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I welcome the fact that people in Scotland are living longer, but they are not always living in good health for longer. In East Ayrshire in my South Scotland region, the total burden of disease is estimated to have increased by 2.6 per cent between 2016 and 2019. Will the Government provide an update on the targeted work that it is doing to promote healthy living across Scotland, particularly in our more deprived communities?

I thank Rona Mackay for bringing this debate to the chamber. As others have said, it is a historic first debate about the condition. I also welcome the visitors to the gallery, many of whom I met this afternoon. I want to give a special mention to Eileen Smith, who Rona Mackay mentioned, because we worked together almost 20 years ago. Eileen was a physiotherapist and, like many of our NHS staff, she gave her absolute all to support the clients we worked with, and it was a great privilege to work alongside her.

I thank all the visitors from Chest Heart & Stroke Scotland for meeting me and for the opportunity to hear their stories and to gain an understanding of some of the difficulties that they and their loved ones face. The people we meet in this place often shape us, and I found this meet-up useful in helping me to discuss policy in this area, and it was also heart-warming to be able to meet people who are so passionate about the issues that they wish to raise with us as MSPs.

Of course, I had prepared a speech for this debate, but I think that it is probably far more beneficial to share some of the information that was shared with me earlier today. I will use some of the language and the words that people used with me.

What do sufferers and their families want? As with so many of our constituents, they are not asking for too much at all. They want the condition to be understood, for parliamentarians to find ways to encourage understanding and patience, as Emma Harper said, and to support training in our businesses, the public sector and the wider community. They want people to understand that individuals with aphasia are not stupid or unable but just need some time to find the words.

As others have said, aphasia is a language and speech disorder that happens when the language centres of the brain are damaged. It is a long-term and life-changing condition—that is what many people shared with me today. It is mostly a disorder of older adults, and stroke is the major cause of adult aphasia, but it can also arise from brain injury or neurological disease.

When I worked in the health service, much of my experience involved working with people experiencing degenerative neurological conditions. In that role, I understood the power of language, the need for people to be understood and how speech, language and communication are the cornerstone of many of our interactions as human beings. Language and communication are crucial because they are the foundation of learning, they are key to relationships and relationship building and they help us to understand the world around us, particularly the shared world. They enable us to share ideas, build connections, develop empathy and succeed in our lives, whether that is in education, at work or in our social lives.

I absolutely agree with the member. I always take every opportunity to promote training, particularly from allied health professionals—Eileen Smith and I were in that category.

The loss of language has a significant impact on a person’s life, but this evening it is important to mention the impact on family members’ lives. It can be very difficult to watch someone not be able to find the words or to see another person question their intelligence or ability.

Others have highlighted the issues that we hope that the minister will respond to, so I will finish on a point that I often raise in the chamber, which is health inequalities. Research has shown that people who live in Scotland’s most deprived areas are more likely to die in their first year following a stroke than those in the less deprived areas, and that they are much less likely to receive the appropriate recommended treatments. I do not have time to go over that, but it is an important point to raise, and I hope that others will agree with me on it.

I thank members for their speeches and Rona Mackay for bringing the issue to the chamber.

Thank you.

Welcome to the committee, Andrew. Advice Direct Scotland currently operates across a range of subject areas. I am interested to know what experience Advice Direct Scotland has in providing advocacy services. If you have to adapt your ways of working to deliver this service, how might you do that?

That is helpful. At £3.2 million, the contract value is lower than the previous one. Have you got a plan in place to ensure that the lower value will not mean that the service will go down? Will you be able to continue to support the same number of people with the same high-quality service?

I offer my thanks to the committee for all the important work that it carried out before publishing the report. On behalf of Scottish Labour, I welcome the report’s findings and, of course, the opportunity to speak today and contribute to the discussion on how the committee’s report can be used to build on the 2015 act and the national plan.

I welcome the 2015 act’s positive impacts on BSL users, including increased representation and visibility of BSL, as we have talked about. The 2015 act has clearly been a momentous step forward in empowering users, strengthening provision and supporting BSL users to speak up for their rights. I note the points made about the language of BSL, and I thank Karen Adam for her response on important points about language and culture.

Developments over the past decade should be welcomed as we take the next step in considering what further improvements can be made in the short and long term to support BSL users. As was made clear from the committee’s inquiry, despite examples of positive work, much more is required to improve user experience, and I welcome the fact that the Government has recognised that.

One of the main themes in the report is the concern about gaps in the implementation and enforceability of the 2015 act, which is an important issue that we should explore. Following the ALLIANCE’s analysis of the second round of BSL plans from all listed local authorities, it was disappointing to hear that only 72 per cent of authorities published plans, and only 62 per cent met their statutory duty that requires that the plans be published in BSL. That is a failing by the local authorities—the step that they should be taking is quite clear.

I understand that the Scottish Government does not have a regulatory function under the 2015 act, but we should have serious concerns about the fact that we have passed legislation that is not being complied with or properly monitored. We must have a discussion in the Parliament about how we can help with that important matter.

I hope that the Scottish Government can set out what further action it will take to ensure that any legislation, including the statutory duty placed on listed local authorities, is complied with and that consideration is given to how best to support authorities to fulfil legislative requirements. As a Parliament, we should think about how we can support local authorities. I am sure that the action plans that the Deputy First Minister set out will help with that.

People who live in rural areas face a particular disadvantage when it comes to accessing services, due to a shortage of interpreters. In those communities, getting an interpreter can often involve travel over really long distances as there might not be suitably qualified people in the local area. Pam Gosal made the point that, in certain circumstances, BSL users often want to have some relationship with the person they are speaking to.

I recognise the challenges that local authorities face, particularly in rural areas. However, living in remote and rural communities should never be a barrier to accessing the care and services that people need; everybody should have equal access to those services across Scotland. We need to do much more work to make sure that people are trained in providing them.

We know that living in a remote and rural area can also increase feelings of isolation and loneliness. Will the Government outline any work that is being done to support the key roles of groups and facilities such as deaf clubs, which aim to bring communities together, and to ensure that all people feel supported and included? I know that it can be difficult in my area to secure premises, to get people together—because of issues with transport—and to make sure that people know that such facilities are available.

I would like to address many areas of the committee’s report, including those on the challenges around early years provision and equal access to education. Others have mentioned—and constituents have spoken to me about—how difficult it is to enter early years provision and then move into primary and then secondary education.

I thank Martin Whitfield for that intervention. I was going to make that point.

I thank Daniel Johnson for bringing this important debate to the chamber. Working with other members across parties, Daniel Johnson has been a real champion in the Parliament for people with autism, ADHD and other neurodevelopmental conditions.

The report adds to the growing body of evidence that change is needed to our approach to assessment, diagnosis and support for neurodivergence in Scotland. Members might be aware that, earlier this year, the Health, Social Care and Sport Committee conducted an inquiry that gave people and families who have experienced neurodevelopmental services the opportunity to share those experiences and recommend changes to ensure that we can better serve our neurodiverse constituents. I look forward to the report being published. It was an important inquiry and many lessons were learned, so I hope that the report will reflect that and will be useful in adding to other on-going work in the area.

The royal college report rightly points out that, despite the dramatic rise in need, Scotland still lacks a dedicated and standardised pathway. It goes on to say that, in the absence of appropriate services, individuals are being referred into general adult mental health pathways, not because they have a mental illness but because there is no suitable alternative. The report points out that those services have never been designed to assess or support people with those conditions and they have just become a catch-all for those referrals.

That structural mismatch is now overwhelming the system. Waiting lists have grown to unmanageable levels. It is therefore important that issue is addressed.

I think that members will recognise what the report is saying, and I want to raise the voices of my constituents, because the frustration of people and families cannot be overstated.

Over the four years that I have been in Parliament—I have said this before—the most frequent requests that I have got in casework have often been very simple. Constituents ask, “Please can you help me understand?”, whether it is to do with waiting lists or service provision for people with autism, ADHD or neurodivergence. They ask, “Can you help me?” with primary school or secondary school, or as children move between primary, secondary and further education, when families often find themselves in conflict.

I thank the member for that important intervention; I have had that issue raised with me in casework.

I believe that colleagues in the chamber have heard very similar requests from constituents. More recently, I have heard about the use of the private sector for assessment, which can be incredibly stressful, as other members have mentioned. Many children—and, as we now know, adults—are seeking private assessment after having made many attempts to get an assessment through the national health service. The long NHS waiting lists and the lack of service mean that exhausted families are often using much of their own money and resources to get a diagnosis. That is very stressful, and even after they do that, there is no clear pathway for them.

Many of us in the chamber have heard about how poorly co-ordinated shared care is. That has been mentioned today, so I will not go over it again. However, I note that families are often rejected not just for medication, but by GPs and CAMH services. A constituent raised with me a similar situation in our education system. Parents seek a diagnosis, and then, within the education system, children are denied community services such as occupational therapy or speech and language therapy because their private diagnosis does not link in with the school’s way of recording and reporting, and supporting people.

Parents report to me that they feel that public services—health services, social care, education and criminal justice—lack a basic understanding on the front line. That is an important point, and I will finish on it. The resources are often there, at what has been described to me as quite a high level, but the question is how we enable the front-line teams to pick up on the issues.

I would have liked to say more, Deputy Presiding Officer, but I appreciate the time.