Chamber and committees

As a member of the Health, Social Care and Sport Committee and as a nurse with a current registration, I am pleased to speak in today’s stage 3 debate on the Patient Safety Commissioner for Scotland Bill.

The bill was introduced in response to the recommendation of the Cumberlege review and in direct response to patient-led campaigns on the use of the hormone pregnancy test Primodos, sodium valproate in pregnancy and transvaginal surgical mesh. Each of those products was associated with significant patient harms and injury, and one of the main findings of the Cumberlege review was that patients were not listened to. As I said when I moved amendments 1 and 2, it is crucial that we ensure that we get the bill right, so that the public can have trust in the commissioner.

The bill proposes the creation of a patient safety commissioner who will be nominated by, and accountable to, the Scottish Parliament. That is important, as parliamentary commissioners are perceived to be more independent of Government.

The bill proposes that the PSC would have two key functions:

“to advocate for systemic improvement in the safety of health care”—

I will touch on that again later—

“and ... to promote the importance of the views of patients”.

Working alongside healthcare providers such as NHS Education for Scotland and Healthcare Improvement Scotland, the patient safety commissioner will be an independent champion for everyone who receives healthcare. The Scottish Government places high importance on the patient voice and the patient experience.

During the stage 1 scrutiny process and in the stage 1 debate, a lot of my interest was on the remit of the Scottish PSC. The remit of the commissioner will include bringing together patient feedback and safety data shared by NHS boards and Healthcare Improvement Scotland to identify concerns and recommend actions. The commissioner will also, when necessary, lead formal investigations into potential systemic safety issues and will have powers to require information to be shared to ensure that every investigation is fully informed.

I believe that the remit of the patient safety commissioner is directly relevant to the constituency work that I have been raising in Dumfries and Galloway, in my South Scotland region. The specific areas involved are cancer treatment, pathways and travel reimbursement.

As colleagues will know, Dumfries and Galloway is geographically located in the south-west of Scotland, but it is aligned with the South East Scotland Cancer Network. Nowhere in D and G is closer to Edinburgh than it is to Glasgow. In many cases, particularly in Stranraer and Wigtownshire, that means a 260-mile round trip for treatment, including radiotherapy. Constituents have been campaigning for that unnecessary travel to be addressed for more than 20 years now. I hear from constituents that the trip can often exacerbate poor health and cause anxiety and additional stress at the very time when people with a diagnosis of cancer should be supported most.

In D and G, patients are currently means tested to be reimbursed for journeys for medical appointments that are more than 30 miles, despite the fact that people living in other rural parts of Scotland are not means tested. Other travel reimbursement schemes exist, such as in the Highlands and Islands. Wigtownshire Women and Cancer and my constituents report that means testing and the journeys travelled lead to worse health outcomes and potentially impact on people’s safety.

I have raised those matters with the Scottish Government on numerous occasions, and I welcome the fact that the language in the bill on the functions of the PSC, under section 2, will allow the commissioner to pick up on those issues.

I welcome the fact that we are moving forward with the Patient Safety Commissioner for Scotland Bill. I also welcome the minister’s commitment to continue to work with me on those issues, and I look forward to hearing more about how we can address cancer pathways in Galloway. The bill is a crucial move that will improve patient safety as we recover from the Covid pandemic. I welcome the fact that we are moving at pace to ensure that we get the bill right for everyone in Scotland.

I am pleased to speak to amendments 1 and 2, which are grouped together and which concern the appointment of the patient safety commissioner.

From the outset, I want to make it clear that it is crucial, particularly given the reasons that have led to the creation of the commissioner post, that patients and their families have trust in the commissioner. That trust might be undermined if the office were held by someone with a strong—and I emphasise “strong”—financial interest in healthcare. That includes those who are currently or have very recently been employed in healthcare or who have a controlling interest in or influence over, for example, a pharmaceutical company.

That said, I think that paragraph 5 of schedule 1 to the bill might, as currently worded, go too far. The current wording would disqualify those with

“a financial interest in a health care provider”

from being appointed as commissioner, but that would also exclude someone who, for example, had a smaller number of shares in a pharmaceutical company. It seems like a very blanket approach, and such fixed, strict wording could exclude an otherwise very suitable, competent and qualified candidate. I am grateful to the minister for working with me on the amendments that I have lodged, which would remove the current disqualification criteria and replace them with a more nuanced approach.

Amendment 1 would require Parliament to inquire whether a person who was to be nominated for appointment as commissioner had a relevant financial interest. It would then be for Parliament to exercise its judgment about candidates, which would enhance the Parliament’s role and its accountability over the appointment of a commissioner. It would mean that good candidates would not be excluded from the outset on account of a minimal and/or indirect financial interest, including those who were part of a pension scheme that happened to have shares in a pharmaceutical company, something that appears to be relatively common in practice. It is my view that the amendment would increase the pool and diversity of candidates applying for the position of patient safety commissioner, which, in turn, would deliver the best possible outcome for patients.

Amendment 2 would simply leave out subparagraph 5(d) of schedule 1, for the reasons explained in relation to amendment 1, and I urge members to support amendments 1 and 2.

I move amendment 1.

I thank Brian Whittle for that. I realise that our food prices have gone up because of decisions that were made by Tory Governments. When Sajid Javid was Home Secretary, in 2019, he agreed with the recommendations of the Migration Advisory Committee that we should have a rural pilot scheme in Scotland. I therefore respond to the member by asking what is the reason for that dither and delay from the UK Government?

I will focus on what I hear from south-west Scotland dairy farmers, who are saying that dairy farming is not seasonal—it requires work all year round—and south-west Scotland has 48 per cent of Scotland’s dairy herd.

I have previously focused on encouraging our own young people to consider rural and agricultural careers. In fact, last week, I was at the Royal Highland Education Trust event in Parliament, which was about supporting young people into agriculture. However, we require migrant workers. They are essential for farm operations, for the supply of dairy produce and for animal welfare. Many agricultural tasks do not have viable or affordable mechanical alternatives, and the availability and capability of local people is limited.

I reiterate that the UK Government needs to support Scotland by allowing the implementation of a rural visa pilot scheme so that we can have the workforce in Scotland, encourage immigration to our area and support our rural economies.

To be clear, I welcome the Parliament’s being able to exercise judgment about the candidates that are chosen. I am not seeking to amend the bill in relation to the disqualification of members of Parliament or the Scottish Parliament, as set out in the bill.

I urge members to support my amendments, and I press amendment 1.

Amendment 1 agreed to.

Amendment 2 moved—[Emma Harper]—and agreed to.

I congratulate my colleague Kate Forbes on securing this important debate. She outlined the issues in support of a rural visa pilot for Scotland scheme very well.

As a member of the Scottish Parliament whose region covers a vast rural area in the south-west of Scotland, I am acutely aware of the real challenges that our agriculture sector faces when it comes to recruitment. Although those challenges are faced across many parts of Scotland, such as the Highlands and Islands, as described by Kate Forbes, they are also faced in the south-west, and I will focus my contribution there.

The Scottish Government is clear that inward migration enriches our society, and migrants make a net contribution to our economy, public services and public finances. Scotland’s demography, our ageing population and the depopulation of some remote and rural areas mean that inward migration is crucial to Scotland’s future prosperity. In the past decade, an estimated 45 per cent of overseas migrants to Scotland have come from the EU, but analysis has shown that there is a reduction of around 30 to 50 per cent in net overseas migration into Scotland as a result of the ending of the free movement of people. That is significant in the context of the latest NRS projections, which were published in January 2022 and which show that in-migration is the only factor maintaining Scotland’s current population growth.

The decline in labour from the EU is particularly acute in Scotland’s agricultural sector, and it is important to say why that is concerning. It concerns me because our farmers are our producers. They put the food on our tables, they are the custodians of our land and they are the future of our food security. Indeed, agriculture is the linchpin of rural Scotland, as it directly employs 65,000 people in production, while also indirectly supporting Scotland’s food and drink industry, which employs 360,000.

I will, but please be quick.

I draw members’ attention to the fact that, while I was an NHS Scotland employee, I paid into an NHS Scotland pension.

On a point of order, Presiding Officer. I had the same issue, and I would have voted no.

I welcome the fact that the Scottish Government continues to do excellent work to foster relationships with our friends across Europe, the United States and the globe. However, the House of Commons Library reports that the UK Government Foreign Office’s spending, including on consular services, has fallen from a peak of £15.1 billion in 2019 to £14.5 billion in 2020 and £11.5 billion in 2021. Most recently, a third of UK Foreign Office spending was on housing refugees in the UK.

Does the cabinet secretary agree that the degradation of UK Foreign Office spending shows that the UK Government is intent on becoming more insular, and that it is only with independence that Scotland can truly play its part as a progressive, outward-looking—

I will start on a point of agreement with the Labour motion. Despite Sir Keir Starmer’s telling his shadow cabinet, “I hate tree huggers,” in response to a presentation from his climate and net zero spokesperson, Labour’s motion reaffirms its recognition of the global climate emergency.

We have huge potential for more carbon sequestration, carbon capture and peatland restoration. I will unashamedly talk about some of the fantastic examples of promoting and protecting nature activity that are taking place in Dumfries and Galloway, in my South Scotland region.

We are at a tipping point for nature. It is in decline around the globe, with about 1 million species already facing extinction. Restoring nature is crucial and will reduce carbon emissions. Businesses are rising to the challenge of the global climate emergency. Although that is key in helping to meet our climate change targets, it is also bringing economic growth, particularly to our rural areas.

There is a fantastic company in Dumfries and Galloway that I have visited on numerous occasions—most recently with the Minister for Energy and the Environment—and it is leading the way in the field of carbon capture. Carbon Capture Scotland, which is based in Crocketford near Dumfries, has a combined investment of £120 million, including funding from the Scottish Government, to remove 1 million tonnes of CO₂ from the atmosphere every year.

CCS is working with farmers, distillers and firms that generate anaerobic digestion energy from waste to capture CO₂ and put it to good use elsewhere or remove it from the atmosphere permanently. CCS uses captured CO₂ to produce dry ice, which caters for the needs of the pharmaceutical and food transport industries. That makes those industries more sustainable, and CCS proudly stands as the UK’s second-largest producer of dry ice.

The company hopes to increase its number of employees to 500 and is a great example of how we can use anaerobic digestion, including through agriculture, to bring economic growth and protect our environment. I would be interested in hearing how the Scottish Government aims to engage and support rural and urban anaerobic digestion in the future.

I welcome the fact that the Scottish Government has scaled up its investment in nature restoration, including peatland restoration. In Dumfries and Galloway, the Crichton Carbon Centre has a project called peatland connections, which highlights the significance of the Galloway peatlands through a range of practical and community engagement initiatives. It is part funded by the Scottish Government.