Seòmar agus comataidhean

I will come at the question from a slightly different angle, given the origins of the proposals for a patient safety commissioner. The issues that were raised were from the 1960s, the 1970s, the 1980s and up to the 2000s. We are looking at a different landscape, and those were the foundations for the need for a patient safety commissioner. In written and oral evidence, people consistently said that patients’ voices were not being heard, with patients perhaps feeling that they were not being believed. People wanted the commissioner to be an advocate for those voices and to raise concerns about issues relating to medication side effects, medication devices and so on. In Scotland, the patient safety commissioner’s remit will be wider than the remit of the commissioner in England and Wales.

Deprivation and austerity will play a part, but the issues that have resulted in the patient safety commissioner have a much deeper history.

I do not think that there has been any further correspondence with the committee, but I am certainly happy to check with clerks and update Mr Marra and other members on that.

That is an interesting question. I hope that perhaps your committee will look at some of those issues around the public’s perception of commissioners and recognition of their role. I imagine, from my casework, that the Scottish Public Services Ombudsman probably has the highest profile of those organisations, but I am sure that some commissioners have profiles that are not as high as stakeholder organisations hope that they would be.

The committee wanted to make sure that the commissioner would make the public more aware of their role and set out the fact that they would not take on individual complaints. Other commissioners could perhaps look at that.

There is certainly the opportunity for the patient safety commissioner to ensure that there is accountability. One of the things that struck me when reading through the evidence was that stakeholders, professional organisations, professional regulators and individuals described the commissioner as potentially being the golden thread that could unify and unite patient safety and clinical governance structures, as there are numerous clinical governance structures, oversight organisations, professional regulators and so on. It struck me that, if patient groups and patient representatives felt that a patient safety commissioner would help to amplify their voice, it would be worth their while to have such a commissioner.

There absolutely must be reviews and accountability, because we are talking about public money. We want the commissioner to succeed in allowing people’s voices to be heard—particularly voices that are heard less often—in ensuring that all healthcare providers are accountable for their practice and for the care that they deliver, and in ensuring that issues, particularly those relating to medicine and medication devices, are highlighted at the earliest opportunity, because, as was reflected in the Cumberlege review, that is not happening at the moment.

One of the key things is the independence of the role. The commissioner has the freedom to define and establish the principles underpinning their work, and the scope and remit of their work. One of the committee’s recommendations was that patients should be given the opportunity to provide input into the scope and remit of that work. Perhaps that is not as evident in other commissioner roles that involve looking at patient safety or in other bodies that look at assessing medical devices and medicines. It was generally accepted by stakeholders that there was a need for the role, and that was certainly reflected in the written evidence that the committee received and in its evidence sessions.

Yes, please.

We move to Carol Mochan.

I have a follow-up question about reformulation, which was mentioned earlier—in particular, reformulation of drinks in anticipation of introduction of the sugar tax. We know that sweeteners can have adverse effects and that they do not make drinks any less sweet. I take on board what Mr Gulhane said: they might change the taste, but they do not make the drinks less sweet, so they do not retrain the taste buds. To what extent, do you believe, is replacing sugar with artificial sweeteners the correct approach?

I thank the witnesses for their attendance this morning. Next week, the committee will not be meeting, as we will be undertaking external engagement in Skye as part of the committee’s inquiry into healthcare in remote and rural areas. That concludes the public part of our meeting.

Dr Cass, what key conclusions in relation to future provision for gender services would you want practitioners in Scotland to draw from the review?