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Our next petition is PE2031, which has been lodged by Maria Aitken on behalf of the Caithness Health Action Team. It calls on the Scottish Parliament to urge the Scottish Government to ensure that children and young people in Scotland who have type 1 diabetes and would benefit from a life-saving insulin pump are provided with one, no matter where they live.

I am reminded that that was a key issue in the very first session of Parliament in which I was elected, from 2007 to 2011; it is always intriguing to see how things develop. At that point, insulin pumps had just come on the scene, and we were very keen to have them made available through the NHS.

I welcome again Edward Mountain, who has remained with us since our earlier discussion on the A9 inquiry as he has an interest in this petition. I will invite him to say a few words in a moment.

The committee last considered the petition on 20 September 2023. At that time, we agreed to write to Diabetes Scotland, the Insulin Pump Awareness Group and the NHS regional health boards. The committee has received responses from eight of the 14 health boards, copies of which are included in our meeting papers.

A number of the responses refer to utilising additional Scottish Government funding to increase the number of children and young people who are accessing insulin pump therapy and the need for further Scottish Government funding to support on-going staffing and resource requirements that are now necessary to meet the demand for insulin pump therapy. It is also the case that, since the third session of Parliament, from 2007 to 2011, the incidence of diabetes has continued to increase dramatically within the population.

We have received a response from Diabetes Scotland that highlights the benefits of diabetes technology for people with type 1 diabetes, which include the improvement of blood sugar management and a reduced risk of complications such as stroke, eye damage and kidney disease. The response draws our attention to the “Diabetes Tech Can’t Wait” report, which Diabetes Scotland published in November last year. The report includes a number of recommendations to the Scottish Government and to health boards to support the faster roll-out of diabetes tech, with the aim of ensuring that 100 per cent of children and 70 per cent of adults living with type 1 diabetes are able to use hybrid closed-loop tech by 2030.

Before I invite the committee to share thoughts on how we might proceed, I invite Edward Mountain to comment.

Do not get me wrong—some of those things are required, and we have distinguished between the different operations that we have. It is important to say that we talk about commissioners, but in some cases we are talking about a commission full of commissioners. Even the language that is used for the office that people occupy is not equal.

Yes, I think that that would be the case. Those budget requests are largely about requirements for additional staff to exercise functions. In some cases, it can be that the work of the commissioner has become better known, which has prompted many more public inquiries of that commissioner, and those inquiries have to be tackled. It could be that a commissioner has been given additional responsibilities by the Government and they have to have the resource in place to tackle those responsibilities.

With regard to scrutiny of the outcomes for public benefit, the corporate body takes the view that it is very much the responsibility of the subject committees to take that forward. Our responsibility is to ensure that the housekeeping within the actual commission is effective, that it represents a good use of public money, and that public money is being carefully managed.

That is a fair point, and that is why I think that Parliament has to decide on and design the architecture of all this and, by a deliberate act of policy, identify the very point that you make and thereby decide, if that type of commissioner is created, what the accountability route should be. At the moment, everything is simply consequential on a commissioner being appointed without proper thought having been given before the post is created to what the commission would do or how it would be properly held to account.

I would very much welcome this committee taking a lead in that regard, which I am sure the corporate body would be happy to endorse.

The figure could easily become 15 per cent. It is 12 per cent of our budget. We are spending £18 million on the current raft of commissioners and the amount is only going to get greater. You have to ask yourself whether those people—who are not elected—are being properly held to account. Was there a proper structured architecture by which they were appointed in the first place? That is what we should be considering putting in place.

You will notice that the percentage allocated for commissions in next year’s budget increases by considerably more than any other headlined increase, because we will have to fund an additional commissioner.

I sound a note of caution on the point about a sunset clause. I had thought that that would have been achieved through the inquiry conducted by the committee that was set up in 2008, but the problem that we found was that, when there is any suggestion that a commissioner might not be renewed or that it could fall, MSPs find themselves lobbied considerably about not allowing such a heinous act of violence to be visited on the very valuable individual’s work. That is the obstacle that I think that colleagues would face.

You have probably exhausted the potential to draw the corporate body’s experience and views out any further. However, I am grateful to you for this opportunity to give evidence to the inquiry, particularly given that it arose from an initial approach to you, through the budget process. We very much welcome the fact that it is taking place. I do not know how else it would have happened, and it is taking place in time for a proper conclusion to be reached that could have implications for the next session of Parliament. I very much hope that that is the case.

I will comment briefly, just to add to what Maggie Chapman has said.

I certainly would not begin by reverse engineering the position that we have just now. Equally, although I have listed the different advocacy commissioner roles that there could be, it is not the corporate body’s responsibility to decide whether those would be a good thing. Nevertheless, given what I said earlier, I think that the corporate body would welcome the Parliament’s establishing the architecture by which these things could be properly evaluated and deciding what it would like in that respect.

As for your question whether some commissioners could be merged, in the conversations that we have been having in our meetings with them, the existing commissioners themselves have indicated where they think there is potential for mergers. It might be that you first establish the architecture to judge whether and how future commissioners are appointed and subsequently look again at the existing commissioners to establish whether they comply with whatever that architecture has evolved into after a certain period, when it has been properly tested.

I would say that the common thread in everything, when I have been on the ground floor of any decision that has been made, is that the people who make the decision move on, and other people come in behind them, who, in turn, are succeeded by other people again. Those people who understood the what, the why, the where and the when have disappeared, and the agenda of the people who are there subsequently is different.

There are lots of things in public life that any one of us might have been involved in, and we might look at what is being done now and think, “That’s very different from anything that was going on when I was involved in it. I’m not sure that’s why it was there or what it was there to do.”

I think that that is just the natural process. The Parliament is not a fixed body; it is a body of parliamentarians. As I have observed before, I think that we had 50 new parliamentarians in 2016 and 40 new parliamentarians in 2021. Of the 129 current MSPs, very few of them were here before. The number who were here when the Parliament was created, or even when any of the decisions about commissioners were taken in 2006 or 2008, is very small. I do not think that people are reminded of the institutional memory of Parliament in any respect whatsoever. Everybody just lives in their current stream and operates within it. That is how we function. That is not to be recommended, but it is as it is.