Chamber and committees

There is certainly the opportunity for the patient safety commissioner to ensure that there is accountability. One of the things that struck me when reading through the evidence was that stakeholders, professional organisations, professional regulators and individuals described the commissioner as potentially being the golden thread that could unify and unite patient safety and clinical governance structures, as there are numerous clinical governance structures, oversight organisations, professional regulators and so on. It struck me that, if patient groups and patient representatives felt that a patient safety commissioner would help to amplify their voice, it would be worth their while to have such a commissioner.

There absolutely must be reviews and accountability, because we are talking about public money. We want the commissioner to succeed in allowing people’s voices to be heard—particularly voices that are heard less often—in ensuring that all healthcare providers are accountable for their practice and for the care that they deliver, and in ensuring that issues, particularly those relating to medicine and medication devices, are highlighted at the earliest opportunity, because, as was reflected in the Cumberlege review, that is not happening at the moment.

One of the key things is the independence of the role. The commissioner has the freedom to define and establish the principles underpinning their work, and the scope and remit of their work. One of the committee’s recommendations was that patients should be given the opportunity to provide input into the scope and remit of that work. Perhaps that is not as evident in other commissioner roles that involve looking at patient safety or in other bodies that look at assessing medical devices and medicines. It was generally accepted by stakeholders that there was a need for the role, and that was certainly reflected in the written evidence that the committee received and in its evidence sessions.

I will come at the question from a slightly different angle, given the origins of the proposals for a patient safety commissioner. The issues that were raised were from the 1960s, the 1970s, the 1980s and up to the 2000s. We are looking at a different landscape, and those were the foundations for the need for a patient safety commissioner. In written and oral evidence, people consistently said that patients’ voices were not being heard, with patients perhaps feeling that they were not being believed. People wanted the commissioner to be an advocate for those voices and to raise concerns about issues relating to medication side effects, medication devices and so on. In Scotland, the patient safety commissioner’s remit will be wider than the remit of the commissioner in England and Wales.

Deprivation and austerity will play a part, but the issues that have resulted in the patient safety commissioner have a much deeper history.

I do not think that there has been any further correspondence with the committee, but I am certainly happy to check with clerks and update Mr Marra and other members on that.

That is an interesting question. I hope that perhaps your committee will look at some of those issues around the public’s perception of commissioners and recognition of their role. I imagine, from my casework, that the Scottish Public Services Ombudsman probably has the highest profile of those organisations, but I am sure that some commissioners have profiles that are not as high as stakeholder organisations hope that they would be.

The committee wanted to make sure that the commissioner would make the public more aware of their role and set out the fact that they would not take on individual complaints. Other commissioners could perhaps look at that.

I thank Christine Grahame for her work so far on the bill, which addresses issues that I know are very close to her heart. I also thank the committee for its work on the stage 1 report.

Over the years, there has been a huge shift in the attitudes that we, as a nation, hold about the welfare and care of animals, which is very welcome. Recently, the sixth annual Holyrood dog of the year competition took place. It was described by The Edinburgh Reporter as

“arguably the most sought-after accolade in Scottish politics.”

That is a subjective matter, of course, and I will continue my one-woman campaign for a Holyrood cat of the year competition. Nonetheless, I am sure that colleagues will join me in congratulating my colleague Marie McNair, with her dog Heidi, on winning this year’s coveted title. The competition is not only about celebrating the positive impact that dog ownership has on people’s lives; it also plays an important role in spotlighting welfare issues, and it keeps a focus on where improvements could be made.

Across Scotland, there has been a surge in dog ownership, which has no doubt been exacerbated, in part, by the Covid-19 pandemic. Sadly, that growth has gone hand in hand with reports of record numbers of pets being surrendered to animal rescue centres across the country. When there is a surge in demand, there is a scrabble to provide supply, which has, unfortunately, led to a rise in unscrupulous breeding. The committee’s report acknowledges evidence from stakeholders that the effects of irresponsible breeding can be catastrophic, from young puppies dying within hours of going home to their new families to puppies and their mothers facing serious health risks.

The bill shines a light on the need for us not only to continue to strive for the highest possible animal welfare standards and to call out and stamp out cruel and irresponsible breeding practices that are more to do with caring about money than a love of dogs, but to open what might be a difficult conversation.

There is no doubt that, as much as a dog can bring joy and companionship to its owner’s life, it also brings a great deal of responsibility and duty. Welcoming a dog into your home should be a big decision. It is very concerning, therefore, to hear stakeholders’ concerns that people can be unsure what questions to ask and what research to do before taking that step.

The Kennel Club states that at least a fifth of people will spend less than two hours researching whether to buy a puppy—which is potentially a 15-year commitment—with a third saying that they do not know how to spot a rogue breeder. Ultimately, people need trusted information about the important questions to ask of breeders, about the health concerns that relate to particular breeds and about their responsibilities as owners.

Members across the chamber will know that, for many years, I have called for an end to the cruel and outdated practice of greyhound racing, and, earlier this year, I was pleased to welcome Mark Ruskell’s proposed bill to prohibit greyhound racing.

I pay tribute to the many organisations and individuals who have campaigned for years for an end to greyhound racing. Many of them are constituents of mine. They have highlighted welfare concerns about those dogs to the public and to elected members across the political spectrum. In my Rutherglen constituency, that chapter of history is now closing, and our community can look forward to a new future for the Shawfield stadium site.

It became very clear to me from the constituents who contacted me ahead of this debate how deeply important animal welfare issues are to them. Like many members—perhaps every member—across the chamber, I would definitely characterise my constituency as one of dog lovers.

The crux of the bill is to improve the health and wellbeing of dogs throughout their lives, starting from the point that a prospective owner decides to welcome one into their life. I am sure that we can all support that aim, and I look forward to further discussions about how it can be progressed.

I refer members to my entry in the register of members’ interests—I hold a bank nurse contract with NHS Greater Glasgow and Clyde.

The publication of the Cass report has probably produced more column inches in newspapers, more social media posts and more worry and anxiety in the patient group that it relates to than any other report that I can remember. This important inquiry into gender identity services in NHS England, under the direction of Dr Hilary Cass, should be treated with the utmost respect.

A point that should be emphasised is that the report is about NHS England services, and we must take the time to cross-reference it accurately and thoroughly to our own services here in Scotland. There should be measured consideration of its many recommendations, and their applicability to services in Scotland should be properly assessed. I welcome the decisions by clinicians in NHS Lothian and NHS Greater Glasgow and Clyde to pause prescribing some pharmacological treatments. It is vitally important that clinical decisions are made by clinicians.

Although we all recognise that this can be a polarising topic, we cannot lose sight of the children and young people, and of course their families, who seek help with gender identity issues. The past few weeks will have been a difficult time for those children and young people who have been affected by the recent changes to clinical pathways. It will have been a time of uncertainty about their current treatment and about what treatment options will be available to them.

One of my young constituents contacted me last night. Her words were:

“I’m 13 and I have been on the waiting list for the gender clinic since I was 11. I’m a girl. I don’t want to be forced to develop as a male. I just want to be happy for the rest of my childhood. But now the gender clinic won’t help me.”

I have previously asked the Minister for Public Health and Women’s Health what support is being put in place while there has been a pause in the prescription of puberty blockers, and while clinicians assess the best treatment options and care pathways in the light of the Cass report’s recommendations. I welcome her reassurances that NHS teams and third sector organisations are working to provide additional support to those young people. I am also pleased to see in the Government’s amendment that it will

“thoroughly examine the recommendations”

of the Cass report

“and its applicability to NHS Scotland services”

and that it will

“update the Parliament on the outcome before the summer recess.”

Children and young people such as my constituent need that certainty.

Of course, it did not take the publication of the Cass report for the Government to start a broad programme of work to improve gender identity healthcare, and it is absolutely committed to that aim. Importantly, throughout its work, the Government has engaged with trans and non-binary people across Scotland who have lived experience of accessing, or waiting to access, gender identity services. To build on that, I know that it will continue to engage directly with young people and the stakeholders who represent them. I hope that, in the heat and light of the debate and discourse, that will offer them reassurance that their voices will be represented and that their experiences will be centred in any work that is designed to improve their healthcare.

I thank the witnesses for their attendance this morning. Next week, the committee will not be meeting, as we will be undertaking external engagement in Skye as part of the committee’s inquiry into healthcare in remote and rural areas. That concludes the public part of our meeting.

Yes, please.

We move to Carol Mochan.