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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 22 April 2025
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Displaying 710 contributions

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Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

Certainly. I would expect the committee to be involved in how the role develops, and to meet and speak to the commissioner. The Government will undoubtedly be interested in what the commissioner has to say and their early thoughts on how the role should develop, the remit of the role and the priorities that they want to set. I think that we will find that, as the role evolves, each commissioner will bring a different flavour. However, it is important that the Scottish people hold that commissioner to account.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

Undoubtedly. We will be watching. I imagine that our commissioner will be looking very closely at what is happening in England and will work very closely with that commissioner to see exactly how they are working and how that role is developing. Our commissioner will have a slightly broader remit than the commissioner for England, who is focused largely on medicines. Is that right?

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

I absolutely appreciate the challenge and the tension there. It will be tricky to get that right. However, our ambition should be to be as broad as possible to ensure that we can deal with all of the concerns that patients raise. As I have said before, it is a complex landscape with many people operating in different ways. It is really important to have a patient safety commissioner who will help to draw all the information together.

I do not think that it will be the norm for the patient safety commissioner to have to carry out inquiries themselves, so I do not think that there will be duplication of effort. I would still expect bodies such as HIS or the ombudsman to carry out inquiries when issues are raised with them. However, I would expect the commissioner to be looking at the evidence that those organisations find and pull it together, in order to help patients navigate that complex landscape and to pick up on systemic issues given that opportunities to identify those have been missed in the past.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

I guess there is the tension; are they patients when they are in social care? The patient safety commissioner will be very focused on patient safety.

As social care develops, people are looking very carefully at how to build in some of the systems that are focused on safety that are used in the NHS. At the moment, however, the focus of the remit should be on healthcare. It should not cover social care. If it was to be broadened to cover social care, the role might well be too broad initially and we could lose the essence of what the patient safety commissioner is about. That would be the concern.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

You are right about care and compassion. We brought in a duty of candour in 2018. That duty does what it says on the tin. It is about trying to remove the defensiveness and hostility that sometimes comes across when patients are trying hard to understand what has happened and why outcomes have been the way that they are. We very much want the role of the patient safety commissioner to be on inquiry and helping the system to learn. We want them to look honestly and openly at what has occurred and try to learn the lessons compassionately to ensure that that does not happen to patients in the future. It is about care and compassion. There is probably also a role for helping people who have been bereaved to understand what has gone on. I can see that that would be a powerful role for the patient safety commissioner.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

I am bound to say that I think that we have got the balance right. I can understand where Paul O’Kane’s questions are coming from, as it is difficult to get that right. However, as I have mentioned, a key point is that we do not want it to become another organisation that is looking to apportion blame. That is the last thing that we want. The two absolutely key things that we want from the patient safety commissioner role is for the patient’s voice to be heard and for the system to learn lessons. Those are really key.

I think that there are enough powers to make sure that the commissioner can inquire and take action, that Government has to listen to them and that there is an accountability to Parliament. However, as with any new role, there will be lessons learned and evolution as we go along.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

We might, and as I have said, I am open to that possibility. As the role develops and is evaluated by Parliament, that might well be an issue that we as parliamentarians will need to consider.

However, the commissioner might develop a really slick way of working with all the other organisations that do such jobs and be able to help individuals to navigate the system. It is very clear, for instance, that individual patients do not know how to get their issues investigated or how to get an appropriate resolution from the healthcare system. The commissioner might therefore develop in a very slick way and help patients to navigate the system and ensure that their voices are heard, as well as picking up on those systemic issues that we have not been fast enough or slick enough at picking up on in the past.

That will depend on how well the commissioner works with all the organisations in this space. That collaboration will be absolutely key.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

I would say that the need is well established. We have shown and demonstrated that such a role is currently absent and that it would help to prevent harm.

The types of harm that I would envisage the patient safety commissioner picking up on and preventing are not only devastating for patients but often very costly to the system. Therefore, I think that this is a reasonable investment to prevent harm. We have established that the current system is not managing to prevent harm in the way that we would have hoped that it would.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

Absolutely. That will be part of the dialogue when that person is in post. We will undoubtedly be interested to hear what the commissioner thinks that their priorities are and how they intend to measure the outcomes and demonstrate robustly to Parliament and to other interested parties that they are doing the job that we intended them to do.

Health, Social Care and Sport Committee

Patient Safety Commissioner for Scotland Bill: Stage 1

Meeting date: 14 March 2023

Maree Todd

Yes, absolutely—I think that that is clear.

It is not that the commissioner will never do investigations; we have given them some investigative powers because we think that there may be occasions on which it would be useful for them to do that. By and large, however, other organisations will do that work.

Nevertheless, I think that listening to individuals is important. Awareness of the big tragedies that I have mentioned a couple of times this morning started with one patient speaking up and then grew. It is important that the patient safety commissioner is able to listen to patients and pick up on the noise from the system. It seems to me that we do not currently have an organisation that is able to do that.

When such issues have arisen before, that has occurred as the result of an individual situation—nobody has been able to put it together. The patient safety commissioner will be able to put together that picture and listen to the noise from the system.