Hansard

As the convener of the Health and Sport Committee, I am pleased to speak to our report on the Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill.

We support the objective of putting people first, so let me start by thanking all those who assisted the committee with our scrutiny: those who responded to our call for views, those who gave evidence in person or online, and, not least, the committee clerks and other Parliament staff who enabled our report to be made despite Covid-19 and the circumstances that it caused.

I particularly thank those women who had suffered rape or sexual assault who spoke to us back in March, facilitated by Rape Crisis Scotland. We were truly grateful for the insights that they offered, as well as deeply impressed by their courage in doing so.

As we have just heard, the bill will require national health service boards to provide forensic medical services to victims of sexual offences and will allow victims over the age of 16 to refer themselves to the NHS for forensic examination before deciding whether they want to report to the police.

The committee supports those changes and, more broadly, we support the general principles underlying the bill. Those principles are that victims should be given choice, through the power to consent, and control—the very things that were denied to them by the perpetrators. Placing a duty on NHS boards to provide those services and allowing victims to self-refer to the NHS gives individuals the opportunity to decide whether and when they want to report a sexual assault to the police. That gives them the choice, first and foremost, to get the medical and healthcare support they need, which may help to reduce future psychological trauma. At such a time, the victim’s health and wellbeing must be the top priority. The decision on reporting to the police and undergoing the process that follows that can be a secondary and separate choice for the individual to make.

Self-referring for a forensic medical examination allows victims to make decisions about what happens going forward. Section 4 of the bill details the information that individuals must receive before an examination takes place, which allows them to give their informed consent to what happens next. Under the bill, individuals should have the right to control what happens next, after they have self-referred. They can control whether and when they enter the criminal justice system; they can control the timing of reporting an incident; and, if they choose not to report an incident to the police, they can request that the collected evidence be destroyed and any clothing or belongings returned to them.

We support the legislation in principle, as a step forward in putting victims’ needs and rights first and improving access to forensic medical examinations. Those are things that the victims of such offences told us were greatly needed.

Our report concentrates on areas where we think that the bill, as it is currently drafted, might not quite achieve its three fundamental objectives; where we think the bill needs to be strengthened to make sure that everyone gets the support they need; and where we need to make sure that its laudable rights and principles will work for all those who need to access such services.

People will benefit from the right to self-refer only if they know the right is there. By its nature, the bill and its provisions might not be widely discussed. Many people will not consider the process until after they are victims of sexual assault, and, in those circumstances, it is understandably difficult for victims to be clear about what to do next. Self-referral will benefit victims only if they are, or someone they confide in is, aware that it is an option.

We believe that there needs to be a focus on raising public awareness of the principles, rights and choices in the bill by making information readily available and easily accessible to everyone. There also needs to be an early and on-going public awareness campaign as the law comes into force. It should be accompanied by local online content, and actual information should be made available in healthcare and police settings.

The Government’s response is that it will achieve that by providing dedicated sexual assault telephone lines as the first point of contact. That is welcome, but I ask the Government to consider the risk that such a service might be visible only to those who have already taken the first step of presenting and to consider what more can be done to reach those victims who simply do not know that such dedicated phone lines exist. Likewise, those who present to the NHS to access self-referral services need clear information to allow them to make informed choices.

Psychological and physical trauma following an incident can have devastating effects on individuals. We are, therefore, delighted to see the Scottish Government’s commitment to trauma-informed care and that it has informed the bill, but we think that it is important that the bill explicitly requires NHS boards to deliver trauma-informed care. That is another of the committee’s recommendations.

That should go hand in hand with a statutory right to independent advocacy. If people are to have the choice and control to make informed decisions, they might well need support to do so, especially if they are suffering from psychological trauma. We do not believe that advocacy should be offered on a case-by-case or opt-in basis; it should be a right that is provided to everyone as standard across every service. Individuals must be given the choice and the opportunity to accept, to decline or to opt out of receiving such support if they so wish.

Advocacy support should be on-going from the moment of engagement, through interaction with the health service, once the individual has returned home, and through all subsequent interactions with Police Scotland and the court process. We look forward to hearing how that can be achieved consistently across Scotland.

We will undoubtedly reflect on the Government’s response that this is, first and foremost, a health bill. That might well be true, but it is also a justice bill, and the portfolio heading should not be what decides the provision of vital support. Much of the point of the bill is about services being joined up and the provision of support throughout the whole experience of examination, reporting and, ultimately, prosecution.

In the spirit of delivering trauma-informed care, we believe that the bill should seek to eliminate any potential for further trauma in the process itself. Victims of rape and sexual assault, as well as organisations that are working to support them, were clear on two priority areas. First, we need to ensure that there are no delays in forensic examinations, thereby minimising the psychological impact on victims who are unable to shower or change following an incident. The second priority is that we give victims the opportunity to choose the gender of the person carrying out the examination. I was pleased with what the cabinet secretary had to say on that matter. Many of the women who are victims of rape or sexual assault say that guaranteed access to a female examiner would be the most important single improvement to the current system.

We have, therefore, recommended that the bill should be strengthened to require a 24/7 forensic medical examination service and to guarantee victims the right to choose the sex of the examiner. Those recommendations are vital to support and give choice and control to people who have experienced such crimes.

Again, I note the Government’s response and the intention to report when delays exceed three hours. The risk could be that three hours becomes by default an “acceptable” time to wait. Reporting on the operation of the service should therefore also have a strong focus on actual waiting times, to encourage the service to do everything possible to meet the needs of those who are seeking assistance.

For the bill to deliver on its fundamental principles and its main policy objective of improving the experience of people who have been affected by sexual offences, there also needs to be robust monitoring, evaluation and learning from experience. We have, therefore, further recommended that IT systems should be in place to collect, store and access data from services across Scotland, alongside an annual reporting requirement on NHS Scotland to evaluate and drive forward service improvements. Joined-up and effective online health records have been called for by the committee in report after report this session. I hope that the cabinet secretary will agree that this is one of the many areas in which achieving that objective could make an enormous difference to service users.

In conclusion, the committee unanimously supports the general principles of the bill while seeking further clarification on the issues and concerns that we raised in our report. I am sure that the cabinet secretary will reflect further on our report, this debate and the concerns that were raised by witnesses in the committee’s inquiry, and that the bill will, as a result, be even better and stronger after stage 2.