Chamber and committees

I would like to expand that question for Amit Aggarwal. Should we explicitly include people from the pharmaceutical and health technology industries? Should the commissioner engage with people in those industries in order to understand the bigger picture of what can go wrong and, thus, how we can take steps to prevent it?

Thank you and good morning, Dr Duncan and Dr Hughes. I am interested in the particular powers that you have in your role and the powers that we might seek to provide to our commissioner in Scotland. When we talk about the establishment of a commissioner, everyone shows that they are keen that the commissioner should have teeth; that expression is used quite a lot. What powers do you have? Are there any powers in your role that you would like to be expanded? That is quite an open-ended question.

Thank you for that overview.

This morning, we had an interesting discussion with representatives of people who work in health and social care about whether the recommendations that are made to organisations and staff have to be more binding, being cognisant of the whistleblowing nature of making whole-system and lasting improvements. In your experience so far and your initial assessment of the role, would it be useful to you, and to us in the Scottish context, to have the ability to make binding recommendations or enforcement orders?

Thank you, convener. Good morning.

In evidence, the committee has seen a high degree of support for the patient voice, but it is important that we explore the staff voice, too—especially with regard to whistleblowing processes and provision of safe spaces for staff to communicate their concerns and to add to intelligence on what patients are saying in the process. Therefore, my initial question is whether, with regard to the role of the commissioner, there is a place for that and for engaging the staff in that way. That question is for Matthew McClelland, first.

Do you sense that patients have responded well to that approach, in terms of feeling that they are getting to the answers and results that they need through that more collaborative and encouraging approach, or is there a sense that they want to see an option of last resort, almost, in terms of being able to enforce things?

Shaun—do you want to comment?

Thank you, convener. I am very grateful to the committee for permitting me to attend this morning.

I have an interest in the matter as a result of meeting Mr Barr, who is a constituent, and taking some time to tour Hawkhead cemetery with him. I have seen at first hand the impact that the policy has had on many of the graves of people whose families are still living and visit the cemetery regularly. I am also very conscious of the work of “friends of” groups that care for cemeteries, which are, of course, very important places for people who have been bereaved.

From my 10 years as a local councillor, I am very aware of the challenges that Councillor Wood outlined. On the whole, councils are genuinely concerned about upkeep of our burial grounds and cemeteries to ensure that they are respectful and dignified places in which we can take pride.

However, councils have also been very conscious of the health and safety implications that arose from the tragic fatality at Craigton cemetery in Glasgow, although I feel that a blanket approach, rather than a more nuanced approach, has been taken. Councils are very keen to comply with guidance that is issued by the Government.

Councils are required to ensure that they stress test and monitor headstones, but the challenge for them often relates to finance. It can be very difficult for local authorities to maintain the standards that we would expect in cemeteries without additional burdens being placed on them, given the local government financial settlement.

I recognise much of what the petitioners have said about the blanket approach of laying stones on the ground not being the best way to proceed. That can lead to bereaved families coming to a grave and finding that their stone has been lowered. There is a lack of communication, and communities in different areas interpret the guidance in different ways. That causes great distress.

It is clear to me that there is a cost impact, so we have to look at how we properly fund local government to do the more detailed and considered work that Mr Torrance referred to.

From a public health angle, I asked Maree Todd, the Minister for Public Health, Women’s Health and Sport, in a written question, whether there was any intention to provide a fund for local authorities to access in order that they can deliver what Mr Barr described as a rolling programme of making historical stones and larger stones safe. Unfortunately, the Government said in its response that there are no plans to provide such a fund. That might be useful information for the committee.

I am concerned that the issue is not just for local authorities. We have a number of private cemeteries in Scotland. Across the country, the Roman Catholic Church, the Jewish community and the Muslim community maintain their own cemeteries. For example, St Conval’s cemetery in Barrhead—one of the largest Catholic cemeteries in the country—is in my region. There might be cost implications, so we have to consider how the costs will be borne not only by local authorities but by religious groups.

If the Government wants councils to meet their obligations, it needs to be clearer about what the national standards should be. It is clear that the current blanket approach is not working. The Government has to provide funding for councils to maintain our cemeteries with the dignity and respect that we would all hope for.

In my speech, I think that I have outlined the importance of the relationship with the dentist in ensuring that a person’s appointment is their gateway to the services that they require for good oral health.

“What’s needed now is real reform to a broken system. There can be no more kicking the can down the road—a sustainable model must be in place come October.”

Those are not my words; they are the words of the chair of the British Dental Association’s Scottish dental practice committee, David McColl.

As a matter of urgency, the Scottish Government must fix the systemic issues in the current funding model if it is serious about maintaining a universal NHS dentistry service across Scotland. We need to shift the debate away from the proportion of the public who are registered with a dentist and focus on who is able to access a dental appointment.

If action is not taken, we will see the end of dentistry as we know it in Scotland, with a two-tier system of care: one for the rich and one for the rest.

I thank the Liberal Democrats for bringing this debate to the chamber. I am pleased to open on behalf of the Scottish Labour Party.

The proposed national care service is one of this Government’s self-proclaimed flagship policies in this parliamentary session. It is, of course, a concept that this party first suggested more than a decade ago, but our vision was not the shambles that the Government is currently presiding over. The SNP has presented a hollowed-out, unfunded mess of a bill that is not worthy of the name “national care service”.

As each week passes, the voices raising concerns about the bill continue to multiply. The Coalition of Care and Support Providers in Scotland has called for the bill to be paused because of the “considerable work” needed to make the legislation workable. The Convention of Scottish Local Authorities, the umbrella body for Scotland’s councils, has called for a pause due to insufficient funding and lack of clarity around key aspects of the bill, including the viability of local authorities. Unite the Union has withdrawn from the co-design process due to its losing confidence in the Government’s approach. Unison has described the bill as “unfit for purpose” and stated that it “would be better withdrawn”.

This Parliament’s own committees—including the Finance and Public Administration Committee, the Education, Children and Young People Committee and the Local Government, Housing and Planning Committee—have raised significant concerns about the scope and structure of the proposed bill. Only last week, the Delegated Powers and Law Reform Committee joined the chorus of voices calling for the bill to be paused.

The minister said that he will listen to Parliament. I think that his message on the national care service bill is becoming clearer by the day.

That will only exacerbate and further entrench existing health inequalities in oral health.