Seòmar agus comataidhean

I do not know whether any of the other members of the panel want to comment, but I will ask one final question of you, Professor Conway.

You mention

“slow recovery of training and support”

for the programmes. Why is that, and how urgent is it that programmes for adult oral health are reinvigorated?

No, but he is accurate in saying that the first set of figures that he quotes were provided to me in answer to a parliamentary question, I think. I am happy to provide that information to the committee if you do not already have sight of it.

I am so grateful, convener. I did not know that I had such an interest in camper vans until now, but I suggest that the committee might want to consider a debate in parliamentary time, given the level of interest.

I acknowledge, convener, your own particular contribution to tackling the mesh scandal in Scotland, and I know that we will get a good hearing from all the committee.

I echo my colleague Katy Clark’s call for the committee to ask the Cabinet Secretary for NHS Recovery, Health and Social Care to give evidence on the issue and to give an update on all the promises that the Scottish Government made prior to the debate in January, as I have yet to understand whether those commitments have been fulfilled.

There is a need for a viable and safe alternative to mesh, and Maree Todd acknowledged as much in a previous committee meeting in June 2022, when she agreed that the skills gap between mesh and natural tissue repair needed to be bridged. I am keen to know what progress has been made on that.

Some patients have very recently had mesh inserted, and the petitioners have raised concerns that no discussion took place about the risks or the alternative treatments, if any, that could be offered. Patients in Scotland have the right to a choice and to make informed decisions about their healthcare, and medical professionals should be given the tools to answer patients’ questions about the risks and alternatives. It cannot be right that patients are relying on one another for information through support groups. Clear guidance needs to be in place and shared with all general practitioner practices across every health board.

I find it hard to believe, but the Scottish Government previously said that the mesh hernia repair used at the Shouldice hospital in Canada would not work for the Scottish demographic—I really do not understand why that would be the case. I believe that the opportunity remains to create a national treatment centre that properly offers alternatives and deals with the problems of mesh, and I wonder whether we can explore the matter.

We cannot continue to deprive those people who have had hernia mesh repairs of options for removal treatment. I would therefore be most grateful if the committee would do the petitioners and all of us a favour and press the Scottish Government in that regard.

Thank you very much, convener. I am very grateful for the opportunity to speak.

Gordon McPherson is, in fact, a world ambassador for world thrombosis day. He has been campaigning on this issue for 20 years, and I feel that I have known him for each and every one of those years. He is persistent, and rightly so, because he is asking the Scottish Government to raise greater awareness of deaths in Scotland that can be attributed to thrombosis, as you have outlined, and to show the risk factors, signs and symptoms to look for in order to reduce mortality and morbidity.

The petitioner lost his daughter, Katie, who was an occupational therapist, in 2003, when doctors at two hospitals failed to spot a blood clot in her leg and she was sent home with painkillers. Mr McPherson feels that if medical staff had been more aware of the risk factors, plus the signs and symptoms, Katie may not have died from untreated thrombosis.

The Scottish Government has not run an awareness campaign on the condition since 2011, and Mr McPherson feels that it is not treating the matter as seriously as is required. As a result of a lack of awareness on the part of both the public and medical professionals, he is concerned that there will be increased cases of thrombosis. He is keen that the Government does more than it is already doing. He is not looking for something that is hugely expensive—he has suggested practical stuff. For example, he has talked about blood clot alert cards, such as are available in Ireland. They inform patients of the risks and signs of clots and of the need to get medical attention fast in the event of a clot. That strikes me as something that the Scottish Government could do effectively without too much cost. He has raised issues such as that with the Scottish Government over the past 20 years and it has been particularly unhelpful in trying to progress the matter.

What makes the issue more significant—and is I think the reason why he has lodged a new petition—is that new research by the BMJ shows that, after a Covid-19 infection, there is an increased risk of DVT for up to 3 months, pulmonary embolism for up to 6 months and a bleeding event for up to 2 months after infection. The circumstances around thrombosis have changed since the Government’s last awareness campaign in 2011 when Covid-19 was not the health risk that it is now. In that light, I would be most grateful if the committee could consider whether it would be wise for the Government to take another look at public and medical professional awareness of thrombosis so that more lives such as Katie’s are not lost.

I definitely move amendment 15, convener.

I am surprised at the minister’s response, given the fact that the First Minister issued warm words on accepting the need for Milly’s law. Clearly, wires have got crossed somewhere.

My experience of what has happened for a lot of bereaved families is that public inquiries have been fought for; they have taken years to set up and conclude; and, meanwhile, families have had to live every day with the pain of justice delayed in relation to the loss of their loved ones. Making legislation clear is something that the Parliament should be about. Leaving things at such a high level that they are entirely open to interpretation is not helpful in cases such as the one that we are discussing. I was going to say that I would be happy to work with the minister and bring something back at stage 3, but, given the absolute nature of her response to me, I will press the amendments to a vote.

I am grateful to the committee for allowing me to come along to move amendment 14 and to speak to the other amendments in the group. I believe that they will go some way towards righting past wrongs and, if agreed to, will ensure that patients who have been seriously injured or harmed in a healthcare setting and—even more tragically—those families who have lost a loved one in such circumstances are never again left struggling to get answers and justice. In effect, this set of amendments is the basis for putting Milly’s law into effect.

The scandal at the Queen Elizabeth university hospital shows in all too obvious a way how families have to battle simply in order to get answers to what has happened. Even in recent days, we have heard horrifying stories of health boards spying on bereaved families who are seeking justice for their loved ones. I am sure that all of the committee will agree that that is absolutely shameful.

However, it is not the first time that there has been major injury or harm in a healthcare setting. Perhaps I can take as an example for the committee my own experience, with the Clostridium difficile scandal that we had at the Vale of Leven hospital and where having a patient safety commissioner would have been so valuable. I am minded—as we all are—that an independent inquiry is under way, and I do not wish to interfere with that process. However, with the Patient Safety Commissioner for Scotland Bill, we have an opportunity to ensure that families such as those of Milly Main and Andrew Slorance—and, indeed, the C diff families—will never again be left crying out for help, for answers, for support and, yes, for justice.

Let me address the amendments in turn. Amendment 14 would add to the duties of the patient safety commissioner for Scotland, meaning that they would be required

“to advocate for those affected by a major incident”,

while amendment 34 defines the term “major incident” itself.

Amendment 30 would introduce a new section to the bill relating to the commissioner’s role in becoming aware of a major incident, including their contacting

“patients affected by ... and the families of patients who died”

because of a major incident and providing

“relevant information including ... sources of support ... information on accessing legal advice and representation ... details of any investigations or inquiries relating to the major incident”

and advice to whistleblowers. Significantly, the amendment would also require the commissioner to consider initiating “a formal investigation” into an incident within one year of their becoming aware of it.

Amendment 31 would require the commissioner to

“produce and publish a charter for those affected by major incidents”.

The charter, which would be consulted on, would

“include ... the obligations of public bodies in relation to affected patients”

and their families, which will be critical in holding such public bodies to account. As an illustration, we know, for instance, that although the duty of candour may exist in principle in Scotland’s NHS, that is not the lived experience of those who have had to fight for answers.

Under amendment 29, where the commissioner completes a formal investigation, they would be required to provide a copy of their report into the incident to both the police and the Crown Office and Procurator Fiscal Service. The amendment also confirms that the report could be used in legal proceedings.

Although, under the bill as it stands, the patient safety commissioner does not have the power to “make ... redress”, “assist” those “seeking redress” or “opine on” actions that should be taken in relation to individuals, amendment 15 would ensure that major incidents, specifically, are exempt from that. That will, of course, be critically important.

The amendments would empower the patient safety commissioner for Scotland to be an advocate for people who have been let down by the system in a healthcare setting and ensure that the people who are affected by such scandals are supported in knowing their rights and getting the appropriate help. We must ensure that those people are listened to and that thorough investigations that can be used in legal proceedings are undertaken. Most important, this is about getting answers.

I move amendment 14.

Although I am disappointed at the outcomes on my other amendments, God loves a trier, so I will move an amendment one last time, and I indicate to the committee that I will be bringing back all the amendments at stage 3.

Amendment 34 moved—[Jackie Baillie].

Thank you very much, convener. I point out that John Urquhart is in the gallery, such is the interest in the petition.

Far be it from me to pick up the convener on something that he omitted to say, but I invited committee members to come and have a look at the area in question. Admittedly, in doing so, I said that it was the summer—there are 14 days to go until the summer commences—but I look forward to a response and a wee trip up the side of Loch Lomond for the committee.

Whichever route is preferred—whether it is the low road, as Transport Scotland suggests, or the high road, as the petitioners’ suggests—the issue is whether a STAG appraisal has been carried out. We are talking about a significant amount of investment, and such an appraisal

“is required whenever Scottish Government funding, support or approval ... needed to change the transport system”

is being considered. Through the STAG process, there should be wider consideration of the transport project, such as the benefits that would be accrued to people living in or visiting the national park. Consideration of place, not just project, is required. What local people want must be considered, and—dare I say it?—the project has significance because it is in Scotland’s first national park.

I will take the points in turn. In its submission, Transport Scotland agrees that a full STAG appraisal has not taken place. Instead, it says that its approach was underpinned by STAG and DMRB principles. With the greatest respect to Transport Scotland, that is not the same. It is taking the principles and applying them but not doing a full STAG appraisal. It considers that that is

“consistent with STAG appraisal requirements”,

but that is a bit like Transport Scotland marking its own homework.

The petitioners have raised questions about the costings of tunnels and exaggeration of costs. Cycle paths have also been included where there was no need for them and the costs of disruption have been underestimated. That all serves to distort the conclusions that Transport Scotland has reached.

A STAG appraisal would allow those issues to be corrected but, much more important, it would consider place issues as well. For one thing, it would consider the impact on the economy and the lives of people who live in Tarbert and Ardlui. It would also consider the impact on the national park, which we should treasure and conserve.

I will turn briefly to the national park authority’s response to the committee. Perhaps it is the fault of our process, but it almost seemed to be responding as a statutory consultee. However, the matter is much wider than planning, so it is not about the authority’s response as a statutory consultee.

It is fair to say that the national park authority does not like either option. It does not like the option presented by Transport Scotland, which would involve big swathes of road going out over Loch Lomond, which would be catastrophic, and it is clear that the authority also has concerns about the high road proposal. However, I submit that a STAG appraisal would help to work through that, unlike the short-cut approach that Transport Scotland has taken.

The matter is too important not to get right. I recognise that it is critical to hauliers from the Highlands and further afield who need to use the road, but they would equally want to get it right so that they get a decent route and we conserve our environmental heritage at Loch Lomond and the Trossachs national park.