Hansard

I thank Jackie Baillie for providing us with a further opportunity, following last week’s members’ business debate, to discuss the experiences of people with learning disabilities during the pandemic.

I am acutely aware of the pandemic’s impact on people with learning disabilities. Our regular meetings with key charities and People First (Scotland) have allowed us to respond quickly and provide additional support and funding. For example, we provided £56,000 to a range of learning disability organisations to help to reduce social isolation in winter, £115,000 to the Profound and Multiple Impairment Service—PAMIS—and Down’s Syndrome Scotland to support unpaid carers and £30,000 to Down’s Syndrome Scotland and Enable to support the siblings and parents of people with Down’s syndrome and to provide vaccination support for people with learning disabilities. I thank the organisations with which we are working for their flexibility and dedication.

In her motion, Jackie Baillie mentioned the need for Covid-specific

“data on infection and mortality rates of people who have learning disabilities”.

On 4 February, we announced that the Scottish Learning Disabilities Observatory had published a high-level summary of its Covid data. A pre-print of the full report was made available on 9 February. The data showed that people with learning disabilities are more than three times more likely to die from Covid-19 than people who have no learning disability.

Any death is regrettable, as it is the loss of a unique and irreplaceable individual, who is mourned by many. We have agreed with the Scottish Learning Disabilities Observatory that it should continue to collect and analyse data for the duration of the pandemic.

Ms Baillie’s motion also mentions the wider research that the Scottish Government commissioned from the observatory last year on the health of children and adults with learning disabilities, which confirmed that there is still a 20-year disparity in life expectancy for adults with learning disabilities, many of whom die in their early 50s, often due to preventable causes.

For children, the position is more complicated and further work is required. Last year, the observatory hosted a successful round-table discussion with leading clinicians to explore the evidence and agree actions. A round-table on adults will take place next month.

Under our proposed new plan for learning disabilities and autism, a priority is to make further progress on health outcomes. There is no single solution. It will take a range of co-ordinated actions, including further training of the health and social care workforce and work with primary care on annual health checks. The latter is currently being piloted in Aberdeen, and is led by learning disability nurses who work with the local practice.

We are determined to build support to tackle health inequalities as a fundamental human right. That brings me to the concerns regarding the awareness and use of “Do not resuscitate” forms for people with a learning disability, as mentioned by several participants in the debate. I make it absolutely clear that the Scottish Government values the lives of people with a learning disability, as we do any other life. Covid-19 has brought no change to our advice on the use of “Do not attempt cardiopulmonary resuscitation” forms. A learning disability should never be a sole reason for considering whether someone would benefit from CPR. Our document, “COVID-19 guidance: ethical advice and support framework”, which was published on 29 July 2020, emphasises that point and makes clear that health conditions or disabilities that are unrelated to a person’s chance of benefiting from treatment must not be part of a clinician’s decision making regarding access to treatment.

The motion picks up on the issue of prioritising vaccinations for people with a learning disability, and routine Covid testing for staff who are supporting people outwith care home settings. On vaccinations, members are now aware that, on 22 February, the First Minister announced that, in Scotland, in consultation with the chief medical officer, we will vaccinate everyone with a learning disability in group 6. That is currently taking place. We have written to national health service boards and health and social care partnerships to underline the key role of learning disability nurses in that programme.

On staff testing outwith care homes, we have made significant progress. We will soon be expanding the availability of Covid-19 testing to front-line staff in learning disability settings and a range of other settings.

In the debate, both Shona Robison and Jackie Baillie mentioned the Fraser of Allander institute report on employment opportunities for people with learning disabilities, which was published yesterday. The members may be interested to know that, last week, I met Jamie Hepburn, the Minister for Business, Fair Work and Skills, on that very issue. I asked for a focus on improvement in employment outcomes for people with learning disabilities, improvement in data collection and capacity building with employers. I assure members in the chamber that I am committed to working across ministerial portfolios to improve life chances and employment opportunities for people with learning disabilities.

Joan McAlpine spoke about a concern that has been raised with her by a constituent. The Scottish Government has funded Down’s Syndrome Scotland to support families with shielding and vaccination queries; however, if Ms McAlpine wants to write to me regarding the specific details of her constituent, I will certainly endeavour to help her.

There was also mention of the commissioner for learning disability and autism. The towards transformation plan that the Scottish Government is working on with the Convention of Scottish Local Authorities will explore further the proposals for a commission or commissioner to protect people’s rights. Over recent weeks, I have met the three key organisations that have called for a commissioner. Today, I met autistic people’s organisations and individuals with learning disability and autism to discuss the issue, and we will continue those conversations.

As I have just referenced, we have been working with COSLA on the towards transformation plan, which pulls together our learning from the experiences of the pandemic and the input of key stakeholders, autistic people and people with learning disabilities. The plan takes a human rights approach. We do not yet know the full legacy and impact of the pandemic, but we are able to use what we know now to take some priority actions. Those priorities include improving physical and mental health; progressing the Morgan report and action plan for additional support needs in schools; a review of supported employment; and, following the publication in February of the “Independent Review of Adult Social Care”, our announcement about a new community living change fund of £20 million, which will deliver a redesign of services for people with a learning disability.

I welcome the publication of the report of the human rights task force. Its recommendations will result in a world-leading framework that, for the first time in Scotland, brings together internationally recognised human rights in one place.

As discussed last week, we have committed to explore further the proposals around a commission or commissioner to help to protect people’s rights. This morning, I had a valuable experience listening to people with lived experience, which will certainly play into our thinking as the Scottish Government. Councillor Stuart Currie from COSLA was also in attendance at the meeting.

I thank Jackie Baillie for the motion, and for the opportunity to have the debate. I also thank all members across the chamber for their contributions.