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Thank you for raising that question, because I know from watching the evidence that the definition of supervision is playing on a lot of people’s minds.

As I highlighted in my opening statement, we have not included specific provisions on that in the bill, because we are still in discussions with the UK Government on the United Kingdom Internal Market Act 2020. It is the view of the Scottish Government that part 3 of that act would be engaged by legislation that set training standards in this area. We want to ensure that we have the right conversations and make the right decisions about training and supervision. That is covered under section 5 of the bill, which will allow us to make secondary legislation on such matters.

Our conversations and work with the UK Government have been progressing. Both the Department for Business and Trade and the Department of Health and Social Care are involved. I will write to the UK Government, probably later this week, to see how we can make progress. Sadly, however, one of the unintended consequences of UKIMA is that we can no longer make specific decisions on public health that we could have made when we were part of the European Union.

I thank Mr FitzPatrick for pressing that issue. In drafting the bill, we have always been clear that there is a difference between healthcare need and the aesthetic wish to have certain treatments. If I go back to my past life, I used to work with the BBC Scottish Symphony Orchestra. Two of the players had specific issues that affected their ability to play, and both were prescribed Botox injections. Children living with cerebral palsy can also get Botox injections. Therefore, we must ensure that that element of healthcare is not lost. With regard to chiropractors, they can give a hyaluronic acid injection to reduce joint pain. That is another aspect. However, I am content to take the issue away, given that it has been raised by both you and Dr Gulhane.

As you will know, Ms Harper, the MHRA is a reserved body, but you have highlighted the exact issue that we are trying to cover by saying that a healthcare specialist needs to be there in case something goes wrong. That has been the premise behind permitted premises with the right qualified staff and the regulations from Healthcare Improvement Scotland. As I said in my response to Mr FitzPatrick, I am happy to provide you with further information on that.

That is always a concern when bringing in regulations. I have been asked whether we are introducing the regulations too late, and my response has been that, when it came to driving safety, it was not too late to bring in rules on wearing seat belts in cars. It is important to recognise the need to regulate in this area in order to improve public health and safety, but we need to enforce it well, too, and that is why we have been working with Healthcare Improvement Scotland and environmental health officers.

We have said that we will bring the act into force on 6 September 2027. I have not had any conversations with officials on whether there will be a phased introduction, but I am happy to come back to the committee on that.

I will ask Rachel Coutts to answer that from a legal perspective.

Thank you. I am pleased that, in the bill, we are also considering two amendments to the Certification of Death (Scotland) Act 2011, to extend the right to request an interested person review and to amend the provision concerning the authorisation of cremation in Scotland when the death has occurred elsewhere.

The extension of the interested person reviews set out in the 2011 act represents an important step in strengthening public confidence in the death certification process by allowing all relatives equal standing in being able to request an interested person review. Medical reviewers already undertake randomised reviews to improve the quality and accuracy of medical certificates of cause of death, but where such a review has taken place, an interested person review cannot then be carried out. The amendment allows individuals with a legitimate connection, such as family members, healthcare professionals or funeral directors, to request a detailed review where they believe further scrutiny is warranted. It will mean that interested persons can request a review, irrespective of whether a medical certificate of cause of death has been randomly selected for review already.

With the bill enabling further targeted reviews, all bereaved families will have the same right to request a review. The system will be more transparent and responsive, ensuring that specific issues can be examined thoroughly and sensitively. Ultimately, this amendment will enhance accountability and provide an additional safeguard to reassure the public and professionals who are involved in end-of-life care.

On the other amendment set out in the bill, section 18 of the 2011 act currently applies to deaths that occur “outwith Scotland”. That includes deaths that occur in other parts of the UK, thereby creating a legal requirement for medical reviewers to authorise cremation in Scotland where a person has died in England, Wales or Northern Ireland. Other UK nations have robust procedures in place for death certification and apply relevant checks, and it is appropriate for those procedures to be respected in cases in which it is intended for the deceased to be cremated in Scotland. The amendment set out in the bill will remove the need for medical reviewers to authorise cremation where a death occurs in another part of the UK, thus recognising the reciprocal checks in other parts of the UK and avoiding unnecessary duplication of work.

The extension of interested person reviews and the amendment to section 18 of the 2011 act reflect our continued commitment to clarity, transparency, and public trust in the death certification process. The changes will not only strengthen safeguards for families and professionals but ensure that our legislation recognises existing robust checks and procedures and is responsive to real-world practice.

I therefore propose that the committee recommend the extension of interested person reviews and the amendment concerning the authorisation of cremations in Scotland where the death has occurred outwith Scotland, and I look forward to answering any questions that the committee might have.

I will pass that question to Katrina McNeill.

As I said in my introductory remarks, there will be no change to the fact that people can have reviews. That has always been the case, and people should be informed of that and aware that they can do that. The change just ensures that, if a case is randomly chosen for review, it will not stop a connected person—whether it be a member of the family or a healthcare professional—asking for a further review.

The ability for people to have a review is already there. However, what I am taking away from this is that it is, perhaps, not known widely enough, so we should probably take the issue away and look at it.