Official Report 1298KB pdf
The final item of business is a members’ business debate on motion S6M-19675, in the name of Patrick Harvie, on unacceptable waiting times for accessing gender identity clinics. The debate will be concluded without any question being put.
I invite members who wish to speak in the debate to press their request-to-speak buttons.
Motion debated,
That the Parliament notes with deep concern the figures on what it sees as the unacceptable waiting times at NHS Scotland gender identity clinics (GIC), which were published by Public Health Scotland on 28 October 2025; further notes in particular that Scotland’s largest GIC, the Sandyford in Glasgow, which serves eight NHS boards covering nearly half of Scotland’s population, is reportedly overwhelmed, with around 4,000 people on its waiting list and fewer than 50 first appointments per year as of March 2025; shares the concern of Scottish Trans that “the most hopeful estimate is that you would wait 80 years for a first appointment” and that “without drastic action, most people on the waiting list will never be seen”; believes that the strategic action framework for 2022-24 for the improvement of NHS gender identity services, which was published in 2021, has failed to deliver its aims, which included piloting new gender identity services to reduce waiting times and improve trans people’s experiences, and notes the calls on the Scottish Government to urgently set out a plan of action to ensure that trans people in Glasgow and throughout Scotland are able to access the services they need.
18:50
I thank those members who have stayed a little later than expected, as well as all those who signed the motion, allowing us to debate the subject this evening.
MSPs from all sides of the chamber raise the issue of waiting times in our national health service regularly. In a search of the Official Report from the past two weeks alone, I saw members rightly expressing concern about failures to meet waiting-time targets of 12 months for some conditions, and 62 days in another case. A member raised the issue of waiting times again at portfolio question time today. There are many examples, and we all understand the impact of the problem on our constituents’ lives and the immense challenges that the NHS faces in addressing it.
However, the example that I raise today is extreme. The data from Public Health Scotland, which are mentioned in the motion and were published last month, illustrate a wholly unacceptable situation throughout Scotland, but in particular at the Sandyford in Glasgow, where the service is utterly overwhelmed. That is Scotland’s largest gender identity clinic; it is the service for eight health board areas covering almost half the Scottish population. As at March this year, in comparison with the previous year, there were three times as many people on its waiting list who had been there for more than five years. The clinic was offering first appointments to people who had been waiting for six and a half years.
A six-and-a-half-year wait for a first appointment is bad enough, but that is not what new patients today are facing. With almost 4,000 people on the waiting list and fewer than 50 first appointments being offered in the course of a year, new patients will be looking at the situation in utter despair. At that rate, it would take 80 years to reach the head of the queue. That is not even the worst estimate—independent research has put the figure far higher and shown that the situation there is by far the worst in any part of the United Kingdom.
Whether we measure a theoretical waiting time like that in decades or in centuries, it is hardly helpful. Either way, it is clear that, without transformational change, most people will simply never be seen. They will never even get a first appointment, let alone actually receive the healthcare that they need. More to the point, only those with the resources to go private will be able to do so, and even then, they will find it next to impossible to get an NHS general practitioner who will accept them and treat them.
All that stands in stark contrast to the Scottish Government’s stated commitments. In 2021, it committed to
“reform the current model of Gender Identity Services to meet the needs of the community”,
bringing the service
“within national waiting times standards.”
The “NHS gender identity services: strategic action framework 2022-2024”, which promised “transformation” of the service, was published in late 2021 and was due to be implemented between 2022 and 2024. As part of that, a commitment was made to
“test new multidisciplinary models for delivery of gender identity healthcare”,
among many other improvements.
How must the people who are waiting for year after year after year feel, knowing that such promises were made and that the situation has simply continued to fall apart? Well, many of them have told me how their lives are affected. I have heard from those who have been left with no option but to seek private treatment, including those who have been forced into debt to do so. I have heard from those who have been refused treatment from their GP or who have had to change their GP multiple times.
I have heard from those who were offered no support of any kind while waiting, and no clarity at all about how long the wait would be. I have heard from those who suffer the distress of having a complete lack of control over their own lives, not as a result of being trans, but as a result of the indefinite wait for support or treatment.
I heard from one constituent, who is herself a doctor working in the NHS. She was told that the waiting list was two years long when she joined it, only to be told, as two years passed, that the wait would be another two years. She has now been waiting for six years and fears that she may be waiting for many more.
My constituent’s description of desperation in seeking private care—as she described it,
“to bridge the gap while waiting”,
only to find that the wait would become interminable—was distressing enough to read. What I found even harder to read was her request that I quote from her experience, but not use her name. She said:
“I mostly just don’t want to be potentially harassed at my workplace if this is linked back to me.”
That is from someone who worked to provide emergency care during the Covid-19 pandemic to serve her community and her country.
We need to recognise the context in which all this is happening. Recent years have seen a continually rising tide of transphobia, generating hostility, fear and prejudice. We see legal demands for segregation. We see flat-out denial of trans and non-binary people’s identities, of their human rights and of their dignity. We see a campaign to stir up and weaponise transphobia—a campaign that is every bit as ugly and toxic as the homophobia of the 1980s and 1990s, and in the early years of the Parliament. That campaign is coming not only from the far right, but from across the political spectrum.
Turning to the subject of the motion that we are debating, we see outright attempts to abolish trans people’s healthcare altogether. I know that the Scottish Government does not intend to support that, but the position now is so severe that, without transformational action, that is what will have happened by default, and the Scottish Government will have allowed it.
We must not permit that—not the Government, and not the Parliament. Every MSP has constituents who are waiting for too long, and waiting for us to act. They have a right to expect better. They want to hear from the Minister for Public Health and Women’s Health today what is going to happen now to resolve the crisis, and so do I.
18:58
I thank Patrick Harvie for bringing the debate to the chamber. I also thank Scottish Trans for its briefing.
I have met with constituents on this matter, as I am sure that other members have. Waiting times, in particular at the Sandyford in Glasgow, are far too long. Things are slightly better in Edinburgh, relatively speaking, as the waiting list is around two and a half years. However, that is still an unacceptable length of time for people to be waiting for life-saving treatment and care—and when I say “life-saving”, I mean “life-saving”.
A constituent has stated to me that
“This waiting time is often after gatekeeping by GPs”,
which is an issue that Patrick Harvie mentioned. My constituent went on to say:
“as an example, my GP first refused and I only got referred after I saw another GP two months later. People will unfortunately die from suicide on these waiting lists, and the importance of gender-affirming care can’t be understated.”
We should be looking to move towards an informed-consent model of trans healthcare—as was approved at last year’s Scottish National Party conference—that trusts trans people in their assertion of who they are, and which does not rely on a medicalised approach. My constituent said:
“Currently, we have to prove that we have gender dysphoria, which not every trans person has, in order to access treatments like hormone replacement therapy or surgeries. Additionally, trans healthcare should be more integrated into general healthcare.”
That is a really important point. My constituent went on to say:
“My current GP, while kind, has no idea what he is doing when it comes to ... my hormones or referrals to other services.”
Partially as a result of this segregation of trans healthcare and partially due to systemic and societal stigma and discrimination, trans folk and LGBTQI people face worse healthcare outcomes within the NHS overall.
What needs to happen? Another important point is that other health boards must begin to take responsibility for their trans and non-binary patients. We talk about postcode lotteries in some types of NHS care, but it is an important issue when it comes to gender-affirming care. Only a couple of health boards provide such services, so the current model of having a small number of services covering large areas of Scotland simply is not working. Other health boards must begin to provide gender-affirming care to their patients.
The Scottish Government must also look to provide funding and support for these new services in different health boards—I look forward to hearing what the minister says on that particular point—and it must do so on the basis that these services trial new models of care in line with the new standards that have been developed and learning from successful pilots in England.
Scottish Trans has raised the issue of funding. The Scottish Government should ensure that the transgender knowledge and skills framework has the maximum impact possible by increasing the number of staff working in gender identity healthcare.
The commitment in the Scottish Government’s strategic action framework that trans and non-binary people were most hopeful about was the commitment to pilot new services that try to deliver gender identity healthcare in more modern ways, with less reliance on specialist centres. This should be the key focus of Scottish Government funding and support.
Trans people and non-binary people in East Lothian deserve access to healthcare and they are currently in a situation where many die before they receive it. This means that they are going without the healthcare that they need to live happy and healthy lives. Many are having to put themselves under significant financial strain to access private healthcare, or having to self-medicate without medical oversight.
The fact that roughly half of trans and non-binary people in Scotland find themselves in those situations after such a significant piece of work to improve services is unacceptable. I look forward to hearing the minister’s response to the debate.
19:02
I put on record my thanks to Patrick Harvie for lodging the motion so that we can have this debate in the chamber.
I will use my time to raise a constituency case with the minister. I have raised it with her in the past, but it is important to get the details on the record, because they highlight a lot of the issues and concerns that Patrick Harvie raised in his speech.
My constituent contacted me in summer 2022. She had already been referred to the adult gender service two years previously, in November 2020, by her GP. She got in touch with me to say that she was in considerable distress—she had had to wait two years and had accrued significant personal costs in pursuing a private alternative. She said:
“I found it necessary to go down the private healthcare route as the NHS waiting times are three years minimum and more likely five years. I thought the only way I’m ever going to get any of my life is to take things into my own hands.”
As I said, she decided to go private, but she still tried to pursue healthcare through the NHS—we all have a right to access healthcare free at the point of need. However, she said:
“Any time I try to contact them, I get the same reply, which is that I’m on the waiting list and will be contacted when I reach the top, but the list seems to get ever-increasingly longer.”
I was shocked to hear that she had been waiting for two years without any indication of when she would reach the top of the waiting list, so I raised that with NHS Tayside. I was told that the provision of gender identity services was being reviewed by the population health directorate of the Scottish Government with the aims of improving waiting times, improving the support that is available to those who were on waiting lists and delivering new models of gender identity healthcare. Finally, in late 2022, my constituent received a first assessment. She was then placed on the medical review waiting list at the Glasgow adult gender service.
To fast-forward to summer 2025, my constituent was—five years since she was initially referred—still no further forward on the waiting list. Remembering that she had said to me that she thought that the wait would be
“three years minimum and more likely five years”,
I realised that it had already been five years and that there was still no end in sight.
I raised the matter once again—I contacted Sandyford, which is mentioned in Patrick Harvie’s motion, but it unfortunately could not provide an approximate date. It conceded that it could not comply with the 18-week referral-to-treatment guidance. It also outlined that the gender identity services have been under considerable operational pressure since 2014—so it is not a new issue—but the clinic has also experienced unprecedented demand, which has outstripped its ability to provide appointments in a timely manner.
I escalated the case to the minister—she may remember it, but I appreciate that a lot of cases come across her desk. Although she confirmed that the Scottish Government’s on-going commitment to improving access to and delivery of NHS gender identity services, that does not help my constituent, who has been waiting for more than five years.
It is clear that something in the system is not working. As Patrick Harvie said, the issue is not just in gender identity healthcare—hundreds of thousands of Scots are stuck on waiting lists on the Government’s watch. It is possible to bring down waiting lists, but we need the Government to get a grip.
I ask the minister, in her closing remarks, to let me know what hope she can offer my constituent that she will not be waiting for 80 years—as referenced in the motion—for an appointment, and to update me on what progress has been made on developing the support that is available for those who are waiting. In particular, I would like to hear about progress on any local support in people’s home health boards so that they do not have to travel outwith their health board area, and ask her to acknowledge that the scale of the problem warrants urgent action from the Government.
I end with a final quote from my constituent:
“Perhaps nothing will come of it, but at least they will know we are not sitting quiet any longer.”
19:06
The figures that were published by Public Health Scotland in October should shake every one of us in the chamber. They lay bare a crisis that is not abstract or distant but is one that is lived day to day by thousands of our fellow Scots.
There are nearly 4,000 people on the waiting list, and fewer than 50 first appointments each year, with—as Scottish Trans put it starkly—“the most hopeful estimate” being an 80-year wait for a first appointment. Eighty years is a lifetime—a lifetime of being told to wait for the healthcare that someone needs simply to live as themselves. That is not just a failure of a system, but a failure of responsibility: our responsibility.
The strategic action framework had ambitious aims such as piloting new services, reducing waiting times and improving trans people’s experiences of healthcare, but we have failed to deliver on each of those. High-quality, gender-affirming healthcare requires specialist expertise. We need specialist clinicians who understand the complexities and nuances of gender identity care. However, we have heard, loudly, from many trans people that they are being funnelled towards specialist services when that is not always necessary.
If mainstream professionals—GPs, nurses and sexual health staff—were properly trained and supported to provide routine transition-related care, many people could get help more quickly, closer to home, without being added to an already-overwhelmed gender identity clinic waiting list. Specialist clinics must be there to meet specialist needs, not because the rest of the system is unprepared.
Training and education are, therefore, absolutely central. Staff themselves, as noted in the recent “Evaluation of the Impact of Scottish Government Funding—Gender Identity Healthcare”, highlighted that training is underdeveloped. We are dealing with a recruitment crisis in this field—not because people do not care, but because there simply are not enough clinicians with the prerequisite skills.
When there is recruitment, existing staff are stretched even further because it takes time—months, and sometimes years—to train new staff to competency. We are nowhere near the critical mass of trained professionals that is required.
In addition, GIC work is demanding emotionally, clinically and logistically. Staff regularly work far beyond their contracted hours. Many could earn the same, or more, elsewhere in the NHS, without the relentless pressure that is created by those chronically long waiting lists. If we are to retain skilled staff, grading and pay must reflect the reality of the work that they do. Otherwise, we will continue to lose precisely the people we are most desperately keen to hold on to.
Let us be clear: long waiting lists do not affect all trans people equally. Disabled trans people, minority ethnic trans people, homeless trans people, trans people in rural communities, very young trans people and older trans people face multiple intersecting inequalities. Some travel for hours, taking three or four buses, just to get to their appointment. Far too often, for some who are already dealing with anxiety or the hostile political climate, that journey is unbearable. Inclusive, adaptable and regionally responsive services are not optional; they are essential.
Finally, we must confront the simple fact that Scotland has only four GICs. Sandyford alone covers eight health board areas and is the only service for young people. Scottish Trans has been unequivocal in its view that, even if we expand and fund the existing clinics properly, that model is unsustainable. We need more clinics closer to the communities that they serve, and we need them urgently.
I am grateful to Patrick Harvie for securing this debate. Now we need the Scottish Government to act to ensure that trans people across Scotland can access the care that they need without waiting a lifetime or paying to go private, and to build a healthcare system that is compassionate, responsive and rooted in dignity and human rights. Minister, please act.
19:11
I speak in support of Patrick Harvie’s motion and to express my deep concern about the waiting times across Scotland’s gender identity services. The figures that were published last month are not just numbers on a page; they reflect the lived experience of people in distress, people who are seeking support and people who feel that they have been left waiting for far too long, with a never-ending wait ahead of them. As someone with experience of a five-year wait for neurological child and adolescent mental health services, I understand acutely how difficult it is to be faced with such an unfathomable wait.
No one in this chamber should be comfortable with the situation at the Sandyford clinic in Glasgow, which serves nearly half of Scotland’s population geographically, with around 4,000 people on its waiting list and fewer than 50 first appointments a year. That is not the standard of care that any of us would wish to see. It is not what the Scottish Government set out to achieve, and it is not what trans people in Scotland deserve. When organisations such as Scottish Trans say that
“the most hopeful estimate is that you would wait 80 years for a first appointment”—
remember, that is a hopeful estimate—that must give us all pause for thought. It is a stark reminder that, despite our commitments and ambitions, we have not yet delivered the meaningful improvements that are so clearly needed.
Honesty is really important in this area. The strategic action framework that was published in 2021 was meant to bring about earlier intervention, new pathways and reduced waiting times. Although some progress has been made in understanding demand and designing new models, the lived reality for patients tells us that the pace has simply not been good enough. I say that not to cast blame on those who work tirelessly in our NHS, who have been open about the challenges that they face and who are striving to support people under extraordinary pressure every day, but to acknowledge the reality facing our trans community.
Behind each of those 4,000 names on the waiting list for treatment at the Sandyford clinic is a person—perhaps a young person whose mental wellbeing will deteriorate as they wait, an adult who has finally taken the difficult step to ask for help, or a family trying to support their loved one through uncertainty. Those people deserve compassion, respect and timely access to healthcare, just like everyone else.
I hope that the Government is listening, and that the minister hears the frustration—and that she shares it. We must recognise that this is a moment that demands urgency and focus. I join my colleagues in calling for a clear and deliverable plan of action that expands capacity, strengthens local services and ensures that no part of Scotland is left struggling on its own. It must be a plan that is genuinely co-designed with clinicians and the trans community, and is matched with the resources and the political will that are required to make it a reality.
This discussion cannot be about political point scoring, and it cannot be an extension of the culture wars that we have seen dominate the lives of trans people for the past few years. This is about dignity. It is about ensuring that our values of equality and compassion are reflected not only in our words but in the services that people experience and have timely access to.
My trans and non-binary constituents deserve a service that is based in Ayrshire, and I urge the Government to work with health boards to ensure that they play their part, as it is simply inconceivable that the Sandyford clinic continues to serve such a sprawling catchment area. Modern multidisciplinary services, such as those operating in the Lothians and the Highlands, are needed urgently. Both of those areas now have some of the shortest waiting lists across the entire UK, and they should be emulated. Like others, I have had casework in which trans and non-binary individuals who have come to me for support have had to go private and then could not get shared care. A young trans person told me that their family was going without food because they could not otherwise afford their medicines, because they could not get access to a GP.
I want trans people across Scotland to know that they have not been forgotten, and I want our Government to be committed—not just in principle but in action—to building a service that meets their needs, supports their wellbeing and does so without indefinite waits or impossible delays. I fear that anything else is a dereliction of duty that should be felt by members across the chamber.
19:15
I join colleagues in thanking Patrick Harvie for securing the debate. I also put on record my thanks to Paul McLennan for his recent motion marking trans awareness week and trans day of remembrance. I know that both motions mean a lot to trans and non-binary Scots, their families and their friends.
The fact that we are having this debate tonight reminds people that they are not alone. I should not be shocked, but when I consider the data in this area and listen to colleagues discuss the waiting times, I find the situation truly shocking. If the issue that we were debating involved people waiting 80 years for cancer treatment or an appointment for diabetes, heart disease or any other medical issue, it would be on the front page of every paper. There would be an emergency piece of legislation and something would be done. We are here collectively to appeal to the Scottish Government to do something. In my view, the actions that people and organisations, including the Equality Network, are calling for are within the gift of the Scottish Government. We need to look to every health board in Scotland and ask them to step up. There needs to be some accountability.
From the statistics in front of me, I can see that around one in five referrals to the Sandyford clinic involves a person from Lanarkshire—my community. What is NHS Lanarkshire doing? I know that the Scottish Government made additional funding available, but that did not lead to any new services and it did not change the outlook. I share colleagues’ fear that, when people are told that the best estimate of the wait for their first appointment is 80 years—an entire lifetime—they will lose hope and there will be an impact on their mental health.
It is important that we remember the human stories behind the statistics. I will not name constituents or people who have been in touch with me, in order to respect their privacy and dignity. However, when we hear people say that they feel that they are being tortured, that they cannot cope with the menstruation that they experience every month, that there is no support and that they have to access the internet and the dark web to get hormones and medication without medical supervision, that is not okay. We need to think about the safety of people right across Scotland.
We also need to support the workforce, who are often at the sharp end of the situation, which has an impact on their mental health as well. I would be interested to hear from the minister tonight what work is being done on workforce planning.
I will reinforce some points that have been made in the debate. It is clear to me that we need an urgent plan from the Government to address and reduce waiting times. We need investment in distributed service models, so that care is not concentrated only at the Sandyford clinic—as Mercedes Villalba said, people need to access healthcare in their own communities. We must address staffing shortages and training gaps.
On the current strategy, there have been multiple health secretaries and many different health ministers, and we cannot keep passing the issue on to the next person. I hope that the minister will hear tonight that, across the Parliament, there are MSPs who are willing to help her with that work and who will raise the issue with her and colleagues to ensure that it is a priority. We need to leave the chamber tonight knowing that the Government has a plan and that people will be able to find some reasons to be hopeful.
19:20
I thank Patrick Harvie for bringing this important debate to the chamber. We have heard some passionate and powerful speeches, albeit with shocking content.
I start my contribution by praising a young constituent of mine and his family. I met him during the previous parliamentary session and he made an everlasting impression on me. With full family support, along with support from his school and expert counselling, that youngster transitioned and is now an impressive, fully confident and happy young man who has gone on to university and will no doubt have a promising career. He is a credit to his family.
His transition would have been so much more difficult, if not impossible, without the clinical care and guidance that he received at the Sandyford clinic in Glasgow, which is, as we have heard, the largest in Scotland. His journey was not without difficulties. At one stage, he accessed private care to receive the healthcare that he needed, but he would have had to wait for at least six years, and maybe longer, for his first appointment. To say that that is unacceptable would be an understatement. At such a critical time in a young person’s life, it is inconceivable that they have to wait so long for healthcare.
The Sandyford clinic has almost 4,000 people on its waiting list, which is an increase of almost 1,000 people since 2023. I am no arithmetical genius, but I do not need to be one to work out that, with almost 4,000 people waiting and fewer than 50 appointments being offered a year, the most hopeful estimate is that someone would wait for 80 years for a first appointment.
My constituent and her son met the former health secretary, Jeanne Freeman, just before the strategic action framework was established. It was a hugely optimistic time, and I remember the meeting well. The framework, which was meant to transform gender identity services and address long waiting times, included significant Government funding for existing services. Unfortunately, however, the waiting times for a service that covers approximately half Scotland’s population are now significantly worse than they were when the framework began.
It is true that the strategic action framework has had a number of successes, including new national gender identity healthcare service standards, a transgender care knowledge and skills framework, and a reduction in waiting times for some of the gender identity services in Scotland. Lothian and Highland now have some of the shortest waiting times in the UK, but that is of no comfort to all those people who are trying to access Scotland’s largest gender identity clinic, who could die before they even get their first appointment.
What is happening here? Why are the waiting times so long? It could be because, as we have heard, Sandyford covers eight of the 14 territorial health boards in Scotland and does not have the capacity to serve all the people who are referred to it. I have also heard anecdotal evidence of alleged staff harassment at Sandyford affecting staff retention. If that is the case, it is beyond shocking.
The second driver of the long waiting times could be model that is used at Sandyford. Scottish Trans believes that the service uses an outdated model that is overly reliant on psychiatry and psychology. Although they are important, clinics such as those in Lothian and Highland have updated their service models to incorporate more multidisciplinary ways of working, and they have had far greater success in reducing their waiting times to some of the shortest in the UK. That was evidenced in the report, “Evaluation of the Impact of Scottish Government Funding: Gender Identity Healthcare”, which showed that services that had used Government funding from the strategic action framework to diversify their staff teams and hire healthcare professionals such as nurses and general practitioners were able to shorten their waiting times. One of the commitments in the strategic action framework was to fund new pilot services in Scotland, but that was not achieved—I do not know the reasons for that.
It is crucial that more staff are trained to work in specialist services, including those that want to be able to deliver gender-affirming care, and GPs should also be involved.
Four years ago, when the Scottish Government committed £9 million in funding and the strategic action framework was established, the situation was poor, but it was better than it is now. Trans and non-binary people in all our constituencies and regions deserve to have access to healthcare, but currently they are in a situation in which they are likely to die before they receive it. There could not be a more powerful message to come from tonight’s debate, and I urge health boards and the Government to reflect on that.
19:24
I thank Patrick Harvie for raising an important matter in the Parliament and for the opportunity to respond to the concerns that have been outlined by him and by Scottish Trans. I also thank members for the respectful manner of all contributions this evening.
I begin by speaking directly to all trans and non-binary people who are affected by the issues that we have discussed tonight. I know that you are facing multiple challenges in this time of debate around gender identity, much of which is harmful and unnecessarily divisive. I reassure you that this Government sees you, supports you and remains committed to improving access to gender identity healthcare. I hear clearly the frustrations, and I share them. I have a simple view—that people are people the world over.
Our commitment was made clear in December 2022, when we published the NHS gender identity services strategic action framework, which outlined 17 actions to improve access to and delivery of gender identity healthcare. Those actions were developed with a multidisciplinary team of professionals and people with lived experience of gender identity services. Fifteen of those actions are now complete, and the remaining two are well under way.
One of those actions was to commission Public Health Scotland, which has been referenced in the debate, to publish waiting times for gender identity services. That is the first data of its kind to be published in the UK, giving Scottish services an opportunity to properly determine where progress is being made and where there are, clearly, on-going challenges to address. We can now properly scrutinise activity levels in gender identity clinics across Scotland. It highlights waiting times in NHS Greater Glasgow and Clyde specifically, which holds responsibility for a large share of the population, as every member has noted, and therefore faces unique challenges.
However, in acknowledging those challenges, it is important to note increased activity across gender identity clinics and the positive progress that is being made. I appreciate that that needs to go faster and further. Additional investment of more than £5.2 million has been provided directly to health boards. That is having an impact on first appointments in Lothian, Grampian and Highland, and on activity across all areas. In Scotland in 2024-25, 700 individuals had a first out-patient appointment with an NHS gender identity specialist. That is an increase of 101 people. There was also a clear increase in return attendances. In 2024-25, 6,527 return out-patient appointments took place, which is an increase of 1,773.
I whole-heartedly appreciate that those are numbers; however, behind every single one of them is a person. In Greater Glasgow and Clyde specifically, where there has been a focus on moving people through the service to free up capacity to bring people in, the data on adult return appointments shows an increase of 354 in this reporting year.
However, waiting times are only one indicator of improvement. Members will recall that, in my September 2024 statement, I highlighted that an independent evaluation of the impact of our investment on waiting times and quality of care was under way.
Will the minister give way?
I will just finish my paragraph.
The report highlights that funding supported improvements across Scotland’s gender identity clinics, including the recruitment of additional staff to expand multidisciplinary teams, improved communications with patients, the development of new resources and processes to support people on the waiting lists, and closer collaboration.
The minister is drawing attention to areas in which she says that improvement is happening. I am sure that she does not deny that the situation that my constituents face is significantly worse than it was when the strategic action framework was published. I think that my constituents would like to know not a few statistics about where things are getting a little better but what is going to be done to transform the areas where things have got so much worse. What can I tell them? Can the minister tell me what I can tell my constituents about what is going to change now?
I am finding this debate incredibly difficult. This is something that is close to all our hearts and I want to make a difference. I am trying to act and to make a change. I am working closely with officials and health boards and, if I can continue, I will try to outline what we are doing.
The report also highlights specific barriers to improvement, including the increased public, political and media scrutiny of this area of healthcare. That is felt particularly in Greater Glasgow and Clyde, which has the largest service in Scotland and the only one providing care to young people. The often-divisive attention and rhetoric that we see has had a negative effect on staff morale, wellbeing and safety and makes the recruitment and retention of specialised medical expertise particularly difficult, as Maggie Chapman and others have said. The report highlights that, despite challenges and a divisive and polarising climate,
“the staff are exceptionally passionate about, and committed to, supporting patients and delivering the highest quality care possible”.
I thank staff across all the services, who often work overtime and take on additional workloads in this difficult and challenging area of healthcare.
The situation is, as is usually the case, more complex than the statistical headlines suggest. However, I absolutely accept that there is more to be done, particularly in GGC, which serves more than 65 per cent of the patient population and provides the only specialist service for young people in Scotland.
Will the minister accept an intervention?
I am sorry; I cannot take an intervention. I apologise and will be happy to speak to Jamie Greene afterwards.
NHS Greater Glasgow and Clyde is already taking forward a number of actions to improve waiting times, including the introduction of clinical pharmacists; recruitment of an additional psychologist; the introduction of nursing staff to improve waiting times; and engagement with primary care to pilot the increased use of shared care agreements.
The Scottish Government also continues to work with NHS Education for Scotland to ensure that the right training and development are in place across healthcare and with Public Health Scotland to further refine data collection. My officials and I are in discussion with health boards to explore how the additional funding can continue to support gender identity services, including working with health boards to establish appropriate treatment pathways through and between services and health board areas. There is also the collaboration that Paul McLennan spoke of and the support in home health boards that was mentioned by Mercedes Villalba. I know that health boards will have clearly heard this debate.
I am content to meet with members from across the chamber, as Monica Lennon suggested, to see how we can move further. I hope members realise how strongly I feel about the issue. [Interruption.] I am sorry; I am not taking any more interventions.
It is right that all health boards collaborate to ensure that their patients can access the dignified care they need, when they need it. Although waiting times for gender identity services may not yet be where I want them to be, I assure all members, Scottish Trans and everyone currently waiting for treatment at a gender identity clinic that we will continue working across organisational and geographical boundaries to build on the improvements that have been made to date and to deliver the caring and compassionate services that people deserve.
Meeting closed at 19:34.Previous
Decision Time