Chamber and committees

Will the member take an intervention?

I have worked with the BMA on a number of amendments to the bill. Professional judgment is really important. I wonder what the member would say about the areas in which the BMA wants professionals to be allowed to make judgments. Each and every one of us will have private conversations with medical professionals and we expect them to make judgments based on their professional capacity.

I worked with BMA Scotland on the proposal for amendment 293. The purpose of the amendment is to establish a formal process for the review of all assisted deaths as they occur, through an assisted dying review panel. The panel would review the documentation from each assisted death to ensure that the correct process had been followed and to make recommendations for how the process and service could be improved, including—but not only—from a medical perspective. It would ensure that the documentation from each case was brought together centrally and analysed to ensure the compassionate, safe and practical operation of the act.

Review committees are common in other jurisdictions where assisted dying is provided, and they are included in legislation that was recently passed in the Isle of Man and in Jersey. The Isle of Man recently confirmed that a compulsory post-death review will be mandated in every case, and that reviews will scrutinise statutory declarations, medical records and compliance with all the safeguards that will be put in place.

Having a system for the routine monitoring and review of individual cases is important for those who provide assisted dying and for patients who might want to access it; it is also important in maintaining public trust and confidence in any system that is established. In a healthcare system, it is normal to discuss cases, to take on best practice and to learn from experience. An assisted dying service, if one comes into being through the bill, should be no different. It is difficult to see how that could happen when, under the current proposals in the bill, only a copy of the documentation would be kept and individual medical records would be spread across the whole country, with no way of bringing the information together for formal audit or review.

It was suggested at stage 2 that amendments to create a review panel were unnecessary and repetitious, because of the role of the Scottish fatalities investigation unit, which sits within the Crown Office and Procurator Fiscal Service, or because of the review that would be required under section 27 of the bill. However, neither of those options would provide the information, oversight or learning opportunities that would be presented by an assisted dying review panel, as I am proposing.

It is currently the case that the Crown Office and Procurator Fiscal Service investigates all sudden, suspicious, accidental or unexplained deaths in Scotland, but none of those terms apply to deaths under the provisions of the bill. In evidence at stage 1, COPFS said “it is likely” that the Lord Advocate would require all assisted deaths to be reported to COPFS, but there is no certainty about that at this stage.

At stage 1, the Crown Office also said that it would expect its involvement in investigating assisted deaths to be relatively short and unlikely to uncover concerns.

Section 27 is a retrospective review—

Ariane Burgess wanted some evidence on the impact of rent controls. Will the cabinet secretary outline what has happened to the buy-to-let market and the mid-market-rent and build-to-rent sectors in the capital? Everyone I have met has withdrawn from the capital, and we have seen the collapse in the supply of housing. That has been a direct consequence of rent controls.

I suppose that the cabinet secretary would probably say what he has been saying and note that the Scottish Government is of the view that this amendment, and many other amendments, may give rise to issues of legislative competence. However, amendment 102, in the name of Neil Gray, would remove the reference in section 15(8) to approved substances, which would mean—I think that this is the point that the member is trying to make—that my amendment would therefore require only consultation on regulations in relation to the training of authorised health professionals, which is an issue that ministers should know is fully devolved to this Parliament, so I do not see why that would be outside the competence of our Parliament.

The Delegated Powers and Law Reform Committee recommended that a statutory requirement to consult with the chief medical officer should be added to the bill, which is why I lodged amendment 223. It does precisely what is needed by requiring consultation with the chief medical officer.

I thank the cabinet secretary for taking my intervention, because it is on an important aspect. Perhaps he can tell me at what point during the history of the Scottish Parliament a Government minister has not attended stage 2 proceedings.

Will the member take an intervention?

Like Jackie Baillie, I have worked with Children’s Hospices Across Scotland to lodge amendments 169, 170, 300 and 301, which would ensure that anyone who is being assessed for assisted dying is made aware that support is available, including social work or mental health services. The amendments would strengthen protections for under-25s by making certain referrals automatic, including a requirement to refer anyone under 25 for social work or mental health support if certain indicators are present, including concerns about capacity, fluctuating or unpredictable diagnoses, safeguarding issues, communication needs, multiple disadvantages or limited or no social support.

The amendments would also allow ministers, following consultation with relevant professional bodies, to set additional rules about the training and qualifications needed for practitioners who make those referrals.

My amendments would ensure that the Parliament can set clear regulations that support safe and consistent referral processes for young adults under the age of 25. Importantly, I believe that they would maintain coherence across the bill and ensure that there are no gaps in ministerial powers.

I note that amendment 103 pre-empts amendments 104 and 105 and my own amendment 223, which I have lodged on behalf of the RCN Scotland, which is neutral on the issue of assisted dying. RCN Scotland’s position is that amendment 103 is not necessary because section 15(8) relates to the training requirement for a devolved health service, not the regulation of professionals. The role of registered nurses as authorised health professionals means that, if the bill passes, nursing leadership will be vital for ensuring that appropriate protections and training are put in place. Amendment 223 would require ministers to consult the chief nursing officer, the chief medical officer and others they consider appropriate before laying regulations specifically around training, qualifications and experience that a registered nurse or registered medical practitioner must have in order to take on the role of authorised health professional.

There is another side to this whole debate, which is that there was no Government minister at stage 2. Ministers might be guiding members both for and against the debate, but the fact that those who lodged amendments previously and, in lodging them again, have found that they are being ruled apparently incompetent, shows that the Government did not provide that commentary at stage 2. It is important that we recognise that ministers have not given that information at stage 2.