Meeting of the Parliament (Hybrid)

Meeting date: Wednesday, March 3, 2021

Official Report 1079KB pdf

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Autism and Learning Disabilities

The final item of business is a members’ business debate on motion S5M-24199, in the name of Alexander Burnett, on further support for autism and learning disabilities.

The debate will be concluded without any questions being put. I ask those members who wish to speak in the debate to press their request-to-speak buttons.

Motion debated,

That the Parliament commends ENABLE Scotland, National Autistic Society Scotland, Scottish Autism, people with a learning disability, autistic people, families, carers, professionals and academics, who have come together to campaign for what they consider is much-needed change; commends the vision and aspirations of the Scottish Strategy on Autism and the Keys to Life Strategy for people with a learning disability, both of which come to an end in 2021; considers that there is still much more work to be done to realise the aspirations of these strategies across a range of areas, and that this is evident from the members of the Cross-Party Groups on Autism and Learning Disability; believes that such areas include diagnosis, post-diagnosis support, additional support in school, access to employment, social care, quality and appropriate healthcare and housing and advocacy, as well as training for professionals and greater understanding among Scottish society, including in the Aberdeenshire West constituency, and notes the calls for a new commissioner role to bring further accountability to the system, uphold the rights of autistic people and people with a learning disability, and their families, and improve access to services and support so that they can be equal members of society.

18:14  

Like many newly elected MSPs, five years ago, I was faced with a huge variety of case work, much of which I had no prior knowledge or experience of. A lot of it involved the lack of access to services and support for those in the autism and additional support needs community, and, speaking to fellow MSPs in the Parliament, I found that that was not just a north-east issue. Therefore, I thank members from across the chamber for their support in securing this debate.

I also thank them—in particular, my co-convener, Annie Wells—for their on-going support for the cross-party group on autism, which we founded in 2017. I offer special thanks to the National Autistic Society Scotland and Scottish Autism, which have successfully been the secretariat since then—so successfully that it is undoubtedly the best attended CPG that I am involved with, and the current Zoom format has allowed more people from across Scotland to join. I believe that we were one of the first to take our CPG on the road, up to the north-east, which allowed participation by many who otherwise would have continued to be excluded.

Before I talk about the issues, I thank those in the community for two particularly important lessons. The first is how personal autism is to each individual: no two people are alike.? Learning to listen to them and understand individual needs leads to understanding their individual potential. The second lesson is that autism is not a learning disability. Thirty per cent of people with autism might have learning disabilities, but to conflate the two stigmatises and hinders understanding and resolution.

Those points turn into three stumbling blocks. The first is diagnosis: people are crying out for diagnosis and for care and support after they receive it. However, there is a huge gap in the provision of those services. People wait months for diagnosis and then the battle to get support for them begins, which is an on-going struggle for many.

The second stumbling block is education. Right now, with home schooling, we have varying feedback. Some pupils have flourished, whereas others have had huge setbacks to their education. That has not been helped by the fact that there is a severe lack of understanding of their needs. That is not the fault of our wonderful teaching staff, but they need the resources and training to provide the support. What has been startling to me is that so many children from the community are not supported in their transition from education into the working world, which is a scary process for any teenager.

That leads to the third stumbling block: employment. Those with autism and ASN have found that they fear furlough and redundancy more than others, as they are scared of asking for reasonable adjustments. If they lose their job, the struggle of having no job and no income can be exponentially more stressful to that community, and the fear of finding a new job that supports them can be crippling.

Fortunately, many organisations are doing their utmost to work on those issues and more. I thank not only the national bodies but those closer to home. I have had the good fortune to visit and work with ASK North East, the Grampian Autistic Society, Grampian Opportunities and SensationALL, to name but a few. They have worked for many years to assist the autism community, and I thank them for giving me a broader understanding of the further support that is required in the north-east.

The most serious issue for me came through my awareness of those with autism who, instead of receiving understanding and care, were ignored and locked up in mental institutions, which caused further deterioration, with no prospect of improvement or release. One of those cases involves Kyle Gibbon. Members across the chamber know that I have brought much attention to that individual case and have raised it directly with the Minister for Mental Health—with, it pains me to say it, disappointing results. Kyle has been locked up in the state hospital at Carstairs for most of his adult life and remains there to this day. While staff justify keeping him there on behavioural grounds, his mother, Tracey, strongly believes that his detention is causing problems, not solving them. Allegations of bullying and inappropriate treatment fail to see the light of day.

It is not only Kyle. Ruth Hughes came forward with her story of her son, Gordon. He has been locked up in Carstairs for the past three years. His doctor recommended that he be moved to a medium-secure hospital. However, he was sent to Carstairs instead, because no medium-secure beds were available, and he remains there to this day.

What is so shocking is not just the further allegations of mistreatment on which families fail to get answers, but the fact that the future for those young men, who are in good physical health, is a lifetime of incarceration, locked up alongside those who are guilty of heinous crimes, simply because the Government will not resource their treatment.

All of that, however, leads to potential solutions. A recent report from the cross-party group proposed a commissioner to allow accountability and safeguard rights for autistic people and those with additional support needs. I support the next steps of investigation, which should come in the next Parliament.

That might be the required outcome, but it should not prevent other solutions being arrived at or absolve others of existing responsibilities. Improvements in policy development and professional practice, consistency across local authorities and increased budgetary consideration can be delivered today and are all within the power of the Scottish Government.

That failing of Government is not confined to autism but, sadly, demonstrates a far greater problem with Holyrood. However, one thing is clear: the autistic community needs a voice and needs to be part of the solution. The cross-party group was long overdue and has given them a voice here, in Holyrood, which tonight’s debate amplifies. Nevertheless, we must not stop now. The autistic community must not be left behind, and I will continue to do all that I can to ensure that we achieve true equality for that community.

18:21  

I congratulate Alexander Burnett on securing the debate. As the vice-convener of the cross-party group on learning disability, I am delighted to support calls for a commissioner for learning disability and autism. We have made progress in Scotland, with keys to life and the Scottish strategy on autism, but there is much more to do, as Alexander Burnett outlined in relation to the shocking examples that he just gave with regard to autism. My remarks will be about learning disability.

Over the course of the pandemic, I have raised concerns about the higher mortality rate of learning disabled people, but care workers for learning disabled people received routine testing only this year and all learning disabled people got prioritised for the vaccine only last week. I hope that a commissioner would have pushed for that earlier.

Keys to life acknowledges the poor health outcomes and the need for reasonable adjustments for people with learning disabilities, but those do not always happen. It also recommends the provision of better data to identify people with learning disabilities. We now know that that is not in place, which will make it harder to reach that community with the vaccine. The understandable desire to ensure that people with learning disabilities are treated as equal citizens has perhaps created a fear of medicalising them inappropriately, but that ignores their vulnerability, and I hope that lessons can be learned by any future commissioner.

Another issue that I have raised, which I hope that a commissioner would address, is the loss of support services during the pandemic—in particular, building-based day services. That has happened despite the Cabinet Secretary for Health and Sport repeatedly stating that the health and social care partnerships would be fully reimbursed for providing those services, as well as writing to the heads of social work to tell them that day services are important. My motion on that subject received cross-party support, and I thank all those who signed it, but, unfortunately, it did not secure debate time. Even when shops, pubs, schools and other services reopened last summer, adult day services remained closed or severely restricted. Alternatives, including those using self-directed support, were often poor—perhaps a walk for a few hours a week around a shopping centre, colouring-in packs or a chat on an iPad for a couple of hours.

Several families have told me that health and social care partnerships were using the pandemic as an excuse to close those services altogether. The father of a young adult who attended the Murray Owen centre in East Kilbride told me—as did others—how much his daughter was suffering from the disruption to her life that the closure of the centre has caused. He said that it offered stimulation through a variety of activities, professional support and, perhaps most important, a caring community. That has all been snatched away. Her dad told me that she wants to be with her friends but that her views are ignored.

Glasgow and North Lanarkshire have already closed day service centres, and Inverclyde and South Lanarkshire are currently redesigning them. The dad to whom I spoke believes that those decisions are driven by an ideological antipathy to day services, which ignores the views of those who use and love the services. The services are not for everyone, but, if we are in favour of personalised care, we need to listen to people. I hope that any commissioner who is appointed will understand that the community of people with learning disabilities and autism is as varied in its needs as society at large and that all individuals must be listened to, even when some of them want to use services that do not correspond to current fashions.

Although I support the creation of the role of commissioner, I have concerns about demands for the full incorporation into Scots law of the United Nations Convention on the Rights of Persons with Disabilities. That follows my meeting with the Royal College of Psychiatrists and LEAD Scotland, which highlighted the unintended consequences of removing the concept of incapacity. Doing so could end guardianship, remove caring families from decisions that affect their loved ones, resulting in worse health outcomes, and put power in the hands of the very authorities that have presided over poor outcomes for years. The Royal College of Psychiatrists says that that is why the convention has not been fully adopted by any other jurisdiction in the world, and it is concerned about how consultations around mental health and incapacity in Scotland have been conducted.

As someone who has direct family experience of someone with a learning disability, I back the campaign for a commissioner. However, I hope that any future commissioner, and the minister, will accept that vulnerable people face real life challenges and must come ahead of abstract concepts that could make their lives even more difficult.

18:26  

I am participating remotely, so I cannot see which minister is responding to the debate. However, I look forward to hearing the Government’s response.

I thank my colleague Alexander Burnett for introducing such an important debate. It has been a busy news day, but raising awareness of such issues, whether we participate remotely or otherwise, is our bread and butter. I, too, receive a lot of casework on the matter, which I will delve into in my contribution.

I will start by reflecting on a wider point, which is the greater impact of the events of the past year, specifically on people with autism and learning difficulties, based on my experiences of helping people through my remote case work. Just last week, I was contacted by a mother in Ayrshire whose son is a young adult who suffers from developmental disabilities. Previously, he attended his local college, and she told me that he loved it. He has been out of college for the best part of a year, and has been told not to expect to return until after the summer. That is causing them both great concern. She understands why the college is staggering the return in phases, but she is frustrated at the lack of any apparent plan to get special needs students back into classrooms and colleges.

Another family got in touch just before Christmas. They messaged my office about the deteriorating mental health of their autistic son, who was in a learning disability care home and was not allowed any visits from his parents, for obvious reasons. He was not allowed to come home for Christmas, and, despite plans having been made to get university students back home for Christmas, no such plans were made for him.

Before Christmas, we flagged the issue to the Deputy First Minister and Cabinet Secretary for Education and Skills, and it was disappointing to learn afterwards that no plans were put in place. My constituent is still not sure when her son will receive his vaccine, although we are all pleased with the changes to the Joint Committee on Vaccination and Immunisation’s recommendations in that regard. Anyone who listens to BBC Radio 2 will know about that, as it has been developing the story.

Over the past few months, I have heard many examples of similar situations. I have heard about people engaging in self-harm and about an increase in depression and anxiety because many people have simply been unable to understand the restrictions that they and their families have been asked to follow. Their norms are topsy-turvy due to the need to wear face masks, observe physical or social distancing and, not least, changes to their everyday routine and a lack of social interaction. Such things are difficult enough for us as individuals, but they must have a profound effect on those with learning disabilities or severe autism. It has been an anxious time, and we can only imagine how amplified such frustration and anxiety will have been for those individuals.

I commend the National Autistic Society for its good work in researching this. We know that nine out of 10 autistic people worried about their mental health during lockdown and that 85 per cent of respondents to the society’s survey said that their anxiety levels had worsened. There have been some instances of people taking their own lives during lockdown because they were unable to cope or to see a way forward. Those are unbearably tragic situations.

There are still too many gaps in the system of support for this group. The Education and Skills Committee took evidence on the Morgan review into additional support needs provision in Scotland. That review said that support was “fragmented and inconsistent” and that it is

“not ensuring that all children and young people who need additional support are being supported to flourish and fulfil their potential.”

That is the vital point. Those young people must be able to flourish and to fulfil their potential. It is estimated that almost a third of school pupils have some form of additional support need. There is no simple fix for that: tweaking the system is not a solution. Systemic assistance must be delivered in our schools.

The number of additional support needs teachers has fallen by more than 1,000 in the past 10 years. Recruitment is heading in the wrong direction. That is a perfect storm, and I have spoken about it many times in the Parliament.

I pay tribute to Angela Morgan’s report and encourage the minister to read it and its recommendations. It sets out a number of things that the Government—indeed, the next Government—could do immediately to provide better for ASN pupils.

The debate is short and it is hard to keep track of time without a clock on my screen, but we must think about our approach to ASN provision. The pandemic has highlighted a number of challenges that we already knew about and has shed light on many others. Physically disabled young people and those with additional support needs or autism deserve the same high standards of education, health and life as those that any other young person in Scotland is entitled to. We should not accept anything less.

18:32  

I thank Alexander Burnett for lodging the motion. It is a pleasure to take part in the debate.

I commend all those who have come together to campaign for much-needed change and to improve the lives of people with autism and learning disabilities. In particular, I pay tribute to unpaid carers for all that they do for their loved ones. They have our thanks and admiration, and they deserve to be recognised by the Parliament.

The motion is a reminder that, despite the progress that has been made, there is still much for the Parliament to do and to consider further in the next session. A number of those challenges are set out in the motion, including in relation to diagnosis and the importance of good post-diagnosis support. I underline, as Joan McAlpine did, the importance of day services and of advocacy, particularly as legislation and welfare rights continue to change and evolve.

We all share an ambition to build a more inclusive Scotland in which all our rights are respected and where nobody is unfairly denied opportunities. We all have a responsibility to realise those shared ambitions.

This week, we marked a full year since the Covid pandemic arrived in Scotland. Like Jamie Greene, I am conscious of the impact that the past 12 months have had on autistic people, people with learning disabilities and those closest to them.

The roll-out of a vaccine gives real hope that the crisis is coming to an end. However, as Joan McAlpine said, many of those working to support people with learning disabilities have concerns about the way in which the roll-out is being progressed.

The priority plan established by the Joint Committee on Vaccination and Immunisation places people with severe or profound learning disabilities in group 6. They will have begun to receive appointments. The First Minister has indicated that others with learning disabilities will be prioritised, too, which is welcome.

However, some vulnerable adults with learning disabilities are currently falling through a disturbing gap in the programme. I know of one provider, Cosgrove Care, which estimates that 50 per cent of the people in its supported accommodation have not yet been offered a vaccine. The Scottish Government rightly wants to prioritise the most vulnerable, yet here is a group of vulnerable people who face significant challenges in receiving the vaccine.

Joan McAlpine mentioned a lack of data. Different records are held by different surgeries and many of the people concerned need to be vaccinated at home, not in a central vaccination centre.

Providers have rightly commended—as do I—the work of the people on the ground who are delivering the vaccine and, in particular, those who are involved in the roll-out of the vaccine to care homes. They tell me that a consistent approach to vaccination that was modelled on the programme in care homes, that was co-ordinated and that allowed vulnerable people to receive the vaccine in their own home would make an enormous difference. It would ensure that nobody in supported accommodation would fall through the gap.

I ask the minister to consider whether the roll-out is addressing the needs of people with learning disabilities, especially those who live in supported accommodation, which I am sure that the Government understands is a unique environment. I know that the Government has received various requests for different groups to be prioritised, but I impress on the minister the importance of rolling out the vaccine to the most vulnerable people as soon as possible.

Let us get the vaccine to the people who need it most and then, as we emerge from the pandemic, let us begin the work of improving the lives of autistic people and people with learning disabilities.

18:35  

I thank Alexander Burnett for securing the debate. Although this is not quite my final speech as a member of the Scottish Parliament, it is my final speech on this subject. I begin by making my final declaration of interests as a parent of a child with autistic spectrum disorder.

I will spend the majority of my speech offering some reflections on a decade of campaigning on the issue and why that leads me to support the campaign of NAS Scotland, Scottish Autism and Enable for a commissioner for autistic people and people with learning disabilities. At the outset, I thank those organisations for their briefing, which was instructive and chimed with much of the experience of my case load, not just during the pandemic but in general.

Alexander Burnett mentioned that autism is not a learning disability. That is absolutely correct but, as he also mentioned, there is clear intersection, where there are people who have autism and a comorbid learning disability. Therefore, it makes sense for the campaign to focus on the area that it focuses on, because there are a reasonable number of people who have autism and a learning disability, and for whom many of the challenges of autism and learning disability are manifest.

The briefing from NAS Scotland, Scottish Autism and Enable talks about the exhaustion of families. Over the past 10 years, if there was one word that would sum up the experience of the families I have encountered, whether constituents or the people I have come to know as dear friends who have children with learning disability or autism and whom I have encountered through the groups that my son attends, “exhaustion” would be one of the top words that I would use. That is the case because, for too many people, the securing of appropriate support—support to which they are entitled—is a fight. Too often, they are told “No” when they should be told “Yes”. It is only after expending a significant amount of energy on fighting decisions and recruiting councillors, MSPs, MPs and supporting organisations that they can finally secure that support. All too often, it feels as though the system’s first reaction to many people is to turn them away, and that only when they take on the system do they find that it works in their favour. That must change.

Many good things are being done at a governmental level; I know that from my time as a minister and as a Government back bencher. The problem is how that filters down to those on the front line and how they deliver the support to the people who require it. That leads to the question of accountability and why I believe that the role of commissioner is needed. For too many of the good intentions and the well-thought-out policies, the accountability for delivery is not there. We saw that when local autism plans were introduced. Too many local authorities were given money, but there was no accountability for the construction of those plans and their subsequent delivery at local level. The creation of a commissioner, as envisaged by the charities, would help with the accountability question. I do not deny that good work has been done, but there is still a road to travel, and the implementation of the charities’ asks could do a huge amount to support the people whom we as MSPs represent.

18:40  

I, too, thank Alexander Burnett for bringing the debate to the Parliament, because it is on a hugely important topic with which I am intimately concerned. I should declare my diagnosis with attention deficit hyperactivity disorder and the fact that I am a trustee of the ADHD Foundation. I make that declaration because, quite simply, it is impossible to talk about the issues without discussing the intersections between the conditions.

Alexander Burnett, in setting out the case, was absolutely right to make a distinction between autism and learning disabilities and to take us through the issues surrounding diagnosis, education and employment. In all those categories, people with autism face critical issues, and there is a failure to provide joined-up assistance for them.

I will briefly mention Joan McAlpine’s contribution. Although I want to focus largely on the role of the commissioner, the point about day care cannot be made—[Inaudible.]—a number of day care organisations facing exactly the challenges that Joan McAlpine mentioned. Those organisations faced challenges before the pandemic, but the challenges have been deepened by the approach that has been taken during it.

Alexander Burnett mentioned shocking cases regarding the incarceration of people with autistic spectrum disorder, and I will add some additional shocking prison facts. People with ADHD account for around 3 to 5 per cent of the general population but 25 per cent of the prison population, which is five times the incidence in the general population. In the general population, dyslexia has an incidence of 10 per cent, but half of all prisoners have dyslexia. Around 2 per cent of the general population have autism, but between 4 to 8 per cent of the prison population are found to have it, which is two to four times the general incidence.

That is shocking. The disproportionate level of people with those conditions in prison represents an abject failure of public services and public policies. If any other section of society was overrepresented in that shocking way, there would be a national outcry. We need a broad change in the way that we approach those conditions and the way that we design services to address them, because, right now, there is a silent failure of huge proportions that has occurred for people with those conditions.

Autism and learning disabilities need the focus of a commissioner—[Inaudible.]—is broad and systemic. People within the broad bracket of neurodiversity conditions account for 20 per cent of the overall population, but the services that they use are not joined up and are not designed for them. As Mark McDonald outlined, people have to fight to gain access, and they are being failed. I do not deny that progress has been made, but, all too often, policies have been confined to the silos of education and health. The policies do not involve joined-up thinking and, ultimately, they are not designed to help people in their day-to-day lives; they are designed to manage the deficit and disability rather than to help people with their talents and capability.

A change in attitudes is also required, because we find, all too often, that the conditions are used as terms of abuse. When was the last time that members heard someone regard a person’s spelling as “a bit dyslexic” or someone failing to pay attention as being “a bit ADHD”? When was the last time that members heard a person described as being “on the spectrum” because they appear slightly odd or socially inadequate? The sad reality is that, all too often, people use those terms as terms of abuse and do so acceptably and without reproach or comment. Attitudes need to change, as well as services and policies. That intolerance is completely unacceptable and must end.

In closing, I will briefly mention the Morgan review, which underlined the fight that people have to make, the marginalisation that people experience and the fact that, all too often, although the issues are acknowledged, mainstreaming simply means pupils being placed in cupboards for the provision of their learning or part-time timetabling for their education. The need for change has never been more apparent. A commissioner could be the lightning rod for that change, because people with autism and learning disabilities need change—[Inaudible.]—with talent, ability and contributions to make. Without those changes, they will simply be denied the ability to take part in society that they have every right to expect.

18:45  

I, too, thank Alexander Burnett for bringing to the attention of Parliament the campaign of Enable Scotland, the National Autistic Society Scotland and Scottish Autism for an autism and learning disability commissioner. I also thank members for their speeches and contributions in what has been a useful debate for raising awareness of autism and learning disabilities. I recently met those organisations, and it was good to hear more about their campaign, what they foresee the role of the commissioner being and, more important, how that will improve the lives of autistic people and people with learning disabilities.

I am aware that the recommendation for the establishment of a commissioner was in the report of the cross-party group on autism, “The Accountability Gap”, which was published in October 2020. I had the pleasure of speaking to the cross-party group in October, to update it on autism and learning disability policy.

As has been mentioned, the Scottish strategy for autism comes to an end this year. Along with the keys to life strategy, it has set out the key priorities for Government and public services in how improvements can be made to ensure that autistic people and people with learning disabilities can live independent and healthy lives. Those strategies have been informed by people with lived experience. The Scottish strategy for autism is currently being independently evaluated, and I look forward to seeing the results of that evaluation in the spring.

Going forward, and learning from the experiences of the Covid pandemic, the Scottish Government has been working with autistic people and people with learning disabilities, autism and learning disability representative bodies and care providers on a towards transformation plan. The plan, which we are developing in partnership with the Convention of Scottish Local Authorities, will take a human rights-based approach and will look at the particular needs of Scotland’s autistic people and people with learning disabilities.

We see the plan as the beginning of the conversation about how we change Scotland for the better for autistic people and people with learning disabilities. I am pleased that wide stakeholder engagement has taken place, with People First (Scotland) and the autistic people’s organisations inputting into how the plan is led and governed. It is essential that autistic people and people with learning disabilities are at the centre of how their human rights are protected.

The debate has demonstrated the wide understanding among members that autistic people and people with learning disabilities face inequalities and prejudice in many aspects of their day-to-day lives. The towards transformation plan will set out a number of priorities that we want to deliver on in order to ensure that rights are protected and inequalities addressed.

There have been many positive developments in education policy in the past year—an issue that Jamie Greene raised. In December 2020, we published the autism action plan, which sets out actions to improve the support that is provided to autistic children in Scotland’s schools. An implementation group will drive forward that important work and will report to the Deputy First Minister.

Angela Morgan’s review of additional support for learning, which was published in 2020, suggested several areas for improvement in how we support children and young people to flourish. Her report sets out a clear direction, and the Scottish Government and COSLA have developed a joint action plan to implement its recommendations. We are determined to improve the educational experiences of children and young people with additional support needs and to make Scotland the best place in the world for them to grow up in.

Members will be aware that we debated the independent review of adult social care in February. That review gives us the opportunity to improve people’s lives—particularly the lives of people with autism and learning disabilities. Although it will be for the next Parliament and Government to move forward on the review, we have taken immediate action to secure improvements for people with autism and learning disabilities, including through a new community living change fund of £20 million, which was announced by the Cabinet Secretary for Health and Sport on 16 February. The fund will deliver a redesign of services for people with complex needs, including autism and learning disabilities, and for those with enduring mental health problems.

I declare that my wife is an ASN teacher at a primary school in Helensburgh, so I hear a lot about the fantastic work that they do in supporting children with all sorts of difficulties. An area of concern is higher and further education, in which there is definitely a gap because of the need for more support and its retention. Decisions about budgets that are being made in higher education might mean that those people are lost and not replaced, which is an important issue. In this day and age, we need to ensure that our young people are properly prepared for life, in which regard, I was interested in Daniel Johnson’s comments about prisons. Does the minister agree that we need to address those issues, particularly in higher education and prisons, as well as helping people to understand the learning support needs of the young people concerned and giving them a fair chance in life?

As the minister with responsibility for autism and learning disabilities, I support having any additional support for those communities. Maurice Corry will be aware that, over the course of the pandemic, additional moneys have been provided to higher and further education to support the wellbeing of students through what has been a challenging and difficult time. I accept that, for members of the learning disability and autism community, the pandemic has been even more challenging. We are working closely with charities and representative bodies to do what we can to support those people, including those in higher and further education. I thank Mr Corry for his intervention on the matter.

I am pleased that discussions have commenced with a wide range of autism and learning disability organisations. I will meet a range of autistic people and people with learning disabilities in the coming weeks in relation to the Scottish Government’s towards transformation plan. In that plan, we have committed to exploring further the proposals for a commission or commissioner to help protect people’s rights.

I turn now to points that members have made in the debate. A couple of members raised concerns about the vaccination programme for people with learning disabilities. We are working closely with national health service boards to ensure that everyone with a learning disability is identified for vaccination. On 25 February, the chief medical officer for Scotland and the chief nursing officer for Scotland wrote to confirm the role of learning disability nurses in both identifying people with a learning disability and delivering those vaccinations, including in people’s homes, where that is more appropriate.

At the outset of the debate, Mr Burnett raised two specific cases. As members will appreciate, due to the laws governing patient confidentiality, I am not able to discuss individual patients. However, secure units, including the state hospital, focus on the provision of high-quality and person-centred care and treatment in a safe and secure environment. All patients at the state hospital have the right to make an application to the Mental Health Tribunal for Scotland if they wish to appeal against their detention or the level of security that they are held under. Those safeguards are important and are rightly channelled through the mental health tribunal.

I want to hear at first hand the views of the learning disability and autism communities on the proposal for a commissioner, what they would want a commissioner’s role to be and, crucially, the wider routes that could be investigated to ensure that the human rights of autistic people and people with learning disabilities are upheld and protected. To that end, as well as meeting various organisations, I am arranging a meeting with autistic people and people with learning disabilities, to hear from existing commissioners about their role in improving lives. Again, that will be an opportunity for people with lived experience to be part of the conversation on developments that affect them. I am committed to ensuring that autistic people and people with learning disabilities continue to be at the heart of exploring the introduction of a commissioner.

I thank members for their contributions to the debate.

Meeting closed at 18:55.