How greater care for sexual assault victims can save lives – Dr Catherine Calderwood

Good progress is being made towards improving healthcare and forensic medical examination services for people who have experienced rape and sexual assault, writes Dr Catherine Calderwood, Scotland’s Chief Medical Officer.

The way sexual assault victims are treated by the authorities has changed (Picture, posed by model: Gareth Fuller/PA Wire)

What must it feel like to have been sexually assaulted? Fortunately most of us will never know. Yet almost 2,000 women and men in Scotland experience a serious sexual assault every year and report it to the police. This figure hides the fact that many more do not come forward. Fear of not being believed, shame, having to re-live the assault and the trauma of being examined and starting a criminal process – all of these are reasons given for not seeking help or justice.

I’ve met a number of people who have bravely shared their experiences in the services designed to help them. Their stories made me cry, left me holding my head in my hands in despair. How did we expect victims to go to a police station, to sit and wait, to be seen and examined in the same surroundings as the perpetrators of crime – sometimes sharing the premises with their assailant – and navigate their way through emergency contraception and support services? I felt sadness and frustration that the quality of care they received fell short of expectations. Forensic medical examination can have a long-lasting effect on someone’s well-being.

“It was worse than the assault itself – I had blocked that out of my mind – but I could not forget that cold clinical room and the lack of empathy or knowledge of what I was now going through having just been raped,” said one. I learned about the effect on their experience of other healthcare services such as routine smears, ante-natal care and childbirth. As an obstetrician, I found this profoundly troubling. Those experiences are now, I hope, confined to the past.

I have the privilege of leading a national taskforce set up to improve NHS services for people who have experienced sexual offending. Over the last two years, the taskforce has been a catalyst for change, ushering in a seismic and long overdue shift in culture and approach. By making an individual’s holistic healthcare needs paramount, services are no longer primarily viewed through a justice lens, as was the case.

I am proud these forensic examinations no longer take place in a police station and that all 14 NHS health boards are being supported to develop a Scottish Sexual Assault Response Coordination (SSARC) service, so people can access the support they need in an appropriate environment. I was encouraged to read about the recent experience of a woman who described the staff in her local NHS service as treating her with extraordinary care, sensitivity, dignity and respect, which she credits with saving her life.

The importance of ensuring a person is given a sense of control at a time when all control had been taken away cannot be underestimated. The Forensic Medical Services (Victims of Sexual Offences) (Scotland) Bill currently being scrutinised by the Scottish Parliament will underpin the work of the taskforce and introduce self-referral across Scotland so people do not have to first make a report to the police. I welcome the widespread support received for the legislation from Rape Crisis Scotland, Victim Support Scotland, the General Medical Council and the Royal College of Nurses.

Much has been achieved, but there is still a great deal to do and I would like to thank the taskforce members, NHS staff and our partners who are working to help create a healthcare and forensic medical examination service in Scotland of which we can all be proud.

Catherine Calderwood is Scotland’s Chief Medical Officer and she is grateful to Greig Walker, team leader, Forensic Medical Services Bill, for his contribution.

If you or someone close to you have experience of the issues highlighted, you can contact Rape Crisis Scotland’s helpline, which is open every day between 6pm and midnight on 08088 01 03 02, for free and confidential support and information.