Chamber and committees

I will pick up the point about international collaboration and working together. We are talking about a small number of persons who are seeking care in relation to gender. In my previous job as a registered nurse, I would look at what people were doing in England, Ireland and Wales, and when I worked in California, it was the same thing—you network with the people who are specialists. That would be part of the engagement of networking with people who provide specialist care, such as researchers, doctors and so on. I imagine that that is what Professor Sir Gregor Smith is talking about. We are not just waiting and watching in Scotland for somebody else to take action: there has been participation and collaboration from the start.

This will be my final question. Has the decision to stop self-referrals had any impact on the length of the waiting list?

I forgot to make it clear earlier that I am a former NHS Scotland and NHS England employee and am still a registered nurse.

I come back to the point about having a multidisciplinary team approach. We know that the skills that are required are specialist ones. Who would be in such an MDT?

I go back to what you said about multidisciplinary teams. When the Minister for Public Health and Women’s Health gave her statement on 3 September, she said that there would be a move to a more distributed network, with a more regional model and a multidisciplinary team approach, which you have already described. What might such a regional model look like, especially when we are already struggling to staff services?

It is about having knowledge and skills in the right areas. For example, neurodiversity is linked to gender dysphoria.

I welcome the opportunity to speak in the debate, and I congratulate Emma Roddick on securing it. Having listened to what she has described this evening, I value her knowledge and input. I recognise the concerns that she highlighted in her motion, which reflect my own findings regarding misinformation, extreme nonsense, fake news and the use of AI by bad actors to damage reputations, to exploit people and to harass victims, especially in relation to violence against women and girls. We know that that must be addressed, where possible, by regulation and legislation.

However, it will come as no surprise to colleagues across the chamber to hear that I intend to speak about the potential of AI in healthcare, given that I worked in a tech-driven perioperative environment as a registered nurse.

As we have heard, “artificial intelligence” is a broad term, which spans everything from simple decision trees that are akin to flow charts to complex large language models and generative AI, an example of which is ChatGPT. The risks that are posed by each type of AI are different, and it is important that we are careful not to unintentionally tar all AI models with the same brush. The risks with simpler AI and even machine learning are low in comparison with those that are associated with the deep learning that is used by platforms such as ChatGPT.

It is important to note that we have been using AI safely in healthcare since 2010. We introduced AI to replace the second clinician in our double-reader national diabetic retinopathy screening service. We also use AI in dynamic radiotherapy treatment, paediatric cardiology, paediatric growth measurement and the use of radiology for medical image acquisition, including in CT scans. Therefore, it is important that we carefully consider the risks of not implementing AI, as well as the risks and benefits of implementation. A balance needs to be struck, and we must remain cognisant of the fact that overcaution could lead to slower progress in positive healthcare outcomes.

For example, recent evidence from trials of AI to prioritise cases of suspected lung cancer in Scotland indicates that around 600 more people each year might survive the disease as a result of the introduction of AI alongside other measures to optimise the pathway. It is so important that we create a balance and recognise the distinction between different types of AI, and I ask the minister to keep that in mind when it comes to the development of AI policy.

The performance and risks of AI are highly localised to the context in which it is used and deployed. It is impossible to remove all risk in advance of implementation, and it is essential that we proceed to implement AI. The only way to mitigate and manage risk is to understand the risks, and I suggest that that should be done in healthcare through controlled AI. I recently engaged with a healthcare AI expert, who made the point that, in healthcare, the focus is and must continue to be on humans plus AI, not humans versus AI.

I turn to the need for legislation and regulation on the use of AI. To address Emma Roddick’s point about the dangers of AI, legislation, regulation and policy must all help to make AI safer. It is especially important that we focus on the standards that are necessary in implementing the use of AI in public service. For example, the medical device regulations already govern the use of AI in relation to the investigation, diagnosis, treatment, prevention, monitoring, prediction, prognosis and alleviation of disease, injury or disability.

I am conscious of time, Presiding Officer—you told me that I had up to four minutes. I recognise and agree with what Emma Roddick has described effectively. I highlight the fact that we can and should progress the use of AI, but we need to manage and mitigate any dangers and risks.

We might have strayed a wee bit from the technical aims that the SSI is supposed to be achieving. There has been a lot of discussion about rebasing, retargeting—however we want to describe it—and co-design. Part of what needs to happen is the promotion of trust and engagement, including with young farmers, new entrants and our next-generation farmers, and that is what seems to be coming out of this.

However, I want to bring our discussion back to the fact that we are supposed to be approving the statutory instrument so that payments can continue. Am I correct in understanding that this is a technical instrument?

Good morning, minister and officials—thank you for being here.

You say that 2030 is the backstop, but that does not mean that 2030 is when people will start doing the work and making the changes that are needed for all the different schemes, including those that you have discussed. It is not just about LFASS; there are other issues around suckler calves and so on. A lot of schemes need to be developed, and my understanding is that resources are already driving those changes forward.

In the past fortnight, the committee has received a lot of evidence from different people that shows that there is a level of concern. One response says that you

“gave assurances that this does not necessarily mean that schemes ... will go to 2030”.

Can you reassure the committee that, should we approve the SSI today, although 2030 will be the backstop date, that does not mean that nothing else will happen before then?

I quickly put on record that my understanding is that this is a technical statutory instrument. I hear what Rachael Hamilton is saying about the wider issue and the number of people who submitted responses to this statutory instrument. It shows that, as the co-design of the policy moves forward, work needs to be done to promote trust and to engage with the rural and agricultural sector, new farmers, new entrants and all of that. This is a technical instrument, but it highlights and uncovers wider work that we need to be sensitive to when engaging with stakeholders.

Thanks.