Chamber and committees

The minister will know that it is cost effective to provide hearing-loss services for adults in the community, rather than in hospitals, and that primary care and high street audiologists are expert clinicians who can improve access to care in communities throughout Scotland and can timeously address hearing loss at the right time to reduce associated loneliness and isolation. Does the minister agree that we could benefit from approaching hearing loss in Scotland in the same way as we approach eye tests in the community—as set out in Specsavers’ recent “It’s Time To Talk About Hearing” report—to improve patient experience and relieve pressures on valuable national health service resources?

I will cover the theme of assisted dying as an adjunct to palliative care. We have heard quite clearly that we have to look at assisted dying and palliative care as two separate things, and I think that that is absolutely right. We have had written submissions and oral evidence saying that palliative care can be complemented by assisted dying as an alternative. People have stressed that there is a therapeutic value to having a choice of an assisted death and how that can remove an element of suffering not addressed by palliative care, even if it is ultimately not exercised.

Conversely, we have also heard that the two are not compatible and that assisted dying would divert resources away from palliative care and erode its quality and availability.

I would like to explore that a little bit. Do witnesses recognise the potential therapeutic value that accessing assisted dying can have for individuals approaching the end of their life, especially those individuals for whom the best palliative care would perhaps not be enough to relieve their suffering?

I will start with Amy Dalrymple and work across from left to right.

I am actually going to ask you whether you can lengthen your answer a little bit for me. I want to explore the therapeutic effect that access to assisted dying has reportedly had for some people who may not eventually exercise their right to it but who report that unpacking those really difficult conversations with palliative care specialists—availing themselves of that opportunity to explore all the options—allows them to live as best they can for the remaining time, even though they do not exercise that right at the end.

Does anyone else have any thoughts on that?

I have a final question, which is about 16-year-olds. Someone spoke earlier about whether 16-year-olds have the capacity to make a decision on assisted dying. However, we allow them to make decisions about healthcare in general. Can you explore that idea? Perhaps Dr Provan could start.

That is quite helpful. The questions that I am trying to get at are in relation to assisted dying being an adjunct to palliative care. They are two separate systems, but if the bill became law, there might be an integrated pathway where the two systems would have to interact with each other—it is about considering how they could mutually benefit the patient.

In the interests of time, I will move on and let Dr Mills and perhaps Rami Okasha answer as well.

I remind members of my entry in the register of members’ interests: I am a member of the Humanist Society Scotland.

We have already touched on the issue of capacity, but I would like to explore it a wee bit further. Some submissions to the committee set out concerns about the ability of doctors and specialties outwith psychiatry to undertake capacity assessments as part of the assisted dying process. Conversely, last week, we heard from the mental health witnesses that they did not share those concerns, and they argued instead that undertaking capacity assessments was a core part of medical practice. However, they did share a concern that the bill turns an incapacity test into a capacity test, which is different to what they do as part of their work. They were also looking for the reference to mental illness to be removed altogether, and they suggested that more senior doctors be involved in the capacity assessments, as we touched on previously.

Do the witnesses have any concerns about the approach to assessing capacity as set out in the bill, and could you explore a wee bit more what specialist training needs to be undertaken?

Colin Poolman, you are looking at Dr Provan, so we will start with him.

I will explore that a bit further. If an individual determines that they are not going to proceed with treatment—they are taking a decision that will absolutely result in their death—what is the difference between having a stand-alone consultant or GP assess their capacity to make that decision versus requiring a specialist service to assess someone’s capacity to make a decision around assisted dying?

To ask the Scottish Government whether it will provide an update on the progress being made to improve the educational experiences of children and young people with additional support needs in school settings. (S6O-03960)

I know that the cabinet secretary appreciates that there has been an increase in the number of pupils who are recognised as having neurodivergent needs but who do not yet have a diagnosis. She also appreciates that effective relationships between parents, carers and schools are paramount in ensuring that there are no unnecessary pressures on families or associated issues that act as barriers to learning. Does the cabinet secretary agree that the use of team around the child meetings can be essential in identifying much-needed supports while a diagnosis is being sought?