Hansard

Thank you, Presiding Officer. I welcome the publication of “The keys to life”, which is the second 10-year strategy for tackling learning disabilities and ensuring that independent living is at the heart of everything that we do.

The strategy quite rightly builds on a relatively successful strategy that was commissioned by the previous Executive’s “The same as you?” publication. That strategy saw a move away from long-stay beds, which has resulted in there being 1,000 fewer, over the years. It also saw a move away from the traditional day centre set-up. I welcome both of those changes, but I am also heartened to hear the minister say that there is still an essential role for day centres in some circumstances. In my experience, it may even be a desirable role in some circumstances. I will speak about that later.

While the second strategy was a long time in the making, it was right to take two years to evaluate the previous 10-year strategy and to run that through the national learning disability strategy group. All stakeholders can rightfully say that they have had a key partnership role in producing this second 10-year strategy.

I want to focus initially on some of the health recommendations. The Learning Disability Alliance Scotland said in its very helpful submission that that is the right thing to do. I might also refer to some of those points later if I have time. There is a 20-year reduced life expectancy for adults with learning difficulties, and many learning disabled individuals have complex learning needs and multimorbidities. It is only right that the health recommendations be a major focus of the strategy.

It is also quite right that we quantify the extent of the issue before we can fully address problems and barriers. That is why I welcome recommendations 9 to 12, particularly the new HEAT target that is to be developed to identify and track just how the learning-disabled are using the national health service. In a few years we will ask ourselves why we never tracked that use in the first place. It is clearly the right thing to do, not just for its own sake but, as the strategy makes clear, to identify trends and patterns. I assume that it will also help us to identify areas where improvement is needed, and help us to understand key issues better, such as the unnecessary deaths that still occur within the learning-disabled communities.

The most significant aspect of the recommendations is the attempt to identify and track the social work resources that are provided to the learning disabled using the unique NHS number that every learning disabled individual has, like the rest of us. That will be important and I will perhaps say more about that later, if I have time.

In terms of the broad thrust of the health improvements that we seek, I commend the recommendation on oral health, and with regard to epilepsy, I welcome the greater access to specialist nurses at an appropriate time. I will welcome greater access to neurological services, should we make it a reality.

A meaningful improvement could be made the next time the general practitioners’ contract is reviewed. It would perhaps be worth having within that contract a special indicator of how GPs deal with the learning disabled. We should also mention the greater advocacy needs that the learning disabled may have in accessing GPs and other services, and the greater time that they may need with the GP. There is a lot to welcome within the health aspect of the strategy.

I also give a nod to recommendation 7, which suggests that local authorities and NHS boards should, by 2015, have joint commissioning plans to

“take account of the needs of people with learning disabilities”.

Recommendation 7 also says that plans should maximise “independence and control”. That is clearly the direction of travel in which we want public policy to go to meet the needs of our learning disabled communities.

I will concentrate now on recommendations on traditional social care and independent living. In doing so, I will—as members could probably predict—mention Glasgow City Council’s reform of day centres for the learning disabled. I preface that by saying that local authorities of all political persuasions have not always got that right. This is not a party-political attack; it is me representing constituents whom I defend and whose interests have not been taken account of.

Recommendation 5 in “The keys to life” is:

“That in preparation for the legal duties imposed by the Social Care (Self-directed Support) (Scotland) Act 2013, local authorities and their NHS partners should work with private, voluntary and third sector agencies to ensure that people with learning disabilities have access to a creative variety of providers and supports and are assisted to think creatively about how outcomes can be met and what assistance they may need to develop control.”

I emphasise that it is about

“what assistance they may need to develop control.”

I ask members to indulge me, because I also will consider recommendation 27, which is:

“That by June 2018 the Scottish Government in partnership with local authorities, the Third Sector and people with learning disabilities and carers review and further develop day opportunities”.

I have missed out the second part of that recommendation because of time constraints, but I emphasise that the recommendation says that

“people with learning disabilities and carers”

should get to

“review and further develop day opportunities”.

In other words, as the Learning Disability Alliance Scotland puts it, the recommendations

“could have been strengthened from the start by re-emphasising the phrase ‘Nothing About Us, Without Us’”

in terms of the learning disabled.

It is in the light of those good principles being included in the new strategy and their having been a thread running through previous strategies that I look at Glasgow City Council’s approach. The council developed a plan to close three day centres for adults with learning disabilities. It did not consult them, but instead presented the closures as a fait accompli and consulted on the alternatives after the centres were closed. That is not about control; is about marginalisation of some of the most vulnerable people in society. It should not be allowed.

I stress again that carers and adults with learning disabilities in Glasgow have said that they are open to reforming day-centre provision and general learning disability provision within the city, but the council should speak to them. There should be a two-year moratorium on closures in order that they can engage positively with Glasgow City Council to map out the best service provision and support for adults with learning disabilities in the city.

To what do adults with learning disabilities have recourse when councils get it wrong? Councils have statutory duties in terms of consultation if they decide to consult. However, when they get it spectacularly wrong, as they have done in Glasgow—and, sometimes, elsewhere; it is not only about Glasgow—to what can those most vulnerable people whom I seek to represent have recourse?

There is a fantastic 10-year strategy in front of us, but we should also be mindful of the gaps that still exist and the need to represent the most vulnerable people in our constituencies.