Tess White has a supplementary question.

The committee has heard evidence on the curriculum and framework that the Royal College of Obstetricians and Gynaecologists has published for specialist training in mesh complications, and I am keen to hear about the clinicians who have been through that training. Can you give us any numbers? Have all the surgeons involved in mesh removal in Scotland been through that training?

I thank the Minister for Public Health and Women’s Health and Greig Chalmers for their attendance this morning and for their evidence. The committee looks forward to seeing the written responses that the minister and her official have committed to sending to us.

At our meeting next week, we will continue our scrutiny of NHS boards, as well as taking further formal evidence as part of our inquiry into female participation in sport and physical activity. That concludes the public part of our meeting.

That would be helpful, minister. I think that Sandesh Gulhane has a question on this theme.

Thank you, minister. I am aware that we have taken you over the allotted time, but Stephanie Callaghan has one brief question before we finish.

Can you give a timescale for when the leaflet will be available to women?

Carol Mochan has a brief supplementary question.

Good morning, and welcome to the 17th meeting in 2023 of the Health, Social Care and Sport Committee. I have received apologies from Paul Sweeney and Emma Harper. James Dornan joins us remotely.

Agenda item 1 is a decision on whether to take item 3 in private. Do members agree to do so?

Members indicated agreement.

Our second agenda item is follow-up scrutiny of the complex mesh surgical service. I welcome Jenni Minto, Minister for Public Health and Women’s Health, and Greig Chalmers, head of the chief medical officer’s policy division at the Scottish Government.

We move straight to questions. Minister, there are plans to create a single patient leaflet that will be available to women at the point of referral to the service. Why is that leaflet not already being designed, given the length of time that the service has been in operation? How will the leaflet clearly explain the various elements of the whole referral and treatment journey, whether patients opt for surgery with the service, NHS England or a private provider?

I refer members to my entry in the register of members’ interests. I am a registered mental health nurse, with current Nursing and Midwifery Council registration.

In September 2020, the Parliament debated the independent medicines and medical devices safety review—the Cumberlege review—and the then Cabinet Secretary for Health and Sport, Jeane Freeman, set out how its recommendations would be implemented in Scotland. Those recommendations included establishing a patient safety commissioner.

As the convener of the Health, Social Care and Sport Committee, I am pleased to speak to our stage 1 report on the Patient Safety Commissioner for Scotland Bill. The committee unanimously supports the bill and believes that the role has the potential to improve patient safety across healthcare services.

I was not the committee’s convener when it took evidence on the bill, so I thank Gillian Martin for her leadership during the bill’s scrutiny. I also record our thanks to the committee clerks, the Scottish Parliament information centre researchers and everyone else who has supported the committee’s work on the bill so far.

Before commenting on the committee’s recommendations, I will take a moment to reflect on the evidence that those who engaged with the committee provided. I thank everyone who assisted the committee with its scrutiny—those who responded to our call for views and those who gave evidence in person or online.

I particularly thank Charlie Bethune, Marie Lyon, Fraser Morton and Bill Wright, who spoke about their experiences of serious patient safety issues. They told us that their voices were repeatedly ignored by a system that was meant to provide care and support for them and their families, and by those who were meant to regulate that system. They told us that their fights were not over and that their issues were still not resolved—some are still not resolved after more than 70 years. They told us about investigations that are still needed and support that is still required. In some cases, there has been no resolution; grief has been compounded by the way in which people have been treated, and families have had no closure.

We are grateful for those people’s testimony. We know how difficult it must be to keep recounting their experiences. I commend their passionate campaigns on behalf of others in similar situations who do not have that opportunity or voice. Their experiences emphasise the vital role that a patient safety commissioner can play. A patient safety commissioner cannot change what they have been through, but the role could make a difference to how cases like theirs are managed in the future, by providing a voice for patients and their families and championing their causes.

The commissioner could use their powers to make sure that no one else has the same experiences. Crucially, they could ensure that lessons are learned and that other such incidents are prevented from happening. They could identify patient safety issues that require investigation but which the system is not yet aware of.

Our report concentrates on areas where the bill might need to be clarified to make sure that it can achieve the intended outcomes. The committee supports widening the remit of the role beyond medicines and medical devices to include patient safety more broadly. Although the committee recognises the complex systems for patient safety, governance and regulation that are already in place, we believe that the voice of patients is missing from those systems. The commissioner can fill that gap by amplifying patients’ voices and advocating for systemic improvements that draw on patient experiences.

The committee welcomes the independence of the role as set out in the bill. It endorses the proposal that the commissioner should have the freedom to define and establish the principles that will underpin their work and the remit and scope of that work.

We believe that patients should be given an opportunity to provide input into the process of establishing the office of commissioner and informing its strategic direction. That will ensure that patients’ concerns are addressed and that their voices are heard as the commissioner embarks on their important work.

During its scrutiny, the committee heard a range of views about the scope of the commissioner’s role—some argued that it was too wide and others argued that it did not go far enough. Issues were raised about how safety concerns in social care would be dealt with, especially given that, as one witness noted,

“People do not experience primary care, secondary care, social care or nursing care; they experience care.”—[Official Report, Health, Social Care and Sport Committee, 21 February 2023; c 18.]

Some people suggested that the commissioner should have an additional role in taking on individual cases. On the whole, the committee believes that the bill strikes the right balance by defining a remit that is broad but manageable. However, we would like the Scottish Government to confirm that the commissioner will be empowered to investigate, to make recommendations and to act as the voice of patients on issues that intersect with or transcend health and social care.

The committee does not want to interfere with the commissioner’s independence, but it calls for a commitment that the principles that underpin the commissioner’s work will include an explicit commitment to listen to and support underrepresented voices. The committee believes that that is important particularly because of the specific patient safety issues that gave rise to the Cumberlege review and the circumstances of those affected by them—notably women.

The committee considers that it is vital for the commissioner to have the necessary capabilities to compel evidence from all organisations that are involved in providing healthcare, including private companies that supply medicines and medical devices. The commissioner should also have the power to follow up on the implementation of any recommendations.

Public confidence in the role of the commissioner is of paramount importance. Given the patient experiences that the Cumberlege review highlighted—many people felt that they were not listened to and felt frustrated by the time that it took for their problems to be acknowledged—work will need to be done to raise public awareness of the new role but, equally, to manage expectations. Crucially, the role will need to be sufficiently resourced to fulfil its functions.

The committee recommends robust monitoring and evaluation to ensure that patients’ voices are effectively amplified through the commissioner’s work and that there is on-going public confidence in the role and in the wider system for reviewing and addressing patient safety issues.

In conclusion, the committee is content to support the general principles of the bill and considers that it will be a crucial addition to the patient safety landscape in Scotland that should help to ensure that patients’ voices are consistently heard and acted on. I am grateful to the minister for having provided such a quick response to the committee’s stage 1 report. We look forward to seeing further improvements to the bill at stage 2, as set out in that response, to reflect our key recommendations.