 Ac ydw i'r ddiesfyn automatig yn Gweithgaredd ond derbyn i eisiau dduffermu Yma Harper o amgueddwyr mwych yn amlwg ein ffasodyd 2019. Ertych yn cwnaet hwn i yw ddigon ni'n iawn i ddiwedd以ctf anfa, ac rwy'n cael ei fod dduffermu those who wish to speak in the debate to press the request to speak buttons. I call on Emma Harper to open the debate for around seven minutes please. Thank you, Presiding Officer. I am pleased to be leading this debate today, noting that yesterday, February 4, 2019, marked World Cancer Day, and I'd like to thank my colleagues who supported my motion and I'm looking forward to everybody's contribution. I'd like to thank Cancer Research UK for their media support in print and social media in the last week, as well as ITV border in my own South Scotland region, for their coverage of my sister's primary breast cancer treatment and recovery journey, raising awareness was the whole purpose. Cancer is a global subject, possibly too big to cover in the time allocated. In my previous career as an operating room nurse, I assisted in tumour removal and tissue repair daily. One in two people get cancer in their lifetime, but over the last 40 years, survival rates have doubled and half the people diagnosed are now surviving cancer thanks to the great progress made in cancer research. The theme for this year's world cancer day is unity and I'm wearing my unity band today because we must unite to beat cancer. No single person, organisation or country is going to beat cancer alone. We must all unite and work together to make faster progress on achieving the goal of three out of four people's surviving cancer by 2034. As Cancer Research UK has outlined, four in ten cancers could be prevented by actions like not smoking, keeping a healthy body weight, cutting back alcohol, eating a healthy balanced diet and keeping active as well as enjoying the sun safely. I say that as somebody who needs a factor at least 50 when she goes to the sun. We need to raise awareness of the reduced uptake of cervical cancer screening in Scotland, and this was debated recently here also. It's really important that women accept their NHS invitation to attend the cervical screening. Research is being conducted in Dumfries and Galloway for a simple home self-test for cervical screening for HPV, which is the cause of 99.7 per cent of cervical cancers. There are 6,000 women in NHS Dumfries and Galloway health board area alone who have not taken up their cervical screening invitation, and I would like to encourage them all to do so. That highlights the importance of research to make screening easier, less uncomfortable, more accessible and easier to engage with. When cancer is detected early, treatment is more successful. One area that I would like to highlight is smoking. As convener of the cross-party group on lung health and with a sister who is a respiratory nurse consultant, I am keen to support any activity that we can implement to help people to quit smoking. Cancer Research UK provided a briefing ahead of this debate, which I thank them for. According to the briefing, smoking is the biggest preventable cause of cancer and is linked to 15 cancer types. Unfortunately, smoking prevalence is still close to 40 per cent in some groups in Scotland, and it is a greater cause of health inequality than social position. It is responsible for half the difference in life expectancy between those from the most and least deprived backgrounds. Smoking cessation services are extremely important to reducing smoking prevalence. NHS stop smoking services are successful in reaching people from communities where we see a lower success rate for quitting smoking. My mum was a smoker for 40 years, and she has been able to stop with the help from local NHS stop smoking service. She has achieved non-smoking status for the past 10 years, and that is fantastic. Cancer Research UK is calling on the Scottish Government to ensure local and national levels of investment in quit-your-way services so that they are maintained for the duration of Scotland's five-year tobacco control strategy. I echo those calls. Last year, the Scottish Government published a healthier future backed by £42 million of investment with the aim of improving the health of people of Scotland. It has a particular focus on obesity, which is the second biggest cost of cancer next to smoking in Scotland. Obesity is linked to 13 types of cancer, such as breast and bowel, and some of the hardest to treat, such as pancreatic and esophageal. Pancreatic cancer is particularly difficult to diagnose, and I recognise my colleague Claire Adamson's continued effort to highlight pancreatic cancer, and I am sure that she will expand more on that in her contribution. It is interesting to note that only one in four Scots know that being overweight could put them at risk of cancer. That is particularly concerning when we consider that Scotland's level of obesity is among the highest in the UK and we are among the heaviest nations in Europe. I was therefore pleased to see the Scottish Government publish the healthier future plan, which sets out 67 action points, including reducing excessive junk food consumption, improving the health of our young people and providing better and easier access to healthier food for families on a low income, all of which are extremely welcome steps. Additionally, the plan calls on the UK Government to bring a change to broadcasting laws, to restrict the promotion of certain foods on TV, which I would ask the Scottish Government to continue to push the UK Government to do as soon as possible. Last week, I, along with other members in the chamber, had the privilege of taking part in a photo for the organisation Make Seconds Count, and I was pleased to meet Lisa Fleming, the founder of the group. Make Seconds Count is a charity here in Edinburgh that is created to raise funds to support women and men, of course, with secondary breast cancer. Additionally, one of their principal aims is to raise awareness of secondary breast cancer, as one woman described how she felt discarded. She says, We want to count, too. We need to be part of research and funding. I wouldn't be here today without being part of a perjetta trial. All of the funds raised by Make Seconds Count go to the research team at MRC Institute of Genetics and Molecular Medicine at the University of Edinburgh. Presiding Officer, while I do not have time to mention all of the organisations that are carrying out important work with cancer patients and their families, I would like to recognise some in my south Scotland region, where, in Dumfries and Galloway alone, we have 1,130 people living with cancer and 530 cancer deaths each year. DNG has a cancer information and support centre, a joint venture between Macmillan Cancer Support and Big Lottery Fund and NHS Dumfries and Galloway. It offers confidential counselling and support information on living with cancer and treatment, complementary therapies, stress management and relaxation tips, as well as links to local support groups where persons can come together to share their experiences and even just have a bit of company. We also have Ayrshire hospice based in Ayr. The hospice helps adults in Ayrshire and Arran with life-limiting illnesses such as cancer and other neurological conditions. I would like to thank the many organisations that are made up of extremely hard-working volunteers and staff who are working tirelessly together to support anyone who is affected by cancer. In conclusion, Presiding Officer, no single person, organisation or country is going to beat cancer on its own. We must all work together to make faster progress on our goal of three out of four people surviving cancer by 2034. Once again, this year's World Cancer Day theme is unity, uniting people, communities, researchers and Governments to raise awareness and take action. We must unite in the fight against cancer. Can I remind any member who wishes to speak in this debate to have a wee check and make sure that their buttons have been pressed? I seem to have a very low uptake here. I call Miles Briggs to be followed by Joan McAlpine. I thank Emma Harper for bringing this debate forward today. I thank all the organisations who have provided briefings for today's debate. It has been lovely and uplifting to read about Emma's sister's story, Buffy, and she has outlined that today already. It is important that, as we see those campaigns go forward, the human side to those stories are often so vital in doing so to encourage our fellow Scots to buy unity bans and help raise funds for clinical research. There cannot be many people in this chamber who have not been touched by cancer or have a cancer story themselves. I shared in my maiden speech when I said that I had lost my mother to breast cancer when I was seven. World Cancer Day is an opportunity for all of us to recommit ourselves and our country to work to try to tackle cancer and make sure that people with cancer can live as long and good lives as possible. Yesterday, as part of a visit for World Cancer Day, I visited the Maggies Cancer Centre here in Edinburgh at the Edinburgh Cancer Centre, along with the Public Health Minister. I would like to pay tribute to all the charities and volunteers from across Scotland who work to support people and their families as they go through a cancer journey. We are all wearing our unity bans today. I want to start by paying tribute to everyone who has helped to fundraise in whatever way they have to help to support the work of cancer charities in delivering vital care and research. Yesterday, I met a constituent from Livingston who was about to start a five-week treatment for bowel cancer. She highlighted to me a number of key points that I thought were important for the debate, which I said that I would raise during the debate. Often, when you are going through cancer treatment in Scotland with our fantastic cancer centres, some of the challenges around that struck me with conversations. It was not necessarily the treatment or anything, it was around transport and aspects of that. One of the things that struck me were the changes in our demographics in Scotland today. A number of adults do not have children and a larger percentage of people in Scotland are living on their own. Often, when people commence their cancer treatment, they are told that someone will need to drive them or someone will be helping them with tasks or someone will be there when they get home or be supporting them. The message that she really gave me loud and clearly was that, for her, that someone just did not exist. How we can help patients and develop a truly holistic approach for people living with cancer and understanding what they are going through in their treatment is important. In Scotland, we have been world leading with the development of maggies and other charities in this field, but it is something that we need to look towards. As an ask-really minister, the cancer patients survey has provided a great opportunity for us to learn and hear people's experiences, so I hope that we will make sure that that is fully funded going forward for future surveys as well. As has already been said, in terms of breast cancer, last week I was also delighted to meet with the remarkable ladies from Make Seconds Count, a number of which I have been campaigning with in other campaigns. The fact that the ladies campaign with such guts and strength with everything that they are going through anyway is just remarkable, but I know from those who I have campaigned with alongside the Projeta campaign that breast cancer is still very much a forgotten form of breast cancer and something that needs to be talked about as we look towards how we can improve research. That is despite only 5 to 9 per cent of national funding for breast cancer research going to secondary breast cancer and I think that that really does have to change. There is good news about breast cancer and I do not want to put that in any question at all because when you look at statistics, the mortality rate has improved so dramatically over the last few decades. In Scotland, we now see that 32.5 per cent per 100,000 people in 2017 compared to a mortality rate of 53.5 per cent in 1992, so, as a nation, we have made real progress. In terms of my final points on that, World Cancer Day has presented us with an opportunity, I think, to look at what is happening in Scotland but globally. I recently attended a conference in Oxford when I met some Syrian cancer specialists. They told me about the tragedy of what is happening in their country and the loss of all their national health services there and how it has diminished their whole opportunity to treat patients. What they hoped for on a day-to-day basis was just to have access to electricity. How we make sure that we tackle some of the issues globally are so important. One of the facts that they gave me was the number of people in the world with cancer who have no pain relief whatsoever. I think that that is something that we and World Cancer Day should consider and look to how we collectively can look to address. I know that I forgot to say four minute speeches, so I will say it now. Four minute speeches, please. I have a lot to get through. John McAlpine, followed by Neil Findlay. Thank you very much. I, too, would like to congratulate Emma Harper for securing this debate on World Cancer Day. I would like to pay tribute to Emma's sister, Buffy, for her fight against breast cancer. Anyone who knows Buffy cannot fail to be impressed by her outgoing personality and her optimism, and we are all really pleased with her recovery. I wanted to speak today in this debate, partly in tribute to Buffy and also to the hundreds and thousands of people affected by cancer. Cancer Research UK and Emma today have pointed out that survival rates have improved significantly in the last two decades. That is in no small part due to the work of Cancer Research UK, and a lot of that work is going on here in Scotland in our world-leading universities. This month, I have decided to support that work by signing up to Cancer Research UK's campaign, sugar-free February. It aims to help to beat cancer and beat cravings, too. I have a hopelessly sweet tooth, but I have to say that it hasn't taken long before I have stopped missing chocolate cakes, even white wine, which is full of sugar. Of course, we know that being overweight, as Emma said, can increase the risk of getting a range of cancer, so going sugar-free sends an important message there. I would predicate that by saying that I have known many slim, healthy people who lead impeccable lifestyles who get cancer, too. Cancer can be illogical and it can be unfair. Again, that is why we need more research. As for my sugar-free fundraising, I have raised £160 so far, and if I could convert a few of those pounds sterling raised into pounds and stones lost, I would be a very happy woman. Here is my pitch. I know that there might be quite a few people in the chamber who would appreciate seeing less of me, not least my political opponents, so now you really can achieve that by heading for my Cancer Research giving page on Facebook and Twitter. After that, I am ashamed most pitch. This is a day to remember that many people survive cancer, of course, and those survival rates that we have heard are improving all the time, but there are still huge challenges. I wanted to finish by talking about my most recent experience of cancer, which illustrates an issue that we need to talk about more, which is cancer in older people. My father, Jim, died of an unspecified cancer, aged 83. He was very fit. He was a very healthy man. He never sat down. He was also a carer. He contributed to his community, his church, and, like many older people, he spent his retirement making a difference to his family and the people around him. I know that we were very lucky to have him so long, and I have heard Miles Briggs talk about losing his own mother as a child. Many people who have lost loved ones much earlier will probably wish that they had their mum or dad as long as I had my dad. Cancer in older people can be devastating. It is not true that it always progresses more slowly, and that was not the case in my dad's illness. He was dead within a few weeks of his diagnosis, and he suffered very greatly. That affects a lot of people. The number of people over 75 diagnosed with cancer is expected to rise by 80 per cent in the next 20 years, and the majority of cancer patients at the moment are over 65. Understanding the differences in how cancer develops and behaves in older people is an urgent issue for researchers. I was very pleased to see the briefing from Cancer Research UK from last year, advancing care, advancing years, improving cancer treatment and care for an ageing population. Older people respond in different ways to chemotherapy and pain relief, but, if there is not an understanding of that, we cannot treat them effectively. Despite the prevalence of cancer in the elderly, treatment studies rarely include people older than 70. That means that doctors do not have clear guidance on what works best for older patients. In geriatrics, we are always having to extrapolate from treatment guidelines based on younger people, but the gap is most extreme in cancer care. As our population ages, that is no longer acceptable. Older people live worthwhile lives, such as my father, who is often the linchpin of their communities, as volunteers and as cancer carers. I am very pleased that progress has been made and that this issue is being recognised. I hope that in the next 20 years that we see advances in cancer care for everybody who suffers from the disease, no matter what age they are. Neil Findlay, followed by Alison Johnstone. I thank Emma Harper for bringing the debate forward. We all have a friend or relative wife, partner or child who is affected by cancer. On the face of it, the disease does not discriminate. It impacts on people being the black, white, young, old, male or female. However, that is a day for telling our stories, because that is the way in which we understand and empathise with people who are affected. Cancer can be a brutal, uncompromising thing. Mylon Dahl was a big bearer for a man who worked as a bricklayer all his life. It took him 15 years ago at the age of 64. He was reduced to a shell of his former self as the disease worked its way through his body. I miss him every day. Like too many people in communities like mine, his life was cut short well before his time because of the disease. However, the experience of dealing with cancer can also be life-affirming and very uplifting. When my wife, Fiona, was diagnosed with breast cancer three years ago and she is wearing my unity band today, I feared the worst. I wondered if my dad's experience would be repeated with her, but I thank every day the NHS staff, our family, friends, colleagues, every God that exists and most importantly her for that not happening and that today she is back to full fitness and well. She was lucky, but she was also fantastically and skillfully looked after by Dr Barbar, nurse Laura and the entire team at the St John's oncology unit and the western general radiotherapy unit. Whilst the experience of my dad and other relatives, friends, neighbours and constituents has often been grim and brutal and life-ending, for others it can be life-changing for very positive reasons. Contrast this, falling the tears and emotion of my wife's diagnosis, within a few days our house was full of cards and flowers and visitors and people offering their help and support, but we couldn't help reflect on how fortunate we were, how many people are there and all of the communities that we represent who get a cancer diagnosis, maybe a terminal diagnosis, in the return to a cold, empty house with no cards, no flowers and barely see a visitor or get an offer of any help or support. I thank you for the feeling of being told you have cancer and I have no one to talk to about it, no one to share your fears or tears, no one to go with you to hospital or make you a cup of tea or sit with you during chemo or take you on the 26 miles to the western general every day for radiotherapy. Trying to imagine that brutal loneliness haunts me every time I think about it, I have to say. My ambition, of all of us here on this week of world cancer day, is that we find a cure, but that we improve prevention, especially in the most deprived communities, where the mortality rate in Scotland is absolutely scandalous, 60 to 70 per cent higher. That is where cancer does discriminate in communities like where I live. I want us to get a grip on waiting times and I want us to show that addressing a disease that will affect one in two of our population over their lifetime is really and genuinely and truly a national priority. Alison Johnstone, followed by Stuart McMillan. I will start by declaring that I am currently enjoying my third sugar-free February, and I am finding it easier this year. It is already the fifth of February. World cancer day is not the only time that we can reflect on what we can do better to help reduce the incidence of cancer, survival rates and the quality of cancer care, but it is a really important opportunity to step back and to take stock, to reflect on how far we have come but on how much more we have to do. I too would like to thank Emma Harper for giving the chamber that opportunity today and to thank Buffy too for her inspiration. As the motion notes, 40 per cent of cancers are preventable and being more physically active can play an important role in reducing cancer risk. Physical exercise, we know, helps to tackle obesity, the second biggest risk factor, but evidence shows that being more active can help to reduce cancer risk through other mechanisms too, such as by improving our digestive function, which can reduce colon cancer risk. There is approximately a 30 per cent lower risk of colon cancer and 20 per cent lower risk of breast cancer associated with being active every day. An active travel and cycling in particular is associated with reduced risk of cancer. A 2017 study from Glasgow University looked at the impact of travelling to work by bike and on foot and found that commuting by bike, even partially, was associated with a lower risk of adverse health outcomes, including several cancers. Physical activity is really important for people who are waiting, who are having or recovering from treatment, who are waiting on treatment. Exercising, while undergoing cancer treatment, for example, can help to prevent decline in physical function and control cancer-related fatigue. We have to do all that we can to make sure that that activity is available for everyone. The Scottish Health Survey shows that 65 per cent of adults meet the guidelines for moderate or vigorous physical activity, but that falls to 56 per cent in our most deprived communities. Members will have heard me talk about investment in active travel before and I will raise it here again. So many car journeys in Scotland are short, and they could be undertaken by foot or on bike. 33 per cent are between one and two miles, 11 per cent are under a mile, so let's promote walking and cycling. In doing so, we reduce risks of cancer. The motion rightly calls attention to the doubling of cancer survival rates over the past 40 years, but as Neil Findlay pointed out, an individual's chances of getting and surviving cancer are still very much influenced by their socio-economic situation. Cancer incidents are more common in the most deprived areas of Scotland. Incidents rates have been typically 30 per cent to 50 per cent higher in the most deprived areas compared to the least deprived. Macmillan and NHS national services report that deprivation and cancer survival in Scotland found that mortality from cancer is highest among those from the 20 per cent most deprived communities and that the difference was statistically significant for eight cancers, including breast, liver and lung cancer. As the motion notes, early detention is one of the keys to successful treatment. We're still not doing enough to ensure that Scotland's experiencing deprivation are accessing screening programmes and I'd be grateful if the minister could comment on that in closing. I, too, would like to thank the incredible campaigners from MakeSeconds Count. I think that their visit last week has had an impact on each and every one of us. I'd like to thank all those who work with the 50 per cent of us who have cancer. My mum was diagnosed with myeloma in a blood cancer in 2014. She's had a stem cell transplant and is currently having a three-monthly check with hematology, but she in particular has been very grateful to two Macmillan nurses who are based in Westerhale's healthy living centre. She's spoken of the fact that it's not just health support, it's support on so many areas, from nutrition to exercise to entitlements to transport to support getting a blue badge. Absolutely everything is covered. I think that my thanks to all those who are involved in helping those with this disease. To close, world cancer date is a time to reflect on the huge progress that we have made learning about a disease that will impact about 50 per cent of Scots. I look forward to hearing more from the minister in closing about how we can tackle it together. Before I call Mr Macmillan, I know that this particular debate is one that people want to say a lot in and I do have a lot of members still wishing to speak. I'm happy to accept a motion under rule 8.14.3 that the debate be extended by up to 30 minutes. I would ask Ms Harper to move the motion. I move the motion. Question 14 is that, under rule 8.14.3, the debate is extended by up to 30 minutes. Are we all agreed? Oh, thank you. I was worried for a minute there. Yes, thank you very much. The debate is there for extended. I call Stuart Macmillan to be followed by Mark McDonald. Thank you very much. First of all, I would like to congratulate my friend and colleague Emma Harper for securing this important and timely debate. The motion is succinct and Emma Harper laid out further in her opening speech. I'm not going to stand here and profess that I'm an expert in the field of cancer, as I'm clearly not. However, cancer knocks the door of many families and households indiscriminately. The motion talks about one in two people who will get cancer in their lifetime. That may appear to be at a high stat, but I'm not aware of many families who actually haven't been affected by cancer. The survival rate is increasing as something that, firstly, we will all welcome, but secondly, recognise that this hasn't happened by chance or overnight. This is where the research is so important and the investment to fund that research is crucial. We've received various briefing notes prior to today and I want to thank all the organisations that work and also help in the cancer field. The figures that they highlight about research provide an indication as to how much there has been, but there's also spent, but there's still that journey that we still have to go on to actually beat cancer. With Cancer Research UK spending £38 million alone last year and breast cancer now spending just over £16 million, it's clear that the sector is working hard. I want to thank everyone involved in cancer research and I also want to thank everyone who works with patients to provide them with the expert care, the attention and the information that they require every single day. Every year MSPs don a bit of pink to highlight the weird pink day to both raise awareness of and also raise funds about breast cancer. I must admit that we do look ridiculous at times, but it's for a good cause. My constituents see the funny side of it when the photo appears, all apart from one that is. All appreciate the fun element highlighting the serious, serious message. In my constituency I've got dealings with Marie Curie and also Macmillan and I appreciate everything that they do to help make the lives of my constituents better and also more comfortable. I take a slightly cold position on cancer and I tend to approach it in a state of defiance. Sometimes I might mean that I might possibly not show enough emotion when I talk about it or actually work with others on the issue, but that general is my self-defence mechanism. On the issue I need to try to remain as impersonal as possible. I know and I've known too many people with cancer. Some have managed to beat it and others haven't. I also admire and cherish those that have survived and continue with their lives, usually with a different perspective. One final point that I want to raise is the issue of the media and TV programmes. Emma Harper spoke about TV earlier on. They play a hugely important role in portraying a message. At the moment, as a programme on STV cold feet, one of their characters, Jenny, played by the wonderful Fyrrachly, is playing that character and someone who has been diagnosed with breast cancer. I've not seen the last night's episode yet, but I'll see it later on in the week. However, the connection with the characters that I've actually got with the audience is testimony to both the excellent writing and the acting. However, the storyline is extremely powerful but highlights both the importance of talking about breast cancer, the early diagnosis of cancer, the treatment that is required but also the mental challenge of facing up to and dealing with it. That's where the media has got such an important part to play. I want to thank the programme makers for introducing this storyline so carefully but also so sensitively. I'm signing off yesterday was for a cancer day, but cancer day starts for someone new every single day. I do thank Emma Harper once again for securing this debate, and I want to once again thank everyone working in the field for their efforts to both improve the research but also the treatment of people with cancer. One day, one day, society will defeat this awful and discriminant disease forever. Thank you very much, Presiding Officer. I congratulate Emma Harper on securing this important debate today. I was listening to her speech and she was listing the ways in which we can prevent cancer or protect ourselves against cancer by not smoking, cutting down on drinking, losing weight and taking more exercise. I was contemplating that as a non-smoking tea totaller who has managed to lose three stone in the last year and is currently in training for two marathons this year that appear to be ticking plenty of the boxes. Yesterday, World Cancer Day was a very poignant day for myself and my family because 4 February 2019 marked the second anniversary of my father's death. I have mentioned it in a question to the minister in the chamber. I want to say a little bit more about the circumstances of my dad's cancer. Neil Findlay quite rightly said that this is an opportunity for us to tell our stories. I think that my father's story has a very important message attached to it, which I think benefits for me to relate. My dad worked a large part of the year in Africa. He had a business interest in Ghana. Just prior to leaving to return to Africa, he noticed under his false teeth at the base of his mouth what he thought was an ulcer. Being that he had false teeth, he assumed and tended not to visit the dentist so that he did not have regular oral health check-ups. It is often a misconception for many that if you do not have your own teeth that sometimes you do not need to go to the dentist. Anna Sauer has left the chamber as the resident dentist in Holyrood, but I am sure that a test of the fact that dental checks are about much more than just checking that your teeth are okay. It is about your wider oral health. He dismissed it and went off to Africa. He was due to come back for the period that would span his 60th birthday. We were going to have a big party and a big celebration. He arrived back with a very large growth on his jaw, which he had initially dismissed as probably the result of an insect in his face reacting as a consequence to that. After a period of time and some nagging from my mother, he eventually made an appointment to go and see the emergency dentist, from which he was very quickly referred to the Maxwell official clinic from where he was referred for a biopsy. It was during this process that I began to join the dots and realised that we were probably heading towards the destination of a cancer diagnosis. You read so much in the news about cancers being caught early and people being effectively treated and recovering. We have heard some fantastic and inspiring stories about people's recovery journeys this evening. In June of 2016, my father received the diagnosis of cancer and was told that the cancer had developed to a stage that there was no hope for recovery. Neil Findlay mentioned the point about the effect that cancer had in relation to his father. It was an exceptionally difficult period to watch my own father, a man, who was always making jokes, always making people laugh and himself had the most infectious laugh. Slowly losing the ability to communicate, slowly losing the ability to speak and be understood. The frustration that that gave him when he would try to make conversation but could not be readily understood because of the effect that oral cancer was having on him. I mentioned to the minister when I raised a point in the chamber around oral cancer that last year—sorry, 2017—the year that my father passed away, the number of oral cancer deaths in NHS Grampian rose from 21 to 28. A point that NHS Grampian officials made to me was that late presentation is often a key factor in relation to that. I often think back about what if my dad had gone and got seen too quicker. What if he had had regular dental check-ups? What if he had taken the steps that could have perhaps identified that cancer earlier? Would he still be here today with us laughing, joking, playing with his grandchildren, enjoying time with his family and friends? We do not know for definite, but it would certainly have increased his chances. One of the key messages that I wanted to send and have tried to send since my father's passing in particular during the recent Mouth Cancer Awareness Month was to make sure that people understand that even if they think that it is nothing, to go and get something checked if they notice anything unusual, because the people are there who are qualified to tell you that it is nothing, but if it is something, it is better to know and it is better to get it dealt with, because if you leave it until later, often that can mean leaving it until it is too late. Presiding Officer, I thank Emma Harper for bringing this debate to the chamber this evening. I am feeling a tad emotional. Lots of people have shared personal experiences with the Saviom ond that Dad died of cancer, so I found Mark McDonald's contribution in particularly moving. I thank Neil Findlay and the others who have shared their experience this evening. It is a very brave thing to do. I wanted to start this evening by thanking my friend and colleague Hannah Bardell MP, who recently had her own smear test recall to the hospital and the worry surrounding that. Hannah has campaigned tirelessly for years for the Michelle Henderson cervical cancer trust. Michelle was a young woman in her constituency, a friend of Hannah's, who died in her twenties from cervical cancer. Hannah has used her recent experience to remind young women in particular how important it is that when we are offered screening, any of us, how important it is that we take up those offers, because I know particularly for young women that that rate of taking up those opportunities has fallen recently. It is just so very important that, with all the work that has been done to help people, people take up those opportunities so that we can prevent cancers from developing. Emma mentioned that I have a particular interest in pancreatic cancer. That has indeed come to me through the Begley family from Lanarkshire, who shared their own experience with their father with me. My colleague Nicky McManus, who works for me, died from pancreatic cancer. I know that is a loss that she and her three children still feel very deeply. I was not very aware of the issues around pancreatic cancer. I think that what we have heard today is that every day's individual journey with cancer is unique to them, but we have trends and statistics that we can talk about. I will move on to some of those at the moment. When I heard the pancreatic cancer event last year, there was only one survivor in the room who had lived for more than 10 years. It is a stark reality of this particular type of cancer that the statistics have hardly changed in the last 50 years. There is great work going on to try and reverse that trend. I was delighted to meet the young leaders from the precision plank research team at the Beeston Institute for Cancer Research. The precision plank programme is funded by Cancer Research UK, and we thank them for all that they have done to promote today and to send us the briefings for this debate. It is also funded by the Scottish Government, and it seeks to make those vital breakthroughs that are so important for pancreatic cancer research. Is it unique? It is a cancer where the five-year survival rate for Scotland is only 5.6 per cent. That has increased only by 2.1 per cent in the last 20 years. In 2016, 784 people were diagnosed with pancreatic cancer in Scotland, and 790 people died. It has an incredible attrition rate. It is a cancer that is quick, and its rapidity is staggering. It is one that we really have to make some of those vital breakthroughs, and while we celebrate every success and everything that is happening and every survival, we have to recognise that, in this particular case, there is much more to do. I thank the UK for the work that they are doing. They have a petition at the moment to try and get the UK and the Scottish Government to increase the treatment rates for cancer. The ask is that this particular cancer is treated as an oncological emergency to ensure that people get treatment vitally needed more quickly. I will leave it there. It has been a particularly good and informative debate this evening. I thank everyone because, as has been said already, this is someone that touches each and every one of us in our lives. Tom Mason, followed by Gillian Martin. Thank you, Presiding Officer. It is a great privilege to speak in this debate, having done so at this time last year. I am grateful to Emma Harper for bringing this motion forward for us to discuss. The subject of today's debate is one that will close the hearts of many members, perhaps through experiences with constituents, friends or family members. Improving outcomes for people with cancer is a goal that we all share across any political divide that we normally have. That is why I am pleased to mark World Cancer Day and welcome the important progress that has been made in recent years and decades. As the motion notes, there has been marked change in survival rates over the last 40 years. That is in part to the advances in medical treatment and technology, as well as a change in how we recognise the lifestyle factors that lead to cancer. In many cases, the changes that are needed to prevent cancer are fairly simple, for example, eating healthily. Some are more challenging, such as with smoking, but when making the change, it can sometimes make a difference between life and death. We cannot overstate its importance. However, as we look at the good progress and work that has been done, it is important to consider where we could be doing better. One of the key markers here is the Scottish Government's own 95 per cent target for 62 days' standard for referral to treatment. According to the latest statistics, only two health boards have managed to meet this, with NHS Grampin in my region coming in at just 76.6 per cent. NHS Grampin also falls behind with the target for treatment within 30 days of decision to treat, at 90.5 per cent versus the 95 per cent target. Even looking at Scotland more generally, the national average of treatment within 60 days of referral in the last published quarter fell from 84.6 per cent to 81.4 per cent. Set against 90.5 per cent targets, those figures are simply not good enough. There comes a point where good will and good wishes do not cut it. We must see improvement and we need to do it fast. Personally, I feel that there is another consideration, the quality of life for cancer survivors. Let us be in no doubt, even when successful cancer treatment frequently has long-term side effects. This can cause substantial physical and psychological damage. Having been on the receiving end of myself, I think that more attention could be paid to making sure that patients receiving treatment can live their lives as comfortably as possible, and I welcome any work that can be done in this regard. No-one doubts that this is a vital issue and one that should command full attention. Important work is being done and that should continue, but there are areas where improvement is needed. By 2027, it is estimated that around 40,000 cases of cancer will be discovered in Scotland every year. It is vital that we transform services to deliver better, more supportive care, as well as use of resources wisely. I welcome the debate and hope that we can make the changes that we need to make sure that progress over the next 40 years exceeds what we have come to be used to in the past. The last two contributions are from Gillian Martin, followed by Monica Lennon. I thank Emma Harper for bringing this debate to the chamber for her online story with her lovely sister Buffy, to raise awareness and to the constituents affected by cancer who have got in touch with me asking me to take part in today's debate. There are so many aspects that we can cover in a debate like this, but I want to concentrate on one of the third sector agencies in my area who work with those with the cancer diagnosis in their families, Clan. A few months ago, I spent some time at Clan in Inverurie with a few people in their families who have used their services. I want to thank the manager, Fiona Cormack and her team, and everyone I met for making me so welcome. When I wrote that phrase, I realised that using their services does not seem adequate for what people's relationship is with Clan. In the times that I was there, I met families who told me how Clan supported them in all manner of ways while their loved ones were seriously ill. I met cancer patients dealing with trauma of their diagnosis who needed that pastoral care that cannot be so easily provided in a health care setting and sometimes is not appropriate to be delivered in a health care setting. I met people who had lost loved ones to cancer and visited the centre for months and years on from that point for emotional and practical support. What is Clan and what does it do? What does it do would be easier to cover? Clan does what it can to fulfil whatever a person needs, whatever they come and ask them to help them with. That could be advice and support, advice on finances, just simple friendship, community opportunities to share experiences with others with cancer diagnosis and no shortage of listening ears. They provide complementary therapies to that sort of thing that can give a person a bit of respite from medical procedures and the stress of their condition, such as massage and aromatherapy. Their centre has therapy rooms in it, which are just outstanding. It also has support groups for particular groups, one for children and one for teenagers who are affected by cancer. One group that I met at the centre was a men's group. They were just back from a walk and they meet up once a week for a walk, then a cup of tea and a chat about anything. They were discussing music when I butted in and two of them also took the opportunity to give me some case work, which has got nothing to do with their health whatsoever. They are just there for friendship and support. A friendship group happened to be made up of a range of people affected by cancer. They were currently dealing with a diagnosis and treatment, those in recovery from cancer and there were a couple of people whose connection to Clan and the group was through a family member. One regular visitor was the widow of a woman who died over a year ago, who pops in regularly for a chat with the friends that he has made there. Hospitals cannot provide that sort of thing. That is why the third sector organisations such as Clan are needed. Clan also operates in the north of my constituency in Turf. They have to meet in the local library, but they do not have a fantastic facility like Inverdory. I pass off and cross there as I do a constituency surgery there. They might not have the facilities that Inverdory has, but they offer the same support. Like Inverdory, they have monthly coffee mornings for people to meet and catch up. There is no manual on how to cope with a diagnosis of cancer. There is not one for the person who is receiving the diagnosis and there is not one for their family and friends. When I spoke to the many people that I met at Clan, one thing came up time and time again, and that was the relief that they felt that they had found Clan when they needed them. There was a reflection on what they would have done if they had not found Clan and they had not had them to turn to for support. It struck me that every person who found out about what they do, there will be others out there who need them but have not found them yet. That is why I wanted to make them the focus of my contribution today. I want everyone in my area to know that Clan is there. You might be fortunate enough never to have to walk through their door, but thank goodness that they are there for the people who do it. I am also grateful to Emma Harper for bringing forward emotion and giving us the opportunity to come together to mark World Cancer Day. I know that the emotion talks about the unity band, and I think that we have seen the Parliament unite this evening because we are all touched by cancer. We have heard a mixture of sad stories of people who have lost loved ones, but also hopeful stories such as Emma Harper's sister, Buffy, Alison Johnstone's mum, who is hopefully doing well. I know that my own mum who has had her own cancer journey recently and is going back to work tomorrow after an operation a few months ago. Often people think that politicians are out of touch and we do not understand the issue. We could have all taken part tonight without any briefings. Of course, we are all grateful to Macmillan, Cancer Research UK and Breast Cancer for their very helpful briefings. Of course, for the brilliant jobs that they do supporting families affected by cancer and for their tireless campaigning and fundraising. I want others to pay tribute and say again a personal thank you to our wonderful NHS staff who support people and their families through this difficult illness. I know that, in the past two years, my family certainly had our money's worth out of the NHS and probably a bit more. The word cancer used to be a taboo subject. It carried a lot of stigma and families did not talk about it, and I am glad that that is changing. We also know that survival rates are improving. We are seeing positive campaigns to help to break the stigma, such as breast cancer now's wear at pink campaign, which is a lot of fun, and George Truss's work encouraging women to go for smear tests. I was grateful to colleagues who took part in my member's debate last month to mark cervical cancer awareness week. Groundbreaking cancer research would not be possible without incredible fundraising efforts of people in our communities. I see it in my own region, and even just last week, I picked up the local paper, the Hamilton advertiser, and the Hamilton bowling club. Lady's section had raised £3,000 for cancer research UK. That generosity happens day in and day out. Others have talked about the third sector and volunteering. I was pleased to hear Miles Briggs mention transport. In my own mum situation, the Lanarkshire Cancer Care Trust was invaluable to her. She did not want to rely on family to fit in with her appointments, but she was able to make a donation to the volunteer group. She started to affectionately call it the cancer bus, because the other people on the bus had the same experiences or could understand what she was going through. The driver was an expert in getting through the traffic and getting to the right department, because she was going to the beach since she was going to hear Miles in other places. Again, even when you have a family to come home to, as Neil Findlay was touching on quite often, it is not your family that you want to open up to. For my mum, that was important experience. In Lanarkshire, I am trying to remain positive. I am pleased that recent stats show that the majority of patients have been treated with entreatment time standards, but we know that, in terms of diagnostics, that is not the experience nationally. Perhaps when the minister is closing, he can give the chamber a bit of an update. I know, again, the cross-party group on cancer has been doing some really good work here. We all want to keep improving and supporting each other. Others have touched on the fact that there is a lot that we can do to prevent cancer, and we really have to focus on that. We have to make sure that, when we have strategies and policies, we have to make sure that it is realistic and that it is easy for people to make lifestyle changes and to look at the barriers that people face in order to make the right choices, the healthier choices. We have seen a great amount of progress. We know, in this Parliament, that we can do tremendous things such as the smoking ban. My own gran, whom I loved very much and miss dearly after 16 years, was a heavy smoker, but she was a barmaid and she worked in smoke-filled working men's clubs and pubs. She died of lung cancer. I remember every day from a daughter who is now called after her, Isabella, but those are the kind of things that hopefully we are going to see less of. I thank everyone for their contributions. I now ask Joe FitzPatrick to respond to the debate for around seven minutes, please, minister. Thank you, Presiding Officer, and thank you, Emma Harper, for securing this important debate. I am pleased to join Emma and others in the chamber in wearing my unity band. Today's debate provides us with the opportunity to reflect upon the preventable causes of cancer and the steps that all of us can take to reduce the impact of this terrible disease. It is fitting that we should have this debate today following World Cancer Day yesterday. This day is intended to target misinformation, raise awareness and tackle the stigma so often associated with cancer. The day is important for those who are currently affected by cancer in reducing the number of people who develop cancer in the first place in detecting cancer at the earliest possible stages and in supporting those who have a cancer diagnosis to their families and friends. I was pleased yesterday to be able to mark cancer day by visiting Maggie's and Edinburgh. My paths crossed with Miles and like Miles Briggs. I really appreciated the time that people took to speak to us around the kitchen table. Maggie's is one example of some of the many organisations that do some fantastic work. Gillian Martin mentioned CLAN and others mentioned Macmillan nurses. There are so many organisations doing so much good work and we thank them all. I was also very pleased to be able to speak at the Scottish Cancer Prevention Network Conference yesterday. This is an important gathering of world experts on cancer prevention, who are largely based here in Scotland. We can be proud that our NHS and academic institutions are working together on highlighting and helping everyone in Scotland to live healthier lives. That conference highlighted projects such as Act Well, led by Professor Annie Anderson from Dundee University, encouraging women across Scotland who attend breast screening programmes to reduce the risk of developing breast cancer by taking up physical activity, mentioned by Alison Johnson, eating healthy and losing weight. It is delivered in partnership with breast cancer now volunteers and supported by the Scottish Government. The project is making a real difference to women across Scotland, including in my constituency. Let me assure everyone here in the chamber that the Scottish Government is determined to play its part in tackling cancer. Current projections from Cancer Research UK tell us that 1 in 2 people in the UK born after 1960 will be affected by cancer. We need to reduce those figures over time and to ensure that the right support is in place to help those affected by cancer. Significant progress has been made over the past 10 years, with the overall cancer mortality rate falling by 11 per cent. However, more needs to be done to reduce the risk factors associated with cancer. Our £100 million cancer strategy, beating cancer ambition and action, sets out our ambition for the future of cancer services in Scotland, improving the prevention, detection, diagnosis, treatment and aftercare of those affected by all forms of cancer. One of the areas of course is research, and it is an area where Scotland is to the fore. Clare Adamson mentioned the precision bank project, and the Scottish Government has committed some £4 million to precision medicine ecosystem, including £700,000 direct to the precision bank project. That is a project that can potentially make a real difference to ensure that cancer treatment, particularly for pancreatic cancers but others, is based on the genetics of the individual patient's tumour, so that there is a real progress potential there. It is also important that we make sure that the whole journey is as positive as it can be. That is why the cancer patient survey mentioned by Miles Briggs was so important. I am pleased to be able to say that we have just concluded that the cancer patient survey closed in December of last year, and we are expecting to publish the results from that in the spring of next year. We will use the results of that to identify gaps in services so that we can focus on addressing those going forward. Gillian Martin also mentioned the holistic support for people with cancer. That is a very important point, and it is specifically within our cancer strategy. I hope that the cancer patient survey will help us to make sure that we are getting that right and making sure that people are getting the support that they need. Organisations such as CLAN are useful in helping us to achieve that support. As Emma Harper said, it is estimated that four in 10 cancer cases can be prevented, and that can largely be done through lifestyle changes such as not smoking, maintaining a healthy body weight, eating a healthy and balanced diet, reducing alcohol intake, protecting the skin from sunburn and keeping active. Neil Finlay rightly made the point that we have a higher mortality rate in Scotland's most deprived communities, and that is why, in each of our strategies—I will try to touch on some of them—we specifically in tackling smoking, healthy eating and drinking alcohol, we specifically have a focus on tackling that health inequality. I will talk later, hopefully, if I have time, about some of the success that we have had in that. One of the first areas that we have seen success is in relation to smoking, so we have had particular success across Scotland, where we now have just one in five adults in Scotland smoking, and the number of 15-year-olds who smoke regularly has dropped by more than two thirds in the last decade. However, it is clear that there is still more smoking, it is still more prevalent in the more deprived areas, but we are now starting to see success in reducing those levels. Emma Harper asked whether we about the stop smoking services, and I can assure you that there is no intention to reduce those services. There are £10 million provided annually to health boards, and I think that that is particularly important as we perhaps are now getting to the point where people need more support who have not already given up smoking and much of that in the most deprived areas. As we have heard, obesity is the second largest preventable cause of cancer, according to Cancer Research UK and linked to some 2,200 cases of cancer in Scotland. That is why it is really important that we make progress in reducing diet-related health inequalities. One of the first things that I did as Public Health Minister was to launch our diet and healthy weight delivery plan, tackling the issues through a focus on prevention. One of the areas that we know that we have to work together on is in relation to foods that are high in fat, salt and sugars. Our consultation has just closed asking about restrictions on multi-buy promotions, placements at check-outs and product promotions. That will be a really important area that this Parliament can help our population to see. It might make it easier for the population to make better health choices, but it will be one that we have to work together on going forward. A number of members have asked about screening and early detection, and we know that if cancer is detected earlier, that leads to a better prognosis going forward. Our national cancer screening programmes continue to work towards identifying bowel, breast and cervical cancer at the earliest stages. Alison Johnstone and Neil Findlay both mentioned and rightly so that levels of uptake of screening is lower in those areas of deprivation. I want to talk about one of those areas of screening, which is the bowel screening test, in which Scotland was one of the first to introduce the simpler bowel test, the fit test, in November 2017. We have now seen increasing levels of participation in the bowel screening. Statistics that have just been published today show that we have now exceeded the 60 per cent target for uptake for the first time. That is really important. One of the most important things is that the biggest improvement has been among those living in the most deprived areas, where we have seen a 10 per cent increase in those areas of deprivation. That is really important. If you are encouraged to get a test if you have one of those bowel tests at home sitting in the drawer or one is going to come through in the weeks coming, please take the time to complete it and post it in, because it could save your life. Monica Lennon asked about diagnostics, and we are continuing to look at how we can make improvements there. One of the areas that we are particularly looking at is the development of rapid diagnosis and treatment centres, which are currently being piloted in England. A final report on that pilot work is due to be published later this year. Our Scottish Cancer Taskforce will consider the results of that to learn where we can use that to improve our services. In coming to our close, I want to take the opportunity to thank all the staff, volunteers who work tirelessly in our NHS and the charity sector to help to deliver our strategies for cancer in prevention, diagnosis, treatment and support for those with a cancer diagnosis. Their unending commitment is invaluable in driving back the disease. In the final conclusion, I want to thank Emma Harper for lodging this important debate and for her and many others for sharing their personal stories, which I think is really important in a debate like today. Thank you all very much. That finally concludes the debate, and this meeting is closed.