Chamber and committees

I know the work that Dr Gordon Baird and the Galloway community hospital action group have done to get the petition to the Parliament, and I know that local people feel powerless. I know that Professor Sir Lewis Ritchie is interested in how Australia’s National Rural Health Commissioner works—Australia is also a big rural country. I also know that a centre of excellence for remote and rural medicine is being created, but it does not have an advocacy role. That is what Professor Sir Lewis Ritchie said when he gave evidence.

The proposed agency is not about picking up individual casework. That is not what Dr Gordon Baird was after when he asked for an agency to be created. It is about advocating for and giving a voice to people who feel powerless and who do not know that, for example, they should be offered a choice of care that might be closer to home. That is one of the challenges.

NHS Dumfries and Galloway committed to addressing cancer care pathways and then Covid came along. Therefore, when the board comes in front of us, we will need to ask specific questions about where it is with altering cancer care pathways and what steps it has taken. This is not about addressing all the challenges overnight. I know that there are real challenges—everybody does; I was a healthcare clinician as well.

I am keen to ensure that, whatever pathway we take, Dr Gordon Baird is permitted or invited to give evidence about the challenges for remote and rural healthcare and advocacy for patients.

I am well aware of this petition; I was at the Citizen Participation and Public Petitions Committee meeting at which it was presented by the petitioners, and I know that other members in the room were there, too. I know the history behind it, and I am keen that we do not lose sight of rural health and social care needs and that we hear people’s voices.

The example that I have before me is the experience of people in Stranraer. A key issue that the petitioner has been trying to raise for 20 years now relates to the fact that NHS Dumfries and Galloway is part of the south-east cancer network and that, as a result, patients in the south-west of Scotland—which isnae in the east of Scotland—end up having cancer treatment in Edinburgh instead of at the closest cancer centre for radiotherapy, which would be in Glasgow. It means that, instead of just going up the road to Glasgow, people who are undergoing radiotherapy or other cancer treatment have to travel a distance that is pretty hefty for them.

My understanding is that, for 20 years now, Dr Gordon Baird, who is a retired GP and former chief medical officer at the Galloway community hospital, has been trying to look at ways in which we can hear the voices of people who live in remote and rural parts of Scotland, particularly Dumfries and Galloway—although, as we can see from the other petitions, the issue goes wider than that to, for example, Caithness. The question is how we support what is best for patients; it is not about telling them, “You’ll get your treatment where we tell you,” but about giving them the best opportunity to get the best care where they choose and reducing the issue of travel.

Currently, the people in question are means tested for their travel, whereas those in other parts of Scotland are not and get their care without having to cough up from their own finances. That is a health inequality issue, too—means testing people for their care should not be happening.

There are other issues regarding maternity services. I know that a review of the midwifery-led service in Galloway is happening right now because no baby has been delivered in Stranraer for four years. That is similar to the issue at Dr Gray’s hospital, which has been raised in the chamber of Parliament on a number of occasions.

My concern is that, for 20 years, little progress has been made to hear the voices of the people who live in remote and rural areas, whether that is in the area that NHS Dumfries and Galloway covers or more widely. If we in the committee do not keep the petition open and hear from witnesses, I am concerned that we might lose sight of what the real issues are for people in remote and rural areas.

I know that the Cabinet Secretary for Health and Sport said that he did not want to

“clutter a landscape”

that

“already has a fair bit of bureaucracy around it”—[Official Report, Health and Sport Committee, 17 January 2023; c 14.]

through the organisations, agencies and institutions that we already have. I am aware that the establishment of an agency is not the route that the cabinet secretary wants to take. I suppose that the big issue is how we ensure that rural voices are heard. We have raised the issue in debates and through questions in the chamber, but how do we get rural voices heard if we do not continue to pursue evidence taking?

I know that the petition calls for the establishment of an agency. I need to understand whether we need the petitioner to submit a new petition that addresses the specific issues with remote and rural healthcare rather than calling for an agency.

I am interested in the panel’s thoughts regarding the patient safety commissioner having sufficient powers to bring about improvements in patient safety. We already have the Scottish patient safety programme, which has been widened to look at maternity and neonatal primary care, paediatrics and medicines. I was part of the surgical safety stuff when I worked in the operating theatre in California, implementing the surgical safety checklist and things like that. Will the patient safety commissioner have enough powers to make safety improvements?

I do not have anybody in particular in mind.

I have a quick question. Looking at the report on your first 100 days, I see that concerns have been raised about electroconvulsive therapy and Covid vaccination. I am the co-convener of the cross-party group on mental health, and the ECT issue has come up with us, as well. There is a lot of fake news out there about Covid vaccines. Will your role help with concerns where evidence issues need to be addressed? Will it combat fake news, for instance?

Earlier, you talked about the value of your independence, and you are talking about listening to people and hearing their concerns. Are you already finding that people are engaged with and have trust in the role of patient safety commissioner for England that has been created?

In a previous evidence session, one of our panellists spoke about the Health and Safety Executive, enforcement orders and fines, and the patient safety commissioner’s potentially having those sorts of powers. Do you have any thoughts or opinions on whether the patient safety commissioner should be able to act in that way?

Thank you.

Thank you.

To govern is to choose, and the Scottish Government has made its choice. Emma Roddick stated that very well. Eradicating child poverty, transforming the economy in order to deliver net zero and creating sustainable public services are the key aims of the Scottish budget this year. Families, businesses and our public finances are under sustained economic pressure, and the Scottish Government has acted decisively to provide what support it can within the resources that are allocated to us.

Steps that the Government takes now will help to ensure that Scotland emerges from the current crisis a stronger, fairer, greener and more equal country. I welcome James Dornan’s description of that in his speech, and I welcome his return to the chamber.

Of course, the Scottish Government would like to go even further, but the cost of living crisis has laid bare the fiscal constraints of devolution and the need for Scotland to take its place as a normal independent nation.

Using the current fiscal powers and right through the budget, the Scottish Government is, more than any other UK Administration, acting to tackle poverty. Scotland is the only part of the UK to have introduced a child payment: the Scottish child payment has now been increased to £25, which is a 150 per cent increase in eight months. The budget extends the payment to all under-16s, which will, it is estimated, lift 50,000 children in Scotland out of poverty. The Joseph Rowntree Foundation said that

“The full rollout of the Scottish Child Payment is a watershed moment for tackling poverty in Scotland, and the rest of the UK should take notice.”

Indeed, a recent report from the Child Poverty Action Group shows that the cost of bringing up a child in Scotland has been significantly reduced, thanks to Scottish Government interventions including the Scottish child payment, free school meals, best start grant payments and free bus travel.

However, that progress is being undermined by the actions of the UK Government. The same report states that

“Scottish policies are immensely important in reducing the level of financial strain and hardship on families ... but they are fighting a rear-guard action”.

They are fighting a rearguard action, Presiding Officer.

Difficult decisions are required, and the budget ensures that resources are targeted at where they are most needed and can secure maximum value for every pound that is spent. However, the choices that are faced are all the starker because of the UK Government. Economic projections show the staggering cost of continued Westminster control. As the Deputy First Minister has rightly mentioned, the International Monetary Fund recently predicted that the UK will be the only major economy to shrink in 2023. That is a devastating indictment of the UK Government’s management of the economy, and will only exacerbate further the significant challenges that are faced by the Scottish Government.

The UK Government’s disastrous approach to Brexit has damaged the labour supply through the loss of the free movement of people and has undermined frictionless trade with our nearest markets.

At no stage since the reconvening of the Scottish Parliament in 1999 have the conditions been more volatile and the dangers more severe. In autumn, the Scottish Government had to make unprecedented reductions—totalling £1.2 billion—to its spending plans, midway through the current financial year. The Scottish Government had to do that because, in the absence of borrowing powers to address in-year volatility, and in the absence of the ability to alter income tax, once a financial year commences the Government operates within a fixed total budget, unless the UK Government allocates additional money to Scotland.

In addition, for the first time since the SNP Government took power, the finance secretary has announced a budget for the next financial year that assumes that the Scottish Government will not carry forward any fiscal resources from this year to next. For comparison, I note that the Scottish budget for this year was underpinned by £450 million of resources that were carried over from the previous year. The absence of such a carry-over increases the financial challenges that the Government faces.

On the national care service, I am not sure where Douglas Lumsden was sitting in the committee room when we took evidence at the Health, Social Care and Sport Committee from the many people who support a national care service—especially the people with lived experience who want their care to be more joined up and more about what they choose. I wonder whether he wants to ignore and disregard the voices of lived experience when we take evidence at committee.