Meeting of the Parliament (Hybrid) 01 October 2020
I undertake to keep that under review, and I am sure that we will return to that issue when we get to stage 2. I note that Rape Crisis Scotland and the Law Society of Scotland support the position that we have taken at this point in the bill process. However, as with other matters, we should be open to further discussion and to keeping that under review.
It is important to be clear that the principles of trauma-informed and person-centred care will apply whether or not a police report is to be made.
There has been very strong support for the bill’s objectives, with 91 per cent of respondents to the 2019 consultation agreeing with the proposals in the bill. The chief executive of Rape Crisis Scotland welcomed the bill and said that it was a “significant ... step” that had
“the potential to transform how forensic services”
are delivered.
I am pleased that the committee’s stage 1 report welcomes the bill. It recognises that the bill will help to improve the experience of victims of sexual crime across Scotland.
The bill will underpin the work of the chief medical officer for Scotland’s rape and sexual assault task force, which was set up in April 2017 to provide national leadership for the improvement of services in response to the 2017 report by Her Majesty’s Inspectorate of Constabulary in Scotland. I put on record my sincere thanks to our former chief medical officer, Dr Catherine Calderwood, for her support and leadership in driving that work forward.
A five-year work plan that was published in October 2017 set out actions across a range of issues, and the bill is one important part of that. Through the work of the task force, and supported by funding of £8.5 million, the transformation of the national health service’s response to rape and sexual assault is already well under way. Healthcare Improvement Scotland published national standards in 2017 to ensure consistency in the approach to healthcare and forensic medical services and to reinforce the high-quality care that everyone should expect. All health board chief executives have committed to working towards the delivery of sustainable trauma-informed services, in line with those standards. Quality indicators underpinning the HIS standards were published in March this year, and health board performance against those standards is being closely monitored.
Another key recommendation was the establishment of dedicated healthcare facilities across Scotland. Funding is being invested in all 14 territorial health boards to enhance existing, or to create new, sexual assault response co-ordination services across the country, in line with the national service specification. All examinations that were previously located in a police station have now moved to an appropriate healthcare setting, which paves the way for a national model of self-referral. Funding is also being provided to develop regional centres of expertise to support those local sexual assault response co-ordination services.
We know that having access to a female sexual offence examiner is very important for anyone who requires a forensic medical examination following a rape or a sexual assault, and improving that access was an early priority for the task force. Since 2016-17, funding has been provided to NHS Education for Scotland to provide specific training for doctors, with the aim of increasing the number of female examiners who are available to undertake that work. That training is also open to nurses who are involved in providing trauma-informed care for victims. In response to Covid-19, NHS Education for Scotland is now delivering key elements of that course virtually to ensure that demand for the training continues to be met.
Baseline workforce data indicates that 61 per cent of sexual offence examiners in Scotland are now female, which is an increase of around 30 per cent on the indicative figure in the 2017 HMICS report. The task force is committed to developing the role of nurse sexual offence examiners, as recommended by HMICS. For the first time in Scotland, two appropriately qualified and experienced nurses are currently being recruited to that role, which will mean that they can undertake the forensic medical examination of a victim of rape or sexual assault and give evidence in court, as doctors currently do. I am grateful to the Lord Advocate for his willingness to explore and evaluate that important initiative.
I am also delighted to announce that we are funding 20 priority places on a new postgraduate qualification in advanced forensic practice at Queen Margaret University, in Edinburgh. Those funded places bring the total funding allocated to the task force to develop the role of the nurse sexual offence examiners in Scotland to £250,000. The QMU course, which starts in January next year, will offer the first qualification of its kind that is available in Scotland. Enabling access to that training is vital to developing a multidisciplinary task force and a workforce for the future, so that health boards are better placed to offer a female examiner if that is the person’s preference.
Other important improvements that are being progressed include the development of a national clinical information technology system, which is due to go live in spring next year. Before the end of the calendar year 2020, the task force will launch a comprehensive package of resources to ensure a consistent national approach to the recording, collation and reporting of performance data on those services.
The package includes Scotland’s first national clinical pathway for adults as well as for children and young people, which the committee has recognised will sit alongside the bill. Work is also well under way to develop a robust protocol for health boards on how to maintain the chain of evidence in a way that meets the requirements of the Scottish criminal justice system; to prepare for a public consultation on the appropriate retention period for evidence that is obtained from a self-referral examination; and to progress plans around how individuals will access self-referral services. That work is being carried out together with a national awareness-raising campaign, so that people know about the options that are available to them. All that preparatory work will help to ensure that health boards are ready for the commencement of the bill.
In my remaining time, I will briefly address the Health and Sport Committee’s recommendations in its stage 1 report. The committee has delivered a fair and full report, which was no small challenge given the wide range of oral and written evidence that was provided to it, which, in some respects, offered quite different perspectives on key matters. The Government’s response to that report was published on 25 September, and I hope that members will have had an opportunity to review that ahead of the debate. I am pleased that we can support a number of the committee’s recommendations, particularly those concerning a new delegated power to modify the minimum age for accessing self-referral, a statutory annual reporting requirement and a revised data protection impact assessment for the bill.
On the first of those recommendations, I consider it prudent that the minimum age for accessing self-referral remains prescribed at age 16, in line with current clinical practice and the most relevant and applicable legislation, while we are keeping open the possibility of that age changing in the future should wider changes to law and guidance make that appropriate.