Chamber and committees

I commend Jeremy Balfour for bringing such a serious issue to the chamber for debate. A number of excellent contributions have been made so far.

We are discussing failures in paediatric audiology at NHS Lothian. As we know, the review identified 155 children who were seriously affected. However, as other members have said, because of the timeframe, the review might not have picked up everyone who was affected. I raise that as an urgent point and ask the minister to look into it further to see whether anyone has been missed.

The root causes that were identified as contributing to the failures were listed as a lack of scientific leadership; a lack of knowledge, reflection and inquiry; and a lack of robust quality assurance processes. That led to assessments being carried out incorrectly. It is very disappointing that, at this stage, departments are being run in that way. If the minister is not able to advise on that today, I ask her to write to me and others on what progress has been made to deliver on the many recommendations that the review made. Many of those recommendations were extremely urgent.

This week, I took the opportunity to speak to two families in my constituency who were affected. I spoke to Stephanie, mother to Rory, who is 11. Despite repeated testing when Rory was a baby and a young toddler, unfortunately, he was not diagnosed as profoundly deaf until he was four. He went on to be fitted with a hearing aid and, later, cochlear implants. Stephanie told me that that represents five years of missed communications. Rory will start high school in the not-too-distant future, and his mother is very concerned that the developmental delay that was created by that level of misdiagnosis will not be closed by the time that he goes to high school. That will put him at a disadvantage without significant additional support, which he is, unfortunately, not receiving.

The second family I spoke to have quite a similar story. Their daughter was tested repeatedly as a baby and young toddler. When she was three years old, the family was told that she could hear perfectly well, which, of course, was incorrect. Her case was eventually picked up in the audit, and she was finally diagnosed as being deaf from birth. She is now four and a half and has been fitted with a hearing aid. However, disappointingly, at the family’s most recent audiology appointment, the clinical staff seemed to have no notes and seemed unaware of or unable to understand the diagnosis. Unfortunately, that does not fill that family—and perhaps others—with confidence that the culture that led to the failures in the first place has been addressed and improved on.

Misdiagnosis and mismanagement have caused both of those children and their families unnecessary suffering. The issues in NHS Lothian must be addressed, and those who have been affected need support. Fiona Hyslop put it very well when she said that that support needs to be specific, additional and on-going. I suggest that it should perhaps take the form of a full, individualised support plan for each child and their family; Carol Mochan made an excellent point in that regard. Such support is essential and, to be frank, it is the least that can be done to support the children and families who have been affected.

I hope that the minister will take on board the points that have been raised and that she will work with the cross-party group of MSPs to make the progress that is sorely needed.

As others have done, I commend my colleague Michelle Thomson for securing the debate and for her excellent remarks commemorating this tercentenary. Adam Smith’s ideas have shaped the world as we know it, and the Scottish enlightenment, of which he was a leading part, was characterised by Scottish thinkers and the intellectual leadership of Europe. It was a movement of ideas and, importantly, the disputation of ideas.

As we have heard this evening, Smith is most famous for his book “The Wealth of Nations”. Like Mr Cameron, however, I will focus my remarks on his other book, “The Theory of Moral Sentiments”, which was published in 1759. That book very much put Mr Smith on the map. It brought him fame, and students from other universities—even in other countries—left their courses to come and study under him in Scotland. Further, it was considered by Smith to be his superior work.

I want to read out a passage from that book, although I will not do so in its entirety as it is quite long. In it, he talks specifically about systems and plans for how we govern, using an analogy involving chess pieces. He says:

“in the great chess-board of human society, every single piece has a principle of motion of its own, altogether different from that which the legislature might chuse to impress upon it.”

I will paraphrase the rest. He says that, if the principles coincide, the “game of human society” will go on easily but that, if they do not, it will go on miserably.

In other words, he says that Governments are most successful when they work with people rather than against them. I agree with that, and I sense that there is a bit of agreement with that sentiment in the chamber, too. It is important for us all to ponder that as we go about the work of this legislature.

Like Pam Gosal, I understand and have taken on board Smith’s belief in free speech and how that relates to society—and particularly to modern society at the moment. I think that his idea of free speech was tempered by respect for others and also by empathy for others. He might not understand our modern idea of empathy, but it is certainly based on sentiments that he wrote about in his book.

The Scottish enlightenment teaches us that we need to be free to think, to debate and even to offend, and that we need to base our thinking—our critical thinking—on facts and also on science, which is a sentiment that Smith expressed very much. I think that there is immense value in robust debate—that clash of competing opinions that benefits society and Governments.

Smith and the enlightenment continue to inspire us. They inspire us to pursue knowledge and to create an environment that encourages the free exchange of ideas, because that is how we progress.

I am curious to know, if Saturday is the new busiest day in terms of passenger numbers, what the new least busy day is.

Thank you.

Liam, I did not ask you to come in, because I assumed that that line of questioning was more for your colleagues, but if you have anything to add, feel free.

Who else would like to answer?

Does Liam Sumpter have anything to add?

Clearly, the pandemic had quite a profound effect on the number of rail passengers. The situation is perhaps beginning to settle into what we might call a new normal for numbers of rail passengers. Has enough been done to adjust services to meet those new travel patterns? It would be helpful if you could also give the committee an idea of the implications for rail finances of the changes in traveller numbers.

Does that represent a change, or is that the same as it was before?

David or Joanne, do you have anything to add?