First Minister Nicola Sturgeon has said an interim report into mental health services in Tayside will be published “imminently”.
Responding to questions from Scottish Labour leader Richard Leonard about the inquiry, Ms Sturgeon said she would expect relatives who campaigned for the inquiry to be given advance copies of the interim report, which is expected to be published this month.
The inquiry was launched following a public campaign by families who blamed poor care at the Carseview Psychiatric Centre at Ninewells Hospital for a series of suicides.
The interim report will be published next week although it will be several months before the full inquiry report is completed.
Mr Leonard told the First Minister that some of the relatives whose campaigning led to the inquiry feel they have not been kept up-to-date with its progress and believe it is not “transparent”.
He said that when the inquiry was set up then health secretary Shona Robison said it should be seen as “a force for good” and asked if Ms Sturgeon believed this aspiration is being met.
Mr Sturgeon said it would be wrong for the Scottish Government to “pre-empt” the inquiry but said its findings would be scrutinised and any recommendations acted upon.
She added: “Of course we want to learn lessons and our sympathies are with the families who have experienced those losses.
“We established an independent inquiry in Tayside. That hasn’t yet reported. I hope it will report soon and it will be fully scrutinised by the government.”
Mr Leonard said Mandy McLaren, the mother of Dundee suicide victim Dale Thomson, has lost confidence in the inquiry.
He said: “She asked me to ask you directly if families will see an advance copy of the interim report before it is published.
“Will you listen to the voices of those families? Will you do what you can do to restore their confidence in this inquiry?”
Ms Sturgeon replied: “This inquiry is being led by David Strang. It is an independent inquiry.
“If the government was interfering in the conduct of that inquiry, I am sure Richard Leonard would be raising that in the chamber.
“I understand David Strang has met with family members. It would be full my expectation that an advance copy of the report would go to those directly affected.
“I will pass that specific point to David Strang but I would stress it is an independent inquiry.”
Earlier, Conservative MSP Bill Bowman pressed health secretary Jeane Freeman over plans for a 24-hour crisis centre in Dundee.
Councillor Ken Lynn, the the vice-chairman of Dundee Heath and Social Care Partnership, has pledged his “total commitment” to creating a centre in Dundee, but Ms Freeman the issue had not been raised with her or the minister for mental health, Claire Haughey.
Mr Bowman said later: “It was clear from the cabinet secretary’s answer that the SNP are disconnected from the challenges faced on the ground.
“There seems to be no plans for the new centre in Dundee, or for the government to help NHS Tayside create one.”
A probe into serious abuse allegations at Carseview could impact a controversial shake-up of mental health services.
The first phase of a planned review, which will see general adult psychiatry acute admissions centralised in Dundee, is due to begin in June.
However, health chiefs say they are prepared to make changes if necessary,when the findings of an independent investigation into claims patients were pinned to the floor and mocked by staff at the Carseview mental health unit in Ninewells.
The Perth and Kinross Integration Joint Board heard preparatory work on the mental health review is already under way, with the first phase due to begin in June.
The plan was agreed in January 2018, following months of consultation and protest. Learning disability inpatient services will be provided at Murray Royal Hospital Perth, after services were transferred out of the outdated Mulberry unit at Stracathro in Angus.
The board was given an update by the four-person panel leading the review.
Conservative councillor Colin Stewart asked: “We’ve heard that we need to work quickly to address risks, but we are also told there are delays to the redesign programme.
“I understand there is going to be an interim report on the independent inquiry published later this month.
“Have you had any indication that there may be points raised for action in this report, that might have implications for the redesign programme?”
Arlene Wood, associate director for mental health, confirmed she had not had any feedback or update on the review. “The clear steer that we have had from the chief executive is that we continue, for now, on the quality improvement and redesign programme because we know there are inherent risks in the system and this work needs to happen,” she said.
“It would be remiss of us to wait for the report. If there are things raised that require us to change our course of action, then we would address that at the time.”
The board heard the heads of health partnerships in Dundee, Perth and Angus were working on a Tayside Mental Health Alliance, to tackle a range of challenges facing the sector.
Professor Keith Matthews, associate medical director for mental health services said: “It would be a mistake to underestimate how challenging the environment is for mental health services.
“We have issues with recruitment and there are emerging difficulties with retention of staff.”
He said the Scottish Government was attempting to address a national shortage of psychiatrists with an international recruitment campaign.
“Although many efforts are being taken to resolve these matters, the likelihood of anything being resolved soon are pretty low.”
He added there was a need to move away from a workforce reliant on high-cost agency work.
Suicide rates in Dundee are higher than any other city council area in Scotland, according to a new report.
The Scottish Suicide Information Database also shows that men accounted for three-quarters of suicides across Tayside in the last seven years.
According to the report, there were 164 deaths caused by suicide in Dundee with an average of 16.7 per 100,000 population between 2011 and 2017.
Angus along with Perth and Kinross Councils recorded 98 and 126 suicides respectively.
For Tayside as a whole, 388 suicides were recorded with an average per 100,000 population of 14.1.
Men were more likely to take their own lives, with the rates across Scotland highest among those aged 35-54 and in deprived areas.
Nearly three-quarters of those who died had contact with healthcare services in the year before their death.
An inquiry is currently under way into NHS Tayside’s mental health services after a number of concerns surrounding the Carseview Centre.
Phil Welsh, whose 28-year-old son Lee took his own life last year, said the latest statistics were “damning”.
He said: “It’s clear that there’s a situation here that isn’t working.
“I think the fact there is an inquiry shows there’s something amiss.
“Mental health is a discussion point now but it’s all well talking, we need support for people afterwards and that is why we badly need a crisis centre.”
A spokeswoman from NHS Health Scotland said: “National suicide prevention programmes need to incorporate a comprehensive public health approach which seeks to reduce stigma, improve mental wellbeing in the whole population and address the underlying causes of poor mental health.”
The NHS in Scotland is not financially sustainable and its performance has continued to decline, the public spending watchdog has warned.
Audit Scotland said health boards were “struggling to break even” and none had met all of the key national targets – with NHS Lothian not meeting any.
It highlighted increasing demand on NHS services, and rising waiting lists.
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
But the watchdog’s report prompted widespread criticism of the Scottish government, with the Conservatives claiming it should “make shameful reading for the SNP”.
The report said pressure is building in several areas – including the recruitment and retention of staff, rising drug costs, Brexit and a significant maintenance backlog.
It said “decisive action” was needed to protect the “vital and valued service”.‘
What does the report say?
The report warned that the NHS in Scotland is “not in a financially sustainable position”, with NHS boards “struggling to break even, relying increasingly on Scottish government loans and one-off savings”.
And it said the “declining performance against national standards indicates the stress NHS boards are under”.
The only target met nationally in 2017/18 was for drugs and patients to be seen within three weeks.
Only three of Scotland’s regional health boards met the target for patients beginning cancer treatment within 62 days of being referred
The proportion of youngsters seen by CAMHS within 18 weeks fell from 83.6% in 2016/17 to 71.2% in 2017/18.
The Scottish government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.
Health boards made “unprecedented” savings of £449.1m, but many relied heavily on one-off savings for this, while three boards – NHS Ayrshire and Arran, NHS Highland and NHS Tayside – needed £50.7 million of loan funding from the government to break even.
This was “significantly more” than in previous years, with Audit Scotland saying four boards have predicted they will need a combined total of £70.9m in this current financial year.
The report said the “NHS is managing to maintain the overall quality of care, but it is coming under increasing pressure”, adding Brexit would create “additional challenges” for the health service.
However the scale of these challenges was “difficult to assess” because of “significant uncertainty” over the terms of the UK’s withdrawal deal from the European Union, and because data on workforce nationality is not routinely collected.
Auditor General Caroline Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing.
“The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.”
What has the Scottish government said in response?
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
She said NHS funding had reached “record levels of more than £13bn this year, supporting substantial increases in frontline NHS staffing, as well as increases in patient satisfaction, reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for more than three years.”
She added: “While our NHS faces challenges, common with health systems across the world, we are implementing a new waiting times improvement plan to direct £850m of investment over the next three years to deliver substantial and sustainable improvements to performance, and significantly improve the experience of patients waiting to be seen or treated.
“Ultimately we want to ensure people can continue to look forward to a healthier future with access to a health and social care system that continues to deliver the world-class compassionate care Scotland is known for.”
What other reaction has there been?
Conservative health spokesman Miles Briggs claimed the NHS was “facing an unprecedented challenge” with boards across the country “staring into a black hole of more than £130m.
He said: “For a government which has been in charge for more than 11 years, this should make shameful reading for the SNP.”
Labour’s Monica Lennon added: “After more than a decade of SNP complacency our NHS is in crisis.”
Dr Lewis Morrison, chairman of the British Medical Association (BMA) in Scotland, said the “stark warning” from Audit Scotland “could not be any blunter”.
But he added this would “come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year”.
And RCN Scotland director Theresa Fyffe said the report “underlines what those in the nursing profession have been warning about for a number of years – an unsustainable pressure on staff to deliver more care.
“This leads to staff burnout and, in some cases, a choice between staying in the profession and their own health.”
SCOTLAND’S most senior civil servant has been commended for speaking about her personal experience of mental health problems.
Permanent Secretary Leslie Evans said she had worked through “several tough and very stressful episodes” in the past, and had seen a health professional at one point.
She shared the information with Scottish Government staff in a personal blog in July, and yesterday made it available publicly on the government’s website.
She said she wanted to help stamp out the stigma surrounding mental ill-health.
Ms Evans had been a low-key figure since being appointed Permanent Secretary in 2015.
But she was thrown into the public spotlight last month when it emerged she had investigated sexual misconduct allegations against Alex Salmond, and the former First Minister launched a legal action against her handling of the case.
Ms Evans did not identify her particular mental health experiences, but they are understood to predate her time in the civil service.
Nicola Sturgeon this week announced an extra £250m for mental health services, particularly those required by young people.
In her “Catch up with Perm Sec” blog on 2 July, Ms Evans included a section on mental health which stressed the importance of good mental health and wellbeing at work.
She wrote: “Last week I took part in an open and frank session at Victoria Quay [the government office in Edinburgh] which reflected on our mental health experiences as individuals, how this informs the culture of our organisation, and where we need to improve mental health and wellbeing support.
“Like many people I have worked my way through several tough and very stressful episodes. What helped me was the support of my line manager, on one occasion seeing a health professional, and the continuing support of my friends and family.
“We all have a role to play in stamping out stigma surrounding mental health and improving our workplace culture.”
Calum Irving, director of See Me, the Scottish campaign to end mental health stigma and discrimination, said: “I was fortunate to hear Leslie speak very passionately about mental health at work and to share her own experience. It is a very challenging thing to do but can have a profound effect, especially coming from people in leadership positions.
“Workplace discrimination because of mental ill health is sadly still commonplace and it prevents people from being treated equally. So concerted action from senior leaders is very much needed, to ensure that we can all live fulfilled lives.”
In recent years, a series of politicians and public figures, including MPs and Prince Harry, have spoken about their experience of mental health.
But Scottish LibDem health spokesman Alex Cole-Hamilton said it was rare for officials to do likewise.
He said: “This is very brave of Leslie and hopefully will give courage to others to come forward and talk about things they might have been going through.
“We often think of the civil service as quite severe and dry place to work. It’s really significant that the most senior civil servant in the land has paved the way for this traditionally quite conservative profession to open up about mental health and I commend her for it.”
Ms Evans is being taken to court by Mr Salmond over her handling of two complaints made against him in January which relate to his time as first minister in 2013.
He is challenging the investigatory process through a judicial review at the Court of Session, drawing on a £100,000 war chest funded by a controversial online appeal.
Ms Evans also referred to Mr Salmond’s case in her blog of 27 August.
She said: “You will appreciate that for legal reasons I am unable to say anything further at this point, but I can assure you that the Scottish Government will defend its position vigorously. I shall update you as and when I can.
“In line with work already underway to tackle inappropriate behaviour, and in consultation with our trade unions, we are carefully considering any issues about culture and working practices.”