Chamber and committees

The petitioner has been made aware of the submissions in relation to the access improvements that have been undertaken.

The next new petition is PE1870, which was lodged by Edward Fowler. It calls on the Scottish Parliament to urge the Scottish Government to introduce legislation that would require teachers of autistic pupils to be appropriately qualified to improve educational outcomes.

In its submission, the Scottish Government states that the Education (Additional Support for Learning) (Scotland) Act 2004, as amended,

“provides a comprehensive legislative framework for supporting children and young people to overcome barriers to their learning and achieve their full learning potential.”

The submission details a variety of work that is being done with the aim of enabling teachers to support autistic children, and it highlights the “Additional Support for Learning Action Plan”, which was published in October last year. Progress made against the action plan is expected to be monitored and reported on next month, in October 2021.

The Scottish Government’s submission also points to qualifications that teachers can obtain to demonstrate their ability to provide support for children with additional support needs, such as a postgraduate certificate or diploma in inclusive practice.

In his submission, the petitioner emphasises the impact of education on the experiences of autistic people later in life and states that many people are now seeking answers as to

“why they were failed by the education system of Scotland”.

Those people want to know what can be done to change the situation, and they want their voices to be heard.

The issue is one that has come before the Parliament in different guises over time. Would anybody like to comment on the petition?

The next new petition is PE1871, which was lodged by Karen McKeown on behalf of the shining lights for change group. We are joined for consideration of the petition by our parliamentary colleague Monica Lennon MSP—good morning and welcome, Monica. The petition calls on the Scottish Parliament to urge the Scottish Government to carry out a full review of mental health services in Scotland, which should include consideration of the referral process, crisis support, risk assessments, safe plans, how integrated services work together, first response support and the support that is available to families affected by suicide.

The Scottish Government’s submission details the work that is under way to improve the quality, access and variety of support that is provided for mental health. That includes tailored programmes to support national health service boards with long waiting lists, the establishment of 24/7 mental health assessment units and the distress brief intervention programme.

In response, the petitioner provided a very powerful submission—anybody who read it will have been naturally affected by it—in which she shared the story of her partner, Luke Henderson, who died in 2017, and their experience of seeking support from mental health services prior to his loss.

In response to deliverables against the suicide prevention action plan, the petitioner notes that the target to reduce the number of suicide deaths by 20 per cent by 2022 does not

“appear to be on track.”

I understand from advice that I have received that our predecessor committee considered a petition along these lines from the petitioner previously.

I invite Monica Lennon to speak in support of the petition to assist us in our consideration.

However, our options are limited. If the committee is agreed, that is the course of action that we will follow.

Thank you all very much for your contributions this morning. I thank our colleagues who joined us.

The next continued petition is PE1723, on essential tremor treatment in Scotland, which was lodged by Mary Ramsay. We are joined for consideration of the petition by Rhoda Grant MSP. The petition calls on the Scottish Government to raise awareness of essential tremor and to support the introduction and use of a focused ultrasound scanner to treat people in Scotland who have the condition.

The session 5 committee previously considered the petition at its meeting on 10 March 2021. At that meeting, the committee agreed to keep the petition open and to include it in its legacy paper for its session 6 successor committee colleagues—us—along with a suggestion to seek an update from the Cabinet Secretary for Health and Sport on the Scottish Government’s plans to make an application to the national specialist services committee for a magnetic resonance-guided focused ultrasound—which is actually easier to say than MRgFUS—service. Magnetic resonance-guided focused ultrasound is a relatively new treatment for essential tremor, which uses magnetic resonance imaging to guide powerful focused ultrasound to a small point in the body, causing an intense local heat that can destroy tissue.

The Scottish Government highlighted guidelines that were published in June 2018 by the National Institute for Health and Care Excellence, which is commonly known as NICE, on the use of unilateral magnetic resonance imaging-guided focused ultrasound thalamotomy for treatment-resistant essential tremor. It concludes that although clinical evidence does not raise safety concerns, current evidence of efficacy is limited. Therefore, evidence of patient benefit is currently too limited for the national health service to adopt MRI-guided ultrasound technology for treatment of essential tremor.

The Scottish Government notes that the national specialist services committee met in December 2018 to consider a stage 1 application for specialist treatment of patients with ET using magnetic resonance-guided focused ultrasound. The committee was unable to endorse the application for funding as a nationally designated service. It was highlighted that NICE guidance is “permissive”, and although there is some evidence for use of magnetic resonance-guided focused ultrasound in essential tremor, there is a clear statement that research is needed into its application for Parkinson’s disease and multiple sclerosis tremor.

The NSSC was clear that, should the evidence base be further developed and magnetic resonance-guided focused ultrasound be recognised as a safe and effective intervention for treatment of tremor, the committee would be willing to consider a reapplication.

On 16 December 2020, our predecessor committee took evidence from Professor Dipankar Nandi, who is a consultant neurosurgeon and head of department at Charing Cross hospital and St Mary’s hospital, and a professor at Imperial College London. Our meeting papers summarise the evidence from that meeting.

In her submission, the petitioner advised that her tremors and the lack of understanding surrounding them have impacted on her entire life. She does not believe that there is a need for further research into and evidence of the effectiveness of magnetic resonance-guided focused ultrasound before the Scottish Government backs it. She notes that the treatment for essential tremor is currently available on Medicare in the USA and on the NHS in Japan, and in other countries around Europe.

When referencing the progress made by NHS England, the petitioner concludes that she believes that

“while England is proceeding a pace with providing this treatment, unfortunately Scotland is falling behind as the costs for bringing it to Scotland are”

simultaneously

“increasing.”

Before I turn to colleagues, I invite Rhoda Grant to speak in support of the petition.

Yes. I think that we should keep the petition open. I am mindful of the fact that the previous Public Petitions Committee considered it at length and that the reality is that the Scottish Government supports the initiative. It has confirmed that it is on budget and has referred to the review that was conducted independently through the digital assurance office. Even so, like David Torrance, I feel that we should probe the assertions that the system has been successfully deployed elsewhere in the world, and I would quite like the Civil Aviation Authority to be quite specific in telling us where it has been tested, and for us to see whether that is the case.

I have picked up on the suggestion that was made by various members that we should write to the Scottish Government to find out the status of the project and whether everything that it has previously said is still the case. We should find out whether it is still being reviewed and found to be being carried out to specification and on budget. I think that we could also incorporate in that letter the issues that Mr Sweeney raised. Do members agree to the proposed action?

Members indicated agreement.

PE1837, which was lodged originally by Stephen Leighton, calls on the Scottish Government to clarify how autistic people, who do not have a learning disability and/or mental disorder, can access support, and to allocate investment for autism support teams in every local authority or health and social care partnership in Scotland. The petition was last considered in February. At that meeting, the committee at the time agreed to continue it and also to include it in its legacy paper, which we have received, along with the suggestion that we take evidence from the Cabinet Secretary for Health and Social Care on the various concerns raised in written submissions on the petition.

Since the petition was last considered, written submissions have been received from Autism Scotland and the Convention of Scottish Local Authorities. Indeed, the petition has received 23 written submissions to date and was considered twice by the previous committee.

The Scottish Government’s submission of 2 December 2020 highlights that

“Support for autistic people is available from a wide range of sources”

that

“provide a range of support including social groups, 1:1 counselling and post diagnostic support.”

It also notes that

“the Scottish Government is working collaboratively with national autism charities and autistic led organisations to deliver a national autism post diagnostic support service”.

That pilot project ran from December 2020 until May 2021. Moreover, according to that submission, a national autism implementation team was established in partnership between the Scottish Government and Queen Margaret University

“to support Health and Social Care Partnerships to consider best practice and improve service in the redesigning of autism diagnostic services.”

The team

“is supporting NHS Boards to examine diagnostic pathways for autism and establish regional experts to assist with improving tiered autism specialisms across health boards.”

In its submission of 11 March 2021, Scottish Autism says that it welcomes the petition’s call for more resources from the Scottish Government at a local level to support autistic people and their families, and it believes that

“there continues to be an absence of consistent and accessible support services”

available in Scotland. However, in its submission, COSLA states that it currently does not support the

“call for a blanket approach”

to providing support teams or ring-fenced funding, due to the impact of ring fencing on local authorities’ ability to fund non-ring-fenced services. COSLA also highlights that

“services are not provided”

to autistic people

“on the basis of the Mental Health Act”

and that, instead, they are provided following professional assessment of

“individual need and ... eligibility criteria.”

In their submission, the petitioner highlights that in the report on rejected referrals to child and adolescent mental health services, the repeated issue that was raised was that services were declining to support autism needs on the ground of its not being a mental health issue. The submission then suggests that if autism is to be considered a mental health disorder, investment from the mental health budget could be used to create autism support teams, which would in turn reduce pressure on mental health and social work services.

The petitioner concludes by stating their view that the status quo is not enough and that the submissions to the petition made by autistic people and their families demonstrate that more needs to be done.

That is a comprehensive analysis of where we are. Do members have any comments or suggestions for our next steps?

It has been a huge issue. I remember colleagues in the previous session lodging motions for debate and speaking regularly on the issue. Many people feel quite passionate about it. We have a specific recommendation in the legacy paper, which is that we should take evidence from the Cabinet Secretary for Health and Social Care on the issues raised in the petition. What do members think of that proposal? Is there an alternative course of action?

I see nods of approval. Do we agree on that course of action?

Members indicated agreement.

We will follow that through and meet the Cabinet Secretary for Health and Social Care to focus on those specific issues.

The next continued petition is PE1838, on the regulation of non-statutory child advocacy services. I welcome Christine Grahame, who has joined us for consideration of the petition. The petition was lodged by Martin Baker and Katherine Bailey and calls on the Scottish Government to ensure that non-statutory child advocacy services are properly regulated to ensure competence, transparency and accountability.

The session 5 Public Petitions Committee last considered the petition at its meeting on 10 March 2021. At that meeting, the committee agreed to continue the petition and include it in its legacy paper, along with a suggestion to write to the relevant minister to seek a response on whether the Scottish Government will undertake the work necessary to introduce legislation to regulate non-statutory child advocacy services.

Including its last consideration, the committee has considered the petition twice and received 14 written submissions.

In her written submission of 1 December 2020, the then Minister for Community Safety stated:

“Any regulation of child advocacy services would require a full consultation and primary legislation. The scope for, and effect of, regulation may be limited as child advocacy services are not only provided by organisations or persons acting in a professional capacity”.

She continued by saying that, in the event that regulation was implemented, consideration would be required as to how it is enforced for persons supporting in the capacity of a relative, for example.

In response to the limitations of the scope and efficacy of regulation due to non-professional persons carrying out the role, the petitioner questioned whether the definition of “services” under any legislation could be outlined to cover paid employees or volunteer staff of organisations that offer such services.

Before I ask for comments from members of the committee, would Christine Grahame like to speak in support of the petition?