Hansard

As a member of the Health and Sport Committee, I am pleased to contribute to this important debate. I am glad to say that Labour will support the general principles of the bill, and I am convinced that parliamentarians across the political divide will recognise that the bill makes victims of sexual abuse a key priority for forensic medical services.

As I touched on in my intervention, many years before I joined Parliament I worked for over a decade running a very busy child protection team in an area of social deprivation. However, that comprehensive experience did not prepare me for the round-table event that Health and Sport Committee staff organised with survivors and victims. The survivors and the organisations that represented them spoke of the horror and anguish that they faced after reporting their attack.

There was an underlying consistency in their messages: that

“criminal procedure re-victimises the victim”,

that

“Forensic examination opens up the horrors of the attack”,

that the

“System does not function correctly,”

and, in particular, that there was a

“Lack of support for victims.”

A strong theme was the need for change, particularly of self-referral for forensic medical examinations and for independent advocacy and psychological support. I am glad that the cabinet secretary and other members echoed those important points, on which I wish to concentrate.

As other members, including the cabinet secretary, have said, we all know that the overall aim of the bill is to require health boards to make forensic medical examinations available on a self-referral basis to people over 16. That means that victims would be able to undergo a forensic examination without any requirement to report the incident to the police.

Donald Cameron has already touched on some of the history of that. Her Majesty’s Inspectorate of Constabulary in Scotland closely examined the provisions for healthcare and forensic medical services, and it drew out three key points, which I wish to emphasise. The inspectorate said, first, that there was a need for increased innovation, especially in relation to island and rural areas; secondly, that there was potential for more collaboration among boards to share specialist staff; and, thirdly, that there was a gap in service provision in cases where a victim of a sexual crime sought support and medical attention but did not wish to report it to the police.

We have already touched on the important issue of self-referral, but I would draw the Parliament’s attention to the fact that section 2(4) of the Age of Legal Capacity (Scotland) Act 1991 states:

“A person under the age of 16 years shall have legal capacity to consent on his own behalf to any surgical, medical or dental procedure or treatment where, in the opinion of a qualified medical practitioner attending him, he is capable of understanding the nature and possible consequences of the procedure or treatment.”

Many respondents to our committee’s call for evidence for the inquiry believed that self-referral should not exclude children and young people under 16. Victim Support Scotland considered that it would be detrimental to restrict under-16s from the self-referral process. VSS wrote:

“Due to their age and the potential nature of the harmful sexual behaviour, especially in instances that may involve a family member, they are likely to feel less comfortable seeking a forensic medical examination through the police and prefer an alternative setting for their initial steps towards seeking the involvement of criminal justice agencies.”

There was other evidence that I found very interesting, from the rape and sexual health centre in Perth and Kinross. As the cabinet secretary will be aware, it reported that one fifth of survivors accessing the centre’s services were aged between 13 and 15. The view of the centre was that self-referral should start at 13. The Royal College of Nursing also supported self-referral for younger children.

A number of members, including the committee convener, have raised the issue of public awareness, which I agree is important. Self-referral will benefit victims only if they are aware that it is an option. The RCN was right to say in its submission that there needs to be a focus on ensuring public awareness of the provisions of the bill.

I would be grateful if the cabinet secretary, in her closing remarks, could specify the Government’s strategy for public information and education. We will all support the bill at 5 o’clock but, if we do not have public information and awareness, the bill will not be worth the paper it is written on.

Particular thought needs to be given to equality of access to information and services for those with learning disabilities and for same-sex victims. The committee made a strong recommendation on that point. The key is informed consent and equality of access, taking into account travel, rurality and low population density.

It is important that vulnerable young victims, who are likely to be shocked and traumatised, have a statutory right to independent advocacy across Scotland.

I agree with the comments made by other members that it is crucial to have female practitioners. Rape Crisis Scotland noted:

“The feedback that we have from survivors is that the most important issue is access to a female doctor. The lack of access to a female doctor is what causes the most trauma.”

The committee recommended that the bill be amended to guarantee an individual’s right to choose the gender of the examiner. I know that the cabinet secretary will say that the Scottish Government’s response is that section 9 of the Victims and Witnesses (Scotland) Act 2014 ensures that people who access forensic medical examinations can request a female examiner. However, we perhaps need to strengthen the bill in that respect.

I will make a point that I do not think others have raised. It is important to stress that the bill does not give an individual the right to a forensic medical examination; examinations are carried out on the professional judgment of a healthcare professional. As the stage 1 report made clear,

“professional judgment can include both clinical and non-clinical elements supported by guidance from the Faculty of Forensic and Legal Medicine.”

The fairer Scotland duty assessment of the bill notes that

“women in lower socioeconomic groups are more likely to be the victim of sexual offending and are thus more likely to benefit from the objectives of the Bill.”

NHS Lanarkshire, for example, uses data collection along with advice from third sector groups to target resources in areas of deprivation. That reflects the committee’s recommendation to require all health boards to capture analysis and publish data addressing equity of access.

This is an important bill for protecting the healthcare needs of victims of sexual offences, and we must listen to the voices of survivors. We need a criminal justice system that puts victims squarely in centre court, does not revictimise or repeat the sin and where victims are listened to, respected and supported. As one survivor said,

“Violators cannot live with the truth: survivors cannot live without it.”

I support the general principles of the bill.