Hansard

I am pleased to speak in this afternoon's debate and welcome the Highland GIRFEC report's measuring of outcomes, putting the child's needs at the heart of decision making and ensuring that there is less bureaucracy and improved communication between agencies, which my colleague Liz Smith referred to.

On the back of this morning's education debate, it is worth acknowledging the improvement in the educational attainment of the weakest children. In these financially challenging times, all that can be achieved with potential reductions in cost—as Margaret Smith referred to—and, I hope, the earlier detection of problems.

I particularly commend the action taken in Highland given the tragic death of Danielle Reid in Inverness some years ago. The death of that child highlighted many failings in interagency working and communication. Although we welcome the excellent progress that Highland has made, we cannot ignore the issue that the Labour amendment raises today, acknowledging that the HMIE report said that half of Scotland's councils

"were assessed as weak or unsatisfactory in relation to the assessment of risks and needs".

This week, the Health and Sport Committee held a discussion on information technology, clinical portals, patient confidentiality, telehealth and telemedicine. Although I note that the SNP motion

"notes progress under the eCare framework",

there is no doubt that we have a long way to go to embrace, share and utilise the new technologies that will undoubtedly enhance the care and support of people across Scotland. Leadership is sadly lacking on that project, and for too long children and others have suffered as agencies work in their silos, refusing to share information that would lead to a holistic approach to addressing a child's needs. I commend the work done in Highland to address that issue, but everything that we welcome and commend today can work only when the agencies are aware of the needs of the child or young person.

The Health and Sport Committee recently conducted an inquiry into child and adult mental health services. The report has not yet been scheduled for debate in the Parliament, but it is appropriate to raise some of the issues on the back of some of the points that Ian McKee made. A particular point is the lack of health visitors in Scotland to advise and support parents with young children. In Inverness, after their 15-month immunisation, a child will next see a health visitor at the age of five, when they start school. Without the standard health checks and support, there can be no doubt that many children slip through the net.

An Audit Scotland report from July 2008 stated that 40 per cent of children in Highland waited for more than eight weeks for a first assessment by the community mental health team. Some waited for more than a year. For very young children, we were told, there is a window of opportunity for addressing mental health issues at a certain age. If that opportunity is missed, the consequences are lifelong poor mental health and many other issues. In committee, Dr Phil Wilson pointed out that there is a

"big increase in the evidence base on what works to stop the bad things happening"

and that early neglect, before the age of two, is the strongest predictor for later childhood mental health problems. There is strong evidence that children with problematic behaviour at two-and-a-half years of age are highly likely to end up with major problems later in life. Dr Wilson also told the committee that

"it is possible to predict at the age of three as many as 70 per cent of the children who will end up as in-patients"—[Official Report, Health and Sport Committee, 25 March 2009; c 1728, 1734.]

in psychiatric hospitals or in prisons.

For all those reasons, I welcome the GIRFEC approach. However, as Dr Wilson stated, children had been completely forgotten and, as a result, no health visitors are being trained in NHS Highland. Elsewhere in Scotland, the service is patchy, to say the least. Although we can all congratulate and commend GIRFEC, it works only when the children who are in need are identified. Unfortunately, the demise of the health visiting profession means that many more children will not be identified at the early stages and will not get the help that they need.

I am pleased that Adam Ingram is the minister in charge of the programme. He has a proven record of commitment to mental health, given that he chaired the cross-party group in the Scottish Parliament on mental health in the first two sessions of the Parliament. I am aware of that, because I was his vice-convener for all those years. I place on record my congratulations to Highland Council, but I highlight the many failings in the system in identifying children in need. I have no doubt that those issues will be given greater prominence when the Health and Sport Committee debate on child and adult mental health services is scheduled in the Parliament.