Seòmar agus comataidhean

There was a huge amount in that question. Ms Webber said that it is all buzzing about in her head, and I think that it is probably all buzzing about in our heads at the moment, as well.

I explained to the committee earlier the level of engagement that we have with partners around getting all of this right as we move forward. At the moment, we have a significant number of folk in hospital who should not be there, and it is best that they are not there. Some of the solutions will be interim ones, but the ambition is to get folk back to living independently, with support, if that is possible and as soon as we can.

Rather than going on about all of the possibilities, we will write to the committee about what we are doing. We do not have some of the information that Ms Webber is asking for regarding people in interim situations. I will write back to the committee in more depth to explain how we are handling that.

I have a figure for the number of autistic people in Scotland; I do not have a figure for the number who are diagnosed each year, but I can see whether we can provide that for the committee.

According to the Scottish Government-funded microsegmentation of the autism spectrum research project, whose report was published on 26 March 2018, there are approximately 44,133 autistic people in Scotland, with a national Scottish autism prevalence rate of 1.035 per cent. Around 32.7 per cent of autistic people also have a learning disability. As I have said, I do not have figures for diagnoses per annum to hand, but we will see what we can do to provide the committee with that information.

I will ask Ms Campbell to respond and then come back in, convener.

I will be a bit controversial and say that I agree with most of what Mr Sweeney said. However, we must also recognise that services deemed good in the minds of some folk might be deemed not so great by others.

When I was in my previous role as Minister for Local Government, Housing and Planning, vast changes, some of which are still on-going, were made in homelessness policy, regulation and legislation, and the voices of folk with lived experience of homelessness were at the very heart of what we did. I am not saying that that was absolutely perfect—it never is—but we are on a good journey and in a good place, because we listened to people and their experiences. I fully intend to do the same in this role. Whether it be in relation to autism services, social care or mental health services, I will continue to listen to the voices of lived experience.

In some of the conversations that I have had thus far in coming into this new role, I have noted that some of the assumptions that we all make, rightly or wrongly, about what we think needs to be improved first and what our priorities should be are not necessarily shared by folks with lived experience. I have talked to folk about mental health services in general, and something that has cropped up again and again and that I think is one of the top priorities for the groups that I spoke to—I know that some folk will disagree with me—is the fact that the complaints system does not work for people. We need to look at that very closely in this area and in others.

Beyond that, in those areas where there is very good practice, you will usually find that service users have helped to shape the service in question. Again, that is something that we need to push further. Some local authorities and health and social care partnerships are very good at listening to the voices of lived experience and shaping services and while others are not quite so good. We need to continue on this journey to ensure that everyone is doing that. I would also point out that one of the proposals in the national care service consultation is for community health and social care boards to have the voices of lived experience at the table, which I think is essential.

The programme for government, which was published in September, committed the Government to carrying out scoping work on the remit of and powers in the learning disability, autism and neurodiversity bill in this parliamentary session. It will take time to scope all that and get it right, and we need to continue some of the conversations that we have been having. For example, there are polarised views on the proposals for a commissioner, and we have to listen to all sides if we are to get that right. That scoping work will happen and we will move on with the matter in this parliamentary session.

Concurrently with that, the Scottish mental health law review is due to report next September. As the committee will likely be aware, the review will make recommendations to give effect to the rights, will and preferences of the individual by ensuring that mental health, incapacity and adult support and protection legislation reflects people’s social, economic and cultural rights, including the requirements of the United Nations Convention on the Rights of Persons with Disabilities and the European convention on human rights. That said, I think that today’s Supreme Court ruling has put some difficulty in our way with regard to embedding certain UN convention rights in legislation, but that is probably a discussion for another day. You will be glad to hear, convener, that I will not go into a rant about that, but it is fair to say that, like many others, I am quite irate about it.

The Scottish mental health law review is extremely important in all this, but we need to listen to people and ensure that we embed rights in any legislative change, whether that be in the learning disability, autism and neurodiversity bill or in anything that comes from the review itself.

It is fair to say that when you take on a new ministerial role you have to do a wee bit of stocktaking to see what is going on out there. In my new role, I have been talking to lots and lots of folk about the various issues that I am responsible for, and the committee can be assured that that general stocktake applies right across the board.

As I said, I know of a number of health and social care partnerships and local authorities that are doing very well in this area, and I know of a number of others that are not doing as well as they should be to meet their people’s needs. I will continue having the very detailed conversations that need to be had, to do that stocktake and to ascertain what is going on out there that is right and what is not going quite so well.

Mr Stewart knows me from numerous other committee appearances—we seem to cross each other’s path on a regular basis—so I will probably bore him by saying something that he has heard me say many times before. We have had some success in other areas with this approach, but I am one of those folks who get very frustrated when we do not export best practice across the board. We are a small country, but sometimes people are afraid to blow their own trumpets and say what they are doing well, which means that others do not have the opportunity to pick up that good practice. Convener, I assure you, Mr Stewart and the rest of the committee that my ethos with regard to the exporting of best practice remains in place. That is what we will aspire to do.

I will make some general comments about the provision of one-stop shops, which I think are important. I think that the point being driven at is that provision varies from local authority to local authority, and local authorities are responsible for commissioning and delivering those local services. We have examples of really positive provision in some local authorities such as South Lanarkshire, which operates an autism resources co-ordination hub, and Edinburgh, with its Lothian one-stop shop. There is also a one-stop shop that is supported by Perth and Kinross. However, there is still work to do to ensure that other parts of the country have the right provision, because it is fair to say that some parts have very few services to meet the needs of autistic people.

The Government works with national and local autism charities, which also operate a number of services. Indeed, I was having a discussion about that very issue yesterday. Scottish Autism and the National Autistic Society have national coverage, but we also have close links with Inspiring Scotland and with effective and valued local organisations, such as the Aberdeen one-stop shop and Autism Rights Group Highland.

As I said—and I think that we have to be honest about this—provision is excellent in some places but not in others, and we need to encourage, cajole and perhaps even take further action through regulation to ensure that, in the short term, provision across the board gets better. Beyond that, we have the opportunity with the changes that we are making through the national care service and other actions around that to put in place a framework of high-quality standards that all can expect.

Given all that we are doing at this moment, it is important to highlight that the work that we will be carrying out and the legislative change that we will be making in care in Scotland put the person at the very heart. What we need on many occasions are more person-centred approaches. That happens in many cases, but where it does not happen, it causes great difficulty for the individual, their family and often their community. We have to start looking at such approaches more and more and, indeed, at a very early stage, instead of waiting for somebody’s life to reach crisis point before the services that are required are provided. We must move to much more preventative measures and take folks’ views into account to ensure that we get this right as we move forward.

That is something else that we need to take cognisance of in shaping services: waiting for a diagnosis does not mean waiting for help and support. Help should come naturally, no matter whether or not there is a diagnosis. Some places have got that service provision and help right, but that is not so much the case in other places.

I am not a person who likes to stand still—there always has to be continuous improvement. Although there is no doubt that the legislation is very important, that is not to say that we should not be taking action in the here and now, where that is possible, outwith the legislative framework.

Government officials are working to consider all the recommendations from the review. I have already been provided with some advice and we have already taken some actions, as I outlined in my opening statement. We will co-ordinate a full Scottish response to the report; coronavirus has delayed some aspects of that work, but we are now getting back on track.

Work has been carried out on a number of specific recommendations. For example, we have already published new mental health standards; we have commissioned the Scottish learning disabilities observatory to carry out a study on the use of psychotropic medication; and we have committed to scoping out and introducing the bill that I mentioned in my opening remarks. As we move forward, we will continue to do all that we can outwith the legislative framework to ensure that there are improvements.