Chamber and committees

By “the two registers” you mean the land register and the crofting register.

Do the referrals normally come from teachers or GP practices?

Does more work need to be done to support those perceived gatekeepers to raise awareness of ADHD and autism and how people can have both? I like the language that Patrick Harvie used in the previous session, when he talked about the need for more neuro-affirming language, so that people who are working in the public sector have more knowledge and are more able to listen and learn. In Dumfries and Galloway, a group called Sleeping Giants did a consultation called think differently, which surveyed 185 people to help them get support, for instance. It was really well written and well done. It has now made recommendations, some of which are about awareness raising for the wider public sector.

I will pick up on the shared care approach. Does there need to be a once for Scotland approach? Dr Williams, you talked about governance, good practice, national guidelines and a national approach. Do we need to move forward in that way if we are going to have a shared care model where private healthcare is supporting the NHS, or vice versa?

You said that Healthcare Improvement Scotland does the governance checking of who is doing assessments, but not everybody is validated in relation to good practice. Would Healthcare Improvement Scotland be a way to make sure that governance and good practice is widespread across the whole of Scotland?

Even just giving people a heads-up to whether there is a quiet space that they can go to can be quite affirming if somebody has issues.

Yes, I was conscious that Louise Bussell has not spoken.

We are talking about diagnosing people. I want to highlight that there is an overlap sometimes—people can have both autism and ADHD—so you cannae just pigeonhole people into one diagnosis.

I am thinking about referral processes. Our briefing papers mention that, in its evidence to us, the Royal College of Speech and Language Therapists referenced the use of open referral. It said:

“Fife and Dumfries & Galloway, which both have strong”

speech and language therapy

“representation in the pathway leadership teams, are excellent examples of good multidisciplinary collaboration”.

I am interested to hear about the advantages or disadvantages of open referral in neurodevelopment diagnosis, assessment and support.

I thank Brian Whittle for lodging his motion on a hugely important subject that he has consistently—and rightly—raised over his time on the Health, Social Care and Sport Committee, which both of us have been members of during this and the previous session of Parliament.

It will be a challenge to cover the diverse issues in fower minutes, but I wanted to highlight some of the work of the Non-Communicable Disease Alliance. In Scotland in 2022, 53,000 deaths—about 85 per cent of all deaths—were attributed to non-communicable diseases.

The Government and the professionals who deliver public health policies from day to day place a huge emphasis on preventative healthcare. That cannot be overstated. However, for much of its early existence, our health service was mainly reactive, due partly to the economic circumstances and post-war austerity and partly to the medical technology that was available for front-line professionals. In recent decades, there has been a quantum leap in the technology and science that are available for our front-line staff to deploy where they need it.

I witnessed the advances in technology when I worked for the NHS as a registered nurse. I am still a registered nurse, and I like to keep up with the inventions and the on-going tech. Today, our healthcare staff have access to an incredible and efficient range of diagnostic tools. Blood samples can be taken from patients, tested and analysed rapidly—that includes immediate point-of-care testing and rapid results. The scale at which testing and screening can take place has increased almost exponentially. Magnetic resonance imaging and CT scans are absolutely routine across the country, and labs operate around the clock. The fact that mass screening programmes are deployed across the country to thousands of people allows for much earlier diagnosis and treatment.

There has also been an incredible development of vaccines across our population. Many of us will have memories of seeing those who survived polio but were left disabled by its effects. Thousands died from the polio virus every year, with little hope of treatment and no vaccine to prevent the disease in the first place. Mass vaccination has saved thousands of lives and saved tens of thousands of people from long-term health conditions that would affect their quality of life and demand increased care and support from our healthcare system.

That is why the purposeful disinformation on this side of the Atlantic—and, sadly, from the heart of Government on the other side of it—is so dangerous. Already, drops in vaccination rates in some areas of England have resulted in measles outbreaks. Measles isnae a benign virus; it is a serious and potentially deadly one.

I agree with Brian Whittle that the projected scale of funding for our health service over the next five decades is, in some ways, pretty terrifying. Fifty years ago, back in the 1970s, the idea that we could have the capacity or the technology to vaccinate every two-year-old against flu, to rapidly develop new vaccines for threats such as Covid-19, to begin to eliminate cervical cancer through the human papilloma virus vaccine, to screen for bowel cancer for 25 years everyone who reaches their 50th birthday, or even to routinely screen women for breast and cervical cancer—I could go on—would have been at the edge of science fiction. Today, those things are embedded in our health service, and our biggest challenge is driving up the uptake rates when invitations for screening are sent out.

Brian Whittle is also right to highlight the fact that healthcare and being healthy are cross-portfolio issues. Active travel spending has increased in recent years; that is not just about transport policy, as it will deliver healthier lifestyle benefits.

I am concerned about the rise of ultra-processed food and how that relates to poor health outcomes. I want the good food nation plan to address that. The promotion of shopping local, short supply chains, keeping local butchers and greengrocers open and the planning policies of the 20-minute neighbourhoods help to drive better health and wellbeing, even though, on the surface, it may not look as though those are health portfolio policies.

The issues that Brian Whittle highlights are not unique to Scotland. Nearly all the western world faces similar public policy challenges. I believe that the preventative and holistic approach that I have outlined is at the heart of the Scottish Government’s agenda and that it is absolutely the correct one.

Therefore, I hope that members can work across parties, collegiately, as we often do in the health committee and when I speak in debates led by Brian Whittle. We need to work collegiately to ensure that, in future decades, we can look back at this era as one of continued progress and continued improvement in our nation’s health.