Hansard

Certainly. As a prescriber, I recognise the role of medication in the treatment of ADHD. It is not the only treatment, and neither is it the first-line treatment. There are a number of steps to go through before medication is prescribed for ADHD, but I recognise that medication can be life changing for people with that diagnosis.

I put on record the fact that we have a higher number of staff delivering more care to a larger number of people than ever before. For the first time ever, national performance has met the 18-week child and adolescent mental health services standard, with 90.6 per cent of children and young people starting treatment within 18 weeks of referral.

The budgets for direct mental health programmes have also more than doubled in the past five years. Collectively with NHS boards, we spend more than £1.5 billion in this area each year, and we expect more than £1.5 billion to be spent in the current year. Health boards continue to make good progress towards their target of spending 10 per cent of their front-line spend on mental health and 1 per cent on CAMHS.

A range of work is under way to improve support for neurodivergent adults. We have accepted the recommendations from the adult neurodevelopmental pathways pilot and we are working with partners to implement them. We also fund the national autism implementation team to support NHS boards to develop, enhance and redesign local neurodevelopmental services for adults. Through our adult autism support fund, we invest £1 million a year to provide support to autistic adults. That fund has supported 1,800 autistic people and 470 families, and a formal diagnosis is not required to access the support that is provided.

Training and development for the workforce is also key to improving services and getting better at meeting demand. That is why we have commissioned NHS Education for Scotland and the NAIT to develop a range of professional learning on neurodevelopmental conditions.

As I said recently in the chamber, we are also taking action to support young people with neurodevelopmental needs. Building on our previous investment of more than £1 million, we provided nearly £250,000 in 2024-25 to fund a range of individual projects that are aimed at improving assessment and support for children and young people.

In partnership with the Convention of Scottish Local Authorities, we have undertaken a review of the implementation of the national neurodevelopmental specification. The review offers an opportunity to reflect on learning and progress, and it will inform improvements to support health boards and local authorities to deliver the specification. I will provide a further update on that to the Parliament in due course.

I know that many people are concerned about the issue of private diagnosis and shared care policies. Some NHS boards have shared care policies, but it always remains at the clinical discretion of each individual GP to decide the best course of action for their patients. My officials have written to all health boards, seeking information on the adult neurodevelopmental services and support that are offered locally, including protocols for patients with a private diagnosis. However, I highlight that any local protocols cannot require GPs to enter shared care agreements. GPs are independent contractors and are not obliged to enter into agreements as a consequence of their contracts with local NHS boards.

I also know that an issue of concern to many people with ADHD and their families is shortages of medication for ADHD. The chief pharmaceutical officer wrote to NHS boards in January to provide further background on medicine shortages more generally and how those are managed and to clarify the current position on ADHD prescribing.

I look forward to hearing from colleagues and to responding to more specific issues in my closing speech.

I move amendment S6M-17670.3, to leave out from “of the mental” to end and insert:

“and urgency of unmet need in both mental health and neurodevelopmental support, particularly in the context of a sharp rise in demand for neurodiversity assessments and treatment for adults and children following the COVID-19 pandemic; notes the additional pressure on services caused by the global shortage of attention deficit hyperactivity disorder (ADHD) medication, which has led to the closure of titration clinics in some areas and significantly impacted waiting times and access to care; recognises the profound distress and disruption this causes for individuals and families who are left without timely diagnosis or support; acknowledges the knock-on effects on the health service, as well as the wider economic consequences of rising levels of economic inactivity linked to unmet neurodevelopmental and mental health needs; notes with concern the widespread removal of shared care arrangements where patients who obtained a private diagnosis could receive ongoing care and medication through the Scottish NHS; calls on the Scottish Government to work urgently with NHS boards and local authorities on their shared care arrangement protocols, but understands that decisions around the best course of treatment for patients are for individual clinicians; further calls on the Scottish Government to expand and create adult neurodevelopmental pathways and stepped care models, as recommended by the National Autism Implementation Team and Royal College of Psychiatrists in the 2021 National Clinical ADHD Pathway Feasibility Study; notes the four pilots that the Scottish Government funded following these recommendations, the establishment of a neuro-affirming community of practice and ongoing scoping work on demand and capacity for adult neurodevelopmental services, including work with NHS boards and local authorities on local neurodevelopmental data; calls on the Scottish Government to convene a cross-party summit on addressing waits for neurodevelopmental support and mental health capacity to avert a crisis for individuals and families waiting too long; recognises the progress made towards the Scottish Government’s commitment to allocate 10% of NHS spending to mental health and 1% to CAMHS by the end of the current parliamentary session, and thanks the dedicated NHS and wider workforce for its hard work in providing neurodevelopmental and mental health services in this time of increased demand.”