Chamber and committees

I look forward to the publication of the report that was commissioned by the minister.

Vaping has serious environmental and health impacts. That is why campaigners such as Less Waste Laura, the Daily Record and a growing number of councils have highlighted those harms. I thank them all for their work.

A full ban on disposable vapes is needed, but does the First Minister agree that there is much that can be done to reduce harm ahead of a full ban, such as keeping the products away from public view—as is the case with cigarettes—raising awareness of the legal purchase age and highlighting disposable return points? Will the First Minister join me in calling on retailers to step up to the plate and implement those measures?

To ask the First Minister whether the Scottish Government will consider a full ban on disposable vaping products on health and environmental grounds. (S6F-02109)

I, too, welcome the bill’s introduction, and I thank all those who gave evidence to the Health, Social Care and Sport Committee, the committee clerks and the organisations that provided briefings for today’s debate.

This is one of the rare occasions when we do not disagree on an issue and can have a genuine discussion about how to get the best out of the bill for patients. The committee heard a wide range of views from those who gave evidence. We heard varying opinions on how the commissioner should respond to individual cases. When I asked her about that in committee, Baroness Cumberlege said that the commissioner will need to take an overall system-wide view in order to identify trends and that other organisations can support individuals.

We heard from Haemophilia Scotland that people do not always know where to go when they have complaints and that a culture of defensiveness in the NHS may prevent their complaints from being addressed. Haemophilia Scotland made the powerful point that the infected blood inquiry has resulted in the issuing of the apologies that some people have been waiting 20 years for and that there would be value in the commissioner being the first point of contact rather than the last. However, there was largely a consensus among those who gave evidence that the commissioner should not take on and solve individual cases, although they should certainly listen to individual concerns and identify where they form a pattern.

The commissioner’s role in relation to individual cases must be clearly defined as the bill progresses through Parliament so that it can be clearly communicated to the public. As the committee report states, given the on-going issues around

“patients feeling they were not listened to and the length of time taken for their problems to be acknowledged ... raising public awareness, as well as managing expectations, in relation to the role of Patient Safety Commissioner”

will be essential, and the Government must plan for that accordingly.

Alongside excellent communication about the role and responsibilities of the commissioner, there must be an early focus on the building of relationships. It was stressed to the committee that patients will need to see the commissioner as someone who is on their side when they may have struggled to be heard for some time.

The commissioner must take a person-centred approach to complaints that recognises the individual who is behind the complaint. Those with lived and living experience of patient safety issues should also have a meaningful role in the recruitment process. That will be essential in establishing patient trust and confidence in the commissioner. Consulting people with lived experience and other stakeholders should be an on-going process and not a one-off event.

The committee’s report calls for the commissioner to consult stakeholders on the principles that will underpin the role and says that these should

“include an explicit commitment to listening to and supporting under-represented voices”.

The commissioner needs to be keenly aware that not all complaints are treated equally and that existing inequalities will impact the experiences of patients when things go wrong. The Cumberlege review examined themes that specifically affected women and found a culture of silence about women’s pain and discomfort, which are often dismissed or ignored by the very system that is meant to keep patients healthy and well.

The commissioner must take an intersectional approach. The MBRRACE-UK report in 2022 revealed that, in the UK, black women were 3.7 times more likely to die from complications from pregnancy than white women were, Asian women were 1.8 times more likely to die than white women were and mixed ethnicity women were 1.3 times more likely to die than white women were.

The General Medical Council has suggested that the commissioner should adopt an explicit focus on addressing and mitigating healthcare inequalities that have the potential to impact on patient safety. I fully support that call.

On the relationship between NHS staff and the commissioner, I appreciate the comments from the then Minister for Public Health, Women’s Health and Sport during her evidence session. She was clear that there should be communication between NHS staff and the commissioner and that that could be clarified in the bill.

The Royal College of Nursing has welcomed that commitment and has highlighted that, although policies and procedures are in place for staff to raise concerns, staff do not always feel that those concerns are heard. Given the pressure that staff are under at the moment, it will be essential to build positive relationships from the beginning, so that staff are not reluctant to raise issues because of fears about punishment. Staff and the commissioner will share a commitment to patient safety, so we need to create an environment where they can work towards that common goal.

The commissioner will need to work co-operatively and not just be seen to be wielding a big stick. As the committee report notes, the complex governance structures that are in place, with responsibility for the safety of patient care shared among several organisations, not only create the risk of overlap and duplication of effort but can make things confusing for patients and lead to them having to tell their stories over and over to different agencies.

That is one example of how raising complaints can be traumatic for patients. More detail is needed on how the commissioner will work with other agencies in a way that will ensure that there is no meaningful duplication or overlap. I look forward to that clarification being added to the bill.

Although the establishment of a commissioner will, I hope, help to alleviate some of the aforementioned trauma that has been experienced by patients who are raising complaints, the need for emotional and practical support is still clear. As we have seen from the infected blood inquiry, seeking resolution for complaints can be an extremely lengthy, drawn-out process that can reinforce trauma for patients. The support that is available to patients and how they can access it while their complaints are being investigated need to be made clear.

The appointment of a patient safety commissioner is a vital step towards improving patient safety and will reassure people that, when things go wrong, their voices will be listened to and lessons will be learned. The Scottish Greens will support the bill at stage 1.

I thank the member for taking an intervention. Does he also acknowledge that the work of the patient safety commissioner should be seen not only as a stick but as a learning opportunity for staff and health boards more widely in order to change policy and go forward in a positive manner?

Good morning, minister. We around the table can agree on plenty that is in the bill: for example, on Anne’s law. How do we make progress towards that?

Obviously, we want national standards. Some areas have further to go than others to meet such standards. What work can be done, especially over the summer—before the legislation comes in—to have conversations with local authorities and care homes to ensure that we meet the standards that we want in the legislation, before it is in place?

That is great—thanks, minister.

I recently hosted a meeting of the cross-party group on carers with a particular focus on young carers and how they interact with this process, and what they want to see from the national care service. Are there plans to take evidence, particularly from young carers, over the summer? That is an ideal time, because young carers might not be in school or university or other places, so some—only some—of the pressures will be less. Obviously, those pressures are multifaceted, but that would seem to be an ideal time to take some of that evidence and to hear those voices. Will the minister commit to doing some of that work over the summer?

That is great. Thanks.

I have a question on the final theme, convener.

Now that the work of the short-life working group on buffer zones has concluded, does the First Minister agree that all of our collective focus should be on delivering national legislation as the most robust way to put buffer zones in place in Scotland, and that our collective aim should be to bring forward the final proposal for my member’s bill before summer recess?

Yes, it does. Thank you.