No time to be missing targets on mental health

Each year, one in four of us in Scotland will experience a mental health problem.

Mental ill-health is deeply personal and often isolating. Despite efforts by governments and charities, there remains a social stigma and lack of understanding about psychiatric conditions.

At every level of our society, we could and should do more to help those who struggle with mental health issues. We could and should show more compassion. We could and should have better treatment services.

In my practice as a solicitor, I see how prevalent mental health problems are in our country and the impact they have. Some are short-lived periods of distress brought about by an event – bereavement, divorce or an accident. But for many their condition is chronic; it is controlled, rather than cured, over the long term.

If you have, or know someone who has, struggled with long term depression or another psychological condition, you will understand the impact of this on every aspect of life. It can affect physical health, personal relationships and employment.

This month, the coalition Government announced new ambitious targets for the treatment of mental health illness in England and Wales. Treatment times for a serious psychotic episode will match those for cancer and patients with other conditions such as depression would have improved access to talking therapies: 75% treated within six weeks and 95% within 18 weeks.

Fast and effective treatment is essential for the individual, but it is also important for the wider economy. The cost to Scottish employers due to mental health problems is estimated to be about £2.15bn per year; the cost to society due to lack of employment among people with mental health problems is estimated to be about £1.44bn per year.

In Scotland, we have had targets for mental health treatment since 2012. The Scottish Government’s Mental Health Strategy for Scotland committed to access psychological therapy within 18 weeks by December 2014.

However, the most recently published statistics, show that only 82% of people across Scotland are seen within 18 weeks. The year before, it was 81%.

Patients in Edinburgh and the Lothians are faring even worse, with only 73% of patients receiving treatment within the target time.

It is perhaps not surprising then that in early 2014, the Scottish Government revised down its target to 90%.

Unless serious steps are being taken now, it looks like the SNP Government will have failed, not just in its original promise but its lesser one too.

Since the referendum, the SNP has been pressed on public service funding and delivery in Scotland, particularly regarding the NHS. Too many people are struggling with the real problems that life can throw at us: poor health, inadequate housing, lack of meaningful employment. These are the issues of Government. These are the issues that impact real lives in Scotland.

The goal of better mental health for our country is important and attainable. On this, among a number of issues, the SNP Government needs to focus on what really matters and make up time lost while Scotland was on pause.


Salmond And Yes Campaign Can’t Give The People What They Want: Answers

Last week, I was sceptical about the impact the debate would have. I wasn’t convinced that we would see or hear much that we hadn’t before or that many outside of the ‘bubble’ would be interested; Alistair Darling would present the calm and measured case for the Union; we would get the usual rhetorical flourishes from Alex Salmond; the substance would come second place to style.

How wrong I was.

On Tuesday night, a staggering 1.7 million people tuned in, Alistair Darling gave a full blooded, passionate and aggressive performance and substance did matter.

But most importantly, Alex Salmond, First Minister and figurehead of the cause for an independent Scotland, faltered on the issue which is now at the heart of the referendum campaign: what is the plan B on the currency.

For the last six months, I have been speaking to voters about the referendum several times a week. The people I speak to for the longest are those that are undecided. I ask them what the issues are that matter to them and what will make up their mind one way or another. Time and again, the response I get is ‘I don’t feel I have enough answers about independence yet.”

The currency is key on the doorstep. You don’t have to have a Nobel Laureate in economics to appreciate that currency has an impact on jobs, trade, pensions, mortgages, interest rates and the economy – basically every other issue in the referendum debate. Uncertainty over what you would get paid in and what you would spend in the shops has been the biggest issue for the undecided voters I have spoken to.

Six months ago, these voters were willing to give the Yes campaign time to give them the facts they needed before they ruled out a vote for independence. They thought they would have them before they went to the polls.

Fast forward to August and I am still being told, “I don’t feel I have enough answers about independence yet.”

That we have got to less than six weeks until the referendum vote and the Yes campaign have failed to address the key issue for these voters is a problem of their own making.

A surprising number of the undecided voters I have spoken to since last Tuesday watched the debate. They are obviously keen to hear the arguments in their search for answers. They have not been impressed with Alex Salmond’s failure to give them the answers – and the reassurance – that they want and need. That the first poll post debate showed such a massive increase of lead for the No campaign shows how important the debate – and its content – has been for voters.

I am confident that the Yes campaign will lose the referendum for the same reason Alex Salmond lost the debate: lack of answers on the issues that matter most to voters.

This is not to say that the Better Together campaign and everyone working for a No vote can or should rely on a weakening opponent. There is no room for complacency, after all.

I don’t want people to just vote against independence; I want them to vote for the Union. Our positive vision for a strong Scotland in the UK, with enhanced devolution for Holyrood, needs to remain integral to our campaign as we go into the final stretch.

I have my own radical vision for Scotland: a strong and proud devolved Scottish Parliament which uses the powers it has to improves the day to day lives of those that live in this country and stands up for its interests; better Governments with better policies that make lives better; a parliament that uses cooperation and consensus to makes laws rather than one that relies on a government majority; politicians who focus on the issues that really matter – jobs, health, education, housing, transport – rather than the constitution.

This shouldn’t be radical, but in the summer of 2014, it seems that way. This is the Scotland that the majority of voters yearn for. If there is a No vote next month, lets all get to work on giving them what they want.

Does banning e-cigarettes send the wrong smoke signals?

A few months ago I was on a bus with a young man using an e-cigarette. It was pretty unpleasant. It filled the bus with an awful smelling cloud. 

Their use on buses has been prohibited since June 2013, but it made me think about their use in other public places: I may find it unpleasant, but if it isn’t harmful to me, should they be banned?

E-cigarettes are a booming industry and smokers are turning to them in their millions as a ‘healthy’ alternative. But medical opinion is divided on whether they really should be seen that way.

On Tuesday the Metro ran a story about a new study that suggested that e-cigarettes ‘may cause cancer like normal cigarettes’. On Thursday, the Times had another new study that concluded that doctors should recommend e-cigarettes as a ‘harmless way to help smokers quit’.

It is early days for research into the impact of ‘vaping’ but how should public policy respond?

The Scottish Labour Party is rightly proud of introducing a smoking ban in public places in 2006. It had a transformative effect on public spaces and our attitudes to smoking. Decreases in child asthma, heart attack admissions to A&E and premature births have all been attributed to the smoking ban.

But should the public ban be extended to e-cigarettes? No. Or at least, not yet.

Cigarettes were banned in public places the grounds of their impact on the health of non-smokers. So far, there is no body of evidence that the same can be said for passive vaping. Such evidence would be needed before such a ban could be justified. Otherwise, the grounds upon which the 2006 smoking ban was based become hugely undermined. The state cannot ban e-cigarettes just because we find them objectionable, like I did on that bus.

There also appears be a health case to support holding back from a ban.

About 25% of all deaths in Scotland are linked to smoking tobacco. But smoking related deaths amongst the poorest in Scotland are more than double that among the most well-off. Moving smokers from tobacco to vapour, with a view to quitting entirely, would have a momentous impact upon the overall well-being of Scots as well as tackling this huge health inequality.

If e-cigarettes can be used as an effective replacement therapy that can prevent some of these deaths, we shouldn’t be putting up the barriers to their use, we should be keeping them down.

None of this is to say that e-cigarettes shouldn’t be regulated in terms of safety, standards and advertising and there are plans afoot for this to be the case. And if they are classified as medical products then this opens up the possibility of them being available free on NHS prescription in Scotland.

The smoking ban was one of the greatest achievements of the first decade of the Scottish Parliament. With the evidence and the public on their side, Holyrood enacted legislation that has been, and will continue to be, of tremendous benefit to health of our nation.

But unless the same solid evidence is there for e-cigarettes, we should resist a ban on their use in public places.

A healthier and happier Scotland must be the legacy of Glasgow 2014

In 1990, after watching the rhythmic gymnastics at the Commonwealth Games in Auckland, I successfully persuaded my mum to buy me a ribbon. It was yellow and I loved it. I have fond memories of playing with it excessively at school playtimes and at home.

It will come as no surprise that that was the limit of my passion for rhythmic gymnastics. But I am sure there were others who watched the same Games and took it further.

The first four days of the Glasgow Commonwealth Games have been tremendous. Team Scotland sits third in the medal table, the sun has shone and the crowds have been lively, generous and supportive of all athletes.  

It has been inspiring stuff. Who hasn’t watched a momentous sporting event and then had the sudden urge to go out and pick up a tennis racket, kick a ball or take a dive at the local pool?

For some, it may go no further than that. But there will be those who find themselves starting to time their cycle around the block and then pushing themselves to go that little bit faster. For these people, the Games inspire them to learn, train and compete. It inspires them to be the Chris Hoys of the future. 

The legacy of the Games has to be a fresh commitment to Scots, particularly young Scots, leading healthy and active lives. But it is not just about physical health; it is also about mental health.

The benefits of exercise to mental well-being are well established. Healthier, happier kids grow up to be healthier, happier adults and have healthier, happier families.

Improving the health of our country’s children should be a priority for all politicians – whatever the party. We need an improved attitude to physical and mental health in this country that is instilled in childhood and lasts a lifetime.

In May, a report by Strathclyde University gave Scotland’s children an F for overall physical activity. I was shocked earlier this month to read that 100 Scots a month have amputations linked to obesity. In 2012, 17% of children in Scotland were at risk of obesity, a rise of 1% since 2003. We need bold and ambitious policies to tackle these problems.

I want to play my part in ensuring the best possible provision of physical education in schools and opportunities for all kids to get involved in sport. I want to play my part in ensuring great local facilities and support for coaches and community clubs so that the legacy of Glasgow 2014 is not just for Glasgow, but also for the whole country. 

The Sir Chris Hoy Velodrome is an amazing addition to the nation’s sporting resources but unless we make daring changes in our approach to health and fitness the length and breadth of the country, the Velodrome won’t reach its maximum potential – and neither will our children.

The Commonwealth Games, Identity and the Referendum

I was a London 2012 naysayer. I was deeply sceptical about the Olympic Games and its impact.

That all changed with the opening ceremony. Within 10 minutes, I was a huge cheerleader for the games and Team GB. The next day, I had a sense of community in my city that I had not been aware of the day before. Strangers smiled at each other. We chatted on buses and over garden fences.

And this feeling continued for the duration of the games. At the end, we all wished it would continue. But in the same way as the closing ceremony failed to live up to the highs of the opening, our hopes of a lasting feel good factor ended in disappointed.

Fast forward two years and we are days from the Commonwealth Games. Twelve days to unite the country and bring some joy for all could not be better timed.   For many, the independence debate has been either bruising or boring. The official referendum campaigns will take their feet off the gas a little for the Glasgow games, so we can all cheer on these world-class athletes without politics getting in the way.

When the events start, I will be cheering (possibly screaming) on Team Scotland. But The Commonwealth Games are about a family of nations. And in that spirit, I will be supporting the other UK countries as well – and Guyana, another member of my personal family of nations.

My paternal grandfather came from Guyana during the Second World War, having joined the RAF. After the war he attended St Andrew’s University and became a teacher. This heritage is part of who I am, part of my identity.

The issue of identity has been, at times, problematic in the referendum, with accusations that some are second class Scots and that others have been petty and insular.

Given that identity was always going to have a place in a debate on the issue of national sovereignty, the best and only way forward is for everyone to acknowledge and respect the differences that exist. My sense of who I am, and why, deserves no more or less respect than any one else’s.

The games will allow people from across the Commonwealth to experience and express national pride and identity in the best sense: joy and magnanimity in victory; honour and solace in defeat. 

During the games, the sense of community and shared happiness we felt during London 2012 will surely return. And while the campaigns take a short hiatus, all involved would do well to look to Glasgow. There will be lessons to be learned about fair play and mutual respect for the next two months and beyond.