Chamber and committees

There have been five outbreaks of avian flu in Aberdeenshire since July and, earlier this month, 1,500 birds were killed near Peterhead. It is no wonder that NFU Scotland has described the situation as very worrying and said that it remains a serious concern. Will the minister reassure poultry farmers that the Scottish Government will consider all safeguards against avian flu ahead of the festive period, including housing orders for commercial stocks?

The minister is aware that Scottish and Southern Electricity Networks intends to construct a substation in the Mearns and to install new overhead lines. There are huge implications for farming, tourism, property and wildlife habitats in the area. Does the minister agree that new energy infrastructure projects must always be completed with the consent of residents? Will the minister confirm that no attempt will be made to override the concerns of local communities in Scotland following the Scottish National Party’s failed attempt to amend the UK Government’s Energy Bill?

To ask the Scottish Government what action it is taking ahead of the festive period to support poultry farms, in light of the potential threat of avian flu. (S6O-02576)

I also suggest that the minister reconsiders that point. The Scottish Conservatives lodged an amendment on information sharing at stage 2 with input from the GMC, which the minister said she would not support since it was unsuccessful. I understand that the minister has provided assurances to the GMC on how the commissioner and regulatory bodies will work in practice and share information. As the minister will not support Carol Mochan’s amendment 6, I seek clarity and assurances from the minister on that point. The Scottish Conservatives will support all the amendments in the group.

I rise to support Jackie Baillie’s amendments in group 1. The Queen Elizabeth university hospital scandal has haunted families for years—families who are desperately seeking answers from a health board that has pulled down the shutters and said, “Nothing to see here.” We saw the same thing happen in NHS Tayside in the Sam Eljamel case. His medical negligence has had devastating consequences for his patients. Patients and their families should not have to go up against a large public body in order to find out the truth. That is in no way a fair fight.

In 2019, the Scottish Government announced the Scottish hospitals inquiry to look into the QEUH campus and, earlier this month, it announced that there would be a public inquiry into Dr Eljamel. Those inquiries are welcome, but they can take years and leave families in limbo. Against that background, it makes sense for the patient safety commissioner to advocate for those who have been affected by a major incident in a healthcare setting, where they believe that it is appropriate to do so. Jackie Baillie’s amendments are, however, a significant expansion of the patient safety commissioner’s remit, with implications for resourcing. If the amendments are successful—and I hope that they will be, after the Scottish National Party and Greens rejected them at stage 2—the commissioner will need to be able to deliver on them. I hope that the minister and Jackie Baillie will be able to address that point.

Amendment 11 requires that the “statement of principles” must consider ways of engaging with NHS staff to seek

“their views on patient safety concerns”.

A similar amendment that, as the minister will remember, I lodged at stage 2 sought to place a duty on the commissioner to “seek the views” of NHS staff in relation to patient safety. In her response at the time, the minister raised concerns that the commissioner is

“already empowered to do so”—[Official Report, Health, Social Care and Sport Committee, 13 June 2023; c 16.]

and that such an approach could detract from “patients’ voices”. As such, I have softened the approach of the amendment at stage 3 to focus it on how the commissioner can engage with NHS staff, instead of creating a requirement for them to do so.

I am revisiting the amendment, because, in the period between stages 2 and 3, the trial of former neonatal nurse Lucy Letby reached its horrifying conclusion. That deeply distressing case has shocked the public and has shaken the foundations of the healthcare system. Lessons can and must be learned by healthcare providers, especially given that other NHS staff raised the alarm but were overruled by their managers. I know that recourse exists for NHS staff to raise red flags about safety, but, as the Royal College of Nursing has argued, staff do not always feel that their concerns are heard or addressed, as in Lucy Letby’s case.

The minister suggested that the commissioner’s hearing from NHS staff could cut across patients’ voices, but I would counter that, in many cases, such processes could be concurrent and complementary. It would, of course, be at the commissioner’s discretion how to amplify the voice of patients while engaging with NHS staff, but the amendment is designed to facilitate that process.

I move amendment 11.

I will press the amendment. I am deeply disappointed that the minister has not considered the case of Lucy Letby or the recommendations by the RCN.

I will press amendment 12. I am deeply disappointed that the minister has not heard what I have said. The parliamentary committees have huge resources at their disposal for research and holding inquiries. I think that the minister’s decision is a big mistake, and I hope that, if the amendment is rejected, the commissioner, when he or she is in post, will use that facility to his or her advantage for patient safety. I press amendment 12.

Amendment 12 would create a duty for the commissioner to consult the Health, Social Care and Sport Committee, or whichever parliamentary committee is concerned with patient safety, on the principles and on the strategic plan.

Amendment 12 is another amendment that I lodged at stage 2 and have brought back at stage 3. I thank the minister for the opportunity to discuss it with her earlier this month. At the time, the minister shared with me her concerns that amendment 12 would compromise the independence of the commissioner by specifying that they must consult parliamentary committees. She added that the role is first and foremost for patients and their representatives, as she said earlier in the debate.

The commissioner must have the freedom to define their own principles. However, I do not believe that the independence of the commissioner should preclude their consulting parliamentary committees, especially when committees can—and do—act as a bridge between the public and policy makers. The Health, Social Care and Sport Committee is uniquely placed to understand the healthcare system in Scotland and so can support the work of the commissioner.

More widely, members of the Scottish Parliament regularly advocate at health boards on behalf of patients, and provide assistance in complex cases in which a patient’s safety might have been jeopardised. The cases of patients who have experienced use of surgical mesh are cases in point.

The Scottish Conservatives will support Paul Sweeney’s amendment 13, which he has brought forward from stage 2. The Health, Social Care and Sport Committee’s stage 1 report called for the principles to include

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

especially in the context of women having been badly let down by the healthcare system. The Cumberlege report made for difficult and distressing reading in that regard.

I move amendment 12.

I will speak briefly on amendment 22. It is a probing amendment to facilitate debate on the resources that the commissioner will require to carry out their work, and to enable Parliament to consider whether those resources could be shared with other commissioners.

The SNP convener of the Finance and Public Administration Committee, Kenneth Gibson, wrote to the Health, Social Care and Sport Committee in January to express concerns about

“the increasing number of commissioners with their associated costs”.

For 2023-24, those costs amount to £16.6 million, which is £1.2 million more than was budgeted for in the previous year and 5.4 per cent more than was forecast. The finance committee convener added that a

“more strategic approach to the ... resourcing”

of the commissioner system

“might be considered in future.”

Amendment 22 suggests a way in which such a strategic approach could be implemented.

Although I will withdraw my amendment, I urge the Scottish Government and the Scottish Parliamentary Corporate Body to consider value for money for the taxpayer if the commissioner system continues to expand and the number of commissioners increases from seven to 14. Commissioners can be very valuable, especially as they are operationally independent of the Scottish Government. However, the system cannot keep growing so significantly without formal review or evaluation of its effectiveness.

I move amendment 22.