Chamber and committees

The latest figures, which were published yesterday, show that a record 149 people in my health board area of NHS Ayrshire and Arran have been waiting more than a year to see a cardiologist. Will the minister reassure me and the around 13,000 people who are living with cardiovascular disease in my constituency that CVD will remain a priority for the Scottish Government, with a dedicated resource to support the improvement of cardiology services?

What more can the Scottish Government do to reinforce the message that people who visit beaches, such as those in my Carrick, Cumnock and Doon Valley constituency, must act responsibly and must not interfere or inappropriately interact with wild animals when they encounter them in and around our seas? Our beaches are very busy. I think that the issue must be tackled early, and in the school setting.

Will the member give way?

It is clear that we are facing significant challenges in how we support individuals with neurodevelopmental conditions in Scotland—challenges that demand not only honest recognition, but bold and compassionate action.

We are all acutely aware of the profound pressures on our mental health services. Those pressures were hugely intensified by the Covid-19 pandemic. Many individuals, such as my own loved one, became unable to mask their neurodiversities when the world went back to normal, and their whole lives were impacted. Believe me—total burnout and withdrawal from life for more than a year is horrendous.

Demand has risen sharply, not just for CAHMS but for adult services as well. More people are seeking answers, assessments and support for neurodevelopmental conditions such as autism and ADHD, and they are not wrong to expect timely, effective care. We as a Parliament cannot shy away from the fact that there are far too many people being left to wait, too many families struggling to keep their heads above water and too many GPs and educational settings bearing an unsustainable burden.

I fully recognise the distress that is caused by the current situation. I have heard from many constituents about the subject. I have heard from parents who are battling for a diagnosis and from adults who are coming to terms with a new understanding of themselves but who face years-long waiting lists for assessment and treatment—or, indeed, who have no way to get on to those waiting lists because they are closed to patients unless there is a demonstrable, co-occurring, severe and enduring mental health condition.

One of my constituents has lodged a petition with the Parliament, entitled “Improve access to ADHD diagnosis and treatment across Scotland”. Our constituents should not have to lodge petitions to get access to healthcare.

Despite my own child’s four-year wait for assessment, I consider my family to be lucky—unlike the family who came to see me in my office last Friday. They have a child who is experiencing acute mental distress, but despite being told that their child is most likely autistic, they have no way to seek assessment as their GP’s multiple referrals are being knocked back. They are pushed between services: the school is trying to support through decreasing attendance and a GP is recognising the mental distress that is being experienced, but a system that rejects all the evidence is saying that it is all down to their suspected, but as yet undiagnosed, neurodivergence. That is not acceptable. We cannot have a system that sees people’s mental health spiral down due to unmet neurodevelopmental needs, nor a system that requires such deterioration in order to access the pathway.

The Scottish Government has committed to delivering the national neurodevelopmental specification and we are all avidly watching to see its manifestation. The specification is vitally important because it aims to ensure that children and young people can access timely, co-ordinated support regardless of whether they have a formal diagnosis. I know that that is supposed to be what is happening now—it is a fundamental shift, from waiting to identify need to responding to it early and holistically.

We must also ensure that services in local areas are resourced, supported and trained to undertake that work. That is what was supposed to happen for my own family, but there was no support on the ground. It is one thing to say that no diagnosis is needed and another thing to have services responding to the real and urgent need that all our inboxes tell us is there and that requires it.

We cannot overlook the reality of the workforce pressures, the structural complexity of services or the trauma that delays can cause. We also cannot pretend that private diagnosis is a viable option for most families—and, when it is used, we need a transparent, clinically safe, shared care framework that allows for collaboration with NHS professionals, not the blanket refusals that we are all hearing about.

We cannot shy away from the scale of the challenge. I acknowledge that progress is being made in the background but it is yet to be felt on the ground by my constituents. Let us work together across the chamber with a cross-party summit being convened to ensure that every Scot—whether diagnosed or undiagnosed, child or adult—gets the support that they need to thrive.

Does the minister recognise the concern among some of last week’s panel members about what they perceive to be delays in implementing what has been agreed?

Good morning. I wonder whether you could respond to the cabinet secretary’s evidence to the committee last week, in which we heard that providing a right to treatment in legislation that is not incorporated in any other aspect of health and social care is a potential challenge and could lead to a precedent being set.

The committee heard quite a bit of evidence that requiring a diagnosis of a medical professional risks being exclusionary to those who are seeking treatment and potentially exacerbates feelings of stigma. How do you respond to that?

Last week, the witnesses expressed a sense of urgency about devising a sectoral negotiating body, but their perspectives slightly differed. A union representative was quite relaxed about and supportive of the LCM and stated that it would not threaten the progress that the fair work in social care group has made. Other witnesses felt that the bill had already created a delay and that refocusing on it would further delay implementation in a sector that urgently needs a means to ensure parity across the sector. Given that there does not appear to be total agreement on the way forward for sectoral bargaining in social care, will the Government consider further consultation on the issue?

Would the bill give other individuals who face other conditions the understanding that they would perhaps have the right to seek legal standing in their pursuit of treatment? If so, could that deprioritise spending in other areas, or does your bill seek to level the playing field?

You have clearly stated that you do not think that there is a hierarchy of the services that somebody should be able to go for, so your bill encompasses all the different options that are available to individuals. I have listened to you speak about a budget uplift of up to 24.5 per cent, which is significant in this area. I would always argue that we need more money in this area. However, having previously signed off on allocations towards the creation of new residential rehabilitation provision, I know that just one facility costs tens of millions of pounds.

How would we not see a reduction in the money that goes to other areas where we need all the provision that is available to people—namely, harm reduction, the community rehabilitation model that we have in community facilities, psychosocial support and substitute prescribing? Knowing the cost of residential rehab, stabilisation services and crisis services—all of which we do not have enough of—I wonder how we can square that with ensuring that all options are available for individuals.