Chamber and committees

There are more and more MSPs seeking to lodge more amendments, which is great to see and is a testament to our desire to create robust legislation. The dedicated, hard-working team that supports us is very small, however—and I put on record my thanks to them this week in relation to our emergency legislation.

The last 18 months of a parliamentary session are always busy, with bills making their way through. What more can be done to increase the team, ensuring timeous support for MSPs and, therefore, the efficient passage of legislation?

Good morning, minister. I want to explore some issues around the fair work agenda. We have already touched on some of that, but I would like to go into a bit more detail.

Stakeholders have advised that a definition for ethical commissioning should be discussed and agreed, emphasising that that is critical in delivering the fair work agenda.

We have heard from you this morning about the sectoral bargaining issues that you have been discussing with your UK counterpart, which was quite helpful. It might be good to get a bit more information about that.

We have also heard about the pressures that will be put on the system by the estimated £21 million in additional costs for the third sector because of the national insurance changes. We know that there are good examples of collaborative commissioning and procuring arrangements, such as the Granite Care Consortium and the Fife care at home collaborative. How do you intend to further facilitate and accelerate more ethical commissioning models and improved procurement practices, bearing in mind that those new pressures will perhaps put some spanners in the works?

I have one other wee question—you touched on it earlier—about many of the workers within the sector being part time; also, a lot of them are women. I would like to explore a little how we will make sure that the workforce will have their lot improved, as far as we can possibly do that.

If we are not proceeding with the national care service at this stage, how can we protect that workforce as much as possible in the meantime, given the precariousness that we are now seeing, with the added pressure of that national insurance change?

To ask the Scottish Government whether it will provide an update on what action it is taking to improve access to audiology services. (S6O-04002)

The minister will know that it is cost effective to provide hearing-loss services for adults in the community, rather than in hospitals, and that primary care and high street audiologists are expert clinicians who can improve access to care in communities throughout Scotland and can timeously address hearing loss at the right time to reduce associated loneliness and isolation. Does the minister agree that we could benefit from approaching hearing loss in Scotland in the same way as we approach eye tests in the community—as set out in Specsavers’ recent “It’s Time To Talk About Hearing” report—to improve patient experience and relieve pressures on valuable national health service resources?

I will cover the theme of assisted dying as an adjunct to palliative care. We have heard quite clearly that we have to look at assisted dying and palliative care as two separate things, and I think that that is absolutely right. We have had written submissions and oral evidence saying that palliative care can be complemented by assisted dying as an alternative. People have stressed that there is a therapeutic value to having a choice of an assisted death and how that can remove an element of suffering not addressed by palliative care, even if it is ultimately not exercised.

Conversely, we have also heard that the two are not compatible and that assisted dying would divert resources away from palliative care and erode its quality and availability.

I would like to explore that a little bit. Do witnesses recognise the potential therapeutic value that accessing assisted dying can have for individuals approaching the end of their life, especially those individuals for whom the best palliative care would perhaps not be enough to relieve their suffering?

I will start with Amy Dalrymple and work across from left to right.

I am actually going to ask you whether you can lengthen your answer a little bit for me. I want to explore the therapeutic effect that access to assisted dying has reportedly had for some people who may not eventually exercise their right to it but who report that unpacking those really difficult conversations with palliative care specialists—availing themselves of that opportunity to explore all the options—allows them to live as best they can for the remaining time, even though they do not exercise that right at the end.

Does anyone else have any thoughts on that?

I have a final question, which is about 16-year-olds. Someone spoke earlier about whether 16-year-olds have the capacity to make a decision on assisted dying. However, we allow them to make decisions about healthcare in general. Can you explore that idea? Perhaps Dr Provan could start.

That is quite helpful. The questions that I am trying to get at are in relation to assisted dying being an adjunct to palliative care. They are two separate systems, but if the bill became law, there might be an integrated pathway where the two systems would have to interact with each other—it is about considering how they could mutually benefit the patient.

In the interests of time, I will move on and let Dr Mills and perhaps Rami Okasha answer as well.