Chamber and committees

Will the member take an intervention?

To ask the Scottish Government what discussions it has held with Network Rail regarding passenger services on the west coast main line, including services calling at Lockerbie. (S6O-01886)

The TransPennine service at Lockerbie is in a complete fankle. Trains are consistently cancelled or delayed with no notice, no replacement bus and no alternative options. That has a major impact on my constituents who rely on the service to travel to the central belt and south of the border. Currently, only 43 per cent of TransPennine services run on time, with CrossCountry, Avanti and LNER occasionally picking up the slack by making unplanned stops at Lockerbie. Will the minister agree to make representations to TransPennine regarding how unacceptable the situation is, and will she commit to facilitating a meeting with me and Network Rail regarding the contract for the service?

I congratulate my colleague Ruth Maguire on securing the debate and on her very powerful opening speech; I know that she is sitting right behind me.

We know that the human papilloma virus vaccine helps to protect people from HPV-related cancers, including cervical cancer. The first study of its kind, which was funded by Cancer Research UK, has shown that rates of cervical cancer in women in their 20s who were offered the bivalent Cervarix HPV vaccine at ages 12 to 13 in England were 87 per cent lower than the rates in those who did not receive the vaccine.

That is why it is essential to vaccinate all those who are eligible by improving uptake so that they receive their vaccine. The HPV immunisation statistics for Scotland for the 2021-22 school year show that HPV vaccination coverage increased in comparison with the previous year. However, the numbers are not equivalent to pre-pandemic levels in all areas, and there is still significant regional and local variation.

Coverage of the first dose of HPV vaccine for secondary 1 pupils increased in 2021-22, with overall coverage rates of 73.5 per cent, in comparison with 52.1 per cent in 2020-21. By the end of S2, 86.4 per cent of females had received the first dose. While those statistics are welcome, however, I ask the minister to ensure that the Scottish Government is doing all that it can to enable HPV vaccine take-up.

I want to touch on screening also. We know that screening is key to both preventing cancers developing more widely and detecting cancers at an early stage, when treatment is more likely to be successful. Cervical screening aims to identify whether a person is at higher risk of developing cervical cell changes or cervical cancer, which enables them to access treatment quickly.

Self-sampling as part of screening for HPV is an area that I have been pursuing. I know that the Scottish Government is pursuing that also. In the previous session of Parliament, I was made aware that 6,000 women in Dumfries and Galloway had defaulted on their invitation to attend their screening smear test. That meant that 6,000 women were being missed. I met Dr William Forson and Dr Heather Currie, who, along with their team, were attempting to improve screening numbers by introducing a self-sampling approach, which they wanted to test for effectiveness in addressing the women who were failing to accept and attend the invite to screening.

I am pleased to hear that that approach has now been picked up by the Government. There are benefits to self-sampling. Home tests, away from clinics and general practices, offer people a choice of place. There is no interruption to work or travelling to an appointment necessary, and there are no other barriers to the take-up of cervical screening.

As we have heard already, some women find the intimate examination that is involved in having a smear test very difficult, painful, distressing and embarrassing. Self-sampling for HPV is one way to help increase screening uptake, especially for women in remote, island and rural areas such as my South Scotland region. I was one of the defaulters who were contacted by NHS Dumfries and Galloway, and I had the opportunity to take part in the self-test trial, so I would be grateful if the minister could provide an update on the status of home sampling and on whether there are any findings about its success.

During lockdown, I attended a Jo’s Cervical Cancer Trust online meeting with women who were part of the Wigtownshire Women and Cancer charity. It was an excellent presentation. The Jo’s Trust representatives were fantastic, and they supported a continuation of engaging with women and supporting them in taking up their screening. I encourage women to do the same.

Again, I thank Ruth Maguire for securing the debate, and I look forward to hearing the minister’s response.

Dr Lamont, I want to pick up on what you said about amplifying the patient’s voice and about avoiding harm in the first place and addressing concerns. I will use an example that I used last week. People in the south-west of Scotland get radiotherapy in Edinburgh, which means that on their way they pass within 4 miles of the Beatson cancer care centre. I think that it is a 240-mile round trip. People’s voices in the south-west of Scotland are not being heard when it comes to cancer pathways, for instance. Harm has not necessarily occurred, but the simple fact of being those miles away from their family, Monday to Friday, might lead someone to drop out of radiotherapy. They might say, “I’m fed up. I’m no doing it any more.” Is that something that the patient safety commissioner could consider? They could go to NHS National Services Scotland or Healthcare Improvement Scotland—whichever pathway it is—to help to sort it out.

I am also thinking about what you said earlier. In my notes, I have written “listen, advocate, champion”. I am thinking about risk assessment and risk management, and about being heard. I do not know if that has been missing in the past. That might have been Fraser Morton’s experience.

One of the first things that the website of Healthcare Improvement Scotland says is that

“the affected person receives the same high quality response”

and that

“organisations are open, honest and supportive towards the affected person, apologising for any harm that occurred”.

That information was an update about adverse events that had happened previously. I am interested to hear about your experience of interacting with the current systems of scrutiny and clinical governance. Where are the gaps and weaknesses in the current systems? How will the patient safety commissioner help to fill those gaps? Perhaps Fraser Morton would like to come in on that.

Good morning, everybody. Thank you for coming. What are your thoughts on whether the patient safety commissioner for Scotland should have a wider remit than that of the commissioner in England, for example? That would go wider than mesh, sodium valproate and Primodos.

I will pick up on some of the questions about the patient safety commissioner’s remit. Baroness Cumberlege’s report wanted the commissioner to look at medicines and medical devices, which is what the commissioner in England is doing, but the remit here seems to be broader. Thinking about all the people who are involved in promoting safe patient care, there is a bit of a crossover that I am worried about. I am interested in how the panel feels about widening the remit to enable the patient safety commissioner to hear from people who have had poor experiences.

My question might be more relevant for the next panel of witnesses. I am thinking about the system for reporting incidents, which is perceived as punitive by healthcare staff. It is better to deal with near misses than to wait for a significant adverse event. My background is 30 years of operating room nursing. It is highly technical. It is very unsafe—not in the sense of the practice, but there are sometimes so many barriers, and it is a team-driven environment. Errors are not intended, but the Swiss cheese model comes to mind when we talk about patient safety.

I am interested in hearing your thoughts about how we need to encourage the reporting of incidents so that we can put effective measures in place to prevent them and about how that would support a patient safety commissioner’s work to look at encouraging reporting so that we can develop safer methods.

I welcome the opportunity to ask about levelling up in the chamber. It seems that one of the UK Government’s central tenets is that its fund should bypass the Scottish Parliament entirely and avoid the inconvenience of democratic oversight. That is in contrast with what happened with decades of European Union structural funding, which was allocated through co-ordination between the European Commission, the Scottish Government and local communities, and was delivered through the LEADER programme, for example. Does the minister share my concern that Westminster has encroached on devolved responsibilities and failed to engage with communities directly?