 I remind members of the Covid-related measures that are in place and that face covering should be worn when moving around the chamber and across the Holyrood campus. The next item of business is a member's business debate on motion 1089, in the name of Siobhan Brown, on fetal alcohol spectrum disorders, awareness day 9 September. The business debate will be concluded without any questions being put. I would first of all wish to ask those members who would seek to speak in the debate to please press the request of speak buttons now. I call on Siobhan Brown to open the debate up to seven minutes please, Ms Brown. I would like to thank everyone who supported my motion to recognise International Fetal Alcohol Spectrum Disorder Awareness Day on 9 September, allowing for it to be debated in the chamber today. Fetal Alcohol Spectrum Disorder, commonly known as FASD, is a condition that deserves national attention and awareness. In my motion I pay recognition to the work done by OSHE, an organisation within my constituency of air, which provides support, advice, guidance for parents and carers of children who are affected by FASD. OSHE was founded by Mary Ellen and Billy McFail. McFail has been fostering for over 20 years and has looked after more than 50 foster children during this time. Over the years, the McFail family has been shocked to learn of the prevalence of FASD, particularly in children in care, and about the lack of resources for families and foster families affected. The story of the OSHE charity, however, is one that spreads hope, a hope of those with FASD that can lead a thriving and fulfilling life with the right support in place. Today, I want to tell you the story of Taylor, Mary Ellen and Billy's son, with an FASD diagnosis as a baby, which at the time was quite rare, as it only came about because the doctor noted the mother's alcohol dependence on the baby's medical notes. Clinicians told the McFails that Taylor would never walk, never talk and never sit up. Taylor, supported by Mary Ellen and Billy, had other ideas and surpassed all these milestones. To cut a long story short, he is now in mainstream education. Taylor proved in part to be the inspiration for the charity. When he was nine years old, he wrote a book about an octopus called OSHE. In the story, OSHE, the octopus, was invited to a party but was worried that his tentacles would get stuck on the slide. All his friends lent them their socks to wear, meaning that OSHE could be just like everyone else and go down the slide and enjoy the party. I believe that this story, written by Taylor, shows how we want Scotland to treat those like OSHE. The answer is not to try and make the person fit in, but to make the surroundings fit the person and then everyone can enjoy the metaphorical party. How common is FASD? It is estimated that around 4,500 people in Scotland have Down syndrome, about 44,000 have autism, around 37,000 have ADHD and it is estimated that close to 285,000 in Scotland could have FASD. We must look at ways on how we can reduce occurrences of FASD through education, raising awareness and we can also offer resources and support to those already affected. Similarly, to the fantastic work that has been done in Scotland to make Scotland more autism friendly, I urge the Scottish Government to implement an FASD strategy to address prevention, diagnosis and support and engagement for awareness and training across all sectors, public health, medical, education, social work, criminal justice, third sector and housing. Today I want to highlight diagnosis, support and prevention. You will already know that FASD is caused by exposure to alcohol in the womb. Without a fully developed liver, the fetus is unable to filter out the toxins that are passed freely through the placenta into the bloodstream. One in seven babies experience significant alcohol exposure in Scotland. However, this is what is not commonly known. There is a suggestion that 99 per cent of fetal alcohol spectrum disorder cases are left undiagnosed. People with FASD experience problems with thinking, speech, social skills, timekeeping and memory. The condition often exists alongside autism, ADHD and mental health problems, but it is not just a brain issue. It can also affect facial features, limbs and height. All those together mean that the condition requires sophisticated diagnosis and treatment. With research showing an early diagnosis can make a massive difference. A 2017 study on doctors across the UK found that only 31 per cent of the GPs said that they had an in-depth education regarding FASD. It is very welcome that the Scottish Government has been funding the fetal alcohol advisory and support team since 2015. The small team based in Ayrshire has become the national hub for providing training, research and consultations on FASD. They offer assessments for children and provide support and mediation in schools for parents and carers. FASD usually comes with overlapping social issues. 50 per cent of individuals end up in prison, psychiatric hospitals or drug treatment facilities. An FASD diagnosis is 28 times higher in these settings than in the general population. Those with FASD are more likely to experience homelessness, unemployment and dependent living. With such experiences leaving them to face additional issues such as addiction, 35 per cent have drug and alcohol problems and 23 per cent have received inpatient care for mental illness. When looking at ways to support those with FASD, we must look at a multi-strand plan of action. That means looking at poverty, domestic violence, mental health and safe and secure housing, just to name a few. The Scottish Government has taken considerable action to raise awareness of the dangers of drinking while pregnant and to train health practitioners on how to educate women. Since 2016, we have also increased screening of alcohol intake while pregnant, with midwives encouraged to record instances of alcohol on the mother's health records. However, I am led to believe that in many cases it is not recorded on the baby's medical record. That is key to ensuring that the correct diagnosis of FASD, especially within the care system, means being on the child's record not only just the mother's. 80 per cent of children in care have FASD and it can be easy for society to demonise biological mothers. When pregnant, it is important that the mother feels that she can be honest about her alcohol use. If it is an addiction, it is not easy to stop. We must remove the stigma for those seeking help. We must educate society on the dangers of alcohol to an unborn baby, the ones we know about and the ones we are hearing about today. We must inform mums to be. We must treat people with compassion, but most we need to recognise that the support and help of those children, young people and adults with FASD needs. I thank my colleague Siobhan Brown for leading the debate. I would like to extend my gratitude to the work carried out by Alcohol Focus Scotland for providing on-going information and support to all those affected by fetal alcohol spectrum disorder. As a country, our relationship with alcohol is fractious and troubled at times. Tackling harmful patterns of consumption undoubtedly represent one of the most significant public health challenges that we face today. It can be difficult and a sensitive issue to address, considering that we all know people whose lives, families and communities have been impacted by the effects of harmful alcohol use. Despite that awareness, fetal alcohol spectrum disorder is often described simultaneously as the most prevalent and the most invisible neurodevelopmental condition in Scotland. Often misunderstood and misdiagnosed, the effects of FASD are diverse and can lead to a wide range of both mental and physical issues, including a reduced capacity for learning and understanding behaviours. As a teacher, I have witnessed first-hand the limiting nature of FASD. For children affected by the condition, the already intimidating school environment can be incredibly difficult to navigate. Developmental problems with social skills and communication and the requirement for additional educational support sadly place these students at a greater risk of exclusion and bullying, an experience that they will likely carry for the rest of their lives. In addition, the limited knowledge and expertise of teachers at times in managing and accommodating children with FASD represents a further obstacle in their efforts to create a constructive and inclusive learning environment. Thankfully, we are here to remind and inform people that FASD is preventable. It is crucial that we promote recognition of the dangers attributed to drinking alcohol during any stage of pregnancy and that we do so in a way that does not seek to penalise or condemn women. Our focus should remain firmly on education and health of the population of all, while taking care not to stigmatise FASD, which would only deter individuals from seeking the help and treatment that they need. I am therefore pleased to see that the Scottish Government has remained committed to its 2018 pledge to increase support for children and families affected. Since 2018, amidst the provision of more than £395,000 in funding to the Fetal Alcohol Advisory and Support Team, the Government has launched a successful FASD hub. Through the hub, essential tiered support services and vital lifelines are offered to members of the public. I would also like to highlight the creation of a free FASD learning resource on the NHS Education Scotland website, which includes valuable guidance for educators and helpful resources for parents and carers. I hope that we can continue to promote and increase awareness so that no child is born, avoidably suffering the consequences. I firmly believe that, by championing campaigns such as hashtag no alcohol no risk and supporting the sustained development and expansion of services designed to help families across Scotland, we can improve the physical and mental wellbeing of our children and provide them with the high quality of life that they deserve. As we have heard, Fetal alcohol spectrum disorders can cause children to have a range of issues that are a direct result from alcohol consumption during pregnancy. We must continue to raise awareness of that condition to ensure that mothers understand the dangers of drinking while pregnant and the impact that it can have on their unborn child. FASD was not something that I was aware of until I was in my mid-20s and, for me, education is one of the best ways for people to learn about having a happy, healthy pregnancy. Given that three in every 100 babies in the UK are affected by that condition and that roughly 45 per cent of pregnancies are unplanned, educating young people might be one way to reduce the number of children being born with that condition. Another, and I know that we do not have enough time to discuss this in more depth today, is to continue to tackle the issues that we have in Scotland in relation to binge drinking. We also know that the issues relating to binge drinking have only been exacerbated by the Covid-19 pandemic, causing real concern to health boards, experts and organisations that offer advice regarding FASD. Although FASD is completely preventable, Alcohol Focus Scotland and other organisations have suggested that it is a cause for concern, as no amount of alcohol is safe for pregnant women or women planning for a pregnancy. Turning to children and adults with FASD, I agree with Siobhan Brown and others that we must do more to support them. Although there are a wide range of benefits and support networks to help families with that condition, as FASD goes undetected for quite some time, it means that many tried to cope without talking to organisations who could assist them. Turning to my earlier point of education, if teachers and childcare professionals were trained to spot the symptoms of FASD, that might allow families to understand what support is available to them. During Ms Brown's opening contribution, she spoke passionately about the area that she represents and the excellent work that is being carried out by a FASD organisation based in Ayr, and also about the wonderful story that she told about Taylor and Oshaley Octopus, which gives us an insight about people living with FASD, and it is why it is so important that we must continue to talk about that condition. Therefore, I would like to continue with that narrative by talking about the work that was carried out by NHS Lanarkshire on the run-up to FASD awareness day, which took place on 9 September. As part of their campaign, NHS Lanarkshire released figures that were conducted by alcohol focused Scotland, which have reeled around 29 per cent of adults who were drinking more than before Covid-19 restrictions were introduced. In addition, younger adults were more likely to report an increase in frequency and quantity of alcohol consumed. NHS Lanarkshire took to social media to raise awareness but also targeted those who were more likely to become pregnant or who were trying to conceive, providing details of who they can contact for support. Although the campaign was positively received, more work needs to be done to make this new developmental condition more known. Various groups, including alcohol focused Scotland, have called on the Scottish Government to introduce mandatory alcohol labelling to increase awareness of the risks associated with drinking. Most of the labelling on bottles are not satisfactory at present, with many being a small picture with no information or explanation of why you should not drink whilst pregnant. Alcohol focused Scotland argued that providing helpful messaging on labels will provide information and advice at the point of purchase, which will help women to make a choice that is healthy for their unborn child. I would once again like to thank Siobhan Brown for bringing this issue to the chamber today, and, hopefully, by raising awareness, more can be done to support pregnant women and families living with FVSD. I now call Paul O'Kane to be followed by Rona Mackay. I also thank Siobhan Brown for bringing this important debate to the chamber today, as we mark international FVSD awareness day, which, as we have heard, fell on 9 September. It is vitally important that, as a Parliament, we have an opportunity to talk about this issue, to raise awareness and to call for continued action to support interventions to reduce the prevalence and impact of FVSD in Scotland, and to support those living with it. I thank, as colleagues have done, alcohol focused Scotland for the informative briefing ahead of today's debate, and, indeed, for its continued work to raise awareness and campaign for solutions. As we have heard already, it has been estimated that around 3.2 per cent of Scotland's young people are living with FVSD. As Siobhan Brown said, when we compare that to other conditions such as autism, it is quite stark. Indeed, a study in my region in West Scotland suggests that prevalence is higher than previously thought, with as many as 40 per cent of babies showing signs of exposure to alcohol in the second semester and one in seven showing signs of exposure to high and frequent consumption. If FVSD affects people throughout their lives, 90 per cent experience mental health problems, 79 per cent experience unemployment, 60 per cent have disrupted school experiences, 43 per cent have their education disrupted, 35 per cent have been imprisoned as adolescents, and 20 per cent have needed in-patient psychiatric care. Life expectancy for people with FVSD is tragically short at just 34 years, with many deaths attributed to addiction, misadventure or suicide. Those figures are stark, and they point to the need for renewed action, which is incumbent on all of us. Action such as the calls by alcohol-focused Scotland and others to move to a mandatory system of labelling on alcohol, which Meghan Gallagher alluded to in her remarks. Those warnings have to be clear on the risks, particularly during pregnancy, because we know that more than a quarter or 28 per cent of women in the UK are unaware of the current health advice from chief medical officers, which makes it clear that there is no safe amount of alcohol to consume during pregnancy. It is clear that more must be done to compel alcohol companies to label products appropriately, making clear risks with health information and advice at the point of purchase. It is important that we do not demonise women or stigmatise FVSD, as Cocab Stewart alluded to. Interventions such as labelling must sit alongside better community supports and education, particularly during pregnancy. We know the difference that a strong supportive relationship with a trusted professional can make. I want to acknowledge the work of GPs, nurses, midwives and social workers in that area. I hope that the minister will pick up in some of those areas in closing. As I begin to draw my remarks to close, I would like to call for better support for those living with FVSD, particularly young care-experienced people, because we know the challenges that are particularly experienced by that group. As we seek to keep the promise that we all want to do, we must deliver. Adoption UK, through our FVSD hub in Scotland, has made clear the need for diagnosis and support to be improved sitting alongside that work in prevention. Particular calls include a published FVSD-specific strategy to cover awareness raising, diagnosis and support services, individual plans and lifelong support for all children diagnosed with FVSD, including home, educational, mental health and access to work support and resources. Individuals who have a diagnosis of FVSD should be given a multidisciplinary support plan, acknowledging their individual needs and that of their parents, carers and wider family. That should include access to relevant and required support services. We must continue to raise awareness of FVSD and to do all that we can to support prevention, diagnosis and support in order to save and improve lives. I now call Rona Mackay, who will be followed by Brian Whittle. Brian Whittle will be the last speaker before I ask the minister to wind up the debate. Rona Mackay. First, I thank my colleague Siobhan Brown for bringing this important debate to the chamber to recognise international FVSD awareness day. For highlighting the great work that has been done in her constituency, it is my pleasure to speak in this debate. As Siobhan Brown said, anestimated 285,000 children and young people and adults throughout Scotland could have fetal alcohol spectrum disorder, a lifelong, life-changing, neurodevelopmental condition, and yet, amazingly, less than 1 per cent of them have ever been formally diagnosed and properly supported, even more startling as the reality that FVSD is preventable, but sadly it is not so often prevented. Presiding Officer, around seven years ago, I was a children's panel member east end of Glasgow. I was fortunate to attend a lecture by, I think, Dr Jonathan Share of the Queen's Nursing Institute of Scotland, whose knowledge on the subject is beyond compare. Apologies if I have confused him with someone else, but I am pretty sure that it was Dr Share. He told panel members that many of the children referred to us would be suffering from FVSD. In effect, much of their behaviour and many of their issues related to having this condition, but many were often undiagnosed. This made immediate sense to me and it shone a light on many of the young people we saw and the day-to-day difficulties they faced due to being exposed to alcohol in the womb. I also remember that he spoke about advice given to pregnant women at that time about limiting their alcohol intake. He said that the only way to be sure that your child would not be affected by FVSD was to avoid drinking entirely, as the body processes alcohol differently in every person. He pointed out that what might have low impact on one person could be devastating to another. His message, the only way to avoid giving your baby FVSD was to drink no alcohol at all. In Scotland, we want to give our every child the best start in life and our policies reflect that. However, some children are denied getting that best start before they are even born. FVSD is a family of complex conditions arising from exposure to alcohol at any stage of pregnancy. It affects the child's physical and mental health, capacity to learn and it is the most common but unrecognised neurodevelopmental condition in Scotland. It can cause learning, disability, speech and language difficulties and many other issues that we have heard members outline today. Early diagnosis and support for people with FVSD is crucial to avoid a range of issues that they commonly encounter. In later life, 90 per cent of those affected are estimated to experience mental health problems, a large number of experience unemployment, imprisonment and many need in patient psychiatric care. Last November, the Scottish Government and NHS Education Scotland launched an excellent e-learning resource on FVSD accessible to anyone, which explains what FVSD is, how to prevent it and the support available. In 2017, adoption UK conducted a survey of nearly 3,000 adopters looking at a range of issues. 70 per cent of respondents said that they weren't warned that their child could be at risk of FVSD when they adopted. Furthermore, 85 per cent have not been told since they adopted that their child may have FVSD and 35 per cent have considered that their child might have FVSD. The report that 55 per cent of children waited two years or longer for their FVSD diagnosis and 78 per cent of parents whose children were diagnosed with FVSD didn't feel that healthcare professionals were knowledgeable about the condition or its various presentations. As we've heard other members say, they recommend improved diagnosis and support for people living with FVSD through the introduction of a dedicated multi-year national strategy for treatment and prevention. That combined with increased awareness of the risks associated with drinking during pregnancy. In conclusion, FVSD is a condition that is entirely presentable. It is not about stigmatising or shaming women, it just requires women not to drink for the entirety of their pregnancy. What we are facing today with the scourge of a global pandemic still prevalent, surely that's not too much to ask to ensure that our children do get the best start in life. Thank you, Deputy Presiding Officer, for letting me sneak into this debate at the last minute. Can I thank Shwam Brown for bringing this really important debate to the chamber? She highlights the impact of a diagnosis of FVSD can hammer a person that increased likelihood of custodial sentences. Early death, as Paul Cain talked about, is homelessness, unemployment and the higher level of mental illness. I have a personal interest in that because I was approached by a couple of foster parents who work with their adopted son and daughter both who have a diagnosis of FVSD. I have such fondness for those parents and respect for what they do in taking on children in this condition. The positive thing is to talk about the impact of giving opportunity to children with the condition to participate and the benefits of sport. You knew that I was going to get sport in here somewhere, Deputy Presiding Officer. I have worked specifically for this young man for several years and he is nothing but a ball of fast twitch fibres. His outlet for his fast twitch fibres happens to be sport. I think that the point there is that if he did not have that outlet, where would that energy go? If you met this young man, you would say that he was very active. He is a very energetic, he laughs a lot, he smiles a lot, but he has an outlet. I think that the benefit of sport brings to self-discipline, the structure that that brings to his life is immense. He has become an international athlete himself, he has had the opportunity to travel, and that in itself has helped him to develop as an individual. He is at college at the moment, he is now studying at college. I think that that tells a story that is very similar to the story that Siobhan Brown made. Covid has had a specific impact on people with this kind of condition, because when that discipline structure and support is unavailable, when I was managing to get my athletes back to see them, the impact on him was much more marked than it had been on the rest of the squad. I have to say that he obviously had a love of doughnuts, I think, is probably the way I would like to put that, and I think that that is something that we do need to consider when, as I say, I am a big believer, as you know, in giving kids the opportunity to participate. It does not have to be sport, it could be music, art, drama or whatever, but the impact that Covid has had on the vulnerable and that they have not been able to access that. The system needs to consider, I think, also how support is maintained from a child into adult in a foster situation, because the support drops off dramatically once they get to a certain age. I think that FASD is a preventable condition. I think that, as Siobhan Brown has said and others have said, we need to look at how we prevent that from happening in the first instance. It is a health issue, and we need to consider Scotland that Scotland has an unhealthy relationship with alcohol. I think that that is where we need to start. I thank Siobhan Brown once again for bringing the debate to the chamber and for yourself, for letting me sneak in. I now call on Kevin Stewart to wind up for the Scottish Government up to about seven minutes. Thank you very much, Presiding Officer. First of all, I pay tribute to Siobhan Brown for bringing this motion to the chamber. I would like to thank every single member for their consensual approach to the debate and on this extremely important issue. I would also like to pay tribute to the McFales and their work that Ms Brown has described today. Taylor's book, Oshie the Octopus, will now definitely have to be on my reading list, and maybe Ms Brown can help me to source a copy of that. Fetal alcohol spectrum disorder, or FASD, which is caused, as others have said, by prenatal alcohol exposure, is one of the most common neurodevelopmental conditions in Scotland, but it is also one of the lesser known ones. It is in respect of those simple facts that I find myself wholeheartedly in agreement with today's motion. We must all do more to promote the dangers of alcohol consumption during pregnancy, but also to support those with a diagnosis of FASD. We all must do our level best to destigmatise the situation that some of the folks who have alcohol problems have in getting them to the right help. We should also be supportive of the pregnant women in our lives, whether we be partners, family members, friends in all of this. There is no safe amount of alcohol that can be consumed during pregnancy. The advice from Scotland's chief medical officer is clear—no alcohol, no risk. The Government is taking forward a range of work to help support this message. Our 2018 alcohol framework demonstrates that we are committed to improve health messaging on alcohol, and we have committed to press alcohol producers to put health information on physical products and packaging labels. We will be prepared to consider taking a mandatory approach in Scotland if progress is not made. That action will include consideration of pregnancy warning labels. Positive progress is however being made as alcohol consumption in Scotland in 2020 remained at its lowest level since 1994. Reduced levels of alcohol consumption across society can lead to a reduced prevalence of FASD. Prevention and early intervention remain vital in respect of reducing the impact of FASD, but it is also vital that children and young people with a diagnosis can access the right support in terms of both health and social care, or even sport, as Mr Whittle mentioned in his speech. To best ensure support to those who are impacted by FASD, we have funded the Fetal alcohol advisory and support team since 2018 to deliver training nationally. That improves the knowledge of professionals working with individuals with FASD. We have also funded the Royal College of General Practitioners to produce an e-learning module on FASD for GPs and the wider healthcare community in primary care. Furthermore, we have provided adoption UK Scotland with over £526,000 since June 2019 to establish FASD Hub Scotland. The hub provides a foundation on which awareness of FASD can be further promoted. It also provides a dedicated helpline and support and advice to parents, carers and children who have been impacted by FASD. It is notable that on FASD awareness day earlier this month, adoption UK called on Governments across the UK to replicate the success of FASD Hub Scotland. In addition to our FASD-specific offerings, the Scottish Government has also published principles and standards of care through a new national neurodevelopmental specification for children and young people. The new specification aims to ensure that children with neurodevelopmental profiles, including those with FASD, receive further support than is currently available. The offering will sit alongside the child and adolescent mental health service CAMHS, and that work will benefit from the recently announced £10.83 million funding to support service provision through phase 2 of our mental health recovery and renewal fund. Specifically, £5.25 million of that funding is being allocated to NHS boards to build professional capacity to support children and young people with neurodevelopmental support needs. Furthermore, we are at an early stage and I put in resources in place to allow us to start consulting on what people would like to see from the wider autism learning disabilities and neurodiversity bill, which we committed to in the latest programme for government, with part of that being the creation of a commissioner. The bill has arisen from discussions around autism and learning disabilities in particular, but consultation on the bill will include other neurodevelopmental support issues such as FASD. As with every piece of proposed legislation, working with individuals, with lived experience and organisations will be at its heart. I would encourage all interested parties to get involved in those discussions when we begin them early next year. Our proposal to develop a national care service also provides significant potential to better ensure that those impacted by FASD can access the social care support that they need and deserve. In conclusion, I record my thanks for the opportunity to take part in that debate and for the thoughtful contributions of all colleagues across this Parliament in their contributions today. While FASD remains a significant lifelong condition affecting an individual's mental and physical health, it remains preventable and early diagnosis and tailored interventions can improve outcomes for children. In Scotland, we have a solid foundation on which to build their level of support in respect of FASD through work with OSHAs and other organisations like them. The Government remains committed to continuing to take forward this important area of work. Finally, I thank Ms Brown once again for bringing this important debate to the chamber. That concludes the debate, and I suspend this meeting until 2.30.