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Essential Tremor (Treatment) (PE1723)
Agenda item 2 is consideration of continued petitions. I am delighted to say that we are joined by our very good supporters and petition champions, Rhoda Grant and Monica Lennon.
Rhoda Grant joins us in relation to the first continued petition, PE1723, on essential tremor treatment in Scotland. The petition, which was lodged by Mary Ramsay, calls on the Scottish Parliament to urge the Scottish Government to raise awareness of essential tremor and to support the introduction and use of a focused ultrasound scanner for treating people in Scotland who have the condition.
In her written submission, the petitioner states that the current treatment for essential tremor—deep brain stimulation—costs a minimum of £30,000, whereas the magnetic resonance-guided focused ultrasound service costs £10,000. Twenty-five patients were treated in Dundee with the MRgFUS over 18 months, with 14 of them being eligible for DBS but facing a two-and-a-half-year waiting list.
The national services division has shared that it received an updated application from the lead consultant neurologist working in NHS Tayside for a new MRI-focused ultrasound functional neurosurgery service to treat patients with essential tremor. The NHS Tayside executive leadership team advised that it was supportive in principle of the application but that a paper outlining the proposal in detail had not yet been submitted for executive approval so could not be progressed. The NSD advised that an application should be resubmitted for consideration in 2024-25.
I have to say, before I ask Rhoda Grant to speak, that I am quite sympathetic to what the petitioner said in her most recent submission. She does not put it in this way, but, as has been the case with other health-related issues, those affected being able to present evidence to the committee can sometimes be a powerful additional stimulant in our seeking to progress the aims of a petition.
Rhoda, over to you.
Mary Ramsay and others stand ready to present to the committee, and I think that that would be powerful. She has had deep brain stimulation and is not eligible for the new treatment because of that. However, others are willing to give evidence, so you would see the contrast and hear the different experiences that people have faced. It would be powerful for the committee to hear that. The petition has been running for some time, so those who gave evidence previously did so to a previous Parliament and committee. It would be good for members of this committee to hear that evidence, so I very much back Mary Ramsay’s proposal.
It is really frustrating, because we thought that we were there. We have the machine in Scotland, and there are individual patient applications to get the treatment in Scotland, but we are still stalled in relation to the treatment becoming available to all as par for the course. I do not totally understand what happened in NHS Tayside. The stage 1 application was put in, but something delayed or prevented the stage 2 application from going in. I do not understand that, given that the equipment and staff are there already.
I wonder whether the committee would write to the chief executive of NHS Tayside to find out what happened and whether it stands ready to make a substantial application at the next round, which, I understand, is next year. It might also be helpful if the committee could write again to the national services division to clarify the timescale for applications—when it would need applications—so that we are all clear as to what is required to get this as an NHS treatment in Scotland as in the rest of the United Kingdom.
Those are the two things that I recommend, and I back Mary Ramsay’s offer for her and others to give evidence to the committee, because I think that that would be really helpful.
The very actions that the committee was considering taking are the ones that you have just proposed, so thank you very much for those suggestions. Are we happy to incorporate Rhoda Grant’s suggestions in relation to NHS Tayside?
Members indicated agreement.
We will hear what NHS Tayside has to say, but we will do that on the presumption that, having heard what it has to say, we might very well seek to have the petitioner or others who have been affected by the condition give evidence to the committee, so that we have that on the record, with everyone able to see what the condition has led to and the difficulties that people have had in finding a way forward. Are colleagues content to proceed on that basis?
Members indicated agreement.
Thank you very much. You came, you asked, you got.
I hope that the rest of the day is like that. [Laughter.]
If only Government ministers were like that.
Mental Health Services (PE1871)
The second petition, PE1871, which was lodged by Karen McKeown on behalf of the shining lights for change group, calls on the Scottish Parliament to urge the Scottish Government to carry out a full review of mental health services in Scotland, including the referral process, crisis support, risk assessments, safe plans, integrated services working together, first response support and the support that is available to families affected by suicide.
Following our evidence session with the then Cabinet Secretary for Health and Social Care, the committee received additional details on the suicide prevention strategy, such as information about the outcomes framework and the reporting cycle.
Information about the mental health assessment units is provided in the submission. NHS Forth Valley, NHS Greater Glasgow and Clyde, NHS Lothian and NHS Highland have dedicated units, whereas the remaining health boards have repurposed existing services or resources to provide 24/7 access to a senior clinical decision maker. It is noted that the redesign of urgent care programme will work on improving unplanned access to urgent assessment and care to provide support quickly, at the first time of reaching out and, where possible, close to home.
The recent submission from the Minister for Social Care, Mental Wellbeing and Sport indicates that the first annual report on the suicide prevention strategy outcomes will be published in July 2024.
The petitioner has provided another written submission, which, once again, urges the committee to call for a review of mental health services. She feels that that is the only way to determine what is and is not working. She shares concerns about mental health support falling to the third sector, expressing that that is not appropriate in all cases, particularly for people in crisis. There has been some reaction from the Government in how it has moved forward with the petition’s aims.
We are joined by Monica Lennon, who has followed the petition with us through its various iterations. Is there anything that you would like to say to the committee before we consider our next move?
Good morning. I thank the committee for its on-going work. It has been helpful to see the recent responses from the Scottish Government. Unfortunately, Karen McKeown cannot be here in person today, but her plea is for the committee to keep the petition open, because, in her view and that of many of my constituents, the situation on the front line and in communities is getting worse, not better.
We all welcome the Scottish Government’s on-going interest and commitment. The strategies and frameworks are at a very high level, as they often are, and are fuelled by good intentions, but I am afraid that there is an on-going disconnect, because the resources that we need in our communities for our health services, for local government, which also has a role to play, and for the third sector are not there. The capacity is not there, training has not been kept up to date and the workforce is burnt out.
I was struck by Karen McKeown’s words in one of her submissions when she talked about the time when her partner Luke was in crisis before he died by suicide. She talked about the really hard time that she had in trying to keep him safe. We must consider the impact on family, friends and colleagues.
Luke died at the end of 2017, but, in the few years since then, we have had the pandemic and its impact on citizens in Scotland. Having come through that, people then had to deal and cope with the cost of living crisis. Our public services are on their knees like never before. There needs to be a deep dive into mental health services to understand why so many people are getting to crisis point and why, despite all the good intentions around prevention, the system is not working well enough.
Some voices that could inform that deep dive include those of people with direct experience—those who have been in crisis themselves or have lost loved ones to suicide. We need to hear more directly from those who are on the front line. With respect, I do not mean chief executives and senior people at board level; I mean the people in teams who have caseloads that would simply make your eyes water. Police Scotland also has a big story to tell. Often, when our constituents are in crisis, it is the police who are called and it is police officers in uniform who come to the door. They provide a really important service, but their being called is another sign that the system is not working.
09:45To bring it back to a human level—I am sure that this is familiar to all committee members—I point out that one life lost to suicide is, of course, one too many; we hear too many tragic stories in our own areas of people losing their life. When I go on to my local Facebook groups, I increasingly see neighbours in my community crowdfunding to cover funeral costs for people who have lost their life and have left families behind. I worry about the impact on the children and loved ones who are left behind, because so much trauma is being stored up.
Again, I pay tribute to Karen McKeown. I know from the Government submissions that it is grateful to her for lodging the petition. When the former cabinet secretary, who is now our First Minister, gave evidence to the committee—I have had discussions with him—he was very moved by not just Karen’s experience but her commitment to ensuring that we prevent suicides and prevent other families from going through that pain and suffering.
There is more work to be done. I am pleased that the Government is committed to further monitoring and to doing what it can, but the problems in the health service and society started before the pandemic. We need to have conversations that are quite often difficult to hear with people who are on the front line, working in every part of the NHS. I mentioned Police Scotland, but social workers also have important stories and solutions to share. It is not just about stories; it is about trying to find solutions. We know that, for people who experience poor mental health, there is still a lot of stigma. We know that that interfaces with substance use issues, and parliamentarians care a lot about such issues.
The petition has been on the committee’s books for quite some time, but I know that Karen McKeown and the many people and groups that she is in contact with appreciate it. As we have seen, the experience can differ across the country. We have different models of care. Those are appropriate if they meet local needs, but, too often, people feel as though they are falling through the cracks of a broken system. Basically, there is a postcode lottery across Scotland.
I thank the committee for allowing me to say a few words on behalf of Karen McKeown and my other constituents who have a deep interest in the issue.
Thank you very much. I also thank Karen McKeown—we send our best wishes to her.
We have been looking at the petition since 2021. Do colleagues have any thoughts or comments?
I wonder whether the committee would consider writing to the Minister for Social Care, Mental Wellbeing and Sport to ask how the mental health assessment units in NHS Forth Valley, NHS Greater Glasgow and Clyde, NHS Lothian and NHS Highland have been evaluated and how the lessons learned have been implemented across health boards. For comparative purposes, we could also ask the minister to set out in detail the journeys for individuals who are seeking support during a mental health crisis in areas with mental health assessment units and in areas with repurposed existing services. In particular, information could be provided about each step in the process—from seeking support to receiving the appropriate care—under both approaches.
There might come a point when, in order to advance the aims of the petition, we ask the Health, Social Care and Sport Committee to look at where the petition might go. I think that we should keep the petition open; in the first instance, write to the minister, as suggested; see what the response is; and then consider the best way forward in trying to secure the aims of the petition. Do we agree to that approach?
Members indicated agreement.
I thank Monica Lennon for her contribution.
Wind Farms (Community Shared Ownership) (PE1885)
PE1885, which was lodged by Karen Murphy, calls on the Scottish Parliament to urge the Scottish Government to make community shared ownership a mandatory requirement to be offered as part of all planning proposals for wind farm development.
We have received a response from the Scottish National Investment Bank, which states that it has been working with the Scottish Government and Local Energy Scotland while engaging with communities and developers on shared ownership. Local Energy Scotland conducted research on developer and funder appetite for shared ownership models and ways in which barriers can be overcome.
The Minister for Energy and the Environment’s submission to the committee highlights that the Scottish Government would be interested in exploring the possibilities of utilising tax powers as a lever to support wider policy objectives. In response to the minister, the petitioner notes that there is no indication of how discussions on the Scottish Government’s work will take place or how she and others might engage.
The Government has shown some interest in the issue. Members, do you have you comments and suggestions?
I have a few suggestions to make. As the clerks have helpfully suggested, perhaps we can write to the Minister for Energy and the Environment to ask whether the Scottish Government has the power to mandate community shared ownership for new wind farms, first, by using the devolved power under section 36 of the Electricity Act 1989 to lower the threshold for when an application to build a wind farm requires a minister’s consent and, secondly, by withholding consent from any application that did not agree to a community shared ownership model. That is my first suggestion.
I want to make another suggestion, or an extended comment, if I may, convener. On rereading the submissions, I note that the Scottish National Investment Bank’s submission is dated 13 March, which is a long time ago now, and that the minister provided a submission on 6 April. Both submissions were quite helpful. Both referred to the work that Local Energy Scotland is doing, to which you have alluded, saying that they expected to hear from the organisation—this is the phrase that both used—“in the coming weeks”. Weeks have come and gone—months have elapsed—since then.
I will give one example. I spoke to a wind farm developer who is proposing to develop a fairly large wind farm in the Dava area of my constituency, which is already covered with wind farms and where the populace’s view of them is mixed. Initially, the developer wanted 50 turbines but is now down to 18, mainly because the Cairngorms National Park Authority has negotiated the number down to that figure. I have long thought that a way in which community ownership can be made to work, without its being seen as a penalty on commercial companies, is that, instead of a developer proposing 18 turbines, they propose 20 or 22, with the additional two or four being community owned. In other words, the company gets what it was planning to get anyway, but, in exchange for planning permission, it is required to enable the development to be expanded so that communities can add two or four turbines. In those distant days of yore when I was the responsible minister, funding was available for that to be facilitated. Triodos Bank, Close Brothers, the Co-operative Bank and some others funded it to the tune of between 90 and 95 per cent, with the Scottish Government funding the remaining 5 to 10 per cent. That allowed communities to have a real stake of ownership. My worry is that time is passing us by. Such applications are being made all the time, and every one that is granted is a lost opportunity.
The petitioner, Karen Murphy, has pointed that out. Lots of applications for onshore wind farms are going on all the time. Therefore, I wonder whether we could ask the minister and the SNIB to show a little bit more urgency in telling us what Local Energy Scotland has said, as they promised they would do within a few weeks of their submissions but have not done, and generally knock them out of this somewhat complacent approach when the real opportunities for Scotland, which everybody sees—I do not think that this is political, convener—are passing us by. We are losing those opportunities, when we used to grab them. There is a long history to this, and I have probably gone on long enough, so I will not even go to chapter 1 of that long history, you will be relieved to hear.
That was just the prologue.
Indeed. It was the preface to the prologue. [Laughter.]
I feel very strongly that that approach could transform rural Scotland by providing not just £5,000 per megawatt, which is looking a bit jaded and out of date now, but a real ownership stake. That is when the real opportunities to transform rural Scotland will arise, by using the fund to invest in young people’s training, education and future.
I thought that making those remarks might help the minister to see that opportunity knocks but that we are in danger of the postman going on to the next house. That could happen in this case.
With that metaphor ringing in our ears—the postman never knocks twice. Is that the—
That is a different kind of movie. [Laughter.]
In which case, with that very entertaining polemic, are we content to embrace those suggestions? I quite like the idea that we encapsulate, in our further inquiries, the point about missed opportunity. This petition has been with us now since—when was it first lodged?—August 2021. Two years have gone by. Mr Ewing makes the point about applications being granted but nothing happening, which means that there have been two years of lost opportunity. There we go.
We could have done that instead of doing a few other things.
As there are no other suggestions, are we content to proceed on that basis?
Members indicated agreement.
Domestic Abuse Perpetrators (Family Court Proceedings) (PE1968)
The next petition is PE1968, which was lodged by Angela Evans. It calls on the Scottish Parliament to urge the Scottish Government to review existing legislation on family law and seek to stop perpetrators of domestic abuse causing further abuse and distress to partners and children by removing their ability to apply for contact orders under section 11 of the Children (Scotland) Act 2020.
We considered the petition at our meeting on 8 February. At that time, we agreed to write to the Scottish Government, the Law Society of Scotland, Scottish Women’s Aid, Shared Parenting Scotland and the Children and Young People’s Commissioner Scotland. Copies of the responses that we have received are in our meeting papers.
The then Minister for Victims and Community Safety’s response, which was submitted in March, provides details on the work that is under way to commence the various provisions of the Children (Scotland) Act 2020, with measures to regulate the provision of child contact centres expected to be introduced later in 2023. That minister also highlighted budgetary pressures in taking forward that work, noting that establishing a register of child welfare reporters might cost around £5 million a year.
The responses from Shared Parenting Scotland, Scottish Women’s Aid and the Children and Young People’s Commissioner Scotland all noted concern about the slow progress that is being made to implement the 2020 act, with the commissioner calling on the Government to make funding available to progress implementation. Shared Parenting Scotland suggested that more detailed statistical information on child contact cases should be recorded by the Scottish Courts and Tribunals Service in order to establish information about what happens in those cases. Scottish Women’s Aid also shared concerns that no routine data is available on courts’ practices and outcomes in disputed child contact cases in Scotland, emphasising that is not possible to monitor the implementation of children’s rights without that data.
The Law Society of Scotland’s submission notes that appropriate and sensitive procedural rules should address concerns that family courts can be a traumatising experience for victims of domestic abuse, with judicial training a vital component in ensuring that practitioners and the court can respond to the particular circumstances of each case. The response also notes the view of the child and family law sub-committee that there is already a solid framework in law that regard must be given in circumstances where there has been domestic abuse, and a full suite of powers is available to judges to deal with these matters.
Colleagues, do you have any thoughts?
Would the committee consider closing the petition under rule 15.7 of standing orders on the basis that the Children (Scotland) Act 2020 contains measures that are designed to improve the position of families that are affected by domestic abuse, with measures to regulate the provision of child contact centres expected to be introduced in 2023, and the Law Society of Scotland considers that there is already a solid framework in law that regard must be given in circumstances where there has been domestic abuse, with a full suite of powers available to judges to deal with those matters early on in the proceedings?
Obviously, 2023 is fast disappearing and nothing has materialised yet. Are we content to close the petition?
10:00
I wonder, convener, whether we can highlight to the petitioner that, if they are not happy, they could bring back the petition in a year’s time.
Yes, that would be sensible. It has been suggested that a number of things are in train and we sometimes leave open petitions just to see whether those things materialise. If we close the petition on that basis, we should make it clear that it will be possible to bring it back if they do not. Do members agree to close the petition?
Members indicated agreement.
I thank the petitioner very much for bringing the petition to our attention. The Government has promised action. We will have to see whether that action is forthcoming.
Domestic Abuse Perpetrators (Sale of Matrimonial Home) (PE1981)
The next petition is PE1981, which has been lodged by Caroline Gourlay, and continues a theme that we have just been discussing. It calls on the Scottish Parliament to urge the Scottish Government to strengthen legislation to stop perpetrators of domestic abuse who have been excluded from the matrimonial home by a court order being able to cause further trauma and distress to their victims by trying to force the sale of the property.
We previously considered the petition on 8 February, and members will note from our papers that we have received responses from the Scottish Law Commission, which indicates that the issue is one of the topics being considered as it determines the scope of review of civil remedies that are available for domestic abuse, and from Shared Parenting Scotland, which suggests that the Scottish Government could provide better public information on what communications are covered by exclusion orders. The response goes on to note that, in the case of child contact arrangements, third-party contact is likely to be in the interests of the child so long as the person or agency issuing the communication is doing it in a professional and non-threatening manner.
The Law Society of Scotland response notes that interdicts can last for lengthy periods and that there is a difficult balance to strike between the rights of a property owner and the rights of a victim of domestic abuse to be protected from their abuser. Therefore, the Law Society considers that a blanket position would not be appropriate and again stresses the importance of training for lawyers handling cases involving domestic abuse. Linked to its view on PE1968, the Law Society’s child and family law sub-committee view is that there is already a solid framework in the law that regard must be given in circumstances where there has been domestic abuse, and a full suite of powers is available to judges to deal with such matters.
I feel that we are in a similar position. Do colleagues have any suggestions?
I wonder whether the committee would consider closing the petition under rule 15.7 of standing orders on the basis that the Scottish Government has no plans to reform the Matrimonial Homes (Family Protection) (Scotland) Act 1981; the Scottish Law Commission is currently focusing on a review of the law on civil remedies for domestic abuse, with a consultation document expected in the first half of 2024; and the Law Society of Scotland considers that there is already a solid framework in the law that regard must be given in circumstances where there has been domestic abuse, with a full suite of powers available to judges to deal with such matters early on in proceedings.
I wonder whether we could also write to the Scottish Government recommending that better public information be provided on what is covered by exclusion orders and related legal communications.
Even while we close the petition?
Yes.
Fair enough. Colleagues, do we agree? Do you agree, Fergus?
I was just going to make an additional suggestion.
Of course.
I can see the logic of the replies from the Scottish Law Commission and the Law Society that this is a difficult area and that a blanket solution does not necessarily present itself. I note—this is my suggestion—that the Law Commission says that, in its 11th programme of law reform, which has not been published yet, it expects that aspects of family law, including issues relating to how family law intersects with domestic abuse and violence, should be covered between 2023 and 2027. I wonder whether it would not be indecorous or impolite for us to recommend to the commission that it perhaps tries to focus on that early on in its consideration. On the face of it, a man who carries out violence and has sole title to the matrimonial home is in a position of, if you like, benefiting from his crime to the extent of being able to sell a property—in certain circumstances anyway; interdicts might apply.
I just wonder whether members feel that we could urge the Scottish Law Commission to bring forward consideration to the early part of January 2023. This is an issue on which the commission’s advice will be essential, because it has provided family law in Scotland with a very solid base from the Family Law (Scotland) Act 1985 onwards, and that has served Scotland well. However, there are still loopholes to be filled, and I make this plea directly to the commission. If we were to write to it, I do not see that that would do any harm, and that might give the petitioner some comfort that we are not just kicking the issue into the long grass.
In closing the petition, we could make that suggestion, as Mr Ewing has recommended, together with Mr Torrance’s suggestions. Again, an important matter has been highlighted. Given that the Scottish Government has no plans to amend the legislation, this is probably the most effective route that we can recommend, and we will close the petition on that basis. Are we agreed?
Members indicated agreement.
Young People (Question Session with First Minister and Cabinet) (PE1990)
The next petition is PE1990, which was lodged by Jordon Anderson. It calls on the Scottish Parliament to urge the Scottish Government to request the introduction of a monthly chamber session to allow young people to put questions to the First Minister and the Cabinet.
In our previous consideration, we agreed to write to key stakeholders—we delegated authority to me, as convener, to agree who those stakeholders might be. The Scottish Parliament information centre has provided a list of possible stakeholders, which is in the clerk’s note. However, since the petition was last considered, the committee has published its report, “Embedding Public Participation in the Work of the Parliament”, which includes a response to the recommendations made by the citizens panel. Colleagues will recall that one of those recommendations is very similar to what the petition calls for. Recommendation 14 is to
“Schedule specific time in the debating Chamber for individual public questions to be asked.”
As members will recall, we concluded in our report that
“We do not support the recommendation for a question time which is part of formal Parliamentary business, as we think it raises too many difficulties both of practice and principle … Having said all that, we would be willing to see the idea further explored, if there is cross-party support for doing so.”
The petitioner has provided information that supports his view that young people are becoming increasingly engaged in politics and need greater representation in it. Authority was delegated to me previously, but I want to bring that back to the committee, given our inquiry into the subject matter. We could write to a number of stakeholders, as identified by the clerks: the Scottish Youth Parliament, the Children’s Parliament, the National Union of Students, Who Cares? Scotland, the Scottish Commissioner for People with Learning Disabilities, Intercultural Youth Scotland, Children in Scotland and YouthLink Scotland.
Are we content to get their views, ahead of what I understand will be a session of the Scottish Youth Parliament here, at Holyrood, potentially next year? If there is sufficient interest, that might well be a route that we could recommend as a way forward for the petition. Are we content to continue on that basis?
Given our report and the recommendations in it, could we write to stakeholders to ask specifically about alternative ways that they could engage with the Scottish Government outside parliamentary business?
Yes. That would make sense, too. Thank you.
My daughter is a member of the Scottish Youth Parliament. Can we increase the frequency with which the Scottish Parliament and the SYP hold joint sessions?
I do not think that we have ever held a joint session. The Scottish Parliament has provided its campus for the Scottish Youth Parliament to meet. The policy has been that that happens once in each session of the Scottish Parliament, I think. Are you suggesting that we write to the Scottish Parliamentary Corporate Body, to ask whether it would—?
Yes, to ask the SPCB to consider holding joint sessions. That would give—
Has the Scottish Youth Parliament made that request itself?
I have had a few meetings with youth parliamentarians and they have suggested that they want more engagement with MSPs.
Could we write to the corporate body to draw its attention to the petition? We could say that the committee would be interested to know whether the corporate body has had any engagement with the Scottish Youth Parliament as to whether it might be possible to facilitate more regular sessions of the SYP in Holyrood. Are members content to do that?
Members indicated agreement.
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