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Data has shown that the number of mental health related calls to NHS 24 increased from 20,434 in 2019 to 139,008 in 2022, which by my calculation is a 580 per cent increase, which is an extraordinary number. Has that overwhelmed you? It seems an incredible figure that is not necessarily proportionate to the extra resources that you have been able to put into the service. How have you been able to adapt to that significant increase in demand?

From what you are saying, that certainly sounds like a promising process improvement, and I hope that it will yield significant results. You mentioned that one of the key sticking points is the interface with emergency departments at acute hospitals. Last week, we heard about a pilot that is being trialled in some health boards to ease demand on emergency departments, whereby ambulance crews phone ahead to speak to an emergency medicine consultant, who decides whether it is best for the patient to be presented to the A and E department or to a different facility. Do you have an insight on the system that is being trialled? Could it be scaled up to ease demand on emergency departments on a national scale?

It seems to be clear that the dental and mental health areas are significant parts of the overall healthcare system that are under serious pressure. How sustainable is it for NHS 24 to be the first point of contact, and how effective can it be to refer on when there is not the capacity in the other services to which you are signposting? Do you feel that that approach is sustainable as part of the overall model?

My final question is about the interface between Police Scotland and NHS 24. We know that there has been an increase in the number of call-outs for the police to attend mental health-related incidents in the community. Do you refer people to the police? Are people contacting NHS 24 instead of the police? Is that a more appropriate presentation? Can you provide any analysis of that?

The context is the severe budgetary pressures that are being faced by healthcare, so it is not just about demand. The mental health budget has, in effect, been frozen in cash terms this year, with the cut to mental health being restored to bring it back to the level that it was at last year. What impact has that had on your services? Have you been able to offer an alternative interface or are you feeling the pressure as well?

Thank you for joining us today. I have a question regarding the codes that were mentioned in your submission. You indicated that red and purple are assigned to emergency calls, but, despite those emergency markers, I understand that red or purple call patients can still wait hours to get a response. I am familiar with one constituency case in which a red call patient waited six hours and 50 minutes for a response. Paramedics and your team are trying exceptionally hard in impossible circumstances. What can the Scottish Government do to support the service and improve response times to such critical calls, and how can the system improve the flow of returns?

You mentioned that flow navigation is implemented in one form or another across all territorial boards. You are in a fairly unique position in that you sit across all those boards and have that perspective. How dynamic and adaptive are the territorial boards in sharing best practice? Are you able to indicate where approaches are doing well elsewhere that could be adapted across the nation as a whole and bring everyone up to a higher performance level?

I want to pick up an issue that is frequently raised by police officers, which is the amount of time that they spend dealing with cases that they do not feel qualified to address or capable of dealing with. The number of calls made to Police Scotland in which a mental health crisis or a suicide risk was cited increased by almost 10,000, from 14,540 in 2018 to 23,406 in 2022.

You mentioned the pilot of triage cars, three of which are operating in Scotland at the moment. Do you feel that there is an opportunity to look at a business case to expand that model if it is shown to be a more effective and more cost-effective solution, given the huge costs that are incurred by the police in responding to incidents involving people who have a known history of calling the police on such issues or incidents with which they are not qualified to deal when they arrive at the scene?

Sections 10 and 11 of the bill as drafted outline the requirement for the commissioner to prepare a report following any formal investigation, as well as the requirement for a person to respond to any recommendations made to them in a commissioner’s report.

Amendment 22 would give the commissioner the power to make a special report if it were to appear that recommendations made in their initial investigation report had not been, or would not be, implemented. A special report would be sent to the persons to whom the formal investigation report was sent in the first instance, and a copy would be laid before the Scottish Parliament. Further, the report could also be made public if the commissioner considered that to be appropriate.

In committee evidence, patient groups cited a need for accountability. Marie Lyon, from the Association for Children Damaged by Hormone Pregnancy Tests, said that, up to now,

“people have tended to get away with it. There has never been accountability and there have never been consequences.”—[Official Report, Health, Social Care and Sport Committee, 7 February 2023; c 22.]

Where there is a concern about patient safety, and where changes need to be made, bodies cannot be left to mark their own homework. The commissioner can be effective only if they have the ultimate option of escalating matters if recommendations are dismissed or ignored by the relevant authorities, and I believe that my proposed amendment would give the commissioner the teeth that they need in order to ensure that necessary changes are implemented. I believe that that would be a proportionate enhancement of the commissioner’s powers.

I move amendment 22.

Amendment 24, in my name, would ensure that private companies supplying medicines and medical devices are captured in the category of person who would be required to provide information under section 12 to inform investigations undertaken by the commissioner. There is a lack of clarity over whether the commissioner’s proposed powers to require organisations to provide information will apply to private companies, given that section 12 refers only to “persons” or “healthcare providers”. Amendment 24 seeks to insert a definition that ensures that, for the purposes of this section, the term “health care provider” also includes companies in the private sector that provide medicines and medical devices. I think that that is a reasonable definition.

I should also say that we will support the Government’s technical amendments to the language in section 12. We would therefore be eager for the minister to at least consider revising her position on amendment 24, as I think it entirely reasonable that we clear up the definition.