Equally Safe consultation: analysis of responses

Executive Summary

i. On the 15^th February 2019 the Scottish Government opened a consultation on legislation to improve forensic medical services (FMS) for victims of sexual crime. For these victims, forensic medical services may play a significant role in the healthcare response and deliver an essential part of the evidence base within the justice system. 

ii. The consultation received 53 responses from 18 individuals and 35 organisations. It contained questions on health board functions, the framework for handling samples, data and other evidence from police and self-referrals, safeguarding victims’ rights, provisions for children and young people; and views on any potential impacts of the proposals put forward. 

Question one: a specific statutory duty for Health Boards

iii. Respondents were asked ‘should a specific statutory duty be conferred on Health Boards to provide forensic medical services to victims of rape and sexual assault for people who have reported to the police as well as those who have not?’. Almost all – (91%) selected ‘yes’, 2% selected ‘no’, 2% selected ‘don’t know’ and 6% did not answer the question.

iv. Most respondents (44 out of 53) provided additional detail alongside their answer to the consultation question. The majority of these comments explained why the respondent supported the proposal. Themes included the value of a statutory duty, the importance of self-referral routes and the positive impact of embedding trauma-informed care and adopting a health-focused approach to FMS. Thirteen respondents described their support for the proposals and also mentioned other issues for the Scottish Government to consider. These typically involved calls for resources, training and comments on service delivery models.

Question two: evidence in the case of police referral

v. This question asked ‘do you have any views on how a legislative framework for the taking and retention of samples, personal data and other evidence in the case of police referral should operate?’ Over half (57%) selected ‘yes’, 15% selected ‘no’, 8% selected ‘don’t know’ and 21% did not answer the question.

vi. This question generated comments from over half of the consultation respondents (35 out of 53). Within these a range of views were identified about how a legislative framework should operate in the case of police referral. Themes in the comments included: consent and the need for clear information and communication; the storage, transfer and deletion of data; the need for a legislative framework; considerations in relation to vulnerable groups; consistency with existing guidelines; victims’ needs; and considerations in relation to children and young people.

Question three: evidence in the case of self-referral

vii. Respondents were asked ‘do you have any views on how a legislative framework for the taking and retention of samples, personal data and other evidence in the case of self-referral should operate?’. Over half (57%) selected ‘yes’, 11% selected ‘no’, 8% selected ‘don’t know’ and 25% did not answer the question.

viii. Many respondents repeated elements of their response to the previous question; there were 20 comments specifically on evidence in the case of self-referral. These included reflections on the legislative framework, the storage, transfer and deletion of data, consent and the need for clear information and communication, considerations in relation to children and young people and other vulnerable groups.

Question four: impact on data protection and privacy

ix. This question asked ‘more generally, do you have any views of the potential impacts of the proposals in the chapters of this paper on data protection and privacy (the handling of personal data including “special category” data about health)?’ Just under half (49%) selected ‘yes’, 21% selected ‘no’, 6% selected ‘don’t know’ and 25% did not answer.

x. In 29 comments consultation respondents conveyed a range of views about the impacts of the proposals in relation to data protection and privacy. These included reflections on current data laws, the proposed guidelines, consent, treatment of data, data storage and considerations regarding children and young people. 

Question five: safeguarding rights to dignity

xi. Respondents were asked ‘how might legislation help safeguard victims’ rights to respect for their dignity?’. This open-ended question generated comments from over three-quarters of the consultation respondents (42 out of 53). Comments included: reflections on the value of trauma-informed delivery, wider discussions on safeguarding rights, and considerations in relation to children and young people.

Question six: potential impact on human rights

xii. Respondents were invited to express views on how the legislation might have an impact on human rights, by responding to the following question: ‘more generally, do you have any views on potential impacts of the proposals in the Chapters of this paper on human rights (including economic, social and cultural rights such as the right to the highest attainable standard of physical and mental health)? 

xiii. Over half of the consultation respondents (30 out of 53) provided some comment. Twenty-four of these responses contained an additional suggestion, example or consideration for the Scottish Government to consider. Themes included the needs of marginalised or vulnerable groups, accessibility, and practical implications for service delivery. Six respondents emphasised their support for a human rights approach, explaining why the proposed legislation will have a positive impact on victims. 

Question seven: special provisions for children and young people

xiv. This question asked ‘should special provisions be included in legislation to reflect the distinct position and needs of children and young people? Do you have any views on how such special provisions should operate?’. Over three quarters (79%) selected ‘yes’, 2% selected ‘don’t know’ and 19% did not answer the question.

xv. Three-quarters of the consultation respondents (40 out of 53) provided some comment. Almost all advocated for special provisions and gave some detail about what these could be, either echoing proposals put forward in the consultation document or describing other matters for consideration by the Scottish Government. 

Question eight: special provisions for children and young people

xvi. Respondents were asked ‘more generally, do you have any views on potential impacts of the proposals in the chapters of this paper on children and young people including their human rights or wellbeing?’ Just over one third (38%) selected ‘yes’, 21% selected ‘no’ indicating they had no views to share, 6% selected ‘don’t know’ and 36% did not answer the question.

xvii. Thirty consultation respondents provided some comment. Half of these comments reiterated responses to question 7. Other responses included specific considerations in relation to children and young people, and discussions about child protection.

Question nine: Equality Impact Assessment

xviii. This question asked: ‘do you have any views on potential impacts of the proposals in this paper on equalities (the protected characteristics of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation)?’ Over half (58%) selected ‘yes’, 23% selected ‘no’, 8% selected ‘don’t know’ and 19% did not answer the question.

xix. Just over half of the consultation respondents (32 out of 53) provided a comment. Twenty-three respondents reflected on implications for equality in some detail. These responses often described a particular issue for the Scottish Government to consider when developing the legislation, or other opportunities to enhance equality impacts. Seven endorsed the proposals outlined in the consultation document without further suggestion. Their comments conveyed a view that the Government’s intentions will achieve a positive impact in relation to equality.

Question ten: Socio-Economic Equality Impact Assessment (the Fairer Scotland Duty)

xx. Respondents were asked ‘do you have any views on potential impacts of the proposals in this paper on socio-economic equality (the Fairer Scotland Duty)?’ Less than one-fifth (17%) selected ‘yes’, 59% selected ‘no’, 4% selected ‘don’t know’ and 30% did not answer the question.

xxi. Eleven respondents commented on potential impacts. These included some discussion about socio economic quality, with four respondents conveying a view that the Government’s intentions will achieve a positive impact in this regard.

Question eleven: impacts for people in rural or island communities

xxii. When asked ‘do you have any views on potential impacts of the proposals in the Chapters of this paper on people in rural or island communities?’, over half (55%) selected ‘yes’, 15% selected ‘no’, 8% selected ‘don’t know’ and 23% did not answer the question.

xxiii. Almost two thirds of respondents (32 out of 53) provided a comment on the potential impacts in relation to people in rural or island communities. Twelve focussed on the impact with almost all seeing it as positive. A further eleven identified challenges associated with delivering FMS in such areas. Six combined discussion on positive impacts with the challenges. Cross-cutting themes evident in the comments included movement of staff, travel by people from rural and island communities and potential service improvements.

Question twelve: financial implications of the proposals

xxiv. This question asked ‘do you have any views on the financial implications of the proposals in this consultation paper for NHS Scotland and other bodies?’ Just under half (47%) selected ‘yes’, 23% selected ‘no’, 6% selected ‘don’t know’ and 25% did not answer the question.

xxv. Almost half of respondents (26 out of 53) provided detailed comments on the potential cost implications of the proposals including specific types of costs identified (such as training and premises), general comments about the likely scale of costs and suggestions about models of service delivery.

Question thirteen: other comments

xxvi. Respondents were also asked ‘do you have any other comments that have not been captured in the responses to other questions you have provided?’ One third (34%) selected ‘yes’, 44% selected ‘no’ and 23% did not answer the question. 

xxvii. Twenty-one respondents provided a final comment. Fifteen shared additional information that they had not provided elsewhere in their response and six reiterated points made previously.