Meeting of the Parliament 08 October 2025
I, too, extend my thanks to Edward Mountain for securing the debate and for his on-going efforts to raise awareness of bowel cancer and bowel cancer screening. Finlay Carson just described his action as formidable, and I agree entirely with that. Many of us here will remember that members received a stoma bag from Edward Mountain to raise awareness of stoma care—I am fairly sure that mine was tied to the door handle of my office. It was extremely effective and it brought the issue home to me in a very real way.
As the Cabinet Secretary for Health and Social Care, Neil Gray, has said, he will meet Mr Mountain to discuss the five asks for improved stoma care, and I look forward to hearing the outcomes of that meeting. I assure Edward Mountain that, as Mr Gray has already indicated, we are keen to work with him to realise his asks.
I echo Mr Mountain’s and Alexander Stewart’s gratitude to bowel cancer charities. The Scottish Cancer Coalition, which consists of 31 third sector organisations, informs and amplifies our detect cancer early messaging. Bowel Cancer UK, as well as being a valued member of the bowel screening programme board, provided personal stories for our be the early bird campaign. Those are just two examples of the invaluable support that cancer charities provide to the NHS and the Scottish Government. More importantly, the support that they provide to people who are diagnosed with bowel cancer is a lifeline that can be huge at the most difficult of times, and I cannot express my thanks for that enough.
Finally, I thank everyone for their contributions today and for their obvious passion and concern. I always find it very difficult to respond to this debate, because my father died of secondary cancer as a result of his bowel cancer not being diagnosed soon enough. On the flip side, one of my best friends was diagnosed early and I am very pleased about that. She and I are going to see Deacon Blue on Friday night—she is doing very well. It is easy to talk about statistics and percentages, but, as I have just illustrated, behind every cancer story is a personal one.
As we have noted today, Scotland was the first nation to fully implement the UK national screening recommendations, so the entire eligible population was offered screening. Along with Wales, we continue to have the lowest referral threshold, which means that more people are sent for investigative tests. That means that more cancer is detected early, when treatment is likely to be more effective, and more people are given the chance for another birthday, another Christmas, to see a child get married or simply to have more time with family and friends. We should never take that for granted. We should also not assume that we have reached the limits of what is possible, which is why we continue to consider advice from the UK National Screening Committee, which is an independent expert advisory group, and I have asked my officials to explore engaging with that group on eligibility criteria.
As many members have noted, with around two thirds of people returning their screening kits, we are exceeding the 60 per cent target. However, as Jackie Dunbar and Jackie Baillie said, that means that a third of people are not returning them. Those are often people in areas of high deprivation or who face other barriers that make screening difficult. I have no hesitation in saying that that is not where I want Scotland to be.
There are no easy fixes, but I assure members that we are working to find solutions. Some will seem to be small, but they will have significant impact. For example, Public Health Scotland is improving the bowel screening invitation letters to include a suggested return date for the kit. A pilot revealed that that simple step increases uptake. Work is also on-going to make it easier to request information in other languages and formats, which will increase accessibility for people across Scotland.
More broadly, the 2023 equity and screening strategy set out a vision to improve accessibility across screening programmes. It has resulted in all health boards developing bespoke inequality plans, and we now have an equity and screening network that allows experts to share what works and, just as importantly, what does not. Those initiatives might take time, but I am confident that we will see reduced inequality and increased uptake across all screening programmes, including bowel cancer.
We will continue to make £1 million available annually to support that work. In 2026, we will also publish an updated equity strategy that includes the valuable input from third sector organisations. I have noted some of the contributions tonight that we will be considering.
I have heard the clear calls to lower the referral threshold. I am ambitious to make that happen, and that ambition is shared across the NHS. However, our ambitions must be delivered responsibly and take into consideration the impact on NHS services and individuals. As members have mentioned, without more capacity, a higher number of tests will result in delays for symptomatic or higher-risk patients.
We are working to overcome those challenges and to increase the detection of polyps and cancer. This year, we allocated more than £10 million to endoscopy services, building on our endoscopy and urology diagnostic recovery and renewal plan that was published in 2021. Those steps will make a difference, and our aim remains to work towards a lower threshold, but we can do so only when we know that it will truly improve outcomes.
Again, I thank Edward Mountain for his motion, and I urge everyone to complete their bowel cancer screening when they are invited to take it up. The few minutes that it takes can and does save lives—please do the test.
Meeting closed at 19:31.