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I do not agree with Brian Whittle’s proposal to scrap the legislation. I note Sandesh Gulhane and Brian Whittle’s in-principle support for many of our amendments to reform health and social care, and I urge them to vote for those.

With regard to Mr Cole-Hamilton’s proposal, I ask members to instead support use of the words “Care Reform” that I am proposing, as they offer a broader description.

Amendment 1 agreed to.

Section 2—Responsibility for the National Care Service

Amendment 2 moved—[Maree Todd]—and agreed to.

Section 3—Responsibility for improvement

Amendment 3 moved—[Maree Todd]—and agreed to.

Section 4—Establishment and abolition of care boards

Amendment 4 moved—[Maree Todd]—and agreed to.

Schedule 1—Care boards: constitution and operation

Amendment 5 moved—[Maree Todd]—and agreed to.

Schedule 2—Care boards: application of public authorities legislation

Amendment 6 moved—[Maree Todd]—and agreed to.

Section 5—Financial assistance for care boards

Amendment 7 moved—[Maree Todd]—and agreed to.

Section 6—Strategic planning by the Scottish Ministers

Amendment 8 moved—[Maree Todd]—and agreed to.

Section 7—Strategic planning by care boards

Amendment 9 moved—[Maree Todd]—and agreed to.

Section 8—Care boards’ planning process

Amendment 10 moved—[Maree Todd]—and agreed to.

Section 9—Frequency of planning by care boards

Amendment 11 moved—[Maree Todd]—and agreed to.

Section 10—Meaning of ethical commissioning strategy

Amendment 12 moved—[Maree Todd]—and agreed to.

Section 11—The National Care Service charter

Amendment 13 moved—[Maree Todd]—and agreed to.

Section 12—Further provision about the charter

Amendment 14 moved—[Maree Todd]—and agreed to.

Section 13—Independent advocacy

Those views have been expressed directly to me, too, and I have said to the individuals that I share their disappointment in the lack of progress. For each bill, there are reasons why there has been a delay. For the National Care Service (Scotland) Bill, I think that we will get back on track reasonably soon. I have said that I will update Parliament in the new year on how we will make progress. That is a pause at stage 2. I recognise that it is a pause on a bill that has taken a very long time to come to fruit, but I am confident that we will make progress.

As for the human rights bill, I was involved when we incorporated the United Nations Convention on the Rights of the Child into Scots law. That proved very challenging, as you know. The United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Bill was caught up in contest and controversy after it was passed because it touched on issues that may be devolved or reserved. It is very challenging to incorporate human rights law because of the devolved nature of our legislature.

As I understand it, progress on the human rights bill has been paused because there is a new Government in the United Kingdom. There is potentially a chance to work on a UK-wide basis on incorporation of some treaties, which would clearly be far preferable to doing that on our own in Scotland. We would not run into the devolved and reserved challenges, and we would make progress across the UK. It is worth taking time on that and spending the time to work with our UK counterparts.

On the LDAN bill, the challenge involves two main areas where there is not consensus. One is the scope of the bill—who is in and who is out. There is no agreement on that, and further work needs to be done to get it right. There is also the issue of how we build in accountability.

I understand that people feel as if they are being let down on all fronts, but we have made significant progress with each piece of legislation, and I am confident that we will continue to make progress. There is broad parliamentary consensus for much of the LDAN bill’s ambition. Between ourselves as parliamentarians, with our commitment to that work, and stakeholders, we can keep its profile high. I am confident that we will legislate in the future and that the legislation will have a simpler and more straightforward passage through Parliament because we will have taken the time to get it right before introducing it.

I think that you started by saying that you cannot make a difference to the things that you do not measure, and then I think that you quoted from the dynamic support register statistics, which were published today. Those statistics show some of the progress that we have made in collecting data on this particular challenge. The data collection that is associated with the dynamic support register has given us a better understanding of who is where in the system and better visibility at the local level. Much of this is a local responsibility, because the statutory responsibility for social care still lies with local authorities. We can tussle all day about whether that is where it should lie, but that is where it lies. The dynamic support register provides visibility in the local system on where people are.

What we see in the latest publication of statistics this morning is, probably not unsurprisingly, an increase in the number of people who are on the local dynamic support register. There were 195 people in hospital and, as you said, 85 of those cases were classified as a delayed discharge. What is particularly vexing is the number of people who have very long stays in hospital. Seventy-two of those people have a length of stay of more than six years. As I said, better visibility means that local systems have better oversight of these cases and are more able to take responsibility and to take steps to sort the problem.

It is not a straightforward problem to fix, as we have seen over a number of years. We have invested extra money. On the back of “Coming Home: A Report on Out-of Area Placements and Delayed Discharge for People with Learning Disabilities and Complex Needs”, we put in £20 million into local systems. We have created the dynamic support register and a practitioner support network. We are looking to create a family support network. We have taken a number of steps as a national Government to try to effect change in the area.

I cannot remember exactly what you said about your opinion on what is happening with the national care service. I am absolutely committed to delivering fundamental change in social care. The status quo is not acceptable and we need to make progress. There is a lot of consensus around what needs to happen in social care, including within the National Care Service (Scotland) Bill. There is generally consensus on the commissioning and procurement of complex care.

I am keen to put on the record why we think that such legislation is needed. It has already been mentioned that even though a number of powerful strategies, ambitions, policy and legislation are in place, we are still slow in making progress in this area. The provision of statutory underpinning for some of the work that we have done is one reason to consider legislation.

Another point to understand is that we are sure that some outcomes are particularly poor for people with learning disabilities and neurodivergent people. There are some really significant differences between that population and the general population. On family, for example, only 5 per cent of people with learning disabilities live with a partner, compared with 56 per cent of the rest of the population. Between 40 and 60 per cent of parents with a learning disability will have their children removed from their care as a result of their being assessed as unable to provide adequate care.

The same population is overrepresented in the justice sphere. About 39 per cent of prisoners have a learning disability or difficulty. It is likely that people with fetal alcohol spectrum disorder are very overrepresented in the justice system. They are 19 times more likely to be imprisoned than people without FASD. There are significantly higher rates of experience of gender-based violence in that population.

People with learning disabilities and neurodivergent people really struggle to fulfil their educational potential, and when it comes to employment, there are significant differences between that population and the general population. For example, around 4.8 per cent of people with learning disabilities are in employment. That rises to about 29 per cent for autistic people but, for the general population, the figure is significantly higher—it is 82 per cent—and more than 50 per cent of members of the general disabled population are employed.

Those are really different outcomes, which all point to the fact that this particular population is really struggling to have its human rights recognised and upheld in every situation, which is why it is so important that we make progress. It is also why legislation is needed, because we really are struggling to effect change without it.

We have spoken a fair bit about data. We have covered annual health checks and, as I said, I am determined to make progress on that. On education, we are currently exploring options to strengthen the existing professional learning opportunities for education staff on additional support for learning. We have also committed to undertaking an analysis of the learning hours that are attributed to additional support for learning content in IT programmes across Scotland.

We have touched on employment a little. In the short term, the Scottish Government will, by the end of this year, respond substantively to the Economy and Fair Work Committee’s inquiry report into the disability employment gap. We will also continue to implement the fair work action plan and the no one left behind approach.

We talked about the work on gender-based violence. There is a commitment to deliver the gender-based violence and learning disabilities steering group action plan. Actions in the plan include improving access to justice and support services for women and girls with learning disabilities. That mirrors the outcomes that were agreed by the steering group.

Jacqueline Campbell spoke about the work that we are doing with parents with learning disabilities, particularly with People First, on ways to support them. That is about early intervention to prevent that particularly tragic unfolding situation in which 40 to 60 per cents of parents with a learning disability are having their children removed. Work is on-going on transitions.

On diagnosis and support, I am asked regularly in Parliament about the access to diagnosis and ND assessments for children and adults. There is a rise in the number of people seeking those diagnoses, which is partly related to the decrease in stigma. In some areas it is a 1,500 per cent rise, which has proved very difficult for local areas to accommodate. We are working with local health boards to put in place access to ND assessments. Those assessments should not be the be-all and end-all. Using the getting it right for every child approach, children in the education system should have their needs met and their rights upheld whether or not they have a diagnosis. However, access to a diagnosis is important. It is not unnecessary, and we are trying to speed up and improve that on the ground.

Work is on-going on mental health law. We recognise the challenge around how learning disabilities and autism in particular are caught up in mental health law and in the definition of “mental disorder”, and we hear that concern. The committee will have heard about that in some of the evidence that it has received. We are very cautious about making changes in case there are unintended consequences, but we are doing a piece of work to see whether there is a better way to approach the issue. A number of recommendations have been made to update mental health law, and while we look at that piece of work, we will certainly consider whether the definition of “mental disorder” is right. Therefore, there is a suite of work.

As I said, at the meetings with the three panels next week, we will get into the detail of that and talk about what work we want to see happening and when we think that it might be possible to feel the tangible difference and the impact of the voice of lived experience on the progress on that work. Therefore, pretty soon, we should be able to speak to the community and come to an agreement on what we expect to see going forward as well as the legislation, which will progress at a slightly slower pace.

Thank you, convener and members, for inviting me to talk about the LDAN bill and the work that is taking place to deliver it. My work with and for people with learning disabilities and neurodivergent people is a key part of my portfolio. I believe very strongly that this is an area in which we need to change our approach. The committee has heard from some of our stakeholders and partners, and we have heard that there is significant disappointment about the length of the timescales for the bill. I share the disappointment and frustration at the length of time that real change can take, and I have expressed that directly to many of the people who we have worked with closely over the past two years.

However, it is important to be really clear that this Government is strongly committed to this work. We believe that there is fairly broad cross-party consensus and that the bill needs to progress. I will address a couple of key concerns. Some people are worried that this pause means that we are back to square 1 or that the LDAN bill might not happen at all. I want to tell you why that is not the case.

The bill started as the result of a successful campaign by leading charities to highlight the need for greater accountability for autistic people and people with learning disabilities. From that starting point, we have built a significant body of work over the past two years. That has included publishing work on commissions and the commissioner landscape; early pre-consultation work with stakeholders; setting up three bill advisory panels for stakeholders, practitioners and up to 27 people on a lived experience advisory panel—the LEAP; a review of the existing evidence; taking a human rights-based approach and working in partnership with the LEAP to jointly produce an extensive consultation paper; conducting and publishing an analysis of the nearly 900 responses to the consultation; and a commitment to publish draft bill provisions and to working iteratively with the bill panels on the policy and provisions.

The content of the consultation paper itself is an indication of how far we have come. It highlights and evidences the reasons why legislation is needed—primarily the challenges and poor outcomes that continue to shape the lives of people with learning disabilities and neurodivergent people and the way that those can reach across different ages and stages of life. Improvement approaches in previous strategies have brought about some beneficial change and additional knowledge, but they have not brought about the step change that is needed to allow neurodivergent people and people with learning disabilities to play a full part in their society and communities.

Therefore, we are not at the beginning of the process—we have come a long way. We have set out proposals, around many of which there is broad consensus and strong support. However, there are also areas of difference, including around the scope of the bill and who should be included in the provisions. Therefore, we still have a significant amount of work to do to have a bill ready for introduction with a set of effective, sustainable and funded proposals. Additional work is needed on accountability options, particularly because of the Parliament’s own inquiry into the commissioner landscape but also because this is an area on which there are varied views.

However—and this is key—it is our intention to build on the invaluable work that has been done already and to publish draft provisions for a bill, working on that directly with our bill panels. Next week, we are bringing together the members of the panels to set out our proposals and to agree how we will do that together. That will very much also include what we can take forward now, in this interim period before a bill can be introduced.

Our continued work towards the proposed bill provides the foundation for the longer term. It is the keystone, but not the single solution. Government cannot work alone to change behaviours and perspectives. Partnership working between all of us is what will make the real, longer-term step change happen, with people with lived experience at the heart of it and cross-party consensus that will prioritise the work. We have a lot to do for the people whom we serve, and I am delighted to be here today to talk to all of you about it.

There are different challenges in different areas. Each of those individuals has their own story, and there are different challenges for each of them. In some parts of the country, the issue is the ability to commission people to work and provide the necessary care and support. In the case that was discussed on BBC Radio Scotland when I was listening this morning, the family said that there are people in place to deliver care. The challenge for that individual was finding suitable housing.

I am keen to put on the record why we think that such legislation is needed. It has already been mentioned that even though a number of powerful strategies, ambitions, policy and legislation are in place, we are still slow in making progress in this area. The provision of statutory underpinning for some of the work that we have done is one reason to consider legislation.

Another point to understand is that we are sure that some outcomes are particularly poor for people with learning disabilities and neurodivergent people. There are some really significant differences between that population and the general population. On family, for example, only 5 per cent of people with learning disabilities live with a partner, compared with 56 per cent of the rest of the population. Between 40 and 60 per cent of parents with a learning disability will have their children removed from their care as a result of their being assessed as unable to provide adequate care.

The same population is overrepresented in the justice sphere. About 39 per cent of prisoners have a learning disability or difficulty. It is likely that people with fetal alcohol spectrum disorder are very overrepresented in the justice system. They are 19 times more likely to be imprisoned than people without FASD. There are significantly higher rates of experience of gender-based violence in that population.

People with learning disabilities and neurodivergent people really struggle to fulfil their educational potential, and when it comes to employment, there are significant differences between that population and the general population. For example, around 4.8 per cent of people with learning disabilities are in employment. That rises to about 29 per cent for autistic people but, for the general population, the figure is significantly higher—it is 82 per cent—and more than 50 per cent of members of the general disabled population are employed.

Those are really different outcomes, which all point to the fact that this particular population is really struggling to have its human rights recognised and upheld in every situation, which is why it is so important that we make progress. It is also why legislation is needed, because we really are struggling to effect change without it.

We have spoken a fair bit about data. We have covered annual health checks and, as I said, I am determined to make progress on that. On education, we are currently exploring options to strengthen the existing professional learning opportunities for education staff on additional support for learning. We have also committed to undertaking an analysis of the learning hours that are attributed to additional support for learning content in IT programmes across Scotland.

We have touched on employment a little. In the short term, the Scottish Government will, by the end of this year, respond substantively to the Economy and Fair Work Committee’s inquiry report into the disability employment gap. We will also continue to implement the fair work action plan and the no one left behind approach.

We talked about the work on gender-based violence. There is a commitment to deliver the gender-based violence and learning disabilities steering group action plan. Actions in the plan include improving access to justice and support services for women and girls with learning disabilities. That mirrors the outcomes that were agreed by the steering group.

Jacqueline Campbell spoke about the work that we are doing with parents with learning disabilities, particularly with People First, on ways to support them. That is about early intervention to prevent that particularly tragic unfolding situation in which 40 to 60 per cents of parents with a learning disability are having their children removed. Work is on-going on transitions.

On diagnosis and support, I am asked regularly in Parliament about the access to diagnosis and ND assessments for children and adults. There is a rise in the number of people seeking those diagnoses, which is partly related to the decrease in stigma. In some areas it is a 1,500 per cent rise, which has proved very difficult for local areas to accommodate. We are working with local health boards to put in place access to ND assessments. Those assessments should not be the be-all and end-all. Using the getting it right for every child approach, children in the education system should have their needs met and their rights upheld whether or not they have a diagnosis. However, access to a diagnosis is important. It is not unnecessary, and we are trying to speed up and improve that on the ground.

Work is on-going on mental health law. We recognise the challenge around how learning disabilities and autism in particular are caught up in mental health law and in the definition of “mental disorder”, and we hear that concern. The committee will have heard about that in some of the evidence that it has received. We are very cautious about making changes in case there are unintended consequences, but we are doing a piece of work to see whether there is a better way to approach the issue. A number of recommendations have been made to update mental health law, and while we look at that piece of work, we will certainly consider whether the definition of “mental disorder” is right. Therefore, there is a suite of work.

As I said, at the meetings with the three panels next week, we will get into the detail of that and talk about what work we want to see happening and when we think that it might be possible to feel the tangible difference and the impact of the voice of lived experience on the progress on that work. Therefore, pretty soon, we should be able to speak to the community and come to an agreement on what we expect to see going forward as well as the legislation, which will progress at a slightly slower pace.

Does Carmen Murray want to say a little more about the specific work that we did to reach out to ethnic minorities?