Chamber and committees

As you know, people are falling between the cracks. I will leave that with you.

You mentioned CAMHS. In the NHS Tayside area in my region, the current waiting time for children who have been referred to its neurodevelopmental services is 154 weeks. That is almost three years. We know that children with autism and additional support needs are five times more likely to be excluded from school, but those children feel that they are being left in limbo through no fault of their own. What support is available to those children if they cannot access diagnosis and treatment?

Minister, I will build on my colleague Paul O’Kane’s question about non-legislative interventions. You have described to the committee a host of work that is going on. However, you cannot manage what you do not measure. For example, of 181 people in hospital with learning difficulties and complex care needs, 84 were classified as delayed discharges, which is close to half. That is a huge issue. You said that you are struggling to effect change without the bill, but there are some key areas that you are accountable for. The LDAN bill has been delayed and the Scottish Government has finally conceded that the National Care Service (Scotland) Bill is not fit for purpose, and meanwhile the social care sector is in crisis. Therefore, what action is the Scottish Government taking now to ensure that adequate care is available in the community for people with learning disabilities and autism and neurodivergent people?

But it is not able to do that.

I have two final questions. Following the Cass report, under-18s in Scotland will be screened for mental health and neurodevelopmental conditions, such as autism, during initial assessments for gender dysphoria. The chief medical officer has confirmed that resources will need to be found to increase capacity. Given the exceptionally long waits for autism assessments, what progress, if any, has been made in that regard?

Earlier, Jacqueline Campbell talked about holding your feet to the fire, and I would like to do so on that issue, minister.

The employment rate for autistic people is only 29 per cent, and you said that more work can be done with employers. I have a constituent who has been waiting years for an autism assessment. She is in work, but she cannot get an assessment, which her employer needs in order to make reasonable workplace mitigations and adjustments. She is in a catch-22 situation, and the fact that she has had to wait years is just not good enough. She is one of the lucky ones, because she is in employment. Jacqueline Campbell is nodding her head, so she obviously realises that that is a huge issue.

I asked my constituent about going private, but she said that she cannot do that because she would then be out of the system. She needs an NHS assessment, but she cannot get one.

Minister, what suggestions do you have for increasing the number of autism assessments?

At the start of the meeting, you said that we are struggling to effect change without the bill. The view is that you are kicking the can down the road. I accept that they are not simple, but the committee has given you some clear concrete suggestions and examples relating to assessment, measuring and having proper data. I hope that you will take those away and start to effect change as soon as possible.

That rolls off the tongue.

In a damning indictment of the situation leading up to last week’s critical incident, senior NHS Grampian clinicians sounded the alarm in August, stating:

“There is no evidence to support any planned improvement work or capacity changes that will meet the impending increase in demand seen over October and sustained over the winter period.”

The winter crisis has hit health boards, and it is abundantly clear that the health secretary’s winter preparedness plan is not worth the paper it is written on. Today, Audit Scotland has warned that the Scottish National Party Government has “no clear plan” for wider NHS reform. Lives are at risk.

What is the Scottish Government doing now, with health boards across Scotland, to stave off the looming Christmas chaos in the NHS and to protect patients and staff from serious harm?

Those are just words. The British Medical Association in Scotland has described the diversion of ambulances away from Aberdeen royal infirmary as “a major warning light” for the NHS. The reality, however, is that this dire situation will not improve while NHS Grampian has the lowest bed base per head of population in Scotland. Aberdeen royal infirmary has been operating above capacity since 8 September. Increasing capacity and the bed base in NHS Grampian is contingent on the delivery of the delayed Baird and ANCHOR projects. With the service lurching from crisis to crisis, patients and staff have absolutely had enough.

What is the cabinet secretary going to do differently—I emphasise “differently”—after this central belt-obsessed SNP Government has been short-changing NHS Grampian for years?

To ask the Scottish Parliamentary Corporate Body whether it will provide an update on the output of the working group that was established to review the visitor experience in the chamber. (S6O-04043)

I am not talking about First Minister’s questions. Despite my raising concerns about the seating arrangements for visitors in the chamber, guests in the Scottish Parliament are still being positioned at the back of the gallery, even when there are empty spaces at the front. That does not afford them the best viewing experience, and many have travelled significant distances to be able to watch proceedings.

We should not be letting constituents down, particularly when they have travelled such a long way to see us, their MSPs, speaking on their behalf. Please could I have reassurances from the SPCB that expedient action will be taken to improve the visitor experience in the chamber?

GPs in the north-east have raised serious concerns with me about the Labour UK Government’s short-sighted and disastrous decision. I am told that the rise will cost GP practices tens of thousands of pounds in some cases—the cost is equivalent to a GP’s salary. It will impact the services that are available to patients through primary care and the sustainability of general practice at a time when contracts are already being handed back.

Ultimately, the Scottish Government has a decision to make. Will it protect primary care providers and mitigate that financial burden?