Seòmar agus comataidhean

Yes, of course.

I am detecting an openness to consider the matter, as social care and the role of the PSC develop, and that there can be a conversation on that.

Thank you, convener. Good morning.

In evidence, the committee has seen a high degree of support for the patient voice, but it is important that we explore the staff voice, too—especially with regard to whistleblowing processes and provision of safe spaces for staff to communicate their concerns and to add to intelligence on what patients are saying in the process. Therefore, my initial question is whether, with regard to the role of the commissioner, there is a place for that and for engaging the staff in that way. That question is for Matthew McClelland, first.

I would like to expand that question for Amit Aggarwal. Should we explicitly include people from the pharmaceutical and health technology industries? Should the commissioner engage with people in those industries in order to understand the bigger picture of what can go wrong and, thus, how we can take steps to prevent it?

Thank you and good morning, Dr Duncan and Dr Hughes. I am interested in the particular powers that you have in your role and the powers that we might seek to provide to our commissioner in Scotland. When we talk about the establishment of a commissioner, everyone shows that they are keen that the commissioner should have teeth; that expression is used quite a lot. What powers do you have? Are there any powers in your role that you would like to be expanded? That is quite an open-ended question.

Thank you for that overview.

This morning, we had an interesting discussion with representatives of people who work in health and social care about whether the recommendations that are made to organisations and staff have to be more binding, being cognisant of the whistleblowing nature of making whole-system and lasting improvements. In your experience so far and your initial assessment of the role, would it be useful to you, and to us in the Scottish context, to have the ability to make binding recommendations or enforcement orders?

Do you sense that patients have responded well to that approach, in terms of feeling that they are getting to the answers and results that they need through that more collaborative and encouraging approach, or is there a sense that they want to see an option of last resort, almost, in terms of being able to enforce things?

Shaun—do you want to comment?

Thank you, convener. I am very grateful to the committee for permitting me to attend this morning.

I have an interest in the matter as a result of meeting Mr Barr, who is a constituent, and taking some time to tour Hawkhead cemetery with him. I have seen at first hand the impact that the policy has had on many of the graves of people whose families are still living and visit the cemetery regularly. I am also very conscious of the work of “friends of” groups that care for cemeteries, which are, of course, very important places for people who have been bereaved.

From my 10 years as a local councillor, I am very aware of the challenges that Councillor Wood outlined. On the whole, councils are genuinely concerned about upkeep of our burial grounds and cemeteries to ensure that they are respectful and dignified places in which we can take pride.

However, councils have also been very conscious of the health and safety implications that arose from the tragic fatality at Craigton cemetery in Glasgow, although I feel that a blanket approach, rather than a more nuanced approach, has been taken. Councils are very keen to comply with guidance that is issued by the Government.

Councils are required to ensure that they stress test and monitor headstones, but the challenge for them often relates to finance. It can be very difficult for local authorities to maintain the standards that we would expect in cemeteries without additional burdens being placed on them, given the local government financial settlement.

I recognise much of what the petitioners have said about the blanket approach of laying stones on the ground not being the best way to proceed. That can lead to bereaved families coming to a grave and finding that their stone has been lowered. There is a lack of communication, and communities in different areas interpret the guidance in different ways. That causes great distress.

It is clear to me that there is a cost impact, so we have to look at how we properly fund local government to do the more detailed and considered work that Mr Torrance referred to.

From a public health angle, I asked Maree Todd, the Minister for Public Health, Women’s Health and Sport, in a written question, whether there was any intention to provide a fund for local authorities to access in order that they can deliver what Mr Barr described as a rolling programme of making historical stones and larger stones safe. Unfortunately, the Government said in its response that there are no plans to provide such a fund. That might be useful information for the committee.

I am concerned that the issue is not just for local authorities. We have a number of private cemeteries in Scotland. Across the country, the Roman Catholic Church, the Jewish community and the Muslim community maintain their own cemeteries. For example, St Conval’s cemetery in Barrhead—one of the largest Catholic cemeteries in the country—is in my region. There might be cost implications, so we have to consider how the costs will be borne not only by local authorities but by religious groups.

If the Government wants councils to meet their obligations, it needs to be clearer about what the national standards should be. It is clear that the current blanket approach is not working. The Government has to provide funding for councils to maintain our cemeteries with the dignity and respect that we would all hope for.

Good morning to the panel, and thank you for your important testimony this morning. I want to expand on how the patient safety commissioner might understand emerging themes and patterns and so might be able to prevent some of the issues that we have discussed. To what extent do the witnesses think that their experiences are rooted in a failure to pick up on early signals of adverse outcomes? We have heard about some of that already, so I suppose that my follow-on is: what confidence do the witnesses have that the patient safety commissioner could improve the capacity to pick up on early signs of adverse outcomes?

I wonder whether Fraser Morton or Marie Lyon wants to comment on that.