Chamber and committees

I welcome this debate on the health and wellbeing of young people and thank all those who gave evidence to the committee.

During committee sessions, we heard a wealth of evidence about how the pandemic has impacted on children and young people and the services that care for them. It has been a turbulent two years for young people, who have seen their education disrupted, their social lives restricted and, unfortunately, in some cases, their loved ones becoming very ill. In the wake of multiple lockdowns, it is vital that we examine the many ways in which young people have been affected, and what that means for their health.

The committee report recommends that the Scottish Government and other key stakeholders should continue to monitor the long-term impacts of the schooling restrictions that were imposed by the pandemic on the health and wellbeing of children and young people, particularly those who have struggled with or missed out on important milestones in their education. That must be prioritised to reduce the risk of young people falling through the cracks and disengaging from services.

During evidence, we heard from many witnesses about how Covid has impacted on engagement with young people and their families and carers. In particular, we heard about the difficulties that schools have had in engaging with parents after remote learning, with school and nursery staff reporting that they were not having the same depth of engagement with many families when communication was not face-to-face. Work must be done to re-establish those relationships.

Alongside improving engagement, we need to ensure that services are there to help young people when they need help, and that no one is turned away. Long waiting lists for CAMHS were frequently highlighted to the committee, with Mary Glasgow from Children 1st stating that:

“We need to fill that gap between universal services and very specialist services such as CAMHS with that whole-family support and community-based offer that any parent or carer, without stigma or shame, can reach out to and access quickly to get the support that they need.”—[Official Report, Health, Social Care and Sport Committee, 11 January 2022; c 13.]

As well as improving waiting times for CAMHS, we need to expand provision in the community so that people can access support without referral to specialist services, where that is appropriate. That is why, as part of the Bute house agreement, the Greens and the Scottish Government committed to doubling the budget for community-based mental wellbeing services for children and young people to £30 million.

It is also important that community services are properly equipped to help children and young people. For example, link workers play a vital role in GP surgeries in connecting people to local resources. They must have the training and the resources that they need to help children and young people and to connect them with person-centred, dedicated support that takes account of the particular issues and challenges that they face.

The committee also heard about children and young people being subjected to a postcode lottery. The NSPCC highlighted that we need to urgently understand what local capacity there is across health boards because, although there are examples of good practice, as Gillian Martin told us, levels of provision are variable and there is no clear national picture.

In its report, the committee recommends that the Scottish Government commissions further research on the prevalence of mental health conditions in children and young people and maps levels of existing capacity across mental health services. Given the pressures related to the pandemic that I laid out earlier, we know that there is greater unmet need. We must determine the level of need and what support is already available if we are to properly plan services for the future.

That leads me on to my next point, which is about data on health inequalities. During a committee evidence session, Dr Mairi Stark from the Royal College of Paediatrics and Child Health said:

“The prevalence of mental health difficulties is probably much higher than we realise. We often see only the tip of the iceberg, but a lot of children could do with a lot more support.”—[Official Report, Health, Social Care and Sport Committee, 18 January 2022; c 21.]

We need to have a better understanding of the barriers to accessing support that young people face. For example, we do not know whether members of marginalised groups are more likely to receive a rejected referral. Improved data on that will aid our understanding of why some people are not getting the help that they need.

Given that it is pride month, it would be remiss not to mention LGBT young people’s experiences. We need to ensure that health services are able to help LGBT young people with the particular issues that they face. Yesterday, it was revealed that hate crimes against transgender people rose by 87 per cent over the past year. That appalling figure reveals the discrimination and hate that trans people, including young trans people, have to face every day. It would be foolish to imagine that that will not take a toll on their mental health.

We know that 40 per cent of LGBT young people consider themselves to have a mental health problem, compared with 25 per cent of all young people in Scotland. It is vital that services are properly equipped to deal with that and that there is awareness and understanding of the specific challenges that LGBT young people face and how those impact their health.

According to the Mental Health Foundation, although being LGBT is not in itself a risk factor when it comes to developing a mental health problem, some LGBT young people are more likely to develop a mental health problem, as a result of their being at greater risk of exposure to certain risk factors, such as discrimination, loneliness, homelessness and poor access to health services, than their non-LGBT peers.

The Mental Health Foundation also highlighted that the pandemic has increased waiting times for young trans and non-binary people who are seeking to access gender identity clinics, which could severely impact their mental wellbeing. Progress is being made to reduce waiting times, and I welcome the Minister for Public Health, Women’s Health and Sport’s commitment to improvement, but waiting times are still too long. We need to ensure that trans and non-binary young people receive compassionate, informed and understanding support from health services while they are waiting for an appointment.

Children and young people have had a very difficult two years, and much work needs to be done to improve their health and wellbeing and ensure that they get the help that they need, when they need it. The committee’s report sets out a clear way forward, and I, too, would like to thank everyone who gave evidence and helped the committee with its work.

Thank you, convener, and my apologies for being late; there was an additional Parliamentary Bureau meeting that I had to attend. Given the time, I will ask my two questions together.

First, to what extent are health and care services taking a trauma-informed approach, and what improvements need to be made?

Secondly, we have heard this morning about interactions between income and poverty. In other evidence sessions, we have heard about how disability, sexual orientation, gender identity, asylum status, justice experience, being a carer and many other factors interact to present cumulative barriers. To what extent, in each of your areas, are health and care services equipped to take an intersectional person-centred approach?

I welcome the decision to specifically include disparities in how the handling of the pandemic impacted on certain groups, as it has been well documented that Covid-19 has not affected everyone equally. Given the public interest in any outcomes of the Scottish inquiry, how will the Scottish Government ensure that its conclusions—including interim conclusions, if appropriate—are in accessible formats, in order to provide to all families who have lost someone the answers that they deserve?

The RCN survey found that students and support staff are being asked to fill staffing gaps and to undertake the work of registered nurses. How will the Scottish Government work with health boards to ensure that all students and staff are aware of their rights, and that there are clear channels for them to raise concerns if they are being asked to fill in for nurses inappropriately?

Minutes from meetings of the college board of management refer to allegations of systematic bullying and intimidation of a number of staff, and potential financial irregularities. They also show that South Lanarkshire College failed to comply with the code of good governance. What steps is the Scottish Government taking to resolve those on-going issues with South Lanarkshire College and to address the issues that the Educational Institute of Scotland—Further Education Lecturers Association has raised around the governance structure?

To ask the First Minister what the Scottish Government’s response is to the finding of the Royal College of Emergency Medicine’s report, “Beds in the NHS”, that, since 2010, 4,227 hospital beds have been taken out of active service in the national health service in Scotland. (S6F-01175)

Staffing pressure is one of the biggest issues facing hospitals, and Brexit has worsened matters. Dr John-Paul Loughrey, who is vice-chair of the Royal College of Emergency Medicine said yesterday that

“across the whole acute system, [we have] lost staff members who would have come to work in the UK, or who have had to leave the UK, because of the situation with Brexit.”

Does the First Minister agree that this has been a time when the NHS has faced, and continues to face, unprecedented pressure, and that Brexit, which Scotland overwhelmingly rejected, has made the pressures so much worse? Can she outline how the Scottish Government and NHS Scotland are working together to address the situation?

To ask the Scottish Government what discussions it has had with the Scottish Funding Council in light of the reported on-going governance concerns at South Lanarkshire College. (S6O-01166)

Do witnesses have a view on whether universal basic income or a minimum income guarantee is an effective method of tackling health inequalities?

Yes, I will do that—I will try to anyway. Earlier, we touched on the issues of services and intersectionality. Everyone on the panel has expertise in different areas. Perhaps I should direct my question to Claire Sweeney. Given the increasing cost of living, what would you point to as one of the biggest interventions that we could make on health and poverty?