Chamber
Plenary, 15 Jun 2005
15 Jun 2005 · S2 · Plenary
Item of business
Sexual Health
As MSPs are aware, the Executive decided to produce a sexual health strategy because sexual health in Scotland is undeniably poor. The number of unintended teenage pregnancies in Scotland is among the highest in western Europe, as is the incidence of sexually transmitted infections. Worryingly, the situation is worse in areas of deprivation. That is why "Respect and Responsibility: Strategy and Action Plan for Improving Sexual Health" includes a target for reducing teenage pregnancies among under 16-year-olds in the most deprived areas.
As MSPs will also be aware, the incidence of STIs is not confined to young people. Some of the highest rates of infection have been among those aged over 30. As the issue of sexual health affects us all—both the young and the not so young—the strategy is inclusive. Rather than target a particular age group, it seeks to address the issue in a comprehensive and cross-cutting manner. That is why I emphasised the sexual health strategy's central contribution to our health improvement agenda when I announced the launch of the strategy. That will be achieved through the provision of accurate information, improved and more easily accessible services and closer working across national health service boards to make better use of existing resources.
We want to foster and encourage the development of a culture of respect and responsibility. The answers to improving sexual health lie with each and every one of us. We can do something about it.
I was particularly heartened by the general welcome that the strategy received from all sectors of society at its launch. I appreciate that some aspects of the strategy will not have universal appeal, but we have always recognised that, on such a sensitive subject, views are deeply held. That is why the strategy is respectful of young people's rights and of parental and personal responsibilities, and why it recognises faith, cultural and gender diversity. However, it was reassuring that there was general agreement on the principles that underpin the strategy, which are self-respect, respect for others and strong relationships.
I am pleased to advise the Parliament that we have made good progress since the launch of the strategy. In February, the first of two workshops for key stakeholders and commissioners of sexual health services took place. That event was for clinical service providers and was attended by representatives of all NHS boards. It was quickly followed in March by a wider stakeholder event, which was attended not just by clinical service providers but by sexual health promotion specialists and representatives of local authorities, the voluntary sector, special health boards and other key stakeholders. The purpose of both events was to take forward the strategy and action plan for improving sexual health.
The consensus among those who attended the workshops indicated a strong welcome for the strategy and a great willingness and enthusiasm to make progress as soon as possible. The outcomes from the workshops included initial discussions on the benefits of clinical service provision on a regional basis; development and submission of draft integrated clinical service plans; agreement on timescales for the production of local interagency sexual health strategies; and confirmation of the need to engage fully with all stakeholders in the development of local sexual health strategies
When we launched the strategy, I was pleased to announce some £5 million of new funding for each of the next three financial years to support the strategy's implementation. That is £15 million over and above what the Executive already spends on sexual health and related issues. My aim is to ensure that that funding is targeted at making improvements in front-line clinical services. To that end, by 31 March 2005 all NHS boards had submitted initial clinical service plans that reviewed current services, with the aims of working towards integrated links between family planning services and genito-urinary medicine services; increasing services at a primary care level; and providing training opportunities to increase the capacity of hardworking professionals in the field.
The objective for all concerned is to provide a sexual health service that is fit for the 21st century. I am very pleased that the boards, in their interim clinical service plans, have already made a number of key proposals. They include proposals for additional specialist nursing and medical posts and associated training programmes; for integrated family planning and GUM services with outreach services at a more local level suitable to patients; for targeted approaches, such as increased testing for sexually transmitted infections; and for specific user services such as psychosexual services and an increased number of youth clinics.
On the basis of those clinical service plans, funding allocation letters have now been sent to boards. An important aspect of the strategy—this was recognised by the independent expert group that prepared the earlier draft strategy—is the need for leadership. At a local level, boards have now nominated an executive director lead for sexual health; all boards have either identified or are in the process of identifying the clinical lead for sexual health services; and all local authorities are identifying a strategic lead for sexual health in their area.
As regards leadership at a national level, MSPs will recall that when I launched the strategy I announced that we would set up a national sexual health advisory committee, which will be wide ranging. I will chair the committee and its membership will be drawn from a number of key stakeholders. The committee will have a pivotal role in monitoring the progress of the strategy. Most important, it will help to support the implementation of the action plan.
I see the committee's work as falling under three broad headings. Between them, the headings encompass all the actions in the remit that we set out in "Respect and Responsibility". The broad headings are the promotion of a culture of respect and responsibility; the prevention and reduction in the number of sexually transmitted infections and unintended pregnancies; and the provision of better services.
I have today announced the most up-to-date list of the membership of the committee. The first meeting will take place on Tuesday 28 June. I am indebted to the organisations and individuals who have readily agreed to be committee members. Although the membership of the committee reflects stakeholders with a major interest in sexual health, it has just not been possible to include everyone who wanted to be represented. The intention is that the work of the committee will be taken forward by sub-groups that will be able to draw on wider experience and expertise as necessary.
The committee will be an excellent forum to help to draw together other cross-cutting initiatives such as those for adult survivors of childhood sexual abuse and for street prostitution, and our work to reduce the levels of smoking among pregnant women.
In addition to the initial clinical service plans, boards have been asked to submit more detailed service plans by the end of September 2005. I have also asked boards, in collaboration with other local stakeholders such as local authorities and voluntary sector partners, to provide local interagency sexual health strategies that reflect the underpinning principles and general themes of "Respect and Responsibility". Those strategies should reflect the sexual health needs of local populations and should emerge through consultation with professionals, parents, service users and the wider community.
In that way, our approach to dealing with sexual health and well-being reflects the wider, holistic nature of the issue and the role that has to be played by local authorities, the voluntary sector, schools, parents and other key stakeholders. Ultimately, however, it is important that we all take responsibility for our own sexual health. Of course, parents have a key role in protecting the health of their children.
Although the strategy is in no way confined to young people, education has a key role to play in delivering the cultural changes that lie at the heart of "Respect and Responsibility". The strategy seeks to build on existing principles of and guidance on sex and relationships education, and to improve further the key dimensions, such as parental engagement with classroom materials and the consistent delivery of sex and relationships education to all pupils, including those who are vulnerable or disaffected.
The Executive is working with the healthy respect project and the Scottish Catholic education service to develop materials for use in denominational schools. That is an extremely positive step that reflects the absolute importance of stakeholders working together for the common good.
When I launched phase 2 of healthy respect, I had the opportunity to meet and talk to several young people who use the Midlothian young people's advice service in Dalkeith. During our discussion, which lasted for more than an hour, they shared their views on sex education, smoking, drugs and alcohol. They highlighted the value of places such as MYPAS in providing advice and services not only on sexual health, but on a range of issues that they felt were relevant to them. The attitude of the staff towards young people was highlighted as a key element of such a good service.
As I indicated, the strategy is not just about young people. I will make efforts to visit fairly soon the Sandyford initiative in Glasgow, which is an example of how sexual health services can be provided in a location that is suitable for people of all ages.
Although I am pleased with the excellent progress that has been made to date and with the support of all the key stakeholders in the field, I know that we all recognise that this is a difficult and deep-seated issue to tackle. Scotland's poor sexual health is not something that has occurred recently; indeed, it is not an easy issue for a lot of people to talk about. As I said earlier, we have made good progress, but we have still to sort out the problems of poor communication and attitudes, inaccessible and inappropriate services and a lack of knowledge and skills.
This is the start of a long journey, but I am confident that we can move forward with speed and purpose. Crucially, I am determined that we need to continue to make progress in supporting "Respect and Responsibility" throughout Scotland, which is why I am pleased to be chairing the national sexual health advisory committee in its key role of supporting the implementation of the strategy.
I move,
That the Parliament acknowledges the progress that has been made to date in implementing Respect and Responsibility, the Scottish Executive's Strategy and Action Plan for Improving Sexual Health; commends the work by stakeholders to date, and welcomes the creation of a National Sexual Health Advisory Committee which will be a key element in taking forward the action plan.
As MSPs will also be aware, the incidence of STIs is not confined to young people. Some of the highest rates of infection have been among those aged over 30. As the issue of sexual health affects us all—both the young and the not so young—the strategy is inclusive. Rather than target a particular age group, it seeks to address the issue in a comprehensive and cross-cutting manner. That is why I emphasised the sexual health strategy's central contribution to our health improvement agenda when I announced the launch of the strategy. That will be achieved through the provision of accurate information, improved and more easily accessible services and closer working across national health service boards to make better use of existing resources.
We want to foster and encourage the development of a culture of respect and responsibility. The answers to improving sexual health lie with each and every one of us. We can do something about it.
I was particularly heartened by the general welcome that the strategy received from all sectors of society at its launch. I appreciate that some aspects of the strategy will not have universal appeal, but we have always recognised that, on such a sensitive subject, views are deeply held. That is why the strategy is respectful of young people's rights and of parental and personal responsibilities, and why it recognises faith, cultural and gender diversity. However, it was reassuring that there was general agreement on the principles that underpin the strategy, which are self-respect, respect for others and strong relationships.
I am pleased to advise the Parliament that we have made good progress since the launch of the strategy. In February, the first of two workshops for key stakeholders and commissioners of sexual health services took place. That event was for clinical service providers and was attended by representatives of all NHS boards. It was quickly followed in March by a wider stakeholder event, which was attended not just by clinical service providers but by sexual health promotion specialists and representatives of local authorities, the voluntary sector, special health boards and other key stakeholders. The purpose of both events was to take forward the strategy and action plan for improving sexual health.
The consensus among those who attended the workshops indicated a strong welcome for the strategy and a great willingness and enthusiasm to make progress as soon as possible. The outcomes from the workshops included initial discussions on the benefits of clinical service provision on a regional basis; development and submission of draft integrated clinical service plans; agreement on timescales for the production of local interagency sexual health strategies; and confirmation of the need to engage fully with all stakeholders in the development of local sexual health strategies
When we launched the strategy, I was pleased to announce some £5 million of new funding for each of the next three financial years to support the strategy's implementation. That is £15 million over and above what the Executive already spends on sexual health and related issues. My aim is to ensure that that funding is targeted at making improvements in front-line clinical services. To that end, by 31 March 2005 all NHS boards had submitted initial clinical service plans that reviewed current services, with the aims of working towards integrated links between family planning services and genito-urinary medicine services; increasing services at a primary care level; and providing training opportunities to increase the capacity of hardworking professionals in the field.
The objective for all concerned is to provide a sexual health service that is fit for the 21st century. I am very pleased that the boards, in their interim clinical service plans, have already made a number of key proposals. They include proposals for additional specialist nursing and medical posts and associated training programmes; for integrated family planning and GUM services with outreach services at a more local level suitable to patients; for targeted approaches, such as increased testing for sexually transmitted infections; and for specific user services such as psychosexual services and an increased number of youth clinics.
On the basis of those clinical service plans, funding allocation letters have now been sent to boards. An important aspect of the strategy—this was recognised by the independent expert group that prepared the earlier draft strategy—is the need for leadership. At a local level, boards have now nominated an executive director lead for sexual health; all boards have either identified or are in the process of identifying the clinical lead for sexual health services; and all local authorities are identifying a strategic lead for sexual health in their area.
As regards leadership at a national level, MSPs will recall that when I launched the strategy I announced that we would set up a national sexual health advisory committee, which will be wide ranging. I will chair the committee and its membership will be drawn from a number of key stakeholders. The committee will have a pivotal role in monitoring the progress of the strategy. Most important, it will help to support the implementation of the action plan.
I see the committee's work as falling under three broad headings. Between them, the headings encompass all the actions in the remit that we set out in "Respect and Responsibility". The broad headings are the promotion of a culture of respect and responsibility; the prevention and reduction in the number of sexually transmitted infections and unintended pregnancies; and the provision of better services.
I have today announced the most up-to-date list of the membership of the committee. The first meeting will take place on Tuesday 28 June. I am indebted to the organisations and individuals who have readily agreed to be committee members. Although the membership of the committee reflects stakeholders with a major interest in sexual health, it has just not been possible to include everyone who wanted to be represented. The intention is that the work of the committee will be taken forward by sub-groups that will be able to draw on wider experience and expertise as necessary.
The committee will be an excellent forum to help to draw together other cross-cutting initiatives such as those for adult survivors of childhood sexual abuse and for street prostitution, and our work to reduce the levels of smoking among pregnant women.
In addition to the initial clinical service plans, boards have been asked to submit more detailed service plans by the end of September 2005. I have also asked boards, in collaboration with other local stakeholders such as local authorities and voluntary sector partners, to provide local interagency sexual health strategies that reflect the underpinning principles and general themes of "Respect and Responsibility". Those strategies should reflect the sexual health needs of local populations and should emerge through consultation with professionals, parents, service users and the wider community.
In that way, our approach to dealing with sexual health and well-being reflects the wider, holistic nature of the issue and the role that has to be played by local authorities, the voluntary sector, schools, parents and other key stakeholders. Ultimately, however, it is important that we all take responsibility for our own sexual health. Of course, parents have a key role in protecting the health of their children.
Although the strategy is in no way confined to young people, education has a key role to play in delivering the cultural changes that lie at the heart of "Respect and Responsibility". The strategy seeks to build on existing principles of and guidance on sex and relationships education, and to improve further the key dimensions, such as parental engagement with classroom materials and the consistent delivery of sex and relationships education to all pupils, including those who are vulnerable or disaffected.
The Executive is working with the healthy respect project and the Scottish Catholic education service to develop materials for use in denominational schools. That is an extremely positive step that reflects the absolute importance of stakeholders working together for the common good.
When I launched phase 2 of healthy respect, I had the opportunity to meet and talk to several young people who use the Midlothian young people's advice service in Dalkeith. During our discussion, which lasted for more than an hour, they shared their views on sex education, smoking, drugs and alcohol. They highlighted the value of places such as MYPAS in providing advice and services not only on sexual health, but on a range of issues that they felt were relevant to them. The attitude of the staff towards young people was highlighted as a key element of such a good service.
As I indicated, the strategy is not just about young people. I will make efforts to visit fairly soon the Sandyford initiative in Glasgow, which is an example of how sexual health services can be provided in a location that is suitable for people of all ages.
Although I am pleased with the excellent progress that has been made to date and with the support of all the key stakeholders in the field, I know that we all recognise that this is a difficult and deep-seated issue to tackle. Scotland's poor sexual health is not something that has occurred recently; indeed, it is not an easy issue for a lot of people to talk about. As I said earlier, we have made good progress, but we have still to sort out the problems of poor communication and attitudes, inaccessible and inappropriate services and a lack of knowledge and skills.
This is the start of a long journey, but I am confident that we can move forward with speed and purpose. Crucially, I am determined that we need to continue to make progress in supporting "Respect and Responsibility" throughout Scotland, which is why I am pleased to be chairing the national sexual health advisory committee in its key role of supporting the implementation of the strategy.
I move,
That the Parliament acknowledges the progress that has been made to date in implementing Respect and Responsibility, the Scottish Executive's Strategy and Action Plan for Improving Sexual Health; commends the work by stakeholders to date, and welcomes the creation of a National Sexual Health Advisory Committee which will be a key element in taking forward the action plan.
In the same item of business
The Deputy Presiding Officer (Murray Tosh):
Con
The next item of business is a debate on motion S2M-2958, in the name of Andy Kerr, on sexual health, and three amendments to the motion.
The Minister for Health and Community Care (Mr Andy Kerr):
Lab
As MSPs are aware, the Executive decided to produce a sexual health strategy because sexual health in Scotland is undeniably poor. The number of unintended t...
Shona Robison (Dundee East) (SNP):
SNP
In response to the statement made by the minister on 27 January this year, the Scottish National Party gave a broad welcome to the Executive's strategy and a...
Mrs Nanette Milne (North East Scotland) (Con):
Con
It is now 40 years since the advent of the contraceptive pill in the 1960s put women in charge of their reproductive lives. As a result, society has changed ...
Patrick Harvie (Glasgow) (Green):
Green
Can Nanette Milne perhaps bring herself to mention any positive benefits that have come from women taking control of their reproductive lives?
Mrs Milne:
Con
I can indeed. As I have said, women have been given untold freedom. It is not all negative, but I am highlighting the downsides simply because we know that s...
Scott Barrie (Dunfermline West) (Lab):
Lab
I agree with Mrs Milne that parents have a key role to play in assisting in any sexual health strategy, but does she agree that her overemphasising of that r...
Mrs Milne:
Con
We know that there are parents who are not best equipped to educate their children, but we must look at giving them support. It is a multi-agency problem, an...
Linda Fabiani (Central Scotland) (SNP):
SNP
Will Mrs Milne give way?
Mrs Milne:
Con
I have given way twice already. Sexual health education is a complex subject. It needs to help all children with their confidence and self-esteem—not just th...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
Will the member give way?
Mrs Milne:
Con
I will take no more interventions.We want an assurance that the sexual health strategy will not undermine the authority of parents by providing a plethora of...
Patrick Harvie (Glasgow) (Green):
Green
I will try to follow that speech with a seriousness that it does not deserve.Yesterday, I talked at an event that the Telephone Helplines Association organis...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
The strategy and action plan for improving sexual health are all about ensuring that a culture of respect and responsibility based on sound values is at the ...
Alex Johnstone (North East Scotland) (Con):
Con
How would the member define "equitable"? Is there a role for parents in contributing to the decision-making process?
Mike Rumbles:
LD
Of course parents have a role to play, but we are talking about taking an equitable approach so that all school kids throughout Scotland have the same inform...
Marilyn Livingstone (Kirkcaldy) (Lab):
Lab
Sexual health is a controversial subject on which people have deeply held views. However, given the rising rates of diagnosed sexually transmitted infections...
Fiona Hyslop (Lothians) (SNP):
SNP
My question to the minister is, "Why are we having this debate?" Is it just to announce the formation of a committee? If that is the reason, it is a bit feeb...
Carolyn Leckie (Central Scotland) (SSP):
SSP
Fiona Hyslop asked why we are having the debate. She also asked many questions that I want answers to. One of the reasons why we are having the debate is tha...
Phil Gallie (South of Scotland) (Con):
Con
I think that Carolyn Leckie is being a bit hard on the Conservatives. There are at least two men on our benches, but there are no Scottish Socialist Party ma...
Carolyn Leckie:
SSP
That is because we bumped them out of the debate.There is a serious point to be made here. There is an element of right-wing reaction, particularly in relati...
Susan Deacon (Edinburgh East and Musselburgh) (Lab):
Lab
I am surprised that the question has been asked why we are having this debate. It is more than five months since the Executive published a major, long-awaite...
Alex Johnstone (North East Scotland) (Con):
Con
Given comments that were made earlier in the debate, I feel that I am the token male on the Conservative benches. However, I think that I have something to c...
Mike Rumbles:
LD
Alex Johnstone has missed the point. What members objected to in Nanette Milne's speech was the fact that she was advocating that people should be able to ve...
Alex Johnstone:
Con
I believe that Mike Rumbles has misunderstood what was said. I hope to address that in greater detail as I progress.The Parliament has become famous for the ...
Patrick Harvie:
Green
Bigots.
Alex Johnstone:
Con
Well, that is a fairly simple definition, and one that perhaps does not belong in the debate. That is not what we are talking about today.The truth is that I...
Linda Fabiani (Central Scotland) (SNP):
SNP
I have some sympathy with Fiona Hyslop. How much more can we say about this subject? I came to the debate thinking, "What on earth can I talk about this time...
Alex Johnstone:
Con
Is the fact that so many parents are unable to fulfil that responsibility not one of the primary issues that we need to address?
Linda Fabiani:
SNP
The need to remove the stigma about such matters is an issue, as Susan Deacon explained very well. However, we also need to address reality: some parents are...