Health Social Care and Sport Committee – The NEN

Parliament Committee backs Bill which would introduce safe access zones around abortion services

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.

Read the report:

Stage 1 report on the Abortion Services (Safe Access Zones) (Scotland) Bill

Committee offers conditional support for National Care Service Bill

The Health, Social Care and Sport Committee has published its Stage 1 report on the National Care Service (Scotland) Bill following months of scrutiny.

The Parliament Committee has made a majority recommendation that the general principles of the Bill be supported.

Read the report

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.

Holyrood Committee seeks views on healthcare in remote and rural areas

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’s call for views is open now: Healthcare in Remote & Rural Areas (parliament.scot)

The call for views closes on 11 August.

Holyrood Committee launches call for evidence on female participation in sport and physical activity

An inquiry has been launched into female participation in sport and physical activity by the Health, Social Care and Sport Committee.

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.”

Let the Committee know your views

The inquiry’s call for views closes on 9th December.

Tackling Scotland’s health inequalities requires immediate joined-up action, warns Holyrood Committee

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.

Read the report

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.

tackling-health-iinequalities-report Download

Holyrood report spotlights mental health of expectant and new mothers and expresses concern over access to support services

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.

HSCS062022R3 Download

THREE Holyrood Committees join forces to look at tackling drug deaths and problem drug use

The Scottish Parliament’s Criminal Justice Committee, Health, Social Care and Sport Committee, and Social Justice and Social Security Committee are coming together to hold two special sessions looking at the actions taken to reduce drugs deaths and problem drug use in Scotland.

The sessions, which will question the Scottish and UK Governments, as well as the new Chair of the Scottish Drugs Deaths Taskforce (SDDT), will seek to focus on what progress has been made and actions taken so far, including implementation of SDDT’s recommendations, as well as what more can be done.

The Committees are working together, recognising the issues which lie behind this crisis stem from different policy areas. Each Committee will send representatives to question witnesses and consider the progress made.

The Committee will question Rt Hon Kit Malthouse MP, UK Minister of State for Crime, Policing and Probation, on the afternoon of Tuesday 1 February.

On the following day, MSPs will then question the new Chair of the Scottish Drug Deaths Taskforce, David Strang, followed by the Scottish Government’s Minister for Drugs Policy, Angela Constance MSP.

Speaking as the joint sitting of the three committees was announced, Criminal Justice Committee Convener, Audrey Nicoll MSP (above), who will chair the joint sitting, said: “Problem drug use, and tragically, drugs deaths blight too many families and communities in Scotland.

“We know that the roots of these issues are complex and historical, and that the Taskforce recommendations touch many policy areas.

“Implementing the wide ranging solutions requires a co-ordinated approach by Parliament and Government.

“Addressing this drugs crisis is a priority for our committees. We want to support the individuals and families affected, as well as the agencies who work with them and the Government in taking the right actions to reduce drug deaths and tackle the misuse of drugs.

“I hope these sessions allow us to see some progress in this area, and perhaps find consensus and focus on what more can be done.”

The Committee is a joint meeting of three Committees and not a new Committee.

It is expected the following MSPs will attend the joint sessions as delegates:

Audrey Nicoll (SNP) (Convener)

Miles Briggs (Con)

Foysol Choudhury (Lab)

Russell Findlay (Con)

Gillian Mackay (GRN)

Gillian Martin (SNP)

Pauline McNeill (Labour)

Paul O’Kane (Lab)

Sue Webber (Con)

It is expected that the new SJSS Convener will also attend, once this person is appointed. (SNP).

The meeting with Kit Malthouse is expected to take place virtually between 3 – 4:30pm, Tuesday 1 February.

The meeting with the Taskforce and Angela Constance MSP is expected to take place virtually 10am – 12:30pm, Wednesday 2 February. The panel with the taskforce anticipated to last 10 – 11am, and the Minister thereafter.

MSPs launch inquiry into how Scots access healthcare services

An inquiry into the different ways patients access healthcare services in Scotland has been launched by the Health, Social Care and Sport Committee.

Traditionally, when a person seeks healthcare their first point of contact is usually with a general practitioner (a GP or family doctor) but the inquiry is focused on other routes to accessing healthcare that exist in the community, referred to as ‘alternative pathways’.

The aim of the inquiry is to explore how and to what extent these alternative pathways are being used to access primary care, and to identify key issues and opportunities for improvement.

Alternative pathways to healthcare in the community include:

Seeing a different health practitioner, such as a physiotherapist, nurse, pharmacist, speech therapist, or podiatrist who works in the GP practice or in the local community.
Being directed to other types of support to improve health and wellbeing – such as walking groups, community groups, advice, or volunteering (referred to as ‘social prescribing’).
Using telephone helplines websites to access additional information, advice and online therapies.

The Committee is seeking to find out the current level of awareness amongst health practitioners and patients of alternative pathways to healthcare other than seeing a GP and how this might be improved in the future.

They are keen to find out what capacity other primary healthcare professionals have to take on more patients, the role of social prescribing in alternative pathways and how technology can improve services.

Speaking as the inquiry launched, Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said: “The traditional model of primary care where you went to see a GP for any and all health issues is placing ever increasing pressure on GP services.

“This isn’t a sustainable situation for general practices – but it’s also not good for patients struggling to get a GP appointment when there may be alternative and better routes they could go down to get the healthcare they need.

“Through our detailed work on this inquiry, the Committee is keen to explore what opportunities exist to make more and better use of these alternative routes to healthcare.

“We want to find out what role they have to play in creating a modern, flexible, community-based healthcare system which allows patients to access the right professional, at the right time.”

If you are a medical professional or organisation who would like to respond to the inquiry you can do so here: https://yourviews.parliament.scot/health/alternativepathways

Members of the public can give us their views here: https://yourviews.parliament.scot/health/alternativepathways-survey

The call for views will close on 22 February 2022.

Holyrood Committee launches inquiry into health and wellbeing of children and young people

An inquiry has been launched into the health and wellbeing of children and young people by a Scottish Parliament Committee.

The Health, Social Care and Sport Committee is seeking to find out the key issues around health and wellbeing for children and young people in Scotland. They will investigate what the challenges and opportunities are for improving their health and wellbeing, and how addressing poverty can lead to improved health and social care outcomes.

The inquiry will focus on 4 key areas:

• Child poverty (including the Scottish Government’s current child poverty delivery plan), inequality and adverse childhood experiences;
• Issues affecting care experienced young people;
• Mental health, access to Child and Adult Mental Health Services (CAMHS) and the importance of early intervention;
• Health and wellbeing in schools

Speaking as the inquiry launched, Gillian Martin MSP, Convener of the Health, Social Care and Sport Committee, said: “There are a whole host of factors which impact the health and wellbeing of our children and young people, and our Committee will consider these in detail.

“The physical and mental toll of the pandemic on children and young people cannot be overstated and we know that prior to this pandemic there was already a high and
increasing demand for youth mental health services in Scotland.

“As we emerge from the pandemic and with the Scottish Government’s current child poverty delivery plan due to run until 2022, our inquiry comes at a pivotal time. We are determined to find out how children and young people can best be supported to live healthy and flourishing lives.”

You can let the Committee know your views here:

Inquiry into the Health And Wellbeing of Children And Young People – Scottish Parliament – Citizen Space

The call for views will close on 7 December 2021.