Chamber and committees

The money is hugely welcome—I am sure that we all welcome it. Another particular concern that has been raised with me is that there is geographical variation in the ease of access to breaks—you will be well aware of that, minister, as a rural constituency MSP—and also variation in the support that is available. Not everyone will want what I am sure many members of the general public have traditionally seen as short breaks. Many people want to be able to take their loved one with them on holiday and to be supported to do that.

What specific work is going on in those two areas—addressing geographic variations and improving the diversity of short break offerings—in order to make sure that we will be ahead of the game by the time the provisions in the bill come into force?

As other members are, I am very pleased that the bill has reached stage 3, so I follow others by thanking all those who have put work into the bill.

The Scottish Greens have supported the appointment of a patient safety commissioner throughout the process because we believe that that will lead to an improvement in patient care. It will also help to rebuild relationships between patients and the health service, where there has been a breakdown of trust. Patients must have confidence in our health system, its safety and its ability to respond quickly when problems arise. They need to know that, if they raise concerns, they will be heard and that they will not be left with sometimes life-changing injuries with no means of redress.

The patient safety commissioner will have oversight of the entire system and will be able to promote system-wide improvements while amplifying the voices of patients and their families. That will mean that trends and patterns will be identified more quickly and that widespread issues will be addressed.

There has been discussion about whether the commissioner should look at individual complaints. I support the commissioner taking a systematic approach to identifying trends and areas for improvement, although that process should be based on clear evidence, with protection of vulnerable people being prioritised.

There might be some confusion among members of the public about the specific role of the commissioner—especially in the first few years after they have been appointed. We need to ensure that the role of the commissioner is well understood and that any materials that explain the role use inclusive and accessible language. The Health and Social Care Alliance Scotland has called for inclusive communication processes to be incorporated into the functions of the commissioner at the earliest opportunity, in order to ensure that communication and information provision is inclusive for all. I second that call. That cannot be seen as separate or as an add-on to the appointment of the commissioner; it should be embedded from day 1 so that people do not feel disheartened when they attempt to contact the commissioner only to be informed later that their individual complaint will not be considered.

Alongside excellent communication about the role and responsibilities of the commissioner, there must be an early focus on building relationships. The public should see the commissioner as someone who is on their side and who is working to make health services safer, rather than as an official who serves to protect the NHS and make problems go away.

It is vital that human rights are at the heart of the patient safety commissioner’s work, and that the commissioner fulfils their functions while upholding equalities legislation. As I mentioned during my stage 1 speech, the commissioner must be aware that not all complaints are treated equally and that existing inequalities such as those related to gender, race and economic status will impact on the experience of patients when things go wrong. As I said then, I fully support the commissioner adopting a focus on addressing and mitigating existing health inequalities and on how they can compound system-wide problems.

Following on from the point about equalities, I say that the appointment of the commissioner must be fully transparent, with people who have lived and living experience of patient safety issues playing a meaningful role in the recruitment process. Consulting people with lived experience should be an on-going process, not a one-off event, so I welcome the requirement that half of the advisory group be made up of people who are representative of patients.

I agree with the Health and Social Care Alliance Scotland’s statement that the commissioner’s strategic plan should be explicitly co-produced with people with lived experience of patient safety issues, and with unpaid carers. That will ensure that engagement with lived experience is not tokenistic but is embedded in the work of the commissioner from the beginning.

The appointment of a patient safety commissioner is a vital step towards improving patient safety and demonstrating that, when mistakes are made, patients will be listened to and complaints will be taken seriously. The Greens will therefore support the bill at stage 3.

That is an interesting suggestion. We should definitely take that back.

I will move on to a slightly different topic. We have often spoken in Parliament about the need for a “no wrong door” approach. Is there evidence that that is being implemented in practice, or do people who use drugs still face barriers when accessing mental health treatment and other services? That comes back to what we said earlier about thresholds to services.

Very briefly, if there was one area of anti-stigma work that the panel would like to see prioritised, what would it be?

I will come back on Kirsten Horsburgh’s comments. If we know what is in those drugs—if we do that level of regulation—what do you believe the public health outcomes will be? We know that one of the issues is that people are not aware of the strength of the drugs that they are taking. Often, they are told that one thing is in the drug, but it actually has something else in it as well. What do you believe the public health outcomes of that policy approach would be?

Thank you.

On a point of order, Presiding Officer. I think that the wi-fi dropped. I was not able to connect, but I would have voted no.

I will pick up on what Tracey was saying about the multiple ways in which people can be stigmatised. How do we address that compound stigma—stigma relating to mental health conditions, blood-borne viruses, housing status and various other things—that could also be impacting individuals who use drugs? We know that stigma kills and that it is compounded by the other things that I have mentioned. How do we give a voice to the impact of that stigma? I do not think that we hear enough of that. We all know that stigma has an impact on individuals, but I do not think that we hear enough of that in people’s own words. Do you think that enough is being done to address the compound stigma?

I agree that it is vital to share all information that can be shared ahead of decisions being made to ensure that we bring communities along with us with these decisions. That includes staff and all clinicians who are working in the units.

“The Best Start” report recommended a new model of neonatal service provision based on the suggestion that the care for the smallest and sickest babies be consolidated to deliver the best possible outcomes, and that change is part of the new model. The report was produced in conjunction with clinicians.

I begin by expressing my sincere thanks to all those who work in neonatal units across the country and who care for some of the sickest babies born in Scotland. I also thank everyone who has shared their story so bravely today.

Understandably, neonatal care is an extremely emotive subject, and it is vital that the concerns of parents and staff about the changes that are under discussion are heard and responded to. That is why it is so important that we clearly set out what those changes mean, how people in the NHS Lanarkshire health board area will be affected and, crucially, what services will look like.

University hospital Wishaw is in my region, and I have heard from people who are worried about what any changes to neonatal care will mean for staff, patients and their families. I am sure that many of us in the chamber have received correspondence from staff members who are concerned about those changes and why they are taking place. Alongside today’s debate, it is vital that the Scottish Government engages with staff from University hospital Wishaw and that a forum is provided for them in which to raise questions and have those answered.

It is important to recognise that this proposal is a result of recommendations from expert clinicians.