Chamber and committees

I previously sat on the Health, Social Care and Sport Committee, and we completed an inquiry into self-directed support last year. It is clear that the system is not working. SDS is not working, and vulnerable people are being badly let down. The SHRC report highlighted specific issues with self-directed support. What are your concerns about SDS, and how can they be remedied?

I am grateful to the committee for the opportunity to speak to PE2136. I pay tribute to the petitioner Fiona Drouet, who is here in the committee room. Fiona lost her daughter Emily in the most tragic circumstances after her boyfriend abused her while they were students at the University of Aberdeen. I first became aware of the devastating physical and psychological impact of choking a sexual partner during a parliamentary event that I held with the women’s support service, Beira’s Place, towards the end of last year.

The issue had not come to my attention before then, but once you know about such a thing, you have to do something about it. As you said, convener, there are devastating effects. Within six to eight seconds, a woman loses consciousness. After 15 seconds, her bladder will be incontinent. After 30 seconds, her bowels will open. She will be brain dead within four minutes.

As Fiona has said herself, no one—no woman or girl—could ever consent to this; indeed, there comes a point where a woman or girl is physically unable to do anything about it. How can you consent to something if you lose consciousness? It is not “breath play”—that is a euphemism that men use. They say, “Oh, it’s just breath play during sexual intimacy.” It is not; it is truly frightening, and it can be a predictor of dangerous and potentially fatal behaviour.

The petition, as you have rightly said, convener, calls for a stand-alone criminal offence for non-fatal strangulation. My view is that the common-law offence of assault does not adequately capture the complexity of what is a startling and ever-growing problem. In recognition of the fact that, as the committee has just heard, non-fatal strangulation can occur without obvious physical injury, England, Wales, Northern Ireland and Ireland have already introduced stand-alone offences with robust penalties.

I note, as does Fiona Drouet, the concerns expressed by the Cabinet Secretary for Justice and Home Affairs about unintended consequences and what she has said to the committee about having a separate law, especially its interaction with existing domestic abuse legislation. However, that response does not cover two key points. This is a form of abuse and control; it can be part of domestic abuse, but it is also part of violence against women. It is also a non-consensual act. So, although I acknowledge the need to stress test any changes to the current law in Scotland, I am massively concerned that the Scottish Government is kicking the can down the road. This feels like yet another issue impacting women that is being pushed to the bottom of the legislative agenda.

Finally, convener and committee, as a Parliament, we have a year to go—please do not allow this to be lost. We could be talking about your daughters or your nieces. Something needs to be done. The Scottish Government now has an opportunity to signal a zero-tolerance approach to non-fatal strangulation, and I urge it to act with the urgency that the issue deserves.

Will the minister take an intervention?

I welcome the opportunity to lead this members’ business debate on sexual violence in Scotland’s hospitals. I thank Michelle Thomson for supporting the motion and allowing it to achieve cross-party support. That means that we can shine a much-needed light on a serious safeguarding issue in Scotland’s national health service.

I pay tribute to the Women’s Rights Network Scotland, which is represented in the public gallery, especially Mary Howden and Carolyn Brown, who authored the sobering report—which I have with me here—“How safe are our Scottish hospitals?”

Once again, it is a grass-roots women’s organisation that has brought concerns about safety and safeguarding in Scotland’s public sector to the fore. The Sunday Post has built on that work in recent weeks by exposing the issue and holding the Scottish National Party Government to account. The WRN submitted close to 200 freedom of information requests to Police Scotland and surveyed 198 hospital settings over a five-year period. Data was made available for only 57 of those hospitals, which is just 29 per cent of Scotland’s total. It showed that, between 2019 and 2024, 276 sexual assaults and 12 rapes were reported and 163 sexual assaults and rapes occurred on hospital wards. Twenty-two sexual assaults and one rape took place in NHS Grampian, in my region, and 17 sexual assaults and three rapes took place in NHS Tayside. Out of a total of 288 incidents, only 156 individuals were charged.

Those are spine-chilling figures. By no means is that a complete picture. We do not have data for almost two thirds of Scotland’s NHS and private hospitals. Underreporting and a lack of data management mean that we simply do not know the full scale of the problem. We can all agree that even one sexual assault in our NHS is too many.

Whether it is to receive medical care ourselves or to visit a poorly loved one, we are often at our most vulnerable when we enter a hospital. We are placing our physical and psychological safety in the hands of health boards and NHS staff. We are entrusting our children and our family to their care. We must be able to do so without fear. Staff, too, are vulnerable. Members will recall the shocking revelations in autumn 2023 about female surgeons being sexually assaulted and harassed by male colleagues in the operating theatre. The safety of patients, visitors and staff must be the SNP Government’s top priority when it comes to the NHS.

I was extremely concerned to learn that some women are afraid to seek treatment because of the potential risk to their safety. I hope that the minister will address that in closing the debate. Earlier this year, I raised with the First Minister concerns about the Carseview psychiatric unit in NHS Tayside, which has mixed-sex wards. The WRN’s research suggests that seven sexual assaults and two rapes took place in this so-called secure psychiatric setting.

One of my constituents received treatment in Carseview for postpartum psychosis following the birth of her second baby. I understand that, at that most vulnerable point in her life, she was repeatedly subjected to another patient exposing himself. She was terrified and traumatised, she was separated from her support network and she was scared for her safety on a mixed-sex ward. How can that be? Where was the duty of care? For women giving birth or accessing support for serious mental ill health or learning disabilities, safeguarding has to be of paramount importance.

The Equalities, Human Rights and Civil Justice Committee recently heard evidence that 90 per cent of women with learning difficulties and disabilities have been subjected to sexual abuse, with 68 per cent of them experiencing sexual abuse before turning 18. Women have been raped or sexually assaulted at Scottish maternity hospitals on at least five different occasions, and one of those rapes was reported at Aberdeen maternity hospital. Sexual assaults have also been reported in other psychiatric units and palliative settings.

That cannot go on. We must see urgent action from the SNP Government, health boards, NHS partners and Police Scotland to allay the concerns of women and girls.

What is the way ahead? I often say that we cannot manage what we cannot measure. I understand that Healthcare Improvement Scotland is working to standardise the reporting of incidents, and that is to be welcomed, but we need details from the Scottish Government on how that will operate in practice. To address the risks and weaknesses and to put preventative policies in place, we need to see the data.

There is a wider issue about mixed-sex wards. Protecting single-sex spaces in our public sector should be at the top of the policy agenda, and I have had rigorous exchanges with SNP ministers on that issue. Since 2005, the Scottish Government has expected health boards to ensure that their facilities comply with the guidelines and recommendations on the elimination of mixed-sex accommodation that were published 25 years ago. However, that is just not happening on the ground, and I think that that is evident from the data.

Our hospitals must be safe for people—especially women and children—who access those settings. The SNP Government must act swiftly to address sexual violence in Scotland’s hospitals. [Applause.]

Will the minister take an intervention?

Finally, I have noted that you have said that you want to provide leadership on the PSED and that you want to put your money where your mouth is, yet 80 per cent of respondents to the committee’s call for evidence said that public bodies do not understand and have not implemented the PSED properly. So, there is an issue with public bodies. During the previous evidence session, the EHRC said that there was an issue with the education sector and we have highlighted an issue with hospitals. I have also talked about big issues with Police Scotland.

In relation to the lack of implementation of the PSED, your leadership and putting your money where your mouth is, should you and/or the Scottish Government not suspend the pay rises of the leadership of those public sector bodies that are allegedly in breach of their duties? As a head of HR, if there were a specific issue in a part of an organisation, I could not take money off people, but I could and would suspend pay rises. If you have concerns and you are providing leadership, would it not be a practical thing to say, “Hang on a minute, let’s just suspend pay increases and review the implementation of PSED?”

What is your view on whether the Scottish Government should provide guidance on the Equality Act 2010 in addition to the EHRC?

To follow up on that, you said that the numbers will be small. I will take women in hospital as an example, which is when they are their most vulnerable.

The NHS Tayside single-sex accommodation policy allows trans-identified males to be placed on women’s wards, which effectively creates mixed-sex provision. That policy is based on the patient’s presentation—the way that they dress, their name and the pronouns that they currently use. You say that the Scottish Government is providing leadership on the PSED, which is good. Does the Scottish Government support the principle of allocating people to hospital wards based on their gender identity, or does it believe that wards should be single sex?

So the data is important.