Seòmar agus comataidhean

I wonder what your thoughts are on section 7, which places a duty on registered medical practitioners, during the first declaration, to discuss palliative care and any other care that might be available to that individual. That would allow the individual to make an informed decision about any palliative care plans or future care planning that could be made. That is a safeguard; that will be discussed at that point. However, if you were to tie that to eligibility criteria, that person would not have the autonomy to say, for example, that they did not want those plans to be made. Indeed, when timeframes are really short, that might preclude somebody from accessing the supports that are available under the bill.

I want to spend a little time looking at the definitions. We have touched on that aspect quite a few times this morning, but it would be helpful if we had an understanding of where each witness sits on them. I will start with the definition of “sustainable development”. Section 2 of the bill gives a definition that was inspired by the 1987 report “Our Common Future”. It states:

“‘Sustainable development’ is development that improves wellbeing in the present without compromising the wellbeing of future generations.”

Kristers Lukins touched on the Scottish Youth Parliament’s work to look at what sustainable development means to young people, and I will give him an opportunity to come back in. First, however, I want to hear from the other witnesses about what they feel about the definition of “sustainable development” as set out in the bill. Perhaps Frances Guy can start.

Lloyd, do you want to comment from a Scottish Environment LINK perspective?

That is very helpful. I had a question about how we could make the bill stronger to show that we have to pay due regard to planetary boundaries and environmental limits and to make that explicit link. Kristers and Skye, from the perspective of the Scottish Youth Parliament, is that something that you thought about when you worked through this with MSYPs? Did you consider how we could make the links between wellbeing and sustainable development and the planet?

Thanks for that.

Frances, you started the evidence session by speaking about the need for human rights in this regard and about the UN sustainable development goals. Does the bill present an opportunity to weave a thread through all those things to achieve real coherence with regard to how we conduct ourselves, before future generations have to deal with what we have perhaps not dealt with?

That is helpful. Perhaps Adam Milne would like to comment from a Carnegie perspective.

I would like to spend a wee bit of time thinking about data. This morning, we have heard a lot about data gaps and the work that is being done to understand those in every local area. I understand the robustness of the child and adolescent mental health services waiting times data and how that is assessed and presented by Public Health Scotland. I am interested in understanding—and I think that the committee would benefit from understanding—the impact that the national specification implementation and the focus on CAMHS waiting times has on neurodevelopmental waiting lists and what that looks like at the local level. That is very different from the CAMHS waiting lists as we understand them. It would be helpful if you could set out for us, as you understand it, what impact that has had on CAMHS neuro waiting lists.

Where it becomes tricky for individuals at a local level is the fact that, for some people, it will be CAMHS that does the assessments once they get there. That feels a bit confusing. It will be confusing for someone whose child has come off the list that it is perhaps still CAMHS that eventually delivers that service.

My final question on data is on whether the Scottish Government would commit not only to collecting and publishing data on neurodevelopmental waiting times but to understanding the need in that respect. I am thinking of missing data sets such as gendered data and information on co-occurring conditions that it might be useful for, say, a GP to understand. They might have a patient who has been diagnosed as being autistic or as having ADHD, so they might ask, “What other things should I, as their general practitioner, be looking at? What other conditions are they presenting with?”

It is all about understanding what data we do not have. For example, we do not publish sex-disaggregated data in this space, and I think that we really need to start looking at that. Is the Scottish Government looking at that data issue as something that the task force could address?

Good morning, minister and your officials.

I want to explore that area a bit further—I thank Patrick Harvie for starting us off. I am thinking specifically about an individual constituent of mine: a young person who has had no access to any waiting list, despite repeated referrals by his GP. He finds himself in a situation in which he does not have the co-occurring mental health issues that are required in order to access, in Ayrshire and Arran, the services that are set out in the national specification. His family have the means to seek a private diagnosis, but his local GP practice has a blanket ban on undertaking any such shared care arrangements.

How does the Government envisage a system in which that type of situation can be addressed in a way that I think the Royal College of Psychiatrists has set out in its paper, which talks about the fact that no one agency or model will be able to do all the work that we need it to do? In some situations, we have seemingly blanket bans in GP practices not to undertake any shared care. That is not based on an individual or clinical assessment of the patient—the practice is just not entertaining that, yet the patient is not meeting the practice’s referral thresholds to get on to a list. That leaves some young people who are essentially hidden in the system and whose needs are not being met. How do we address that type of situation?