 The next item of business is a debate on motion 4472 in the name of Humza Yousaf on long Covid. I'd be grateful if members who wish to speak in the debate were to press their request to speak buttons now. I call on Humza Yousaf to speak to and move the motion up to 12 minutes, cabinet secretary. Thank you very much, Presiding Officer. I welcome today's opportunity to discuss our collective commitment to supporting the health and wellbeing of people in Scotland living with the long-term effects of Covid or long Covid, as it is often called for short. As we will hear today, while most people recover quickly from coronavirus, some people, both adults and children, can experience on-going symptoms for some months or even years after their initial infection. When we talk about long Covid, it's important to remember that this is an umbrella term. It covers a spectrum of different symptoms. Again, I suspect that when members are talking across the chamber about stories of constituents and those that they have engaged with with long Covid, they will no doubt go through a number of those different symptoms, which can vary in their presentation and have different impacts from person to person. Those symptoms include fatigue, shortness of breath, changes of smell and taste, difficulty in treating muscle aches and many more. It is very clear that, for those adults, children and young people who are most severely affected, those symptoms can have a significant impact on many areas of their lives, from physical health, mental health, relationships to education to employment. I have met people who have told me that their lives today are, effectively, unrecognisable to the ones that they had prior to catching Covid. Brian Whittle is very grateful to the cabinet secretary for taking the intervention. Would he consider assessing certain types of long Covid within the disability as a disability and potentially bringing that within those rules? It should be said under current legislation that my understanding is that those suffering the effects of long Covid could be termed as having a disability, depending on what the impact is and what the effect of that is. I am interested in further discussion about long Covid and whether it should be brought under the umbrella of a disability or not. Of course, we work closely on a four-nations basis with other parts of the UK, given the fact that there can often be overlaps and devolved and reserved competencies in this regard. It is an important point that Brian Whittle raises. Given the range of symptoms that can be involved, there is no one-size-fits-all approach to supporting people, insisting in terms of interventions, support and response to their own unique circumstances. For example, some people with long Covid may benefit from information and support to help them to feel more control of their condition and manage it on a day-to-day basis. I had a family member in that very position. They do not need any further support at this stage and hopefully not in the future, other than managing that condition, the breathlessness that they face and managing that on a day-to-day basis. However, I fully accept—and I have met many people—that require assessment by a member of their local primary care team, who may conduct tests to investigate their symptoms and provide access to other services where that is appropriate, such as community and mental health services, including rehabilitation. For a smaller group of patients, they may require further investigations and assessments that are delivered in a specific clinic or hospital setting. I also mention that, at this stage of children, when we often talk about long Covid, we often talk about adults. I suspect that most members in the chamber will have also engaged with long Covid kids, an important organisation that represents young people who are suffering the long-term effects of Covid. They have produced a support guide specifically for children receiving it formally in the coming weeks. On top of the health issues that affect particularly children, the mental health issues that particularly affect children, there is a desire in all by those who represent children who suffer the long-term effects of Covid for more to be done around education. Is that a challenge to us? I will give shortly. Can the Government do more around flexibility in education? I have promised long Covid kids and others that that is an issue that the Government will address. Of course I give way to Alex Cole-Hamilton. I am very grateful to the cabinet secretary for giving way. I am also grateful for him taking time out of his remarks to talk about young people and children who suffer long Covid. Can he quantify that for the chamber? How many children in Scotland currently have long Covid? It is quite hard to stick to come by. We know that we can prevent long Covid in children by preventing them catching coronavirus in the first place, by the installation of hyperfilters in Scotland's classroom. Can he address that and whether his Government plans to do just that? I do not know if I have the figure in terms of children. Let me have a look at that and I will come back to the member. Perhaps we will address that in closing, but we know of course that the most reliable surveys on long Covid tell us that over 155,000 people are suffering from long Covid here in Scotland. I think that there is probably more that we can do in relation to the data gathering. On long Covid, any good ideas that come forward in relation to education and educational settings are ones that this Government absolutely will look to not just progress but where appropriate resource is. On the interventions and actions that we are taking as a Government, let me put to bed any suggestion—I am sure that that will not come across in the chamber—but let me put forward any suggestion at all that a hard-working NHS and social care staff are not currently helping to care for people with long Covid. That is a notion that simply is not true. My thanks goes to every single doctor, every single nurse, every allied health professional, every social care worker, every member of the third sector, as well as many many others who have been working tirelessly to support those suffering from the long term effects of Covid. For example, the Thistle Foundation is delivering its remote self-management programme with a specific focus on supporting people with long Covid. This initiative has received £60,000 in the self-management fund, which is administered by the Alliance on behalf of the Scottish Government. Talking about his experience of using the service, Calum Kennedy said, quote, "...thanks to the incredible support received from Thistle, he now has confidence that at some point in the future he will be able to make a full recovery." Chest, heart and stroke Scotland, also supported by the Scottish Government through funding, is delivering a long Covid support service. This is enabling people to receive advice from nurses trained in managing common long Covid symptoms, such as breathlessness, such as fatigue. Almost 1,500 people have accessed the service since it was established, and 85 per cent of respondents to an evaluation exercise have strongly agreed that they felt supported to look after their health and wellbeing. NHS Inform has a dedicated website for people with on-going symptoms after coronavirus setting out key information and sources of support. In addition, all of our NHS boards have been delivering support to people with long Covid through providing access to local services that are relevant to addressing people's symptoms and needs. To provide just one example, NHS Lanarkshire's primary care occupational therapy service has supported people with long Covid to address issues affecting their day-to-day quality of life, including managing pain, fatigue and supporting their return to employment. One person who accessed the service described her local occupational therapist as being an amazing help in her journey. Let me be equally clear. I have heard from too many sufferers of long Covid that they do not feel that they have had a consistent level of support or care, and that concerns me greatly. It presents challenges for those living with those persisting symptoms who understandably are desperate for an answer on how long their symptoms can be expected to last and what are the underlying mechanisms that are causing those symptoms. It also presents frankly challenges to our health and care staff who are supporting people living with a new condition, for which the chapter in this medical book, in all earnest, is still to be written. I share the deep sense of frustration of those who are living with long Covid that, although there may be approaches and treatments for managing some of its symptoms, there is, to quote the National Institute for Clinical Excellence, a lack of evidence for pharmacological interventions to treat long Covid. That is why, of course, some of the funding that we bring forward is for further research into this. However, we are not simply waiting for research funding. Yes, of course. I give way to Pam Duncan-Glancy. Pam Duncan-Glancy. I thank the cabinet secretary for taking the intervention. Can the cabinet secretary confirm whether that data collection will include inequalities and the way in which long Covid has affected different groups of people? As I responded to that, I absolutely should. I am up front and I am being frank about this. I do not think that we have the level of granular detail that we need in relation to those who are suffering from long Covid. We have, as I say, some of the headline figures, but in a granular level when it comes to children, people with disabilities, how many minorities does it affect, etc. I think that data, frankly, is not at a place where I would like it to be. We are not just waiting for research findings, of course, to materialise. We are listening, we are taking action, we will continue to take whether action is necessary. In that light, I am delighted to confirm that we are allocating additional funding, and I stress that word, additional funding, of £3 million to health boards across 2022-23 to bolster the support that they are already providing to people with long Covid. That responds directly to the needs highlighted by boards, and they are learning from supporting people with long Covid since the start of the pandemic. Crucially, it has also been shaped by the priorities highlighted by people with long Covid themselves. People with long Covid highlighted that finding the right support and navigating your way through it when you are experiencing multiple symptoms, particularly forgetfulness or brain fog, can be challenging. That is why our investment will test the introduction of care co-ordinator roles that provides a single point of contact for people with long Covid and their families. People with long Covid also stress the value of clinicians taking time to listen, showing empathy, feeling understood and having their concerns validated. That is why our investment will provide extra resources to support people with long Covid to have a holistic assessment of their needs to ensure that they can access the community or healthcare support and service that is most appropriate for their individual circumstances. The funding will also provide additional capacity for community rehabilitation services such as occupational therapy, which can support people with long Covid to address issues affecting their day-to-day life, their quality of life, including managing pain, fatigue and supporting a return to employment. Some of that investment will also be focused on children part of greater Glasgow and Clyde funding, for example, for a paediatric OT. I give way to Jackie Baillie. Can I thank the cabinet secretary for taking in intervention? Could he confirm for me, because I think clarity is important, that the £3 million that he talked about that was additional is actually part of the £10 million that he announced in September 2021? I mean by additional. Yes, it is part of that £10 million fund, but what I mean by additional is that it is on top of what has already been spent to help to address and alleviate, I would hope, some of the symptoms that sufferers of long Covid are suffering from. I am very conscious of my time and it is towards the end. There is plenty more. I could say, I am sure, that my colleague the minister will sum up and add some further detail. What I will say is, from our perspective, our strategic network, which is made up of clinicians, it is made up of course of colleagues from health boards, but importantly with those with lived experience will continue to guide us on the way forward in relation to managing and hopefully being able to assist those suffering from the long term effects of Covid and closing. I would like to reiterate my own personal commitment and that of this Government to continue to listen, to learn, to draw upon the best available evidence to make sure that every person with long Covid is able to access the safe, effective and person-centred support that is right for them as locally and as quickly as possible. I move the motion in my name. Thank you. I now call on Sandesh Gulhani to speak to and move amendment 4472.3. Thank you. It's great that today's key debate on long Covid has been rescheduled, but given the growing scale of problem it is many months overdue. The Cabinet Secretary might be surprised to hear that we agree with him. We also recognise the negative impact that long Covid is having on so many Scots and the debilitating long-term effects. Plus, we also agree that the NHS and third sector are working so hard to help with long Covid, but waiting times are so long. For example, our waiting gynaecology in Glasgow for cancer, which is currently about six to eight weeks. But I'm pretty sure that those struggling with long Covid, some watching in the gallery today like Stuart, others following the debate at home, won't be impressed if we just continue to reel off generalisations. They don't really want to hear platitudes like those who need clinical support should have the right help at the right time. Long Covid sufferers want concrete action from this Parliament and they need it now. In fact, they needed it last year. The SNP Green Government's inaction is having a real impact on those affected by long Covid. When the Government's long Covid paper was published in September last year, we estimated that around 79,000 people were suffering from long Covid in Scotland. Now, after eight months of dither and delay, that number has almost doubled to 151,000. Please let that sink in. It's not as if we didn't know long Covid was coming either. In March 2020, Scotland confirmed its first case of Covid-19. From the summer of 2020, it was clear that a rapidly growing number of people were not getting over their run-in with the virus. At my GP surgery, more and more patients were presenting with what seemed to be random symptoms, such as fatigue, dizziness, brain fog, pain in their joints, poor mental health, symptoms that were just so wide-ranging, including slurred speech, indescribable headaches, fluctuating heart rate, numbness, abdominal issues. Long Covid is hitting the country hard, impacting. Yes, I would. Alex Cole-Hamilton. I'm very grateful for Sandesh Kilhoney taking the intervention. He describes his experience in the foothills of the pandemic. Does he recognise that those who had long Covid from the first wave perhaps didn't have a Covid positive test result on their medical records because we weren't testing? Similarly, now we aren't testing, and people who catch long Covid or develop long Covid as a result of their infection will have to fight to get that diagnosis recognised again. Sandesh Kilhoney. I absolutely agree and think that it's important that if we have long Covid support, one of the key tenants is not a positive Covid diagnosis because we know that to be the case. Cabinet Secretary, I have spoken about this and I feel that he agrees with us. As a clinician, confirm that getting somebody's support for any of the long-term effects of Covid is not reliant on that positive test. You'll be able to confirm that as a clinician. Absolutely, and as I said, the conversations that we have had, I think that you do agree with this point. Long Covid is hitting the country hard and impacting individuals, families in the labour market and the delivery of healthcare services. As the Cabinet Secretary says, long Covid hits patients hard. As a practicing GP, I have countless examples. A young mum who had a job used to run 5 to 10 kilometres a day, she has family but now can barely make it to the toilet without feeling breathless, no choice but to give up work, financial pressures are coming and she was forced to sell her house and move in with her parents. I know a doctor here in Scotland who was forced to quit because of the exhaustion and headaches which made it impossible to function. In fact, telephone consultations were out of the question because she was so breathless and couldn't do them. Then there's our youth, over 80,000, 12 to 16-year-olds across the UK struggling to function with long Covid. In my Scottish Parliament made a speech on 27 May last year, I underscored the problem of long Covid. Then, on 1 June, as MSPs debated national health service recovery plan, I called on the Cabinet Secretary for Health to commit to establishing a specialist long Covid clinic. Our paper, Treating Long Covid in Scotland, came out shortly afterwards, setting out an action plan that includes investing in a network of specialist clinics and an app-based treatment centre at service, ring-fence funds for Covid care and a programme of research to discover more about the disease and its long-term impact. Having extensively researched how regions across the UK were responding to long Covid, I recommended the Scottish Government to take the holistic approach developed by the Hertfordshire Community Trust. This involved a rehab pathway involving an MDT, including GPs, physios, respiratory nurses, dieticians and clinical psychologists who can then refer into other clinics. Much of this is delivered remotely. The team in Hertfordshire freely admits that they didn't get everything right, but would happily come and tell us how to get things going in Scotland. I'm concerned that we might want a north of the border solution for just that. We're still waiting for a solution. On 9 September, the Cabinet Secretary for Health announced in the fanfare £10 million for long Covid and I promise to deliver the best models of care to help health boards to respond to the condition. Yet now, in May 2022, where are we? While England has 90 long Covid clinics and I accept not all of them have positive feedback, Scotland does not have any. As for the £10 million fund to support long Covid services, this has been tweaked, £3 million allocated this year and next, and more money to come. Will this even touch the sites? Indeed, will there be a clear audit trail on how this new money is spent? I do hope so. Scotland is facing a tsunami of long Covid cases, but the Scottish Government has not been acting. This has not lost on the long Covid patients that are suffering. I received an email this week from a man who caught Covid in 2020 and suffers from cognitive and visual issues for two years. No clear clinical pathway exists for him. He says his mental health has not been looked at. He does not feel that mental health has been part of the long Covid dialogue, yet it is crushing thousands of Scots with this condition. He knows of two long Covid sufferers who have recently died from suicide. He signed off by saying he watched the Cabinet Secretary on BBC's The Nine and was deeply disappointed in the clear lack of understanding regarding the situation that sufferers face. Today, we were hoping that the Cabinet Secretary had good news for the country's 151,000 sufferers. We welcome more detail around the role of a long Covid coordinator. For example, are they clinical or non-clinical? Are they going to be available throughout Scotland? What would good news look like for people who are watching in the gallery and around? To start with, we need a joined-up approach where GPs can make speedy referrals to a Covid clinic and not have to see the patient multiple times and make multiple referrals to specialties such as occupational therapy, physios, cardiologists or respiratory specialists. We also need urgently to create an NHS-long Covid app for Scotland. We do not need to reinvent the wheel. We do not need to repeat the issues of the failed Covid passport app. We should be noted that the NHS Trust in London Barts had an app up and running in December 2020. Going forward, we should be learning from tried and trusted best practice from north and south of the border. In fact, east and west, it does not matter. In our major cities, it may still be desirable to bring specialties together under one roof, but a central belt solution does not work for the highlands or the borders. Many long Covid sufferers cannot travel. They simply cannot. Why the Hertfordshire model works? It's not a one-size-fits-all clinic. Presiding Officer, to conclude. NHS staff are going above and beyond, but they cannot provide the service patients deserve because we are failing to tackle long Covid head-on. We need to launch and operate a network of long Covid clinics. Tackling long Covid is key for the whole of Scotland to speed its recovery from the coronavirus pandemic. Long Covid sufferers are demanding long Covid clinics. They are begging for long Covid clinics. We need to listen to long Covid sufferers. For this reason, we cannot support the Scottish Government's motion because it does not go far enough, despite some of the things that we do agree with. I move the Scottish Conservatives motion on my name. I wish to draw members to attention on my registered interests as a practicing NHS GP. I now call on Jackie Baillie to speak to and move amendment 4472.1. Presiding Officer, as others have said, this debate is long overdue. Cancelled last month to spare the Cabinet Secretary's blushes because not one penny of long Covid money had been allocated. Two years on from when I and others first raised long Covid with the SNP Government, we now have baby steps being taken. Snails move at a faster pace. There are now an estimated 151,000 people in Scotland suffering from long Covid, as many as 10,000 are children, and 64,000 have experienced symptoms for over a year. That number is rising steadily by tens of thousands, month after month, as Covid continues to tear through our communities. Long Covid is debilitating. It impacts on daily lives. Many are unable to work or to undertake the most simple of tasks without being exhausted. David told Long Covid Scotland how he's gone from being a fit and professional civil servant working 40 hours per week to being housebound. That's what he had to say. I did my part and didn't seek treatment at the height of the pandemic. I went to bed each night, not knowing if I would wake up the next day. I've hit a wall with treatment and there's basically nothing available to support me. Freya told Long Covid Scotland, my life has been on hold due to long Covid and my world has shrunk. It is inhumane to leave us suffering like this with no treatment. That is the reality for those living with long Covid. The £10 million announced for long Covid treatment last year has actually still to be spent. Not a single penny has yet been used to treat and support those with the condition. From Dumfries and Galloway to the Western Isles, from Lothian to Glasgow to Ayrshire and Arran, not one single health board has received any money so far. Do you know what? They all got a letter today notifying them of funding in time for this debate. A person much more cynical than me would wonder at the timing. Cabinet Secretary, tell us about the timing. I thank her for giving way. Is she seriously suggesting that our hard-working nurses, doctors and AHPs have not been treating people with long Covid? Of course, if they have been treating people with long Covid, that is funded by the Scottish Government. It is additional funding on top of what we have already been funding, our national health service. Does Jackie Baillie accept that point? That is disappointing, Presiding Officer, because if nobody else knows this, the Cabinet Secretary knows that the NHS is stretched to breaking point. It is at crisis. You are asking them to do even more with the little money that you give and the £10 million that you announced months ago that you have not put out to help them to put in place services that are required. Shame on you! It is £10 million over three years, which works out as a paltry £33 per person per year. No specialist clinics, no specialist dedicated pathways and little support for Scots with long Covid in England. At least £210 million has been announced for long Covid clinics, for services for children, money for GPs to help with diagnosis. In Wales, they resource dedicated clinical pathways more than a year ago. Another £5 million now, £10 million for a country with a population half our size. Why is the scale of the SNP's ambition so much less? On almost every issue, the SNP will claim that it is the UK Government that prevents them from acting. The reality is the opposite. Health is fully devolved. It cannot act, but it simply won't at the pace and scale required. The Government talked about joined up treatment pathways, yet a long Covid Scotland survey in March found that patients struggled to get their symptoms investigated. Heart and lung problems are associated with long Covid, but only one in four people said they had been referred to a cardiologist or a respiratory clinic. Only one in 20 people said they had been referred to neurology, right, cognitive impairment and brain fog being among the most commonly reported symptoms. When patients were seen by a secondary service, they often reported only one appointment with no follow-up treatment. The Government will argue that tackling the issue requires a holistic approach, but when one health board put in an evidence-based bid to deliver that holistic approach to access the funding, they were told that their proposals are more than the Scottish Government is willing to give. The truth is that the SNP is simply not serious about helping those with long Covid recover. At the moment, Government policy seems to be that community transmission of Covid is something that we have to live with. But as people catch Covid again and again, despite being vaccinated, so more are getting long Covid, and that is true for children too. Unless action is taken, like improving air quality in schools, and that is hepper filters, rather than slicing the bottom of classroom doors, then more children will be infected and more will end up with long Covid. There has also been a lack of action around research on long Covid. Where is the quality paediatric research? Where is the research on antivirals or prophylactics? There is much more the Government needs to do. But I want in my closing moments to turn to look at employment. Long Covid Scotland carried out an employment survey in March this year. It discovered that the condition had a profound effect on people being able to work. Some have managed to return to work, some are there with reduced hours, some have not been able to return at all. Employers are struggling to understand that they are not making reasonable adjustments, and some are insisting that staff return to work when they are simply not able to do so. Some are on full pay, some are on reduced pay, some have lost their jobs completely. This is especially frustrating for frontline workers who put themselves in danger, caught Covid, now have long Covid and are being threatened with no pay if they do not return to work, whilst they are still really ill. There is an urgent need for occupational health service, advice and support for employers and employees. It is available in major public and private sector bodies, but it is not the case everywhere. Let me close, Presiding Officer, with words from Ikey Worker. I worked on the front line during the pandemic with very little PPE. I just feel discarded. I gave my health to help others and now I'm just a number. The voices of the 151,000 who are suffering with long Covid can no longer be ignored. It is high time that long Covid is met with the gravity and urgency that it deserves. I move the amendment in my name. Thank you. I now call on Alex Cole-Hamilton to speak to and move amendment 4472.2. Thank you very much, Presiding Officer. I rise for the Liberal Democrats and I move the amendment in my name. Today, finally and belatedly, we debate this devastating condition in government time. It is shameful that the SNP green coalition have made sufferers wait this long. Long Covid was first recognised over 18 months ago, as we've heard several times. It affects over 150,000 Scots and that is rising. It has been characterised as possibly the biggest mass disabling event but the government's progress on this has been utterly glacial. Long Covid is insidious, it is debilitating and it is widespread. It manifests in any combination of literally hundreds of symptoms, air, hunger, diarrhea, muscle spasms, brainfrog, chronic fatigue. It ruins livelihoods and it hobbles lives. Presiding Officer, until now, sufferers have been deprived of voice in the proceedings of this Parliament. So today, they speak through those of us, like myself, like Jackie Baillie, like Dr Sandesh Gilhane, who from the opposition benches have dragged the government to this point. Today we speak for sufferers like Anna, who at just eight years old has had her education and her childhood ruined by Long Covid. When asked by her mum Helen Goss, one of the founders of Long Covid kids, to describe her condition to the first meeting of the Long Covid CPG in this Parliament, she did so in just three words. I hate it. Anna is just one of over 10,000 Scottish children battling the condition and who seldom get the attention that they deserve. I speak today for Stuart, my constituent, who is with us in the public gallery today, a man of ages with myself who had his whole career before him and who can't be sure if he'll even have the strength to leave the house on any given day. Even now, despite the latent recognition in the remarks of the Cabinet Secretary, each of them and the 150,000 people like them would be better off moving to England where there are Long Covid clinics, care pathways, dedicated research trials. Presiding Officer, on this matter, this Government have been woefful only after the initial pressure. Did the Cabinet Secretary announce £10 million for Long Covid in September last year but until this month not a penny of that money had even been allocated? Prior to that point and at every time since, Long Covid is only ever raised in this chamber in opposition time. In November, I led the first parliamentary debate on the matter. In January, my colleague Beatrice Wishart asked the Government to provide an update on the fact of Long Covid. She was told that it would perhaps be discussed as an option at the bureau. In February, I highlighted to the First Minister that less than 1% of Long Covid sufferers have been referred to the chest, heart and stroke support service. She told me there was no need to intervene. In March, Jackie Baillie and myself and Sandesh Cole-Honey pressed the First Minister on why none of the £10 million have been allocated to the Long Covid support fund and she said that allocation would come in following weeks, weeks and weeks have passed. The weeks and months have passed and the SNP green coalition's approach to this awful condition is one of manifest disinterest to add insult to injury. Neither party could be bothered to send a representative to the national Long Covid hustings ahead of the council elections. I say to the Government benches both SNP and green that the long Covid sufferers will find you out. Their announcement that £3 million will be spent this year is eight months too late. It is wholly unequal to the challenge and it will not touch the sides. That is what we have come to expect from this Government when its main resource that it makes available to sufferers these past two years is the chest, heart and stroke Scotland support line. Make no mistake, this is a valuable service to Long Covid sufferers, and it offers them a safe place to speak to their advice line nurses and provides wider support through the Long Covid patient support group. I want to make clear that my frustration on the lack of progress does not lie with them but as I have already mentioned fewer than 1% of patients have been referred to that service fewer than 1%. While the First Minister may believe there is no good reason to intervene here I can assure her there absolutely is. There is currently no primary care to the service meaning that when someone with Long Covid visits their GP it is unlikely that they will be automatically referred. They may be lucky to have a GP who is aware of the support line and encourage them to call but many will not. Compare this to England where those who visit the GP about Long Covid can be referred to post Covid clinic where they can be assessed by either doctor or nurse or a physiotherapist. A Government may try to say that these clinics don't always have the best feedback but at least patients in England have the option to use them. We don't even have that here and as such, Scottish sufferers are being left far behind. They are not getting the help they need. The Scottish Government must recognise the enormity of the public health disaster that this represents. Cabinet Secretary, you have got to start listening. Listen to Chess Heart and Stroke who tell ministers that they need an automatic integration of the referral system to be put in place. Listen to the Long Covid Scotland and the other third sector organisations who are calling for a human rights-based approach to provision and listen to Long Covid sufferers like Stuart, like eight-year-old Anna crying out for you to hear their lived experience and to act on them. When Scotland's pandemic story is written, the tragedy of that story will undoubtedly be found in our care homes but the scandal of that tale will be told in this Government's indifference to Scotland's Long Covid sufferers. I move the amendment in my name. We now move to the open debate and I call Evelyn Tweet to be followed by Brian Whittle. I very much welcome the Scottish Government's recognition of the impact of Long Covid and its commitment to help those suffering from this debilitating condition. As the National Institute for Health and Care Excellence points out, post Covid-19 syndrome is an emergent condition. It has made recommendations for further research on Long Covid in numerous areas. Their guidance is continuously reviewed and updated as new guidance comes to light. Further, it notes that there is a wide-ranging array of symptoms the most commonly reported as already stated today including fatigue, breathlessness and brain fog. It is right that the Scottish Government is not suggesting a one-size-fits-all approach but instead supporting a holistic patient-centred assessment of need and a range of approaches to treatment. Yesaba. I am very grateful to Evelyn Tweet for giving way. I have heard that phrase no one-size-fits-all approach will work several times from the Government's ventures today. No one-size-fits-all is right, but does she recognise that up until this point there has been no-size-fits-all from the Government? Evelyn Tweet. I am sorry, I would not agree with the member on that point and I will come on to say why within the speech. The symptoms really can be life changing. As Angela May constituent told me last year I was leading kayaking trips and hill walks and now I can't get to the shopping back, she added that my employer has been understanding I've had a phased return to work during half days in office instead of out on site but the reality is that if things haven't drastically improved in the next five months then I could lose my job. I was however disappointed to hear that Angela had been referred to the excellent NHS 4th valley reach rehabilitation teams which provide advice, treatment and support to local people recovering from Covid-19 in the community and at home as well as a severe medical impact on the individual that adverse effects on society and the economy should not be overlooked. The Royal College of Nursing reports that people working in health and social care are significantly more likely to report having long-term sickness as a result of Covid than the wider population but it's not only that sector that's affected. Earlier this year the Chartered Institute of Personal Development surveyed 804 organisations representing more than 4 million employees that survey found a quarter of employers now include long Covid among their main causes of long-term sickness absence Further they noted that only a quarter of organisations are providing training or guidance for line managers on how to support people to stay at work when managing health conditions and less than a fifth provide any guidance for employees. In response the CIPD is calling on organisations to urgently review their health and wellbeing strategies and ensure they are providing supportive support for those with long Covid. We have to recognise that each individual's experience is completely different and I would encourage all employers to read the CIPD's report and recommendations. I appreciate that there have been calls in some quarters for the establishment of long Covid clinics following a model adopted by some NHS trusts in England and that has the potential for all health boards in Scotland. However, I understand that many patients are waiting many months in England to go to these clinics. Excuse me I also understand that if replicated in Scotland one stock clinics could take precious resources from other parts of the health service. We need a system that offers long Covid sufferers quick access to a range of services depending on their particular needs that is flexible enough to develop and change as our research and understanding improves. I believe that the Scottish Government is supporting health boards across Scotland to do this, augmenting existing services with £10 million of funding that I am delighted with the additional funding that has been discussed today. I am also aware from my work on the health, social care and sport committee that the cabinet secretary regularly meets stakeholders, particularly those with long experience of long Covid so I am confident that lived experience will be at the heart of policy making. Presiding Officer, I note that the health and care, social care alliance Scotland will, like me, welcome the Scottish Government's commitment to a person-centered approach to long Covid care. Keeping people like my constituent Angela with lived experience at the centre of policy will ensure we get this right. Let's help all people suffering from long Covid to get their lives back. Thank you. I call Brian Whittle to be followed by Emma Harper. Thank you, Presiding Officer. I am pleased to have the opportunity to speak in today's debate. Long Covid is a condition that has taken the Scottish Government too long to recognise, document and respond to. I think that this, of course, is in the back of a Covid-19 pandemic which has impacted on so many aspects of our lives. If we look back to March 2020 in the day that the First Minister announced the first lockdown with the support of all parties, those of us in the chamber at the time, I think although we knew it was coming, we were still pretty shell shocked. I think the thought of shutting down a country was hard to imagine. That decision then was taken on the best epidemiological modelling, I can nearly say it, available to the Government at the time and into lockdown we went. Always with the phrase following the science to assure the public that there was method in the decisions that were made all with the support of the Parliament. Incidentally, following the science it was never properly explained because the science, of course, continually evolved and continues to evolve. For example, the First Minister went on television saying there was no evidence that mask wearing would be effective and we now know that evidence emerged to the contrary in that position changed. I think that lack of explanation about following the science made it more difficult to take the public with us. What we didn't recognise at the time was that the results of that modelling as the results of that modelling we've been implementing there was no modelling of what the unintended consequences are, the harms that might be of that lockdown which we now know to be significant. I think that's where the splits between the Government and other parties began and I know that I've asked many times in this chamber and in the Covid Recovery Committee how the Government is responding to these growing issues or even gathering the data on these problems and the answer has always spun back to tackling Covid. Of course, tackling health issues directly associated with Covid had to be front and centre but not exclusively. Recovering from Covid and its effects the gathering of data and data analysis is absolutely crucial. We needed a system that took this modelling and compared it to the outcomes of its implementation and in real time so that modelling could change and adapt and afford us the most informed pathway going forward. That effective IT system which could gather all relevant data and inform science and therefore the Scottish Government on the next steps and issues arising. We know the impact on cancer care, elective surgery and chronic pain all of which are going to be years in the recovery and we now have long Covid. As I said the Scottish Government have been too slow to react too slow to gather the data required 151,000 people in Scotland estimated to have long Covid estimated, Presiding Officer. The effects can be devastating in individuals as we have heard and their quality of life and as yet no treatment pathway for those 151,000 patients. We are once again behind the curve compared to other parts of the UK and I have to ask the question why did we not at least follow their data and their plans while we established their own. That is, of course, Cabinet Secretary. Will the cabinet secretary accept that there is a mountain of mounting evidence that long Covid clinics are inadequate that they are ineffective that they, frankly, just simply delay even further the treatment that somebody requires if he is not sure of that then will he at least accept that I will offer him that evidence afterwards in writing because I am afraid to say that there is a mounting body of evidence of qualitative data including an all-party group from Westminster suggesting that long Covid clinics are inadequate. Brian Whittle. I thank the Cabinet Secretary for that intervention because as I am about to go on to tell him that what I am highlighting here is not a new problem for the Scottish Government because prior to the pandemic Scotland was already behind the curve that allowed information gathering and free-flowing of that information. It was an issue, as the Cabinet Secretary is aware of. I have raised many times in the Health and Sport Committee last term with various witnesses who overwhelmingly agreed that a system where communication and collaboration are enabling across all health boards between primary and secondary healthcare pharmacies including the care system would allow for much more efficient responses. Now, Cabinet Secretary to answer to your question, the Health and Sport Committee, and I would ask you to read the report that was published on 1 February 2018 about technology and innovation in health and social care. This is the key to your intervention how we gather data and how we access that data. I quote here, we note a disconnect between Scottish Government strategies and local delivery and unwanted variations between health boards. We also recommend that the Scottish Government offer Scotland approach to the implementation of its forthcoming digital health and social care strategy. The interoperability of IT systems is essential for the fundamental of the Scottish Government draft vision to be achieved. What you are asking me is to take data from elsewhere. Through the chair, Mr Whittle. Through the chair, please. Sorry, Presiding Officer. When we agreed to carry out this inquiry, we thought we might be investigating ways of modernising the health and social care sector through the use of modern and groundbreaking technology and innovative and fresh ways of working. What we didn't expect to hear was a culture that was reluctant to adapt to new ways of working where innovation is not encouraged and a heavily outdated IT system still caused major barriers. We are way behind in Scotland in gathering and utilising data and an IT system that is interoperability across all data streams and the Scottish Government is slow to respond to long Covid as a direct result of this longstanding issue. I know that the cabinet secretary shares my interest in this area and I would ask him in closing if we would make this a priority in our Covid recovery including for long Covid because data and data analysis must happen and we must do better and ensure an endeavour to recover from this pandemic's effect and that must include long Covid. I welcome the opportunity to speak in this debate on long Covid. We have heard from more and more Covid-19 survivors that the impact of the virus last beyond the first few weeks of immediate symptoms as well as even over a year for some patients Covid-19 has a long-term far-reaching impact on their daily lives and we have heard this already. It impacts them physically, emotionally and cognitively and cabinet secretary and Evelyn Tweed has described post Covid syndrome now called long Covid symptoms already. As well as the respiratory complications I am interested in the cardiovascular and coagulation complications that are now being published. The BMJ notes a spectrum of cardiovascular complications sinus tachycaria, hypotension, various arrhythmias, mycar elischemia, acute myocarditis and heart failure, pulmonary thromboembolism and right ventricular dysfunction as well as left ventricular hypertrophy. The symptoms that I have just described serve to show that Covid and indeed long Covid is and can seriously impact a person at their physical health and that it is a complex condition. The Conservatives amendment refers to the need for long Covid clinics. NHS England states that the long Covid clinics bring together doctors, nurses, physiotherapists and occupational therapists to offer both physical and psychological assessments and refer patients to the right treatment and rehabilitation services. The clinics are largely virtual and they signpost people to the correct specialist service. The Scottish Government's long Covid service paper backed up by the £10 million investment it is the same investment as in England. It states, we recognise and acknowledge the impact that long Covid can have on the health and wellbeing of those affected. We are committed to ensuring that every person with long Covid is supported with access to the care they need in a setting that is as close to their home as possible. The long Covid service sets out support to ensure when someone presents at primary care with long Covid, they cannot access the services they need most. There is also a really useful sign guidance for patients for a booklet. Actually, I found it really helpful as well and it helps to explain what support is available in Scotland. In reference to the symptoms that others have highlighted earlier, these are complex and they include blood tests, multi-disciplinary team assessments and interventions to diagnose, for example, left ventricular hypertrophy or complex clotting issues that may be part of long Covid presentation. Both the Scottish NHS and NHS England's approaches are virtually identical. I think that it is important not to downplay the approach being taken here in Scotland. Scotland does offer people support. The Scottish Government is supporting health boards to provide a flexible, tailored approach which meets each individual health boards demographics in rural and urban areas. Of course, I'll take an intervention. Brian Whittle. I'm very grateful for Emma Hartford for taking an intervention. If the Scottish Government is in essence reflecting and mirroring what's happening down south, presumably you'll disagree with the Cabinet Secretary who says down south that it's not working. Emma Hartford. I never said we're mirroring. I said what the multi-disciplinary team approach is already taking place in Scotland. We have a different NHS in Scotland as well. We manage our services slightly different. We need to support what works better for our own health boards and our own areas. I don't think that I have time to give away it actually. Presiding Officer, I'm the Commonwealth Parliamentary Association's gender champion in this Parliament. I was really interested to read that women are very much impacted by long Covid. According to the ONS, the prevalence of long Covid was greatest among the female workforce. The workforce in social care is 85 per cent women. In education 68 per cent women. In healthcare 76 per cent women. Women are working in these high-risk areas and the likelihood that women will experience long Covid is higher. It creates challenges for women in the labour market and participation for employers to support long Covid is something that we probably need to highlight as well. According to the TSTUC they had a survey in 2021 that found that over half 52 per cent of respondents said that they had experienced some form of discrimination or disadvantage due to long Covid. One in six respondents, 18 per cent, said that the amount of sick leave they had taken had triggered absence or human resource processes. That's a concern because, as we're mentioning like the workforce that are involved in social care in education and in health, predominantly women, we need to support them in any way we can. It would be particularly difficult as evidence from close gap also showed that women have been forced into using their sick leave entitlement to undertake additional unpaid care during the pandemic especially during school and nursery closures. Given that, I would ask the cabinet secretary or the minister in closing to comment about whether the Scottish Government are undertaking any specific analysis of the link between long Covid and gender and whether additional consideration is required for those taking time off work due to long Covid. Presiding Officer, in closing it is important to recognise that people with long Covid in Scotland are and must be supported by a full range of NHS services primary care teams, community based rehabilitation services with referrals to secondary care where necessary. We must look to emerging research from other countries also and partner with other nations as we learn and evolve to apply samples of best practice to our approach to improving outcomes for those living with long Covid here in Scotland. We are emerging throughout this pandemic and we need to support our long Covid patients in order to give them the best service. Thank you. I call Mark Griffin to be followed by John Mason. Thank you Presiding Officer. I want to echo colleagues' comments today welcoming the debate on long Covid. It's really astonishing that it's taken so long for us to do so. Long Covid is a new, devastating, disabling disease. It's an industrial disease. People suffering from it as many speakers have mentioned before that number, now in excess of 150,000 have seen their lives and livelihoods destroyed. Consumed by the relentless and horrifically common symptoms of brain fog, breathlessness, extreme fatigue, constant business and joint pain. Given the Government's rhetoric on supporting disabled people seeking to give them dignity, fairness and respect they deserve, I think it's particularly distressed on how little support long Covid sufferers are getting. I genuinely believe that this Government has strung them along with warm words. When I asked the then Cabinet Secretary for Social Security in September 2020 how the Government might use its powers on assistance for people with employment injuries to support workers who are suffering from the long-term effects of Covid-19. That was then just six months into the pandemic and long Covid was very clearly the most devastating workplace disease Scotland has seen in a generation. The then Cabinet Secretary's response was simply that the Government encourages people who have long-term Covid-19 and are experiencing symptoms to access the benefit systems as anyone else would. In other words, they should try a PIP claim with the DWP. I think many of us in this chamber, if we will probably very well know but if we asked a disabled person with a fluctuation condition they would be horrified at just how cruel the prospect of applying for PIP would be, they'll tell you of their traumatic experiences because, as we've heard many times in this chamber the DWP systematically discounts their illnesses and that bears out in the statistics in January 2022. Just 99 people in Scotland had been successful with a PIP claim for long Covid. Presiding Officer, making long Covid an industrial disease means we can then strip away that assessment process of evidence from those people and those occupations suffering the most. Whether we should use the new powers of this Parliament is a question that I've also repeatedly put to the First Minister because even in 2020 it was clear that Covid was having a substantial impact on people who were catching it at their work. The testimonies I relayed to the First Minister at the time a retail worker who was in a coma for weeks and now has to walk with a stick a social care worker who also had to use a stick never recovered their sense of taste and smell and who had been referred to a respiratory clinic. Those are two of many of the stories that I've learned since describing how key workers those key workers that looked after us who protected us are now too unwell to the jobs that they love. A survey in March by Long Covid Scotland who I also want to commend for their tireless campaigning on this issue highlights the significant numbers unable to return to work or their previous levels. Half still off. Feeling judged for still being ill those who had returned feeling that the return to work had negatively affected their symptoms. The response from the Government is more empty words. I had an undertaking to look specifically at what the Government should and could look at providing support. That yielded a letter saying that the Government would defer to the UK Government's advisory council on industrial injuries who in turn refused to prescribe the disease last March. Even though employment injuries is fully devolved to this Parliament dignity, fairness and respect but not if you have Long Covid. Colleagues across the chamber particularly those on the Opposition Benches who supported it will know that I am pursuing a private member's bill to establish a Scottish advisory council to secure an employment injury system fit for purpose in 21st century Scotland. The genesis of that bill is asking the question to key workers should Long Covid be an industrial disease? Given how many caught Covid at work simply for doing their job and in too many cases virtually destroying their ability to go back that answer remains an overwhelming yes. I would be delighted as many others would be too if the minister would close today by confirming that people with Long Covid will have an entitlement to the Government's employment injuries assistance because putting the decisions in the hands of a statutory body independent of government to research and advise on the risks facing workers with the energy to reshape the benefit system to support them is the only way that Long Covid will be recognised as the industrial injuries disease that so many workers are enduring today. John Mason to be followed by Gillian Mackay for around six minutes. Long Covid has been discussed and questions asked at the Covid committees the previous one and the present one of which I have been a member and we've heard different titles given to it for example post Covid syndrome and I think the WHO is calling it post Covid-19 condition and from my personal experience of a friend and his wife who both had Covid early on, she got it more seriously but recovered more quickly whereas he continued to have problems with breathing for a number of months and he said it was like never being able to take a proper deep breath. I was also reading a Guardian article on a personal account of somebody with Long Covid in England in which he says that none of the 80 specialist clinics there are offering effective treatments. So it seems clear that while Long Covid clinics may be part of the answer they themselves do not guarantee a better patient experience. In preparing for today's debate my staff found a useful piece by the British Heart Foundation detailing some of the research around Long Covid. For example there is a three year study involving data from 60,000 people to help define what Long Covid is and improve the way it is diagnosed. They are seeking to explain why some people get Long Covid thanks to a person's health and ability to work and the factors that affect recovery. Other research that I understand is going on includes whether existing medicines can help prevent Long Covid and relieve its effects, for example statins and anticoagulants. Another study is on Long Covid in 11 to 17 year olds to identify symptoms in children and young people who are not treated in hospital. At least another 15 research projects across the UK covering topics like breathlessness, reduced ability to exercise and brain fog. The Royal College of Physicians of Edinburgh in their briefing also confirmed that there is no internationally agreed clinical definition or clear treatment pathway. It seems to me that when we read these kinds of articles and realise the type of very basic research in a sense that is going on that it strikes home how little we actually do understand about Long Covid and how it can be treated. Therefore I think we do need to accept that this is a long-term project. Of course it is very important for the 150,000 or so people with Long Covid in Scotland of whom maybe one in six are so ill that day to day activities are limited a lot and in one study half said they were unable to return to work. They are urgently looking for treatment and cures. One previously very active person said to me quote I have to get better unquote. But it is perhaps useful to think of some of the timeline around ME. Now I understand that my algeic encephalitis was observed in 1934 in Los Angeles. It was thought at first to be atypical polio. In 1946 it was called Icelandic disease after appearing there and in 1956 it appeared in the Lancet. It was called chronic fatigue syndrome in 1984 and yet it is still not well understood today. If ME is anything to go by we are not going to get quick answers concerning Long Covid. It is certainly argued by some that research is not progressing fast enough while some... Yes, I give way to Mr Marr. Michael Marr. I regret interrupting but it sounds like a bit of a council of despair for the many people across Scotland who are suffering greatly at the moment. What would you say to the clinicians in my region who are astonished at the lack of resource that has been put forward by the Government and allowing them to develop new pathways and to try and innovate? We cannot accept the kind of timeline that John Mason is laying out for decades to come. John Mason, I can give you the time back. Thanks very much. I think that the cabinet secretary did largely answer that before by saying that treatment is going on and in fact the part of the friend I mentioned is happening right now. Call me pessimistic if you want. We had a very good Covid meeting that Mr Whittle was at this morning and one of the points that scientists were making was that at the beginning all Governments were too optimistic about this. All Governments said, we will get through this in a few weeks and that is around the world. Call me pessimistic but I am trying to bring a little bit of realism here that if we compare with ME and it is not the same as ME I accept but that has been a long-term project. There have not been easy answers and I do not believe there are easy answers to long Covid but as I was saying we have to invest in research. I believe the UK is spending 20 million or more Germany perhaps 6.5 million euros France 2.2 million so I very much welcome the Scottish Government funding of 2.5 million that is absolutely excellent. Of course whether we fully understand long Covid or not we need to try and support people suffering as much as we can. Support in Mind Scotland emphasises that mental health is important and the health and social care alliance reminds us of needs such as access to social care social security as Mr Griffin just said food, housing adaptations and mobility aids. Those canons should be happening even if we do not fully understand long Covid. The motion indicates that there should be flexibility for health boards and that seems right as what works for Glasgow might not work in the highlands. We should not be pushing for an over-centralised approach so it could be about strengthening the co-ordination of existing services or establishing dedicated services including long Covid clinics. I note that the Royal College of Physicians in Edinburgh believes that supported self-management and long Covid one-stop clinics are quote worthy considerations as part of the long Covid puzzle. They also quote nice in recommending access to multidisciplinary services which could be one-stop clinics but they point out too that long Covid services should not divert services away from rehab services to the detriment of patients with other conditions. I think that we need to be a little cautious about more specialist standalone facilities. I also note in the health and social care alliance briefing that they want quote equitable access to high standards of support wherever they live in Scotland and I guess I can live with that term or a term like equitable access as long as it does not mean rigid uniformity. There is rightly an emphasis on people receiving good primary care and community-based support although there are accounts of people having mixed experiences as they interact with their GPs about long Covid. Given what has already been said about the need for research it is clear that we cannot expect GPs or other primary care providers to be experts on all aspects of long Covid. The alliance makes a very valid point that access to social security and other entitlements is often more difficult for people with energy-limited and fluctuating conditions so we need to try and ensure that our systems are in place to cope with that and to adapt as we find out more. You need to be winding up, Mr Mason. I think that there is a lot of encouragement for us here and especially for those suffering from long Covid. A lot is happening by way of treatment right now, research right now and so on and that I believe we need to understand better and find better treatments. Thank you very much, Mr Mason. I'm sure colleagues will be as grateful as Mr Mason to know we have a little time in hand so if you do take interventions you should get the time back and I call Gillian Mackay to be followed by Craig Hoy for around six minutes. Thank you, Deputy Presiding Officer. The true extent of the impact of long Covid is still unknown and may remain so for some time. In Scotland the figure is estimated but that figure does not adequately capture the devastating impact of this condition on many of those affected. Long Covid can have a significant impact in quality of life and its effects range from fatigue, shortness of breath to brain fog, chest pain, sleep disturbance and other symptoms that we are still now discovering. The variation of those symptoms means that people have had to fight for diagnosis and treatment. In their briefing for this debate the Royal College of Physicians of Edinburgh highlighted internationally agreed clinical definition or clear treatment pathway for long Covid and the evidence base for the condition is still developing. This presents a significant challenge for health services and requires concerted co-ordinated efforts to treat. We must not underestimate the pressure that will place on health services and forward planning is essential. We should prioritise further research into long Covid and welcome the Government's commitment to this. Such research must include the effects on children and young people and should also be intersectional as there is already evidence that certain groups are disproportionately affected by long Covid. Organisations such as the Health and Social Care Alliance and Long Covid Scotland have called for improved data collection on long Covid so we know exactly how many people have this condition, how they are being affected and who is most at risk. Accurate reliable data will enable us to design services that will properly meet the needs of many people with long Covid. Many people with long Covid will require long-term care. Data published in the Lancet show that 43.5 per cent of people had at least one complication post-acute Covid. Supporting people to self-manage their symptoms where this is appropriate is essential. A number of organisations have highlighted the need for patients as well as health and social care staff to be informed about how to find support if symptoms present. In short, we need to ensure that people know what symptoms to look out for and where to go for help when they need it. I call on the Scottish Government to do all that can to raise awareness in this regard. We also need to raise awareness of the disproportionate impact of long Covid on certain groups of people. We know that the pandemic has not affected everyone equally. The most recent Office for National Statistics data release shows that long Covid is more prevalent among women despite the fact that acute cases of Covid tend to be in men over the age of 50. Close the gap has highlighted that women are more likely to be in occupations where this is an increased risk of developing long Covid, such as healthcare and education. Their concentration in low paid precarious work also makes them more likely to miss out on statutory sick pay. There are also wider impacts on people's employment. A recent survey conducted by Long Covid Scotland on people's experiences employment revealed that 52 per cent of respondents were unable to return to work and that 72 per cent reported that their current work patterns were unsustainable. I echo calls made by the TUC and close the gap for the UK Government to urgently recognise long Covid as a disability under the Equality Act so that employers cannot legally discriminate against workers with long Covid, who will then be entitled to adjustments that remove, reduce or prevent any disadvantages they may face. No one who is experiencing long Covid should be denied reasonable adjustments at work. We need to take a holistic view of how people have been impacted by long Covid and provide wraparound support. People have been physically affected but that may have knock-on effects to their employment, housing, education as well as their mental health and their need to access health and social care. In their briefing for this debate the Alliance has rightly highlighted the impact of long Covid on mental health. Physical symptoms combined with potential issues around employment, financial worries and struggling to gain access to treatment will all take their toll on their emotional and mental wellbeing and studies have already demonstrated that. It is therefore essential that mental health support is considered alongside any treatment for physical symptoms. Long Covid is a new condition and research into its effects is still in its infancy. It is therefore vital that we allow clinicians the time they need to undertake their own learning. We all know the extraordinary pressure that health services are at the moment and the huge demands that are being made on clinicians' time but they must have protected learning time to ensure that they can deliver the best care to their patients. Primary care will play a vital role in the identification of long Covid and I am aware that the Royal College of GPs have long been calling for protected learning time to be built into the working week of GPs. Given that this is a new condition it is vital that we listen to the people who have long Covid. Unfortunately many report having to fight for their voice to be heard or their symptoms to be recognised. We need to take a person-centred rights-based approach that enables people with long Covid to feed into and shape the design of support services and I was glad to hear some of that reflected in the Cabinet Secretary's speech. I would welcome any further comments on how the Government plans to engage with people and reflect lived experience. To conclude, Presiding Officer the impact of the pandemic will still be felt for generations to come at least by those with long Covid. Any recovery plans must include support and care for people with long Covid to be provided now and for as long as they need in the future. Thank you very much. I now call on Cwyd Hoy to be followed by Stephanie Gallahan for around six minutes. Thank you, Deputy Presiding Officer. Before I was elected to this Parliament and at the early stages of my career I was a journalist and I used to sit in galleries much like that looking at the demeanour of ministers and trying to work out as I might use to describe that demeanour. Today I would say sheepish and squirming because, Minister, we have waited months for today's debate and announcement from you and it simply wasn't worth the wait. Promises recycled money reannounced past pledges simply polished up again and a shocking level of complacency. Too many people who have fought to be heard who are suffering from long Covid are suffering the consequences and are waiting for answers and solutions from your Government. SNP ministers must now finally get on top of the long Covid crisis because it is a condition that is affecting nearly three in every 100 Scots and if you don't act Minister this will spiral out of control and have very serious knock-on consequences for other services in Scotland's NHS. Last year in our policy paper we called for the creation of long Covid clinics and a co-ordinated approach to the disease across health and social care in Scotland and the findings of our report were supported across the sector. Third sector organisations such as Long Covid Scotland, Chess Heart and Stroke Scotland support in Mind Scotland and the Royal College of Physicians in Edinburgh but one year on there are still long Covid clinics and still no co-ordinated response to the disease in Scotland and yet the minister says today that long Covid clinics don't work but in the motion he puts before Parliament he says that Parliament recognises the role of NHS boards to design models of care including long Covid clinics so it's in his own motion. I will give way. I say that the important point that he deliberately, I suspect, omits is that I was referring to the mounting evidence that long Covid clinics in England, as they are designed at the moment are not working in many occasions. That's not just something I said, of course, Dr Gohani. His colleague said that there seem to be evidence that in some cases they were in effect. Does he accept that there is no mounting evidence that some of the long Covid clinics in England simply aren't working? I accept that he's got an army of spin doctors, civil servants in parliamentary draftsmen but I cannot submit a motion to this Parliament that conveys that. That is his problem and not ours. He wants to talk about England. Let's compare the situation between Scotland and England. In Scotland, people with long Covid are 20 per cent more likely to be severely affected by a disease in their day-to-day life compared to those living elsewhere in the UK. While in England there are 90 specialist long Covid clinics in Scotland, there are none of them. In England, there are over £224 million committed to the development and delivery of long Covid services. In Scotland, the best that the SNP can deliver is £10 million. It's not that you have more money and you know that you don't have more money. That's £3 million a year. It simply will not touch the sides. Perhaps the Government might now be able to say today how much money has been paid out and what it has been used on so far. Sufferers of long Covid feel unsupported and undermined by SNP ministers. Take a constituent from Dunbar. She suffers from long Covid, ME and postural orthostatic tachycardia syndrome or POTS. She told me, I get POTS-related paralysis episodes and these have become much more frequent in Covid-19. With that combination of issues, I am almost entirely housebound and use a wheelchair to get around my house. Much of the oppression reported, she says, by people with chronic illness takes the form of invalidation and disbelief of their impairment. I hope that long Covid, she says, will mark a change in that culture. The point in time when we start to take energy impairment seriously. It is often very passionate pleas from those suffering from long Covid are being effectively ignored by this Government. For over a year, ministers have reverted to type and Mr Yousif does so again today. Dither, not direction. Delay, not decision and excuses, not action. I will take an intervention. Emma Harper. I think Mr Hoy for taking an intervention. I'm just wondering if you heard the cabinet secretary earlier say that he was having direct experience with people with lived experience of long Covid. Cabinet Secretary has been meeting with those people. This is the story all along. Meeting with people with lived experience. Listening to people with lived experience. But not acting on what he hears. That is a condition right throughout his own Government. The Government says that they do not want a way to one-size-fits-all approach. Minister, any concrete approach would be welcome to start to relieve the isolation and the suffering felt by the patients suffering from long Covid. Presently, there is no clear clinical pathway for those suffering from this disease. The Government has failed to deliver any meaningful support to the 150,000-plus people living with this condition in Scotland. Let's not forget that the number of people suffering with symptoms for more than a year has doubled now in six months so this problem is getting worse and the ministerial inaction makes their suffering only greater. It is now time for ministers to end their false promises and to act and that's why I encourage colleagues to support the motion in Dr Cahani's name. Thank you Mr Hoy. I now call on Stephanie Callaghan to be followed by Pam Duncan-Glancy during six minutes. Thank you, Presiding Officer. Long Covid is a crisis in Scotland and across the globe and there is absolutely no hiding from that. It attacks our weaknesses and devastates lives and physical symptoms can include chest pain, difficulty breathing, headaches, internal blisters, fatigue, brain fog, frustration, grief, anxiety, depression. The list goes on and on and you've heard plenty others today. Some sufferers are unable to return to work and miss out on important family events too. As if that's not scary enough research also suggests that psychiatric, neurological and inflammatory issues and even elevated suicide risks. Let's not forget individuals with long Covid are not the only ones suffering. Their families walk this path with them. They provide care and support and often they struggle with uncertainty of whether normality will ever return for their loved ones. We've heard today about the huge variation in symptoms and I welcome the Scottish Government's holistic approach to research, treatment and policy from education and social security right through to health and social care. I really warmly welcome today's news of the 320 investment in NHS Lanarkshire to support a multi-disciplinary Covid rehabilitation team. I really look forward to the detail around this access point for supported self-management. Today I'll be focusing and researching the lived experience of friends and family from a Dinsden and Bells hill constituency before finally touching on workplace culture and how we treat people with long-term illnesses and disabilities. I must sincere thanks too to those who have taken the time to tell me about their own personal experiences. Research is the key to improving our understanding of the effects of long Covid on people's physical and mental health and to identifying effective treatments. It is right that the Scottish Government contributes to the growing evidence base across the UK and internationally and the £2.5 million to support nine research projects is very much needed. There is some disagreement around the value of making comparisons between long Covid and other post-viral conditions such as ME and chronic fatigue syndrome or CFS as it's often known. However, one friend I spoke to yesterday about Covid before testing was available or long Covid was even heard of and looking back, she tells me that she feels really quite lucky when she was with CFS following Covid because she was advised to incorporate something that we call pacing as a treatment early on. Pacing is an activity management strategy and it's designed to help ME and CFS patients limit the number and severity of relapses while remaining as active as possible. My friend has gone from swimming 100 laps in the pool to just four laps once a week from walking 20 miles to struggling sometimes with 500 metres and while that pacing in itself can be quite frustrating it's saved her from pushing beyond her limits and it still does two years down the line. I'm told one of the major issues for people living with long Covid is the endless cycle of going for tests only to be told over and again that everything looks okay. People talked about the frustration and the helplessness they felt and the very real impact on their physical and mental health. Long Covid sufferers have told me again and again that we must empower researchers to investigate long Covid alongside similar post viral conditions so that we can make connections between conditions and drawn existing treatments whilst developing humans too because effective treatments improve lives. It's paramount that lived experience remains at the centre of policy practice and decision making and I'm sure that's not popular with Mr Hoy when we're developing services and supporting people nothing about us without us is such a simple and powerful principle and we must embed this in policy practice and developing services for long Covid as we have with other things we know that Covid targets the marginalised and disadvantaged and we must listen to the experiences of the young and the old of women, ethnic minorities and people from disadvantaged area too many people are hidden and we must reach right into those communities to make sure that we hear those voices. Presiding Officer it's telling that the 2021 NESUWT wellbeing at work survey found that 17% of respondents in Scotland have not disclosed long Covid to their employer and that brings me to my final point. At times our culture can exploit and damage people living with long term health conditions and disabilities since the beginning of the pandemic some have pushed the narrative that we should just get back to work perhaps put in profit before people but here in Scotland our governance fair work policy promotes fairer work practices and really encourages flexibility when employers do step up to the mark to support full time home working as with one of my friends she was able to continue with the job that she loves and I'm absolutely sure she will pay them back tenfold Embedded in our culture is a belief that when a bad day comes along we must make up for it somehow by putting in extra the next day instead GPs advised against this telling long Covid sufferers to prioritise three things to rest, to pace and to take time so instead of trying to make up time we must learn that it's okay and it is indeed good to follow this advice to protect our mental and physical health and keep us functioning at our best in closing at this critical juncture we must continue to invest in research to understand and develop treatments for long Covid and put lived experience at the centre of all we do and also recognise that crisis brings opportunities so let's take this opportunity to look at the bigger picture and encourage workers and employers to protect and empower workers as we recover from Covid and face the biggest cost of living crisis in over 40 years let's stay focused on what matters most our collective health and wellbeing Thank you very much Ms Callaghan and I call the final speaker in the open debate after which we'll move to closing speeches Pam Duncan-Glancy for around six minutes please Thank you Deputy Presiding Officer for many of us life is beginning to feel more like it did pre-pandemic we're living in a new normal looks quite like the normal we knew before for those living with long Covid however life couldn't be more different the new normal for them is terrifying life after the pandemic has become one of constantly feeling exhausted and in pain in some cases experiencing brain fog and problems with memory feeling chest pain or having heart palpitations and insomnia for the estimated 100,000 people in Scotland living with long Covid their life is immeasurably different like many people who acquire impairments they are now having to make significant changes to the way that they live their lives for them the pandemic has meant losing various degrees of their independence and for some it's left them struggling to return to work like all health conditions long Covid affects people differently and unequally 93,000 workers believe they caught Covid at work women were overwhelmingly focused in jobs that had high exposure to Covid focused in sectors like social care teaching and education and are far more likely to suffer from long Covid as a result those sectors and the women in them kept many of us going through the pandemic they put their own lives on the line to save ours they are more likely to work in low paid and precarious jobs and hold 70% of roles that aren't eligible for sick pay they're finding that employers are not doing enough to meet their needs and that they cannot afford to be off because despite their invaluable selfless contributions to help others they themselves are not entitled to support now this government must do all that it can to ensure they act fast and support what they need today people with long Covid are battling two viruses long Covid and inequality in a way that they may never have had to before people shouldn't have to fight day in and day out just to get by or for their rights it doesn't have to be this way both governments must use every lever they have to meet the health and care needs and protect the rights of people with long Covid they must encourage businesses and employers particularly where companies are carrying out public funded contracts to recognise long Covid as a disabling condition not because the law could in fact be interpreted to recognise it as such and can I clarify for the benefit of the record and for the benefit of people with long Covid where the EHRC have perhaps been less than clear on it whether or not a condition is classified automatically as a disability in the quality act it does not mean it is not considered a disability under that law or therefore you do not have rights so please assert them and we in this place have a duty to help you hold them but they shouldn't just be doing it because of the legal case they must support people because they have a moral obligation to provide people with long Covid the support they need and because doing so will allow them to live up to their full potential I'd also like to see the government encouraging the use of the TUC's reasonable adjustment passport scheme which recognises fluctuating conditions like long Covid this passport means disabled people not only have to explain their needs not every time their role or their line manager changes recognising this would remove a barrier to people receiving the proper support they need and I'd welcome the government's view on that in their closing remarks I want to thank the TUC and close the gap at this point for their hard work in campaigning for this and for their important research in this area we should use the powers of this Parliament to do all we can and that includes supporting my colleague Mark Griffin's proposal for a Scottish Employment Injury's advisory council bill this would lay the framework for a new independent public body with a substantial authority to shape and remodel industrial injuries benefits and use the powers of the Parliament to make sure that people who are disabled as a result of long Covid can access the same compensation schemes that workers experience in other illnesses such as best dose related conditions hearing loss and COPD as a result of their employment for too long people with similar impairments have had to fight to be recognised as disabled people they have battled against discrimination let's learn from their fights and ensure that people with long Covid are protected against it protected against discrimination and mistakes of the past and make sure that employers understand that they could have a duty to make reasonable adjustments to remove, reduce or prevent any disadvantage to workers with long Covid and finally let me turn to the point on research that I spoke with the cabinet secretary earlier on in the debate on and data and I want to thank again TUC and close the gap for the work in this area as a new and emerging condition there is much we still don't know about long Covid but there is certainly far more to do to identify the reality we don't know the extent to which the condition disproportionately affects some groups more than others and I appreciate the comments earlier from the cabinet secretary and I hope that we will start work to get that data as soon as possible because collecting it is crucial to ensure any decisions act to support people in the way that is needed and ensures we address inequality to conclude people have been left suffering with no answers and no dedicated healthcare the government must do all it can to ensure people with long Covid are recognised as disabled people get the support that they need including at work and can access social security quickly by speeding up access to adult disability payment they have fought for their rights for too long they are fighting for illness through illness and for their rights is this government's duty to act quickly and cannot be left to fight this battle on their own any longer thank you thank you very much Mr Duncan Glancy we now move to closing speeches and I call Alex Cole-Hamilton for around six minutes thank you very much Deputy Presiding Officer Deputy Presiding Officer you will recall that three weeks ago Liberal Democrats got our business day we get roughly one a year so it's actually quite a celestial alignment for us had we not had sight of the government's intentions we would have used that very precious single day for us to debate this issue but because the government the SNP government had indicated that they would finally use government time for long Covid the day after we decided to focus on other things but after our business was submitted the parliamentary agenda was set the government pulled their debate Presiding Officer that was a craven example of this government once again dodging scrutiny on an exposed flank once again because it occurred to them that they literally had nothing to say while Presiding Officer three weeks on and not much has changed it is an exposed flank and I know there was much hope attached to that abortive debate as there was to this one today but this I have to say is thin grwl including as I say I think Jackie Baillie was right to flush out the fact the pretense that this government was attaching to the £3 million though it was some kind of new money to re-badge of the first iteration Cabinet Secretary tried to strike a conciliatory tone but in reality he was just summing as many government members did a praisey and a list and a summary of the problems as we find them they were very thin on solutions this was rightly I think and succinctly identified by Dr Gilhoney and I am grateful for Dr Gilhoney and the cabinet secretary setting out in the intervention exchange that we had in his debate future sufferers who do not have a positive Covid test as a result in their medical records will not face the same battle for belief and for support that the first waivers did and in some cases are still doing and I will remind the Government of that commitment going forward we heard a lot about personal stories several put forward in an excellent speech by Jackie Baillie and she was right to identify the cynical choreography of a government rushing out letters to sufferers every day of this debate and can I associate my self with Jackie Baillie's remarks on employment and also offer my support to Mark Griffin in his forthcoming member's bill around making long Covid an industrial injury Presiding Officer sufferers need action, we need action but there was not much encouragement for sufferers in the words of Government members and I have a lot of respect for Evelyn Tweed but to suggest that funding the creation of long Covid clinics somehow robs Peter to pay Paul and deprives the health service funds elsewhere, betrays a fundamental lack of understanding around the scale of this public health disaster. I will. Edward Duncan, who is professor of health research at the University of Stirling says that there is good clinical reasoning for arguing that investing in existing services and supporting them to deliver rehabilitation is better than having a bespoke centre. Does the member agree with that and can the member tell me which specific treatments are being provided within NHS England's long Covid clinics that are not already available to those in Scotland? Alex Cole-Hamilton, give you the time back. The minister does a good job of reiterating the point made by Emma Harper but if Emma Harper had taken my intervention when I had made it, I would have pointed to the long Covid sufferers in the gallery who will show her the truth to that lie and the fact that they were all shaking their heads at this apprehension that the Government is creating, that these services are somehow already there if you half-close your eyes and know where to look it's just laughable. It's a public health disaster and its impact will be felt across our economy, our schools, our economic activity, our workforces. I found the intervention of the cabinet secretary on Brian Whittle also astonishing when he sought to reiterate the point that the minister has just made. They continually attempt to hinge their opposition to long Covid clinics. Clinics that the long Covid community are crying out for on suggested that focused, holistic, multidisciplinary support obtained in a one-stop shop will actually hinder their health outcomes. That is enraging. I've talked about Emma Harper. That's the problem. The SNP-backed benches have clearly overheated the long Covid Wikipedia page in preparation for this debate but it's hard to imagine that many of them have actually spent time with sufferers or the group that support them. I must make progress. Indeed, it was many months from their first request to do so and several embarrassing FMQs before this cabinet secretary first met with Long Covid Scotland. The outlook remains bleak for support and we hear nothing today to change that. John Mason unwittingly did the job of these opposition benches when he revealed his own government's failure to sufferers of long-term conditions like Emma Harper of the past 15 years of their government. I am haunted by the words of eight-year-old Anna Goss in describing her condition. I hate it. You can hear the anger and frustration of such a young life so badly restricted by a condition that no adult around her can fully explain and to which she is not offered adequate support. Anna cannot wait for the amassing of data that Gillian Mackay described as a prerequisite to support. We can help her today but Ms Mackay's Government chooses not to. What's more, we can protect children like Anna, all those who might become like Anna now not by cutting off the bottom of classroom doors but by installing HEPA filters in every classroom in Scotland cleaning the air that we ask children and their teachers to breathe. If government policy is to live with Covid then we have a duty to protect our children from what Covid can become. It is clear from the very factual and clinically informed speeches prepared for SNP MSPs today that the Government understands the pathology of long Covid but I am not persuaded that they understand the humanity or the urgency of this awful condition. Thank you Mr Cole-Hamilton. I now call on Carl Mocken for around six minutes Ms Mocken. Thank you Deputy Presiding Officer and I welcome this opportunity to close the debate on behalf of Scottish Labour. Can I start by thanking all the people who have allowed us to share their stories and to those who have made the journey here to the Scottish Parliament in the gallery tonight? I hope that the Government tonight will listen and react with some speed. As mentioned by speakers before me we have had to drag the Government to this point but thankfully we have finally brought this crucial issue to the chamber after far too many delays despite long Covid being at the forefront of public debate. As has been mentioned throughout the debate we had to watch a debate on the topic that was cancelled last month for seemingly no reason. All the while this Parliament has been coming and going and yet long Covid has never been given the attention it deserves. Let's hope that this ends today. As we have seen from many contributions so far there is some broad cross-party support to get this sorted. A step that Scottish Labour wholeheartedly welcomes and hopes we can get in place. For some in Scotland the threat of Covid appears to be dwindling away but for others the lasting consequences are part of their everyday life. We must not forget that many of our family and friends are still suffering from the consequences of the past two years and in some cases those consequences are drastic and life-altering. I think it was very vividly put by Alex Cole-Hamilton's contribution a horrible disease and an important mention by Jackie Baillie and Alex Cole-Hamilton on the suffering of children. We believe that as many as 151,000 Scots are living with long Covid in one form or another and yet their needs and concerns are rarely taken into account. The Government seemed to avoid communication with sufferers and support groups and taken on board the points that they are making. As many colleagues have noted there have been a number of serious issues with this Government's response to the emergence of long Covid which only makes it worse for those groups particularly when they do not feel fully involved in the decisions. The 10 million long Covid support fund which was announced in September 21 has yet to be fully delivered a disservice to our hard-working NHS staff. We do not have any network of specialist clinics for those dealing with the symptoms of long Covid as there are in other parts of the UK and there seems a complete reluctance today to even consider the suggestion that there may be some good practices that we could get from looking at this. In terms of the occupational support for those suffering from long Covid to help them back into the workplace there seems little or none. I thank my colleague Mark Griffin for his remarks around the importance of considering long Covid and industrial injury and in particular to our valued key workers. I look forward to the cabinet secretary responding to their remarks from Mark Griffin tonight. In this debate we need to answer why could those funds not have been allocated directly to health boards to treat those already in pain and in a much faster, quicker fashion we know that the money has not been allocated. Why weren't those suffering from long Covid asked to play a much more active part in the design and implementation of these plans and why are we not properly considering the financial impacts such a condition has on people who have fallen victim to it. I hope the cabinet secretary can answer some of those questions and I hope that he will answer Emma Harper's points around gender. Those are serious considerations yet most of the commitments from the cabinet secretary today are about the long-term future a vague long-term Covid plan there is far too little detail about how we will help patients in the present now how will we help people now. I know that the long-term Covid is a problem that we do not ensure adequate measures are in place and that those who have long Covid get their distress and discomfort are simply extended by this. We know that despite under 50-year-olds being at a lower risk of dying from Covid there are higher rates of complications across all age groups and we know that long Covid is a problem that we do not have a full grasp of yet which is why it is so important to develop expertise and ensure that health services and the scientific community work together in a co-ordinated manner. There is a broad willingness to do this but a serious lack of commitment and progress on this. It seems to me that the reality of what Covid can do to you beyond the worst fate of all in our public life, this Government do not want it to be discussed openly. It would go a long way to improving our ability to limit Covid if the public were better informed about the potential consequences arising from this virus in general. Well-funded long-term research will improve understanding of the lasting effects of Covid and help to identify effective treatments for all arising from it. Committing to such funding will put Scotland at the forefront of this vital discussion but that is not going to happen if we are simply seen as being behind the rest of Europe and unwilling to commit serious investment. Any future planning from this Government must respond to both the immediate and long-term impacts of long Covid in Scotland, not simply a measure of lip service and to conclude I want to say that our positive spec is being considered here today but is the Cabinet Secretary listening? Does the Cabinet Secretary really think that long Covid support fund which, as mentioned by my colleague Jackie Baillie, equates to around 33 pounds per person per year is sufficient to tackle the problem? I think that we all know that it is not and that this issue has not been taken seriously enough by this Government. Thank you, Presiding Officer. Thank you very much. Ms Mocken, it now falls to Ms Webber and the Minister to take us up to the question time. Sue Webber, you have a very generous seven minutes. Thank you, Deputy Presiding Officer. I welcome the chance to speak in this much delayed debate and looking at the motion in front of us today, there is absolutely nothing in this content that could not have been presented to the chamber before 5 May. The SNP Government is failing to treat long Covid with the seriousness that it deserves. SNP ministers must urgently deal with long Covid now before it spirals out of control and has serious knock-on consequences for other services in our NHS. The ONS estimates that 151,000 Scots are suffering with long Covid and that number is rising. 64,000 Scots have been experiencing long Covid symptoms for more than a year and this is more than double the number suffering just six months ago. 56,000 Scots are reporting that long Covid is having a significant impact on their daily activities and Mr Cole-Hamilton spoke about how debilitating it is and how it is ruining livelihoods. There are huge numbers of people suffering while the SNP fails to act. The figures also include constituents of mine and we've heard many of these stories and one has contacted me with heartbreaking story. I was in Edinburgh and is suffering from long Covid. Her story breaks my heart certainly. After contracting Covid in 2020, she was signed off work in August that year and was not able to return until February 2021. When she returned to work and managed to maintain herself at work again until August 21, she then went off sick again with extreme fatigue, constant headaches, continuing dizziness. Her job is now at risk as she is still not well enough to return to work. Despite the fact that she is still waiting for further assessment and referral because there is no primary care pathway for GPs to access the services. My constituent feels very strongly that the system does not work. As I've said, there is no clear pathway into referrals for services. A network of long Covid clinics would ensure that we reach everyone struggling with this very debilitating condition. Patients cannot wait for years for action. Too many people who have fought Covid are still suffering with the consequences months after they've caught the virus and without proper long Covid clinics many people will continue to be missed. Aside from clinics, we need the Government to ensure that there are better guidelines for support across health and social care. My constituent said, long Covid is not going away. I do not appear to be getting better and I am not getting any kind of meaningful treatment. I do not appreciate being left to rot having done my duty and attended work during the pandemic to support my frontline colleagues in my nursing role. Nor do I appreciate being written off due to others ideas of disability and capability. Quite humbling to get that email. Physical health conditions can negatively impact a person's mental health. Financial stress is also associated with poor mental health with long Covid being documented to affect people's ability to work. The stress, fear and trauma of having long Covid and the uncertainty around the future are also noted to have exacerbated poor mental health. Everyone knows that people who suffer from long Covid are likely to experience mental health problems, such as post traumatic stress disorder, anxiety and depression. Recent research into long Covid mirrors this, determining that there is a high probability that rates of suicide will increase in people who are experiencing long Covid. That is a result of the psychiatric, neurological and physical symptoms of the virus. However, suicide is not even getting a mention in Scotland's long Covid service document. The Scottish Government's motion makes reference to a benefit the management of other long-term and complex conditions. Like John Mason, I want to make reference to the similarities between Covid and ME and how they have been recognised. Attitudes to ME have been changing with the emergence of long Covid, which is very much similar to much of ME. It too is a post-viral disease and has many identical fluctuating symptoms. The hallmark symptom of ME is post-exertional malaise, a worsening of symptoms that can follow minimal cognitive, physical, emotional or social activity. Many are extremely concerned that doctors treating long Covid patients are not aware of the dangers of exercise to patients suffering from fatigue. The nice guidance on ME, which was published in October 21, has not yet been implemented in Scotland, leading to a void in guidance on treatment of ME. Long Covid patients who have ME face being treated by doctors who have little knowledge or understanding of ME and, at worst, will recommend treatment that will harm them. In January 2019, Jenny Freeman made this statement to the Petitions Committee in response to ME actions Scotland's petition. We should not wait until we have a better research base, a greater clarity on what treatment options might be appropriate. People are living with ME right now, so we need to look at what work needs to be done before to increase awareness and the understanding of the condition. This statement was made over three years ago, and yet nothing has changed for those people with ME in Scotland. We cannot allow the same in action to take place with long Covid. Baby steps a snail's move at a faster pace are some of the comments that Jackie Baillie made earlier. My colleague Dr Gohani made it clear that patients with long Covid are looking for concrete action from this Parliament. We urgently need to see a clear strategy to tackle the disease and ring-fence funding to treat long Covid patients. NHS staff are going above and beyond, but they cannot provide the service patients deserve because the Scottish National Party Government has failed to resource them properly. Although we welcome the £10 million of funding, which has spread over three financial years, Jackie Baillie said that it was 33 pounds per person. Jackie Baillie In order to extend the time, would the member care to comment on the fact that in England £210 million has been announced so far for the treatment of long Covid? In Wales, £10 million, with half the population of Scotland, does she understand why this SNP Government just simply lacks ambition to treat long Covid? I can't understand what's going on in the heads of our Cabinet Secretary on this, but I surely you would think there would be the appropriate level of funding for the people of Scotland to support and to present a solution for something that's coming forward. Yes, I will, Cabinet Secretary. First of all, of course, this is additional money that we've announced, so money is already being spent on long Covid. Of course, in Scotland, we spend £111 I'm just telling you, Craig Hoy, that Scotland we spend £111 more per head than her party does in England. I believe that it's £2.5 million on research, so I think there's a long way to go before we have parity with the rest of the UK when it comes to research or investment in long Covid services. In June last year, we published a paper, a policy paper on long Covid, and this raised awareness on the extent and impact of the disease and what we should be doing to tackle it. We want the SNP Government to give the disease recognition and the patients the treatment they deserve. Publish a clear long Covid strategy, create a specific long Covid care fund and work with health services and research institutions across the UK to discover more about the disease and write more than just chapters that was mentioned by the Cabinet Secretary early on. We need to invest in a network of clinical specialists and adopt an app-based treatment service. My colleague Craig Hoy also said today that in Scotland people with long Covid are 20 per cent more likely to be severely affected by the disease in their day-to-day life compared to those living elsewhere in the UK. In England the NHS operates 90 specialist long Covid clinics and in Scotland there are none. The SNP Government's inaction is having a real impact on those affected by long Covid. When the SNP Government's long Covid paper was published, the UNS estimated that 79,000 people were suffering from long Covid. Now that's 151,000 people. Six months of dither and delay means that 72,000 people have not been able to access the support that they were promised in September. That is why we need a network of specialist long Covid clinics. If there was a will rather than a may in your motion today then there would be a way for us to support the Scottish Government's motions but unfortunately we cannot. Thank you very much. I now call on the minister to wind up the debate if you could take us to just before 5 o'clock. Thank you Presiding Officer. Thank you to all of the members who have taken part in today's debate. It's given us the opportunity to reflect on the progress that we've all achieved so far to acknowledge the complexities and to discuss where there are further opportunities to improve our support for people living with long-term effects of Covid-19. Importantly, it has enabled us to provide Parliament with an update on the outcome of the thorough planning process that's been undertaken by NHS boards to determine the key priorities for the first allocations of the long Covid support fund and to hear members' feedback on these proposals and what else we can do to ensure that people living with long Covid continue to be supported. All of us in this chamber, either from our personal experience or our professional one in engaging with our constituents, will recognise that long Covid continues to be prevalent in Scotland as it is across the UK and worldwide. As we've heard today, long Covid presents a new challenge for our healthcare system to respond to in the context of wider pressures caused by the pandemic, which amounts to the most significant challenge that our NHS has faced in its 73-year history. Perhaps when the minister is talking about the additional funding, will she say how much of that money has been paid out of that £10 million to be paid out and for what treatment? All of that money is for this financial year so it will be paid out during this year. It is important to stress that, while Covid may be new, we are not by any means beginning from a standing start. The fact is that experiences of people living with long Covid underline the relevance of key services that are already being delivered by our NHS, the reforms and improvements that we are already taking forward. For example, expanding multidisciplinary teams within primary care, giving people access to a wider range of healthcare professionals through their local practice includes the recruitment of further community nurses to assist with diagnostic tests and chronic disease management and physios to treat musculoskeletal issues in the community. Give me one moment to finish this section. Musculoskeletal issues in the community as well as pharmacists to help with repeat prescriptions. As my colleague said, we spend £111 per head, per person in Scotland more than they do in England in health. We have invested £600 million a year. We have invested £360 million to recruit these teams over four years and we are investing a further £170 million as part of the 2023 budget to continue their expansion. We have published our NHS recovery plan back by over a billion of funding which sets out our plan for increasing inpatient day case and outpatient activity to address care backlogs. We have announced £120 million of recovery and renewal fund in February 2021 to deliver the commitments set out in the mental health transition and recovery plan in response to the mental health needs arising from the pandemic. Finally, I am going to take an intervention from Mr Whittle when I finish this section. As part of our recovery and rehabilitation framework we are awarding an initial funding of £350,000 to support the delivery for Scotland rehabilitation approach. Mr Whittle. I am very grateful to the minister to give away. We have heard in today's debate a myriad of symptoms that are related to long Covid. We have now got 151,000 people in Scotland suffering from long Covid. Surely what we need to do is gather all that information together. We have a good study group. We should be able to create some sort of treatment by now long before now to help those people with such a debilitating issue. Minister. The investments and improvements that we are making in all those areas are going to benefit all patients accessing NHS Scotland services including people with long Covid. Simply put, just because a service does not say long Covid on the plaque when you walk through the door, it does not mean that those services cannot provide a service to people in relation to the symptoms and needs that they have as a result of long Covid. However, the testimony put forward No, I will not give away to Mr Cole-Hamilton. However, the testimony put forward well, we heard twice from him already today and much of his time was spent explaining that he was not in charge of Government business. I think that the electorate have given their opinion on Mr Cole-Hamilton and his party. However, the testimony put forward by members has highlighted that it still remains more to be done to strengthen the services which are providing the support. We are pleased today to have been able to outline our initial allocation of £3 million to health boards to do exactly that. This investment reinforces our commitment to ensuring that people with long Covid have access to the right care and support and in a setting that is appropriate and as close to home as possible, certainly. The money was announced in September, so what money has been spent and what have we got? Minister. In order to deliver the service that requires to be delivered it would not be appropriate for this Government to consider boards, clinical and expert assessment of their specific needs of their populations and dictate to them what specific models of care they should be putting in place for their patients. The outcome of the robust gap analysis and planning exercise undertaken with NHS boards by the strategic network is evidence of the fact that as the clinical guideline on long Covid, developed by Sine and Nice and the Royal College of Dp's there is enough heckling between the front benches and indeed from the back benches. Let me reiterate and I would have thought that Dr Galhany was aware of this. The clinical guideline on long Covid developed by Sine and the Royal College of Dp's notes one model will not fit all areas but we are providing resource and national support to our NHS boards to equip them to respond in a flexible and tailored way. Much of this debate has focused on the subject of long Covid clinics and to present these clinics as some kind of panacea is unhelpful and it also overlooks the lived experience of those accessing these assessment clinics in England and it overlooks the fact that the Royal College of Dp's which I believe Dr Galhany is a member of, has stated many people with long Covid are cared for by the primary care team accessing investigations, treatments and rehabilitation in the community and not every patient with prolonged symptoms of Covid requires referral to a specialist service. From our engagement with both clinicians and those living with long Covid we know the frustration that is often felt after waiting lengthy periods for secondary care tests and investigations to find these results coming back seemingly normal despite their persistent and very real symptoms give me one moment as such our response has to be focused on identifying the personal outcomes that really matter to people and through shared decision making providing effective and evidence based support that helps people to achieve them as far as possible. Yes, I'll give way to the minister. Very brief intervention Pam Duncan-Glancy. Thank you and I thank the minister for taking the intervention. Does the minister understand that the clinics that she is suggesting people with long Covid attend are already bursting at the seams with other people with long term conditions and unable to get appointments for, in some cases, months and years? Minister. As a public health minister in the midst of a global pandemic I certainly understand the level of strain that our NHS is experiencing right at this moment in time. I will let me finish up as I've said before we do not want to make this a political fight we want to concentrate on supporting people in Scotland in the best way possible for their needs. The Scottish Government along with all of us here are absolutely committed to increasing awareness of the long-term effects of Covid-19 and ensuring that people can access the right care in the right place and at the right time. I want to thank everyone who has taken the time to speak to us to inform our picture of what more needs to be done to meet people's needs and that includes NHS boards, front-line staff, third sector organisations but crucially it also includes people living with long Covid who have been open and honest about what living with these persistent symptoms mean for them. Let me echo the words of my colleague Humza Yousaf we have heard from too many sufferers of long Covid I'm in my closing seconds Let me echo the words of my colleague Humza Yousaf we have heard from too many sufferers of long Covid and we do not feel that they have had a consistent level of support or care and that concerns us greatly this engagement today has been invaluable in informing our approach and our engagement with long Covid sufferers is invaluable in informing our approach to date and we will continue to take as agile and flexible an approach in ensuring that this Government does as much as we can possibly do to support those living with long Covid. Thank you That concludes the debate on long Covid it's now time to move on to the next item of business and there are four questions to be put as a result of today's business and can I remind members that if the amendment in the name of Sandesh Gulhane is agreed to the amendment in the name of Jackie Baillie and the first question is that amendment 4472.3 in the name of Sandesh Gulhane which seeks to amend motion 4472 in the name of Humza Yousaf on long Covid be agreed are we all agreed the Parliament is not agreed therefore will move to vote and there will be a short suspension to allow members to access the digital voting system