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The Official Report is a written record of public meetings of the Parliament and committees.
All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
All Official Reports of public meetings of committees.
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Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
So, what spend has been postponed—I think that that was the expression used in the letter to the Finance and Public Administration Committee—from the mental health transformation fund?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
Is there not a bit of an implementation gap? The Government’s stated position is that it will increase mental health funding by 25 per cent and that 10 per cent of all NHS front-line spending will be on mental health, but things seem to be going backwards, not forwards, on both fronts.
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
We will get on to data and evidence shortly.
One of the clear recommendations of the report that we are discussing concerns the fact that there is a great inequality in the impact of mental ill health. In one of the evidence sessions, we considered the impact on the minority ethnic community and other marginalised groups. Will taking money out of the mental health services budget not also have a disproportionately unequal impact on the communities that are most marginalised and probably most dependent on mental health services?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
There is a joint Convention of Scottish Local Authorities-Scottish Government mental health and wellbeing strategy that refers to the specific needs of minority ethnic groups. However, during the course of our inquires, we have been told that there is no action in the accompanying delivery plan to provide culturally sensitive mental health services. Can you explain why that is?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
Those groups have said to us that a plan does not exist.
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
On that point, how do you respond to the evidence that we were given by Dr Srireddy from the Royal College of Psychiatrists in Scotland, who said:
“We made the shift, we shut the asylums and we have moved into the community—but then we kind of lost interest.”—[Official Report, Public Audit Committee, 16 November 2023; c 18.]
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
The Royal College told us about the reliance on locums and other members are going to ask about the workforce plan.
Dr Srireddy also said that governance has been a real challenge and spoke of fragmentation. You may not agree, but his view and his members’ perspective was that mental health was, in his words, an “afterthought”.
We also have a pretty clear message in the report from the Auditor General and the Accounts Commission, in which key message 3 says:
“The system is fragmented, and accountability is complex, with multiple bodies involved in funding and providing mental health services. This causes complications and delays in developing services that focus on individuals’ needs.”
Those are quite serious charges. How do you respond to those?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
Without batting in defence of homogeneity, we are looking for a bit of consistency, and there seems to be a very mixed picture across the country. That is why, as a committee, we wonder whether you have thought about some of the evidence that we took, in which there was a concern about the legal framework that integration joint boards, for example, operate in. Are you considering reviewing the governance arrangements to see whether they can be simplified, be made more effective, provide better value for money and be more accessible to the people who need the services?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
Is the Government looking at primary legislation or at making changes to the oversight and delivery model?
Public Audit Committee
Section 23 Report: “Adult mental health”
Meeting date: 14 December 2023
Richard Leonard
This goes back to at least 2018; I remember raising the matter in Parliament back in the spring of 2018. The last time I spoke to families with lived experience, they were still perplexed, at best, that insufficient progress appears to have been made and that people are still not getting access to the services that they need. Do you recognise that picture?
