Chamber and committees

Does the member agree that Dr Gordon Baird has been working on that issue for 20 years?

As a member of the Health, Social Care and Sport Committee, I am pleased to speak in this debate on stage 1 of the Patient Safety Commissioner for Scotland Bill, and I remind Parliament that I am a registered nurse with a current Nursing and Midwifery Council registration.

As colleagues have said, the bill was introduced in response to the recommendations of the Cumberlege review. It is a direct response to patient-led campaigns on use of the hormonal pregnancy test Primodos, sodium valproate in pregnancy and transvaginal surgical mesh. Each of those products is associated with significant patient harms and injury, and one of the main findings of the Cumberlege review was that patients were not being listened to.

We took direct evidence at committee from Charlie Bethune, whom I subsequently met, as he is a constituent of mine. He and his wife Lesley have championed the cause of children who have been impacted on by the anti-epilepsy medication sodium valproate, because of the impact that it had on their adopted daughter. Many others have been affected—the number across the UK is estimated to be 20,000.

As colleagues have said, a patient safety commissioner should be created to listen to and amplify the voices of patients, in order to drive systemic improvements in care, with a focus on medicines and medical devices. The patient safety commissioner, or PSC, will be an independent champion for everyone who receives healthcare, and will work alongside healthcare bodies such as NHS Education for Scotland and Healthcare Improvement Scotland. The Scottish Government places high importance on the patient voice and the patient experience.

During the committee’s stage 1 scrutiny, many of the questions were on the remit of the PSC, because the proposed remit is wider than that of the Patient Safety Commissioner for England. The remit of the commissioner will include bringing together patient feedback and safety data that is shared by NHS boards and Healthcare Improvement Scotland, in order to identify concerns and recommend actions.

The commissioner will also, where necessary, lead formal investigations into potential systemic safety issues, with powers to require that information be shared in order to ensure that every investigation is fully informed.

I believe that the remit of the PSC is directly relevant to issues in Dumfries and Galloway, in my South Scotland region, that I have been raising as a result of my work with constituents. I believe that the PSC could play a part in specific aspects, including a focus on cancer treatment and cancer pathways, and travel reimbursement.

Geographically, Dumfries and Galloway is in the south-west of Scotland, but it is aligned with the south-east Scotland cancer network. Nowhere in D and G are people closer to services in Edinburgh than they are to services in Glasgow. In many cases—particularly for people in Stranraer and Wigtownshire—a trip to Edinburgh can mean a 260-mile round trip for treatment. Constituents have been campaigning about unnecessary travel for more than 20 years now, and I know from my engagement with constituents that the trip can often exacerbate already poor health and cause more anxiety and unnecessary stress. Perhaps a patient safety commissioner will help to amplify the voices of my constituents in order to address that.

In addition, patients in D and G are means tested for reimbursement for journeys of more than 30 miles for medical appointments, despite the fact that people who live in other similarly rural parts of Scotland are not. Other travel reimbursement schemes exist in the Highlands and Islands, for instance.

I know that those issues are not overtly safety related, but, considering the specific issues and the evidence that has been presented that care and compassion should also be taken into account, they are worth noting. I therefore seek assurances from the minister that a future commissioner will consider the issues that I have just highlighted, in order to pursue real change.

I welcome the minister’s response to the committee report that was issued this morning. In particular, I welcome the minister’s agreement with our committee’s recommendation

“that the wording in Section 16(4)(c) ... should be amended to specify that”

members of the proposed advisory group who represent patients

“must actively demonstrate a commitment to representing the voice of patients, rather than simply appearing to the Patient Safety Commissioner to be representative of patients.”

That is an important recommendation, because it ensures that those who are receiving care are being represented by someone who has an acute understanding of the impact of their circumstances and who is committed to improving processes in the future. I therefore welcome that appointments to the advisory group will be the subject of oversight by the Scottish Parliamentary Corporate Body, which will function as an external check on their appropriateness.

It is clear that the bill will make sure that the voices of people who are using health services are heard and that their concerns are acted on, with the creation of a champion who is independent of the NHS and of Government and who will focus on the safety of people who are receiving healthcare in Scotland. It is vitally important that patients have a voice and a place to turn to if they have safety concerns, and the bill will help to ensure that that happens.

I look forward to continued scrutiny of the bill as we move forward to stage 2. Brian Whittle’s retelling of the experience of Fraser and June at University hospital Crosshouse was a powerful statement of the need for a patient safety commissioner, so I welcome his comments today.

In closing, I welcome the minister’s comment that the PSC “will work collaboratively with” healthcare bodies, and I thank all those, including the many people who have demonstrated great courage, who have helped us to get to this point today. I, too, support the general principles of the bill.

To ask the Scottish Government what discussions the rural affairs secretary has had with ministerial colleagues regarding the delivery of the rural crime strategy. (S6O-02202)

SPARC has seen positive results in reductions in rural crime and associated financial costs in the past year alone. Between April 2022 and March 2023, there were 284 fewer rural crimes reported than there were in the previous year, as well as an overall reduction in the financial harm to Scotland’s rural communities of more than £2 million, which equates to a drop of almost 36 per cent. SPARC’s approach is working, so will the cabinet secretary meet me and SPARC to discuss what action can be taken to build further on the reduction in crime for our communities across Scotland?

The cabinet secretary has commented on ScotGEM a couple of times. Does he recognise the positive feedback that I have had from NHS Dumfries and Galloway regarding the programme, which is unique to Scotland?

The words “co-design” and “co-production” are often used interchangeably but, in this case, we are pursuing co-design. Just yesterday, I had a conversation with an elected member who used “co-production” and “co-design” as if they were interchangeable. I am interested to hear about what the co-design process really is and how distinct it is from co-production.

I will pick up on some of the issues about engaging with COSLA and the unions. We took evidence from the Scottish Partnership for Palliative Care and heard that

“The national care service is a real opportunity to be part of improving people’s experiences of living with serious illness, and of dying and bereavement.”—[Official Report, Health, Social Care and Sport Committee, 13 December 2022; c 5.]

Age Scotland said that the Scottish Government has made it clear that there is a commitment to involving people with lived experience.

I would be interested in hearing about engagement with unions. I read a statement from Unison that said that

“the bill leaves profiteering at the heart of care”

and I know that there are concerns about employment and pensions. In contrast with the position of the Health and Social Care Alliance Scotland, the Scottish Partnership for Palliative Care and Age Scotland, who all welcome the bill, others have concerns and may feel that they need to have a voice. Can you speak about that, minister?

I have one final question on this wee section. Things such as the regional forums will help to identify the differences that you described, such as differences in pay. As a former nurse educator, I am interested in support for career pathways and career progression, and I think that a national standard approach would give more weight to career pathways for social workers and carers. Will the forums and the plans for regional approaches help to determine that a standardised approach to education will be part of the national aspect?

We need people to be empowered to understand that they will be part of the co-design process and that the bill is a framework that we will build on. Is that what we are asking people to believe and trust—that they will be part of the co-design?

When you made your opening statement, minister, you talked about the fact that you are a Highland MSP. The Highlands is a rural area. I am an MSP for South Scotland, which is also rural. There are complexities in designing impactful changes, so I am glad to hear about the processes that will be undertaken, especially those that will look at services.

In Dumfries and Galloway, there are no council-run care homes, but in the Borders, for instance, there is a mix of private and council-run care homes. Is that going to affect the work that is taken forward? Will that look at the fact that individual areas have specific needs?