Chamber and committees

I would be remiss if I were not following the expert clinical advice that you heard last week, which is clear that the smallest and sickest babies get the best outcomes if they are treated in neonatal intensive care units that have a greater throughput. I find that a really awkward phrase to use when we are talking about babies, but it means a greater number of babies going through the system to ensure that the clinicians, the nurses and everybody else in the units looking after the babies are of the right standard to get the best outcomes for the babies.

I have visited Wishaw, Ninewells and other neonatal units in Scotland. As I indicated in my opening remarks, the staff are fantastic, and I respect and have great confidence in the work they are doing. However, it would be remiss of me as the Minister for Public Health and Women’s Health not to listen very clearly and read very closely the evidence from other experts, clinicians and also BAPM.

It was reviewed by the initial group—the experts who were basing their decisions on expert evidence, which you heard last week. However, once I had made the decision and I was, rightly, being questioned by families and other clinicians, I asked the deputy chief medical officer to review it again to ensure that we had followed the right evidence and that the right results were coming from the report.

I refer to Bliss’s involvement in the best start programme. Right at the start, they made the point very clearly that if you have a baby who is in intensive care for some time, it can be financially draining on the family. Accordingly, one of the requirements of best start was to set up the neonatal family fund, which provided money for families in this situation, whether for food, accommodation or travel. That was covered. We have since extended that to the young patients family fund, which ensures that support is available for families in those circumstances.

I visited the people who organise the YPFF in QEUH, and for people who deal with expenses and finance, they were some of the most caring people that I have met, because they recognise the impact—the pressures and the stresses—that such circumstances can have on families. They ensure that all the staff in neonatal wards are aware of the YPFF, but also make visits themselves, and will support families in completing the application forms for the funds. That can be done on a weekly basis or at the end of a stay. The regularity with which the funds arrive is entirely up to the family. The fund is most important and I commend Bliss for its work to ensure that it was included in our recommendations.

Bliss was very positive on not only the finance side but around psychological support for families in this situation. Psychological support can be provided either on the wards or by the third sector, including by Bliss.

We have had a discussion about that. The bill as it stands provides the right controls around the powers that we are looking to introduce, because, as I have said, it is a very fast-changing environment. I will take your question away and look at the issue further, but as it stands, the bill contains the right safeguards, controls and flexibility so that we can respond quickly to any changes that are needed.

UKIMA is one area that relates to the bill, but I felt that it was important that we brought in legislation, given the level of consultation that we have carried out over several years on the safety of cosmetic procedures. It is about not simply the training but, from a healthcare perspective, ensuring that we have the right premises and proper regulation so that clients are assured of the hygiene and safety levels and the professionalism of the people who work in those premises.

We also think that it is very important to bring in legislation to ensure that young people under the age of 18 cannot legally get such treatment. That is a key driver of the bill. We have therefore focused very much on the age-related elements and the premises, while recognising that, ideally, we want to bring in training and professional qualifications—which we will do once we have achieved the discussions with the UK Government.

On your first point, convener, it is fair to say that conversations about the bill that I have had with members from across the chamber show clear support for ensuring that we get this right from a public health perspective. I therefore appreciate the scrutiny that this committee and the Health, Social Care and Sport Committee have been giving to the bill.

As you correctly pointed out, part of the situation with UKIMA relates to the fact that the Scottish Parliament and Scottish Government are unable to set training and supervision standards for Scotland in this area. We consider that part 3 of UKIMA would be engaged by legislation that sets training standards for practitioners or prevents practitioners who do not hold certain qualifications or are not existing professionals from providing certain procedures. That was a clear concern for us when we were drafting the bill.

As soon as we recognised that, we engaged with the UK Government, and I am pleased that that engagement has been very positive. It is on-going, but we are engaging across the issue because there is a recognition that we need to get it right. As you know, the UK Government is also looking at bringing in legislation in this area of public health concern. We need to get it right for people in both Scotland and the rest of the UK.

That is a good question that has come out in a lot of the conversations that I have had with stakeholders who have fed in their thoughts. Education is really important in some respects. While I was driving to my constituency yesterday, I listened to a Radio Scotland piece on cosmetic procedures and the evidence that the Health, Social Care and Sport Committee is currently taking. Such pieces of work in the media are very helpful in ensuring that we get the right message across. I am content to take the issue away and consider what more we could do in that space.

Yes; it had to be so. As Owen Griffiths pointed out, engagement has happened not just from a health perspective, with the Department of Health and Social Care, but from a business perspective.

I recognise the work that the committee has done on framework legislation, but I underline that I do not believe that this is framework legislation. It has substantive powers that are focused on ensuring that we get the right public health outcomes when it comes to non-surgical procedures.

As I said in my response to Katy Clark, it is important that the legislation is able to respond to changes in the sector in order to remain relevant and to protect the public from potential harms. I understand your point about scrutiny, which is very important. We have worked very closely with cosmetic clinicians and I have met businesses. To ensure that we get the legislation right and in order to make changes that are currently not included in the bill, we need to continue that close engagement. The people with whom my team and I have worked closely want to ensure that this area of work is as safe as possible.

Of course.