Health, Social Care and Sport Committee

Meeting date: Tuesday, March 1, 2022

Official Report 618KB pdf

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Subordinate Legislation

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Forensic Medical Services (Modification of Functions of Healthcare Improvement Scotland and Supplementary Provision) Regulations 2022 [Draft]

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Forensic Medical Services (Self-Referral Evidence Retention Period) (Scotland) Regulations 2022 [Draft]

Items 3 and 4 on the agenda are consideration of two affirmative instruments. We have an evidence session with the Cabinet Secretary for Health and Social Care and his officials, who are all joining us remotely. Once all our questions have been answered, we will have a formal debate on the motions.

I welcome Humza Yousaf. He is accompanied by Scottish Government officials: Vicky Carmichael, acting unit head of the chief medical officer task force; Greig Chalmers, head of the chief medical officer’s policy division; and Jacqueline Pantony, solicitor, and Carole Robinson, implementation team leader, who were both on the Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill team.

Cabinet secretary, with your agreement, given that the underlying subject matter of the regulations is similar, we intend to ask questions on both of them in a single session—I believe that we have already let you know that. I invite you to make an opening statement.

Good morning. I am absolutely fine with that approach and I welcome the opportunity to make some opening remarks. First, let me say that I hope that everyone on the committee is keeping safe and well.

Thank you for the opportunity to give evidence on two instruments under the Forensic Medical Services (Victims of Sexual Offences) Scotland Act 2021. When commenced on 1 April, the act will create a clear statutory basis for health boards to provide forensic medical examinations for victims of sexual crime. Health boards will also be required to provide consistent access to self-referral services. Self-referral will enable someone who is aged 16 or over to access healthcare and request a forensic medical examination without first having to make a report to the police.

First and foremost, I am extremely grateful to the survivors whose courage, bravery and honesty helped to inform the key principles of the act. I know that I can safely speak for my predecessor, Jeane Freeman, when I say that it was a moment of tremendous pride when the act was unanimously passed in December 2020.

I also thank the chief medical officer, Professor Sir Gregor Smith, for his leadership of the national task force for the improvement of these services, and I put on record my thanks to his predecessor, Dr Catherine Calderwood, for her efforts to improve forensic medical services across the country.

The task force has made significant progress against the five-year high-level work plan that was published in 2017, which was supported by a Scottish Government funding commitment of £11.7 million over four years. That investment has helped health boards to get ready for the commencement of the act. One of the most significant improvements is that victims no longer need to go to a police station for a forensic medical examination. Those now take place in an NHS healthcare setting known as a SARCS—a sexual assault response co-ordination service.

Healthcare Improvement Scotland has published national standards and quality indicators. There has been tangible improvement in health board performance against those. In the final quarter of 2021, 87 per cent of examinations were carried out by a female doctor, supported by a female forensically trained nurse. Nurse care co-ordinators are in post in every health board to help ensure the smooth pathway of onward care and support.

National clinical pathways for adults and for children and young people have been published and are followed by health boards. A national clinical IT system has been developed to ensure consistent recording and collation of data, and the system will go live on 1 April.

Task force officials are liaising closely with health boards to ensure that they are all ready to provide self-referral forensic medical services nationally from 1 April. Boards have been provided with detailed guidance and training, as well as additional funding to support implementation and readiness.

I turn first to the Forensic Medical Services (Self-Referral Evidence Retention Period) (Scotland) Regulations 2022. Section 8(1)(b) of the 2021 act enables the Scottish ministers to set, by regulation, the length of time for which health boards will be required to store evidence that is gathered during a self-referral examination. That is known as the retention period. Any evidence that is stored will be destroyed at the end of the period, unless the person examined has requested destruction of their evidence prior to that or has reported the matter to the police, in which case the police will request that the evidence be transferred to them.

The regulations, if approved, will set the retention period at 26 months. That period is based on the outcome of the Scottish Government’s public consultation and on evidence and best practice from across the UK and internationally. Just over half of the responses to the consultation agreed with that period, which seeks to strike the right balance between ensuring that evidence is held for a reasonable timescale and taking into account the practical considerations for health boards.

The Forensic Medical Services (Modification of Functions of Healthcare Improvement Scotland and Supplementary Provision) Regulations 2022, makes amendments to the National Health Service (Scotland) Act 1978 using the powers in sections 13 and 19 of the 2021 act. This technical instrument will give Healthcare Improvement Scotland functions similar to those that it currently holds in relation to wider health services. The functions include a general duty of furthering the improvement in the quality of services that are provided under the 2021 act and the provision of information to the public about the availability and quality of those services.

The instrument will also extend the inspection power of HIS to any service that is provided under the 2021 act. That serves as a backstop power that is likely to be used only in the event that a significant issue of continued concern has not been resolved through existing health board governance and assurance processes. However, the Government considers it prudent for it and HIS to have those powers in reserve, as is the case for other healthcare services.

In summary, the CMO’s task force has made significant progress over the past five years, and Scottish Government officials are working closely with health boards to ensure that they are ready for commencement of the 2021 act. This secondary legislation is an important anchor to that work and helps to underpin the continued improvements that we plan to deliver with our NHS partners.

As always, I am happy to take questions.

Thank you very much, cabinet secretary. Do colleagues have any questions?

Good morning, cabinet secretary. I have a quick question on the 26-month retention period. Our convener rightly mentioned that that is to do with not contacting survivors on an anniversary that is associated with a reported assault. That is part of it, but there was also a consensus on the 26-month period in the feedback from the consultation. Everybody agreed about that, which is why we have got to this point today.

I thank Emma Harper for making those important points. She is absolutely right about why we have a 26-month period and not, for example, 24 months, which would seem a more natural time period. The reason why we avoid 12, 24 or 36 months, for example, is that those would be anniversaries of when the medical examination had to happen, which I imagine can be a traumatic period in a survivor’s journey. We avoid those anniversaries for good reason. That is the feedback that we got from the likes of Rape Crisis Scotland and others.

On Emma Harper’s point about consensus, it is important for me to say that, although the 26-month period was backed by the majority of respondents to the consultation—just over 50 per cent—there was not consensus on what the retention period should be among the remaining group of just over 49 per cent of respondents. Some thought that it should be shorter than 26 months and some thought that it should be longer. It would be remiss of me not to say that the survivor reference group favoured a longer retention period. However, we wrote to the reference group about the 26-month period and it has not pushed back on that.

I think and hope that the reference group understands our reasons for trying to balance important factors: retaining the evidence for a long enough period while ensuring that evidence is not held for a disproportionate amount of time, given the sensitivity of the data.

We looked at evidence from across the UK and found that in the London centres—the Havens—the average time between self-referral and police referral was three months. In other UK centres the average time between self-referral and police referral, for cases that go on to police referral, seems to be between three and six months. Therefore, 26 months seems adequate.

No other members want to ask a question, so we will move on to items 5 and 6, which are the formal debates on the made affirmative instruments on which we have just taken evidence. Are members content to hold a single debate on the instruments?

Members indicated agreement.

I remind the committee that, during the formal debate, members should not put questions to the cabinet secretary and officials may not speak. I invite the cabinet secretary to move motions S6M-03315 and S6M-03316 and to speak to the motions, if he wants to do so.

Motions moved,

That the Health, Social Care and Sport Committee recommends that the Forensic Medical Services (Modification of Functions of Healthcare Improvement Scotland and Supplementary Provision) Regulations 2022 [draft] be approved.

That the Health, Social Care and Sport Committee recommends that the Forensic Medical Services (Self-Referral Evidence Retention Period) (Scotland) Regulations 2022 [draft] be approved.—[Humza Yousaf]

I invite members to contribute to the debate.

I am perfectly happy with what is proposed.

Thank you. I want to thank the Health and Sport Committee in the previous session for the work that it did on the Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill. It was a significant moment for the Parliament when the bill was passed.

I see that no one else wants to contribute and that the cabinet secretary does not want to comment further. Are members content for me to ask a single question on the instruments?

Members indicated agreement.

The question is, that motions S6M-03315 and S6M-03316 be agreed to.

Motions agreed to,

That the Health, Social Care and Sport Committee recommends that the Forensic Medical Services (Modification of Functions of Healthcare Improvement Scotland and Supplementary Provision) Regulations 2022 [draft] be approved.

That the Health, Social Care and Sport Committee recommends that the Forensic Medical Services (Self-Referral Evidence Retention Period) (Scotland) Regulations 2022 [draft] be approved.

That concludes consideration of the instruments. I thank the cabinet secretary and his officials for attending.

Thank you.

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Personal Injuries (NHS Charges) (Amounts) (Scotland) Amendment Regulations 2022 (SSI 2022/45)

Item 7 is consideration of a negative instrument that increases the charges recovered from persons who pay compensation in cases in which an injured person receives national health service hospital treatment or ambulance services. The increase in charges relates to an uplift for hospital and community health service annual inflation.

The Delegated Powers and Law Reform Committee considered the instrument and made no recommendation, and no motion to annul has been received in relation to the instrument. I invite members’ comments.

I would be interested to know how much money has been claimed back through the scheme, versus the cost of the administrative work that is involved, so that we can see what difference the increase will make.

Okay. I take it that that is a point of information, on which you would like to hear from the Government, rather than a comment on the uplift.

It is not a comment on the uplift.

If there are no more comments, do members agree that, other than seeking the information about which Sandesh Gulhane asked, the committee makes no recommendation in relation to the instrument?

Members indicated agreement.

Thank you.

At our next meeting, on 8 March, the committee will start taking evidence as part of our inquiry into alternative pathways into primary care.

That concludes the public part of our meeting today. I thank everyone.

12:00 Meeting continued in private until 12:16.