HOLYROOD’s Health, Social Care and Sport Committee is seeking views on a Bill which would enshrine the rights of persons addicted to drugs or alcohol to receive treatment for their addiction.
The Right to Addiction Recovery (Scotland) Bill was introduced in the Scottish Parliament on 15 May 2024 by Douglas Ross MSP.
The Bill would provide people who have been diagnosed by a health professional as addicted to either alcohol or drugs, or both, to be provided with treatment. Those diagnosed would have a say in what treatment they receive and the treatment would be made available to them within three weeks of treatment diagnosis.
If a health professional decided no treatment is appropriate, or that the treatment which the person wants is not appropriate, then they must inform the individual in writing why this is the case.
Individuals could seek a second opinion from a different health professional if they did not agree with the original decision.
Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said: “The tragic impact of alcohol and drug addiction is clear and is an issue this Committee takes extremely seriously.
“We’re keen to hear views on whether people agree with the purpose and extent of the Bill and whether it will help those facing drug and alcohol addiction. We want to know what the key advantages and/or disadvantages are of placing this right to receive treatment, for people with drug and alcohol addiction, in law.
“We also want to hear views on the proposed procedure for determining treatment, and timescales for providing treatment.
“We want to hear from individuals, charities and support groups who work in this area, health organisations, local and national government, the legal sector and academics. We look forward to hearing your views.”
The Health, Social Care and Sport Committee is calling on the Scottish Government to take urgent action to address the specific challenges faced by remote and rural communities in accessing and delivering healthcare services.
The Committee’s inquiry has found that recruitment and retention of staff is one of the key challenges to effective delivery of services in remote and rural areas. The report highlights the availability and affordability of housing, and access to education and training as significant barriers to recruiting and retaining staff.
The Committee is calling on decision-makers to recognise the extent to which a lack of available and affordable housing is acting as an indirect barrier to healthcare provision in remote and rural areas of Scotland, by making it very challenging for healthcare workers to locate themselves within the communities they wish to serve. It calls on relevant NHS Boards, local authorities, professional bodies, trade unions and other key stakeholders to work together to find practical solutions to these problems.
Another barrier highlighted in the report is the lack of locally available training and development opportunities for staff. The Committee is calling on the Scottish Government and the new National Centre for Remote and Rural Health and Care to set out how they will improve the availability and suitability of local training and development opportunities.
Difficulties with accessing healthcare services in remote and rural areas were repeatedly raised during the Committee’s evidence gathering. These include practical challenges for patients attending in-person appointments and the often substantial additional travel and accommodation costs, which the Committee say must be addressed.
The Committee highlights significant variations in policy on reimbursement of patient travel costs, depending where an individual lives and whether or not they are in receipt of benefits. It calls for a fairer and more consistent policy for reimbursement of travel and accommodation costs to be developed.
The importance of technology and digital infrastructure in facilitating access to healthcare in remote and rural areas was also raised repeatedly during the Committee’s evidence gathering.
While recognising that some will continue to prefer face-to-face appointments, the Committee is calling on the Scottish Government to set out the specific actions it is taking, or that may be required at UK Government level, to improve digital access to healthcare services in remote and rural areas.
The Committee commends existing good practice in the provision of remote and rural healthcare services, including that demonstrated by third sector organisations. However, it concludes that more action is needed to ensure this good practice is more consistently and widely shared across different organisations and areas.
Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said:“Our inquiry has shone a light on the unique challenges facing remote and rural healthcare services, both for those accessing and those delivering those services.
“The evidence suggests that often healthcare policy is developed as ‘one size fits all’, which fails to address the particular needs of remote and rural communities.
“We want to see a whole system approach which designs services in a way that is more flexible and responsive to local needs – while systematically learning from the good practice that is out there.
“We believe that developing a tailored approach to healthcare service delivery that reflects local challenges and circumstances should be an overarching priority of the new National Centre for Remote and Rural Health and Care.
“We also look forward to the forthcoming publication of the Scottish Government’s Remote and Rural Workforce Recruitment Strategy and how this strategy will address some of the workforce-related issues our report highlights.
“The voices of people who live in remote and rural areas and work or receive care in these settings have been at the centre of our inquiry and we thank them for their vital contribution to this report.”
Other findings in the report include:
The evidence gathered by the Committee suggests that the current NRAC funding formula fails to meet the specific needs of remote and rural areas. The Committee reiterates previous calls for this formula to be reformed to take better account of the specific challenges and associated higher costs of healthcare delivery in those areas, which include an ageing population, depopulation, and the greater requirement for small scale service delivery.
The Committee says it has heard extensive evidence of the specific challenges associated with implementing the 2018 General Medical Services (GMS) contract in remote and rural GP practices, in particular the practical challenges associated with trying to develop multi-disciplinary teams. The Committee is calling on the Scottish Government to explore the extent to which a revised, more flexible approach to implementation of the contract, specifically in remote and rural settings, might help to improve the sustainability of these services.
The Committee highlights evidence of acute pressures on the provision of social, palliative and end of life care services in remote and rural areas and warns that the tendency of an ageing population increasingly living in more remote and rural areas of the country will mean demand for these services will increase significantly in the years ahead.
A new report by the Health, Social Care and Sport Committee has found that implementation of the Social Care (Self-directed Support) (Scotland) Act 2013 has been hampered by a range of factors.
The legislation was introduced to ensure that care and support is arranged, managed, and delivered in a way that supports choice and control for individuals. Although the Committee has heard that Self-Directed Support (SDS) has been implemented well and is transformational for individuals in some areas, the report highlights a number of challenges that have meant the legislation is not always implemented in a fair and equitable way across the country.
The Committee say that restrictions on available providers, how services are commissioned and procured, and the financial systems and models of care currently in place mean that, in many parts of the country, SDS has not been delivered in the way intended by the legislation.
The post-legislative scrutiny report concludes that a lack of knowledge and understanding of the principles of the Act among key staff is also limiting effective implementation of SDS. The Committee says social workers face a number of constraints which prevent them from taking a relationship-based approach to their work in a way that would enable them to fully implement the principles of SDS.
Other issues highlighted by the Committee include inconsistent application of eligibility criteria by Health and Social Care Partnerships. The Committee concludes that, in many instances, the way current eligibility criteria are applied contradicts the aims and principles of SDS.
While the Committee heard examples of good practice from certain local authority areas, which are offering those in receipt of care more choice using a range of different collaborative initiatives, they say there have been challenges in applying this good practice across the country.
The Committee also concludes that there is an urgent need to establish a process of national oversight and clear lines of accountability across all levels of decision-making to ensure a significantly improved approach to monitoring and evaluation of SDS.
On the report’s publication, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said:“While it’s clear from our evidence that stakeholders strongly support this legislation, its implementation has not been consistent across the country.
“During our scrutiny, the Committee has heard that there is a lack of national consistency in relation to information, advice and support to ensure fair and equitable access to social care through SDS.
“We also have concerns over recruitment and retention of the social care and social work workforce, the continued impact of Covid-19 and wider funding constraints across the social care system that are affecting proper implementation of the Act.
“Our conclusion is that the current underlying system of social care delivery based on individual assessment, eligibility and transactional care contracts is incompatible with the principles of SDS.
“The Social Care (Self-directed Support) Act was introduced ten years ago with the intention of empowering individuals to have greater choice and control over the care they receive. However, in too many cases, the principles of SDS are not being observed, meaning individuals are not receiving the care they want or deserve.
“We are calling on the Scottish Government, Local Authorities and Health and Social Care Partnerships to ensure proper implementation of the legislation through greater national consistency, by improving local authority practice and processes, addressing issues around commissioning and tendering, and significantly improving processes for ongoing monitoring and evaluation of the policy.
“We would like to thank all of those who contributed to our post-legislative scrutiny of SDS.”
A Holyrood Committee is seeking views on substantial amendments the Scottish Government is proposing to make to the National Care Service (Scotland) Bill.
The Health, Social Care and Sport Committee backed the Bill at Stage 1 (by a majority) but made clear they would seek to carry out detailed further scrutiny of the proposals at Stage 2. This followed the conclusion of a consensus agreement between COSLA and the Scottish Government on shared legal accountability for governance of the proposed National Care Service, which the Scottish Government had indicated would require the Bill to be substantially amended.
Maree Todd, Minister for Social Care, Mental Wellbeing and Sport, has now provided the Committee with draft Scottish Government amendments to the Bill and the Committee is keen to find out views on these proposed amendments, ahead of formal Stage 2 proceedings.
One of the key proposed changes to the Bill which the Committee is seeking views on is the creation of a National Care Service Board which would be responsible for national oversight and improvement of social care and social work services.
The Committee is also seeking views on a newly proposed ‘National Care Service strategy’ and substantial reform of integration authorities via amendment of the Public Bodies (Joint Working) (Scotland) Act 2014.
In a letter to the Committee, the Minister outlines four areas where she says, ‘further work is needed to confirm which legislative approach would best deliver the intended changes.’ These include direct funding, the inclusion of children’s services, the inclusion of justice social work and Anne’s Law, and the Committee is asking for views on each of these areas.
Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said:“When a majority of our Committee backed the general principles of this Bill, we made clear we would need to carry out detailed further scrutiny at Stage 2.
“Now the Government has provided a package of proposed draft amendments, we are determined to make sure stakeholder organisations and the public are given an opportunity to comment on these proposed changes.
“Since this Bill was first introduced as a ‘framework Bill’, many of the original proposals have changed. These amendments represent some quite fundamental changes, including the introduction of a National Care Service Board and far-reaching reforms to integration authorities through amendment of the 2014 Public Bodies Act.
“That’s why it’s essential our Committee takes the time to scrutinise these proposals effectively. After we have considered the views received, we intend to take further oral evidence before formal Stage 2 proceedings.
“The evidence we gather will be vital to aid our Committee’s scrutiny of these proposals, and to inform individual Members as they prepare their own Stage 2 amendments to the Bill. We look forward to hearing your views.”
The call for views is open until Friday 30 August 2024.
After carefully considering views from a broad cross-section of stakeholders, the Scottish Parliament’s Health, Social Care and Sport Committee has agreed to the general principles of the Abortion Services (Safe Access Zones) (Scotland) Bill.
The recommendation comes as part of the Committee’s Stage 1 report. The Committee say the evidence it has gathered has led it to conclude that the creation of safe access zones around abortion services are necessary to protect women’s rights so they can access healthcare services without experiencing harassment and undue influence.
At the same time, the report acknowledges evidence on the potential impact the Bill will have in restricting the human rights of those who engage in anti-abortion activity outside abortion services. The Committee says it recognises the right to protest and private thought are cornerstones of a free democracy, but concludes that the restrictions on human rights imposed by the Bill are proportionate to achieving its aims.
The report highlights a difference in views amongst the Committee on the issue of silent prayer. It says it could be difficult for the police to decide whether a law has been broken by people silently praying and that this issue requires further consideration.
The Committee stress that the Bill’s implementation needs to be subject to ongoing post-legislative review to ensure that these restrictions continue to be proportionate and kept to a necessary minimum, as well as being subject to continuing parliamentary scrutiny. The Committee has made several recommendations to strengthen the Bill to ensure the provisions reflect this and said any future changes to safe access zones should be subject to additional human rights considerations.
The Committee also say it is vital that individual cases are assessed according to their particular circumstances and that how the legislation is enforced will have a critical role to play in ensuring its appropriate implementation.
Speaking on the publication of the report, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said: “Our Committee is united in backing the Abortion Services (Safe Access Zones) (Scotland) Bill.
“We recognise the strong views it has generated and that not all are in favour of its introduction. But ultimately we believe the creation of safe access zones around abortion services is necessary to enforce the principle that everyone should be able to access healthcare free from intimidation or harassment.
“We understand there are competing human rights at play but we have concluded this Bill strikes an appropriate balance.
“We held extensive discussions on the issue of silent prayer and while some Members felt this should be exempt from the provisions in the Bill, other Members felt an exemption would fundamentally undermine its purpose and that silent prayer can be intimidating to those accessing services. This will need further consideration if the Bill proceeds to Stage 2.
“We’d like to thank all who shared their views with us and helped inform our recommendations.”
Some of the other key conclusions in the report include:
The Committee has concluded that, due to the very clear and narrowly defined scope of the current Bill, there is no potential for its provisions to be applied more widely to anything other than abortion services.
The Committee seeks further explanation as to why the default radius of safe access zones has been set at 200m when evidence suggests a radius of 150m would be sufficient for all but one protected premises currently providing abortion services in Scotland.
The Committee say they are satisfied that the penalties in the Bill are appropriate and proportionate to achieving the aims of the Bill.
The Committee has called on the Scottish Government to put in place the necessary funds for Police Scotland to develop and deliver specialist training on the enforcement of offences created by the Bill, and that the financial memorandum be updated to reflect that commitment.
However, they highlight a number of concerns in their report and say their support remains conditional on the Scottish Government addressing these concerns and agreeing to facilitate significant further scrutiny of the Bill at Stage 2, ahead of formal Stage 2 proceedings.
A majority of the Committee say they recognise the need for wide-ranging reform of social care; to address existing inconsistencies in access and delivery across local authorities, address ongoing workforce challenges, improve commissioning and procurement, and most importantly, improve outcomes for those in receipt of social care.
However, the Committee’s detailed 183-page Stage 1 report highlights a series of concerns with the proposals and the process, and calls on the Scottish Government to take a number of actions ahead of stage 2.
Committee concerns include the Scottish Government’s inability to articulate and communicate a model of how the proposed National Care Service would operate. The Committee say they are looking forward to receiving further detail from the Scottish Government on this ahead of the Stage 1 debate next week.
Following the Scottish Government’s announcements that they plan to revise the original proposals, and the partnership agreement reached between the Scottish Government, local government and the NHS in summer 2023, the Committee say they are seeking further details of amendments which the Scottish Government intends to bring forward to clarify its revised proposals.
The Committee say they understand that this is a ‘framework Bill’ but describe the lack of detail at this stage on what that framework will look like as concerning, arguing that this has limited the Committee’s ability to scrutinise the proposals effectively.
Prior to Stage 2, the Committee is calling on the Scottish Government to explore the possibility of establishing an expert legislative advisory group for the Bill to help guide the proposed co-design process.
Assurances are also sought that a full list of Stage 2 amendments will be made available to the Committee as soon as possible and well in advance of formal Stage 2 proceedings to allow for significant further scrutiny.
The Committee has also given due notice to the Scottish Government that it will require additional time to take further oral and written evidence from key stakeholders on the content of these amendments, prior to commencing the formal Stage 2 process.
In the report, the Committee concludes: ‘Subject to these conditions, the Committee recommends that the general principles of the Bill be agreed to.’
Speaking on the publication of the report, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said:“A majority of our Committee welcomes the intentions underlying the Scottish Government’s proposals for the creation of a National Care Service.
“Our Stage 1 scrutiny has undoubtedly been affected by changes to the original proposals, meaning we will have to reserve final judgement until we have had an opportunity to scrutinise the detail of those changes as part of a reinforced Stage 2 process.
“We welcome the Scottish Government taking on board the views and concerns of stakeholders and its plan to revise the original proposals, but it is essential details of these revised proposals are shared with the Committee in a timely manner and sufficient time is allowed for the Committee to undertake substantial further scrutiny ahead of formal Stage 2 proceedings.
“It is on this basis that that a majority of our committee has concluded that it recommends that the Parliament should agree to the general principles of the Bill.”
“We’d like to thank all who have engaged with us during this process. Their insight and knowledge have been invaluable in helping us to consider and scrutinise the Scottish Government’s proposals.”
members of the Health, Social Care & Sport Committee meet with Coalition of Care and Support Providers in Scotland National Care Service Committee at Key in Glasgow. 05 December 2022. Pic-Andrew Cowan/Scottish Parliament
Some of the other key conclusions in the report include:
While acknowledging the Scottish Government’s intention to utilise co-design as a key mechanism for developing the proposed National Care Service once the framework legislation is in place, the Committee has heard evidence from multiple stakeholders that there appears to be an ongoing lack of clarity regarding the definition, the precise scope and key areas of focus of codesign or the anticipated outcomes of the co-design process.
The Committee calls on the Scottish Government to acknowledge concerns from many stakeholders that the consensus agreement between it and COSLA and the way in which this was arrived at has undermined the confidence of many of those who have participated in co-design so far that their input is being taken seriously.
It remains unclear to the Committee at this stage whether the Scottish Government intends to transfer those powers currently conferred on Scottish Ministers under Chapter 4 to the newly proposed National Care Service Board. Nonetheless, the Committee’s report highlights widespread concerns it has heard during its scrutiny of the Bill regarding the nature and extent of those powers.
The Committee welcomes confirmation from the Scottish Government that, under the new consensus agreement with COSLA, local government will retain control of functions, staff and assets following concerns raised by multiple stakeholders.
The Committee believes that a single electronic health and care record is fundamental to the success of the proposed National Care Service and calls on the Scottish Government to complete this as a matter of urgency.
The Committee welcomes indications from the Scottish Government that, as a consequence of the consensus agreement with COSLA, rather than being transferred to Scottish Ministers, legal accountability for the proposed National Care Service will be shared between the Scottish Government and local government.
The Committee says the Scottish Government should mandate a review of the regulation-making powers of the Bill and of any regulations made using these powers, within 3 years of each of the corresponding provisions coming into effect.
The Committee welcomes the commitment to Anne’s Law and considers it should be fully implemented as soon as possible to ensure a human rights-based approach to care.
Members of the Health, Social Care & Sport Committee meet hold a committee meeting focusing on the National Care Service Bill in the Quarriers Centre, Govan, Glasgow. 05 December 2022. Pic-Andrew Cowan/Scottish Parliament
For info:Dissent
Tess White MSP and Sandesh Gulhane MSP dissented from many of the recommendations in the report. More details of this dissent can be found in the report.
Paul Sweeney MSP and Carol Mochan MSP dissented from certain of the Committee’s concluding recommendations on the general principles of the Bill. More details of this dissent can be found in the report.
Alternative wording of a number of the report’s concluding recommendations on the general principles of the Bill were also proposed by certain Members of the Committee. These were all rejected in votes by a majority of Committee Members.
An inquiry seeking to find out the key issues facing healthcare services in Scotland’s remote and rural areas has been launched by the Health, Social Care and Sport Committee.
The Committee wants to hear from members of the public and staff about their experiences of remote and rural healthcare services. They are keen to find out what specific challenges people in these areas face and what can be done to improve services in these areas.
National Records of Scotland data has revealed that the areas with the greatest population growth over the last decade were accessible rural areas. 10.6% more people lived in these areas in mid-2021 than in mid-2011.
Rural areas also tend to have specific demographic challenges when it comes to demand for healthcare, with often a lower proportion of people aged 16 to 44 but a higher proportion of people aged 45 and over (particularly those 65 and above).
Launching the inquiry, Clare Haughey MSP, Convener of the Health, Social Care and Sport Committee, said:“Scotland’s geography means much of its healthcare is accessed and delivered in remote and rural areas and that’s why the Committee is keen to hear of the specific issues impacting healthcare services in these locales.
“We want to hear the experiences’ of individuals and representatives from remote and rural areas, and from those who work or have worked in remote and rural healthcare, on what they think the particular challenges facing the sector are.
“Our inquiry aims to provide a platform for the views of those in remote and rural areas to be heard and our Committee is keen to hear from as wide a range of organisations and individuals as possible.
“Sharing your views will help the Committee better understand the varied and particular issues facing rural and remote healthcare services and help our scrutiny of the Scottish Government and other key stakeholders in their approach to delivering healthcare in these areas.”
The Committee is seeking views from individuals and organisations about female participation in sport at both a community and elite level and how female sport is supported, reported, and promoted.
The Committee is keen to understand what barriers limit female participation in sport and physical activity and what can be done to remove these. This will include investigating additional barriers to participation, such as ethnicity and disability.
Launching the inquiry, Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:“During our inquiry into the health and wellbeing of children and young people, we heard evidence of a significant decline in participation in sport and physical activity by adolescent girls.
“This has prompted the Committee to launch a dedicated inquiry into barriers to female participation in sport and physical activity and how these might be overcome.
“Statistics show that female participation in sport and physical activity in Scotland is lower than that of males from the age of 11 years old, with typically a 10% gender gap in participation.
“This has clear negative repercussions on the long-term health and wellbeing of women and girls.
“Today, we are launching a call for views to find out more about the barriers women and girls of all ages face in participating in sport and physical activity. We are particularly keen to hear the experiences of those with a disability, from ethnic minority or economically deprived backgrounds or who may face other barriers to participation in sport and physical activity.
“Our aim is to identify actions that should be taken to help increase the numbers of women and girls participating in sport and physical activity, and crucially to make recommendations to ensure they are able to remain active throughout their lives.”
A Scottish Parliament inquiry has concluded by calling for urgent, coordinated action across all levels of Government in the UK to tackle health inequalities in Scotland.
A wide-ranging report by the Health, Social Care and Sport Committee calls for urgent action to address health inequalities, and for tackling poverty to be considered a major public health priority at all levels of Government in order to address this.
The Committee heard evidence that the Covid-19 pandemic and the rapidly rising cost of living have further exacerbated Scotland’s health inequalities.
The Committee is calling for action across the UK and the Scottish governments, and by local authorities, which it says is essential if these inequalities are to be tackled effectively. This includes further public service reform and strategic action across multiple policy areas.
Among its recommendations, the Committee is calling for action on education, employment and housing to improve health outcomes and better tackle health inequalities. It says safe, secure and affordable housing must be available for all and highlights the significant impact planning policy can have on health outcomes and, if implemented poorly, in widening inequalities.
In compiling its report, the majority of the Committee agreed with the recommendation by the Glasgow Centre of Population Health that, within budget constraints, the UK Government should take action to align benefits and tax credits with inflation and to reinstate the uplift in Universal Credit introduced during the Covid-19 pandemic.
The report also highlights extensive evidence submitted to the inquiry that informal and unpaid caring has a disproportionate impact on health outcomes and that informal carers face significant health inequalities as a result.
To address this issue, the Committee calls on the Scottish Government and Public Health Scotland to provide more targeted support for carers.
Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:“The evidence is clear that health inequalities in Scotland continue to grow, while the pandemic and ongoing cost of living crisis will only exacerbate these inequalities further.
“A number of witnesses contributing to the inquiry argued that, over the past decade, UK Government policies on austerity have also had a negative impact on health inequalities in Scotland.
“We are particularly concerned that the rising cost of living will have a greater negative impact on those groups already experiencing health inequalities, including those living in poverty and those with a disability.
“Government action to date to tackle health inequalities has not been enough in the face of decades-long, major impacts on household incomes. We are calling for urgent action across all levels of government to reduce these stark inequalities which have real life and death consequences.
“There is currently no overarching national strategy for tackling health inequalities in Scotland. Meanwhile, evidence submitted to our inquiry has revealed multiple instances where the design and delivery of public services may be exacerbating inequalities rather than reducing them. We need to deliver further public service reform to ensure this doesn’t continue to happen.
“The reasons why we have failed to make progress in tackling health inequalities are many and varied. Reducing these will require bold and strategic action across all levels of government and by a range of government departments. Tackling health inequalities must be a major public health priority because lives literally depend on it.”
Other key findings in the report include:
The Committee express concern that certain vulnerable families report being excluded from free childcare provision, including those who care for disabled children and those who do not have a standard Monday-Friday work pattern.
A majority of the Committee is supportive of the concept of a universal basic income and calls on the Scottish Government to work with the relevant UK agencies to consider whether a pilot of the policy could take place in Scotland in order to begin to address health inequalities. A Committee majority would also like to see the implementation of a minimum income guarantee in Scotland.
The mental health of pregnant women, new mothers and their families, including those affected by miscarriage, stillbirth and the death of an infant, has been highlighted by a Scottish Parliament Committee.
The Health, Social Care and Sport Committee’s inquiry into women’s mental health experiences before, during and after the birth of a child (otherwise referred to as the perinatal period) highlights a number of issues faced by new mothers over the support they have received, particularly during the pandemic.
In particular, the inquiry found there was a sharp rise in birth trauma incidences reported since the pandemic began. The Committee calls on the Scottish Government and NHS Boards to redouble their focus on delivering services that directly address birth trauma.
The Committee also looked into the of support for those suffering from miscarriage, stillbirth or death of an infant. During its inquiry, the Committee received evidence of some women affected by baby loss who reported being treated close to women giving birth to healthy babies, causing additional trauma to the women affected.
The report calls for accelerated action to establish specialist baby loss units and, in the meantime, for new national protocols to be set up “that ensure families affected by baby loss are consistently treated with respect and compassion and in a trauma-informed way”.
Alongside a focus on community care, the Committee also examined access to specialist Mother and Baby Units (MBUs), of which there are currently two in Scotland. The Committee emphasises the benefits of providing wider access to MBUs for new mothers with complex needs and they express support for the creation of a new MBU serving the north of Scotland.
Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said:“Up to 20% of women in Scotland experience negative mental health impacts before, during and after giving birth and the aim of our inquiry was to shine a spotlight on this important issue and to see what more should be done to support these women.
“We heard of concerns in certain health board areas with the support structure in place for parents and families impacted by miscarriage, still birth and the death of an infant, and feel more action is needed to give them appropriate support.
“We had discussions with some new parents affected by baby loss who felt they didn’t receive the standard of care they are entitled to expect. That is why we are calling for every effort to be made to accelerate the establishment of specialist baby loss units
“The evidence we received suggests that during the pandemic, there was a sharp rise in incidences of birth trauma. In many instances this was a direct result of COVID-related restrictions, which limited the support women were able to receive from partners and families before, during and after giving birth.
“Our inquiry heard about the benefits of Mother and Baby Units for women who have complex mental health issues in the perinatal period and the Committee would like to see a concerted effort to widen access to these units in conjunction with the community care offer.
“We think there is a strong case to set up a new Mother and Baby Unit serving the north of Scotland but we also need to focus on issues around staffing, resources and general awareness to maximise the positive impact of perinatal mental health services and third sector organisations who support mothers.”
The Convener added:
“The extensive evidence we have gathered during the course of this inquiry has shown the importance of a preventative and community based approach to perinatal mental health. It is clear that only through accessible, joined up care across both the third sector and statutory services, women and families can get the care they need at this critical time.
“We’d like to put on record our thanks to all of the women who spoke with us and shared their stories.”
Other findings in the report include:
• concern that many women and families are currently having to wait longer than 6 weeks to access perinatal mental health support;
• the increased barriers faced by women and families from minority ethnic backgrounds, or for whom English is not their first language, and those from particularly vulnerable or at risk groups, to access perinatal mental health services;
• the critical role that stigma plays in perinatal mental health and the resulting reluctance for individuals to fully engage with healthcare professionals;
• a call for the Scottish Government to ensure further education institutions deliver perinatal mental health training as core training for all midwifery and nursing students as a priority.
