Hansard

It gives me great pleasure to propose the motion that is before the Parliament. This is the kind of debate that I got into politics to lead, and I am sure that I am not alone in that. The issue comes straight from each of our constituency casework surgeries.

On Mondays and Fridays, when we are not in the chamber, we receive our instructions from the people who sent us here and we pick up themes and narratives around what is going on in the country. Since the pandemic, I have seen a worrying uptick—it is almost an avalanche—of people coming to my surgery looking for my help because they are struggling to obtain neurodivergence diagnostic support. Put simply, they cannot get a diagnosis for things such as attention deficit hyperactivity disorder or autism.

Families at breaking point come to us all. Parents are worried sick about their children, who are—for want of a diagnosis, whether of autism or ADHD—struggling in class, with their friendship groups and with the isolation that comes with that. In some cases—at least in my constituency—they have been told that they have to wait as long as seven years for diagnostic assessment. Let me put that in real terms. For a 15-year-old who is struggling to concentrate at school while facing life-qualifying exams—perhaps they are not even able to attend school, given the severity of the situation around their neurodivergence—seven years takes them past their 22nd birthday, and that is just to get to the races, before they are even prescribed anything that will control their condition. Their exams, their confidence, their future work prospects and their relationships are all affected by a fundamental lack of proper support.

The pandemic did not create neurodivergence, but it stripped away the routines and distractions that helped many people to cope, and the scale of unmet need became impossible to ignore. Lockdown forced us to be still, and people who had usually filled their lives with noise and activity suddenly began to understand a great deal more about their make-up. As we emerged from lockdown, referrals for ADHD diagnosis and treatment soared and waiting times exploded. That did not just happen here—it is a phenomenon that we saw the world over. In the year after Covid restrictions were lifted, the number of referrals for ADHD in adults in Greater Glasgow and Clyde rose by more than 1,000 per cent. That is a staggering number, but it speaks to the revelation that we encountered after the pandemic. That was replicated in countries around the world, which led to a global shortage of ADHD medication due to the huge surge in demand. Health boards had reports of closures of the titration clinics that people needed to get started on treatments in order to begin their care pathways, which created a perfect storm.

Desperate for help, many families turned to the private sector. For years, there was at least a safety net there. If someone could scrape together the money for a private diagnosis, their general practitioner could prescribe them medication on the national health service under a system called shared care, whereby they would recognise that private diagnosis. However, in areas such as NHS Lothian, shared care has now been scrapped, with no clear explanation as to why. Do not get me wrong—those families would not normally have gone private. They could not normally afford to go private, but such was their desperation and anxiety about their children’s prospects that they would scrape together that money, and, by so doing, they were doing everyone a favour. If even a small proportion of the people on the list can get a quicker diagnosis privately, they are freeing up space for anybody else left on that list.

It should go without saying, however, that no family should have to shell out thousands of pounds due to a failure in the system. That flies in the face of the fundamental principles on which the NHS was established. I have never had a satisfactory answer from NHS Lothian about why shared care has ended. It is not right to blame GPs—they are stretched to breaking point. Let us be clear that it is a political failure. We have talked previously in the chamber about how GPs in primary care have been let down by the Scottish Government, and this situation is no exception.

Through its amendment, and by the decisions that it is taking, the Scottish Government is failing to tackle or even acknowledge the serious pressure that our GPs are under. I am disappointed by that, but I am not surprised. I also note that the Government’s amendment sidesteps my party’s call for a “robust protocol” for reinstating shared care arrangements. Again, I am disappointed but not surprised. We need to show real leadership here so that people get the support that they need now, not in seven years’ time.