Chamber and committees

That is really helpful. I know that some of my colleagues will have big questions to ask about GPs later.

To ask the Scottish Government when it last engaged with Social Security Scotland. (S6O-02213)

I thank the cabinet secretary for providing that clarity.

The application for adult disability payment from one of my constituents was delayed due to their general practitioner taking over five weeks to provide the key health information required for their application to progress. Will the Scottish Government explore additional options to enhance communications between Social Security Scotland and GPs to promote quicker decisions and payments and to avoid lengthy waits? Is there potential to streamline information technology systems at GP surgeries to speed up that processing?

Absolutely.

I thank Carol for also bringing up endometriosis.

The situation is a clear impediment to securing a correct diagnosis and the right support for people. Irene Oldfather from the Health and Social Care Alliance Scotland spoke for many women when she said:

“To say that they felt that they were not being listened to is an understatement—they were banging their heads against brick walls.”—[Official Report, Health, Social Care and Sport Committee, 7 February 2023; c 8]

I welcome the minister’s recent response to the committee, which recognised our call for the patient safety commissioner’s work to include an explicit commitment to listening to and supporting underrepresented voices and agreed about the need for follow-up and for work with organisations to ensure that recommendations really do bring positive change. Patient trust must be strengthened and early intervention is critical. That is exactly what the commissioner will ensure.

Further to that, the bill recognises the key role that data analytics will play in effectively supporting the patient safety commissioner to amplify the voices of patients. We have heard today that sodium valproate can be an essential medicine for those with epilepsy or bipolar disorder, but we are now aware of the imposed physical and neurodevelopmental risk to babies if it is prescribed during pregnancy and also of the trauma and guilt that Tess White described so well. Substantial evidence reaffirming those risks has emerged since the early 2000s, yet Valproate Scotland has noted that there is still no exact figure for how many people in Scotland have been impacted—there is only an estimate of about 2,000. If prevalence is not understood, those who are affected will suffer in silence and go unsupported. Thanks to fierce campaigning by Valproate Scotland, that data is now being collected.

However, we should not be reliant on campaigners to bring such issues to the forefront. We must be proactive—not reactive—in data collection, to identify trends early and minimise harms. It is good to have the minister’s reassurance that the commissioner will have access to the data analytics that they require to implement robust and evidence-based systematic improvements. We simply cannot afford to allow another surgical vaginal mesh or sodium valproate event to unfold.

Today, we have heard much about patient experiences that highlight the need for the bill and about the importance of creating a patient safety commissioner role that is independent of the Government to champion patients’ rights. We have heard that the patient safety commissioner needs the authority to investigate and report on patient safety matters and the power to make recommendations to healthcare providers, professional regulatory bodies and the Government.

The bill should matter to every Scottish citizen, because any one of us might unexpectedly face a situation that goes beyond an individual complaint and appreciate having a patient commissioner who is on our side. I stand by the bill’s aims, and I hope and trust that members will support its general principles.

I am pleased to speak in the debate as a member of the Health, Social Care and Sport Committee. I, too, thank all those who generously gave their time to provide evidence to the committee, and I thank committee clerks and my colleagues for their hard work and commitment. A special thanks goes to Brian Whittle for speaking with such passion and compassion about his constituent’s experience.

The health and wellbeing of Scotland’s people lies at the heart of the Scottish Government’s responsibilities, and the Patient Safety Commissioner for Scotland Bill is an important step that helps to ensure that good-quality, accessible and patient-centric healthcare services are available to all of us.

The independent medicines and medical devices safety review—known as the Cumberlege review—drew attention to significant changes that were needed for health-related quality and safety and highlighted major disparities in how different groups of patients and service users experience healthcare services, which is an imbalance that must be addressed.

We heard that a patient commissioner would act as an advocate for patients by directly representing their interests in healthcare and drawing on their feedback and experiences to enhance the safety and quality of care. The bill’s primary purpose is to give patients a voice—especially the patients who are least likely to be heard in our healthcare system.

Despite the Scottish Government’s good progress on patient safety in recent years, some patients have been let down, and the consequences of not listening have been extensive and damaging. For example, we heard about vaginal mesh, which is still an issue many years on.

The Cumberlege review and the evidence to the committee highlight that women still experience a lack of understanding of their symptoms. I am sure that we can agree that it is wrong and harmful for women who are experiencing excruciating chronic pain not to be taken seriously. Too many women are told that these are just women’s issues. I thank Carol—I cannot remember her surname—

I have a question about methodology. Are you looking at using “The Scottish Approach to Service Design”? I can see Donna Bell nodding away there, so the answer to that is yes. Are the public sector and other stakeholders in a good place to coalesce around that just now?

Well done, Donna.

Minister, you have already offered clarity on a number of the points that I was going to raise.

During stage 1 scrutiny, the Scottish Government confirmed its intention that the integration joint boards will be replaced by new local care boards. Is that replacement still the intention?

To follow on from that, what reassurance can you give local government stakeholders that care boards will be suitably aligned with local government?

To follow on from that, are you expecting the representation on care boards to be quite standard or expecting variation, or are you not quite sure about that yet? How does that fit in with eliminating variation across local authority areas?

Thanks very much for allowing me back in, convener.

Minister, you mentioned self-directed support, and many of the witnesses have spoken about self-directed support being an excellent initiative and the legislation being excellent. That initiative is along the same lines as the national care service and it has the same kind of ethos behind it, because it is all about people having agency and control, and putting what matters to them at the centre.

With that in mind, is there a focus on building on that initiative and replicating its successes? It has worked incredibly well in some places and not so well in other places where it has not been properly embedded. Is any work being done on that?