Chamber and committees

It is heartening to note the commitment to place the fisheries management and conservation group—FMAC—on a more strategic footing. Given the importance of the inshore region for livelihoods and biodiversity, what plans does the Scottish Government have to develop ecosystem-based inshore fisheries management plans, including spatial or temporal management measures, to help to achieve our legal duty of managing our seas to good environmental status? What are the timescales for that work?

We should consider the issue as part of a wider piece of potential work. The petition is broad and covers a number of areas.

In the evidence session that we had with the cabinet secretary, we explored why some of the challenges are not purely healthcare recruitment issues but issues to do with life in rural environments in the first place. If we were to incorporate the petition into a wider piece of work, it would be interesting to hear from other ministers about how their portfolios could support recruitment in rural areas and support people to consider working in rural and remote areas. At the moment, it is people who come from or have a connection with such communities who take up recruitment and training opportunities and then go back to the community, rather than our making working in those areas an easy choice.

Earlier on, you mentioned communication. There is an interesting line that you might already have had to walk, or that you might have to walk in the future, between individual cases that people believe indicate wider patient safety issues but the investigative body believes do not, and stories of multiple cases that patient groups have talked about happening over and over in different places. How do you see your office, and you as the commissioner, communicating to people—who have often been traumatised as a result of their treatment—where the line is between individual cases that involve an individual failing and individual cases that might have wider implications for patient safety?

My comment is not specifically on this petition; it is on the others.

Dr Williams, how can the patient safety commissioner for Scotland complement the work of the Patient Safety Commissioner for England and the MHRA, and how will the commissioner interact with the work of clinicians up here?

Is there potential for conflict in the relationship, particularly given the overlap between the oversight roles of the two commissioners and the interaction with the MHRA?

On the back of what Tess White has just said, I think that a wider inquiry into rural healthcare services is really important, but I propose that we defer a decision on the petition because of the current work that is being done. The best start north review is based on maternity services in particular, and the minister, Maree Todd, has other pieces of work that are looking at wider issues, including abortion care and other women’s health needs. The other pieces of work that are being done could be lost in a wider inquiry. If those things develop, we might want to take evidence on them, and other issues could arise.

Given that those other pieces of work are still on-going, particularly the best start north review, I propose that we defer a decision on the petition so that we can pick it up again if there are other things going on.

Are there any areas relating to medicines and medical devices that you would like to be included in the remit of the patient safety commissioner that are not covered by the bill?

The First Minister, along with the Minister for Public Health, Women’s Health and Sport, convened a further summit on abortion services earlier this week, which was hugely useful in exploring further themes for my member’s bill. I am very grateful for the Scottish Government’s support.

Will the First Minister update the chamber on next steps and what she sees as the most important steps that we can take to protect and further abortion rights in Scotland?

Having listened to the debate so far, and in the interest of introducing some consensus, I say that I believe that we all want to achieve the same things: better outcomes for people who receive social care, better terms and conditions for those who work in social care and better support for carers.

Sometimes in this policy area, we rightly discuss who should deliver social care and how, but we do not amplify stories about why it is important. There are parts of NCS work that I think we have no argument with each other about. We all know about the issues that relate to the ban on care home visiting during the pandemic. That practice was in place before the pandemic in relation to outbreaks of various viral infections, but such bans’ negative impact became more apparent as Covid dragged on. We should thank the families who campaigned on that issue for using their stories so powerfully. They often had to relive trauma for the betterment of other people’s experience. I know that some of the issues are on-going, so I encourage anyone in that situation to contact their MSPs.

We have discussed the National Care Service (Scotland) Bill, and issues related to the bill, many times in the chamber, but I want to cover one that we have not heard so much about through the process—young carers. The Carers Trust reflected that the size and technicality of the bill and their engaging in such a vast process could have an impact on those who have a caring role. We need to reflect on that when we talk about co-design, and we need to make sure that input from young carers is targeted and sustainable.

As part of its response to the bill, the Carers Trust has undertaken work with young carers to highlight why the bill is so important to them. The majority of young people whom the Carers Trust spoke to are in favour of a national care service. The issue of breaks is hugely important to them, so I want to offer two quotes from young carers. In the Carers Trust report, one young carer said:

“I want to spend more time 1:1 with my mum and dad … I don’t feel confident enough to go with people I don’t know. I want my breaks to be with my own friends and family and with people I choose … If my mum and dad got more help with my sister this would help me too.”

Another said:

“For a lot of young carers—a break away is not just physical but a mental break—don’t need to worry in the back of their mind about the person they care for. Even if attending a hub ... there is not necessarily a mental break. Helps for them to know the cared for person is safe and being looked after by someone.”

We have heard from carers that the mental break that is described in those quotes is one of the most difficult things to provide. Carers are often so focused on how to get everything done and what the next thing to do is that they find it difficult to switch off when they have time for a break. Due to their caring roles, some carers—we know this, because we heard it from them—became more socially isolated during the pandemic because the number of hours of care that they provided or the complexity of care increased. That resulted in them losing touch with friends or not having time for hobbies that they once loved. The cost of living crisis and what it means for being able to survive—let alone to have expendable income for a hobby—has also had an impact.

We need to work to ensure that the breaks that we bring in fit and support carers. We need to make sure that there is support for carers to find comfort and enjoyment from breaks.

Support, particularly for young adult carers, also needs to be better defined. We hear that many carers feel that their support just stops after they move on from school. For some young carers I have spoken to, that does not feel right; many go on to college or university but find that their day-to-day lives do not change other than in that they are getting their education somewhere else, often further from home.

We can address through the NCS bill some of the issues that affect young carers, but, for many young carers, there are many other issues to address. As the bill progresses, we need to keep that in mind for all carers.