Meeting of the Parliament 11 December 2025
I thank members from across the chamber for what has been a thoughtful and constructive set of contributions. The strength of feeling that we have heard on behalf of autistic people, people with ADHD and those with other neurodevelopmental conditions, as well as their families and those who support them, underlines both the scale of the challenge and, I think, our collective determination to deliver meaningful change.
I thank Daniel Johnson directly for securing the debate and for acknowledging the important work of the Royal College of Psychiatrists in Scotland in producing its recent report. The college has made a valuable and timely contribution. The Scottish Government welcomes its focus on multisystem reform, early intervention and support based on need, not simply on diagnosis. Those principles strongly echo our own approach, and they reflect the perspective of professionals, families and communities, whose voices must continue to shape the way forward.
Members are absolutely right to highlight the unprecedented increase in demand for neurodevelopmental assessment and support. We are not alone in saying that. As I have said previously, that trend is emerging across the United Kingdom and internationally, with growing pressure on systems that were never built to manage demand on the present scale. We must meet the challenge, however, and we must do so in a way that recognises the diversity of neurodivergent people’s experiences and the complexity of the systems that they interact with across health, education and social care.
Members have spoken about waiting times. We appreciate that waiting for assessment or support can be challenging, but we are working hard to make that experience better for individuals and families. A diagnosis can be profoundly important to a person’s identity and understanding of themselves. For some, particularly those seeking ADHD medication, it is essential.
Diagnosis alone is not the solution, however. A traditional NHS waiting-list model cannot meet the scale or complexity of the need that we now face. I have heard from many experts about the risks in overmedicalising our response. As the royal college has emphasised, a co-ordinated multi-agency response is required, focusing on timely, needs-based support from the outset. For children and young people, the national neurodevelopmental specification sets a clear expectation that support should begin on the basis of need and should not be contingent on a clinical diagnosis.
Implementation has undoubtedly been challenging in the face of rising demand, but we have already taken significant steps. We have invested in service pilots, in the testing of digital assessment tools and in family support initiatives, and we are working to strengthen multi-agency pathways, building around our getting it right for every child national approach. We have also published the joint review of the implementation of the national specification, jointly carried out by Scottish Government and the Convention of Scottish Local Authorities. The review identifies short, medium and long-term actions to support children’s service partners to deliver the specification more effectively.
To drive that important work forward, we have established a new cross-sector task force, jointly chaired by senior leaders from education and health. Its purpose is clear: to accelerate and co-ordinate systems-wide improvement, drawing on lived experience, clinical expertise and good practice across Scotland.