New Petitions

I am the MSYP for East Kilbride. I am calling for hospitals in Scotland to have specific young people’s wards or rooms for adolescents, and to ensure that staff receive adequate training to support young people’s mental and emotional needs.Being in hospital can be a struggle for anyone—particularly for young people, who can find it a daunting and frightening experience, especially if they are in a mixed-age ward where the next-youngest person is more than 30 years older than them. At 16 we are not children, but much of the health service does not view us as adults, which sends a conflicting and confusing message to this age group.I therefore seek to petition the national health service to provide this age group with staff, resources and rooms that meet our needs, with better specialist services for 16 to 24-year-olds, and with staff who are trained to deal with the mental health as well as the physical needs of that group. I would like the health service to ensure that all young people are consulted and informed about their diagnosis and treatment and are able to play a major role in the decisions that affect them.I seek to ensure that, in line with article 24 of the United Nations Convention on the Rights of the Child, young people receive the best possible care and that, in line with article 12, every child and young person has the right to express his or her views freely about everything that affects him or her. Hospitals should provide rooms within wards that are set aside for this age group, so that young people are placed together even if they are on a mixed-age ward. Finally, there should be recreation areas that are decorated with things such as games consoles, television and the internet as well books and so on. Provision of those services would aid patients’ recovery and therefore shorten their time in hospital.This is not a new request. This age group is the subject of a constant battle between professionals about where they should be placed and cared for when receiving hospital treatment. “Adolescents have distinctive and different needs from both child and adult patients.”That is from a 1993 Scottish Office publication, “At Home in Hospital”. Russell Viner, a leading consultant in adolescent medicine at the University College London Hospitals NHS Foundation Trust, has called for all“staff working with adolescents to have a core of skills, which transcend and are in addition to their specialist training”.He has been doing constant research and consultation, and has proved that enough teenagers are treated as in-patients each year for an average district general hospital to support a specialist teenage ward of 12 to 15 beds. The report found that there were 17 patient bed days per 10,000 youngsters aged 12, rising to 24.6 days per 10,000 19-year-olds. Whereas more boys than girls occupied hospital beds at the age of 12, by the age of 17, more teenage girls than boys were in-patients. The number of beds that were taken up for day cases almost doubled from 2.32 per 10,000 people aged 12 to 4.31 per 10,000 by the age of 19. A survey that was carried out by the Royal College of Nursing showed that“the lack of young people’s facilities left staff feeling unsupported and uninformed about how best to support young people.”Sue Burr, a Royal College of Nursing advisor on paediatric nursing, said that“It is ridiculous that in this day and age we still do not have the services for teenagers.”Even providing somewhere for young people to go during hospital visits, such as a recreational area where they can relax, helps to stimulate their brains, allows them to continue with their education and brings a sense of normality. Informing young people and including them at all levels of consultation and of the design process will improve the relationship between patients and staff. That would show respect for young people and help to identify proper treatment, which might otherwise not happen, with important information not being disclosed.The supporting facts and statistics from various medical sources show that by focusing on the needs of this age group, we can speed up recovery, diagnose more quickly, shorten hospital stays and aid the recovery and welfare of individuals. Being provided with such care within hospitals would allow young people to recover better and would help them to know what is happening to them and with what medical treatment they have been provided. The result would be an all-round better experience at what can be a distressing and disruptive time for them. They would also have a better understanding and knowledge of how to take care of themselves once they are out of the care of the hospital. They would also know where and of whom they can ask questions, if they have any.I will leave you with these aims, which have been cited by University College London:“To appreciate and understand the advantages of implementing an adolescent friendly nursing model and ward routine to both young people and healthcare professionals”and“Professionals communicating directly with young people, listening to them and attempting to see hospitalisation through their eyes.”I thank you for your time and for listening. I hope that you will consider our petition.

There are young people’s services in Britain. At University College London, there are facilities above the paediatric ward for people aged up to 19 or 20. There are also Teenage Cancer Trust wards throughout Britain. Those facilities have had a great impact on young people’s lives. They have been adopted from places such as Australia and the United States, where there are similar services. It has been proved that having such services helps young people to disclose more information and allows them to be diagnosed and treated quicker.After a certain age, young people are put into adult wards, which means that they miss out on a lot of school. The patients in paediatric wards still get schooling. Young people’s wards mean that people can still be educated, which is not possible in adult wards. Examples in other places around the world show that such services work much better compared with young people being put into children’s or adult wards.10:15

We had a consultation involving different people who had experiences of being on a young persons ward, on a children’s ward and on an adult ward. Basically, when young people are on a children’s ward, they might be stuck next to crying babies. The young people often feel ignored because information is given not directly to them but to their parents. The young people might be 15 years old, but they are not being involved in their care.In an adult ward, young people may also feel ignored. Often, young people feel obliged to wait until the older patients are seen, because they are not seen to be as important. For example, older patients might need more care in getting out of bed, whereas young people might be able to get in and out of bed but are still really unwell and are being put to the back of the queue a lot of the time.

The petition comes from both those issues. It has been shown that, mentally and physically, young people recover from treatment quicker when they are on a young persons ward. Often, young people persistently need to go back to a doctor or hospital because they have not been diagnosed straight away due to not having a good relationship with the hospital staff, who often do not know how to deal with young people. That was proved through—

Yes. When you are on a ward—

I do not have the evidence here with me, but it has been shown through a Royal College of Nursing consultation that was done with nurses and with young people that nurses do not know how to deal with young people adequately. Mentally, the nurses were unsure how to speak to the young people, so they were standoffish and ended up speaking to the parents, who might not have information on how the young person is feeling. Similarly, young people may feel that they do not know how to speak to a healthcare professional because they can feel that they are either being undermined or just not being listened to.

I am sorry; I am not entirely sure.

Yes. That is particularly true in the accident and emergency department or when a young person is in hospital. Obviously, as a young person, you mix with lots of people at school all the time, whereas in hospital everyone is very segregated. Usually, arguments take place when young people try to have visitors in during the day. Even if the visitors are their parents, they may not be allowed in. That is one issue.When young people come into an A and E department, the staff automatically think that they will cause trouble. If the young person comes in with five or six friends—obviously, your friends are worried about you—the staff will end up asking the friends to leave even if they are not doing anything wrong. However, another family member might come in with five or six friends, but they will not be asked to leave because they are older.

I have looked at that. Hospitals that provides children’s services normally put young people—depending on their mentality—in the children’s ward until age 16. However, they cannot always do that, which is understandable, and they normally prioritise children who are under the age of 13. That leaves young people who are between the ages of 13 and 19 lingering. Putting a 14-year-old on an adult ward could become a child-protection issue.It is not fair that young people should be asked to wait. There should be a separate ward—you are no longer a child at the age of 16 and you do not want to be stuck next to babies and kids, and neither do you want to be stuck on a ward with a person who is 95 years old because you are left feeling responsible for that person. For example, if that 95-year-old person asks you to get something for them, you might—even though you are sick—be constantly getting up and down to help them. When they are building hospitals, they need to consider putting in place a young person’s ward.

Yorkhill hospital does not receive any young people over the age of 13 unless it is for specialist care. Any person over the age of 13 who goes to A and E there is turned away. That is terrible for a child, who then must go somewhere else, which might be like the situation you have described.

Yes—it can be a frightening experience. As I said, when they put a child or a young person on a children’s ward they think about their mentality. However, someone at the age of 13 can have a young mentality and being put on an adult ward can be very frightening. Normally, you are only allowed one parent or person with you. As you said, there could have been a pub fight and lots of people could be in A and E covered in blood. That is not right—it is not a youth-friendly environment at all.

A young person whom I consulted had the same experience. He broke his arm and had to have an operation. He was turned away from Yorkhill hospital. He was sent—at the age of 14—to an adult ward. I do not understand that.

In Scotland there is a teenage cancer ward in the Beatson hospital in Glasgow. It is part of a successful project that runs across Britain. There will be another two in Scotland. There is a ward in Yorkhill, but that is only for patients up to the age of 16. After reaching 16, patients are transferred to the Beatson.As of this summer, there will be a ward in Edinburgh that will host 12 to 14 beds and it will be a very similar facility to that in the Beatson. There is a volume—thankfully it is a low volume—of young people with cancer and when they go on to those wards they are treated so much better. They are not woken up extremely early and they are allowed to lie in. Their treatments are scheduled around the young person’s life, so they can still go to school and go out. The wards have recreational areas where patients can rest and they can have their family and friends in there at any time. The visiting times are very flexible. The young person feels a lot more relaxed there and feels like things are much better.The NHS is also providing a youth co-ordinator to help young persons to get involved and to talk about the situation, because cancer is a very difficult thing to go through. After receiving a diagnosis, a young person needs someone to talk to. It is good to have someone to speak to who is on their level and is not a healthcare professional, because they could worry about other aspects of life, not just the cancer diagnosis.That facility is very much sought after, and the wards are now cropping up all over. We are going to have another two in Scotland—they are planning one in Aberdeen, as well.

I would not expect every hospital to host one, because not every hospital has a children’s ward, but the bigger hospitals should. The new hospital that is being built in Glasgow is going to be a major, big hospital—they are moving the children’s hospital there—so I do not know why they cannot put an adolescent ward into the plans.They could have adolescent wards in the major hospitals in places such as Edinburgh, Glasgow and Aberdeen, then roll them out to other places later—even if they are just specific rooms.

If there are not wards, a hospital could set aside rooms in which there could be two beds to a room. Although the Beatson has a specific ward, it found that it could not have just young people in a full ward, because that was not in the plans when the hospital was originally built. It has rooms for young people in which there are two beds to a room. It would be really good if hospitals had that.

I am not asking for special treatment; I am just asking for what young people deserve. It has been proven that a young person’s body and mind are completely different from those of a child or an adult. I said that going into hospital can be a frightening experience for anybody—not just for a young person.10:30

When you go into hospital, the majority of people are elderly, so young people are in a minority group already. When young people enter hospital, there could be other young people there, but they could be spread out. If the young people were put together, it could make it a lot easier. There are specialist wards for children and then there are adult wards, but between certain ages we are classified as young people, so we are a distinct group. I am not asking for any special treatment; I am asking for consideration for a group that is identified as being different from children and from adults.

You mentioned the age limit for children’s services going up to 16. Young people should be defined as being between the ages of 16 to 25 or, if not, as being between the ages of 16 to 21 at least. Most places in the world have young people’s wards that go up to the ages of 25 or 21. In London specifically, within Britain, young people’s wards go up to the age of 21. Young people’s wards should be for those between the ages of 16 to 25, or if not, 16 to 21, because you are still developing as a young adult. You are not fully adult yet and the staff do not listen to you when you are a young person.

It is not just about better training. A young person on a hospital ward can be there all day and some wards only let you see people for an hour. If there is some sort of incident on the ward, you do not see anybody for a day or two at a time. It is not good for your mental health if you are stuck in a specific room with all these elderly patients and you are not getting to speak to anybody. You can use technology, but it is not the same.

That is not something that I have looked into, so I cannot fully answer that question—I apologise.

I am not entirely opposed to it, but that situation will not be the case in every single hospital.

That is not guaranteed.

There should still be wards as well.

I am not saying that.

That is not entirely true. When you are placed on a ward, it is usually dependent on what is wrong with you, but you could be placed in an orthopaedic ward when you have something wrong with your heart. You are not always placed on the right ward because you cannot always be held—

No, I am saying that there should be separate provision within the hospital, because if you are in a children’s—

No. I want there to be a ward within the hospital—

For young people.

Yes.

In hospitals, patients are not always put in specialist wards.

As you said, they would be put in a single room.

You are chopping and changing your mind.

I am unsure of that.

There is more cost involved in young people continually returning to hospital because they are not diagnosed correctly the first time, because they do not have a proper relationship with the staff.

I am unsure.

I will follow up on some of the issues that members of the committee have raised.Chic Brodie mentioned that only 4 per cent of hospital admissions involve young people, but the Scottish Government and the Scottish Parliament are trying to create a cohesive society, and the most important aspect of creating a cohesive society is ensuring that people feel equal and that they feel safe. One of the most important aspects of the petition is that young people do not necessarily feel safe or that they are listened to when they are in a ward of adults. It is quite important that young people have an environment in which they feel comfortable and in which they feel okay.As far as significant investment and cost are concerned, I think that the recent revelations down in England surrounding the Mid Staffordshire NHS Foundation Trust mean that we have an opportunity. The NHS needs to be reviewed, and the petition’s proposal needs to be considered. Young people play a massive role in society. The Parliament is meant to build a future for those young people. The committee asks for evidence of why what we are asking for is needed. We are the evidence: an 85,000-strong electorate elected us as the evidence to bring to you. In that sense, I do not think that the committee needs to worry about evidence.When it comes to cost, there is nothing more important than a young person’s future. Although, as Jackson Carlaw pointed out, we have our financial problems, some notice needs to be paid to young people. There needs to be an understanding that young people must be put first. That is important to bear in mind when hospitals with single rooms are being built, but young people cannot just be locked in a room. They need to have an environment in which they can talk to people, have fun and enjoy themselves. Young people who are sick do not have the plague. They cannot just be locked away. There needs to be an understanding of that.

I am the MSYP for the Scottish Epilepsy Initiative.I have a comment rather than a question. I would like to highlight the issue of training for NHS staff. My experience of our NHS has been horrific. Waiting times are ridiculously long. Despite the fact that I have had a diagnosis of epilepsy twice, I have had no proper treatment that has been successful for the past three years. When I go into hospital, I am spoken down to. As young people, we are a forgotten generation. We are pushed to the side and are treated as not important.Issues with mental health treatment are definitely to the forefront. I have been on a waiting list for cognitive behavioural therapy for the past year and a half to two years. As young people, we are forgotten. As Grant Costello said, we are the future. I am contributing to society by going to university and—I hope—getting a job, and yet my health issues are not a concern to society.I do not think that that is right. Training is definitely a serious issue that needs to be considered. If there cannot be specific wards for young people, extra training for staff on how to deal with young people should definitely be at the forefront. At the moment, we are totally forgotten about. That is an issue for me and I think that it should be considered.

I am an MSYP for North-East Fife. I was speaking to some of my constituents who did not feel that we could justify the huge investment and cost for such a small percentage of people. I know that we should be doing something about the issue, but I am not sure that such a big investment is necessary. Could a cheaper alternative be presented to us?

I am an MSYP for Edinburgh Northern and Leith. I am pretty sure that we have hospitals for old people such as the Royal Victoria in Edinburgh, so surely it is only right that we should have specific areas for young people when we have different needs compared with those of the general population.

I am an MSYP for Greenock and Inverclyde. In response to Jackson Carlaw’s point, it is important that young people who have particularly acute illnesses are treated in specialist wards. Rachael, how would you respond to that?

I am an MSYP for Coatbridge and Chryston. I would like to respond to a point raised by Jackson Carlaw. It does not matter whether we are talking about single bedrooms or wards; the Scottish Youth Parliament and Rachael McCully are saying that the young people of Scotland should get the best of hospital treatment. Grant Costello made a good point when he said that, when those young people come out of hospital, what happened to them there will affect them for their rest of their lives mentally and physically. Regardless of whether we are talking about a single room or a ward, we want the treatment of young people to be the best that it can be.

Rachael McCully and Grant Costello mentioned child protection issues and, as a constituency member for Glasgow Southside, I have had constituents describe to me horrific experiences that they have had in the Glasgow royal infirmary when they have been put beside extremely violent patients. I am talking about people hitting staff and having to be sectioned off. That is a horrific experience. Would adolescent wards help to solve some of the major child protection issues that we see in hospitals today?

Thank you for all your comments and points. I will start with Kyle Thornton’s question. Yes, in a ward for adolescents, young people would be more likely to relate to one another on a better level. If there is good communication between young people and staff, patients will be less likely to hit out or be violent. Also, an elderly patient who has dementia could also be violent and hitting out. They are obviously not able to control that and a young person could be frightened by that, at night for example, and they could react again. As far as child protection issues go, it is just not right to put a 14-year-old into a ward with someone who is 70.I just want to touch on the point that Sian Hughes made about epilepsy. In Scotland we have a problem with the neurological side of things, because our brains are still developing but after the age of 14 a patient is often put with an adult neurologist. It has been shown that that is causing real problems, particularly for young people in Scotland who are waiting for a ridiculous amount of time to be diagnosed. I have heard about someone who had to wait for two years to be diagnosed. They were not properly diagnosed and their seizures were not properly under control until they were admitted to the adolescent hospital at University College London, where they were properly diagnosed and put on medication. That is a ridiculous situation. Better work needs to be done on young people with epilepsy.10:45

In response to the question of money, I appreciate that cuts are being made everywhere. However, this approach would save money. As I have said, a lot of money is spent on young people continually going back to hospital because they did not get the right diagnosis at first, because they do not communicate properly with staff and because the staff do not communicate properly with them.