Learning Disability Week
The final item of business is a members' business debate on motion S2M-2869, in the name of Jackie Baillie, on learning disability week. The debate will be concluded without any question being put.
Motion debated,
That the Parliament welcomes the 28th annual Learning Disability Week which takes place from 19 to 26 June 2005; notes that this week is important in raising the profile of people with learning disabilities and family carers; further notes that the theme, "It's Our Community Too", highlights the difficulties that people with learning disabilities face in becoming involved with their local communities; celebrates the work of ENABLE and the Scottish Consortium for Learning Disability in raising awareness, changing negative perceptions, encouraging participation and building respect; recognises that it is five years since the seminal policy document, The same as you?, was published by the Scottish Executive which aims to improve access to opportunities for people with learning disabilities; welcomes direct ministerial involvement in chairing the Implementation Group, and, while congratulating the Executive on the steps taken so far, encourages it to maintain the momentum for change in order to achieve full implementation of the recommendations.
At the outset of the debate, I thank my colleagues for their support and welcome the number of members who have remained in the chamber at the end of what has been an incredibly long parliamentary week. More than half of all MSPs from all parties in the chamber have signed the motion before us this evening and many of them have gone out of their way to express regret that they are unable to attend this evening.
It is now five years since the publication of "The same as you? A review of services for people with learning disabilities" and I cannot praise the Scottish Executive highly enough for its development because it is a landmark policy framework for people with learning disabilities. For the first time, people with learning disabilities, their families, carers and service providers were given the opportunity to raise awareness of their needs at a national level and to identify ways to make their lives better. At the heart of "The same as you?" is the aim of ensuring that people with learning disabilities enjoy the same rights and opportunities as everyone else.
"The same as you?" made 29 recommendations that were to be implemented over a decade. It outlined the vision of flexible and responsive services based on the need of the individual person, and on developing such things as personal life plans, local area co-ordinators, direct payments, employment opportunities, and much more besides. Much has been achieved but, equally, there is still much more to do. By having this debate, we have a chance to renew the momentum behind the challenge of bringing about full implementation of the report. Only by implementing all the recommendations will we be able to meet the needs and aspirations of people with learning disabilities.
Next week is learning disability week. The Scottish Consortium for Learning Disability will have a display in the garden lobby, which I encourage members to visit. The theme for the week—which will be "It's Our Community Too"—seeks to highlight the barriers that prevent people with learning disabilities from playing their full part in the community. Whether those occur in shops, in the street or in accessing health care, education or employment, such stereotypes and ignorance prevent people from realising their potential and leading a normal life. The challenge for us as policy makers is not so much to help the individual to adapt to the community as to change the community and society to adapt to the individual.
The Executive rightly set up a national implementation group to take forward all the recommendations in "The same as you?" I welcome the importance that the Deputy Minister for Health and Community Care has attached to the issue by signalling that she will chair that group. I am sure that, like me, she is well aware of how important it is to monitor the success of changes and the consistency with which those are applied throughout Scotland. It is essential to assess clearly what is happening at the local level, as some people's experiences do not match the expectations of high standards that the Parliament and Executive have.
The first recommendation in "The same as you?" was that each local authority and health board should draw up a partnership in practice agreement to give effect on the ground to the policies that were contained in the report. Some agreements are excellent and were drawn up with the involvement of those with learning disabilities, but we are not there yet for all agreements. I ask the minister to ensure that partnership in practice agreements throughout Scotland meet the same standard.
Local area co-ordinators are, in my view, the real agents for change on the ground. The local area co-ordinators whom I have seen in action in West Dunbartonshire and Helensburgh in my constituency provide direct support to people with learning disabilities and their families. That support is tailored to the needs of the individual.
The local area co-ordinator acts as an interface with what can at times be a confusing plethora of service providers. I have heard local area co-ordinators described as "the glue that makes the system work" and as people's "best friends". They are very much on the side of the person with the learning disability and they offer a person-centred approach. They are also easily accessible, as people do not have to undergo a lengthy assessment process. Also, whereas previous support tended to look at people with learning disabilities as a homogeneous group, local area co-ordinators recognise that people with learning disabilities have differing needs.
As some areas of Scotland still do not have local area co-ordinators, many people miss out on the flexible and tailored support that they provide. Some people with learning disabilities are still outside the reach of public services. Of the estimated 120,000 people with learning disabilities in Scotland, just over 22,000 are known to local authorities. Evidently, a great deal still needs to be accomplished in raising awareness and in reaching out to those who are marginalised.
That need can be seen in the provision of health services to people with learning disabilities, too many of whom still find it difficult to access primary health care. At the moment, health care staff do not receive appropriate training in dealing with people with learning disabilities. Combined with the fact that such patients often find it difficult to describe their symptoms, that situation creates a gap in the level of care that is provided. We need to concentrate on training front-line staff so that we generate a greater understanding of the needs of people with learning disabilities. It is not rocket science. If we actively talked to people with learning disabilities about how services might be developed, we might find that relatively small changes can make a huge difference.
On that point about talking to people with learning disabilities, I commend the Enable publication "Making Consultation Work", which was launched today by the Deputy Minister for Communities. That shows that consideration of learning disabilities is indeed mainstreamed across the Executive in a number of different policy areas.
Finally, there are still huge barriers in employment and we need to change attitudes towards people with learning disabilities. Raising awareness must be about building respect and challenging negative perceptions. The stereotypes that surround learning disabilities prevent people from gaining employment. We know that an estimated one in 20 adults with a learning disability is currently in paid employment. That is the tip of the iceberg, given that 65 per cent of adults with a learning disability tell us that they want to work. As members know, in many areas of Scotland, the labour market is so tight that vacancies remain unfilled. That suggests to me an opportunity.
Developing employment options must be a priority for the future. I welcome the commitment that Allan Wilson, the Deputy Minister for Enterprise and Lifelong Learning, made earlier this afternoon to ensure that all the recommendations in "Working for a change?" are fully implemented.
I believe that "The same as you?" provides a positive framework for action. So far, important steps have been taken to implement the recommendations. I urge the Deputy Minister for Health and Community Care to step up the pace. I know that she shares my view that we need to maintain a momentum over the next five years and beyond in order to make "The same as you?" a reality for everyone in Scotland who is affected by learning disabilities.
I am grateful to Jackie Baillie for securing the motion for debate today. It gives me the opportunity to speak yet again, as I have done over the past few years, about a group of people who feel that they have been let down by the excellent practices that have come in with "The same as you?" I am referring to the elderly carers of adults with learning disabilities, some of whom are in the public gallery tonight. As I have said before and will continue to say, the very good intentions of "The same as you?" cannot be denied. However, there have been losers: the people who have cared for their sons and daughters for up to 50 years and who, to be honest, just need a break. Caring for young adults with learning disabilities is exhausting.
Although I could talk about the lack of respite care, which is an issue in this regard, the main issue for those people—I can talk about the Murray Owen carers group in East Kilbride—is straightforward. All that they want is for their sons and daughters to be settled and adequately looked after before their mums—it is usually women—and fathers, in some cases, can no longer look after them or, indeed, are just not there to look after them any more.
Quite a few carers say that help is provided only when things reach crisis point. I cannot think of a crisis that could be worse for someone with an intellectual disability than to come home from their learning centre one day and find that their mam is no longer there. That is often the time at which social work steps in, which means that the first real care is given when someone with an intellectual disability finds that the person who has looked after them all their life is no longer there. That is a terrible thing to put someone through. It is also a terrible thing that we have elderly carers, some of whom are over 80 and yet are looking after big hulking men and women who require physical help and mental stimulation.
There is a wonderful United Kingdom study, which was carried out by Jane Hubert and Sheila Hollins. It focuses on people with intellectual disabilities and their elderly carers and explores some basic questions about physical difficulties. The study asks how a woman of 75 can be expected to ensure that her son of 50 has a bath or a shower every morning before he goes to his learning centre. Every day is a brand new day. If the son does not want to get into the bath, how can his mother be expected to cope?
Mental health issues are also involved. Sheila Hollins says:
"Psychiatric disorders, including depression, affective disorders, anxiety disorders and delusional disorders, are more frequent among elderly people with intellectual disabilities than among the general elderly population."
We all know that people with some forms of learning disability age quicker and that dementia can set in at a much younger age. We are leaving elderly people to cope with that.
Many carers feel that they are not getting help from anywhere. For example, South Lanarkshire Council refused point-blank to meet me to discuss the issue, even though I wanted to represent about a dozen families. We must talk about the issues and get things sorted for those people. I am sure that Jeannette Kelly, who is vocal about the issue, will not mind my saying that we have been talking about the issue for three or four years, during which Jeannette has not got any younger; she is getting less able to cope all the time. Surely we can find a way of ensuring that Jeannette's daughter, Vanessa, is settled somewhere safe where she feels happy and content before Jeannette is no longer able to look after her.
I have asked ministers before to meet me on the issue, on which I have genuine concerns, but that has not happened. I ask the Deputy Minister for Health and Community Care to meet me and perhaps a couple of members of the Murray Owen carers group to discuss the issue.
I congratulate Jackie Baillie on securing this important debate and I concur with her comments. I apologise to members, but I will have to leave the debate early, as I need to return to my constituency for an engagement this evening. I welcome the debate and the opportunity that it gives us to discuss the many challenges that face people with learning disabilities in our constituencies. Clydesdale has a relatively good story to tell on the issue. In the past few years, organisations have worked hard, particularly the voluntary agencies and the council, to try to make things happen.
I acknowledge Jackie Baillie's comments about the many barriers and problems that people with learning disabilities face in obtaining employment. I will highlight to the minister two projects in my constituency that offer a potential way forward. The first is the Coalyard tearoom in Larkhall, which is a hugely successful project. That is due, in no small part, to the enthusiasm and drive of the manager, Katie Ramage. The tearoom is far more than a tearoom—it is a real learning centre. There is a partnership between the tearoom, the local council social work department, Motherwell College and, most important, local employers. While young adults are at the tearoom, they learn a variety of skills; take Scottish vocational qualification courses and are certificated through Motherwell College; and carry out work placements in the tearoom and with local employers. The scheme has been hugely successful in securing long-term employment for the trainees. The minister should consider that project as a model. I am sure that she would be welcomed if she visited the tearoom—other ministers have done so in the past, so perhaps she will consider that.
In Carluke, a similar project has been opened recently. Cafe Kudos, which is run by the Scottish Society for Autism, tries to develop similar skills and works in partnership with the local authority and other employers to provide young adults with training opportunities. It is often daunting for people who have lived in a secure setting to move into the community and to develop skills in what can be a hostile environment.
I acknowledge Linda Fabiani's comments about older adults who care for adults with learning difficulties. I have found that people can become isolated in places such as Clydesdale, which is particularly rural, especially if they are the only adult with a learning disability in a small village.
During the past two years, we have been trying to develop a befriending project for adults with learning difficulties. I am delighted that the project has now achieved funding. The challenge now is to find the adults who will be the befrienders, because sometimes befriending is not the kind of sexy area that people want to engage in. That will be a challenge for the project, but it will be a worthwhile one, because the people who are driving the project and who have been involved in it are adults with learning disabilities themselves and their carers. I would like to mention a gentleman called Harry Smith in particular. At over 80, he is still committed to caring for both his elderly wife and his son, who has learning disabilities, and he has a great concern for his son's friends. Befriending is vital and we can see opportunities ahead of us. People with learning disabilities have much to offer our communities, much to give and much to share. It is vital that they are active members of our communities. Projects such as the befriending project are good ways of moving that aim forward.
I commend the Executive for the work that it has done so far. However, the final line of Jackie Baillie's motion encourages the Executive "to maintain the momentum". That is important. We cannot rest on our laurels. Much has been done, but there is much more to do. I have given some practical examples of what has happened in my constituency and I am sure that other members can do likewise. I encourage the Executive to keep up the good work and perhaps to find a wee bit of extra money.
Jackie Baillie has introduced an important subject well. As I am sometimes critical of the Executive, it is nice to be able to commend it on "The same as you? A review of services for people with learning disabilities", which was a far-sighted and groundbreaking document in its time and which has led to a lot of good work.
I understand that there is hope that the Executive will commission new work to study better a subject that is still a bit vague: the number of people with learning disabilities who are still being looked after at home without the system knowing about them. The more we know about the problem, the greater our chance of curing it, so I hope that the Executive will find its way to commissioning more work in that area.
The question of support for carers is obviously fundamental for people with learning disabilities. It is important that we keep day centres open. I have been lobbied by people who are concerned that their local day centre is likely to close. Day centres perform a useful task. Short breaks and respite care are important for a whole range of people, but particularly for those who care within the family for people with learning disabilities. I do not fully understand the system, but it seems that the way in which the respite care is organised is not very helpful, in some cases, for parents who need a break. I hope that we can improve local systems.
We should give greater encouragement and support to organisations that provide supported living. Yesterday evening, we had a debate on Barnardo's Scotland, one of whose services is in that area. I have visited the Quarrier's homes, which I think do good work, and I have dealings with Enable Scotland, Turning Point Scotland and other organisations in that sphere. I hope that we can ensure continuing funding. There is still an issue of short-term and project funding for a lot of organisations. We should be able to guarantee that, as long as they do a decent job, they will continue to be funded. I hope that we can achieve that.
One activity that is busily pursued in the Parliament is the work of the cross-party group on autistic spectrum disorder, which held a long and vigorous debate yesterday. It is quite clear how strongly some people hold the view that there is inadequate support for children who have autistic spectrum disorder. There is a strong lobby in the Parliament, and I hope that, between us, we can manage to get provision improved in that area.
Jackie Baillie talked a little about low expectations in relation to employment, but low expectations can also be a problem in colleges. Many people with learning difficulties have low expectations of themselves and other people often have low expectations of them, but people with learning disabilities often do much better than they and others think that they can do. Some time ago, people had low expectations of children at primary school in poorer areas, but we managed to crack that. We must pitch our expectations as high as possible.
There is pressure on voluntary organisations to keep costs down in order to win contracts with local authorities for the provision of residential and other services. As a result, the pay rates for people who provide such services are often shamefully low. We must rejig our financial arrangements. Competition and efficiency are all very well, but they should not be achieved at the expense of inadequate wages for the people who work at the front line.
We are debating an important area and I hope that we can improve services.
Donald Gorrie was right to say that respite care is tremendously important. I am glad that he highlighted autism, because I remember visiting the school in Alloa in which many autistic children were taught. If I remember correctly, I helped the school to secure a grant for a swimming pool, which the school thought would be a considerable help.
Karen Gillon talked about befrienders, who perform an invaluable role. I am glad to have at least one friend who is active in that capacity.
I warmly congratulate Jackie Baillie on her motion on the 28th annual learning disability week, which I strongly welcome. This year's theme—"It's our community too"—was carefully selected to enable people with learning disabilities to tell their communities about their right to be part of the community and to raise awareness of the issues that they and their families face. As Jackie Baillie said, there are no authoritative figures on the number of children and adults with learning disabilities, but it is estimated that about 120,000 people in Scotland have a learning disability that is mild, moderate, profound or multiple.
I commend the hard work and dedication of the Scottish Consortium for Learning Disability and Enable, whose services are of vital importance to people with learning disabilities. Both organisations work extremely hard for and with people with learning disabilities and their families and carers to provide support, guidance, advice and information through the many services that they offer.
In May 2000, the Scottish Executive published the report "The same as you?" after listening to people with learning disabilities, their families, carers and the people who organise and provide services for them. As Jackie Baillie said authoritatively, the report made 29 recommendations, which will make a difference to the lives of people with learning disabilities. The report also emphasised the importance of good will and the need for charitable organisations such as the Scottish Consortium for Learning Disability and Enable to work alongside the Executive to ensure that the recommendations are implemented. The report was important and the action that has been taken so far is extremely welcome. Like Karen Gillon, I think that Jackie Baillie is right to call for momentum to be maintained. We hope that the Executive will continue to work closely with organisations such as the Scottish Consortium for Learning Disability and Enable, as well as with individuals and professionals, to ensure that the recommendations are fully implemented.
The needs of people with learning disabilities should be at the forefront of our minds. It is the mark of a civilised society to give top priority to people who, through no fault of their own, must come to terms with learning difficulties or disability, great and small. It is essential that we respond to those people's needs and aspirations. Above all, we must give them hope and fulfilment. I support the motion.
I, too, add my congratulations to Jackie Baillie—not just on her motion but on her persistence in parliamentary questions on these issues. I also want to thank Enable Scotland for a very full briefing for this debate.
Recently, when I was visiting sheltered housing on parliamentary business, I met an elderly gentleman who told me that earlier in his life he had been kept in an institution for 32 years. That had been his life, before he got a job and moved on. Thank goodness that, to some extent, the days have gone when such things could happen. However, I sometimes wonder how many of the people who sleep rough on the streets have fallen through care nets. They may have learning disabilities and have no one to take up their cause.
The briefing from Enable raises several issues on which I would like to focus. We have already heard that only one in every five people with learning disabilities has been identified by local authorities. There is clearly a huge gap and we have to find the people who are not being given any assistance.
Enable points out that, of the people with learning disabilities who attend further education, 54 per cent attend for only one day or less each week, and only 17 per cent attend for more than three days. That seems to be not just a case of having low expectations of people, but a case of tokenism. We should be truly giving people the opportunity to develop and to fulfil their potential.
Enable also refers to direct payments. I have spoken about direct payments before; they are a wonderful way of allowing people to have some control over their life. They allow people to decide who will care for them and how they will be paid. I do not know whether the issue is part of the minister's brief, but I understand that there will be changes to Direct Payments Scotland. At the moment, there is a network of support service providers for people who use the system. The network, which covers all of Scotland, shares good practice and encourages people to take up direct payments. I think that a little bit of a battle is going on between Direct Payments Scotland and local authorities. Local authorities' noses are a bit out of joint because people now receive payments directly. Local authorities have not been good at helping people to get direct payments.
Enable's briefing says that, in March 2004, 912 people in Scotland were receiving direct payments. Of that total, only 135 were people with learning disabilities—which is only 0.6 per cent of all the people with learning disabilities who are known to local authorities. That is a pretty appalling figure. In building people's confidence, there is nothing better than letting them decide for themselves what they get, rather than simply telling them what they get.
Jackie Baillie spoke about health. A fatal accident inquiry into the death in 2000 of a man with a learning disability led to several recommendations, including having specialist learning disability nurses in general hospitals; offering training in learning disabilities to hospital staff; and providing advocacy services. All of us can feel overwhelmed when trying to explain an emergency in a hospital; I ask members to imagine how confused and lacking in confidence a person with a learning disability might become.
Five years after that inquiry, the implementation of the recommendations has been very patchy. I understand that many health boards have still not produced comprehensive and timetabled action plans. Producing such plans does not seem a terribly difficult thing to do—a point that links to what Jackie Baillie said about general practitioners and primary care. I suspect that there is a huge gap there as well.
I commend the Scottish Executive for what has been done so far, but some pretty practical things could be done right now to improve people's circumstances. I would also like to know how we can identify all the people with learning disabilities who have yet to be identified as such.
I am very happy to take part in this debate on a serious and important issue. I want to focus on two aspects, both of which relate to handovers. The first is the handover from children's services to adults' services; the second is the transition when a person leaves home or the place where they have been staying and moves into their own housing tenancy. However, I will not say much about the latter because I suspect that Fergus Ewing will have something to say about it, too.
As a former community paediatrician, I do not feel that we do too badly for children with learning disabilities. That will sound terribly complacent, but I do not mean it to—I know that there are never enough services. However, the services exist. Even if the number of services is not sufficient, we know what the services should be. A pre-school child will get home-visiting teaching and speech and language therapy and occupational therapy. There are never enough of those services, but they are there and we know that they should be there.
When the child goes to school, there will never be enough after-school provision or holiday play schemes. However, we know that they should exist and that schools will support them. When the child's needs are assessed, many other support services will also be drawn in, including—I hope—respite care services. Children can usually stay in school until they are 19, by which time they are no longer children. That is followed by a major transition.
I used to be the school doctor for a wonderful school in Dingwall that was called St Clement's School, which took children with severe to profound learning disabilities from nursery age right through to the age of 19 and gave them a range of education that went from toilet training through to the opportunity to do Scottish Vocational Education Council modules and to take part in independent travel. Each child's special needs were very different and they each had markedly different capacities, but the environment in St Clement's allowed them to fulfil their potential. The school had highly supportive and experienced staff who could use Makaton with children who did not communicate well verbally. That goes back to what Christine Grahame said about how important it is to be able to communicate with people who have learning disabilities. How many members can do Makaton?
I have seen parents who were in tears when it came to the handover of their child from St Clement's to adult services because it was the equivalent of having the support rug pulled from under them. Many of the personnel with whom they had engaged, on whose shoulders they had cried, by whom they had been helped and whom they, in turn, had advised were to change. Such change can coincide with the transition from children's to adult services in the health service. For example, a young person who attends an epilepsy clinic may have to change to a group of nurses and doctors whom they do not know. The transition stage is a stressful and difficult time.
It is often the case that although many services are available for children, far fewer are available for adults. Although some of the young people whom I knew would go to college or find residential placements or employment when they left school, others might get just two days a week at the local adult training centre and would have to occupy themselves for the rest of the time, when they had been used to being at school full-time. Such a situation is simply not good enough because it does not allow people to realise their potential.
I want to give an honourable mention to the not-for-profit groups that work in communities, which have a good record of employing people with learning disabilities. Campbeltown Wastewatchers combines my passion for recycling with my passion for good employment practice. It employs many people with learning disabilities, who do really useful work for the community and the planet. The company deserves a big pat on the back for that.
I will mention briefly—because I suspect that another member will discuss it—the matter of people getting their own tenancies, which affects people who are in institutions and young adults who are at home, but who want to move out. I knew a young girl who had severe learning disabilities, suffered from epilepsy and other medical problems and had very challenging behaviour. When she was eventually assessed, it was decided that she needed her own tenancy. The tenancy was set up and her funding was used to pay for access to the house in question, but she was never able to move into it from the home that was struggling to look after her because of a lack of staff. There are big issues to do with providing the right support.
There are still people who have not been moved out of New Craigs hospital in Inverness. I get many letters from people in the Highlands who have learning disabilities and who have their own tenancies, but who are concerned about the people who remain in New Craigs. That says a great deal about the warmth and supportiveness of people who have learning disabilities, who think about each other and not just themselves. The money seems to have run out and although the people who were moved out initially—who were probably those whose needs were easier to meet—are now in tenancies, others are still waiting. I echo what Karen Gillon said; the Executive needs to provide a bit more money to support those people.
I congratulate Jackie Baillie on all her hard work.
I will allude to Karen Gillon's reference to the plight of people with learning disabilities who live in parts of rural Scotland, who are often extremely isolated. Linda Fabiani explained movingly some of the consequences that that can have on a human level. This week I received a reminder from a constituent in Badenoch and Strathspey that there is no supported accommodation for adults who have learning disabilities in that area—even though the area is considerably larger than greater London. I am pleased that there are plans for a small unit and I hope that that work can be progressed fairly quickly.
Linda Fabiani mentioned two feisty females, Madge and Jeanette, who gave a bravura performance before the Public Petitions Committee. Jenny Fullarton and Kenneth MacLennan followed them in speaking to that committee. They got a very fair hearing and I am pleased to see that the convener of the committee, Michael McMahon, is here this evening. As Eleanor Scott suggested, they came before the committee because they wanted to explain their experience.
"The same as you?" has had widespread support but initially, as the minister will know, some of the parents of children who have learning disabilities had to be persuaded that it was deliverable, practical and that it would work. They know more than anybody else can ever know the difficulties of looking after children who have profound learning disabilities. Those parents were persuaded after a while because the Government said back in 2000 that there would be no more long-term residential learning disabilities hospitals by 2005—their hopes were raised. As was mentioned, on 16 March there were 33 long-stay residents in the learning disabilities unit at Raigmore hospital. I am told that there were previously 38. The problem is that hopes were raised and then dashed. We should all recognise that and I do not say that in a party-political sense.
There is no single solution and nobody is arguing that one size fits all. Each person who has learning disabilities has the right—we should remember this—to make choices, as we do. We should never speak of people as if they have no right or capacity to make choices. In that respect, rather than repeat points that have been made eloquently by others, I put in a plea for the role of advocates such as Jenny Fullarton, who not only speak out for people who are not always able to speak for themselves, or who might on occasion be unable to do so, but also build up a bond of trust and confidence that allows children especially, but also adults, who have learning disabilities to achieve their potential.
I have no doubt that the minister and everyone here wishes to see the implementation of "The same as you?" The core and cluster model might be worthy of support, especially for people who have stayed for a long time in residential hospitals and who have built up a rapport and friendship with others. It is not necessarily easy for people in such situations to make quick friendships; they might be slow to build up trust, so that model is one option.
I praise the work that has been done by Highland Council, by Councillor David Flear and many others. I am pleased to say that since March there has been progress in respect of five tenancies, so it is not all doom and gloom, even from Fergus Ewing.
I too congratulate Jackie Baillie on securing this evening's debate. I join her in congratulating individuals with learning disabilities, family carers and the many organisations who have shown what success can look like.
Learning disability week gives us the opportunity to celebrate the positive changes in the lives of people with learning disabilities. It is also, as many colleagues have said, an appropriate time to acknowledge the work that still has to be done.
There have been many positive changes since Iain Gray launched "The same as you?" five years ago. Those changes are the result of a combined effort at local and national level. The Executive is grateful for the support of the national implementation group and the users and carers group in addressing priorities. I welcome the good working relationship that we have with colleagues in the partnership in practice network in working to deliver better services and support.
Jackie Baillie mentioned that there are sometimes differences in practice in different parts of Scotland. We are analysing the current round of submissions and feedback will be given to the PIP network. The Scottish Consortium for Learning Disability has recently done an analysis of local area co-ordinators and we will act on its findings.
The SCLD has been one of the key players in supporting implementation. Its work to influence attitudes has been instrumental in providing a focus on ability rather than disability. Many members have recognised that. For me, that has been one of the most positive changes.
For many years, I worked with young people with learning disabilities in the Highlands. Since coming into this job, I have met many adults with learning disabilities who are now partners in planning local services and trainers of professional staff and others who are members of NHS Quality Improvement Scotland and social work inspection review teams.
At the recent event for this year's SCLD leadership programme, I met people from a number of projects who are at the centre of delivering change. The theme was people taking charge of their own lives and there was plenty of evidence of that happening.
So where have we got to with implementation? As many members have mentioned, one of the few targets in the review was the closure this year of long-stay learning disability hospitals. "Home at last?" pulled together the first coherent information from across Scotland. The NHS Quality Improvement Scotland programme of work that it recommended is well under way.
I acknowledge that, at the end of this year, there will still be a small number of people with learning disabilities who await resettlement in the community. Officials are presently undertaking visits to all relevant boards to ensure that robust plans have been agreed for each individual who is still in hospital. This issue will also feature in this year's annual review visits to NHS boards and I will regularly review information on patients awaiting discharge.
Fergus Ewing specifically mentioned the situation in Inverness. Tomorrow, officials from performance management are visiting Inverness. We are saying quite clearly to Highland NHS Board that we do not accept what it is telling us. We want the plans to be fully implemented by April 2006. That will be followed up by an accountability annual review by a minister. Of course, additional money has been put in place. We need to work closely with Highland NHS Board and I intend to do that.
Hospital closure is not an end in itself. It can be successfully achieved only with the right community supports, which is the area where we still have some work to do. We need to build up supports for people who are already in the community and for family carers—many members mentioned the importance of respite. I am acutely aware of that need and had a recent meeting to discuss the development of a possible strategy for respite.
Only this week, officials met colleagues in Enable to discuss issues for carers who support adults with learning disabilities in the family home. Understandably, carers who are growing older worry about what the future holds for their sons and daughters. We have agreed to consider a number of ways in which we can raise awareness and progress person-centred planning at a local level. Many members spoke about the particular problems of older carers who look after adults with learning disabilities.
"The same as you?" is supplemented by a number of developments that work towards the same goals. "Promoting Health, Supporting Inclusion" is taking forward the agenda for training nurses. We are working with the SCLD and Enable to share good practice in relation to meeting people's needs in general hospitals and will take part in a seminar on that subject later this year.
The health needs assessment sets out a tiered model of service provision. Further, a guidance note on learning disabilities and autistic spectrum disorders that was issued earlier this year will ensure that the needs of people with those conditions are addressed at the earliest stages of the development of community health partnerships.
Research has also been published on people with learning disabilities in secure settings. "On the Borderline?" identified a number of action points that are being addressed by the Scottish Prison Service to improve assessment. On Tuesday, the "Go for it!" research report on employment support was published. It, too, relates to a point that many members have raised during the debate. That work will help with an agenda that is enormously important to people with learning disabilities. I know that Allan Wilson is committed to taking work forward in that regard. We are all aware that this matter is not one that is simply for ministers with responsibility for health, as has been pointed out by several speakers.
The national implementation group is now working to tackle a more mainstream agenda, but that does not mean that we are not continuing to focus on specialist services. It is clear from the work that we have done on children's issues, employment and advocacy that building up community supports and inclusion will help local agencies to develop more equitable services.
Many members, notably Karen Gillon, talked about services in their constituencies. She has gone, but when I see her I will tell her that I am more than happy to visit some of the services in Clydesdale that she described.
We have already discussed the potential to influence community planning through the involvement of the most influential people—people with learning disabilities and family carers. They must be at the centre of community planning, taking their place with everybody else. Our users and carers group members are keen to take forward their experience in involvement and engagement to make contact with local planning leads and raise the profile of learning disability.
From there, we will move on to other important issues for people with learning disabilities—and indeed for all of us, because they are issues for everyone in society—including transport, leisure and recreation and further education. All of us who are here today have some responsibility and opportunities to help to take forward the vision of "The same as you?" I say to Linda Fabiani, who talked specifically about elderly carers, that I am more than happy to meet her and members of older carers groups.
I am aware of my responsibilities and I know from listening to colleagues that everybody else is aware of their respective responsibilities. I assure the Parliament that the Executive and I remain as committed to that agenda today as we were five years ago.
Meeting closed at 17:52.