Health and Wellbeing of Children and Young People

– in the Scottish Parliament on 15 June 2022.

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Photo of Liam McArthur Liam McArthur Liberal Democrat

The next item of business is a Health, Social Care and Sport Committee debate on the health and wellbeing of children and young people. I call Gillian Martin to open the debate on behalf of the committee.

Photo of Gillian Martin Gillian Martin Scottish National Party

As convener of the Health, Social Care and Sport Committee, I am pleased to open this afternoon’s debate on the committee’s inquiry into the health and wellbeing of children and young people.

We all want the best for children and young people. We want them to flourish and to lead healthy and happy lives. As a committee, we thought that, post the pandemic, the health and wellbeing of our children merited special attention, and we were glad to have cross-portfolio evidence to support our wide-ranging inquiry.

Before I discuss our findings, I thank everyone who engaged with the inquiry, whether through the call for views or by participating in an evidence session. Committees could not carry out their work without such people. In particular, I thank the children and young people who shared their personal experiences with us in informal settings, and the organisations that supported them to do so, which included Barnardo’s Scotland, Who Cares? Scotland and Carers Trust Scotland.

Our inquiry considered the key issues that have the most significant impact on the health and wellbeing of children and young people. In particular, we looked at the impact of inequality and adverse childhood experiences, issues that impact the health and wellbeing of care-experienced young people and issues around mental health, including access to support and treatment. We also considered the importance of early intervention and the critical role that schools play in that.

As I have indicated, the committee was conscious that the policy area in question is relevant to a number of other parliamentary committees and Scottish Government portfolios. I thank those other committees, notably the Public Audit Committee and the Social Justice and Social Security Committee, for their helpful input. I am pleased that so many members of various committees will participate in this afternoon’s debate. I also thank the Minister for Children and Young People and the Cabinet Secretary for Social Justice, Housing and Local Government for giving their perspectives and outlining the action that they are taking in their work to improve the wellbeing of children and young people.

Poverty was highlighted as having an overriding impact on the health and wellbeing of children and young people by an overwhelming number of people who gave evidence to the committee. Poverty is a key driver of poor health and wellbeing outcomes, as it adversely affects a child’s biological, social, cognitive and emotional development. We heard about the impact of the stigma of poverty on mental health and in presenting barriers to physical activity, as well as the obvious effects that hunger has on children who live in deprivation.

The committee welcomes the Scottish Government’s on-going focus on tackling child poverty, but we must acknowledge that the rates of material deprivation are likely to continue to increase as a result of the current cost of living crisis, and that so much of what the Scottish Government is doing is being swallowed up by fuel and food cost increases. The United Kingdom Government’s welfare system and austerity policies came in for significant criticism from people who gave evidence.

In addressing the overarching impact of poverty, we would like greater detail to be provided on how the Scottish Government’s new child poverty delivery plan will help to improve the health and wellbeing of children and young people who are currently living in poverty. We also want continued concerted efforts to be made to help families to access the cash that they need to provide an adequate standard of living in the face of the challenges that I have outlined.

I turn to the impact of the pandemic. It is clear that the Covid-19 pandemic has had a significant impact on children and young people’s mental health. The closure of schools and nurseries, the challenges around home schooling and care, and the reduced opportunities to stay active and socialise with peers have all had significant impacts.

Certain groups in the young adult population have been particularly exposed to problems with their mental health during the pandemic. Those include young people with pre-existing health conditions, those who receive additional support for learning, young carers, and disadvantaged groups such as those from minority ethnic backgrounds and LGBTQ young people.

As we emerge from the pandemic, we have yet to understand the full extent of its impact on children and young people’s mental health, physical health and wellbeing, or how long lasting that impact will be. Our report therefore calls on the Scottish Government to ensure that the long-term impact of the pandemic remains a key consideration in the future design and development of mental health services and support.

Photo of Alex Cole-Hamilton Alex Cole-Hamilton Liberal Democrat

Gillian Martin cites the pandemic, which is of course a massive cause of mental ill health, but the Ukrainian refugees who are finding safe harbour in Scotland, many of whom are children, also have acute mental health needs. Can she speak to their plight and how we intend to fit them into the existing waiting lists for child and adolescent mental health services?

Photo of Gillian Martin Gillian Martin Scottish National Party

Alex Cole-Hamilton will appreciate that I am speaking on behalf of the Health, Social Care and Sport Committee. I am not a Government minister, and I am certainly not the Government minister for that portfolio. It might be a good idea for the member to address his question to the Government, and perhaps Government representatives will pick it up. We took evidence just before the situation in Ukraine happened, so it is not included in our report. I hope that the member understands that.

In the same way that it affects other aspects of their health and wellbeing, poverty is a key driver of poor mental health among children and young people. Poverty impacts negatively on family relationships and parents who are anxious and stressed about their money situation can feel unable to offer a safe and secure home environment. Many young people experience shame and stigma from living in poverty, which further impacts their mental health. That was put across to us very strongly by the young people we spoke to.

Waiting times for CAMHS is a long-standing issue that pre-dates the pandemic. There has been recent investment to increase capacity, but in some areas the problem persists—there is variability across Scotland. Our report concludes that reducing CAMHS waiting times must be an immediate priority, which could be pursued by accelerating the implementation of the new mental health workforce plan, although we appreciate that there are serious challenges across health and social care on staffing and recruitment.

We also recognise that the Government should consider bringing forward a separate short-term action plan to expand the workforce to meet existing high demand. We heard good examples of where waiting times are coming down, such as in the Grampian area, so we ask that where good practice exists, it is communicated and replicated across Scotland where appropriate.

In the longer term, we need to continue to pursue a more preventative approach that further eases pressure on CAMHS by reducing the number of children and young people who reach crisis point with their mental health. On that note of prevention, schools and youth services play a critical role in the life of every young person and in supporting their health and wellbeing. That includes opening up opportunities for them to be physically active and eat healthily.

The committee was particularly struck by the important role of school counsellors—and by how that intervention was welcomed by many of the people we spoke to—and other wellbeing practitioners in supporting the health and wellbeing of children and young people in schools. We welcome the roll-out of school counselling services to every secondary school in Scotland and look forward to a detailed evaluation of their impact once we have a few years of that intervention to analyse.

However, the committee heard evidence that teachers can struggle with the necessary skills, time and resources to do any effective monitoring of pupils’ wellbeing. The wellbeing of teachers has also suffered during the pandemic, as it has for people in many sectors, further impacting their capacity to support children and young people. Our report calls for a dedicated plan to support teachers with targeted training to give them the necessary tools and skills to continue fulfilling their responsibilities.

Our report also highlights the growing number of children and young people in Scottish schools with additional support needs, and the particular challenges that they face with their health and wellbeing. In that context, we have requested an update on the implementation of the Scottish Government’s additional support for learning action plan and, in particular, its impact on the health and wellbeing of children and young people with additional support needs.

During the inquiry, we heard many encouraging examples of close collaboration with youth workers and schools. We heard about the positive impact that youth workers can have in helping to mitigate some of the wider impacts of the pandemic, supporting young people towards positive destinations and reducing pressure on services such as CAMHS. Youth workers are often more accessible to young people, who might not want to speak to a teacher, for whatever reason. We encourage the Scottish Government to bring forward a follow-up national youth work strategy to continue to embed best practice more widely across the country.

I look forward to hearing the Scottish Government’s response to the committee’s report and to listening to other contributions to this afternoon’s debate. Across the Parliament, we share a commitment to improving the health and wellbeing of young people. For our part, the Health, Social Care and Sport Committee will continue to scrutinise progress in this area, so that all children and young people in Scotland are given the support and opportunities that they need if they are to be able to live long, healthy and happy lives.

Photo of Clare Haughey Clare Haughey Scottish National Party

I thank the committee for its inquiry report and for the opportunity to give evidence to its cross-portfolio inquiry. I am grateful for its focus on the health and wellbeing of children and young people and for the opportunity to speak about the Scottish Government’s work in the area.

My ministerial colleagues and I place huge importance on the wellbeing of our children and young people. They are our future and it is vital that we do all we can to support their healthy development, the relationships that they build and their overall wellbeing.

The committee’s report highlights the adverse impact of the pandemic on the health and wellbeing of our children and young people. As we recover from the pandemic, it is important that we get it right for every child and young person.

That is why improving the wellbeing of children and young people is one of the three key priorities that are set out in the Scottish Government’s “Covid Recovery Strategy: for a fairer future”. The strategy sets out key actions that we are undertaking to improve the wellbeing of children and young people, including action to support more active and healthier lives and targeted investment in our communities and schools.

We are also committed to delivering, over the course of this session of the Parliament, the £500 million whole family wellbeing funding that will enable the building of universal, holistic support services, which will be available in communities across Scotland and give families access to the help that they need, where and when they need it, for as long as they need it.

The wellbeing of children can be supported and promoted through the simple act of play, which gives our children the fun, excitement and friendship that can support healthy development as they grow through life. In 2021, I was delighted to see so many exciting projects and activities being funded by the £20 million get into summer programme, which offered enhanced opportunities for all children and young people to socialise, play and reconnect with their local communities and environments. I am pleased that a further £10 million has been invested in a targeted summer 2022 offer, which is designed to reach the school-age children and their families who can benefit most from access to free holiday childcare, activities and food.

Holiday childcare, especially over the long summer break, can be a cause of concern for families. We will build towards embedding a holiday childcare offer into a year-round school-age childcare system, which will help to reduce inequality of access to a wide range of activities around the school day and in the holidays.

Scotland is seen as a world leader in play as a result of the publication, in 2013, of the “Play Strategy for Scotland: Our Vision”. The strategy has helped to deliver major improvements in how Government and our partners deliver play opportunities in our communities.

We are reinforcing our commitment to the importance of play by providing £60 million to local authorities for playpark renewal over this parliamentary session. The funding will support the acceleration of local plans to improve play opportunities for all children in Scotland. Ten million pounds of that funding has already been allocated, underpinned by a set of national principles that ensure that we prioritise engagement with children and young people, in order to meet their needs.

We recognise the huge importance of our partners in the third sector who deliver vital work to support the wellbeing of thousands of children and families across Scotland. Since 2016, we have been providing £14 million of core funding to the sector via our children, young people and families early intervention and adult learning and empowering communities fund. Last year alone, 116 organisations received funding and supported more than 2.4 million people.

As recognised by the committee report, schools play a key role in supporting children and young people’s mental health and wellbeing, and we have continued to support them to deliver that vital role. We have committed to continued funding of £16 million per year to local authorities to provide counselling support services in all secondary schools in Scotland.

The personal and social education delivery and implementation group has already made good progress in delivering the recommendations of the personal and social education review. We remain committed to ensuring that the recommendations are delivered in full. That will help strengthen our excellent education system to help support our children and young people with the issues that they face as they grow up.

The Scottish Government is acutely aware that households across the country face a serious cost of living crisis—exacerbated by the UK Government’s approach to Brexit—which, in turn, will impact on the wellbeing of children and families across Scotland. Those on the lowest incomes are being hit the hardest, with many of those households likely to carry an increased burden of debt.

The recent measures that were announced by the UK Government are welcome, but they fall far short of what is needed to help the poorest households that are struggling now with the cost of living crisis. UK Government welfare cuts that have been imposed since 2015 have eroded the support for people who need it most. If those cuts were reversed, that would put an additional £780 million in the pockets of Scottish households in 2023-24, which would help to lift 70,000 people, including 30,000 children, out of poverty.

By contrast, the Scottish Government has declared that tackling child poverty is a national mission and has set out wide-ranging and ambitious action through “Best Start, Bright Futures: Tackling Child Poverty Delivery Plan 2022-2026”, which is our second tackling child poverty delivery plan.

Since publishing the plan in March, we have already doubled the value of our Scottish child payment to £20 per week for every eligible child under the age of six, and we have increased the value of a further eight Scottish social security benefits by 6 per cent, including our three best start grants. By the end of 2022, we will roll out the Scottish child payment for eligible children under the age of 16, and we will further increase the value of the payment to £25 per week for every eligible child. That will further enhance the already unparalleled financial support that we provide across the early years. By the end of this year, that support will be worth a maximum of over £10,000 for a family’s first child by the time they turn six; that is over £8,200 more than is available elsewhere in the UK.

Our plan commits to £10 million this year to mitigate the UK Government benefit cap as fully as possible within devolved powers—supporting up to 4,000 households with children. We have also committed to invest up to £81 million this year to deliver a new employability offer for parents, which is focused on providing the holistic wraparound support that they need to access and progress in work. Taken together, the actions set out in “Best Start, Bright Futures” could help to lift more than 60,000 children out of relative poverty in 2023-24.

We remain committed to incorporating the United Nations Convention on the Rights of the Child into Scots law. In May, the Deputy First Minister set out in Parliament how we intend to address the Supreme Court judgment, bring an amended bill back to Parliament and secure royal assent. I am delighted that we can now move forward with legislation that will require all Scotland’s public authorities to take proactive steps to ensure the protection of children’s rights in their decision making and service delivery.

The health and wellbeing of children and young people is a key priority not just for the Scottish Government but for our whole society. I am passionate about that, and I will continue to work with everyone to ensure that Scotland’s children grow up healthy, happy, safe and loved and that they achieve their full potential, and I recognise that we need to support families to achieve that ambition.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

One of my constituents wrote to me in desperation about her 13-year-old granddaughter. She cannot sleep and has regular massive bouts of crying at home and at school. She is suffering so much from mental health problems that the family is at a loss as to know what might become of her. Her teachers believe that she has attention deficit hyperactivity disorder. It took nine months for her mother to get a virtual appointment with child and adolescent mental health services only to be told that they had to wait to be seen by another specialist, probably in eight months’ time.

That young person and her family are struggling to get by. They tried calling the crisis team but found that it is only concerned about suicide. They have also offered to go private to see a child psychologist but have been told that their education board can only act on recommendations from an NHS CAMHS specialist.

Photo of Emma Harper Emma Harper Scottish National Party

I am wondering whether that is part of the evidence that we took for the committee’s report. I thought that we were supposed to be speaking about the report.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

Gillian Martin is in the chamber to speak on behalf of the committee. We are here to talk about not only the report but what we have been told and what we find out as we work. I am telling members about somebody who wrote to me because of the work that our committee was doing.

That grandmother signed off her email with these words:

“Please help. Please help—we are desperate.”

This is June 2022. The Scottish National Party Government’s own standard says that 90 per cent of children and young people should start treatment within 18 weeks of referral to CAMHS. However, that target has never been met since it was introduced in December 2014, more than seven years ago. Members could be forgiven for thinking that, by now, it would be a priority for the SNP Government but, given Tuesday’s fanfare announcement to the media, it clearly is not, is it?

As we drill into the debate, it is important to be clear that, when we home in on failures, we mean systemic failures, strategic failures and failure to plan, resource and protect people and services. We are in no way pointing the finger of blame at families or at professionals in schools and healthcare teams, who are working tirelessly on the front line.

We recognise the hard work and dedication of so many people who are at the forefront of guiding and caring for Scotland’s children and young people: our country’s paediatricians, mental health professionals, campaigners, teachers, parents and guardians. The past two and a half years have been particularly tough and many of those people are suffering with poor mental health, exhaustion and burn-out. We need to take stock of where we are and move forward. The Parliament must step up and do its duty to look after our young people and the people who support them.

We are all aware of the significant impact that the pandemic has had on the mental health of children and young people but, as the committee’s report highlights, the full extent of that impact and how long lasting it will be have yet to be fully understood. However, as many parents and teachers know for sure, waiting lists for CAMHS are far too long by anyone’s yardsticks. Notwithstanding recent investment to increase capacity, our committee has heard extensive evidence of persistently long waits and the negative impact that that is having on the mental health of children and young people who are affected. There is a continuing need for the SNP-Green Government to prioritise investment to further increase the capacity of CAMHS and reduce waiting times.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

Long waits are unacceptable and we remain committed to meeting the standard that 90 per cent of patients should start treatment within 18 weeks by March 2023. I point out to Dr Gulhane that the number of children and young people beginning treatment under CAMHS is at an all-time high. The latest national performance data shows that more than 5,000 children and young people began treatment in the last quarter. That is the highest number ever recorded.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

And yet, our waiting lists are the longest ever. That is the problem. The problem with the SNP-Green Government is that it pats itself on the back instead of thinking what can be done for the people—the children—of Scotland. On that note, I am pleased that Scottish Conservative councillors are keen to introduce trained mental health leads in every school to help to improve children’s wellbeing.

We are also worried about poor mental health among girls. The Government does not seem to have a strategy on that, nor is it tackling poor body image, which bothers many teenagers—boys increasingly but particularly girls. Viewing digitally altered body shapes on social media is impacting children’s self-esteem. As many as one in three teenagers in the UK feels some shame about their body, and 94 per cent of girls aged 11 to 21 believe that more needs to be done to protect young people from body image pressures online.

Members might wish to take a look at a campaign by Dr Luke Evans MP. His body image pledge calls on brands, charities and organisations to promise not to digitally manipulate a person’s body proportions in any of their direct images. A bill that is going through Westminster would require advertisers and influencers to label images that have been digitally altered.

Photo of Clare Haughey Clare Haughey Scottish National Party

I am keen to hear what representations Sandesh Gulhane has made to the UK Government on amendments to the Online Safety Bill that is currently going through Westminster, to which he referred.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

I am supporting Dr Luke Evans, as I have just asked the chamber to do. That is what we need to do: we need to do actual, practical things in order to help people.

The Scottish Government’s commitment to increasing funding for sport and physical activity over the course of this parliamentary session needs to be accompanied by a national strategy with clear and measurable goals for achieving increased physical activity and improved physical health for Scotland’s children and young people. The status quo is not good enough. Scotland continues to face significant challenges, with 29 per cent of children at risk of being obese or overweight, which leads to significant problems. In my general practitioner surgery, we are seeing a rise in the number of children who are developing type 2 diabetes, which is related to obesity, poor diet and a lack of exercise. We need to make healthy foods more affordable and available to families, particularly people from low-income households. We also want funding commitments over the course of the session to remove barriers to accessing sport and physical activity, including play, for those families, as the minister said earlier.

Photo of Sandesh Gulhane Sandesh Gulhane Conservative

I am afraid that I have already taken three interventions.

I am pleased to say that Scottish Conservative councils are keen to reintroduce primary 5 swimming lessons, and to deliver more support for children and youth groups.

Finally, the SNP-Green Government really needs to tackle new and growing threats to the health of our young people. It is estimated that 10,000 Scots children now suffer from long Covid. Those children are victims of the pandemic that the SNP-Green Government has forgotten. I have been calling for long Covid clinics since the summer of 2021. We have all heard the SNP-Green Government announce money, but there has been little in the way of action. Last September, £10 million was pledged, but last month, that was revised down to £3 million for this year. We understand that there is now a pilot project in NHS Lothian involving 70 patients of all ages, which is aimed at courting support. That is a start, but with 150,000 Scots struggling with long Covid, we urge the Government to get a grip faster.

The health and wellbeing of our children and young people has fallen by the wayside. Yes, the situation has been exacerbated by the pandemic, but we were on a downward trajectory well before March 2020. For sure, the issues that are being debated are complex and multifaceted, but let us not forget that our country’s young people are our country’s future.

Finally—if I may be indulged, Presiding Officer—we all need to be aware of the fact that more and more school-age children are using drugs. In a BBC report this week, a Glasgow-based physical education teacher said that he sees at least one student every day turning up in class after taking cocaine, cannabis or amphetamines. That was echoed by a teacher in Ayrshire and a Unison representative for classroom assistants. Few teachers are trained in how to deal with children who are under the influence of drugs, but they are having to deal with growing numbers of those children, which poses a safety risk to the children, other pupils and school staff. We need to provide help to our teachers and schools.

I draw members’ attention to my entry in the register of interests—I am a practising NHS doctor.

Photo of Carol Mochan Carol Mochan Labour

I am pleased to open the debate for Scottish Labour.

We welcome the committee’s report into the health and wellbeing of children and young people. That is an overlooked and important subject that requires much greater attention, especially as a cost of living crisis looks set to grasp hold of many families for months, and possibly years, to come. Let us hope that that does not continue for years—but let us hope that, in the Parliament, we all commit to taking the necessary action to ensure that, if it does, it does not affect our young people. We must do that in every way that we can.

The evidence is overwhelming. It is not just that there are too many children living in poverty in Scotland—even one is too many—but that as many as one in four children is living in poverty. I will say that again: one in four children in this country lives in poverty.

In a great number of cases, those children are not living in homes where no one works, although the right-wing media would like to paint that picture sometimes. Those children are often from working families that simply cannot put food on the table. There are many factors as to why that is the case. Above all, for me, it is a matter of people being underpaid and abandoned to insecure work that simply does not provide enough to raise a family on. If we change that, the mental and physical health of young people across Scotland will begin to improve, year on year.

Naturally, young people cannot wait for all Governments to get their act together, so we must reflect on the marked effects that deprivation has on mental health as well as on physical health right now, and we must do all that we can to prevent inequality and ensure that prevention strategies are properly funded so that our young people’s health is protected right now.

The committee recognised that we must look at CAMHS. At the end of March 2022, more than 10,000 children and young people were waiting for CAMHS treatment. I know that this is said every week to the minister in this chamber, but it appears not to be being heard: these figures are unacceptable and clearly demonstrate the SNP’s long-term inability to improve mental health services. For eight years, the First Minister has followed the same script about her Government’s priorities with regard to young people, but young people need action, not rhetoric.

That includes, as the report highlights, dealing with the limited capacity in our mental health workforce. We clearly cannot wait for the SNP Government’s workforce plan to bear fruit. We have to train and employ a generation of new mental health workers on good wages who can commit their working lives to helping to tackle this problem. Scottish Labour is calling for real investment in mental health services to bring down waiting lists and put specialists in every GP practice, and I reiterate that call today. The Scottish Government must prioritise the issue and do more.

We Labour members recognise that many young people have unpaid caring responsibilities, as the report mentions. Despite that, there is no real strategy in Scotland for unpaid carers—particularly young carers. We heard a lot of evidence about that. Those young carers desperately need the restoration and expansion of respite services, with entitlements to short breaks and wellbeing services as standard. They are entitled to those things and we should press to ensure that they are available across the country.

It has been raised with me that we must also continue to analyse and report on the impact of Covid-19—particularly the impact of long Covid on the health and wellbeing of children and young people—and consider what challenges that is already creating and will create in the future, ensuring that that influences any policies that we implement.

All those reforms will help us to focus on prevention and early intervention in the immediate term, while wider economic change is, I believe, inevitable and essential. The cost of living crisis is rapidly exposing how thin our safety net is, and, in my opinion, the entire concept of employment and the ways in which the state protects and assists its most vulnerable people need to be revisited to create something that is fit for the 21st century.

There is no reason why a wealthy and prosperous country such as ours should even have to worry about this problem; it should be the first order of every day in every Parliament across this country. However, under successive Governments of all stripes, not enough has been done. That has to stop. We all have to do more.

I am sure that I speak for my party and many people in the Parliament and around the country when I say that the current state of provision is well below what is acceptable and we will not continue to put up with it.

Photo of Emma Harper Emma Harper Scottish National Party

Carol Mochan has been talking about tackling poverty, and supporting people’s salaries is obviously one of way of doing that. Does she agree that one way in which we could tackle poverty would be to fully devolve employment law to this country?

Photo of Carol Mochan Carol Mochan Labour

The member knows that we, on these benches, have called for a number of measures. However, when we debate these issues, I would like the Government and back-bench members to come forward with plans that we can implement now. They often tell us that change takes a long time, so let us use what we have here and now to do everything that we can to ensure that children and young people do not live in poverty.

The last Labour Government went some way towards reducing child poverty, but our understanding and methods to combat it have moved on since then, so we will not rest. That is why Scottish Labour’s focused plan has, at its heart, a child poverty commission that will develop real plans to tackle child poverty—we hope—once and for all.

As I said at the start of the debate, if we want to alter the trajectory of young people’s health and wellbeing over the long term, the only solution is sustained investment in services. The Scottish Government must do more to commit to mental health services, in particular. We must look at employing more qualified staff on good salaries. Again, the Scottish Government must do more on that than it has done so far. Above all, we must wipe away that low-pay, insecure world of work that so many families barely earn a living from. All Governments must do more in that regard.

The Deputy Presiding Officer:

You need to conclude now.

Photo of Carol Mochan Carol Mochan Labour

I thank my colleagues from the Health, Social Care and Sport Committee for their work on the report, and I look forward to ensuring that the actions that are recommended in it are delivered.

The Deputy Presiding Officer:

You need to conclude.

Photo of Carol Mochan Carol Mochan Labour

I hope that the committee members will see themselves in the important role of holding the Scottish Government to account.

The Deputy Presiding Officer:

We now have no time in hand, so members will have to stick to their allocated speaking times and accommodate interventions within that.

Photo of Alex Cole-Hamilton Alex Cole-Hamilton Liberal Democrat

I extend my apologies to the chamber, because I will be called away briefly, although I will be back for the closing speeches.

Debates such as this are why I am in politics. This topic is what keeps me, as a youth worker of 19 years and a children’s charity worker of 13 years, up at night. I am therefore grateful to the Health, Social Care and Sport Committee for bringing this important debate to the chamber today. The committee’s report offers much food for thought, but, as many members have done already, I will focus on the state of Scotland’s child and adolescent mental health services.

I am sure that many other MSPs will attest to the fact that, in recent months, there has been a noticeable uptick in our mailbags on the subject of unfulfilled child and adolescent mental health needs. In large part, that is down to the impact of the Covid-19 pandemic and lockdown isolation. However, it is also symptomatic of the fact that we have not been getting things right for a long time. Many have the same story to tell of a young person who is brave enough to ask for help but has to wait an unacceptably long time in order to get it.

Some of the stories are truly harrowing. Many of our children and young people are suffering terribly and without the support that they desperately need. Problems that already existed before the pandemic have been heightened and exacerbated by it, and that is small wonder. Our young people have had to face deep uncertainty about their future while being denied normal access to education and prevented from socialising with their peers—all at a time of deep societal mass anxiety.

Although the pandemic has had an undeniable impact, it would be wrong to ascribe all the failures in the CAMHS system to it. As Audit Scotland has highlighted, mental health care for children and young people was already struggling to meet and keep pace with demand before any of us had heard of Covid-19. To illustrate how dire the situation is, the latest statistics from Public Health Scotland—some of which we have heard already—show that the Government’s 18-week mental health treatment waiting time target was being missed for almost 30 per cent of children and that 1,600 children and 4,400 adults waited more than a year for treatment.

I heard the minister say that more children are being seen than ever before, but we really need to debate and get to grips with the unmet need, which is where the Government has fallen woefully behind. I ask members to think about what that chunk of time in a young person’s life means.

Photo of Gillian Martin Gillian Martin Scottish National Party

In our evidence, we found that the picture across Scotland was variable and that there are areas of Scotland that are getting it right. Does Alex Cole-Hamilton agree that we really need to look at it on a health-board-by-health-board basis and, where there is good practice and waiting times are coming down, replicate the good practice and share it, so that we can learn from the boards that are getting it right?

Photo of Alex Cole-Hamilton Alex Cole-Hamilton Liberal Democrat

Gillian Martin is certainly right about the geographical variability, but that is not something to be pleased about. With regard to rural and remote areas, in particular, the paucity of in-patient tier 4 beds for children anywhere north of Dundee is a scandal. The Government really needs to reflect on that.

Amid that, the latest CAMHS workforce figures show a fall in the number of staff who are working in vital specialist in-patient settings, as I just described. The professionals who are charged with supporting young people are clear that the current system is inadequate—it is leaving children to suffer without the help that they need, and heartbroken parents are powerless to help, which has a demonstrable impact on their wellbeing as well.

The reality of CAMHS is that a person does not get a referral unless their need is deemed critical, which means that the demand for the service might be being vastly underestimated. We are faced with unprecedented demand for those services and fewer staff to meet that demand. Successive health secretaries have spent years trying to spin a positive tale even as the waits for young people get longer and longer. They should take a long, hard look at themselves for that. I have challenged the First Minister about it on countless occasions, yet we still find ourselves in this dreadful position. It became a crisis many years ago, and that crisis, which the Government seems wholly unequal to coming to terms with, is sustained to this day.

Liberal Democrats have long championed the cause of Scotland’s mental health. We secured £120 million for it in last year’s budget and we lodged a motion, which was backed by the Scottish Parliament, to declare a national mental health emergency. We believe that everyone should have access to good local mental health services, and we have called for mental health first aiders at every stage of education. That starts with having a trained talking therapist—a counsellor—available in every school in Scotland.

The Government should also lower the referral bar for young people from deprived communities, because we know that those who are at risk of multiple adverse experiences need access to early support. We still do not know who they are or where they are. We need to capture that information and get help and healing to them fast.

Changes should be made to the CAMHS system now. There should be a single point of contact for CAMHS waiting lists so that GPs and families can understand whether remaining on that list offers a real opportunity of timely care.

The Government needs to act. As the committee’s report recommends, it needs to provide a detailed timeline to clear CAMHS waiting lists. We need action backed up by fresh funds for mental health services and more local and accessible services and practitioners. Instead, in its spending review, the Government failed to provide any detail at all of how it intends to meet its manifesto commitment to ensure that 1 per cent of the front-line healthcare budget is spent on CAMHS by 2026 or how it will ensure adequate staffing of CAMHS.

What is most troubling about the delays in treatment is that some young people’s mental health will deteriorate unnecessarily while they wait for that treatment. Many of them are reaching crisis point, which could have been avoided, and that is heartbreaking.

When it comes to the health and wellbeing of young people, Scotland has a chance to do things differently. In recent years, our young people have made serious sacrifices in order to keep others safe. It is time that we recognised that and met it with action.

The Deputy Presiding Officer:

We now move to the open debate.

Photo of Siobhian Brown Siobhian Brown Scottish National Party

I thank the Health, Social Care and Sport Committee for its inquiry and for bringing the debate to the chamber today.

As my colleagues in the COVID-19 Recovery Committee will agree, the pandemic has had a massive effect across all areas of public life, and as we heard in committee, children and young people’s health and wellbeing are no exception.

On Monday, with many other parents, I attended my youngest daughter’s first sports day. I am pleased to report that she came first in the egg and spoon race. Needless to say, she does not take her sporting abilities from me. My eldest had her school leaving prom last week; I cannot tell you how lovely it was to attend both events and to see some sense of normality returning for our kids. My point in bringing that up is that small events in a person’s life contribute massively to their wellbeing. Being surrounded by friends and family and celebrating together is, unfortunately, something that our young people have, largely, missed out on for the past two years.

During the pandemic, we asked Scotland’s young people to do what none of us had to do at their age: we asked them to give up all sense of normality. We asked them to stay inside, to stay away from their friends, and to do their school work from home. That it was necessary at the time did not make it any easier. We should all say a big “Thank you” to our young people for the sacrifices that they made for the greater good. Our children are our future.

I welcome the committee’s recommendation that

“the long-term impact of the pandemic remains a key consideration in the future design and development of mental health services and support for children and young people.”

It has never been more important to look after our mental health, so I welcome the fact that the Scottish Government is providing record investment to improve the nation’s wellbeing and our mental health services. The Scottish Government’s mental health transition and recovery plan investment of £120 million is the single largest investment in mental health in the history of devolution.

I also welcome mention in the committee’s report of healthy eating and obesity and, more specifically, of the link between poverty and poor diet. I do not think that we should beat around the bush: childhood obesity is too high and we need to do more to combat it. I welcome that Scotland is leading the way to expand access to free school meals, so that more children can feel the benefits of nutritious cooked meals during the week.

When I last visited South Ayrshire Foodbank, volunteers told me that some people who are using the service need a bit more information on healthy eating and cooking. We could look at improving aspects of home economics education in our schools to counteract that.

We all know the impact that living in poverty can have on the health and wellbeing of Scotland’s most vulnerable people, so tackling poverty is one of the Scottish Government’s priorities. Despite the rapidly rising living costs under the Tories’ watch, the UK Government ploughed ahead with the cruel £20 cut a week to universal credit, which has financially impacted on more than 60,000 families, including their children, in Scotland. That comes on top of a decade of enforced Tory austerity, changes to the benefits system and—as we are all aware—a rapid increase in use of food banks.

“Best Start, Bright Futures: Tackling Child Poverty Delivery Plan 2022-2026”, sets out the Scottish Government’s bold action to drive progress on tackling child poverty. A recent Child Poverty Action Group report shows that the cost of bringing up a child in Scotland will be lowered by 31 per cent—equivalent to £24,000—once the Scottish child payment is doubled and the expansion of free school meals is delivered.

Photo of Sue Webber Sue Webber Conservative

Scotland has the lowest level of breakfast provision of all four UK nations and the lowest number of pupils per school on average accessing breakfast provision each school day. Can you explain why that has been allowed to unfold under the SNP Government?

Photo of Siobhian Brown Siobhian Brown Scottish National Party

Thank you for your scripted question.

The Deputy Presiding Officer:

Could both members address points through the chair, rather than addressing each other as “you”, please?

Photo of Siobhian Brown Siobhian Brown Scottish National Party

I am sorry, Presiding Officer. Yes, we are dedicated to expanding free breakfast provision throughout schools.

The newly doubled Scottish child payment, together with the three best start grants and the best start food payment, will be worth more than £10,000 by the time a family’s first child turns six, and it will be worth £9,700 for a second child and subsequent children.

The Government’s actions are putting money in the pockets of families now, which, as we know, is desperately needed because of the cost of living crisis. The policies and funding that it is putting in place across all areas are vital in achievement of our goal of making Scotland the best place for children to grow up in.

Progress is being made. I know that every MSP, regardless of their political colour, shares the Government’s ambition. I highlight today’s news that South Ayrshire leads Scotland with 97.6 per cent of school leavers going on to positive destinations—work, training or further study.

I thought that a 2019 report by the World Health Organization and UNICEF made an interesting point. It was that no country in the world is providing the conditions for children to live a healthy life and an environment that is fit for the future. That means that, although richer countries might invest in children’s health, they are also producing record amounts of CO2, which will affect children all over the world in years to come. That demonstrates that, as with everything else in politics, we must take a multifaceted approach when it comes to the health of our children. We cannot tackle it through one policy area alone. The report also shows that the challenges that we are facing in Scotland are not unique but are being experienced all over the world, and were even before the pandemic began.

If we continue to make children’s wellbeing our priority, we can get it right for every child and can make Scotland a country that is healthy, nurtured and active.

Photo of Meghan Gallacher Meghan Gallacher Conservative

I am very grateful for the opportunity to speak in this important committee debate. I offer my apologies, because I will need to leave the chamber before the conclusion of this afternoon’s debate.

I, too, thank the Health, Social Care and Sport Committee for publishing its report, which makes 99 recommendations for the Government to consider in order that it can improve the wellbeing of young Scots. It now falls to the Government to consider seriously the recommendations and to make much-needed improvements.

In March, the Scottish Parliament restated its commitment to keeping the Promise and improving outcomes for care-experienced young people. Although that was welcome, the SNP ignored calls from the Conservatives to acknowledge the concerns that had been raised by various charities and third party organisations that work directly with young people in care. I found it upsetting that, during the minister’s opening remarks, not one reference was made to care-experienced young people.

Photo of Clare Haughey Clare Haughey Scottish National Party

The member will accept that I had only limited time. I referred in my speech to the whole family wellbeing fund, which is specifically for fulfilling the Promise.

Photo of Meghan Gallacher Meghan Gallacher Conservative

I thank Clare Haughey for her intervention. However, given that the Promise is one of the Government’s flagship policies and a recommendation of the Health, Social Care and Sport Committee, I would have thought that there would be more focus on the matter in the minister’s opening remarks.

On top of that, more concerns have emerged since the SNP’s handling of implementation of the Promise. The concerns outline a lack of progress since the independent peer review that was initially launched in February 2020.

Recently, I had the opportunity to meet Fiona McFarlane, who is the head of oversight at the Promise Scotland, to discuss the work that the oversight board is undertaking to ensure that the Promise is rolled out. She has been critical of the level of progress that the Government has made in the past two years, and she admitted that young people’s lives will not have improved but might even, in some instances, have got worse.

A study that was conducted by the Promise Scotland oversight board found that the pledge that had been made by the Government in 2020 was more of a commitment than a true implementation plan. One of the main flaws in the Government’s Promise policy relates to a lack of meaningful data or true understanding of young people in care. For example, the study shows that between 2019 and the first nine months of 2021, 59 young people died, of whom 17 were children in care, seven were in continuing care and 35 were in throughcare and aftercare. One death of a young person in care is one death too many. It is heartbreaking that the data on the lives of those young people has not been properly recorded.

Failure to understand young people not only makes recording data more difficult—it fails to provide authorities with important information that could prevent future deaths. Although MSPs can accept that the Promise has been described as a 10-year transformational change, those problems have existed for years.

Photo of Meghan Gallacher Meghan Gallacher Conservative

No. I am sorry; I have a lot to get through.

The SNP is failing young people in care by not urgently addressing the glaring issues in implementation of the Promise. That must change.

As I have mentioned before, we are corporate parents. It is our responsibility make sure that we are listening to young people who have experienced the care system so that we can ensure that the Promise can get back on track. I would be grateful for the minister’s committing today to ensuring that appropriate data will be recorded about young people in care, which has previously been rejected by the Scottish Government.

Before I move on, I will raise a local issue that was brought to my attention by a campaigner from Who Cares? Scotland. Despite council tax having been abolished for care leavers five years ago, South Lanarkshire Council does not provide any information on reductions for care leavers. The information is not even listed in the “Am I eligible?” section of the forms. Other councils, such as Highland Council, have a whole section on exemptions for care leavers, but no mechanism for people to select that option. The individual whom I interacted with on social media stated:

“Policies don’t matter if they are still inaccessible after 4 years”.

If there is a quotation to take away from today’s debate, that should be it.

There are also good examples of best practice. City of Edinburgh and Stirling councils display a clear page for care leavers and offer a 25 per cent discount on council tax for other household occupants. Aberdeen City Council has gone a step further by extending the offer to care-experienced young people who have been in kinship care and, who might not have met the definition of care leaver.

However, those examples highlight the inconsistency in the support that is being offered by councils to care leavers and care-experienced young people. It should not be a postcode lottery. I hope that the Convention of Scottish Local Authorities and the Scottish Government will work together to ensure that support for the health and wellbeing of care-experienced young Scots improves across all levels of government.

Presiding Officer, I was hoping to cover mental health and the mental ill-health pandemic that is affecting our young people today, but I realise that I am quickly running out of time. I also understand that the issue has been articulated by many other MSPs in the debate.

The issues that I have raised cover just a few of the recommendations that are set out in the Health, Social Care and Sport Committee’s report. The report lays bare the failings of the SNP Scottish Government and illustrates the measures that we must take to ensure that young people across Scotland receive the necessary help and support. The only way the Scottish Government can fully focus on the day job is if it drops its obsession with breaking up the United Kingdom.

Photo of Stephanie Callaghan Stephanie Callaghan Scottish National Party

I am grateful for the opportunity to speak in the debate, as the health and wellbeing of our young people are central to our nation’s future.

In reflecting on the inquiry into the health and wellbeing of young people this year, it is important to ask what it really means to be a healthy young person. “Healthy” can mean different things to different people but, generally, it means a state of positive physical, mental and social wellbeing. Simply put, it means that someone is happy, thriving and flourishing. That chimes with the Scottish Government’s getting it right for every child, or GIRFEC, policy approach, which seeks to ensure that all our young people are safe, healthy, achieving, nurtured, active, respected, responsible and included.

The committee looked at the barriers to achieving positive health and wellbeing. Time and again, we heard how poverty harms our children and young people. So far, much of the debate has focused on poverty, and it will be my focus, too—I make absolutely no apology for that. In the oral evidence sessions, Heather Connolly of the British Psychological Society, among others, concluded that the biggest issue affecting the health and wellbeing of children is poverty, and that message was echoed again and again.

Aberlour has highlighted the impact of poverty on the family as a whole and reminded us that children spend only around 15 per cent of their time in school. That is why so much of the third sector’s work to support children’s learning focuses on family wellbeing by, for example, helping with challenges around family relationships, struggles with debt and domestic abuse.

The committee heard worrying evidence about how poverty damages health and wellbeing and that the pandemic has hit the poorest the hardest. However, despite all the evidence, the UK Government ploughed ahead with a deadly £20 cut to universal credit, which pushed a further 20,000 children into poverty. That was a really callous and disturbing decision. As the cost of living crisis pushes even more families into poverty, our children will again pay the price through the impact on their health and wellbeing.

Child poverty is a scourge that means growing up without access to good, decent and nutritious food. It means missing out on sport and other healthy activities, saying no to fun with friends and home living conditions that strain family relationships and make it really difficult to study and to learn. Hungry children from cold and damp homes, with parents who are battling poverty every day, will struggle to learn, grow and thrive in our classrooms and in our society more generally.

Poverty has a clear and undeniable negative impact on the mental health of whole families and, as we have heard, it often leaves children feeling stigmatised and isolated. In many struggling families, children are in the heartbreaking situation of looking out for their parents and, in effect, shouldering the responsibilities of poverty. We cannot ignore the stories of kids hiding their school trip leaflets or avoiding social get-togethers with their friends. Too often, having fun costs money, and those kids do not want their parents to feel as though they are letting down their children. Those stories are a clear manifestation of the impact of poverty on our young people’s wellbeing.

Of the committee’s 99 recommendations, I will highlight two that I believe are the absolute cornerstones of enhancing children’s health and wellbeing. The first is recommendation 32, which calls on the Scottish Government

“to further prioritise spending to mitigate the adverse impact of poverty on the health and wellbeing of children and young people.”

The second is recommendation 42, which states:

“Tackling poverty has to be at the heart of an effective strategy to improve the health and wellbeing of children and young people.”

In evidence to the committee, Heather Connolly, from the British Psychological Society, told the committee:

“If we do not target poverty and child poverty, all the other money that we are spending on services and early interventions will not work as well. People will not be able to engage with those services, because they will still be too worried about getting food on the table or getting clothes for their kids in order that they can go to school. They will not feel safe and secure or a sense of hope that things will get better; therefore, they will be unlikely to engage with services or professionals.”—[Official Report, Health, Social Care and Sport Committee, 11 January 2022; c 26-7.]

That is why the Scottish Government continues to invest in actions to tackle the blight of poverty in 2022, as we have heard. I again highlight that more than 100,000 children have already been supported with the Scottish child payment, and I welcome the further roll-out of the payment to 400,000 children by the end of this year. It is also worth mentioning that, this week, encouraging figures were published on positive destinations for school leavers. The gap is narrowing.

In the absence of fiscal autonomy, we, as a devolved Government, are confined to balancing public finances without being able to borrow. However, as Audit Scotland’s recent report acknowledges, the Scottish Government has successfully delivered existing social security benefits and has introduced complex new ones—including the Scottish child payment, the child disability payment and the adult disability payment—in challenging circumstances, amid a pandemic. Audit Scotland highlights that as a significant achievement, and we must continue to step up to such challenges, because our young people are counting on us to make Scotland the best place in the world to grow up in.

Yesterday, the First Minister fired the starting gun on a new campaign for Scottish independence, and she will set out a vision over the coming weeks and months. That vision will have tackling poverty and inequality at its centre, and it could dramatically improve the life chances of our young children. I can think of no better case for independence than finally being fiscally free to invest in strategies that will lift all children out of poverty, thereby enhancing their health and wellbeing.

Photo of Paul Sweeney Paul Sweeney Labour

It is a pleasure to contribute to today’s debate. I pay tribute to all colleagues on the Health, Social Care and Sport Committee. I do not sit on the committee, but I keep a close eye on it, given the importance of its work.

I do not intend to take up the full time that I have available today. I will try to focus my remarks on the crisis that our child and adolescent mental health services face by highlighting the real-life challenges and consequences that many of our constituents live with as a result of that crisis.

The report on the health and wellbeing of children and young people highlights many challenges, but, for me, the starkest of all relates to the pressures that CAMHS across Scotland face. The most recent Public Health Scotland data shows that, at the end of 2021, almost 10,500 children and young people were waiting to be seen by CAMHS. Of that number, 46 per cent were waiting longer than the 18-week target that the Government has set. That is an extraordinary number of children and young people who are, to be frank, being failed by the system. We know that that target is vital. In its submission to the inquiry, Social Work Scotland stated that “long delays” in accessing treatment can lead to “more entrenched difficulties” by the time a child or young person is finally able to access the service.

There is no denying that the impact of the pandemic has been hugely significant, and the report acknowledges that. However, if anything, that makes it all the more important that we get on top of the problem now. We could talk about statistics all day—I am sure that that would be done with the best of intentions—but we cannot shy away from the fact that there are real-life consequences to delays in accessing CAMHS.

Photo of Gillian Martin Gillian Martin Scottish National Party

Recommendation 11 in the report points to the “turnaround” in waiting times in NHS Grampian. Does Paul Sweeney agree—I made a similar point to Alex Cole-Hamilton—that we need to look at where there is best practice and where there has been a turnaround, and that we should replicate what is working elsewhere across the country?

Photo of Paul Sweeney Paul Sweeney Labour

I absolutely recognise that. We need to have in place much more robust mechanisms that show us where performance is good and how that can be quickly cross-pollinated to other health boards in different areas, because there is an administrative lag in the bureaucracy across Scotland—things are quite fragmented. That is a constructive suggestion about how we move forward, and I commend it. I encourage the committee to press that issue with the minister. I hope that he has heard Gillian Martin’s comments and will address the issue in his closing speech.

I will mention a constituency case that troubled me so much. I was contacted by a constituent regarding his 13-year-old daughter, who is care experienced and was adopted by the family about eight years ago. The pandemic had a profound effect on her. The lockdown and the lack of school routine and normal socialising led to some challenging behaviour at home—so much so that the family sought a CAMHS referral on 2 June 2020. More than two years later, there is still no timeline or indication of when she will be given access to the services that she needs.

In April 2021, the family’s GP made another referral, due to the deterioration in her mental condition and a perceived increase in risk. That particular crisis led to an emergency CAMHS appointment, but the assessment was that she should remain on a routine waiting list. Heartbreakingly, she wants to engage with CAMHS and cannot understand why she is being made to wait so long. As the chamber will appreciate, that situation is not only having an adverse impact on my constituent’s daughter; the challenging behaviour is having an adverse impact on the whole family, one of whom has been sitting her national 5 exams in recent months.

My constituent is just one of the parents who find themselves in that position, and his daughter is sadly one of thousands of kids who are waiting for vital treatment. It is clear that, in many circumstances, the 18-week target for treatment is nothing more than a cruel pipe dream. In my constituent’s case, that target has not been missed marginally. We are now 106 weeks down the line—a period almost six times longer than the 18-week target—and the family is no further forward, with no light at the end of the tunnel.

The longer we continue to shirk that issue, the longer children and their families will continue to be failed by the system. I ask the minister to engage with that issue constructively and request that my constituent’s case be looked at urgently. I am happy to share the details with her if she agrees today to intervene and insist that the case is resolved with NHS Greater Glasgow and Clyde.

Fundamentally, we need to do much better, because we are currently failing thousands of children across Scotland who desperately need our help.

Photo of Emma Harper Emma Harper Scottish National Party

As a member of the Health, Social Care and Sport Committee, I welcome the opportunity to speak about how important it is that we value the health and wellbeing of our young people in Scotland. I thank colleagues and everyone who contributed to the inquiry.

Our committee’s report speired, or inquired, into a range of issues and covered a number of areas. It is worth reading the report, but I will focus my contribution specifically on three of the areas that I have been actively involved in: supporting folk experiencing eating disorders, health and wellbeing support for young people in school and education settings, and poverty.

First, a number of submissions to our inquiry highlighted a recent rise in demand from children and young people who need support for eating disorders. The pandemic has exacerbated that trend, with a reported increase of 86 per cent in referrals to specialists between 2019 and 2021.

People with eating disorders typically develop severe physical health problems, and overall quality of life has been estimated to be as low as in symptomatic coronary heart disease or severe depression. Access to the right treatment and support is life changing, and early intervention provides the best chance of recovery.

In our report, we call on the Scottish Government to outline what it is doing to respond to the recommendations of the national review of eating disorder services, including details of any funding that it is putting in place to support their implementation.

I welcome that the minister outlined the Government’s response to the recommendations during a members’ business debate, which I led, on eating disorders awareness week. He outlined that the Scottish Government’s

“transition and recovery plan ... is backed by the £120 million recovery and renewal fund, which will help to transform” eating disorder

“services, with a renewed focus on prevention and early intervention.”

Additionally, the Government announced

“£5 million to implement the recommendations of the national eating disorders review”—[Official Report, 1 March 2022; c 98.]

as well as “more than £400,000” of funding for the fantastic charity Beat to enable it to continue its vital work.

I welcome those steps and ask the minister, in closing, for a commitment that the Government will continue its support to Beat.

I turn to health and wellbeing support in schools. In our report, the committee recognises the central and pivotal role that schools have to play in co-ordinating a whole-systems approach to supporting the health and wellbeing of children and young people. Counselling can help children and young people to explore, understand and overcome issues in their lives to improve resilience.

In Dumfries and Galloway in my South Scotland region, the council has received national recognition, including from Young Scot, for its innovative approach to school counsellors. The local authority has provided the youth enquiry team with access to counselling education, destigmatising the language around the word “counsellor” and encouraging more young people to access support, should they require it. I welcome that action and encourage other local authorities to look at the example of Dumfries and Galloway Council, which seeks to improve services with the aim of achieving the best possible health and wellbeing outcomes for our young people. I will follow up the outcomes and the measurements of the goals and aims of that adopted approach.

Against a backdrop of a cost of living crisis, the pandemic, Brexit and harmful UK Government welfare policies, the Scottish Government continues to mitigate cruel Tory cuts that harm our young people. We know that living in poverty can have severe impacts on health and wellbeing, which is why tackling child poverty, as our committee asked for, is rightly a national mission for the Government. Indeed, in its report, our committee notes that it

“has been struck by the volume of evidence it has received showing the overriding impact poverty and deprivation has on the health and wellbeing of children and young people.”

I jalouse that the Opposition will nae like tae hear this, but it has to be accepted that this poverty is largely down to the UK Government, as Mary Glasgow from Children 1st indicated during the inquiry. Despite the rapidly rising living costs under the Tories’ watch, the UK Government ploughed ahead with a cruel £20 cut to universal credit, which pushed 60,000 Scots, including 20,000 children, into poverty.

Scottish Government analysis found that reversing key UK Government welfare reforms that have been made since 2015 would bring around 70,000 people in Scotland out of poverty, including 30,000 children, in 2023-24. The total cost of reversing those reforms, including the two-child limit, the removal of the family element, the benefit freeze, and changes to universal credit work allowances and the taper rate, would be around £780 million per annum.

Presiding Officer, “mitigate, mitigate, mitigate” are the words that my colleague Christine Grahame used in another recent debate. She said that she was fed up with talking about mitigating Tory policy and I am also fed up with mitigating Tory policy. It is time that the announcement about the independence referendum, the move towards it and the full fiscal autonomy that Stephanie Callaghan talked about in her contribution were taken forward, along with the actions that will support the mental health and wellbeing of all our citizens in Scotland including our children and young people.

Photo of Gillian Mackay Gillian Mackay Green

I welcome this debate on the health and wellbeing of young people and thank all those who gave evidence to the committee.

During committee sessions, we heard a wealth of evidence about how the pandemic has impacted on children and young people and the services that care for them. It has been a turbulent two years for young people, who have seen their education disrupted, their social lives restricted and, unfortunately, in some cases, their loved ones becoming very ill. In the wake of multiple lockdowns, it is vital that we examine the many ways in which young people have been affected, and what that means for their health.

The committee report recommends that the Scottish Government and other key stakeholders should continue to monitor the long-term impacts of the schooling restrictions that were imposed by the pandemic on the health and wellbeing of children and young people, particularly those who have struggled with or missed out on important milestones in their education. That must be prioritised to reduce the risk of young people falling through the cracks and disengaging from services.

During evidence, we heard from many witnesses about how Covid has impacted on engagement with young people and their families and carers. In particular, we heard about the difficulties that schools have had in engaging with parents after remote learning, with school and nursery staff reporting that they were not having the same depth of engagement with many families when communication was not face-to-face. Work must be done to re-establish those relationships.

Alongside improving engagement, we need to ensure that services are there to help young people when they need help, and that no one is turned away. Long waiting lists for CAMHS were frequently highlighted to the committee, with Mary Glasgow from Children 1st stating that:

“We need to fill that gap between universal services and very specialist services such as CAMHS with that whole-family support and community-based offer that any parent or carer, without stigma or shame, can reach out to and access quickly to get the support that they need.”—[Official Report, Health, Social Care and Sport Committee, 11 January 2022; c 13.]

As well as improving waiting times for CAMHS, we need to expand provision in the community so that people can access support without referral to specialist services, where that is appropriate. That is why, as part of the Bute house agreement, the Greens and the Scottish Government committed to doubling the budget for community-based mental wellbeing services for children and young people to £30 million.

It is also important that community services are properly equipped to help children and young people. For example, link workers play a vital role in GP surgeries in connecting people to local resources. They must have the training and the resources that they need to help children and young people and to connect them with person-centred, dedicated support that takes account of the particular issues and challenges that they face.

The committee also heard about children and young people being subjected to a postcode lottery. The NSPCC highlighted that we need to urgently understand what local capacity there is across health boards because, although there are examples of good practice, as Gillian Martin told us, levels of provision are variable and there is no clear national picture.

In its report, the committee recommends that the Scottish Government commissions further research on the prevalence of mental health conditions in children and young people and maps levels of existing capacity across mental health services. Given the pressures related to the pandemic that I laid out earlier, we know that there is greater unmet need. We must determine the level of need and what support is already available if we are to properly plan services for the future.

That leads me on to my next point, which is about data on health inequalities. During a committee evidence session, Dr Mairi Stark from the Royal College of Paediatrics and Child Health said:

“The prevalence of mental health difficulties is probably much higher than we realise. We often see only the tip of the iceberg, but a lot of children could do with a lot more support.”—[Official Report, Health, Social Care and Sport Committee, 18 January 2022; c 21.]

We need to have a better understanding of the barriers to accessing support that young people face. For example, we do not know whether members of marginalised groups are more likely to receive a rejected referral. Improved data on that will aid our understanding of why some people are not getting the help that they need.

Given that it is pride month, it would be remiss not to mention LGBT young people’s experiences. We need to ensure that health services are able to help LGBT young people with the particular issues that they face. Yesterday, it was revealed that hate crimes against transgender people rose by 87 per cent over the past year. That appalling figure reveals the discrimination and hate that trans people, including young trans people, have to face every day. It would be foolish to imagine that that will not take a toll on their mental health.

We know that 40 per cent of LGBT young people consider themselves to have a mental health problem, compared with 25 per cent of all young people in Scotland. It is vital that services are properly equipped to deal with that and that there is awareness and understanding of the specific challenges that LGBT young people face and how those impact their health.

According to the Mental Health Foundation, although being LGBT is not in itself a risk factor when it comes to developing a mental health problem, some LGBT young people are more likely to develop a mental health problem, as a result of their being at greater risk of exposure to certain risk factors, such as discrimination, loneliness, homelessness and poor access to health services, than their non-LGBT peers.

The Mental Health Foundation also highlighted that the pandemic has increased waiting times for young trans and non-binary people who are seeking to access gender identity clinics, which could severely impact their mental wellbeing. Progress is being made to reduce waiting times, and I welcome the Minister for Public Health, Women’s Health and Sport’s commitment to improvement, but waiting times are still too long. We need to ensure that trans and non-binary young people receive compassionate, informed and understanding support from health services while they are waiting for an appointment.

Children and young people have had a very difficult two years, and much work needs to be done to improve their health and wellbeing and ensure that they get the help that they need, when they need it. The committee’s report sets out a clear way forward, and I, too, would like to thank everyone who gave evidence and helped the committee with its work.

Photo of Kaukab Stewart Kaukab Stewart Scottish National Party

I thank the Health, Social Care and Sport Committee for bringing the debate to the chamber and for the report that it published in May on its inquiry into the health and wellbeing of young people across the nation, which covered a wide range of important issues.

As we continue on our trajectory to making Scotland the best place for a child to grow up in, it is important to reflect on the critical work that is currently under way and to speak frankly about the many challenges that we face in getting there.

In Scotland, and in every country, poverty and social inequality are complex and multifaceted. They relate to much more than just income. Amnesty International’s former secretary general, Irene Khan, sums them up as being about

“economic and social rights, insecurity, discrimination, exclusion and powerlessness.”

In the committee’s report, there is worrying evidence of the growing impact of the cost of living crisis on our children and young people. Bill Scott, the chair of the Poverty and Inequality Commission, highlights the fact that

“Control over the vast majority of means-tested benefits, which are the most effective way of delivering support to lowincome families, is held at the UK Government level.”—[Official Report, Health, Social Care and Sport Committee, 31 May 2022; c 26]

If memory serves me correctly, the Conservatives are more concerned with cuts than with offering meaningful support to people who are most in need.

New research published by Action for Children sheds light on the devastating impact of the recent cuts to universal credit. Analysis of the charity’s crisis fund, which provided emergency grants for food, utilities and other essentials to people in difficulty, found that more than half of the grants that were issued were awarded to those who were already receiving universal credit, suggesting that the payment is falling well below what is needed to meet even the most basic living costs. Among the appalling statistics are stories of keyworkers—who are doing all that they can to help—finding children arriving at school with chilblains on their feet because their house was so cold, or helping a single mother of two who, despite working 37 hours a week as a finance officer, still needed food vouchers to feed her family at Christmas.

By contrast—and as stated by the cabinet secretary to the Health, Social Care and Sport Committee—in its never-ending attempt to mitigate the ripple effect of Tory austerity, the Scottish Government has worked hard to strengthen the financial support that is available for low-income families across the early years. The Scottish Government’s package of five family benefits includes the best start grant, best start foods and the Scottish child payment, which was doubled to £20 per week per child in April this year, all of which was achieved as part of the SNP Government’s first tackling child poverty delivery plan.

However, social security alone is not sufficient to tackle inequality. It is crucial to recognise the indisputable link between deprivation and poor mental health and how that, in turn, impacts on young people’s ability to thrive and reach their full potential. The millennium cohort study shows that poorer children are four times more likely to develop mental health problems by the age of 11 than children in higher-income families, not to mention the physical and emotional strain that living in poverty places on parents, causing feelings of shame and embarrassment that invariably filter through to their kids and can alter family dynamics.

Professor Hazel Borland, from NHS Ayrshire and Arran, touched on those feelings in her evidence to the committee:

“Poverty is incredibly stigmatising for families because it reduces choice. It reduces options and means that a child, young person or family cannot say yes to things that they might want to say yes to. Therefore, their world becomes much narrower”—[Official Report, Health, Social Care and Sport Committee, 11 January 2022; c 17.]

and they begin to view themselves through a very limiting lens.

In the light of those points, I was pleased to see that the Scottish Government’s mental health transition and recovery plan is backed by a £120 million recovery and renewal fund over 2021-22. That represents the single largest investment in mental health in the history of devolution, as colleagues have mentioned.

I also welcome the additional £15 million that has been provided to local authorities to deliver locally based mental health and wellbeing support for five to 24-year-olds in their communities, and the announcement of £5 million of funding for see me—the national programme to eliminate mental health stigma and discrimination.

As we look forward, and as part of the wider effort to ensure that children can flourish here, in Scotland, I join the committee in calling on the Scottish Government to set out in greater detail how the new child poverty delivery plan will contribute to improving the health and wellbeing of children and young people who currently live in poverty and to commission further research on the prevalence of mental health conditions among children and young people, so that we can build a better picture and allocate resources most effectively while remaining cognisant of the fact that prevention and early intervention are key.

No child should be going to school hungry or battling the stigma that goes with that. I look forward to the progress that we will make together as a country.

Photo of Tess White Tess White Conservative

I am delighted to speak in this afternoon’s debate. The Health, Social Care and Sport Committee carried out its inquiry into the health and wellbeing of children and young people before I became a member. I pay tribute to the convener, clerks, members, witnesses and stakeholders for such a substantial piece of work on a vital topic.

The committee’s inquiry was wide ranging, which is a reminder that so much has a bearing on the health and wellbeing of our young people—even before the significant impact of the Covid-19 pandemic is taken into consideration. I am especially pleased to see recommendations from the committee that relate to the mental and physical health of young women and girls. I sincerely hope that we will see action in those areas. What happens during the formative years can hugely affect later life, so we need to get our approach and interventions right.

The starting point of the committee’s inquiry was this question: is Scotland the best place for a child to grow up in? Given that the committee made 99 recommendations, there is still a long way to go, but that needs to becomes the reality.

In the past few weeks, the education secretary and the First Minister have been at odds over the timeline for closing the educational attainment gap. On the keystone policy commitment of Nicola Sturgeon’s SNP Government, the situation has got worse on the Government’s watch. There was a real-terms cut of almost £15 million from the children and families budget in the most recent spending review, but—predictably—the SNP still managed to find £20 million to fund preparations for another independence referendum.

Photo of Tess White Tess White Conservative

Will I get the time back, Presiding Officer?

The Presiding Officer:

We are tight for time.

Photo of Tess White Tess White Conservative

I will proceed.

Official figures that were published last Tuesday reveal that more than a quarter of children and young people are still not being seen within the target of 18 weeks for referral to child and adolescent mental health services. In fact, the Scottish Government has never—I repeat, never—met its target in that regard. Yet the SNP-Green Government has found the time to commission and publish a paper—the first of many, apparently—on building a new, independent Scotland. That is another distraction from the SNP’s woeful record on the delivery of public services.

As if that were not enough, Audit Scotland, which scrutinises how the public purse is spent, faces having its “wings clipped” for shining a light on Government failings that long predate the pandemic. In particular, the spending watchdog has repeatedly raised a red flag on CAMHS. It has said:

“Serious concerns have existed for years about access to children and young people’s mental health services.”

The committee rightly looked at CAMHS during its inquiry and suggested a number of recommendations to address lengthy waiting lists and workforce capacity.

The report commends the work that NHS Grampian, in my region, has undertaken to improve waiting times for CAMHS, but I emphasise that that turnaround took roughly 10 years. That is time that the system simply does not have. As the Royal College of Psychiatrists in Scotland has made clear, at one stage last year, more than 1 in every 100 young people was being referred to CAMHS. We cannot leave Scotland’s children and young people in limbo any longer.

The committee highlighted the role of schools in supporting health and wellbeing. I am pleased that schools have started to embed counselling services, but I am aware that there is a shortage of qualified and accredited counsellors in parts of the north-east, which means that some services might not be fully up and running for some time. We constantly come up against poor workforce planning by the SNP Government, and our public services are poorer for it.

The committee called on the Scottish Government to set out how it intends to increase rates of physical activity among children and young people—especially girls and young women. In her evidence, the Minister for Public Health, Women’s Health and Sport said, in relation to low participation levels in women’s sport:

“you cannot be what you cannot see”.—[Official Report, Health, Social Care and Sport Committee, 1 February 2022, c 35.]

In my region, there are some exceptional women who are leading the way in that area. They include Montrose Football Club Women, who recently won the Scottish Women’s Football Championship; Aberdeen-based cricket team Northern Lights, who won their debut match in the Women’s Premier League; and Hollie Davidson, who was the first female to referee a men’s six nations side in a test match. Those are the successes that we must celebrate and share to improve participation in women’s sport and achieve parity of recognition with men’s sport.

It is abundantly clear that the SNP-Green Government has the levers it needs to improve our public services, from health to education. This is not a question of powers but of good governance. The SNP needs to get its own house in order, yet it is already thinking about building a new one. Let us rebuild Scotland, not divide it.

Photo of Pauline McNeill Pauline McNeill Labour

I begin by thanking the Health, Social Care and Sport Committee, as Paul Sweeney did, for its very significant and comprehensive report. However, the question that we need to begin with is why is the demand for mental health support so high, and why is it so commonplace for teenagers and young people in their early 20s to turn to mental health support? We must try to understand why.

Alex Cole-Hamilton talked at length about long waiting lists—rightly so—but it is important that the Parliament understands what is behind that. I said before that I do not think it is simply an issue of resource; it is also an issue of design.

In similar debates, particularly in relation to young people’s mental health, I have said that the system—certainly in Glasgow, which is the part of the country that I represent—seems to be the opposite of what people need. People need to opt into the service and if they do not respond within five days they get knocked off the list; that is the opposite of what people who are struggling with their mental health need. I would like to think that by the end of this parliamentary session some of these issues will have been tackled.

As Carol Mochan, Siobhian Brown and Stephanie Callaghan rightly said, there are complex reasons behind the growing problem of mental ill-health. Poverty is obviously very significant, as are trauma in people’s lives and the impact of the pandemic.

Alex Cole-Hamilton said that we are beginning to realise the impact of being isolated for so long on very young children. We have to try to understand that so that we know how to respond.

Although I am a relative newcomer in trying to understand mental health services, I have made the point before that in redesigning those health services, we need to ensure that we keep pace with good practice and international practice. For example, eye movement desensitization and reprocessing therapy is not widely used, but some people think it could be a useful tool to have available.

I want to focus on an area that I think needs some attention: the mental health of girls, which Tess White also spoke about. Arguably, we have seen progress, but it has been eroded. I was dismayed—but not surprised—to read in the committee’s report that the Association of Scottish Principal Educational Psychologists identified a

“recognisable downward trend” in the mental health of children and young people in Scotland.

It also said that the

“mental health of girls is overall judged as worse than boys, and the mental health of adolescent girls is particularly poor.”

I completely agree with the assessment of NHS Grampian—it has had a lot of mentions today—which suggested that possible underlying causes of that disparity could be that

“Issues of body image and intense sexualisation of girls are impacting upon their wellbeing as seen in issues such as harmful aspects of social media, sexual bullying, revenge pornography etc.”

As has been discussed in many debates, the advent of smart phones and social media has meant that teenage girls are often under pressure from boys to send them nude photographs of themselves. That has been widely reported in the press and there is not only anecdotal evidence of it.

Photo of Gillian Martin Gillian Martin Scottish National Party

We did not have time to look into that issue, but I am glad that Pauline McNeill has raised it because a piece of work really needs to be done on what more the social media companies can do to protect young women and girls.

Photo of Pauline McNeill Pauline McNeill Labour

I know that Gillian Martin is committed to that. Other committees need to consider the matter too, but we cannot ignore the need for a longer-term look at the issue of the social media age. Control over Snapchat, Instagram and TikTok is not a matter for the Scottish Parliament alone, but we know that all those platforms can seriously damage the mental health of many people, not just our children. I support what Gillian Martin said.

It is alarming that boys as young as nine or 10 are viewing online pornography. It affects the way that they view girls and understand sexual relationships, so there is an urgency about the matter. There is talk of something called rape culture in schools. Before we go any further, we must try to understand where that comes from. It also means that we need to do work in schools.

In February this year, the University of Glasgow’s social and public health sciences unit published a report on sexual harassment in secondary schools in Scotland. The study found that it is common:

“almost 70% of students reported having experienced some type of sexual harassment at or on the way to school within the past three months.”

Lead author Professor Kirstin Mitchell said:

“Sexual harassment is common, and often seen as ‘normal’ among teenagers at school.”

There are many issues to address, but that is deeply concerning. If any young person thinks that that is normal behaviour, it is our duty as leaders in communities and as politicians to put that right. We must seek to understand exactly what is going on in schools and give girls support and encouragement not to accept such behaviour. We need a seismic shift in attitudes.

I realise that I have only 30 seconds left, but I will ask ministers about a cross-cutting issue between the justice and health teams. I want to know whether there are plans to expand the equally safe at school programme, which is brilliant, beyond 31 schools.

I will also comment on the issue that Tess White talked about: girls in sport. Recommendation 25 of the committee’s report recognises

“that the mental health of girls can be vastly improved by encouraging participation in sport and physical activity.”

It is sad to see after all these years that, when they leave primary school, girls are not taking up sport for reasons that are on the same theme as I spoke about.

There are many complexities to the matter. I thank the Health, Social Care and Sport Committee for some excellent work.

Photo of Sue Webber Sue Webber Conservative

As a previous member of the Health, Social Care and Sport Committee and, now, a member of the Education, Children and Young People Committee, I am delighted to close the debate for the Conservatives. However, it is hard not to suggest that, under the SNP, the health and wellbeing of our children and young people have fallen by the wayside. The number of children being referred for mental health care in Scotland has risen by 22 per cent since last year, but only 73.2 per cent of children and young people were seen within 18 weeks of referral. The Scottish Government said that it was committed to its 18-week target for 90 per cent of patients beginning treatment, but that target has never been met.

Those figures should remain a source of grave concern for our SNP ministers. The mental health crisis among our young people long pre-dates the pandemic, but there is still not enough action from SNP ministers. The Covid crisis has only aggravated the issues. There must be an urgent plan that will deliver the necessary support; otherwise, the mental health crisis among young people in Scotland will only continue to grow. As we heard from Alex Cole-Hamilton, we have not yet got it right, and have not done so for a long time.

One of my constituents—a young boy—has been on the waiting list for the ADHD clinic since April 2021. His family say that, as a result, it has been left to them and his school to attempt to hold everything together until he can receive treatment. For them, the idea that they will be seen within 18 weeks of referral has been a pipe dream. Every piece of support that he has received has been sourced by his parents or his school. He needs sleep medication, but the NHS cannot help until it has diagnosed him rather than him being diagnosed privately.

I highly doubt that he is the only one who is caught between a private diagnosis and an inability to access medication.

Paul Sweeney spoke about the CAMHS crisis and the extraordinary number of children and young people who are on waiting lists, and the difficulties that are entrenched for those young people by the time they access the service.

Those are real people with real problems, and they are suffering because of the failure to ensure that children and young people can access vital mental health services as quickly as possible. One of the most distressing evidence sessions that we had in committee clearly indicated that we are letting young people in care down.

Like my colleague Meghan Gallacher, I would like to reinforce the Promise, which includes a commitment that every child who is in care in Scotland will have access to intensive support that ensures that their educational and health needs are fully met.

Photo of Gillian Martin Gillian Martin Scottish National Party

My comment relates to the informal evidence session that Sue Webber has mentioned. One of the things that was mentioned by care-experienced young people is that there was some good practice during the pandemic, when young people had access to mental health support over telephone lines, which they would like to see being extended.

Photo of Sue Webber Sue Webber Conservative

I thank Gillian Martin for her comments. That session was empowering and a lot of good practice came forward; however, that session also laid bare some of the concerns that we have.

More needs to be done to raise awareness among care-experienced children of the support that is available to them. The committee has called on the Scottish Government to set out what measures it is taking to do that. We regularly hear that waiting times in CAMHS are because of workforce pressures and a lack of planning and resources. Time and time again, we have asked for specifics and details on how that workforce crisis is being tackled. Little information, rather than big numbers—and certainly no details—has been forthcoming from the minister. Thankfully, in a briefing last week from NHS Lothian, I heard about some of the targeted and innovative plans that are being rolled out in its mental health service to address health staffing—those plans have more to do with adult services, but they are transferable.

For example, NHS Lothian is working with the Open University to expand the route to a registered nurse qualification using a modern apprentice pathway. Staff will be recruited as band 2 apprentices and then progress through band 3 after 16 months. At the end of four years, they will qualify as registered nurses. Importantly, throughout that time, they will be paid to train. NHS Lothian has plans with the corporate nursing education team to introduce a development programme to encourage the retention of experienced staff, which is really important. Those experienced staff will stay at the front line of delivery of clinical services. The board has also spoken about recruiting art and music therapists into additional roles. If those initiatives are successful, NHS Lothian is hoping that other specialties, and indeed, other health boards, may benefit from a similar approach.

As Carol Mochan stated, we should be doing all we can now to help our young people. Devolved benefits that could improve the wellbeing of children and young people in Scotland are being rolled out too slowly. The young carer grant is being rolled out at snail’s pace; Social Security Scotland is failing to properly roll out the Scottish child payment; and the Scottish child disability payment is being processed more slowly than ever.

Photo of Clare Haughey Clare Haughey Scottish National Party

I hear the member’s criticism of the Scottish Government’s benefits; however, would she recognise that the UK Government’s benefit cap, the £20 cut to universal credit, benefit sanctions, the two-child limit, the rape clause and a decade of austerity are contributing to child poverty in Scotland?

Photo of Sue Webber Sue Webber Conservative

I thank the minister for her intervention—actually, I am not sure that I will thank her, as £41 billion has been delivered to the Scottish Government to allow it to make its own decisions about how it spends its money, and that—

Photo of Sue Webber Sue Webber Conservative

Somehow, it has decided to mitigate decisions that the UK Government has made: it is nonsensical. It merely reveals to everyone in the chamber that the grievance culture that is at the very heart of the SNP drives everything and motivates every decision that it takes. [Interruption.]

Photo of Sue Webber Sue Webber Conservative

I could continue to list the SNP’s failures, but I am very aware of the time.

I will highlight some of the proactive measures that the Scottish Conservatives are taking. Dr Gulhane has reminded us that Scottish Conservative councillors across the country are working to introduce trained mental health leads in every school to help to improve children’s wellbeing. In our 2021 manifesto, we pledged to introduce free school breakfasts and lunches. We have proposed legislation in Parliament that would ensure that every child gets at least one week of residential outdoor education through my colleague Liz Smith’s proposed outdoor education bill. The Scottish Conservatives will continue to work on delivering for our children and young people.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

I thank the Health, Social Care and Sport Committee for raising much-needed awareness of the health and wellbeing of young people through its work on this inquiry. I also thank members for their contributions to the debate and I welcome the opportunity to respond to some of the key issues that have been raised this afternoon. The range of topics that have been covered today illustrates how important this issue is.

As Minister for Mental Wellbeing and Social Care, I am particularly interested in ways in which we can further support the mental health and wellbeing of children and young people, ensuring access to appropriate support at the time that it is needed. As a Government, we have made significant investments in the past year to improve mental health support and services for children and young people. Those include the continuation of £16 million a year of recurring funding to local authorities to provide counselling support services in all secondary schools across Scotland, as many members have mentioned. We have also allocated around £40 million to child and adolescent mental health services to reduce waiting times and to support the implementation of a national CAMHS specification. We have also provided funding for a range of children and young people’s organisations in order to create a suite of online resources, information and advice to support the emotional health and wellbeing of children and young people, such as the Aye Feel hub. We have also invested £80 million in perinatal and infant mental health to develop services, increase awareness and enhance workforce and training. Through that investment, I am determined to ensure that children and young people are supported in the most appropriate way that meets their needs.

We know that CAMHS is not always the right option for everyone and that early intervention is crucial to supporting children and young people’s mental health and wellbeing. Young people and families have told us that they need more support for mental and emotional distress and for wellbeing and resilience, and for that support to be delivered in a community setting. That is why we have provided an additional £15 million a year to local authorities, which has funded 230 new and enhanced community services for children and young people aged five to 24. I am pleased to say that, in the second half of 2021, more than 18,000 people accessed those services, which are spread across every local authority in Scotland. Those services include the Aberlour primary outreach service in Falkirk which supports children aged five to 12 with emotional distress, and the LGBT Youth Scotland service in Dundee, which supports the wellbeing of LGBT+ people aged 13 to 25. Earlier this month, I visited a community service in Aberdeen called the Fit Like? hub, which provides whole family support at an early stage to support mental health and wellbeing, reducing the need for escalations to services such as CAMHS. I met parents whose children had been supported by the hub, and it was clear that the strong relationship that they had with those delivering support in their communities was making a difference to their wellbeing and that of their children.

Establishing those services has been a significant step forward in terms of supporting the mental health of children and young people and ensuring that they receive the help that they need, when they need it. However, we are committed to doing more. As a result, as Gillian Mackay outlined, we will double the funding for community-based mental wellbeing services for children and young people to £30 million a year by the end of this parliamentary session. In delivering those policies, we continue to work closely with colleagues across NHS boards, local authorities and the third sector. Without their support and hard work, much of what we are doing would not be possible, and I am grateful for their continued efforts to improve the services and support available across Scotland to our children and young people.

A large amount has been covered in the debate and, from the SNP and Labour benches, there has been a lot of discussion around poverty. I do not think that we can discuss mental health and wellbeing without recognising that poverty creates a major strain for families, young people and communities. Poverty and its stigma have created a real difficulty on top of young people’s experience during the course of the pandemic. Tory austerity, the cost of living crisis and welfare cuts have added to the woes of young people and their families across our country. That has been highlighted today by Stephanie Callaghan, Emma Harper, Gillian Martin and Carol Mochan. Ms Mochan did not want to touch on some aspects of this, but I agree with her on fair work, pay and conditions for workers, which would make real odds. However, I am disappointed that the Labour Party continues to refuse to call for employment law to be devolved to this Parliament, which could make a real difference to our futures.

Photo of Pauline McNeill Pauline McNeill Labour

Scottish Labour does support the devolution of employment law. I do not know where the minister gets his information from, but I have repeatedly called for it.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

That is new to me, and I am glad that Scottish Labour has called for the devolving of employment law, because I think that that would make a real difference in improving wages, increasing the minimum wage and getting it right for people across communities.

That is one of the many things that we need to take control of in this Parliament, in order to truly tackle some of the ills that face our society, including our young people.

We cannot continue to put up with Tory austerity, including the slashing of universal credit and the continued attack on working people across this country by Tory ministers. We should have those powers here, so that we can tackle the cost of living crisis and ensure that we get it right for families across the country.

The Presiding Officer:

Please conclude, minister.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

Sue Webber said that we should not be mitigating Tory cuts. Let us be honest; if we were not, we would be in an even worse place than we are. If we had not doubled the Scottish child payment to £20 per week, we would be in a worse situation.

The Presiding Officer:

You must conclude.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

If we had not increased benefits by greater amounts than the UK Government has done, we would be in a worse situation. We know that the past three years have been exceptionally difficult for the mental health and wellbeing of many children, young people and their families.

The Presiding Officer:

I must ask you to draw your remarks to a close now.

Photo of Kevin Stewart Kevin Stewart Scottish National Party

We are committed to getting it right for people across Scotland.

Photo of Paul O'Kane Paul O'Kane Labour

I am pleased to have the opportunity to close this important debate on behalf of the Health, Social Care and Sport Committee. As we have heard this afternoon, the inquiry has highlighted a number of key challenges and opportunities that we face, as Scotland seeks to improve the health and wellbeing of all its children and young people.

As the convener stated in her opening speech, we all want children and young people to be able to live happy and healthy lives. I think that that was echoed by Alex Cole-Hamilton when he said that the topic should keep us all up at night. We can all agree on that.

It falls to me in closing to try to build some consensus. I think that the debate has found a degree of consensus at points, but it has been challenging in other areas as we exchange ideas and views. However, it is clear to me that everyone who has contributed to the debate wants to see a better future for children in Scotland.

During our inquiry, we asked witnesses where they thought that policy actions should be focused as a first priority to improve health and wellbeing outcomes for children and young people. Our witnesses were unanimous in their response: tackling poverty needs to be the overriding priority. As other members of the committee have done, I take the opportunity to thank our witnesses and all those who gave evidence to our committee.

That need for a primary focus on tackling poverty has been reflected in much of the debate this afternoon. We must acknowledge the evidence that we received, and the minister’s evidence to the inquiry, which illustrates what the Scottish Government is doing to tackle poverty in order to improve the health and wellbeing outcomes of children and young people. As many argued during the debate, we should not be under any illusions that there are not challenges with regard to the policies that are being delivered.

Photo of Tess White Tess White Conservative

On a point of order, Presiding Officer. I cannot hear Mr O’ Kane because there is a conversation going on.

The Presiding Officer:

Thank you, Ms White. It appears to have ceased, for which I am grateful, so we will continue to hear from Mr O’Kane.

Photo of Paul O'Kane Paul O'Kane Labour

As many argued during the debate, we should not be under any illusions that, in the face of the current cost of living crisis, there is not a huge challenge in terms of poverty and the issues that it is creating for children and young people across our country.

In the evidence that we heard in committee, it is clear that we need both the Scottish Government and the UK Government to work closely in addressing the crisis. We have heard an exchange today about some of the things that both Governments need to do in order to make that a reality.

Witnesses told us about the devastating impact that many UK Government welfare reforms and reducing budgets in welfare have had on young people and families across Scotland. However, witnesses also pointed to the need to use the powers of this Parliament to go further on the Scottish child payment and to provide more sustainable funding for local government services and third sector providers in order to tackle the cost of living crisis.

I was particularly struck by evidence that was recently submitted to the Social Justice and Social Security Committee by the Poverty and Inequality Commission, which is included in our committee’s inquiry report. Bill Scott from the Poverty and Inequality Commission put it quite starkly when he said that, irrespective of whether current targets on child poverty are technically met,

“poverty is deepening for real people at the sharp end” and concluded that

“that will have a lifelong impact on ... children’s health and attainment.” —[Official Report, Social Justice and Social Security Committee, 21 April 2022; c 19.]

There can be little doubt that that is a theme that our committee and others across the Parliament will return to over the course of this session. In particular, the conclusions that the inquiry has drawn about the overarching impact of poverty on the health and wellbeing of children and young people are already being taken forward as part of the committee’s current inquiry into broader health inequalities. On the topic of health inequalities and the relationship with poverty, I thought that Carol Mochan, Emma Harper and other colleagues spoke powerfully.

Our inquiry and today’s debate have highlighted a number of key areas in which we, as a committee and as a Parliament, might wish to undertake further, more in-depth scrutiny in the future. We have heard that today in many contributions from across the chamber. Colleagues have highlighted issues, including those experienced by care-experienced young people, which we heard about from Meghan Gallacher, and the cost of the school day, which Stephanie Callaghan highlighted, as being areas that we must drill down into and look at in more granular detail in order to tackle many of the inequalities that we have found through our inquiry.

The inquiry also heard about the intrinsic link between physical health and mental health, and about how participation in sport and physical activity has the ability to benefit both. In its evidence to the committee, the Scottish Sports Association described investment in sport and physical activity as the best buy in public health and it argued that encouraging

“lifelong participation in physical activity ... reduces the burden on the NHS and the need” to intervene to address

“illness and other long-term health conditions.

As part of the inquiry, we have welcomed the Scottish Government’s commitment to increase funding for sport and physical activity during this session of Parliament. All of us will, of course, want to scrutinise the delivery of that. However, it is quite clear that we need to find ways to encourage and support young people throughout their lives to engage in sport and physical activity. Siobhian Brown spoke about the joy that a child might experience in taking part in an egg and spoon race on their first sports day. How do we continue that throughout their life and break down the barriers to participating in sport and physical activity that often exist as children get older?

That is particularly true for girls and young women, and a variety of witnesses told the committee about the challenges and barriers that can exist for them. The committee will look at, in more depth, what those barriers are and how we break them down. We will also look at other groups who experience barriers to participation in sport, not least black and minority ethnic and LGBT+ people. I thank Gillian Mackay for exploring some of the broader health issues for LGBT young people.

Today, there has been a focus on CAMHS and mental health services for young people across Scotland. We heard a large amount of evidence in committee around the need to continue exploring better ways to provide services to young people, and to look at where services are offered in communities and where they are offered in schools. Gillian Martin and others have referenced good-practice examples in places such as Grampian that we need to look at when expanding the available service provision.

Photo of Paul Sweeney Paul Sweeney Labour

On the critical issue of CAMHS, does my friend agree with me that it is unfortunate that the minister did not address the Glasgow case that I have raised? Perhaps he could encourage the minister to take cognisance of that and respond to me in due course.

Photo of Paul O'Kane Paul O'Kane Labour

I was just coming on to reference the challenges that exist in CAMHS

Photo of Paul O'Kane Paul O'Kane Labour

If the minister will forgive me, I am not keen to facilitate a conversation between two members in my summing up on behalf of the committee. I am sure that they might want to take up the issue offline.

Problems persist in CAMHS, as Dr Gulhane and Paul Sweeney both showed when referring to cases to do with a constituent. We need to look in more detail at what happens when people experience a mental health crisis. People need to be taken seriously, and the service that they are given needs to get the heart of the issue and seek to support them in a holistic manner.

I am conscious of the time, Presiding Officer, so I conclude by thanking everyone who has contributed to this afternoon’s debate and by echoing the convener’s earlier words of gratitude for all the contributions that we received during the inquiry.

As we have heard today and throughout the inquiry, although there are many challenges, there are also lots of opportunities and inspiring examples of good practice we can draw on to improve health and wellbeing outcomes for children and young people across Scotland.

I look forward to the Government’s formal response to the committee’s inquiry report and hearing how ministers intend to take forward our key findings and recommendations. I believe that, across all parties, we share a common goal to improve the health and wellbeing of all children and young people. I hope that the debate has been a useful springboard for us on the way to achieving that.