Chamber and committees

The minister might be aware that, last week, IBD UK launched a new report on care for people with Crohn’s disease and colitis across Scotland. The report highlights that, despite the severe impact that such conditions can have on a person’s mental health, none of the 18 adult IBD services in Scotland that responded met the IBD standards for multidisciplinary team staffing, and there was a lack of adequate provision for psychologists across all the services. Indeed, four in five patients reported not being asked about their mental health needs.

What consideration has the Scottish Government been able to give thus far to the concerns raised in the IBD UK report, including about the growing mental health need among people with long-term health conditions?

To ask the Scottish Government how its increased funding for mental health services will help improve access to psychological support for people with long-term conditions, such as inflammatory bowel disease. (S6O-04134)

I still think that you are making my point for me. It perhaps goes back to Michael Marra’s observation about a range of numbers.

There is no denying the amount of work that you have put into the bill. We listen to a lot of people presenting financial memorandums, and the only thing that we can be certain of is that they are always wrong, because that is their nature. [Laughter.] What is your best guess—I suspect that your laughter means that you agree with that—as to where your FM is probably wrong, on balance and all things considered? It is okay to tell the committee, because we like that—

I am intrigued by your comment, Sandy, and I have to say that I do not disagree with you. However, to what extent do you think that the complexity around public sector reform is understood? My perception is that the conversation has coalesced around the need for it, but that is arguably the easy bit, and, as soon as you start talking about the how of it, the issue suddenly gets complicated and will bring up the question of priorities, which is what John Mason was alluding to. As someone who is across a lot of this stuff, to what extent do you think the discussion is starting to mature in a way that involves the consideration of complex issues as well as issues of cost?

I will probably be quite quick. I have been listening with interest to all the questions thus far, and I have just a couple of questions. First, I want to explore a bit more the extent to which you have considered such a significant culture shift and how risk is managed within it. Earlier, you mentioned a level of peer support for people who are administering it. When people think about being involved in such events, they often say, “If I was to do that, this is how I would behave”, but the truth is that people do not really know. When it is the antithesis of the Hippocratic oath that medical professionals undertake, how they will react remains uncertain. My first question is therefore about trying to put a number on such a significant culture shift, given that antithesis to the Hippocratic oath.

Secondly, on risk, we have talked about safeguarding, but we have not looked at it from the point of view that any organisation that is worth its salt would make sure that it buttoned down its processes to protect itself from any kind of legal challenge.

To get both of those areas right could introduce extra costs. We are talking about this as though all things are equal, when it is a dramatic shift for what is quite a small-c conservative country—Scotland. I want your reflections on how actively you have considered both of those elements as part of the financial memorandum.

If you do not mind me saying so, you are almost making my argument for me. My argument is that such a cultural shift will take place. Of course that is happening, but there is a financial cost to it. This is not your bog-standard bill. I am glad to hear that that is happening because it is extremely important but, given that it is happening, the work that will require to be done across the whole range of things that we have covered today will probably be more expensive, because it goes into areas that people might not necessarily have thought about previously. It is quite a big shift.

I thank the First Minister for that response. Non-fatal strangulation is a known, serious and growing problem. Thirty-five per cent of women between the ages of 16 and 34 have experience of it, and each year that passes sees more violence, strokes and deaths. It is clear that the common law route for dealing with this offence is not working. As Fiona Drouet, who lost her daughter, says,

“we know you are eight times more likely to be murdered by the person that has strangled you. We can’t ignore that, we can’t treat that like common assault because it’s far more complicated, far more complex and far more dangerous than that.”

A defence of so-called rough sex is being used and it is being accepted by courts. That resonates with the “she asked for it” idea—a misogynistic myth that it has taken years to overturn.

Doing nothing more is not an option. We require proper data collection via criminal health routes, an awareness-raising programme and a clearer prosecution route. Will the First Minister meet me, Professor Cath White from the Institute for Addressing Strangulation, Fiona Mackenzie from the We Can’t Consent to This campaign and Linda Thompson from the Women’s Support Project to take forward the issue?

To ask the First Minister what plans the Scottish Government has to bring forward legislation to criminalise non-fatal strangulation. (S6F-03622)

You are highlighting, I suppose, the upside of being able to utilise the shared learning around a PMO—the downside is the change management processes that come with that.

I want to pick up on a point that my colleague Kevin Stewart made when you used the term “added GVA”. I am not going to have another go at you; I simply note that, with regard to the announcement by PetroChina, the figures that we have for the impact on jobs is that more than 400 direct jobs will be lost, and the Scottish Government has referred to a wider impact amounting to nearly 3,000 jobs. That surprises me, given that—you can correct me if I am wrong—the £10 million from the Scottish Government for greener Grangemouth was in essence for increasing community wellbeing, instead of specifically seeking to replace jobs. There was reference to the supply chain, and some of the businesses involved were SMEs that provided hamburgers and so on nearby. What are your thoughts on the decision-making processes that led to the focus on community wellbeing rather than jobs, which was the point that Kevin Stewart was making?

Good morning, minister. You might have already mentioned this, but this is just so that I am clear. You are saying, in relation to the mismatch between the lists, that you are seeking to see in the bill the same list of what is specifically devolved and set out in the 1998 act, but that the UK IMA could override that, regardless. I think that that is the point that you made earlier. In that case, what is the point? How are you seeking to address the matter? We know that a most comprehensive cross-party report was done here in Parliament, which set out a wide range of issues in relation to the UK IMA. Beyond the lists matching, what are you doing to make the point about the UK IMA in the light of the situation and the complexities therein?