Chamber and committees

Tapadh leibh, Oifigeir Riaghlaidh. I welcome the opportunity to respond to Helen McDade’s important motion, and I thank her for raising an issue that affects so many individuals, families and communities across Scotland.

The Scottish Government recognises the increasing demand for ADHD and autism assessments among children and adults and the pressure that that is placing on services across the country. We also recognise the importance of the recent neurodevelopmental summits that brought together members from across the Parliament and beyond and established a clear cross-party consensus on the scale of the challenge and the need to make meaningful progress.

I acknowledge the historical context that is highlighted by the motion, which is that the diagnostic criteria have not always accounted for the high levels of co-occurrence in neurodevelopmental conditions such as ADHD and autism. That, alongside factors such as a lack of awareness and stigma, has contributed to underdiagnosis of adults. As a result, many people have gone without support for far too long.

On the question of prevalence that Helen McDade raised, so far, the consensus on the scientific evidence is as described by the Royal College of Psychiatrists in Scotland. What we are seeing is not a sudden increase in neurodevelopmental conditions but the result of historical underdiagnosis, particularly for adults and some specific groups, as well as much greater awareness and reduced stigma.

The Scottish Government is not currently funding any research on cause and prevalence, but an independent review of mental health conditions, ADHD and autism is under way in England. Although the review is focused on England, we will undoubtedly consider any findings and learnings from it. The interim report notes that there is limited evidence that there has been any increase in prevalence and that the epidemiological evidence suggests that the numbers are broadly stable.

I recognise that awareness of needs has increased and that an increasing number of people are seeking help and support. Collectively, we must meet that need, because the impact of going without support reaches beyond the individual and affects the workplace, the criminal justice system and the wider health infrastructure. The overrepresentation of neurodivergent people in prisons and mental health settings highlights the consequences of unmet need. We have a collective responsibility to work together to make Scotland a place where neurodivergent people are welcomed, valued and supported.

I note the statistics that Helen McDade referred to with regard to ADHD medication. However, it is important to recognise that medication is not the right intervention for everyone with ADHD. Although we must ensure that those who want and would benefit from medication can access it, caution is required when interpreting the statistics.

Improving access to medication for people with ADHD is only one element of the holistic support that is needed for neurodivergent people. To achieve that vision of holistic support, we committed in our manifesto to implementing a stepped care approach for adults with neurodevelopmental conditions, as proposed by the Royal College of Psychiatrists. That will reshape how support is accessed, ensuring that people can access support at the right time and close to home, without having to wait for a diagnosis before they receive help. The support will include improved information for people and their families, self-help resources, an increased third sector support offer and a reshaped clinical offer to make access to diagnostic assessment easier when that is the right step for the individual.

Within the first 100 days of this parliamentary session, we will engage with stakeholders to agree a route map for delivering that new model for adults. That work will build on the shared understanding from the summits that progress must be collective, sustained and focused on delivering practical change.

The work on neurodevelopmental support for adults complements our ongoing implementation of the national neurodevelopmental specification for children and young people, which sets clear expectations that children and young people should receive support that meets their needs as early as possible. Recognising the challenges that are involved in meeting rising demand, we partnered with the Convention of Scottish Local Authorities last year to review the specification’s implementation in order to identify what is working well and where further action is needed. That highlighted the significant pressures that services are facing and the need for clearer national direction and practical support to deliver timely, neuro-affirming care across Scotland.

We have acted on that learning by committing to a programme of action that is supported by a cross-sector task force, bringing together expertise from health and education bodies, local government and the third sector. That is strengthening national leadership, improving shared understanding and supporting tangible improvements for children, young people and their families.

Progress is already being made. We have strengthened national communications on neurodevelopment and are in the final stages of improving information for families through Parent Club. We are also working with partners to develop a shared national picture of what support around a child should look like and how services should work together to deliver that, which is underpinning ongoing system improvement. Alongside that, we have backed delivery with additional investment. Last year, we provided more than £2.9 million to support projects that improve access to neurodevelopmental support, which includes family support, transition pathways and new assessment tools.

Let me be clear: the issues that are raised in the motion are complex but not insurmountable. There is now clear consensus across Parliament on the scale of the challenge and the need to act. Our shared task is to turn that consensus into delivery. By focusing on the right interventions for individuals and community-based support, we can build a Scotland in which neurodivergent individuals are understood, supported and empowered.

I am grateful for colleagues’ interest in and focus on the issue across the Parliament, as well as for the lived and professional experience that we collectively bring. This Government remains committed to working in partnership to turn our ambition into reality.

Meeting closed at 18:43.

I agree with Victor Currie that it is damaging for a person to wait for a long time without a diagnosis if all their support hangs on it. I agree, too, that a number of people on the waiting lists will not meet the diagnostic thresholds. However, does he not agree that the appropriate way forward is to ensure that people get the right support at the right time in the right place when they first ask for it?

Joe Long will understand that we are continuing to work with national health service boards, local authorities, the Convention of Scottish Local Authorities, the third sector and other delivery partners to improve access to neurodevelopmental support for children, young people and adults.

CAMHS is not the correct service for children who seek a diagnosis for a neurodevelopmental condition such as attention deficit hyperactivity disorder, unless they have a co-existing mental health condition. For many young people, it is more likely that placement on to an ND pathway will ensure that the right help and support is provided. That approach is intended to ensure that young people who need support for their mental health from CAMHS are able to receive it in a timely manner and that specialist neurodevelopmental support is available whenever it is needed.

The design and management of those services is for individual health boards to decide, and each health board will have its own arrangements in place, and relationships with local partners. However, I expect those to be designed and addressed to ensure that children receive as quickly as possible the right specialist support for their particular needs.

CAMHS is a specialist service for children and young people who have acute mental health needs, and referrals are based on clinical judgment. Although referrals are sometimes not accepted, that does not mean that support is not available. In line with the national CAMHS specification, if a referral is not accepted, the individual must be sensitively signposted to appropriate services, including community-based provision.

We are working with health boards to understand the causes of the rates of non-accepted referrals, ensuring compliance with the specification and delivering timely access to appropriate alternative support.

As I understand it, NHS Greater Glasgow and Clyde, in response to increasing demand for neurodevelopmental diagnosis, has introduced a triaging system. That means that it recognises that some people are waiting longer than they were initially told for their assessments and is proactively communicating to them that they are waiting longer. I will go back and check the quality of the board’s communications to see whether it is giving an adequate explanation.

NHS Greater Glasgow and Clyde has confirmed that it is prioritising diagnostic assessments based on patient safety and risk, due to significant increasing demand for neurodevelopmental diagnosis. That means that some patients are waiting longer than was initially expected for diagnostic assessments, which is being proactively communicated to them.

The Scottish Government continues to work with the Convention of Scottish Local Authorities, health boards, local authorities, the third sector and other delivery partners to improve access to neurodevelopmental support. Last year, we provided more than £2.9 million of additional funding to support several projects, including supplementing health board diagnostic assessment capacity.

I welcome the opportunity to mark world pre-eclampsia day, which was held on 22 May. It is an important moment that reminds us of not only the scale of the condition globally but our responsibility in Scotland to lead with compassion, evidence and action.

I am very grateful to Patricia Gibson for raising the issue and I will start by saying how sorry I am for her loss. There have been powerful personal testimonies from both Patricia Gibson from the mother’s perspective and Jack Middleton from the child’s perspective. All politics is personal and we are at our most powerful when we use our personal experiences to advocate for change.

Pre-eclampsia is a serious pregnancy-specific condition that can, typically, arise after 20 weeks of pregnancy. It happens when the placenta does not work as well as it should, leading to high blood pressure and in some cases affecting different organs in the body, as we have heard. Globally, as others have said, the picture is stark. Every year, an estimated 76,000 mothers and 500,000 babies lose their lives due to pre-eclampsia and related hypertensive conditions in pregnancy. The vast majority of those tragedies occur in low-income countries and are potentially preventable. That tells us that, in many cases, the difference between life and death is timely recognition, appropriate escalation and access to high-quality care.

Here in Scotland, maternal safety is a national priority. We maintain robust, evidence-based systems for the early detection and management of pre-eclampsia. The best start programme and the work of the maternity and neonatal safety collaborative continue to ensure early recognition of risk, consistent escalation of care and equitable access to high-quality antenatal services for all women across all parts of Scotland. However, I am certainly willing to link in with Public Health Scotland, as Patricia Gibson requested, to determine how the data that she referred to could be collected and reported.

Routine antenatal surveillance remains our first line of defence. Women are invited to attend regular midwife appointments, at which a routine review of symptoms and an assessment of blood pressure and urine is completed for all.

In 2024, the First Minister met families who had suffered the devastating loss of their babies as a result of pre-eclampsia. Together with the organisation Action on Pre-eclampsia, those families put forward the case for improved testing to prevent tragic cases such as theirs from occurring again. I am pleased to note that, since that work was established, all women in Scotland now have access to enhanced testing, which is known as placental growth factor—PlFG—testing.

We are also continuing to strengthen our systems. We are developing an updated national maternity early warning score—MEWS—to support the earlier identification of patients whose condition is deteriorating, including those with high blood pressure, and rapid and appropriate escalation to ensure that women receive the right care and treatment as quickly as possible.

We have developed new pathways, which are designed not only to improve immediate outcomes but to address the longer-term impacts of the condition and reduce the longer-term maternal risk of cardiovascular disease, in line with the Scottish Government’s ambition to improve population health.

Over recent years, our understanding of pre-eclampsia has evolved. We now know that it is not just a complication of pregnancy but a marker of future health risk. Women who experience in pregnancy hypertensive disorders such as high blood pressure, gestational diabetes and pre-eclampsia have an increased lifetime risk of cardiovascular disease, stroke and diabetes, and an increased risk of premature death.

I am pleased to inform members that a short-life working group is focusing on reducing cardiovascular risk in women who experience high blood pressure in pregnancy. In 2025, that group developed a national pathway to reduce long-term cardiovascular risk. The pathway represents a significant step forward in how we support women, not just during pregnancy but across their entire life course.

The pathway is clear in its intent. We want to identify women with cardiovascular risk who can be treated early. Such women are provided with a home blood pressure monitor in the period immediately after giving birth and are supported through remote monitoring via an online platform and by their primary care team. There is a strong communication process. Crucially, the follow-up is structured and sustained. Such women are reviewed at six weeks after birth, as normal, again at four months, and then annually thereafter for life. Therefore, it should be perfectly possible to identify such women prospectively and to ensure that they are provided with good care.

The issue of retrospective identification is one that I will take back to officials to find out what we are doing to retrospectively identify middle-aged women like me who had pre-eclampsia many years ago, when the system was not in place.

The pathway will ensure that the window of opportunity that is presented by pregnancy is not lost. It will enable us to provide not only reactive care but proactive prevention, which is what we are after in Scotland. We are currently testing the pathway in NHS Lothian, supported by funding from the British Heart Foundation, and we are committed to evaluating its impact robustly. That is exactly the kind of innovation that ensures the provision of joined-up, person-centred care that is focused on long-term outcomes. There are many points in a woman’s life at which there are important opportunities to identify cardiovascular risk, but pregnancy absolutely remains a key opportunity for intervention.

The health of women and girls is a clear priority for this Government and for me, and I want to ensure that women and girls in Scotland experience the best possible health throughout their lives. I am proud that Scotland was the first country in the UK to deliver a women’s health plan. Women’s heart health has been a clear priority in the plan from day 1, and that focus has continued into the plan’s second phase, which was published in January 2026. Phase 2 of the women’s health plan has a renewed focus on optimising future health. It sets out the action that we will take from preconception and throughout the course of women’s lives.

Let me make it clear to Monica Lennon, for whom I have a great deal of fondness and respect, that I have responsibility for women’s health. That is a responsibility that I am delighted to have, and on which I am keen to continue Jenni Minto’s good, collaborative work. Anna Glasier is currently still the women’s health champion, and phase 2 of the women’s health plan notes that the role will continue, so it is crystal clear that women’s health is still a very high priority for this Government.

Many women in Scotland are affected by the long-term health risks associated with pre-eclampsia. That is why we have prioritised action to ensure that women who experience hypertensive disorders of pregnancy are informed about their lifetime CVD risk and are provided with opportunities to reduce that risk. The invaluable work of third sector agencies such as Action on Pre-eclampsia ensures that we continue to raise awareness and drive improvements in care, and I am very happy to place on record our appreciation for their ongoing work.

I finish by acknowledging the profound impacts that pre-eclampsia can have on women and families in Scotland. We know that, without early detection and management, women and their babies are placed at significant risk. No opportunity to prevent harm should be missed. Every woman deserves the highest standards of care, wherever she lives.

Meeting closed at 18:45.

The Scottish Government is taking action to tackle vaping among young people. In our first 100 days in government, we will consult on the retail display of vapes in order to remove the appeal and visibility of vapes to young people.

Under the Tobacco and Vapes Act 2026, offences on the free distribution and nominal pricing of vapes will come into force on 29 October this year. From 1 June 2027, a comprehensive ban on advertising vapes will come into force, which will reduce young people’s exposure to vape adverts.

We are taking forward substance use education work in our schools through curriculum for excellence. Young people learn about a variety of substances, including vapes, and information is available through the Young Scot, Parent Club and NHS Inform websites.

Planning authorities within local authorities are able to regulate the development of shops, including the creation of new shops, but changes to the specific range of goods that are sold in an existing shop do not constitute development, so they are not within the scope of planning control.

However, Scotland has a tobacco and vapes retail register, and all businesses must be registered to be able to sell those products in Scotland. It is the responsibility of local authorities to enforce compliance with the register in their local areas, and it is already illegal to sell all such products to under-18s. The registration process means that that illegality can be stamped out.