Seòmar agus comataidhean

Given that the underlying aim of the bill is to protect public health, I am content to look at that.

If I have understood you correctly, you are saying that the antidote, because it is a separate prescription, needs to be held on the premises to ensure a timely intervention. That is exactly why we are saying that we need healthcare clinician specialists on site when the procedures are being carried out.

Owen Griffiths is champing at the bit to say something.

As I said to Dr Gulhane, we are still in discussions with the UK Government to understand what we can do as a result of the United Kingdom Internal Market Act 2020. When HIS is regulating specific businesses, there is a provision in legislation that says that those businesses need to be staffed appropriately. Our work on supervision runs in parallel with Healthcare Improvement Scotland and with the work that we are doing on UKIMA.

At this time, I cannot say how many people would be required to be supervised. That will be worked through once we understand the level of training and qualifications and the regulations that Healthcare Improvement Scotland deems appropriate to ensure the proper, robust regulation of those businesses.

As Owen Griffiths said, that is currently the situation with HIS-regulated premises. We are currently looking at whether that would be the requirement in this instance. It is about striking a balance and ensuring that each place to which people can go for such treatments is as safe as possible.

That is a really important question, and we will be discussing it in more detail with HIS. A key element of the bill is that premises are properly regulated, hygienic and safe. That is the work that we are currently doing with HIS.

Paul Sweeney makes a really good point about how we ensure that good businesses can reach the right standard and undertake the regulatory regime that we are introducing.

As I said in reply to an earlier question—which might have come from the convener—we have been actively looking at support for businesses while we have been drafting the bill. We will continue to do so and will take on board the point about incentives.

They are graphic, yes.

I cannot comment on mortality, but perhaps Kirstie Campbell can give more information.

Yes.

Thank you for inviting me to provide evidence today. Addressing concerns about the new model of neonatal care is very important to me, so I am pleased to be here to talk about the petition. First, I will address a point made at the previous committee meeting and make it absolutely clear that no units are closing as part of the new model of neonatal care.

In 2023-24, around 4,500 babies were cared for in neonatal units. Just over 800 were admitted to intensive care. The majority of those babies need intensive care for only a short period—less than 48 hours. A small number need longer, highly specialised intensive care. For those babies, the complexity of that neonatal intensive care has increased, particularly for babies born at extremes of prematurity or with extremely low birth weights.

As the committee heard from Stephen Wardle of the British Association of Perinatal Medicine and Andrew Murray and Jim Crombie, the chairs of the best start perinatal sub-group, the clinical evidence shows that outcomes for the smallest and sickest babies are improved when they are born and cared for in a unit with a high throughput of cases, defined as at least 100 new, very low birth weight admissions per year and where support services are co-located.

That evidence underpinned the best start recommendation and also the professional guidance published by the British Association of Perinatal Medicine. As defined in the guidance and as highlighted by Stephen Wardle to the committee, local neonatal units will continue to provide a level of intensive care and be able to care for singleton births over 27 weeks’ gestation, with babies receiving care in one of the three intensive care units being transferred back to their local neonatal unit for on-going care as soon as possible. The best start report—“The Best Start: A Five-year Forward Plan”—was based on evidence and a range of expert clinical opinion. The options appraisal that followed, as you heard from Jim Crombie and Andrew Murray, was objective, followed evidence-based criteria and was undertaken by an expert group comprising clinicians with service users represented by Bliss Scotland.

I was disappointed to hear at the last committee meeting that colleagues raised again that NHS Lanarkshire was not present within the process. I have corrected that point many times previously, and I am grateful to Jim Crombie for further clarifying to the committee NHS Lanarkshire’s involvement in both the best start perinatal sub-group and the best start programme board. The members were appointed based on national roles that they represented, to provide an objective view to an evidence-based clinical approach. As the committee previously heard, having the right infrastructure in place is essential to support implementation of the new model and to optimise the parents’ experience.

When I announced those changes in 2023, I asked the regional chief executives to lead on detailed implementation plans that described how they would build capacity in the three units before commencing any changes. The Scottish Government also commissioned detailed capacity modelling to inform those plans. In addition, work is under way with the regional chief executives’ task and finish group to look at maternity capacity, financial modelling and cot capacity management. The best start report had family-centred care as one of its core principles. Among the earliest best start recommendations were the establishment of the neonatal expenses fund in 2018, now the young patients family fund, and the provision of accommodation on or near all neonatal units for the parents of the sickest babies. Other improvements include accessible psychological support services for parents, offered throughout their neonatal journey.

Since my appointment, I have been committed to listening to both families and clinicians from across Scotland, and I have seen at first hand the passion and commitment of the neonatal staff by visiting University hospital Wishaw, the Queen Elizabeth university hospital in Glasgow, and the new Royal infirmary of Edinburgh. I have also met with Wishaw neonatal campaigners and elected representatives on several occasions. I had the pleasure of presenting both Ninewells and Forth Valley neonatal units with their Bliss baby charter gold awards, recognising the care that those units provide and will continue to provide.

I also want to thank staff at Ninewells for their efforts in reassuring the local people that the new model is the right model. I want to put on record my thanks to all the neonatal nurses and consultants who do such a fantastic job in caring for babies and supporting families, and to thank Bliss for all its work for families at a time when they need that support the most, and their work to advocate for those families in national policy. I recognise that families will be concerned about the change, but I want to provide reassurance that this decision has been made in the best interests of the very smallest and sickest babies.

I thank the committee for listening carefully to the evidence of those involved in the process, and for taking time to visit Wishaw university hospital.