Chamber and committees

The programme for government, which was published in September, committed the Government to carrying out scoping work on the remit of and powers in the learning disability, autism and neurodiversity bill in this parliamentary session. It will take time to scope all that and get it right, and we need to continue some of the conversations that we have been having. For example, there are polarised views on the proposals for a commissioner, and we have to listen to all sides if we are to get that right. That scoping work will happen and we will move on with the matter in this parliamentary session.

Concurrently with that, the Scottish mental health law review is due to report next September. As the committee will likely be aware, the review will make recommendations to give effect to the rights, will and preferences of the individual by ensuring that mental health, incapacity and adult support and protection legislation reflects people’s social, economic and cultural rights, including the requirements of the United Nations Convention on the Rights of Persons with Disabilities and the European convention on human rights. That said, I think that today’s Supreme Court ruling has put some difficulty in our way with regard to embedding certain UN convention rights in legislation, but that is probably a discussion for another day. You will be glad to hear, convener, that I will not go into a rant about that, but it is fair to say that, like many others, I am quite irate about it.

The Scottish mental health law review is extremely important in all this, but we need to listen to people and ensure that we embed rights in any legislative change, whether that be in the learning disability, autism and neurodiversity bill or in anything that comes from the review itself.

It is fair to say that when you take on a new ministerial role you have to do a wee bit of stocktaking to see what is going on out there. In my new role, I have been talking to lots and lots of folk about the various issues that I am responsible for, and the committee can be assured that that general stocktake applies right across the board.

As I said, I know of a number of health and social care partnerships and local authorities that are doing very well in this area, and I know of a number of others that are not doing as well as they should be to meet their people’s needs. I will continue having the very detailed conversations that need to be had, to do that stocktake and to ascertain what is going on out there that is right and what is not going quite so well.

Mr Stewart knows me from numerous other committee appearances—we seem to cross each other’s path on a regular basis—so I will probably bore him by saying something that he has heard me say many times before. We have had some success in other areas with this approach, but I am one of those folks who get very frustrated when we do not export best practice across the board. We are a small country, but sometimes people are afraid to blow their own trumpets and say what they are doing well, which means that others do not have the opportunity to pick up that good practice. Convener, I assure you, Mr Stewart and the rest of the committee that my ethos with regard to the exporting of best practice remains in place. That is what we will aspire to do.

I will make some general comments about the provision of one-stop shops, which I think are important. I think that the point being driven at is that provision varies from local authority to local authority, and local authorities are responsible for commissioning and delivering those local services. We have examples of really positive provision in some local authorities such as South Lanarkshire, which operates an autism resources co-ordination hub, and Edinburgh, with its Lothian one-stop shop. There is also a one-stop shop that is supported by Perth and Kinross. However, there is still work to do to ensure that other parts of the country have the right provision, because it is fair to say that some parts have very few services to meet the needs of autistic people.

The Government works with national and local autism charities, which also operate a number of services. Indeed, I was having a discussion about that very issue yesterday. Scottish Autism and the National Autistic Society have national coverage, but we also have close links with Inspiring Scotland and with effective and valued local organisations, such as the Aberdeen one-stop shop and Autism Rights Group Highland.

As I said—and I think that we have to be honest about this—provision is excellent in some places but not in others, and we need to encourage, cajole and perhaps even take further action through regulation to ensure that, in the short term, provision across the board gets better. Beyond that, we have the opportunity with the changes that we are making through the national care service and other actions around that to put in place a framework of high-quality standards that all can expect.

Given all that we are doing at this moment, it is important to highlight that the work that we will be carrying out and the legislative change that we will be making in care in Scotland put the person at the very heart. What we need on many occasions are more person-centred approaches. That happens in many cases, but where it does not happen, it causes great difficulty for the individual, their family and often their community. We have to start looking at such approaches more and more and, indeed, at a very early stage, instead of waiting for somebody’s life to reach crisis point before the services that are required are provided. We must move to much more preventative measures and take folks’ views into account to ensure that we get this right as we move forward.

That is something else that we need to take cognisance of in shaping services: waiting for a diagnosis does not mean waiting for help and support. Help should come naturally, no matter whether or not there is a diagnosis. Some places have got that service provision and help right, but that is not so much the case in other places.

I am not a person who likes to stand still—there always has to be continuous improvement. Although there is no doubt that the legislation is very important, that is not to say that we should not be taking action in the here and now, where that is possible, outwith the legislative framework.

Government officials are working to consider all the recommendations from the review. I have already been provided with some advice and we have already taken some actions, as I outlined in my opening statement. We will co-ordinate a full Scottish response to the report; coronavirus has delayed some aspects of that work, but we are now getting back on track.

Work has been carried out on a number of specific recommendations. For example, we have already published new mental health standards; we have commissioned the Scottish learning disabilities observatory to carry out a study on the use of psychotropic medication; and we have committed to scoping out and introducing the bill that I mentioned in my opening remarks. As we move forward, we will continue to do all that we can outwith the legislative framework to ensure that there are improvements.

Thank you. It is a little strange to be back in a committee room. I have participated in committee meetings over the past while, but this in-person stuff is going to take some getting used to again.

I am grateful for the opportunity to give evidence to the committee on how the Scottish Government is supporting autistic people.

The Scottish Government published its plan “Learning/Intellectual Disability and Autism: Towards Transformation” in March. The plan considers the actions that are needed to shape supports, services and attitudes to ensure that the human rights of autistic people and people with learning and intellectual disabilities are respected and protected. We are taking forward exciting new leadership and engagement plans with central roles for autistic people and people with a learning disability, putting them in the driving seat.

The Scottish Government has just published the “Evaluation of the Scottish Strategy for Autism”. The evaluation concludes that the strategy delivered valuable resources and services but that more work needs to be done to meet the Government’s ambition of allowing autistic people to be supported to live productive lives and of seeing change at the local level.

In response, I was delighted to announce £650,000 this financial year for tests of change on adult neurodevelopmental pathways for diagnosis and support. I also announced new funding of £425,000 to trial the Scottish Government’s new learning disability and autism leadership and engagement work, and £400,000 for the understanding autism project charity funding for a second year.

The Scottish Government also established the national autism implementation team, which supports health and social care partnerships to consider best practice and improved service in the redesigning of autism diagnostic services.

On Wednesday 8 September, the Scottish Government published the “National Neurodevelopmental Specification for Children and Young People: Principles and Standards of Care”, and on 14 September I announced £5.25 million for NHS boards to build professional capacity to support children and young people with neurodevelopmental support needs.

Additionally, we have listened to the calls for a commissioner and have committed to publishing a learning disability, autism and neurodiversity bill and to creating a commissioner to uphold and protect the rights of autistic people and other people with neurodevelopmental difference. We are committed to that and will commence scoping work on the bill shortly.

Let me be clear that although money is always important, this is not just about money. It is about how we treat people with neurodevelopmental difference in our communities, our workplaces and our schools. It is about innovation, focus and working together across national and local divides to provide solutions that work for the people we are here to serve. That is what our new engagement will support and, as members will be aware, I am committed to ensuring that the voices of those with lived experience are at the heart of all that we do.

I am interested to hear the views of the committee and I look forward—or maybe not—to your questions.

I gave you some numbers earlier on, convener, but I will repeat them for you. However, I do not have at my fingertips the figures that Mr Torrance asked for with regard to the number of people diagnosed each year or any statistics showing regional variation. Ms Campbell, who is the fount of all knowledge, might well have them, and if not, she will without a doubt find them. As I said earlier, there are approximately 44,133 autistic people in Scotland—I did say “approximately”, but it is quite a specific number.

On the question of regional variation, I will pass over to Ms Campbell.

I will not pre-empt the consultation on the national care service. We have posed a number of questions in the consultation document with regard to what should be in the service, and we will look at the views that we get back. I know that some folk think that some of the questions and proposals are a little bit controversial. No matter what, the national care service will be extremely important as we move forward, because it will set high-quality standards across the board. That is what people want from services, whether they be in or out of the national care service, and that high-quality standard is what we require across the board, including in autism and neurodevelopmental services.

Service users in the autism community and in others are often very frustrated about accountability, and we must ensure that they know who is accountable for the delivery of services. We cannot afford to have a continuation of the postcode lottery in which people who live in one place get a very high-quality service while those in the authority next door have much less of an entitlement. We need high-quality standards, no matter whether services are in or out of the national care service.

We must look closely at all the recommendations and find a way forward to ensure that we provide better support and create better opportunities for people with autism.

I am sure that the committee will pick up on this, and I can go into further detail if required, but the fact is that, although the services provided to people with autism and learning difficulties are very good in some areas, I cannot claim the same for other parts of the country. We need to do our level best in all parts of the country to ensure that we are providing the services and help required to all folk with a neurodevelopmental condition. That will take quite a bit of work.

In all of that, and in light of the recommendations, we all have a duty to continue to listen to the voices of those with lived experience about what works and what does not work for them.