Meeting of the Parliament 13 June 2018
There are thousands of stories behind the children’s mental health waiting times statistics. Each child has their own story of how their name came to be on the waiting list, becoming part of the bigger story that we debate today, and each of those stories will inform the child’s life and their decisions, paths and relationships. That is why waiting lists are most destructive for children, out of all sections of our society. A day is a long time in a child’s life, a week seems like an eternity and nearly eight months—the time that a child in Dundee has to wait for a CAMHS appointment—is unimaginable to them.
Last Monday, I visited Tayside’s children’s mental health service in the Dudhope centre in Dundee, where we have the highest CAMHS waiting list in Scotland. The average waiting times for CAMHS treatment is 23 weeks, which compares with the Scottish average waiting time of 10 weeks, which is still far too long. The main reason that I was given for the long waiting times was consultant vacancies. Tayside has four full-time equivalent CAMHS consultants when it requires seven. Rightly, all the cases are consultant led, so consultant shortages result in longer waits for every child on the list.
The Scottish Government is aware of the issue, but it needs to tackle it urgently. If we are not training enough psychiatrists—and we are not—we need to. The vacancies for GPs, hospital doctors and psychiatrists are in deprived areas, and the reality is that people in more deprived areas have longer waits for mental health services.
We train doctors in Scotland. No one—not the General Medical Council nor the British Medical Association—will give me an official figure, but I understand that we lose about 40 per cent of our trained doctors to New Zealand and Australia. Not only is that a huge brain drain, it is a failure of public policy that, although we invest and pay to train doctors at public expense, we are not able to employ them in the Scottish NHS.
I understand that the location of services is also an issue. To my mind, there is no good reason why consultants based in the CAMHS centre in each health board cannot work for a day in some of the localities. In Dundee, that might mean a day in Arbroath, Menzieshill or somewhere else in the health board area. A CAMHS referral is a significant matter for families. The impact on school, work and the whole family is significant, and more ready access in the community should be considered.
On my CAMHS visit, I, too, was concerned about the rejected referrals. I welcome the fact that information will be published before the end of the month, but it is imperative that we have an opportunity to scrutinise the issue before Parliament, and I would welcome confirmation of that in the minister’s closing speech.
My initial understanding of rejected referrals from the health services point of view is that everything is being referred to CAHMS in the absence of an earlier intervention or support in the community. That is only part of the picture, but I wonder whether the minister has up-to-date figures on the number of educational psychologists working in our schools. I have raised that issue many times before in the chamber. The declining number of educational psychologists makes a referral on to a higher-level intervention inevitable, when that child’s problem could have been addressed in their own community, without a CAMHS referral and all that that means for the child, their family and public resources.
15:27