Meeting of the Parliament [Draft]

Meeting date: Thursday, May 23, 2024

Official Report 982KB pdf

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General Question Time

Good morning. The first item of business is general question time.

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Child Poverty

To ask the Scottish Government whether it will provide an update on what action it is taking to tackle child poverty. (S6O-03476)

Eradicating child poverty in Scotland is a national mission and the First Minister’s top priority. We are supporting families in a variety of ways, including through the game-changing Scottish child payment, funded childcare, free bus travel for under-22s and free school meals for more than 277,000 children. We have also opened up a £1.5 million fund to help to clear school meals debt.

Modelling that was published in February estimates that our policies will keep 100,000 children out of relative poverty in 2024-25. I will deliver a statement to Parliament by the end of June, updating on progress in tackling child poverty.

It is very welcome that the Scottish child payment and other Scottish Government policies will lift an estimated 100,000 children out of poverty this year. Has the Scottish Government had any discussions with United Kingdom counterparts—Tory and Labour—to persuade them of the benefits of what the Scottish National Party Government has done here, and to introduce a UK child payment, which would, of course, lead to more Barnett consequentials money coming here, so that we could do even more to eradicate child poverty in Scotland?

We have repeatedly called for the UK Government to match the scale of our ambition here in Scotland. That includes making changes to the reserved benefits system because, of course, the majority of benefits are still reserved to the UK. Most important, I think, is the introduction of an essentials guarantee to reverse damaging welfare cuts such as the two-child limit. That, in itself, would lift 40,000 children here in Scotland out of poverty this year. It is disappointing, therefore, that the UK Government and the Labour Party have not entertained such types of changes and that both are still absolutely determined to keep the two-child cap.

The First Minister has set out tackling child poverty as his key mission and has acknowledged that almost one in four children in Scotland are still living in poverty. Given the importance that the cabinet secretary and the First Minister place on tackling hunger, will the Government listen to key stakeholders such as Aberlour Child Care Trust and increase the free school meals income threshold for pupils in years when free entitlement does not yet exist?

As the First Minister has laid out, we will do everything that we can to tackle child poverty. I detailed some of our policies in my original answer. What makes it exceptionally difficult is when we see cuts to revenue and cuts to capital expenditure for the Scottish Government being delivered by the UK Government. It is disappointing that Carol Mochan’s party seems to be absolutely determined to keep to Tory spending plans, if a different Government is elected. That ties one hand behind our back, but we will, as I have said, continue to do everything that we can do to protect people in Scotland. It is a shame that the other Government that is also supposed to stand up for the people of Scotland does not do so.

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Neurodevelopmental Assessment Waiting Times

To ask the Scottish Government whether it will provide an update on what action it is taking to reduce waiting times for children requiring neurodevelopmental assessment. (S6O-03477)

Long waits are unacceptable. To be clear, though, the child and adolescent mental health services statistics capture children who meet the CAMHS criteria, and we have seen a sustained improvement in CAMHS waiting times. Children who require neurodevelopmental support are not reported in those statistics unless they also have comorbid mental health issues, so we do not have accurate data for waiting times for neurodevelopmental assessments, nor do we have a treatment time target.

Our key focus is on improving support. Our neurodevelopmental specification places an expectation on national health service and children’s services to work together to implement standards in line with getting it right for every child. Crucially, local authorities have a statutory duty to identify, and to provide support for, pupils with additional support needs, regardless of diagnosis.

We are working with NHS boards and local authorities to improve the support that is available. As part of that, the Scottish Government allocated £55.5 million to boards in 2023-24 to improve mental health and neurodevelopmental services.

I recently met the clinical director of CAMHS in Lanarkshire and was advised that the delays that are being experienced by my constituents in accessing assessments—some of up to three or four years—might be attributed to difficulties in recruiting and retaining psychiatrists. What further action can the Scottish Government take to alleviate those pressures in the immediate and longer terms?

Fulton MacGregor is absolutely correct in his assessment. The mental health and wellbeing workforce action plan established a working group to consider how we can best support the workforce and attract people into psychiatry, including by offering additional places in psychiatry training.

Recruitment into core psychiatry has improved drastically in recent years. Not all children require specialist CAMHS—many will be supported in their community. Local authorities have received more than £50 million since 2020 and have received a further £15 million this year to fund community supports that are focused on prevention and early intervention for children, young people and their families.

For schools, we have published a professional learning resource for staff, which provides the essential learning that is required to support mental health and wellbeing at all stages. We also provide £16 million a year to local authorities to fund school counselling.

There is a crisis in delivery of care pathways for children with neurodevelopmental needs. As Fulton MacGregor said, waiting times can be in excess of four or five years. Some parents and families in my constituency have sought private diagnoses, only to find that their NHS general practitioner will not support the diagnosis or offer a prescription. Shared care arrangements exist in other parts of the NHS. What work is the Government doing with NHS Scotland to allow shared care to exist in cases of neurodevelopmental need?

I understand that there is guidance on shared care from the Royal College of Psychiatrists. However, it is, of course, down to the individual general practitioner to make a decision on whether to accept those shared care arrangements. There is work and guidance available in many health boards around Scotland, but the situation is not consistent throughout Scotland. Individual general practitioners make the decision on whether to enter a shared care arrangement.

Although I appreciate that it is important for children and families to have the certainty of a diagnosis, that should not be necessary in order to get the right support and reasonable adjustments. What measures are being taken to ensure that children who are awaiting assessment, but have clear and identifiable needs, are receiving appropriate support in schools? How are their rights being protected and upheld in the absence of a formal diagnosis?

Emma Roddick is absolutely correct: support for children with neurodevelopmental needs in education is critical. Local education authorities are responsible for meeting the additional support needs of their pupils, and a diagnosis of a particular condition is not needed for them to receive support. Children’s needs should be discussed at child planning meetings. That information should help to inform assessment, formulation and diagnosis, where appropriate and helpful. An individualised approach is essential to take account of the child’s developmental stage and daily environment.

As I have said, and as is set out in our “National Neurodevelopmental Specification for Children and Young People: Principles and Standards of Care”, we expect boards and children’s services to work towards implementing the standards in the specification.

Question 3 has been withdrawn and question 4 was not lodged.

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Police Scotland (Mental Health Calls)

To ask the Scottish Government what its position is on the amount of time that Police Scotland currently spends responding to calls related to mental health issues. (S6O-03480)

I am grateful to police officers and other front-line agencies that support people who are in distress or are experiencing mental ill health.

The Scottish Government and the Scottish Police Authority have established a multi-agency group to ensure that people with mental health needs are able to access the right service at the right time. Officers are often the first point of contact and, therefore, play a vital role in supporting communities and victims of crime. However, it is essential that they are able to transfer care of people with mental health needs to the services that can support them best.

The chief constable of Police Scotland, Jo Farrell, says that the police are receiving calls related to mental health as frequently as

“three or four calls per minute on a busy day”.

The chief constable says that the demands of mental health calls were

“consuming time equivalent to 600 police officers per year”.

She went on to say that officers would take those in distress to “third party support”, but she described such provisions as a “postcode lottery”.

I am aware that the cabinet secretary knows full well the implications of mental ill health, especially for the job of police officers, but can she tell me whether the Scottish Government is looking into a national triage service, for instance, to which the police could take or direct people who are in distress?

I confirm that there is a comprehensive range of action under way that involves senior leadership across the Government, in particular in justice and health. I very much recognise that the role of policing has changed considerably over the past decade, as has the impact of increased demand for mental health support on the police and mental health services. The partnership delivery group that I referred to in my earlier answer is developing a very comprehensive work plan to build on the work that is already in place.

One exemplar is NHS Lanarkshire, which has had a 73 per cent reduction in police conveyances to emergency departments for mental health presentations since 2019. That is because officers there are able to use a triage service for consultation with a psychiatric liaison nurse.

That was a very interesting response.

On triage, I know that the cabinet secretary is aware of the distress brief intervention project, which is a triage service involving agencies including the police, the national health service and the Scottish Fire and Rescue Service. Vulnerable individuals are directed to the correct pathway to help them to deal with issues. I can advise members that the Scottish Borders was one of the first places where that has been rolled out. I am sure that the cabinet secretary welcomes the development of that project.

Since the launch of the pilot in Ms Grahame’s constituency, more than 62,000 people have now been referred to our world-leading distress brief intervention programme. Police Scotland is, rightly, a key national partner in that programme, which provides compassionate, personalised and non-clinical support to people who are in emotional distress and come into contact with front-line services, including the police.

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Early Learning and Childcare Funding

To ask the Scottish Government when it will close the gap in funding for 1,140 hours of early learning and childcare between private, voluntary and independent providers and council-run facilities. (S6O-03481)

The local government finance settlement provides local authorities with funding covering different service areas. The settlement for 2024-25 includes around £1 billion of funding for the delivery of ELC. Local authorities are responsible for designing their own ELC delivery models, and national guidance is clear that councils must set hourly rates that reflect the costs of delivery for private and third sector providers, as well as childminders.

Mr Rennie is aware that the childcare market is a mixed economy, and businesses in the private and third sectors are responsible for making their own decisions on fees for non-funded hours, as well as on overall staff terms and conditions. Local authorities face unique costs as statutory bodies. However, as I have made clear to both the member and Parliament previously, reducing variation in the rate-setting process is a key priority for me, and the Scottish Government is working with the Convention of Scottish Local Authorities to improve the rate-setting process across a number of areas following the joint sustainable rates review.

I am afraid that none of that closes the gap. The promise that was made by the previous First Minister was that the gap would be closed, but that has been happening at a snail’s pace, and that is having a direct impact on retention, recruitment and capacity. All those areas are really important, because the private, voluntary and independent sectors provide the capacity and flexibility that parents need.

Has the minister just given up on closing the gap? What is she actually going to do to make a difference?

Mr Rennie raises an important point here, but I do not fully agree with his assessment. We need to set the scene a little. Rates have been steadily increasing since the implementation of the expansion. The average rate that is paid by local authorities to providers who are delivering funded ELC to three to five-year-olds increased by 64.1 per cent between 2007 and 2023. However, while the average rate has increased, there remains—as I said—variation across Scotland in the rates that are paid. That is why the Scottish Government and COSLA undertook the joint rates review.

We recognise the current period as being challenging for the childcare sector, and the review is clear that there is more to do to ensure that rates are set sustainably for all funded providers. The review recommends a wide-ranging set of actions, and the next steps include enhancing the guidance on the approach to rate setting; developing guidance around the rates for two-year-olds and meal rates; and setting clear guidance around engagement. I am positive that those will have the impact that Mr Rennie wishes to see, and I am happy to keep him updated on the matter

As a result of funding pressures in local authorities, families across Scotland are faced with a postcode lottery when it comes to accessing the 1,140 hours of funded childcare. Some local authorities are offering funded childcare immediately following a child’s third birthday; some are offering childcare a month after the third birthday; and others are delaying access, in some cases for months, until the following school term. What will the minister do to rectify that disparity and support the right of all parents, in particular working parents, to accessible childcare?

I understand that that is an issue. As I said, there is a host of on-going work on both supporting providers and ensuring that our offer is good quality, accessible and affordable for parents. Nevertheless, I will certainly take that issue away and look into it for the member.

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Pupil Behaviour Strategies

To ask the Scottish Government what action it will take in response to the call from the NASUWT teachers union for a system of strategies to be put in place for dangerous and disruptive behaviour, including consequences for pupils. (S6O-03482)

I make it clear that the existing policy framework, including the national policy on exclusion, does not prevent the use of consequences. However, I have been listening carefully to the concerns of the teaching profession, and to members on all sides of the chamber, on the need for further clarification and support on this issue.

In the coming weeks, we will publish a comprehensive national action plan to respond to evidence from our behaviour in Scottish schools research and last year’s relationships and behaviour summits. That plan will be jointly owned with the Convention of Scottish Local Authorities and has been developed in collaboration with the Scottish advisory group for relationships and behaviour in schools.

The NASUWT is a member of SAGRABIS and has provided valuable input on the development of the plan.

The cabinet secretary knows that teachers just want to be safe at work. Yesterday, a teacher told me:

“Nothing’s been done, nothing is changing. There are no sanctions. Nobody seems to care.”

Mike Corbett of the NASUWT in Scotland said:

“The Cabinet Secretary cannot claim to be in any doubt about what is needed to help address this problem. She needs to show real leadership by putting in place national guidelines that make it clear to schools what is expected of them and which uphold teachers’ right to work in safety.”

Will she do so?

I thank the member for his interest in the issue. I met Mike Corbett on Tuesday this week; we engage regularly on issues in relation to behaviour and relationships. As the member will recall, when he previously held the post of education spokesperson for his party, it was his debate that necessitated some of the action that the Government has taken on this very issue, and I recognise his on-going interest to that end.

Since June last year, a range of different actions have been taken. I established a headteachers task force, which met again yesterday to discuss behaviour. We have chaired a number of behaviour summits to discuss a range of issues on relationships and behaviour—[Interruption.]

Excuse me, cabinet secretary. Mr Lumsden, I would be grateful if you could resist contributing from your seat.

Thank you, Presiding Officer.

We have also published national research, as I mentioned, on the experiences of nearly 4,000 teachers and support staff. It is important that the Government listens to those views, and I have engaged extensively with Scotland’s teaching unions.

In November, I set out a five-step action plan confirming funding for support staff and—to go back to the member’s point—providing clarity at national level on advice and guidance to schools in relation to consequences. That work is hugely important, but it has to be jointly owned with COSLA, which is why the action plan and the steps that the Government is going to take will be published in the coming weeks.

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General Practice Out-of-Hours Service (Inverclyde)

To ask the Scottish Government whether it can intervene, in light of concerns following NHS Greater Glasgow and Clyde’s decision to permanently reduce Inverclyde’s GP out-of-hours service, reportedly leaving Inverclyde Royal hospital as the only GP out-of-hours site in the national health service board area not to operate a full seven days a week and overnight service. (S6O-03483)

Decisions about local service provision are the responsibility of health boards, based on their population needs. However, Scottish ministers expect boards to ensure that they deliver a safe and sustainable service to the communities that they serve. I understand that the board underwent a full service change consultation exercise, supported by Healthcare Improvement Scotland, which led to the decision. The board reviewed the results of the public consultation, and current performance, capacity and demand, as well as the overall sustainability and safety of the board-wide out-of-hours service, before determining the position.

People who are served by Inverclyde Royal hospital will now not have access to the same level of locally delivered out-of-hours general practitioner care as before. Instead, they will have to take a 50-mile round trip to Paisley or, as many fear, will simply present at the accident and emergency department, adding another burden on an already strained hospital. That flies in the face of the Government’s commitment of parity across Scotland in relation to locally delivered healthcare.

Eighty per cent of local residents oppose the reduction, as do most local politicians. Will the cabinet secretary please tell the people of Inverclyde why they do not deserve the levels of local out-of-hours GP care that people elsewhere in Scotland enjoy?

I will stress a couple of points. To ensure the on-going accessibility of the service irrespective of patient location, the board has formalised a process for offering patient transport for patients who require to receive care at the primary care centre, and a home visiting service is available across the board area if patients are clinically assessed as requiring that level of care.

I have previously referred to the demand that partly drove the decision, but—in the interests of brevity, Presiding Officer—I would be more than happy to meet Jamie Greene to discuss his concerns and the actions of NHS Greater Glasgow and Clyde to support patients in that area.

That concludes general question time.