Contents
- Attendance
- Subordinate Legislation
- Social Prescribing (Physical Activity and Sport)
- Petitions
- Birmingham Commonwealth Games Bill
Petitions
NHS Centre for Integrative Care (PE1568)
The next item on our agenda is consideration of four outstanding petitions, the first of which is PE1568, in the name of Catherine Hughes, on the funding of, access to and promotion of the NHS centre for integrative care. As is evident from the note by the clerk, which has been made available to the public today, the petition has been discussed at length and in detail by the Public Petitions Committee and, more recently, by this committee.
One of the central requests of the petition is that the centre for integrative care be designated as a national resource. Ministers have been asked about that directly and have confirmed that it is not a decision for them. However, we might be able to explore the issue in a different way.
I invite comments from members.
11:45
Many members will agree that PE1568 is an excellent petition. If my memory serves me right, I was a member of the Public Petitions Committee, along with David Torrance and Sandra White, when the petition was lodged, and I was impressed by its strength. I think that we were contacted by Dorothy-Grace Elder, who has been an excellent advocate for the petition.
An issue that has been raised many times at this committee is the opioid crisis. I would like us to ask the chief medical officer and the Government why they are not seeking the expertise of the NHS CIC in that area. Although the trend on opioids is not quite at American levels, it is extremely worrying and we need to look at it. Without making a judgment on the next steps that we should take on the petition, I think that there are some follow-up questions that the committee should ask.
I agree with David Stewart. The petition continues to be an important vehicle for progressing reform and improvements for patients with chronic pain across Scotland. I co-chair the Parliament’s cross-party group on chronic pain. Most people who attend that group’s meetings feel that, for 10 years, they have been sent round the houses by the health service, and the changes to the CIC have made things even worse.
I pay tribute to Catherine Hughes, who is in the public gallery for our consideration of the petition. I believe that there are opportunities to make progress on it.
I was particularly concerned by the response that we received from Jane Grant. It was not much of a response—she simply said that people who are able to access services are happy enough with them, but the whole point is that people are not able to access many chronic pain services. We need to turn that argument on its head and find out what the Government wants to do for chronic pain patients across Scotland. We have an opportunity to make progress in the area, especially given the Government’s targets and spend on waiting times. We need to look at how patients with chronic pain fit into that argument. Therefore, I would like us to keep the petition open and to use it as a vehicle to continue to make progress in the area.
In my area, there is a local group of people who have myalgic encephalitis. As well as having chronic fatigue, many of those patients have pain management issues. We need to consider how those patients are being served locally and nationally. As part of our work on the petition, it would be worth keeping in mind particular populations of patients who do not have access to certain types of care. I would be keen for us to follow up on that.
A couple of questions have been asked and a couple of points have been made, from which there has been no dissent. If we are agreed that we should keep the petition open, it seems to me that there is a gap in what we know and that we need to find out whether the NHS could designate the NHS CIC as a national service. I therefore suggest that we write to the NHS national services division to ask for its opinion on the suitability of the NHS CIC to be a national service and whether that could be considered by the national specialist services committee. Do members agree to that?
Members indicated agreement.
That takes us forward. On David Stewart’s point about the CMO, I agree that asking a general question that addresses whether the NHS CIC is one of the services that might be called upon to give advice or make an input on the opioid issue seems sensible. That is a separate matter from consideration of the petition, but I think that the petition encourages us to do it. Do members agree to that?
Members indicated agreement.
Whistleblowing in the NHS (PE1605)
We move on to consideration of petition PE1605, in the name of Peter Gregson on behalf of Kids not Suits, on whistleblowing in the NHS. Again, the public papers spell out the previous work that the committee has conducted and, in particular, its work on the Government’s proposed changes in that area.
Do members wish to make any comments on the petition?
There are still key issues on the matters raised in the petition. The Government has acted and has introduced plans. However, the consultation on what the future will look like for people who are put in a position where they want to whistleblow has not included such people. That is where the petitioner has been trying to get more progress. I would like more consultation to take place on some of the questions that continue to be asked about the future role of the Scottish Public Services Ombudsman, how it will investigate and hear the concerns of whistleblowers and what the reporting mechanism will be. That would help to progress the principles that the petitioner has raised.
I support Miles Briggs’s comments. Members will know that I have had a particular interest in whistleblowing following the allegations of bullying in NHS Highland, which, as you know, convener, we put directly to the board some months ago. I support the introduction of the independent national whistleblowing officer, which is to be set up at the SPSO, but the issue that Peter Gregson has raised is about how the SPSO will investigate whistleblowing concerns and hear them directly. I know that there is a good mechanism—we have already looked at that—but I am a little concerned about the gap between people having whistleblowing allegations to make and how the SPSO will actually hear about them. I would like more clarity on the system.
I support what my colleagues have said. I have a specific interest in bullying in the Scottish Ambulance Service, which is a matter that people have raised at quite a few of my surgeries. It seems that people are not willing to whistleblow any more, because of the repercussions. I am interested in how the process will work to give potential whistleblowers the confidence to come forward, and in how the Government plans to monitor the impact of the new ideas about whistleblowing that are emerging. If the outcome is the same as the current situation, in which the people who attend my surgeries are not whistleblowing because of the possible repercussions, the system will not work.
I am keen to continue to follow up how the whistleblowing process, the leadership around it and the local whistleblowing champions will deal with issues that are raised. The petitioner had particular questions about clinical front-facing access and how we might support people who choose to whistleblow. The cabinet secretary is keen to ensure that, as we move forward with processes of engagement with leadership, ultimately, we should not need whistleblowers at all because people should feel comfortable about sharing information. However, I recognise the issues that members have raised with the Scottish Ambulance Service and NHS Highland as well as other local issues that have been brought to my attention. I am keen to know how the whole process will be monitored and supported.
That is helpful.
Members will recall that the committee considered many of those questions in May, when we issued a call for views, following which we received written evidence and held an oral evidence session on how the independent national whistleblowing officer would work in the context of the Scottish Public Services Ombudsman and the structure of that role.
To go back to the aspiration of the cabinet secretary, which Emma Harper mentioned, I was reminded of the fact that, when the national health service was first founded, our predecessors thought that, once it had done its job for a generation, it would not be needed any more. I suspect that whistleblowing will always be essential, no matter how well run our public services are. I guess that our job is to ensure that we are confident that people who have whistleblowing concerns can raise them.
The last order that the Government has brought forward to implement its new system of whistleblowing has now been laid, and we have a fortnight in which we can consult on that. That will allow some of the questions that members have highlighted to be asked. I suggest that, at the end of that process, when we come to consider the order and decide whether to approve it, we could take that opportunity to invite the independent national whistleblowing officer to come to the committee and answer those questions directly. That might ensure that there is transparency in the process and give us confidence that those questions have indeed been answered.
My suggestion is that, if, at that point, we are satisfied with what we have heard and agree that the order should be approved, we could then agree to close the petition, because the issues that it specifically raised will have been addressed. That will close that chapter, although, as I said, I fear that the book will never be closed, because issues around whistleblowing will always arise.
Do members agree with that approach?
Members indicated agreement.
Medical Care (Rural Areas) (PE1698)
The third petition for consideration is in the name of Karen Murphy, Jane Rentoul, David Wilkie, Louisa Rogers and Jennifer Jane Lee, and is on medical care in rural areas, which relates in part to the new general practitioner contract.
As members will recall, on 1 October, as part of our primary care inquiry, the committee took evidence from the Rural GP Association of Scotland and the rural and remote patients group. Clearly, that evidence relates directly to the matters that are raised by the petition.
Do members have any comments?
I have a specific point, although it does not directly relate to what the petitioners are looking for. The Cabinet Secretary for Health and Sport is on record as saying that she recognises some of the concerns around the GP contract in relation to rural communities, with regard to issues such as the ability to continue to provide vaccinations. It would be useful to find out the Scottish Government’s thoughts in that regard as phase 2 of the contract is negotiated and whether the cabinet secretary is saying that there will be a version of the contract for rural GPs, which would almost separate them, in a way. That might have an impact on many of the points that the petitioners have raised.
It appears likely that that is the kind of issue that will be addressed. The question for the committee is whether the petition is a necessary vehicle for that to happen or whether we can encompass the questions that are raised in the petition in our primary care inquiry, which would mean that we could close the petition at this point but come back to the wider issues that it raises in due course.
That is a suitable approach. As an MSP who represents a rural region, I am keen that our primary care inquiry addresses the issue of how we can promote equality in healthcare, regardless of whether it is delivered in a rural or an urban setting. It would be interesting to see whether all the points in the petition are encompassed in our primary care inquiry.
That sounds sensible. With the proviso that we must encompass those matters in the inquiry, do we agree to close the petition?
Members indicated agreement.
Social Care (Charges) (PE1533)
The fourth petition for consideration is PE1533, in the name of Jeff Adamson, on behalf of Scotland Against the Care Tax, on the abolition of non-residential social care charges for older and disabled people.
The committee has already agreed to consider social care in a future inquiry during 2020. Therefore, I recommended that the petition be subsumed within that inquiry and be treated as an item of evidence for it, but that, in the meantime, we close the petition at this stage.
Do members have any comments?
I agree, as long as “subsumed” does not mean that it is made any less important. We need to ensure that the petitioners are kept well informed about our inquiry as we move forward.
Indeed. We will ensure that that happens.