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Our next item of business is a statement by Maree Todd, on improving outcomes for neurodivergent people, autistic people and people with learning disabilities. Questions will be taken at the end of the statement, so there should be no interventions or interruptions.
15:00
I welcome the opportunity to update members on support for people with learning disabilities, autistic people and neurodivergent people. I take the matter very seriously and will use today’s statement to reassure people and organisations who I know are feeling frustrated.
I will outline why the Scottish Government took the difficult decision not to pursue the learning disabilities, autism and neurodivergence bill at this time. That decision was not taken lightly; indeed, we carefully considered all the views that were shared. I appreciate that some people feel that only legislation will bring the change that is required. However, the overarching theme drawn from our engagement with people and the organisations that represent them is this: we need change, right here and right now. I would argue that waiting several years while a bill passes through Parliament would use precious time that could be spent on immediate action, therefore we need to reassess our approach.
Our decision to stop work on the LDAN bill does not reflect any change in commitment or ambition—far from it. This is not about lowering our ambition; it is about taking the best and quickest route to improving people’s lives. Change will now happen through policy reform, service improvement and targeted investment. However, let me be clear that we do not rule out introducing legislation if, in time, the evidence supports that.
As my predecessor Mr Arthur did, I have met many stakeholders, including people with lived experience. I remain committed to continuing that engagement and, from it, I know that rights and accountability are key asks. How will we address these issues and improve lives? Let me be clear that this is not about ticking off and replacing old bill proposals like for like; it is about taking a new approach.
On neurodevelopment, we know that we need to make improvements. People are waiting far too long for the support that they need, regardless of whether that support includes a diagnosis, so tackling that situation first is crucial. We met our commitment to engaging stakeholders in the first 100 days of this parliamentary session, including through a round-table event that I hosted. That has shaped our draft route map for adult neurodevelopmental support, which we will publish in the autumn. The route map, which is based on recommendations from the Royal College of Psychiatrists, sets out a four-level approach that comprises public health and universal, targeted and intensive support based on individual need.
Successful implementation will require a whole-system, cross-sector approach, involving health boards, health and social care partnerships, the third sector and people with lived and living experience. Throughout implementation, we will continue to engage so that we can consider a broad range of perspectives. Our aim is for people to be able to access support as soon as needs are identified, regardless of their diagnostic status, and to ensure that diagnostic assessments are available where clinically appropriate or required.
In recent years, specialist secondary services have been overwhelmed with increased demand for assessments and support. However, we have a diverse and skilled wider workforce, including allied health professionals and general practitioners. Through the route map, we will expand our workforce capacity to support neurodivergent people, including for assessment, which will help them to get tailored support and ensure that they are not waiting to see psychiatrists in specialist secondary mental health services unless that is what they require.
In parallel, we will continue work to take forward actions that were identified through the review of implementation of the children and young people’s neurodevelopmental specification. Supported by the cross-sector children and young people’s ND task force, this will help to progress implementation and support local areas to provide timely, needs-based support to children and young people and their families.
We are backing that work with significant new investment. This year, we provided £7.6 million to local authorities to improve availability of, and access to, support for children and young people with neurodevelopmental needs and their families. We are also providing more than £600,000 of new funding to improve support for autistic adults. That will help more people to access advice, support and assessment where needed, including support while awaiting assessment. Together with wider investment, that will help to ensure that more people can access help at the right time, based on individual need.
Although detailed reporting arrangements for our work on neurodevelopment are still being developed, I am committed to ensuring that there will be clear oversight and governance on progress and that that will be reported transparently. I will return to the Parliament with further detail once those arrangements have been finalised.
It goes without saying that this also requires action across education. We are providing a further £29 million of additional support needs funding to local authorities in 2026-27 to support the ASN workforce. The autism toolbox resource and the digital solutions that we are funding are giving practical help to teachers now.
The publication on 31 August of the route map to a national staged intervention model met the 100 days commitment on ASN. It is the first major milestone in delivering the six recommendations of the McManus review. Those recommendations are interdependent, and the national staged intervention model provides a framework through which the wider McManus recommendations can be explored and implemented in stages over the parliamentary session. In the longer term, that work on national staged intervention and data improvement will support greater consistency in the identification and recording of and the response to children and young people’s support needs, including those of neurodivergent learners. The national staged intervention model will help to ensure that needs are met consistently, regardless of where a child or young person lives in Scotland.
I will now outline actions to ensure that people with learning disabilities can enjoy choice and control to lead independent and fulfilling lives. We continue to fund a range of third sector organisations to improve outcomes. That includes both direct grants to key national bodies and funding via our learning disability support fund. In its first six months, the fund supported more than 2,800 people with learning disabilities, more than 330 families and 605 professionals.
We are also helping to ensure that the health and social care workforce has the knowledge and confidence to deliver high-quality services to people with learning disabilities. Public Services Delivery Scotland delivers our national learning resources and workforce training. Also on training, there has been widespread uptake of the essentials of learning disability programme.
We know that people with learning disabilities experience significant health inequalities, which is why we mandated that national health service boards implement learning disability annual health checks, supported by £2 million of Government funding annually. Delivery expands year on year: last year, health checks resulted in 3,287 onward referrals, providing vital opportunities for prevention, early intervention, treatment and support. However, that needs to increase further.
We are also implementing our “Coming Home Action Plan” to ensure that people with learning disabilities and complex support needs can live independently in their communities, closer to family and friends. The latest data shows that, compared with last year, fewer people are delayed in hospital or placed far from home against their wishes.
We have also developed housing options guidance and training guidance and we are providing a further £20 million this year to support implementation. In addition, that work will deliver key national projects to drive progress and improve accountability, including detailed options for a national support panel, a complex support needs pathway and information and support for families. That all sits alongside wider programmes across Government, including our reform of adults with incapacity legislation, Scotland’s “Disability Equality Plan”, education and ASN reform, and the national transitions to adulthood strategy for young disabled people.
Public service reform offers opportunities to consider training needs for NHS staff, better data, more consistent approaches and better accountability.
We will engage with representative bodies within the LDAN communities to raise awareness of opportunities to contribute to our thinking.
Furthermore, last month’s programme for government committed to a landmark human rights bill that will incorporate further international rights in our domestic legal framework. Everyone in Scotland, including neurodivergent people and people with learning disabilities, stands to benefit from that bill’s incorporation of economic, social and cultural rights. We know that it is often those who are most marginalised and discriminated against in our communities who are furthest away from having their rights realised. Incorporating international rights can bring transformational improvements in the culture in which our public services are delivered, including those such as health and housing that most impact on the experiences of neurodivergent people and people with learning disabilities.
In summary, we have changed approach, not reduced our commitment. Our ambition remains the same, and I am determined to see that ambition succeed. I want to build a Scotland where neurodivergent people and people with learning disabilities are understood, supported and empowered to live their best lives. That should be a goal that the chamber supports.
I intend to allow 20 minutes for questions. As always, succinct questions and answers will allow more people to have the opportunity to question the minister.
I refer members to my entry in the register of members’ interests.
Neurodivergent people and people with learning disabilities know a lot about waiting: waiting years for assessment and diagnosis; waiting for truly inclusive education; and waiting for adult support when they turn 18. Legislation should not be necessary, but the promised bill was sought to provide accountability for people who had been let down for decades, and what did they get? More waiting. They are waiting for breaks for family carers, but there is still no plan; waiting for neurodevelopmental assessment support pathways, which were promised years ago; waiting for the coming home agenda, which was identified in 2018; and waiting five years for a promised bill that never arrived.
Is it not ironic that, for a bill that sought accountability, there has been precious little accountability for its abandonment? The First Minister, when asked, did not answer candidly that it had been dropped. The Minister for Mental Wellbeing, Public Health, Sport, Alcohol and Drugs has come to the chamber now only because we demanded it—
Can you please get to a question?
—and what do we get? Where are the cross-sectoral strategies? Where is the independent advocacy? Where is the mandatory training across public services? Where is the accountability, and where is the apology? Does the minister accept that the accountability gap for those marginalised communities is now a gaping chasm?
What I do accept is that accountability is absolutely key, and it is an area where we are already working at pace without legislation. All policies delivered by the Scottish Government are subject to overarching ministerial oversight.
In addition—as I mentioned in my statement—the new coming home strategic oversight group will meet for the first time in a few weeks. The national implementation group and data steering board to support the delivery of the learning disabilities annual health checks is assembled. For our work on health and neurodevelopment, I made a commitment to ensure that there is clear oversight and governance on progress and that that is reported transparently. I am very happy to return to Parliament with further detail once we have it. I am also very happy to hear from the member any ideas that he would like to be incorporated in that.
In education, there is a new governance structure for additional support for learning that has been agreed with the Convention of Scottish Local Authorities, and we are in the process of inviting members to a first meeting in the coming weeks.
Although I agree with the member that accountability is crucial, and it is one of the key things that people with lived experience were demanding through the bill process, I would not agree that there is a gap there. We are working hard to improve accountability, and I will be happy to continue working with the member and with people with lived experience to ensure that we deliver.
I thank the minister for her statement. The statement gives no estimate of the number of people who require the help that has been detailed in it, but there is agreement that the numbers are on the increase.
I suggest that the cohort of people with severe autism should not be considered together with those within the attention deficit hyperactivity disorder spectrum; instead, we should consider them separately. One reason for that is that there are medical treatments for ADHD, whereas there are not for autism, although the conditions can overlap.
I highlight with regard to those who are severely affected with autism, who would be unable to live an independent life, that it is not medically possible to have an epidemic of a genetic condition, and yet we see an increase in those in the severe category. That leads to a general understanding that there are several factors involved. A previous meeting of the cross-party group—
The member must come to a question.
I thought I had a minute.
At a previous meeting of the cross-party group on autism, a grandfather of an affected boy asked, “At what point do 1,000 video records of children displaying severe autistic traits become evidence?”
What research is the Government supporting to contribute to an understanding of acute, aggressive autism, and when might we know when that is coming to fruition?
The member has asked me that before, and I have explained about the funding that is available for research. Were a research proposal to come forward on that particular issue, it would undoubtedly have an opportunity to be funded within the systems that are available in Scotland and, indeed, across the United Kingdom and Europe, where lots of collaboration on research goes on.
It has to be said, though, that I think that people listening will feel concerned at some of the things that the member has hypothesised today. People with autism and ADHD need support, regardless of whether they have a diagnosis or whether they have severe or mild ADHD. When a support need is identified, what we in the Scottish Government want is for that need to be met within our community or, if needed, in our hospitals—that is the purpose of the change in direction that I have set out.
It is unhelpful to focus—as the member does regularly—on research and questions around incidence. There is a great deal of evidence that the incidence of diagnosis is increasing because awareness is increasing and stigma is decreasing. We should all remember that in these discussions.
Families tell us that children are being left without the support that they need, while waiting sometimes years for a diagnosis. Not having a diagnosis should not be a barrier to people accessing support throughout that time. What help can the Government give to local organisations to ensure that they are publicising the support that is available and to increase the provision of local community services for people with a learning disability, autism or neurodivergence who may require that support?
People should be able to access local support based on need, not on diagnosis, unless that is required for the prescribing of medication. I absolutely recognise the valuable role that local organisations play in that. We continue to invest in independent information, advice and advocacy through the support in the right direction programme, through which more than 18,000 people and families access advice and support. We support local organisations to raise awareness of available support for people with learning disabilities through a targeted third sector investment. The £1.6 million learning disability support fund will provide advice and support in communities. We continue to invest in neurodevelopmental support through our £2.5 million multiyear autistic adult support fund, and we are providing £7.6 million in 2026-27 for a similar support fund for children and young people. We also fund Enquire, the national advice and information service on ASL, to help families to access the most appropriate support.
I thank the minister for her statement and her strong words of support for the LDAN community.
We welcome the expansion of workforce capacity that was mentioned in the statement. However, the Royal College of Nursing has confirmed that the learning disability nursing workforce is in decline, and the number of nursing support workers has reduced by 18 per cent since the previous review. How will the Scottish Government address and strengthen the education pipeline and progression pathways for the workforce?
Learning disability nurses play an absolutely vital role in empowering people with learning disabilities to live fuller, healthier and more independent lives. As well as providing advocacy for individual patients, they boost understanding and awareness more generally within our health and social care services.
There are a number of different routes into that important and fulfilling role. One thing to be aware of is that it is often attractive to groups other than school leavers, so a focus on an “earn as you learn” approach is important when we are thinking about opportunities that work with family life.
The issues are being discussed by the nursing and midwifery task force, and officials from the learning disability policy team and the chief nursing officer directorate are currently developing work to address the particular issue that the member raises.
It is clear from what we have heard that the Government has got this wrong. There continues to be no real understanding that, without a diagnostic pathway, many young people and adults simply will not be able to unlock support. We have not heard anything on that. We need to see progress during this session of the Parliament; members from across the parties will need to work on the proposed human rights bill.
What review has been undertaken of third sector provision, such as that provided by Scottish Autism’s excellent Fife one-stop shop, which I have visited? Will the minister commit to publishing or commissioning a review into local third sector services?
I would be more than happy to work with Miles Briggs on those issues. I agree that the third sector organisations that work in this area are vital. Over the past few weeks, I have met a number of them to explain the decision that we have made. I have met organisations that advocate for that population and amazing organisations that are led by autistic people and people with neurodivergence who are leading the way and leading the charge. As I said, I would be happy to work with Miles Briggs to ensure that we deliver better for them.
I do not think that it is a question of choosing between support and diagnosis, but I agree with Miles Briggs that there is unmet need in relation to diagnosis. There is a bottleneck, because all our support is delivered once someone has a diagnosis, but people should be able to access support without one. I am not saying that a diagnosis is unimportant, but I point out that the proposed LDAN legislation did not focus on diagnosis.
I agree with Miles Briggs that we need to improve our capacity to respond to support needs in the community. That will include building a diagnostic infrastructure, as I mentioned in my statement, and using the multidisciplinary workforce that is out there. That will take time, but I agree that that needs to be the focus of our attention.
The minister says that we cannot afford to wait years for a bill to pass through the Parliament, but it has been five years since the Government first committed to an LDAN bill in its programme for government. In 2024, the bill was delayed, and the Government has now scrapped it right after an election. The Government did the same thing in relation to Monklands hospital. That is exactly the sort of thing that leaves people feeling scunnered with politics.
The minister says that people need change now. They should have had it by now. The commitment to mandatory training for public sector workers on learning disabilities and neurodivergence has now disappeared in the public service reform agenda. Will the minister commit to ensuring that mandatory training remains part of the Government’s new approach and that it will not take yet more years for such training to come into effect?
On mandatory training, which I recognise is an important issue, we reckon that there is an opportunity to progress more quickly in different ways—for example, through employment contracts in the NHS. Public service reform offers us an opportunity to do that in a much more standardised way across Scotland. Far from being a barrier, public service reform is an enabler. We also have the opportunity to increase awareness through other legislation.
Adam Harley must acknowledge that the situation has changed since the proposed bill was first conceived. The level of awareness of neurodivergence has increased to the point at which our systems are overwhelmed with demand for support, because people recognise that they have needs associated with neurodivergence. In the past, there was unmet need and a lot of stigma.
Adam Harley must also understand that, within the Parliament, there has been a change in thinking about commissioners, which has made it much harder to build the accountability in the way that was originally conceived by the people who advocated for the bill. That is not to say that it cannot be done, but the Parliament has made it clear to the Government and the public that commissioners should not be the default setting for accountability.
The minister recognises, as I do, that the needs of neurodivergent children are becoming increasingly complex and that the current system has not always kept pace with that level of need.
The Government has said that its proposed national staged intervention model will help to ensure that children’s needs are met consistently, regardless of where they live in Scotland. How will the Government ensure that that consistency is delivered in practice, particularly for children with the most complex needs? If a school is unable to meet a neurodivergent child’s needs, who will be ultimately responsible for ensuring that that child receives the support that they need?
The member raises an important point. On 31 August, as part of the Government’s 100-day commitment, we published a route map that sets out the actions that are needed to deliver a national staged intervention model for ASN. That is a clear framework for making support in schools more consistent and predictable for children and young people and their parents and carers, regardless of where they live. The model, which is being developed in partnership with local authorities, parents and carers, will also reduce complexity in the system.
We are clear that children and young people should learn in the environment that best suits their needs. The Education (Scotland) Act 1980 places statutory responsibility on individual local authorities. In discharging those duties, authorities are responsible for the setting of the school admissions policy, which includes procedures for dealing with placing requests and the associated appeals process, which, I think, is what the question alluded to.
I remind members of my attention deficit hyperactivity disorder diagnosis.
On 1 April 2025, Maree Todd said to the Parliament:
“I reaffirm my commitment to the proposed learning disability, autism and neurodivergence bill.”—[Official Report, 1 April 2025; c 98.]
That seems like a pretty bad April fools’ day joke, now. What makes it worse is that, throughout the previous parliamentary session, when such issues were raised, we were told to look towards the LDAN bill as the vehicle for change, but now we are being told that we do not need to wait for the bill because the Government has a plan.
I have three questions. When will the number of ASN-qualified teachers rise above 3,000, which is where it was a decade ago? When will waiting times for assessment for ADHD and autism be measured in weeks or months and not years? When will the waiting times be routinely published? If the minister cannot answer those questions, there is no plan at all.
The member asked me to set out timescales for when change will occur. I have been very clear today and I am very collaborative in my efforts to ensure that the Parliament understands some of the challenges that we face. I am not denying the difficulties that we face in Scotland; I am saying that I agree that capacity is not meeting demand.
On the diagnostic assessment, I do not want to give any false hope that I am going to be able to build a system that can meet those needs overnight. We are going to have to train individuals to meet the diagnostic need. In the meantime, we are focused on support. Many people need and cannot access support while they are waiting for a diagnosis. Many people who are referred for a diagnosis will not meet a diagnostic threshold, but they will still require support.
On ASN-trained teachers, I am happy write to the member and let him know what the progress report is on that aspiration for my education colleagues.
If we are to be able to get to all questions, questions and answers will have to be succinct.
I thank the minister for the statement. I, too, have met a range of organisations that have reached out to seek support. Those organisations include Dyslexia Scotland, which was disappointed that there was little reference to that condition in the initial bill. However, it is my understanding that the previous 10-year strategy did not deliver what was required, as mandatory training across a range of sectors—including the justice system—and clear accountability were missing. It is also my understanding that the intention of the proposed bill was to meet those specific unmet needs and the lack of accountability that has already been referred to today.
If mandatory training and accountability were not delivered by the previous 10-year strategy, and if legislation is not going to be introduced, how will those two direct asks be delivered? If a new strategy is developed, what lessons have been learned from the previous strategy?
On the member’s question about the 10-year strategy on neurodivergence and autism, I think that I answered that in previous responses.
On the question of dyslexia, the strategy does not cover it. I have met Dyslexia Scotland a number of times, and I commend the organisation for its powerful advocacy. I know that my colleagues in education are working with it on a number of areas. For example, I was absolutely delighted that the programme for government confirmed that we will progress a new dyslexia passport that school leavers can use to access support in their post-school destinations. From 2025-26, we are providing Dyslexia Scotland with an additional £85,000 to double the number of places for teachers on the professional recognition programme in dyslexia and inclusive practice from 50 to 100.
We are also working with local government partners to continue improving the consistency of early identification through the adoption of the Scottish working definition of dyslexia and the use of the addressing dyslexia toolkit and the dyslexia identification pathway.
I thank the minister for advance sight of her statement. She has been clear in stating that she will not rule out legislation in time if evidence supports it, but was not the original learning disabilities, autism and neurodivergence bill supported by evidence? That position seems a bit strange.
The bill would also have made training mandatory for all public sector workers, and now the minister is simply stating that public sector reform will provide opportunities. The statement provides no real assurance for those affected, does it, minister?
On the point about mandatory training, this is a really hopeful opportunity to standardise practice. One of the challenges that people with neurodivergence face is unwarranted variation in access. I hear loudly and clearly from people whom I meet that the services that they can access is dictated by the local authority area in which they live.
The opportunity to provide a once-for-Scotland training programme for all public sector workers is a real opportunity as part of public service reform, and I am eager to get on with delivering it.
In her statement, the minister made reference to the route map for adult neurodevelopmental support. Does she agree that, for it to be effective, it needs to be placed on a statutory footing?
I emphasise to the minister that neurodivergent folk are overrepresented in the criminal justice system, and the answers to my written parliamentary questions suggest that there is insufficient recognition of those conditions. I argue that a failure to recognise leads to a failure to rehabilitate. What more can the minister do to ensure that there is adequate training and support in the criminal justice sphere for those who are neurodivergent?
As I outlined earlier, the Royal College of Psychiatrists in Scotland’s four-level approach provides a framework through which support can be made available at different levels according to need. It would not be usual to place such a framework on a statutory footing.
The framework moves us away from a situation in which specialist diagnostic services become the only route to help, which is crucial for people with neurodivergence.
I agree with the member that training is vital across the public sector, including in the criminal justice system, and I absolutely agree that these communities are overrepresented in that system.
Voluntary training has been successfully introduced in some areas. We need to replicate the really good work that is happening in some parts of the system and ensure that it happens in every part of the system.
What is the Scottish Government’s plan for improving national data collection on the experiences and outcomes of autistic people, neurodivergent people and people with learning disabilities as those changes are put in place, including in relation to intersectionality? How will that data be used to drive improvement and accountability?
The member is absolutely correct: data is key. We recognise that there are data gaps in some areas—for example, in the number of people who are diagnosed with autism or ADHD. There is a commitment in the road map for children and young people to improve data collection in our schools, which will help us to develop educational services appropriately.
For people with learning disabilities, the exercise that has taken place over the past number of years through the coming home work has really shown the power of good data collection.
What it has achieved is to ensure visibility for those individuals who were placed in institutions that were often very far from family and home. They are visible now in the system locally and nationally, so we are finally turning the corner. These people are coming home and that is one of the most phenomenal improvements in human rights that we will see in this parliamentary session.
I appreciate the answers that have already been given, but one of the most common issues that I see in my casework is a lack of support in receiving a diagnosis. I appreciate that there has been an increase in the recognition of neurodivergence and of conditions such as autism and ADHD, including late recognition for adults, and I welcome the minister’s statement of intent. However, can she expand further on what is being done to increase the capacity for diagnosis in the NHS considering that private diagnosis is often not recognised in education or the NHS for accessing the support that is needed, and on what the adoption of the Royal College of Psychiatrists’ four-tiered approach will mean for my constituents, be they children or adults?
I absolutely recognise that long waits for diagnosis can be frustrating and worrying and that rising demands place pressure on services. My point is that support needs do not disappear while people wait for assessments, which is why our focus is very firmly on ensuring that people can access support as soon as those needs are identified.
The Royal College of Psychiatrists’ four-tiered approach provides a framework through which support can be made available at different levels according to need, which moves us away from a situation in which specialist diagnostic services, often focused through consultant psychiatrists who are based in hospital services, have become the only route for help. Diagnosis will continue to play an important role for many, but our aim is for people to receive the right support at the right time regardless of whether they have received, are seeking or require a diagnosis.
That concludes the ministerial statement on improving outcomes for neurodivergent people, autistic people and people with learning disabilities.
I will pause for a few moments to allow the front-bench members to change over.
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