Forensic medical services
Ministerial Statement – Cabinet Secretary for Justice Michael Matheson
Scottish Parliament, 09 May
Thank you Presiding Officer, I’d like to begin with an acknowledgement to all those within the chamber and those outside who have raised awareness of concerns surrounding the provision of forensic examination services to victims of sexual crime.
Rape and sexual assault are the most horrendous of crimes. They can rob victims of their self-esteem and dignity and the effects last long after the original offence has been committed. The need to treat victims of crime sensitively is never more acute or important than with those who are victims of a sexual offence.
Last year, I was privileged to meet the author of ‘A Woman’s Story’.
Members will be aware that ‘A Woman’s Story’ is a powerful narrative of one woman’s very personal and traumatic journey through each step of the justice process after she had been raped. As Cabinet Secretary for Justice, it is vital that I hear first-hand how an individual can be made to feel when they come into contact with the criminal justice system. That meeting with a very brave woman and the observations she made have stayed with me.
Official statistics show an increase in reported sexual crimes in recent years. This is consistent with increasing confidence on the part of victims to report crimes and a robust approach by police and prosecutors to bring perpetrators to justice. However, whilst convictions for sexual crimes are at an all-time high, it is critical that we understand that a successful prosecution is not the only outcome that matters. Many victims will be on a long journey of recovery which continues well beyond the conclusion of a court case.
It is therefore crucial that the healthcare response is equipped to deliver the services that they need. Often this begins with the forensic medical examination.
As a Government, we have committed to driving forward improvements for victims within this Parliamentary term. In particular, the 2016 SNP manifesto undertook to review how forensic examinations are carried out to ensure that they are done appropriately and sensitively.
We know for example that the majority of victims would prefer to be examined by a female doctor. We know that the current gender balance of doctors with the necessary training does not offer that choice.
A course designed by NHS Education Scotland for the Scottish legal system exists but the uptake from female doctors is low. There are currently only 19 female forensic physicians working in Scotland.
We took forward work in partnership with NHS Education Scotland to understand why. This included a national survey of doctors issued in February to gather information about the perceived barriers to working in this area.
Over 800 responses were received and over half (53.6%) said they would, in principle, be interested in working to provide forensic examinations for victims of sexual crime. 17 doctors proactively followed up the survey requesting further information about how they could get involved. That already is a positive outcome and discussions with NHS Education Scotland and Health Boards will inform further actions to address the issue more sustainably.
In addition, in the same month, we announced the commission of National Standards, to be developed by Healthcare Improvement Scotland.
The National Standards will be the first published national standards for forensic examinations for victims of sexual assault. These Standards will put beyond doubt what is expected of NHS boards in delivering care for victims, and will build consistency of practice throughout the country.
We want to ensure that where a victim reports a rape they are given the very best care no matter where in the country they are. We also think it is important that victims are made aware of the Standards themselves and understand that forensic examination is only one part of a much wider package of healthcare they are entitled to.
The National Standards for forensic examinations will be consulted on during the summer and published by the end of the year.
Presiding Officer, Members of this chamber will have read the recent Her Majesty’s Inspectorate of Constabulary report on forensic examination services which points very clearly to improvements we need to make.
It found significant variations in the provision of forensic medical services in Scotland. It recommended that a better balance should be achieved between the justice and health response to appropriately address the immediate healthcare needs and future recovery of patients.
And it reported that some victims still require to attend a police building to undergo an examination – this is completely unacceptable.
As a general theme the Report found a lack of strategic leadership and governance over provision of forensic medical services.
On 30th March, the same day HMICS’ report was published, the Scottish Government announced that the Chief Medical Officer would lead a group of key individuals to galvanise the necessary leadership within Health and Justice to transform healthcare responses to victims of sexual crime.
On the 27th April I addressed the first meeting of this Taskforce. The Taskforce for the Improvement of Services for Victims of Rape and Sexual Assault has a clear mandate from Scottish Ministers:
- To provide national, strategic governance; and
- To take decisions that will make a tangible difference for victims.
It has a strong membership including Police Scotland, Crown Office, Rape Crisis Scotland, representation from NHS Chief Executives, the Royal College’s Child Protection Committee, NHS Chairs and the Chief Social Work Adviser.
The Taskforce have identified 5 working groups to sit under it, and Chairs are nominated for each under the following headings:
- Workforce planning,
- Regional Delivery of Services,
- Clinical Pathways,
- Quality Improvement and
- Premises and Infrastructure.
Presiding Officer, this chamber should be in no doubt that Scottish Ministers have empowered this Taskforce, through the CMO’s leadership, to be bold and to deliver.
Working groups have been tasked to agree their remits and priorities for the next Taskforce meeting in June, and Scottish Ministers will be receiving regular progress reports. The Chief Medical Officer will also established the Taskforce’s work plan and this will be published after the summer to clearly communicate how work will be driven forward.
Presiding Officer, before I finish I want to raise particular concerns about the provision of forensic examinations in rural and island communities.
I met with Liam McArthur and Tavish Scott in March to discuss provision of forensic examinations in Orkney and Shetland, which have no local services currently operating for victims.
I share the concerns raised about current provision of forensic examinations for victims of sexual assault in island communities and I can give my assurances now, as I did then, that the Scottish Government is committed to making meaningful changes to rectify this situation.
Since that discussion, I am pleased that Shetland Health Board has announced plans for a local victim-centred service to provide forensic examinations and compassionate medical healthcare on the island. This is a very encouraging development.
Presiding Officer, we are aware that much more requires to be done and that the challenges are many. I know members will recognise that these issues require effective planning and appropriate training of staff over the coming period.
I have confidence that the Taskforce is the best place for these challenges to be considered and I look forward to its recommendations in the coming months.