Hansard

I thank Paul Sweeney for bringing this important debate to Parliament and join others in placing on record my appreciation and gratitude to Marie Curie for its incredible work day in, day out to support people who are terminally ill, as well as their families and loved ones.

As has been noted, the report highlights, unfortunately not for the first time, some of the real financial challenges people face at the end of life. It cannot be right that, at that most difficult of times, families must also face that additional pressure. I also acknowledge the work of Barnardo’s, Age Scotland and the Poverty and Inequality Commission, which also provided helpful information and insight on the issue.

I thank members from across the chamber—Bob Doris, Elena Whitham, Carol Mochan, Alexander Stewart, Paul Sweeney, Richard Leonard and Jeremy Balfour—for their contributions. I noted a link between the contributions from Mr Balfour and Mr Leonard. Mr Balfour spoke about the inherent dignity and value of life and the true measure of a successful society, an idea that I felt was very much at the heart of Mr Leonard’s contribution. He spoke powerfully, as did Carol Mochan, about the structural inequalities and wider economic determinants that still too often characterise people’s experience not only of their life and their economic and social circumstances but of the end of life.

While we consider what further specific interventions we can make and what further support we can provide, it is important that we do not lose sight of that more profound question, which is becoming more and more pertinent and inescapable.

I want to respond to the point that Mr Sweeney and Mr Stewart raised about what is happening in Manchester. The advice that I have received is that that is being undertaken under the provisions of section 13A of the Local Government Finance Act 1992. My understanding is that the territorial application of those provisions extends to England only and, as such, we do not have discretion under the act to do the same thing in Scotland. However, I reassure Mr Sweeney and the wider Parliament that we will consider the matter as part of the Scottish Government’s wider work on looking at council tax reform, because it is a very important point.

I turn to the Government’s broader work. We continue to take important steps to address the challenges that are highlighted in the report, and we do so in the context of the powers that we have under the devolution settlement and the constraints of the budgets under which we operate.

The social security system in Scotland quite rightly takes a different approach, fast tracking disability assistance applications from terminally ill people to ensure that they automatically receive the highest rates of disability assistance that they are entitled to. Importantly, there are no time limits included in the definition of terminal illness, and the decision is rightly made by clinicians. The person-centred definition of terminal illness applies to all of our disability assistances—child disability payment, adult disability payment and pension-age disability payment.

Within the constraints of the powers and budgets, the Scottish Government is also committed to mitigating winter heating costs and supporting people to access all support that is available to them. In the coming winter—winter 2025-26—we will provide an estimated £28.3 million for winter heating payment, £11.4 million for child winter heating payment and £157 million for pension-age winter heating payment. Those benefits provide guaranteed support to people who have an identified need for additional heat over the winter months, including low-income households, pensioners and families with disabled children and young people.

The Scottish Government whole-heartedly agrees with the report’s recommendation that the UK Government should introduce a social tariff. Mr Doris touched on that in his remarks. In the Scottish Government’s view, a social tariff mechanism is clearly the best way to ensure that energy consumers are protected against higher bills. We called on the previous UK Government to introduce such a tariff, which was, in part, to ensure that people with terminal illnesses, whose bills can be thousands of pounds higher than that of the average household, would not have to make the horrendous choice between powering vital medical equipment, heating their homes and buying food.

We are also taking meaningful steps to address racial inequality, which members touched on with reference to the report, as it remains an unwelcome reality that communities across Scotland experience health, quality of life and even life expectancy differently depending on their circumstances. We are committed to addressing the significant and persistent health inequalities that are experienced by minority ethnic communities in Scotland. Those inequalities have unfortunately widened in recent years due to the impacts of austerity, the economic consequences of Brexit and Covid, and the subsequent cost of living crisis.

In his September 2024 anti-racism statement, the Cabinet Secretary for Health and Social Care identified racism as a key driver of those health inequalities and a “significant public health challenge”. The statement sets the expectation that anti-racism will be embedded across the health and care system.

In order to tackle the socioeconomic inequalities that are the root of health inequalities, we are complementing our health efforts with wide-ranging cross-Government action. On 17 June, with the Convention of Scottish Local Authorities, we published “Scotland’s Population Health Framework 2025-2035”, which is our refreshed 10-year cross-Government and cross-sector approach to population health. The framework, which is focused on prevention, sets a clear evidence-based aim to galvanise the whole system to action to improve Scottish life expectancy while reducing the life expectancy gap between the most deprived 20 per cent of local areas and the national average by 2035.

We want everyone in Scotland, regardless of age, race, diagnosis or location, to have access to timely, high-quality and person-centred palliative care. Our five-year palliative care strategy includes measures to better integrate specialist palliative care into hospital and community services and improve public information about living with life-shortening conditions. The strategy will help to ensure that people of all ages with life-shortening conditions, their families and carers should receive the right care and support in the right place at the right time and from the right people. Those are only some of the steps that the Scottish Government is undertaking to prevent people from dying in end-of-life poverty.

Again, I thank Paul Sweeney for bringing the debate to Parliament and all members for their contributions. I also thank Marie Curie for its report and for the brilliant and invaluable work that it undertakes day in, day out.