Chamber and committees

Thank you. I might come back to that issue later.

What Elinor Jayne was just saying about stigma is interesting.

I have a question for Kira McDiarmid about mental health and how the bill might support a wider mental health approach. The Feeley report recommended that appropriate care be provided for people with complex issues around their care, such as those involving mental health and alcohol. Do you think the bill is sufficiently clear about how mental health services and support can be provided in the overall framework, and do you have any suggestions about what might need to be added?

I am also interested in the support for people with additional needs, such as those with learning difficulties. The bill talks about

“ensuring that individuals who have difficulty communicating (in relation to speech, language or otherwise) can receive information and express themselves in ways that best meet their individual needs”.

I circled the word “otherwise” and wrote “mental health and dementia”, because the bill might need to clarify what “otherwise” means. I am interested to hear your feedback on that. The language in this framework bill should allow us to move forward with a co-design process. Does some of the language in the bill need to be tweaked to widen out what words such as “otherwise” mean?

Thank you. I want to pick up on what Cathie said about self-directed support not really working. I am aware of some local authority areas where that works really well. Even in one particular local authority area, where it is the perception of my office staff that it is not working well, some folk do get really good self-directed support. During the summer recess, the minister, Kevin Stewart, visited Dumfries to hear directly from folk about the good and bad sides of self-directed support.

I am interested to know whether you think that the national care service will help to raise awareness of what self-directed support is and what it can achieve. There are some folk who get good packages. I think you are right that some folk have never heard of it while other folk really know how to access self-directed support.

One of the care home providers whom we spoke to in Dumfries, Jim Gatherum, thought that self-directed support should be available in care homes. Has anyone taken part in any discussion about that?

I have another wee question about establishing the care boards. Part of the bill covers training and the recognition of the exemplary skills that are required in order to provide care at home or in a care home. Career pathways need to be thought about, established and progressed, because we should value the carers who feel less valued. Is the bill able to create a formalised recognition of the skills that are required to be a carer?

Elinor, you said that some work can be done now, such as tackling stigma, rather than waiting for a bill. I have a meeting with Angela Constance next week to talk about education for all healthcare personnel, not just folk who work in alcohol and drugs, to tackle stigma. As Kira McDiarmid said, it is not only folk who work in mental health who need mental health training. Therefore, the work on tackling stigma will be moving forward now, but the bill has a section about training. Would that provision therefore be welcome, as it would embed that training in the bill, so that whoever takes the training forward would be responsible for ensuring that everybody gets the education that is required?

Thank you.

I have a quick question for Dr Manji, and for other witnesses if they have thought about the issue. As care boards are established, what will happen with integration joint boards and health and social care partnerships and the movement and flow of people? How would that be perceived, and how would that be implemented in practice?

The word “sufficient” is used in the bill—it mentions “sufficient breaks”. We need to consider how looking after a parent, grandparent or sibling interferes with the education of a young person. I am interested to hear your thoughts on what we need to do in order to take a relationship-centred approach to determining what “sufficient” is. There has to be an agreement with the person who is providing the care about what works for them. Henry Simmons said that people dinnae want a lot; they just want what is sufficient for them. Is more guidance on or a definition of “sufficient” needed in order to make the provisions in the bill work for unpaid carers?