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Has the Scottish Government made a recent assessment of the potential merits of introducing compulsory gender pay gap reporting?

It is well established that health is a fundamental human right, and it should be treated as such. Although our healthcare system has faced unprecedented challenges in recent years, my view is that it is essential to use this time as an opportunity to learn and do better for the safety of patients and the foundation of our healthcare system.

We are faced with unique circumstances in this period of post-pandemic rebuilding in implementing the changes needed to put patient safety at the heart of our healthcare. I therefore very much welcome the Patient Safety Commissioner for Scotland Bill, which intends to establish a patient safety commissioner in order to ensure that patients’ voices are heard, amplified and carefully considered.

The bill proposes that the patient safety commissioner would have two key functions:

“to advocate for systemic improvement in the safety of health care, and ... to promote the importance of the views of patients and other members of the public in relation to the safety of health care.”

As a member of the Health, Social Care and Sport Committee, I have had the privilege of taking verbal and written evidence from a range of stakeholders and experts across the sector. Their views have been invaluable in informing the committee. In addition, we have heard from a range of patients and patient representatives, many of whom strongly supported the establishment of a patient safety commissioner for Scotland and told us about the difference that such a role could have made in their cases.

I am incredibly pleased that the committee has unanimously backed the bill. It was introduced in response to the recommendations of the UK Government-commissioned Cumberlege review. The committee was pleased to welcome Baroness Cumberlege to our first evidence session on the bill, earlier this year. The review was established to examine how the health system responds to reports from patients about patient safety concerns that are related to medicines and medical devices.

Our committee has heard on numerous occasions that the Patient Safety Commissioner for Scotland Bill goes further than the corresponding legislation in England. Under the bill as currently drafted, the patient safety commissioner for Scotland would have the power to make it publicly known if an organisation had failed to co-operate. However, it goes further than that. The commissioner would have the power to compel the organisation to act.

It is reassuring to hear that the Patient Safety Commissioner for England has already made remarkable progress. If the bill is passed, I look forward to seeing even better results in Scotland.

I thank the individuals and members of the public who volunteered their time to speak to the committee at an evidence session. Many of them spoke about their personal experiences, and I know that all members who were present were incredibly moved by their stories.

Patients need to feel safe in the hands of our medical professionals. I cannot fathom the unimaginable pain and mental distress that patients across the country and their families have faced. The harm that has been caused to patients and their families is often avoidable, and I appreciate and recognise that many continue to fight for answers.

Safety lies at the heart of delivering our health services, and it will be essential for the commissioner to instil trust and confidence in our communities and to be a clear and strong voice for patients.

We are debating the bill thanks to the tireless work of campaigners and individuals who have been massively affected by the issue. I am absolutely certain that future generations will benefit from safer healthcare thanks to their incredible efforts.

We cannot talk about healthcare without discussing the universal and entrenched inequalities that patients face. During the committee’s evidence sessions, we heard time and again about how marginalised groups bear the brunt of patient safety issues and about how the establishment of a patient safety commissioner could ensure that marginalised patients’ voices are heard and that their concerns are picked up and acted upon.

Patient safety is incredibly gendered. Experts told the committee that women and children are overwhelmingly the groups that have been affected by medicines and medical devices that are thought to have jeopardised patient safety. Women across Scotland have been let down by ingrained prejudice within the medical system. Research has shown that the healthcare system seems to be poor at listening to women and taking seriously their concerns about their health and wellbeing and the outcomes of the procedures that they have had.

Based on the evidence that we have heard, it is clear that there is a requirement for the system to act more coherently for the public interest. The establishment of a patient safety commissioner is an effective mechanism to ensure that.

In response to the consultation, the Health and Social Care Alliance Scotland—the ALLIANCE—set out a number of considerations, many of which I welcome. They included the importance of a fully transparent appointment process for the commissioner and of clearly explaining the role and remit to the general public through accessible and inclusive messaging. With that in mind, and as the bill progresses to its later stages, a clear focus should be given to the following points.

First, the patient safety commissioner’s remit and scope need to be clarified to ensure a clear definition of roles across the medical system. The medical system is a complex landscape, and it is essential that the commissioner’s role is clearly defined so that there is no overlap with current governance systems and so that patients know who they can contact for support.

Secondly, the commissioner needs to be independent of the Government and the NHS and to have the resources to carry out their role properly. That will help to restore public confidence in our healthcare system and encourage patients to come forward to report any cases of medical wrongdoing.

Thirdly, a person-centred approach is necessary and critical. Patient voices, particularly those from marginalised or underrepresented groups, need to be at the heart of the work. A diversity of voices is paramount for patient safety, and people with lived experiences should play a meaningful role in the process of establishing a patient safety commissioner for Scotland.

I am confident that, throughout the process, the Scottish Government will continue to work with the relevant organisations to ensure an outcome that is robust and comprehensive.

I once again thank those who gave evidence to the committee in the run-up to the debate, and I look forward to the bill progressing through its upcoming stages.

I thank Jackie Dunbar for bringing this important debate to the chamber. I, too, express my gratitude to my Westminster colleague, Amy Callaghan MP, for leading the VAT burn campaign, which is calling on the UK Government to remove VAT from sunscreen products that have significant health benefits.

There are 16,000 new cases of melanoma diagnosed each year across the UK, and yet 90 per cent of the cases could be prevented by staying safe in the sun and using sunscreen that is at least SPF 30 with a four-star UVA protection rating or above.

Skin cancer is one of the most preventable cancers, and yet sunscreen products are still subject to VAT, which creates a significant barrier to access. Cancer affects so many of our lives and our constituents’ lives, and making the simple and effective change of removing VAT from sunscreen products could have an enormous impact on people across the country, now and for generations to come.

The benefit of scrapping VAT on sunscreen products is well known, and the UK is a decade behind the US in exempting sunscreen products from VAT-style taxes. If the past few years of Covid and the past 13 years of Tory austerity have taught us anything, it is that we cannot put a price on our health. At a time when thousands of families across the country are facing incredibly difficult decisions regarding their finances, it is clear that making sunscreen more affordable and readily available is a commonsense approach that the UK Government needs to take to save lives. No family should feel that they have to forsake sun protection for the sake of cutting costs.

According to a 2021 survey, 15 per cent of adults think that sunscreen is too expensive, and 29 per cent said that they would wear it daily if it was a little cheaper. Nearly a third of parents who were surveyed said that they cannot always afford to apply sunscreen to their whole family, often deciding to apply it only to their children. Although it is incredibly welcome that some supermarkets have made the decision to absorb the cost of VAT and to reduce the overall price of some sunscreen items, it is essential for the UK Government to recognise that sunscreen is an essential product, not a luxury, and should be treated as such for VAT purposes.

I join many others in condemning the UK Government’s response to the campaign. The argument that Government funding would reduce if VAT on sunscreen products was scrapped is almost laughable, considering that the estimated cost of skin cancer to the NHS is £100 million. To put it in perspective, less than 0.5 per cent of the revenue that is generated by the Treasury from VAT comes from sunscreen products.

It is also massively disappointing that the UK Government has placed responsibility for these issues on retailers, many of which are small businesses and individuals, and many of which are suffering as a result of the cost of living crisis. The UK Government previously committed to reviewing VAT on sunscreen products, and I join others in calling on the Government to consider that commitment once again.

I also very much support the second component of the VAT burn campaign, which is to improve education and awareness around skin protection and sun. May is skin cancer awareness month, when prevention, detection and treatment of skin cancer take centre stage, and this debate is helping to give this important topic the political attention that it deserves.

Research from Melanoma Focus shows that 35 per cent of Scots rarely or never use sunscreen when in the UK, with only 15 per cent always using it. That is despite the fact that 44 per cent of Scots report getting sunburned at least once per year. In recent years, we have seen record temperatures as the climate crisis makes us more susceptible to heatwaves and intense periods of direct sunlight. As we reach the warmer months, therefore, raising awareness of skin cancer prevention and symptoms is absolutely essential.

I am proud of the number of initiatives that Scotland has introduced, such as sunbed regulations; improving sun awareness education for thousands of pupils; and increasing the number of clinical nurses who are specialists in skin cancer, including in Victoria hospital in my constituency. Thanks to the tireless and dedicated work of researchers in the NHS and the medical profession, and of campaigners and cancer charities, those initiatives have made a tremendous impact on the way that we approach skin cancer prevention and awareness.

It is clear that much more has to be done. The contributions to the debate have highlighted just how much support the VAT burn campaign has across all areas of Scotland. It is our duty to make these products more accessible and affordable to our constituents, and I am reassured to see that the Scottish Government’s priority is to improve the experience and outcomes for people who are affected by all cancers across Scotland. With UK Government support for the VAT burn campaign, we could continue to improve the lives of people who are affected by skin cancer and the lives of their families and loved ones.

I thank Emma Harper for bringing this critically important debate before us today. Presiding Officer, I apologise to you and to Emma Harper for not being able to stay to the end of the meeting because I have a committee that is meeting to take evidence at half past 6.

Diagnosis times and the treatment of brain tumours have made leaps and bounds in recent years, thanks to incredible achievements in research. This debate gives us an important opportunity to acknowledge just how far life-saving treatment has progressed and to recognise and thank researchers, medical professionals, campaigners and volunteers for their individual work in improving the lives of people who are affected by brain tumours, and the lives of their families and loved ones.

It is clear that rigorous national campaigning has made the availability of support possible, but while awareness of brain tumours is at an all-time high, we must continue to keep that vitally important campaign on the political agenda in order to build on our recent achievements.

Much has since changed since the topic of brain tumours was last debated in the chamber in 2017. Our health landscape has changed dramatically—not least, due to the pandemic, which saw charities and voluntary organisations experience significant loss of income, and those organisations are now struggling more due to the cost of living crisis. That is why it is crucial that we listen carefully to the policies and recommendations of charities such as the Brain Tumour Charity, as well as to the lived experience of people who are affected by this complex disease.

Although the charities have been leading on the campaign, it is critical that Governments across the four nations provide much-needed support by treating brain tumour research as a critical priority. Campaigners have been asking for more Government support to build research capacity, so I am delighted that Scotland continues to build on its reputation as a hub of transformative world-class research into brain tumours, with institutions such as the brain tumour centre of excellence at the University of Edinburgh leading the way. I give my full backing to campaign calls of experts, researchers and charities, including on the need for more research funding and the importance of early diagnosis.

I was pleased to see the Government’s announcement on Scotland’s new cancer strategy, which has the potential to be a major milestone for people who are affected by brain tumours. I have full confidence that the minister, under our new Government, will use the findings from a cancer strategy consultation to effectively inform the decision-making process. We cannot underestimate the importance of ensuring that the voices and experience of people who are affected by brain tumours are at the heart of the policy. Many of our constituents are impacted by cancer, so it is critical that they be at the centre of our approach going forward.

The Scottish Parliament’s Health, Social Care and Sport Committee, of which I am a member, recently concluded an inquiry into health inequalities, during which we heard evidence that health inequalities not only contribute to the development of cancer but impact on what treatment a patient can access and the ability to access support, overall. That is an important point that has been raised constantly by the Brain Tumour Charity, which found that inequalities in brain tumour trials due to poor health and to cost implications present a barrier to patients entering clinical studies. It is absolutely essential that minorities and people who live in deprived areas across Scotland are included in the clinical trials in order that we better understand their experience of the current system and what improvements need to be made.

As the motion recognises, the side effects of brain tumour treatment can have a severe impact on a person’s quality of life.

I am incredibly proud of the array of services that are available across my constituency, including those that are provided by Maggie’s Fife and the Brain Tumour Charity support group, which provide invaluable support to people who are affected by cancer, including people with brain tumours.

The three early cancer diagnostic centres that have been introduced—in NHS Ayrshire and Arran, NHS Dumfries and Galloway, and NHS Fife—speed up cancer diagnosis and provide GPs with an alternative route to urgently refer patients. Those centres are picking up cancer earlier. Patients presenting with non-specific symptoms can be more difficult to diagnose, and some symptoms, or combinations of symptoms, can have a range of potential causes, not all of which are cancer. Where cancer is the cause, increased time being taken to diagnose a patient can often result in poorer outcomes. Figures up to October 2022 show that the initiative is working, with around 16 per cent of referrals going on to be diagnosed with cancer, and around 20 per cent being referred to primary care for non-cancer-related treatment. Referral for tests to check for cancer is an anxious time for patients and families. The centres provide a clinically safe and effective rapid service to rule out or rule in cancer.

The Scottish health awards are the most prestigious and recognised awards for people who work across NHS Scotland and its partners to deliver high-quality healthcare and social care services to people in Scotland. I was pleased that NHS Fife’s rapid cancer diagnostic service team was shortlisted at last year’s awards ceremony, in the innovation category. That is much-deserved recognition of all the team’s work.

Changes cannot come soon enough in terms of better outcomes for people who are impacted by brain tumours and for their loved ones. It is reassuring to hear that members across the chamber are united in a shared vision to cure all types of brain tumours and to raise awareness of such an important cause.

I thank Pauline McNeill for securing the debate on such an important topic. Provision of taxis is a vital part of our transport system, and I very much share the concerns of taxi drivers across the country about the challenges that are facing the sector as a result of the Covid-19 pandemic, Brexit and the cost of living crisis.

Taxi drivers provided an invaluable service to key workers and vulnerable people throughout lockdown and beyond. There was a great welcome for the £57 million of support that was offered to taxi drivers by the Scottish Government in the immediate aftermath of the pandemic.

As deputy convener of the Citizen Participation and Public Petitions Committee, I have had the privilege of hearing evidence from taxi drivers and their representatives from across the sector on the further support that is needed in order for the industry to fully recover from the effects of the pandemic. The committee listened carefully to the proposals that were set out in the petition that was lodged on behalf of Unite the union. I very much welcome Transport Scotland’s announcement that it will explore with trade unions and other stakeholders the best forum for engagement with the taxi trade and for addressing on-going concerns.

As the motion recognises, support for taxi drivers is not just a transportation issue, but is of cultural, social, economic and environmental concern, so I welcome the Scottish Government’s cross-sectoral approach in treating it as such. For example, I am proud of the Scottish Government’s ambitious plans to prioritise the just transition to net zero by making low emission zone retrofit grants available to taxi drivers to support their shift to lower emissions and greener vehicles. I acknowledge that it has been difficult for taxi drivers in Glasgow to do that. The Citizen Participation and Public Petitions Committee has seen evidence from the taxi sector about potential challenges that low emission zones might present to taxi drivers, so I am reassured to know that our Minister for Transport is working closely with taxi driver representatives and unions to discuss the matter further.

Fife is one of the most heavily populated local authorities in Scotland, and although we benefit from a range of rail and bus services, taxis are an essential part of our transport chain. They contribute significantly to access to Fife’s array of hospitality, tourism, nightlife, manufacturing industries and outdoor activities. With the summer season on its way, it is essential that taxi drivers feel supported and valued as major players in our local economy, as they are in Glasgow, too.

I am sympathetic in respect of the financial pressures that are facing taxi drivers. We cannot ignore the glaring and obvious pitfalls of the UK Government’s recent spring budget. Households across the country, including those of taxi drivers, are facing the biggest fall in living standards on record, and families are seeing their incomes being devastated by the cost of living crisis.

I am confident that the Scottish Government is using its limited powers and resources to address that cost of living crisis. Although the Chancellor of the Exchequer’s increased funding to the Scottish Government is welcome, it is nowhere near adequate to deal with the significant fiscal challenges that the Scottish Government and Scottish local authorities are facing as a direct result of the economic chaos that has been caused by Westminster. I know that it will be a huge disappointment to the taxi industry, but the chancellor missed a vital opportunity to give real support and to grant the Scottish Government the necessary levers to provide taxi drivers with meaningful support.

The chancellor’s measures will also do little to mitigate the damage of Brexit, which has intensified the driver shortage crisis in Scotland. The impact on labour shortages has been felt across Scotland, including in my constituency. In evidence that was submitted to the Citizen Participation and Public Petitions Committee, Fife Council raised concerns about how taxi operators are having to turn down hires regularly because of a shortage of drivers across Fife.

The problem has been exacerbated by a massive decrease in taxi driver numbers. According to the Scottish Taxi Federation, driver numbers have been devastated by Covid, with many deciding not to return to the taxi trade in favour of taking other employment.

I would like to conclude by giving immense thanks to taxi drivers in my constituency and across the country for continuing to provide the people of Scotland with fast, safe, reliable and economical transport. It is clear that the industry faces many pressures in the aftermath of the pandemic, as well as through Brexit and the cost of living crisis. The Citizen Participation and Public Petitions Committee will continue to take evidence from the sector in order to advise the Scottish Government on the best way forward.

On a point of order, Presiding Officer.

I thank Gillian Martin for securing the debate and welcome the great daffodil appeal, which is Marie Curie’s biggest annual fundraising campaign.

I have always been impressed by the work of Marie Curie and its commitment to helping people get the vital care that they urgently need. Of course, none of that would be possible without the tireless dedication of its fantastic fundraising groups. Last year, those amazing groups of people raised more than £3 million of funding for people living with a terminal illness and their families. They play such an important role by organising fundraising events and activities within their local communities, acting as ambassadors and helping to spread the word about the work of the charity.

All across the country, groups of volunteers meet regularly to organise and support fundraising activities to help the 2,000 Marie Curie registered nurses or senior healthcare assistants who care for and support people with terminal illnesses, and who provide emotional support for families, friends and the wider community.

Many volunteering activities were put on hold during the pandemic, but volunteers are a vital part of Marie Curie’s Fife service. They offer companionship and emotional support; provide practical help, such as aiding patients with small tasks; spend time with patients to allow their families and carers to have a break; and help patients and their families to find further support and services that are readily accessible and available to them locally. Without volunteers, Marie Curie would not be able to deliver the range of services and support that it does.

The charity has made an immense contribution to Scotland since it was founded in 1948, the same year that the NHS was established. The work started in 1952 with the opening of a home for cancer patients in the Hill of Tarvit in Cupar, Fife. More homes were opened, medical research was started and day-to-night services were provided.

Since 1986, the daffodil appeal has raised more than £80 million, which has contributed to giving people a better quality of life. With almost 75 years of experience, Marie Curie not only offers nurses who provide hands-on care in hospices with a friendly environment but helps everyone who is affected by terminal illness to get the information and support that they need through the research that it carries out to improve care and support. Last year, the money that was raised helped to support about 46,000 people in their homes or care homes.

Several years ago, the Marie Curie Fife hospice-at-home model—a fully funded integrated care pilot in NHS Fife, which complemented existing services and initiatives—was developed by the Marie Curie service for generalist palliative care. The pilot proved that providing community-based care with a local team is meaningful. The model included registered nurses, healthcare assistants, health and personal care assistants and trained volunteers.

The results of the pilot showed that a large number of patients and carers benefited from an approach that offered them a choice about the level of service that they wanted and where they wanted to receive it, with the vast majority of people being able to die in the place of their choice. Patients supported by the hospice-at-home model of care experienced fewer hospital admissions and fewer visits to accident and emergency departments, and they were two and a half times more likely to die at home. The pilot showed that hospital costs for end-of-life care were reduced by £182,000 by reducing the number of avoidable hospital admissions.

The pilot has informed future service delivery in Fife, with end-of-life services working alongside other palliative care organisations, professionals from palliative care outreach, community nursing, acute health services and Marie Curie.

Thursday 23 March marks the third national day of reflection. On that day, we will all have the opportunity to remember our loved ones who died, to support each other and to be there for people who are grieving. Marie Curie launched the national day of reflection in 2021 as a day to remember those who died during the pandemic, but support for the people who were grieving was affected by lockdown. It is a day on which anyone who has been bereaved—no matter how long ago or what the cause was—can come together and remember loved ones who have died.

I once again thank Gillian Martin for securing the debate. Demand for palliative and end-of-life care is rising rapidly, and that trend is expected to continue as our population ages. During March, I encourage everyone to wear a daffodil pin to raise awareness of the great daffodil appeal and to show support for the individual service that is provided by Marie Curie nursing and hospice staff.

I thank John Mason for securing the debate on a subject that is close to my heart.

The founder of modern camping was Thomas Hiram Holding. In 1853, Thomas travelled through the Highlands of Scotland with a canoe, and went on to write two books about his adventures. In 1901, he founded the first camping club in the world, which was called the Association of Cycle Campers, but it was not until after world war one, when Robert Baden-Powell, the founder of the scout movement—a man whom I have spoken about many times in the chamber—became president of the Camping and Caravanning Club, that the establishment of camping organisations was fostered in a number of western European countries.

Camping has been my passion from a very young age and has stayed with me into my adulthood. Anyone who knows me well will tell you that I can frequently be heard extolling the benefits of camping to anyone who will listen, while gently trying to persuade those who may be a bit hesitant to try it for themselves. I find that many people who have never been camping have preconceived ideas and, perhaps, misconceptions about what camping is and what to expect from the experience. For many, however, once they take their first steps, they never look back.

Albert Einstein said:

“Look deep into nature, and then you will understand everything better.”

I could not agree more with Einstein’s statement. Camping provides a host of benefits for body and mind, including improved relationships, opportunities to learn and develop new skills, connection with nature, reduction of stress, increased physical fitness and—which is important, these days—unplugging and getting away from screens. The list is endless.

I am a lifelong member of the Scout Association who was introduced to the wonders of camping at a young age. These days, as a scout leader, I am privileged to be able to carry on. There is something special about someone’s first camp, and I have been privileged to be able to witness that moment for scores of young people every single year. It gives them the opportunity to try new things, to conquer their fears and to learn skills for life, as well as building their self-confidence and self-esteem. They spend their days being physically active and living together in an environment of co-operation. Respect for others is key in sharing responsibilities and resolving disagreements where they can find out at first hand the importance of communication.

Our annual summer camp in the Ettrick valley is an eye-opener for less experienced scouts. Despite their being told beforehand that there is no cell signal for miles around, it always amuses me when they arrive and the realisation hits home that there actually is no signal. Strangely, my office manager also enjoys it when I am away at Ettrick; I am not sure why. Watching kids take a break from television, phones, social media and the internet, while rediscovering their creative powers and engaging with the real world, real people, real activities, real adventures and real emotion is an absolute joy.

I would like to share an experience that I had at one of the camps that has stayed with me for many years. A young scout, who I will call Johnny, came to his first camp. He was 10 years old and had a difficult background. He had not had many opportunities in life and was under the protection of social care. On his first afternoon, I looked across and saw Johnny standing at the edge of the field all alone and staring into the distance. I walked across to him and asked whether he was okay. He replied, “Yes—it’s just that I’ve never seen a real cow before.” I have never forgotten the look of happiness and contentment on his face at that moment, and I never will. He spent the rest of the week rolling about in the dirt, playing games with other boys and girls, and getting stuck into any and every task. The boy who returned home from that trip was far more confident and self-assured than the one who left home the week before.

Camping is a way of life that offers a sense of freedom and adventure. We are lucky to live in Scotland, a country that is brimming with natural beauty, with an array of majestic mountains, sweeping coastlines and stunning landscapes all on our doorsteps. For those who have not yet tried, it, why not give it a go? They might just end up loving it, as I do.

To ask the Scottish Government what support it provides to the deaf community. (S6O-01990)

I recently met the local deaf club in my constituency to discuss the problems faced by people whose first language is British Sign Language. What actions has the Scottish Government taken to promote the provision of written information and correspondence from Scottish businesses and organisations such as the Office of the Scottish Charity Regulator to BSL users in a format that they can access, read and understand?