Seòmar agus comataidhean

I am well aware of this petition; I was at the Citizen Participation and Public Petitions Committee meeting at which it was presented by the petitioners, and I know that other members in the room were there, too. I know the history behind it, and I am keen that we do not lose sight of rural health and social care needs and that we hear people’s voices.

The example that I have before me is the experience of people in Stranraer. A key issue that the petitioner has been trying to raise for 20 years now relates to the fact that NHS Dumfries and Galloway is part of the south-east cancer network and that, as a result, patients in the south-west of Scotland—which isnae in the east of Scotland—end up having cancer treatment in Edinburgh instead of at the closest cancer centre for radiotherapy, which would be in Glasgow. It means that, instead of just going up the road to Glasgow, people who are undergoing radiotherapy or other cancer treatment have to travel a distance that is pretty hefty for them.

My understanding is that, for 20 years now, Dr Gordon Baird, who is a retired GP and former chief medical officer at the Galloway community hospital, has been trying to look at ways in which we can hear the voices of people who live in remote and rural parts of Scotland, particularly Dumfries and Galloway—although, as we can see from the other petitions, the issue goes wider than that to, for example, Caithness. The question is how we support what is best for patients; it is not about telling them, “You’ll get your treatment where we tell you,” but about giving them the best opportunity to get the best care where they choose and reducing the issue of travel.

Currently, the people in question are means tested for their travel, whereas those in other parts of Scotland are not and get their care without having to cough up from their own finances. That is a health inequality issue, too—means testing people for their care should not be happening.

There are other issues regarding maternity services. I know that a review of the midwifery-led service in Galloway is happening right now because no baby has been delivered in Stranraer for four years. That is similar to the issue at Dr Gray’s hospital, which has been raised in the chamber of Parliament on a number of occasions.

My concern is that, for 20 years, little progress has been made to hear the voices of the people who live in remote and rural areas, whether that is in the area that NHS Dumfries and Galloway covers or more widely. If we in the committee do not keep the petition open and hear from witnesses, I am concerned that we might lose sight of what the real issues are for people in remote and rural areas.

I know that the Cabinet Secretary for Health and Sport said that he did not want to

“clutter a landscape”

that

“already has a fair bit of bureaucracy around it”—[Official Report, Health and Sport Committee, 17 January 2023; c 14.]

through the organisations, agencies and institutions that we already have. I am aware that the establishment of an agency is not the route that the cabinet secretary wants to take. I suppose that the big issue is how we ensure that rural voices are heard. We have raised the issue in debates and through questions in the chamber, but how do we get rural voices heard if we do not continue to pursue evidence taking?

I know that the petition calls for the establishment of an agency. I need to understand whether we need the petitioner to submit a new petition that addresses the specific issues with remote and rural healthcare rather than calling for an agency.

I am interested in the panel’s thoughts regarding the patient safety commissioner having sufficient powers to bring about improvements in patient safety. We already have the Scottish patient safety programme, which has been widened to look at maternity and neonatal primary care, paediatrics and medicines. I was part of the surgical safety stuff when I worked in the operating theatre in California, implementing the surgical safety checklist and things like that. Will the patient safety commissioner have enough powers to make safety improvements?

I do not have anybody in particular in mind.

I have a quick question. Looking at the report on your first 100 days, I see that concerns have been raised about electroconvulsive therapy and Covid vaccination. I am the co-convener of the cross-party group on mental health, and the ECT issue has come up with us, as well. There is a lot of fake news out there about Covid vaccines. Will your role help with concerns where evidence issues need to be addressed? Will it combat fake news, for instance?

Earlier, you talked about the value of your independence, and you are talking about listening to people and hearing their concerns. Are you already finding that people are engaged with and have trust in the role of patient safety commissioner for England that has been created?

In a previous evidence session, one of our panellists spoke about the Health and Safety Executive, enforcement orders and fines, and the patient safety commissioner’s potentially having those sorts of powers. Do you have any thoughts or opinions on whether the patient safety commissioner should be able to act in that way?

Thank you.

Thank you.

Dr Lamont, I want to pick up on what you said about amplifying the patient’s voice and about avoiding harm in the first place and addressing concerns. I will use an example that I used last week. People in the south-west of Scotland get radiotherapy in Edinburgh, which means that on their way they pass within 4 miles of the Beatson cancer care centre. I think that it is a 240-mile round trip. People’s voices in the south-west of Scotland are not being heard when it comes to cancer pathways, for instance. Harm has not necessarily occurred, but the simple fact of being those miles away from their family, Monday to Friday, might lead someone to drop out of radiotherapy. They might say, “I’m fed up. I’m no doing it any more.” Is that something that the patient safety commissioner could consider? They could go to NHS National Services Scotland or Healthcare Improvement Scotland—whichever pathway it is—to help to sort it out.

I am also thinking about what you said earlier. In my notes, I have written “listen, advocate, champion”. I am thinking about risk assessment and risk management, and about being heard. I do not know if that has been missing in the past. That might have been Fraser Morton’s experience.

One of the first things that the website of Healthcare Improvement Scotland says is that

“the affected person receives the same high quality response”

and that

“organisations are open, honest and supportive towards the affected person, apologising for any harm that occurred”.

That information was an update about adverse events that had happened previously. I am interested to hear about your experience of interacting with the current systems of scrutiny and clinical governance. Where are the gaps and weaknesses in the current systems? How will the patient safety commissioner help to fill those gaps? Perhaps Fraser Morton would like to come in on that.