Chamber and committees

I have been listening to what the minister has to say. The biggest problem—and parents will say this to all of us—is that young people have to wait for years on each of those pathways. I have spoken to parents who have had to sell things so that they could get a private diagnosis for their child. Once they have a diagnosis, it will unlock support. However, if a diagnosis is not recognised, a GP surgery will not provide care. Parents are being forced to go private, which is a real concern. I do not think that the Scottish Government really understands what that means in the real world.

Does the data record how many parents have received a private diagnosis for their child? I have received an email from a GP practice saying that, unfortunately, shared care prescribing agreements have been established only between NHS primary care and NHS secondary care. On the back of the debate, will the Government look at how such agreements can be established for people who have had a private diagnosis for their child and want that shared care?

Will the minister take an intervention?

I am pleased to open this important debate on behalf of the Scottish Conservatives. The report on additional support for learning that Audit Scotland published earlier this year was damning, and it highlighted the Scottish National Party Government’s failure to plan and resource accordingly to tackle the issue. Teachers and school staff face unprecedented pressures, and our most vulnerable pupils are being let down.

More than 40 per cent of Scottish pupils receive additional support for learning. In Edinburgh, in my region, the number of pupils with additional support needs has grown by more than 165 per cent over the past 10 years. ASN pupils now represent 39 per cent and 52 per cent of Edinburgh’s primary and secondary school population, respectively.

The Audit Scotland report rightly calls on the Scottish Government and councils to

“fundamentally rethink how they plan, fund and staff additional support for learning as part of core school education in Scotland.”

Stephen Boyle, the Auditor General for Scotland, said:

“The Scottish Government has failed to plan effectively for its inclusive approach to additional support for learning. Current gaps in data mean it is unclear whether all children’s right to have an education that fully develops their personality, talents and abilities is being met.

The Scottish Government and councils urgently need better quality data to understand pupils’ additional support needs and the resources required to provide support to enable all pupils to reach their full potential.”

Ruth MacLeod, a member of the Accounts Commission, said:

“Councils and the Scottish Government must fundamentally rethink how additional support for learning is planned and provided”.

I agree, and that is why we have brought this debate to Parliament.

Fundamentally, we need to urgently understand the levels of additional support for learning in our schools and realistically look at what the Scottish Government and our councils can do to meet that demand and prioritise resources. Teachers tell us again and again that we need leadership to understand how we are going to provide that additional support and what that will look like on the ground. I am deeply concerned that the message from teachers and parents is that they cannot cope unless urgent and significant investment is made to enable schools to effectively deliver the support that we need. It is also important that we understand how the implementation of mainstreaming has impacted on teachers and the wider school community, and the additional pressures that that has brought.

In recent weeks, I have raised two issues at First Minister’s question time. I raised the issue of children and young people who are seeking attention deficit hyperactivity disorder and autism diagnosis pathways being removed from child and adolescent mental health services waiting lists without suitable alternatives being made available and without their being told about or signposted to third sector support.

The Scottish Government’s press release celebrated its meeting the target for referral to CAMHS, which it set almost a decade ago, for the first time. However, I know from speaking to parents whom I represent here in Lothian that that was a slap in the face for parents who have been waiting and waiting, many of whom have now decided that they will seek private diagnosis, with no clear pathway for the delivery of shared care with GP surgeries for their children.

The truth is that the only reason why ministers have been able to say that the target was met is that children and young people who are seeking an ADHD or autism diagnosis have been removed from those figures. One parent said to me that it feels like those waiting times have been gerrymandered, and I agree. That is why we are calling for a review, and I hope that Parliament will back that.

I am also deeply concerned that, in recent months, three of our major health boards—my board in Lothian, the minister’s board in Highland and the board in Tayside—have been escalated to level 3 of the Government’s support and intervention framework as a result of their mental health performance, specifically on CAMHS. Given that the figures will have changed, how will they be judged on improvement now that many children are being taken off that waiting list?

It is not only me who is asking that question. The Royal College of Psychiatrists in Scotland has said that the number of children who are on separate waiting lists to be assessed for neurodevelopmental conditions is now not routinely being published by the Scottish Government. It says that the Scottish Government needs to be more transparent, and I agree with that call.

Dr Laura Sutherland, who is the vice-chair of the Royal College of Psychiatrists in Scotland’s child and adolescent faculty, said that children who are at the most risk are prioritised, which can result in people with a neurodevelopmental condition waiting even longer. She said:

“Often there is not an immediate risk which is why some of these young people can wait for longer but I think overall the impact is longer term ... It means young people can’t get into education or be supported adequately and ultimately some of these young people will go on to develop mental health conditions on the back of neurodiverse conditions.”

Those two issues are critical—we need action, and ministers need to take that forward.

I turn to the amendments. I have no problem with the Government amendment, but that is because it simply states that Parliament

“agrees that all children and young people should receive the help that they need to thrive”.

The Scottish Conservatives agree, but we need to ask why, after 18 years, the Scottish Government is not delivering that.

I welcome what is contained in the Labour amendment. I very much agree that, 10 years on from the Morgan review, we have not seen the progress that we should have seen.

The Green Party amendment was not selected for debate, but it points out—importantly—a

“concern that only 1,215 children in Scotland have a coordinated support plan ... which represents just 0.4% of all children with a recognised additional support need”.

At that rate, ministers will continue to fail. We need a rethink, which is why the Scottish Conservatives are calling for action.

I believe that there are solutions out there to support what we want to see. Last week, I visited the Yard, which is a wonderful charity that is based in Edinburgh. I apologise to the Cabinet Secretary for Education and Skills, as I may have inadvertently signed her up for a visit to see its facility and the fantastic resources that it has developed to provide models of support to teachers and the school community more widely. We need those models to be embraced and rolled out nationally.

I hope that today’s debate will act as a wake-up call for ministers, the Scottish Government and councils to recognise that they are not delivering the support that our children and young people need. I hope that, if Parliament supports my motion at decision time, we will get clear timelines from the Scottish Government on when the key reviews will take place. We urgently need that action.

Teachers and parents are growing more and more concerned at the failure to provide and resource the planning of additional support for learning in our schools across Scotland. That must change, and that is why the Scottish Conservatives continue to stand up for pupils, parents and teachers and demand that SNP ministers deliver the support that our children and young people need to thrive.

I move,

That the Parliament notes the Audit Scotland report calling for a fundamental review of planning and resourcing of additional support for learning in Scotland; recognises concerns over declining numbers of additional support workers and classroom assistants; highlights the need to understand the rise in pupils with additional support needs to better target resources and training; calls on the Scottish Government and local authorities to deliver a new model of support alongside the NHS Education for Scotland trauma-informed practice training on neurodivergence and autism; expresses concern over changes to attention deficit hyperactivity disorder (ADHD) and autism diagnosis pathways removing children from child and adolescent mental health services (CAMHS) support without suitable alternatives, and calls on the Scottish Ministers to undertake a national review into the implementation of mainstreaming policy and the availability of specialist additional school places across local authorities.

Like other colleagues, I pay tribute to Liam McArthur for the manner in which he has progressed the bill during the current session of Parliament.

Ten years ago, prior to being elected to Parliament, I met Amanda Kopel. Many members on all sides of the chamber will know what a formidable lady and campaigner she is—I see that the Cabinet Secretary for Finance and Local Government is nodding in acknowledgement. Before I was elected, I promised Amanda that, if I was lucky enough to come to Parliament, I would try to progress Frank’s law—named after her late husband—to extend free personal care to people under the age of 65.

During that campaign, I met hundreds of people who were living with a terminal illness. Many were diagnosed way before their time—in fact, during what should have been the best years of their lives. I am pleased that, following cross-party working, the Scottish Government agreed to change the policy. A recent written answer showed that, to date, over 71,000 of our fellow Scots have benefited directly from that policy and the help and vital support that it has now legally provided.

The founding principle of our national health service, of care from cradle to grave, has underpinned the social fabric of our country and society for more than 76 years. However, what is often not recognised is the reality that palliative and end-of-life care is provided predominantly by the charitable sector, either in a hospice or in a hospice-at-home setting, with no currently existing legal right to palliative care.

I have to reflect that, after several attempts over the past 15 years to change the law around assisted dying, neither the Scottish Government nor Parliament has come together to demand the vital improvements that we need, now and in the future, to help deliver better palliative care pathways as well as new funding models that would help charitable hospices to become financially sustainable. Those are especially needed following the impacts of the recent rise in employer national insurance contributions and the agenda for change pay increases.

That is why I launched my proposed right to palliative care (Scotland) bill, and it is why, if the Assisted Dying for Terminally Ill Adults (Scotland) Bill is passed at stage 1 this evening, I intend to lodge amendments at stage 2 to introduce a legal right to palliative care. I am grateful for ministers’ engagement on my bill to date and to Marie Curie for working with me on it. I have the utmost respect for those who dedicate their careers to our palliative care and hospice sectors and for the journey that they help individuals and their loved ones to take as they approach the end of life.

As co-convener, along with Jackie Baillie, of the Parliament’s cross-party group on cancer, I have been inspired at every meeting by the lived experiences of people and their families and friends following a cancer diagnosis. No one can be prepared for, or know, how they will respond to a diagnosis of cancer or of any life-limiting disease. However, as an MSP who has, over the past decade, been speaking to people who are living with cancer, I know that the will to live and buy time is strong. It is the will to seek treatment, to seek access to the next drug trial and to spend another day with loved ones, even with the pain that often comes with treatment and living with a disease.

However, as treatment pathways come to an end and people move on to palliative care, there is a fear of pain and of how they will die. Like many families, I and my sisters have supported my parents and other family members in their final days of life. It has never been easy for us, and it never is easy for anyone.

What is essential is that an individual facing the end of life should have the right to make an informed, autonomous choice about their care, including having the option, for those who want it, of assisted dying. As one individual living with cancer for over nine years recently told me when I asked for their view on the bill, they want the ability to reclaim agency over their life and the peace of mind of knowing that they can access an assisted dying pathway when they decide that the pain that they face is too much. They might not decide to use that pathway, but they would have the choice.

That is why, although I continue to have a significant number of concerns about the bill as it stands, I believe that it is our role to ensure that, within whatever legal framework we take forward, individuals can, if they wish, access assisted dying and that their wishes are afforded the dignity and respect that they deserve.

I support a healthcare system that is compassionate and responsive to the complex realities of end-of-life care, and I believe that assisted dying can be made a part of that system, as another legal choice. That is why I will support the general principles of the bill at stage 1 this evening. I will do so with the intention of seeing how the proposals can be progressed at stage 2. Ultimately, it will be for us, as a Parliament, to decide at stage 3 either to pass or reject the final bill. I look towards what measures can be contained in the bill and the conversations that we will need to continue to have as a country about how we die and how we can improve end-of-life care as a whole here, including by improving the choices that dying people can make at the very end of their lives.

I thank the cabinet secretary for advance sight of the statement.

At a time when teaching unions are reporting record levels of violence in our classrooms and teachers are requesting self-defence training, I continue to have deep concerns that the plan and what has been outlined today will not end violence in our classrooms and schools.

Teachers and parents with whom I have spoken said that they had not even heard of the relationship and behaviour in schools action plan. Ministers have a long way to go to demonstrate and give confidence to teachers and our school communities that the plan will deliver the safe school environments that we all want to see. Teachers want to know that they will be supported and that any decisions on disruptive and violent pupils, whom they cannot manage in the classroom, will be respected, including by council management.

The cabinet secretary says that consequences are an essential part of a supportive learning environment—I agree. One of the action plan outcomes was that school staff should

“feel confident to report, record, monitor, assess and respond to individual incidents and patterns of behaviour”.

Will the new guidance on consequences include a presumption that, if a pupil has been violent towards a member of staff—including towards classroom assistants, which I believe is not being recorded—they will be kept out of the classroom until their behaviour changes?

As we have already heard, the proposals by the Edinburgh integration joint board are likely to see key services cut, including drop-in support, carers services and, even as we mark victory in Europe day, veterans support services. The First Minister apportioned blame, but the cuts are not acceptable. The IJB will cut £29 million from services in Edinburgh. Does he think that our health services will be improved by the decisions that are being taken by the IJB? Will he agree to meet the cross-party group of MSPs who are trying to raise the issue in Parliament and who have just had the First Minister whack this back at us? We need action and we want the First Minister to take heed of that today.

The responses to our call for views highlighted concerns around a lack of representation of employers in industry. Have you read those responses? What is your take on how you would ensure that that works?

I raised the matter with the minister during education portfolio questions on 24 April, and the letter that he sent to me on 30 April said that the analysis would be received in June, which would then allow you to update your information. Is that still—

I think that the cabinet secretary has met with Beth Morrison about her Calum’s law campaign. I do not know whether Daniel Johnson’s bill will time out in the current parliamentary session, but it seeks to improve data collection, the recording of incidents and the training of individuals. It does not look as though that is captured in amendment 88, so perhaps the cabinet secretary would look to lodge an amendment at stage 3 to include that.