Seòmar agus comataidhean

I am concluding.

It is through addressing the fundamental causes of violence against women and girls that we can effectively respond to this critical issue. Hospitals should be places of safety for patients and staff, and their safety is paramount. Assaults on patients or staff are abhorrent, and all instances of violent behaviour, including sexual assaults, should be reported and escalated to the police as quickly as possible.

I have listened to what many members have said during the debate, and I will comment on two points. Tomorrow morning, I will meet Professor Anna Glasier, who is Scotland’s wonderful women’s health champion, and I will take the discussion from the debate to her, in order to have a further conversation with her.

I would also be content to engage with members who have taken part in the debate, because I think that it is important that we have a cross-party solution to the issue, and a cross-party approach to how we can work better with our health boards.

I believe that violence against women reflects the worst aspects of our society, and we must do more to ensure that women and girls are safe, feel safe and are respected.

I am going to continue, if the member does not mind.

Those policies are due to be published soon and will provide a standardised approach for all health boards. We are also working with the Royal College of Surgeons of Edinburgh to roll out its “Let’s remove it” campaign, which is designed to raise awareness of sexual misconduct. Furthermore, we have been working with Police Scotland and other parties, using the your safety matters initiative, on tackling violence and aggression across our front-line services.

In addition, supporting survivors is key. In order to support victims and change attitudes, we are providing more than £5.3 million to rape crisis centres through our delivering equally safe fund. We have taken robust action to tackle sexual offending and we are encouraging more victims to come forward, improving support and modernising the law on sexual offences. It is vital that we progress our vision for justice and that we deliver a truly person-centred and trauma-informed system through the Victims, Witnesses and Justice Reform (Scotland) Bill.

The Minister for Equalities recently announced a £2.4 million increase to the delivering equally safe fund for 2025-26. That will allow all funding recipients to continue the vital work that they undertake to prevent violence and to support survivors of violence against women and girls.

Stopping violence against women and girls before it occurs must be central to our collective efforts. To do that, we must tackle the root cause of the problem—

Every member who has spoken in the debate today recognises that violence against women and girls is abhorrent and unacceptable. That is the case in our hospital estate, as it is in every part of our society. It is shocking and depressing that it remains the case that there is violence, including sexual violence, at the hands of men wherever women live and work. I agree with what Tess White said in her opening speech that one attack in a hospital or anywhere else is one too many.

Such violence has a profound, long-lasting and devastating impact on the lives of women and girls, and those around them. It damages health and wellbeing, limits freedom and potential, and is a fundamental violation of human rights. In my office, I have a 16 days of activism against violence against women candle. I see it every day, and the movement is something that I very much understand and support. Although I have not read the WRN report in its entirety, I have read some summaries of it, and it is shocking.

We are, I think united together in our recognition that the drivers of violence against women and girls are firmly anchored in the behaviour of men. It is men who must accept that they need to do much more to deliver the culture and the national change that is necessary to remove that stain that remains with us. As the First Minister said during the debate to mark the annual 16 days of activism against gender-based violence campaign last year,

“men must take up the challenge ... about being a better guy and reflecting on our own behaviour.” —[Official Report, 5 December 2024; c 116.]

Violence against women and girls is, and always will be, an issue that the Government takes seriously. That is reflected in our partnership with the Convention of Scottish Local Authorities through “Equally Safe: Scotland’s Strategy for Preventing and Eradicating Violence Against Women and Girls”. The strategy sets out a vision of

“A strong and flourishing”

country

“where all individuals are ... safe and respected, and where women and girls live free from all forms of violence, abuse and ... the attitudes that ... perpetuate it.”

The strategy works to prevent violence

“from occurring in the first place”

and to build and sustain the capability and capacity of support services and strengthen the justice response to victims and perpetrators.

A number of members have commented on single-sex spaces for women in hospitals. Jackie Baillie is correct that, since 2005, we have expected NHS boards to ensure that their facilities comply with guidelines on the elimination of mixed-sex accommodations. In all new hospital developments, there should be a presumption that there will be 100 per cent single rooms, and where existing accommodation has been refurbished, that the figure will be as close to 100 per cent as possible.

I am just going to continue, if Tess White does not mind.

There are limited exceptions for areas such as intensive care units. Within our hospitals, a number of health boards are participating in the equally safe at work employer accreditation programme. Alongside our commitment to the equally safe strategy, NHS once for Scotland policies on gender-based violence and sexual harassment—

I am just going to continue—

I am happy to take an intervention from Claire Baker.

I thank Claire Baker for that intervention. I agree that we have to look at the data and collect more of it, which is why we are continuing to work with Healthcare Improvement Scotland to improve recording and reporting. I hope that that gives some comfort to Ms Baker.

Stopping violence against women and girls before it occurs must be central to our collective efforts. To do that, we must tackle the root cause of the problem, which—as I said—is gender inequality. Women’s inequality is both a cause and a consequence of violence against women, which is why the equally safe strategy emphasises the importance of primary prevention and focuses on the structures, systems, policies and assumptions that we live with.

In addition to working with Healthcare Improvement Scotland, we are working closely with Police Scotland on reporting of sexual crimes, and through our your safety matters partnership group.

It was ovarian cancer.

I, too, thank Carol Mochan for securing this debate on alcohol-related brain damage. I support her motion.

Like Elena Whitham, I thank everyone who supports people with ARBD. There is still a lot to do to improve lives and reduce harms caused by alcohol. ARBD can be underrecognised as a significant cause of physical, psychological and social impacts. I hope that members’ contributions to the debate will help to raise awareness of the condition and the need for closer working between services.

The provision of the support that people who are affected by ARBD require is shared across healthcare, social care, mental health, primary care and alcohol treatment services, including rehabilitation. The person who is affected must be at the centre of the support pathway across services. I saw that in action when I recently attended the official opening of the Scottish Government-funded expansion to the Maxie Richards Foundation residential rehab in Tighnabruaich. Such services—members mentioned services in other areas—play a crucial role in supporting individuals to reduce harms before they reach the level of ARBD.

Our investment of up to £38 million to add residential rehab capacity is a marker of the actions that this Government is taking to reduce alcohol harms as part of our national mission. A number of members mentioned Penumbra in Edinburgh, on which I understand that a decision will be made imminently.

The Mental Welfare Commission for Scotland published a guide on ARBD for professionals in 2019. It estimated that the condition impacts around 1.5 per cent of Scotland’s population and 30 per cent of dependent drinkers. We also know that it disproportionately affects people in our less well-off communities. The guide notes that holistic support will help to improve prevention, detection and management.

I am pleased that the guide will be supplemented by the United Kingdom’s first alcohol treatment guidance for clinicians, which the UK Government will publish soon. The guidance will cover ARBD-related clinical requirements in diagnosing and treating the condition, which Carol Mochan raised as an issue, and is being supported by a UK-wide expert group, which included Scottish representatives. A Scottish response was provided to the public consultation, and we anticipate publication in spring 2025.

ARBD is preventable. This Parliament has supported the decision to continue minimum unit pricing and to increase the minimum price from 50p to 65p per unit. Public Health Scotland’s evaluation of MUP estimated that it has saved hundreds of lives and reduced alcohol-specific hospital admissions. The increase in the minimum unit price is expected to lead to further positive impacts. However, it is not a magic bullet.

The Scottish Government and its partners are developing a population health framework, which will be published in spring. The framework will build on our preventative public health policy of recent years, with actions that seek to tackle the root causes of ill health. It is clear that alcohol harms fall unequally, and targeting the causes of ill health and health inequalities is vital to reducing alcohol harm.

As Ms Mochan will be aware, the Cabinet Secretary for Health and Social Care has announced the commissioning of Public Health Scotland to carry out a review of the evidence for the range of options that are available to the Scottish Government in relation to alcohol marketing under devolved powers.

Like Elena Whitham, I recognise the importance of cross-portfolio working and that the issue is wider than public health. Last week, I met Ms Todd and Ms Don-Innes to discuss early childhood development. One area that we covered was our commitment to increase awareness of fetal alcohol spectrum disorder, which is an issue that Rona Mackay raised. Supporting improved diagnosis is part of helping to deliver on our key priority to eliminate child poverty.

The work on FASD includes clear messaging from the chief medical officer on alcohol consumption during pregnancy, which is included in the “Ready Steady Baby!” guide and on the NHS Inform website. Education and training on FASD, as well as support for families and individuals, are now more available through our work with the Adoption UK FASD hub, which supports individuals and families, including children and young people.

The University of Edinburgh is delivering training to raise awareness among professionals. There is also support for the Aberlour Child Care Trust, which encourages mothers to regain their lives and create the best possible future for themselves and their young children.

Public Health Scotland has made recommendations on revitalising alcohol brief interventions, which have helped to deliver prevention messaging, raised awareness and helped with referrals to specialist support. To ensure that people with co-occurring mental health and substance use conditions have access to high-quality, person-centred care via joined-up services, in 2023, we published mental health core standards, which promote equality and human rights and help individuals, families and carers to understand what to expect from services. They also aim to eliminate stigma—members have raised that issue today—and discrimination in treatment for those with a dual diagnosis.

The need for services to integrate was one of the drivers of the creation of the integration authorities. The National Care Service (Scotland) Bill seeks to drive further consistency across services. Work on the bill has helped to prepare strategies for better integration by helping areas to take more holistic approaches, as both Foysol Choudhury and Alexander Stewart noted. For example, a new support and improvement framework, improved health and social care standards and a charter of rights will help to deliver the better integration that is necessary to improve support for conditions such as ARBD.

In relation to alcohol policy, some of those strategies are already being delivered through our national mission. A charter of rights on substance use, which was developed by our national collaborative of people with lived and living experience, was published in December 2024. We have committed to publish a service specification for substance use treatments and support services, which will set out what is required locally to deliver on the rights that are set out in the charter. We have also committed to follow that with service standards that will help to improve support for conditions such as ARBD. The introduction of medication assisted treatment standards is already showing some positive change, and similar standards for alcohol services will help to drive improvement there, too.

We have worked with partners to deliver successful public health campaigns on substance use stigma and on naloxone to reduce the risk of death from drug overdose. We will consider the merits of similar campaigns on ARBD, and I would be happy to meet Carol Mochan to discuss that further.

We are taking the actions that I have referred to because we recognise the need to raise awareness and further integrate services to prevent, detect and manage conditions such as ARBD. However, we need to go further. Working with partners on the implementation of the core mental health standards, the established protocol on treatment for dual diagnosis, the population health framework, support for better integration through work on the NCS and the delivery of our substance use national mission, I believe that we will be able to drive a more holistic approach to support for people who are living with or impacted by ARBD.

I re-emphasise the investment that the Scottish Government is putting in to reduce waiting times and improve diagnosis. We have been speaking directly with the two laboratories that check for diagnosis. I am very much looking forward to meeting Annie Wells and the other Opposition spokespeople for women’s health, alongside Professor Anna Glasier, at the end of April, when we can discuss the matter further.