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.

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 that Meghan Gallacher has brought the debate to the chamber, and I note the degree of detail that she described with regard to Dr Gray’s and Caithness hospitals.

I remind members that I am still a registered nurse. As a former clinical educator who provided specific clinical education support for midwives in NHS Dumfries and Galloway, I agree with the member that it is important that expectant mothers are able to deliver their babies as close to home as possible. However, that must be clinically safe, and the right option in each case.

As the minister will know, I have a number of challenges to make regarding maternity services in Wigtownshire and Dumfries and Galloway, and I will focus on some of those.

When mothers have to be transferred further from home to receive the best care for their baby, it is crucial that support is in place to enable parents to be at their baby’s cotside as much as possible. I am aware that the Scottish Government is committed to improving maternity and neonatal services in Scotland in order to ensure that they provide the right care for every woman and baby and give all children the best start in life.

We heard in the previous debate, which I sat through, that in 2015, maternity services underwent a national review, through which “The Best Start: A Five-Year Forward Plan for Maternity and Neonatal Care in Scotland” was developed. In February 2017, the Scottish Government appointed the chief executive of NHS Greater Glasgow and Clyde to lead the implementation programme board that will implement the five-year plan. Implementation of the best start programme was remobilised in May 2022, following a pause due to the Covid-19 pandemic.

The plan for maternity and neonatal care in Scotland updates and builds on “Neonatal Care in Scotland: A Quality Framework”, which was published in March 2013. However, while l welcome that work, my constituents in Wigtownshire are not able to deliver their babies locally, at Galloway hospital in Stranraer. That means that many expectant mothers who are not able or who do not wish to give birth at home are required to travel 72 miles to Dumfries infirmary in order to deliver their babies.

In 2011—sorry, I think that the date is wrong there—the Clenoch birthing centre at the Galloway community hospital was operational as a community midwifery unit, providing low-risk, midwifery-led, intrapartum care as a two-baby facility. In 2018, due to sustained and significant staffing pressures, an operational decision to temporarily suspend the birthing centre at Clenoch was taken by NHS Dumfries and Galloway, and the centre is still closed.

Thanks to campaigning by expectant mothers, the Galloway community hospital action group and others, NHS Dumfries and Galloway commissioned a review of Wigtownshire maternity services, which reported in July this year. The initial findings of the independent review of maternity services in Wigtownshire have been published, and the review has the support of the community maternity hub at Galloway community hospital. The review wants to see the community midwifery maternity hub return to the hospital.

The hub would provide an on-call, intrapartum midwifery unit. A lot of constituents have long campaigned for the return of a local midwifery-led service unit in Wigtownshire. That includes the Galloway community hospital action group, with which I have worked closely. The previous Minister for Public Health, Women’s Health and Sport, along with colleagues, met with members of the action group in Stranraer.

I understand that if the service is to be resumed, changes will be required in the current Clenoch birthing centre, including an upgrade in the facilities and equipment, with projected costs of £103,000. The report says that staff will also require updated education on obstetric emergencies before maternity services can properly resume. Those recommendations are a step forward, and I thank everyone who has been involved in carrying out the review.

I acknowledge, however, that the safety of mothers and babies is of paramount importance. Expert clinicians, doctors, midwives and anaesthetists must be involved, not only for their clinical input; they must be able to be recruited and retained in order for service delivery to be achieved safely and returned to Wigtownshire.

To ask the Scottish Government whether it will provide an update on the role of its international offices in promoting Scotland internationally. (S6O-02520)

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.

We do not have time for interventions in these wee, four-minute time slots.

I am interested in promoting the peatland restoration work that is taking place in south-west Scotland. The team at NatureScot has been working with external partners on the restoration of degraded, eroding and modified peatlands. That is one of the most effective ways of locking in carbon and supporting the promotion of nature. It offers a clear, nature-based solution to the climate crisis.

I visited one of the peat bogs at Moss of Cree near Wigtown with Dr Emily Taylor, who is the Crichton Carbon Centre general manager and a specialist in deep peat. The Moss of Cree project, which involves peat measuring 6m deep, shows how the peatland ACTION restoration programme can support landowners and land managers through the process of peatland restoration, from initial ideas and planning through to successful delivery. The farmer Ian McCreath has worked closely with the programme, which helped him to put in a successful funding application to create a 62 hectare forest-to-bog restoration project and bring it to fruition. That project is a fantastic case study. I invite the minister to come and visit the Crichton Carbon Centre to see that vital work.

Time is short this afternoon. I look forward to hearing the minister’s response and to continuing to progress the promotion and protection of our nature in Scotland.