taking place and some of that process needs to be streamlined to look at where we're going. Back in 2020, Nursing Times reported that senior nurses are seeking to establish this once for Scotland national approach to Stoma care and to end the variations in practice and bringing down some of the costs because they have much roomed over the last few years. And we now have seen a 65% increase over the last five years which now reaches 31 million with reference, but there's only been a 10% increase within patients. So there's something to be to look at as to how that's managed. The cost should be roughly between £700 and £2,000 a year but in some areas it's now exceeding over £5,000 or £6,000 to deal with patients and that has to be managed and looked at. Back in 2018, the Scottish Executive Nurse Director Group commissioned a national Stoma quality improvement group study short life working group to look into the matter and they have come forward with many recommendations. Because of Covid, those recommendations took some time to come through but the report has highlighted that there requires to be a review and I look forward to hearing from the minister in her summing up although I won't be here, I look forward to seeing that later about how we can manage some of that because that's vitally important that we are giving the support to these individuals and issues have been flagged about the review picked up about GPs and the over reliance on GPs who are often stretched and their capacity to manage and support individuals was there. All these groups, as I said, have a common denominator. They are all looking to support and do as much as they can across Scotland to affect everybody. So in conclusion, I am aware on a personal level about the benefits and challenges that happen with under Stoma because my own mother has one and has had one for a number of years. I very much look forward to hearing from the minister as I was saying in her summing up about how the Scottish Government can make and ensure that in the streamlining of Stoma care that is resilient and that we empower Stoma nurses to become much more practitioners in dealing with, they do a phenomenal job on a day-to-day basis but they are, as I say, sometimes the unsung heroes about supporting individuals and we need to commend and congratulate them what they do in supporting individuals day in and day out. Thank you very much. Mr Stewart, looks like it's going to be a busy evening of events in the Parliament this evening. I'll call Gordon MacDonald to be followed by Calmogh in around four minutes, Mr MacDonald. Thank you, Presiding Officer, and I thank Edward Mountain for bringing this motion forward for debate. I wasn't intended to speak tonight but having heard Mr Mountain's earlier question to the minister, I thought it was important that I highlighted my experience because I'm an estimate in one of the 1 in 335 people across the UK who have lived with a Stoma. I've learned to live with having a Stoma over the last seven years. And I'll take this opportunity to thank the staff of the Western General Hospital, especially my consultants, Mr Wilson and Mr Clark, and the Stoma nurses, Ayla and Sheena. Earlier, Mr Mountain suggested that there was a need for an annual review for all ostomates. But in my experience, this is not necessary. Support is required but predominantly when you first find yourself with a Stoma. When you leave hospital after the major surgery to have your Stoma formed, the Stoma nurses visit you at home to support you in Stoma care. The Stoma nurses then invited to their clinic whether you will receive a regular check-up until such times as your Stoma settles into a regular pattern. The Western General also has a dedicated helpline and if you don't manage to speak to a Stoma nurse immediately, they'll phone you back. No matter how trivial the inquiry is as it's about providing reassurance. If you live with a Stoma, you have many questions, especially at the start, what food can I eat? How much liquid can I drink? Is there anything I should avoid? How do I deal with ballooning and pancaking? Is there anything I should avoid like heavy lifting or can I travel abroad? In my experience, the current system works given the pressures on our NHS. Presiding Officer, this Saturday is Stoma Awareness Day and the theme this year is smashed social exclusion. Many people like myself have that hidden condition and can from time to time require toilet facilities that are safe and clean to make Stoma bag changing easier. We require simple changes to facilities to make life easier. Those include a hook on the door, shelf space, a mirror and a disposable bin. Research by Colostomy UK found that some people living with a Stoma found that a lack of suitable toilet facilities led them to feel socially excluded as they have concerns that clean, safe and suitable facilities will be difficult to find when out in public or at events. Edward Mountain has said that here in this Parliament we have accessible toilets but even here they are not suitable for Stoma users. Minor changes would resolve that situation and I am sure now that it has been highlighted in public facilities management team will address the shortcoming. Finally, Presiding Officer, those of us in Scotland with a Stoma are fortunate that we do not face the prescription charges of £9.60 per item that are chargeable south of the border. For my Stoma care I require seven individual items, five of which must be ordered by prescription from my medical practice. In England you may qualify for three prescriptions if you have a Stoma but not if you have a temporary ileostomy. Given the cost of a loving crisis the UK Government should introduce three prescriptions for all those individuals living with a serious health conditions as the SNP Government did in Scotland. Thank you very much, Mr MacDonald. I now call the final speaker in the open debate. Carol Mock in around four minutes. Thank you Presiding Officer and of course thank you to Edward Mountain for bringing this motion and debate today and for making such a personal contribution tonight and to others who have done so. I can also take the opportunity to welcome the people in the gallery. It is called the people's parliament for a reason. It is really important that they come along and they bring the things that they want us here to talk about. And these are the things we can do in the Scottish Parliament to raise awareness of the issue of Stoma care and raise awareness of the team of experts helping every day to make life manageable for people who have been through what the motion describes quite rightly as a life-changing event. We have heard about what a Stoma is and how it affects lives and as Edward Mountain described the bumps in the road. We have heard that I think you said about 20,000 people in Scotland have Stoma support. I also want to mention as others have the exceptional team around people and there are so many that I looked into what kind of support people might need through that journey. So from the Stoma care nurses which have been mentioned to community pharmacy to community care workers, to GPs, practice nurses, family carers, the list is actually endless and I think we should all take the time to thank people who support individuals through this journey and at different times in that journey. In my career before this place I was fortunate enough to see many positive stories of patients going through this really difficult journey and taking them to a place of acceptance, of hope and of understanding that life is there and does go on and I want to honestly say that that came through the support often of the Stoma care nurses. They do help to change lives. So in the short contribution that I have I just want to raise with the minister when we get the opportunity I think we have a responsibility to do that to secure this for the future. Make sure that we have the well-educated skilled nurses for the future and I think it links to a point that the member Edward Mountain made earlier in the chamber around making sure we have the skilled nurses and we have a workforce plan for nurses because to get these extremely skilled Stoma care nurses then we have to have people coming through and into the profession. I recently visited the University of the West of Scotland the Air Campus in my own south of Scotland region where I had a tour of absolute cutting-edge facilities provided to nursing students. I heard and had an extremely useful discussion with the teaching team around the drop in applications to nursing. Now with such facilities and such skilled nurses I would hope we can start to encourage many students to come back into the nursing profession. It is disappointing that the figures in June 2023 show a decline of number of applicants to the Scottish programme. I think it was 6,450 as opposed to 7,930 in 2022. The Royal College of Nursing has asked the Scottish Government to work on how we make sure that this is seen as a valued career with good career choices which of course it is. Have you visited the local university provision? I think we can all champion nursing as a profession. I recognise that I need to conclude and tonight is, of course, so I think Carl Mocken should be commended for encouraging folk into nursing as a nurse. I did what I did for 30 years of forecoming here. I wonder if she thinks that the comprehensive holistic care that Stomach care nurse specialist as part of their central to enabling Stomach care so that people can have good lives. So would she agree that that would be part of what we need to do to encourage people into nursing? An excellent intervention from the nurse amongst us. I think that I had a career in the health service also and we need to make sure that we encourage people to see all the avenues that we have in terms of career in the NHS and it is a wonderful workforce to be part of. But the Scottish Government do have a responsibility to make that an appealing approach for students. In concluding I want to just thank again Edward Mountain for bringing the debate. I want to thank all the hard working staff and teams that are around people who have Stomach care and our hospitals and our communities all the families I'm sure people want me to ask them to support to thank them for their support and have the opportunity to discuss this debate tonight and that I do make a commitment to make sure that if I am able I can ask anywhere that if they have a disabled toilet will they please place a shelf in it? Thank you Presiding Officer Thank you Ms Mocken and I invite Jenny Minto to respond to the debate Minister around seven minutes. Thank you Presiding Officer I too would like to begin by congratulating Edward Mountain on securing tonight's debate. And also welcome everybody in the public gallery. I very much appreciate Edward Mountain taking this opportunity that he has as an elected member in Scotland to raise the profile of Stoma awareness. As Edward Mountain knows my father had bowel cancer and the final three years of his life he was accompanied by his Stoma and so this is very personal for me. I also appreciate Gordon MacDonald sharing his experiences too. I remember these questions what food can I eat my dad asking that what can I drink and I had completely forgotten about ballooning and pancaking until Gordon MacDonald mentioned that. It's strange what memories bring back but I very much thank you for raising this. I think as well that Edward Mountain has done a great service to raising this previously. I've spoken to him about this before. He did an amazing sequence of tweets about his own experience and I remember going home and my husband telling me that he'd just liked one of Edward Mountain's tweets and I have to admit I nearly fell off my chair when he said that but when I understood what it was I was very appreciative of what he had done both my husband and Edward Mountain. So if I can take this opportunity Presiding Officer to support Edward Mountain's message and encourage anyone who believes that they may have symptoms that could indicate the presence of cancer to contact their GP immediately. The sooner cancer is caught the greater the chance of it being successfully treated and as Emma Harper has underlined as well and various other contributions and Douglas Lumsden like my husband social media is a great user and we are in a privileged position to take that responsibility as well and make sure that we are feeding out to our constituents the importance and for example the Scottish Government has be the early bird campaign which I think is really important and I think if we can all on this in round this chamber take the time to promote that then I think that's hugely important. So as I've said earlier I'm glad that we've had the opportunity to speak about stomas here today and it is I think we can all say that an aspect of healthcare that's not in the public eye and as Emma Harper explained she said the reasons for having a stoma can be for many other reasons not just simply cancer and I think that is important for us to recognise here the request for shells in disabled toilets it's something I'm going to start looking out for I believe Sainsbury's has been moving in that direction Yes, of course Christine Grahame I think in the interests of harmony I better discuss this matter with Jackson Carlaw and the rest of the corporate body but I think collectively and I'm so glad that Gordon MacDonald brought it up as well because that would be useful to many other people who use the disabled toilets not just those with stoma bags so I think I just want to put that in the record so that Jackson Carlaw and I will speak to each other afterwards A sensible U-turn minister Yes, no I actually had thought from Jackson Carlaw's response that he would be willing to talk about it so I think maybe he just wishes he'd suggested it as his contribution to the debate perhaps if I may I think the speeches from the members really underline the importance I think everyone here in the chamber is reflecting upon about ensuring that we can express the importance of the support that we can give to those that are living with with a stoma I also think as Carol Mocken clearly outlined there is a whole network of people supporting patients and it can come in many guises from the surgeons and the stoma nurses that everyone's reflected upon in their hospitals to district nurses once the patient returns home and from also from third sector organisations such as Costume UK and also from family members and partners and I think as well it's important to recognise that they need support to and the understanding of how their loved one is living with this bag of life I think as you described it Edward Mountain and I think it's also important for those with stomas that they do have access to the support that they need especially in the early days as they get used to their stoma and this does not have to be restricted to healthcare professionals but also others who have a stoma who can be a very useful source of advice and encouragement and the points that both Carol Mocken and Alexander Stewart raised I'm happy to discuss with the chief nursing officer and ask them to raise with the directors of nursing and see what progress we can make so thank you both I appreciate Alexander Stewart's not here but thank you both for raising that I too will be attending the event in the garden lobby so I'm looking forward to being able to speak to more people in that are joining us tonight so thank you Edward Mountain for organising that in conclusion Presiding Officer it is really important that we have debates like this in the chamber I always feel from being elected this was one of the privileges that we do have to really increase people's awareness across Scotland and further about the various things that we can help with and I'm clear that stroma formation is an important aspect of healthcare whose benefits are perhaps not as widely known as they should be and I hope that tonight's debate will have gone some way to correcting this thank you thank you Presiding Officer that concludes the debate I would suggest Mr Mountain point his colleague Jackson Carlaw in the direction of a transcript of the debate but I wish you well with your event this evening and I close this meeting upon it