 21 gydag o my diary alun matte scol ac amserach mytiau yng ngyhowb yn 2023. Ac rwyf yn wedi bod yn cerddwlad i ddim yn Ces White ac Soo Webber yw yn gweithddiadol i ysgolwch. Y masyltwyd y gwahanol yma yma yn y roi, cy snatcho parodydau ym Nghymru yng Nghymru, amheadd iump sy'n gwneud yn y ddolygu i ni. Rwyf wedi cyfle bryd y mae yng Nghymru, o가�p yn ddiwedd i gêm ei fodion at afaith i gynhyrchu ei ddweud yng nghymru Ddiw Cymysgol yng Nghymru byddiol i Llywodraeth, I welcome Minister for Public Health and Women's Health, Jenny Mintle and her officials. I will explain the procedure briefly for anyone watching. All members should have a copy of the bill as introduced. The marshaled list of amendments, which was published on Thursday 8 June, and the groupings of amendments, which sets out the amendments in the order in which they will be debated. There will be one debate for each group of amendments, and I will call the member who lodged the first amendment in that group to speak to and move that amendment, and to speak to all other amendments in the group. Given that we have other items of business this morning, I would encourage members to ensure that contributions are concise and to the point. If members who have not lodged amendments in the group wish to speak, they should indicate by catching my attention, I will conclude the debate on the group by inviting the member who moved the first amendment in the group to wind up. If the minister has not already spoken to the group, I will invite her to contribute to the debate. Following the debate on each group, I will check whether the member who moved the first amendment in the group wishes to press it to a vote or to withdraw it. If they wish to press it to a vote, I will put the question on that amendment. If a member wishes to withdraw their amendment after it has been moved, they must seek the committee's agreement to do so. If any committee member objects, we will immediately move to the vote on the amendment. If a member does not want to move their amendment when called, they should say not moved. Please note that any other member may move the amendment. If no one moves the amendment, I will immediately call the next amendment on the marshaled list. Only committee members are allowed to vote and voting in any division is by a show of hands. It is important that members keep their hands clearly raised until the clerk has recorded the vote. Once voting has been completed, the clerks will check the result and pass it to me to read out. Once I have read out the result of the vote, should any member consider that their vote has been incorrectly recorded, please let me know as soon as possible. I will pause to provide some time for that. The committee is required to indicate formally that it has considered and agreed each section of the bill, so I will put a question on whether each section is agreed at the appropriate point. I now begin the stage 2 proceedings. I call amendment 11, in the name of Tess White, in a group on its own, Sandish Gullhane, to move and speak to amendment 11. Thank you, convener. Before I start, I would like to draw members' attention to my register of interests as a practising NHS GP. Amendment 11, in the name of Tess White, is a probing amendment to facilitate debate about the length of time a commissioner should serve in a single term. The amendment reduces this period from eight years, which is currently on the face of the Bill to five years. As a point of comparison, the Patient Safety Commissioner for England is appointed to a term of three years with the possibility of a second term. I note that the PSC Bill's policy memorandum that the period of appointment was chosen because it is in line with the terms and conditions of other parliamentary commissioners. Now, these were standardised by the Scottish Parliament commissioners and commissioners Scotland Act 2010, 13 years ago. In the intervening period, the commissioner system has not been substantially evaluated. Meanwhile, as the Finance and Public Administration Committee and the Scottish Parliament's corporate body have highlighted, the number of commissioners could rise from seven to as many as 14, and that's a significant and expensive extension of the public sector. It should follow that the tenure in office is considered as a question of good governance. I recognise the Bill that does include provision for early termination and gives the Scottish Parliamentary Board some flexibility in this area, but nevertheless the period and post provided in statute matters because commissioners need to consistently demonstrate that they are serving the public interest as well as the public purse. I welcome input from the minister and other members on this point. Before I go to the minister, I need to check that the question is that section 1 be agreed to. Are we all agreed? I do not support this amendment. The commissioner will need a sufficient period of time in post to understand the patient's safety landscape, gather sufficient information, carry out any investigations that they feel are necessary and see their recommendations lead to change. Eight years is the standard period of office for all the Scottish Parliamentary commissioners. A commitment has been made to the Presiding Officer that the patient's safety commissioner will be consistent as much as possible with existing procedures in order to reduce the burden on the Scottish Parliament. I therefore ask Sandesh Gilhane in the name of Tess White not to press this amendment. I would be keen to see if we could facilitate a discussion between now and three about where this might sit, but I will for now withdraw. Does any member object that amendment is withdrawn? I call amendment 12 in the name of Tess White group with amendments 13, 20 and 32. Sandesh Gilhane to move amendment 12 and speak to all amendments in the group. Thank you. Amendments 12, 13 and 20 on reviewing the commissioner's work tie together. The main amendment is amendment 20, which inserts a new section on performance monitoring on the face of the bill. This requires that the commissioner must consult with the Scottish Parliamentary Corporate Body. The advisory group outlined in the bill, as well as the most appropriate parliamentary committee on a set of performance standards against which the commissioner believes performance should be judged. Amendment 12 requires that a review of the performance of the commissioner assessed against these standards should be included in the annual report to be laid before the Scottish Parliament. Amendment 13 requires that the most appropriate parliamentary committee must propose a debate on the annual report. When a minister's predecessor came to the committee to give evidence on the PSC bill, I inquired how the commissioner will be evaluated to ensure the office holder is doing what we expect them to be doing. Let's not forget that the public will have high expectations of this commissioner. That came across loud and clear during stage 1. The minister and her official said that there will be strong role for Parliament in scrutinising what the commissioner does. I go on to quote Parliament as the primary means of holding the commissioner to account through its responsibility to the people of Scotland. I welcome that the commissioner will be independent of government and that the line of accountability for this role will be to the Scottish Parliament. However, I would like to see a tangible set of standards to better facilitate scrutiny of the commissioner's performance by parliamentarians. In doing so, we aren't just ensuring that the patient safety commissioner serves the public interest to the highest possible standards, but we are also looking to the effectiveness and value of the commissioner as part of a system that is likely to expand in the future. Amendment 32 requires that an appropriate parliamentary committee must examine how the commissioner and the existing patient safety landscape are working together. As Baroness Cumberlidge emphasised in her evidence to the committee during stage 1, the patient safety commissioner is supposed to be the golden thread running through the patient safety landscape that is already saturated. That is the intention, but is it possible to deliver? Organisations such as Public Service Ombudsman have raised concerns about potential for duplication. Once the office holder has had time to bed in, it is appropriate to review how this relationship is working in practice. I should add that to this new section, it includes a provision which examines how patient safety organisations have implemented the commissioner's recommendation, an issue which was highlighted during stage 1. To conclude, very little evaluation or research has been carried out on commissioners. The Scottish Conservatives support the creation of a patient safety commissioner, but we want to carefully consider the detail too, especially relating to the relationship between the commissioner and the Scottish Parliament, one that we would be happy to work with a minister and a team to ensure that we get the approach correct. I do not support the amendments in this group. Amendments 12 and 20 would require the commissioner to set performance standards for their own office and then report against them in the annual report. I of course agree entirely that there needs to be a robust system for monitoring the commissioner's performance, but I am not convinced that those amendments add anything apart from the burden of more paperwork to what is already in the bill. The bill already obliges the commissioner to produce a strategic plan of activity and include a review of their activity in their annual report. It seems to me right that it is against that plan of activity that the commissioner's performance should be assessed, as well as against the feedback of patients and indeed this committee. I find the idea that the commissioner should have to come up with a separate set of performance standards to be assessed against odd and only likely to muddy the waters about what the true expectations of the commissioner should be. It seems to me right that the time and resource that the commissioner would have to spend coming up with further standards and then consulting on them as amendment 20 would require would be better spent getting on with the job of speaking up for patient safety. The bill already contains an element of annual reporting as drafted, but it must be remembered that some of the commissioner's work will take time to achieve and may only become apparent outwith an annual reporting cycle. Amendment 13 would require the committee to propose a debate in Parliament every year on the commissioner's annual report. The committee is already free to propose a debate on the commissioner at any time. Legislation is not required to create that right and use the law to tell the Parliament, ourselves and our successors, what to spend time on seems to me risk setting a very unwelcome precedent. We should trust the people elected to this place to know the issues that matter to their constituents. The same point can be made about amendment 32, requiring Parliament to arrange a review of the commissioner within three years. If dissatisfied with the commissioner, the committee would be able to carry out an investigation into their work and to report on it to Parliament. Additionally, Parliament already has scope to review the commissioner's work and roll in whichever way they deem most appropriate, including the commissioner's place in the pre-existing patient safety landscape. It seems to me that amendment 32 would only serve to tie their hands, perhaps breaking the golden thread that Dr Galhany spoke about in terms of the approach that they might want to take. Therefore, I urge members not to agree those amendments. Thank you, minister. No other members indicated that they want to speak. Thank you. I would disagree. I think that what we have at the moment in the bill is a strategic plan, which is looking at where—and I'll come on to talk about this next—where the commissioner wants to go. We have some annual reporting, but it seems to me very sensible that, when you have a public body, they tell you what their plan is for that year and then report against that plan. That is what I would expect most public bodies to do. I think that the public expects public bodies to be doing this so that they are aware of where their money is being spent and how the body—and the commissioner in this case—is going about their job. I would like to press those amendments, please. The question then is that amendment 12 be agreed to. Are we all agreed? No. We move to a vote. We are not agreed, so there will be a division. All those in favour, please indicate now. All those against. The council now finalised the vote. The result of the vote, the number of votes for is four, the number against is six, and therefore amendment 12 is not agreed to. I call amendment 13 in the name of Tess White, already debated with amendment 12. Is that amendment 13 is agreed to? Are we all agreed? No. We are not agreed, so there will be a division. All those in favour, please indicate now. All those against. The council now finalised the vote. The question is that amendment 13, the name of Tess White, be agreed to. The number of votes for is four, the number against is six, and amendment 13 is therefore not agreed to. The question is that schedule 1 be agreed to. Are we all agreed? Thank you. I call amendment 14 in the name of Jackie Baillie group with amendments as shown in the groupings. Jackie Baillie to move amendment 14 and to speak to all amendments in the group. Thank you very much, convener, and I am grateful to the committee for allowing me to come along this morning to move amendment 14 and all other amendments in the group. I believe that the amendments before you will go some way to writing past wrongs, and if past, those amendments will ensure that patients who have been seriously injured or harmed in a healthcare setting or even more tragically those families who have lost a loved one in those circumstances and never again left struggling to get answers and justice. Effectively, this set of amendments are the basis of putting Millie's law into effect. The scandal of the Queen Elizabeth university hospital shows in all, you know, too obvious a way how families have to battle to simply get answers about what has happened. Even in recent days, we've heard horrifying stories of health boards spying on bereaved families who are seeking justice for their loved ones, and I'm sure all of the committee would agree that that is absolutely shameful, but this isn't the first time that there has been major injury or harm in a healthcare setting. We have had, if I take you to my own experience, the CDIF scandal at the Vale of Leven hospital, where a patient safety commissioner would have been so valuable. I am minded, of course, as we all are, that there is an independent inquiry underway, and I don't wish to interfere with that process. However, in the patient safety commissioner for Scotland Bill, we have an opportunity to ensure that families such as that of Millie Mayne, of Andrew Lawrence or indeed the CDIF families will never be left crying out for help, for answers, for support and, yes, for justice. Let me turn to 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. Amendment 34 defines what a major incident is. Amendment 30 introduces a new section to the bill relating to the commissioner's role on becoming aware of a major incident, including contacting patients affected by major incidents and the families of patients who died because of one, providing relevant information, including sources of support, information on accessing legal advice and representation, details of any investigations or inquiries that related to that major incident, and advice to whistleblowers. Significantly, this amendment requires the commissioner to consider initiating a formal investigation into an incident within one year of becoming aware of the incident. Amendment 31 requires the commissioner to produce and publish a charter for those affected by major incidents. The charter that would be consulted on would include the obligations of public bodies in relation to affected patients and their families. That is critical in holding such public bodies to account. Let me illustrate. We know for instance that, whilst the duty of Canada may exist in principle in Scotland's NHS, it is not the lived experience of those who have had to fight for answers. Where the commissioner does complete a formal investigation, amendment 29 requires them to provide a copy of their report into the incident to both the police and the Crown Office and Procurator Fiscal Service. It also confirms that the report can be used in legal proceedings. As the bill currently stands, the patient safety commissioner does not have the power to make redress, assist those seeking redress or a pine on actions that should be taken in relation to an individual. Amendment 15 specifically exempts major incidents, and that of course is critically important. In summary, convener, these amendments will empower the patient safety commissioner for Scotland to be an advocate for those who have been let down by the system in a healthcare setting. Those amendments ensure that those affected by such scandals are supported in knowing their rights and getting the appropriate help. It is about ensuring that they are listened to, that thorough investigations are undertaken, which can be used in legal proceedings, and most importantly of all, it is about answers. I move the amendments in my name. I would like to thank Jackie Baillie for her very powerful words. None of us here should ever forget during those discussions that the bill is about making sure that people and their families can benefit from safer care in future. This is at the forefront of my mind every day, and I know that the same will be true for everyone around this table. I know how much of an advocate Jackie Baillie herself has been, and I thank her again for this. We all want the patient safety commissioner to amplify the voice of patients and drive improvements in safety, and it is important that they have the freedom to do that however they see fit. I would absolutely expect that the commissioner would wish to hear from bereaved families as well as from affected patients themselves whenever they wish to raise an issue related to patient safety, including in the sorts of circumstances that we have heard from Jackie Baillie today. What I think is critical here is that we do not inadvertently tie the commissioner's hands in this. Everything that we are doing with this bill is intended to ensure that the commissioner has the freedom, scope and authority to set their own agenda without fear or favour to speak up for patients and drive improvements. Writing very specific steps for the commissioner on the face of the bill would risk getting in the way of the commissioner doing that kind of work and working to prevent major patient safety issues developing in the first place. The key functions of the commissioner's role are set out in section 2 1 of the bill, in particular to look at systematic improvement in the safety of healthcare and to promote the importance of the views of patients and other members of the public in relation to the safety of healthcare. I am concerned that those amendments would limit the commissioner's ability to do that. Those amendments risk clouding the public's understanding of the commissioner's role and would represent a significant departure from the extent of the commissioner's current remit and what was agreed at stage 1. The committee itself at stage 1 agreed that it was appropriate for the commissioner not to become involved in resolving individual cases as there are existing avenues for that. I think that it is critical to let the commissioner be guided by patients and families about what action they need to take and not by politicians. Where I do believe the commissioner would have an important role following a major incident would be in gathering information from people affected and investigating whether there is an issue at a systematic level that led to the major incident occurring. There is nothing to prevent the commissioner from doing that already using existing powers and functions. I therefore urge members not to agree to those amendments. I have no indication that anyone else wishes to contribute in so I will turn to Jackie Baillie to wind up. I am surprised at the minister's response, given that there were warm words issued by the First Minister in relation to accepting the need for Millie's law, so wires have clearly got crossed somewhere. My experience of what has happened for a lot of bereaved families is that there have been public inquiries fought for, they have taken years to set up, they have taken years to conclude and meanwhile families have to live with the pain every single day of justice delayed in relation to the loss of their loved one. I have to say that making legislation clear is actually something that this Parliament should be about. Leaving it to such a high level that it is entirely open to interpretation, I do not think that it is helpful in cases like this. I was going to say that I am happy to work with the minister, bring something back at stage 3, but given the absolute nature of her response to me, I am pushing those amendments to a vote. The question is that amendment 14 be agreed to. Are we all agreed? We are not agreed and there shall be a division. All those voting in favour, please indicate now. All those voting against, please indicate now. The clerks will now finalise the vote. The question is that amendment 14, the name of Jackie Baillie be agreed to and the number of votes 4 is 4 and the number of votes against is 6 and amendment 14 is therefore not agreed to. A call amendment 1 in the name of the minister grouped with amendment 28, minister to move amendment 1 and spectral amendments in the group. Thank you convener. I have lodged amendment 1 in response to calls from stakeholders and an emphasis by the committee in your stage 1 report on the need for a cooperative approach to patient safety. I wholeheartedly agree with that principle and therefore I am keen to clarify with this amendment that we expect this kind of cooperative spirit to extend to all public authorities with functions relating to healthcare as well as among healthcare providers themselves. On Carol Mocken's amendment 28, I do not feel able to support it as while we are all hopeful and expectant that the spirit of collegiate working to improve patient safety extends as far as possible. I am mindful that we cannot propose to Parliament an amendment outside its competence. We are just not able to impose a duty on the English commissioner for patient safety. I move amendment 1 in my name. I will speak to amendment 28 and the other amendments in the group. Thank you convener. Will I bring forward amendment 28 in response to the stage 1 report that highlighted the Scottish Public Service Ombusman's comments regarding clarity surrounding the relationship between the patient safety commissioner and the broader landscape? In doing so, I believe that my amendment puts the necessary requirements on each person named in section 152D to co-operate with the commissioner in the exercise of the respective functions and indeed for the commissioner to co-ordinate with each person named in section 152D in the exercise of their respective functions. I believe that the amendment would be a positive step towards ensuring that there are strong working relationships between the patient safety commissioner and the relevant individuals listed to meet statutory obligations and acts on the Scottish Public Service Ombusman's recommendations when giving evidence. As mentioned in the stage 1 report, the manner of dealings can vary. However, I urge the minister to reconsider this amendment as an initial step to ensuring that the parameters of the relationship are set out and that there is co-operative working across the board to exercise statutory obligations. I would ask the minister again to reconsider the comments that were given previously. In respect of amendment 1 in my name, our aspirations for the patient safety commissioner are that they work in a co-operative way as much as is possible. In being unable to support Carole Machan's amendment 28 due to its seeking to impose a duty outwith competence, I do not disagree with the spirit in which it has been brought. In the event that Carole Machan moves amendment 28, I urge members not to support it on account of the competence issues that it presents. The question is that amendment 1 be agreed to. Are we all agreed? I call amendment 15, in the name of Jackie Baillie, already debated with amendment 14. Jackie Baillie, to move or not move. The question is that amendment 15 be agreed to. Are we all agreed? No. If we are not agreed, there shall be a division. All those voting in favour, please indicate now. All those against. The question is that amendment 15, in the name of Jackie Baillie, be agreed to. The number of votes for was 2. The number of votes against was 8. Amendment 15 is therefore not agreed to. The question is that section 2 be agreed to. Are we all agreed? I call amendment 16, in the name of Paul Sweeney. Groups with amendments are shown in the groupings. Paul Sweeney, to move amendment 16 and speak to all the amendments in the group. Thank you, convener. Amendment 16 intends to require the commissioner's statement of principles, including a commitment to involving underrepresented groups in their work. In committee evidence, patient safety issues, which have disproportionately impacted women, were raised as a valparate and mesh. The mesh scandal is perhaps one of the most commonly known examples of a group, in this case a group of brave and unrelenting women, who often had to seek recourse through the Public Petitions Committee, having to try exceptionally hard to have their voices heard. Dr Aaron Chopra of the Mental Welfare Commission told committee that, despite marginalised groups being predominantly affected by patient safety events, groups such as ethnic minorities are not represented well in patient safety data. Including underrepresented groups in the statement of principles, this amendment would ensure that marginalised groups remain visible in consideration of patient safety issues. I would hope to give everyone equal recourse to advocacy so that having their voice heard is a right and not a privilege. Therefore, the amendment proposes to insert at the end of line 11. A statement of principles must include the principle that the commissioner will seek to involve categories of people that the commissioner considers to be underrepresented in healthcare in the commissioner's work. We will speak to amendment 17 and other amendments in the group. Amendment 17, 18 and 19 in the name of tests relate to the statement of principles in section 3 of this bill, which is currently not clearly defined. Amendment 17 requires that the commissioner must include the principle that they will seek the views of staff working in the NHS on safety concerns. That is in response to the point raised by the Royal College of Nursing, that even though there are already established pathways for NHS staff to raise concerns about safety within their health board, they do not always feel that those concerns are being heard or addressed. The Scottish Government undertook to review the bill to ensure that the commissioner could hear from staff, but it is not clear from the minister's amendments that this has been carried out. I would appreciate some clarity from the minister on this specific point. I note that amendment 16 in the name of Paul Sweeney includes the principle that underrepresented people in healthcare will be involved in the commissioner's work in this, which Conservatives fully support this amendment. And then 18 provides more detail about what the statement of principles should include. It does not seek to be prescriptive, as I agree, that the commissioner should have the freedom to establish their own principles. That is reflected in the drafting of this amendment. What it does do is provide more detail on the face of the bill about the areas that the commissioner should consider when drafting these principles. Amendment 19 creates a duty to consult on the principle of stakeholders, the parliamentary corporation, the advisory group and, crucially, the relevant committee of the Scottish Parliament. I note that the Scottish Government have lodged a similar amendment on consultation on the principles, which covers the strategic plan as well. I don't have an issue with this approach, but Jenny Minto's amendment 5 does not include a parliamentary committee. I would like to see clarity from the minister about whether she would consider including this on the face of the bill ahead of stage 3. Finally, amendment 21 creates a duty for the commissioner to have an annual work programme. This amendment is not designed to be onerous, as I appreciate the commissioner must also produce a strategic plan and the statement of principles. The key point here is that the principles will inform the way the commissioner works and the strategic plan will set out the objectives and priorities over a period for as long as four years. The work programme is intended to be far more agile and an agile document which is produced every year, which also gives the commissioner the opportunity to consider the resources required to carry out their work. After a short period in post, it is worth reflecting on the patient safety commissioner for England's recognition that more resources will be required to support her work. Finally, a further comment on resources I have shared with the minister the possibility of pooling HR finance and legal resources between commissioners to mitigate the costs of office holders where it is possible to do so. As we look at the underpinnings of the commissioner at stage 2 and moving to stage 3, it is worth considering how we can facilitate value for money in the commissioner system. Minister, to speak to amendment 3 and the other amendments in the group, please. Thank you. On Paul Sweeney's amendment 16, I am keen to ensure that patients who are underrepresented are sought out for greater involvement. I have listened carefully to what Paul Sweeney has said about amendment 16 and the importance of focusing the commissioner on hearing from those who are too often not heard from. I agree with that. I cannot support his amendment today because I think the way it is expressed may not quite capture what is intended. Being underrepresented in healthcare is not necessarily the same as being underlistened to. It is very much part of the problem that some groups are overrepresented in the amount of healthcare that they need, and those are precisely the groups with the softest voice. I would like to invite Paul Sweeney not to press amendment 16 today and work with us to bring this important issue back at stage 3. Amendments 3, 4 and 5, in my name, impose the same consultation requirement on the commissioner in relation to the principles as applied to the strategic plan, including in particular a requirement to consult with those that the commissioner considers appropriate to ensure that the principles and the strategic plan reflect patients' concerns. Those give effect to a recommendation from the committee in its stage 1 report. The Government agrees with the committee that it is important for stakeholders' voices to be taken account of when formulating the principles as well as the strategic plan. Amendment 19 in Tess White's name shares common ground with my amendment 5 as Sandesh Gilhane noted in that it would also require the commissioner to consult on the statement of principles. What it adds is an explicit requirement for the commissioner to consult with the relevant parliamentary committee. I cannot support amendment 19 today because of amendment 5 is also agreed, as I hope it will be, the bill would end up with a duplicate consultation duty. If Tess White is willing, I would ask her not to move amendment 19 and work with us to bring an amendment back at stage 3. I am unable to support amendment 17 in Tess White's name because, while I agree that, as part of investigating and monitoring potential patient safety issues, the commissioner will wish to hear from staff, the commissioner is already empowered to do so. Placing a requirement on the commissioner by way of a principle that the commissioner will seek the views of staff risks cutting across the commissioner's focus on patients' voices. Amendment 18 in Tess White's name would add a number of things that the statement of principles must include. A few of the items listed could be described as principles. However, some would more appropriately sit within the strategic plan required by section 5 of the bill, and indeed already do. For example, how the issues to be investigated will be identified. The commissioner's per-view is already defined in section 2 1 of the bill, and on the setting of a threshold for opening an investigation, the varied nature of concerns which the commissioner may investigate means that trying to define a threshold will be appropriate in all cases will be difficult. The government's view is that the commissioner should be trusted to exercise independent judgment about when to instigate an investigation within the framework of the commissioner's strategic plan and principles, and the Parliament can then hold the commissioner to account for those decisions. I therefore ask members not to support this amendment. For a similar reason, I cannot support amendment 21 in Tess White's name. It would use up resources of the commissioner on producing a work programme, much of the content of which is already covered in what is to be included in the strategic plan. The additional requirement to set out the work that the commissioner intends to undertake in the next year does not leave adequate space for the commissioner to react to new and emerging issues of patient safety. For those reasons, I ask members not to support amendment 21. I would request that Paul Sweeney and Sandesh Galhany, on behalf of Tess White, not to press amendments 16 and 19, and that members do not agree amendments 17, 18 and 21. I thank the minister for her response. I am heartened by her indication that she is willing to co-operate on revising potential drafting of an amendment to bring back at stage 3, and on that basis I am content to rest and not press this amendment to a vote. Thank you, Mr Sweeney. You are withdrawing amendment 16. Yes, I would like to withdraw. Thank you. No objections from any members. I call amendment 17, in the name of Tess White, already debated with amendment 16. Sandesh Galhany, to move or not move. With the reassurance from the minister, not moved. Thank you. Anyone object to that? No. The question is, amendment 17 be agreed to. I am sorry, that was one that you have just withdrawn. I apologise. I call amendment 18, in the name of Tess White, already debated with amendment 16. Sandesh Galhany, to move or not move. The question is that amendment 18 be agreed to. Are we all agreed? Okay, we are not agreed. There will be a division. All those voting in favour, please indicate now. All those against. Claps 1, I finalise the vote. The result of the vote on amendment 18 is a number of votes cast for is four, number of votes cast against is six and amendment 18 is therefore not agreed to. I call amendment 19, in the name of Tess White, already debated with amendment 16. Sandesh Galhany, to move or not move. You are happy to work with the minister, so not moved. Is any member object to that being withdrawn? The question is that amendment 19 be agreed to. I am sorry, that was one that I apologise. I call amendment 20, in the name of Tess White. The question is that section 3 be agreed to. Are we all agreed? Yes. I call amendment 20, in the name of Tess White, already debated with amendment 12. Sandesh Galhany, to move or not move. The question is that amendment 20 be agreed to. Are we all agreed? No. We are not agreed. There should be a division. All those voting in favour, please indicate now. All those against. And anyone who is abstaining. The result of the vote on amendment 20, in the name of Tess White, is a number of votes for 2, number of votes against 6, number of abstentions 2 and therefore amendment 20 is not agreed to. I call amendment 2, in the name of the minister, in a group of its own. The minister to move and speak to amendment 2. Thank you. I have lodged amendment 2 in response to the committee's recommendation to remove section 4 of the bill as drafted on the basis that it is already provided for in the equality act 2010. I move amendment 2, in my name. I have had no indication anyone else wishes to speak. Minister, would you wish to wind up? Thank you. In moving amendment 2 to drop section 4, I would like to state that, while recognising that there is existing legislative provision in the equality act 2010, I do of course wholeheartedly encourage any steps by the commissioner to embrace the spirit of this type of communication in their public facing activity. Thank you minister. The question is that amendment 2 be agreed to. Are we all agreed? Thank you. The question is that section 5 be agreed to. Are we all agreed? I call amendment 3, in the name of the minister, already debated with amendment 16. Minister to move formally. Thank you. The question is that amendment 3 be agreed to. Are we all agreed? Thank you. I call amendment 4, in the name of the minister, already debated with amendment 16. Minister to move formally. Thank you minister. The question is that amendment 4 be agreed to. Are we all agreed? I call amendment 5, in the name of the minister, already debated with amendment 16. Minister to move formally. Thank you. The question is that amendment 5 be agreed to. Are we all agreed? I call amendment 21, in the name of Tess White, already debated with amendment 16. Thank you. The question is that section 7 be agreed to. Are we all agreed? I call amendment 21, in the name of Tess White, already debated with amendment 16. Is that amendment 21 be agreed to? Are we all agreed? We are not agreed. There shall be a division. All those voting in favour, please indicate now. All those voting against. The cards will now finalise the vote. Thank you. The result of amendment 21 vote, the number of votes 4 is 2, the number of votes against is 8 and amendment 21 is therefore not agreed to. The question is that sections 8 to 11 be agreed to. Are we all agreed? I call amendment 22, in the name of Paul Sweeney, in a group in its own. Paul Sweeney to move and speak to amendment 22. Thank you, convener. I move amendment 22, in my name. Sections 10 and 11 of the bill has drafted outline the requirement for the commissioner to prepare a report following any formal investigation, as well as the requirement for a person to respond to any recommendations made to them in the commissioner's reports. This proposed amendment would give the commissioner the power to make a special report if it appears that recommendations made in their initial investigation report have not been or will not be implemented. A special report would be sent to the persons who the formal investigation report was sent to in the first instance, and a copy would also be laid before the Scottish Parliament. Further, the report can also be made public if the commissioner considered this to be appropriate. In committee evidence, patient groups cited a need for accountability. Marie Lyme from the Association for Children Damaged by Hormone Pregnancy said, up to now people have tended to get away with it. There has never been accountability and there has never been consequences. Where there is a concern about patient safety and where changes need to be made, bodies cannot be left to mark their own homework. The commissioner can only be effective if it has the ultimate option to escalate if recommendations are dismissed or ignored by the relevant authorities. I believe that my proposed amendment can give the commissioner the teeth it needs to ensure necessary changes are implemented, and I believe that this would be a proportionate enhancement of the commissioner's powers. I therefore move the amendment. I do not support this amendment, which would allow the commissioner to make a special report on any recommendations from a previous report that they feel have not been or will not be implemented. The bill expressly gives the commissioner power to publish information on the implementation or not of their recommendations. That amendment is therefore superfluous. I am also concerned that requiring the commissioner to lay before Parliament a report about actions that they feel will not be implemented could leave them open to actions of defamation as it anticipates or speculates about wrongdoing by others. I urge members not to vote for amendment 22. I note the minister's comments, but I think that this was a critical point of discussion at stage 1, that the fundamental principles are that so often reports are simply ignored because there is no method for sanction or accountability. Therefore, this amendment is brought in that spirit, and I think that we have seen other bodies, public sector bodies, health and safety executives most notably, which has powers of compulsion over ensuring that recommendations are implemented and therefore have the capacity to sanction organisations or authorities that do not comply. Although that might be seen in that instance as overly onerous and perhaps would have a chilling effect on health boards and others co-operating with the commissioner, I think that this was an effort to try to strike a balance where it is not necessarily the punitive powers that health and safety executives might have to shut up premises down, for example, but certainly would allow for areas where the recommendations are merely just ignored or simply noted by authorities and not actioned. Therefore, the commissioner would have the capacity to highlight those instances where that is not happening. It would certainly be a method of naming and shaming authorities that do not comply or do not cooperate with the commissioner, therefore giving it some degree of leverage to ensure that recommendations are implemented. I note the point from the minister about the risk of defamation. That is a judgment that we have based on legal advice by case basis. I do not think that the commissioner would knowingly prejudice themselves in that way or expose themselves in that way, so it is an unnecessary overreach to suggest that that would create that liability. We are all subject to that liability due to the lack of parliamentary privilege in this place, so that is something that needs to be improved across the board in that respect. Therefore, I would press and push this amendment. I think that it is entirely reasonable. Thank you, Mr Swinney. The question is that amendment 22 be agreed to. Are we all agreed? Yes. We are not agreed and there will be a division. All those voting in favour, please indicate now. All those against. Clarkson, I finalise the vote. The result of vote on amendment 22, number of votes for is four, number of votes against is six and amendment 22 is therefore not agreed to. Amendment 23, in the name of Katie Clark, in a group on its own, Katie Clark, to move and speak to amendment 23. I move and speak to amendment 23, which I have submitted, having worked with campaigners who are suffering from debilitating chronic pain and life-altering injury after undergoing a mesh procedure. Members will, of course, be aware of previous debates about transvaginal mesh and the detrimental effect that that has had on many lives. The mesh used in relation to these procedures, such as hernia operations, is different, but a significant number of people who have had hernia mesh procedures are experiencing similar health issues to those women that were implanted with transvaginal mesh. I have been contacted by a number of women and, indeed, men who are affected. However, there is a lack of data, which means that we cannot establish the true scale of the issue. I have tried to gather data on this issue, which is why I submitted freedom of information requests to every health board in Scotland. I wanted to know the number of patients with hernia who were treated with surgical mesh and were subsequently readmitted to hospital due to complications arising from the mesh. Most health boards did not provide that information, but those that supplied data are concerning. NHS A Shanaran revealed that eight per cent of all patients with hernia who were treated with surgical mesh were subsequently readmitted to hospital due to complications arising from the mesh. In NHS Lanarkshire, that figure rose to 10 per cent. Campaigners such as my constituents, Roseanna Clarkin and Lauren McDougall have been seeking a meeting with successive Scottish ministers to discuss an independent review into the use of surgical mesh and fixation devices in the NHS. So far, ministers have refused to meet with those campaigners or, indeed, recognise the need for an independent review. I am hoping that this probing amendment today will enable the minister to reconsider those issues and, indeed, also the need for a meeting and looking at the case for an independent review. The amendment itself would require the patient safety commissioner to undertake an investigation into the use of surgical mesh within the first year of their appointment. The purpose of the investigation would be threefold. Firstly, it would establish the scale of the use of surgical mesh to treat herniers. It would also provide data on the number of patients with a hernia treated by mesh who have subsequently been readmitted to hospital due to complications arising from the mesh. It would then outline the number of complaints that health boards have received from patients about complications arising from mesh and, indeed, detail of those complications. The patient safety commissioner would then be expected to reach a conclusion on whether the use of surgical mesh to treat herniers should be suspended by NHS Scotland. As I say, I do not intend to press this amendment to the vote today, but I will listen very carefully to what the minister says and hope that she will engage with those affected, look into the issues further and, indeed, explore the need for an independent review. I am very sorry to hear that some patients have reported complications after having received a hernia mesh implant. I am grateful to Katie Clark for all her efforts in this area and, indeed, to the patients who have raised their concerns, including those who have petitioned this Parliament. Ministers and officials, including the former First Minister, have heard directly from patients and we have listened carefully and have taken their concerns very seriously. In the chamber last week, you asked me specifically for a meeting, and I believe that my officials have been in touch for them to meet with you. Once that has happened, we can review the situation. As a result of what patients have told us, the Government commissioned the Scottish Health Technologies Group to produce two reports on the use of hernia mesh. The reports are based on current published evidence and support the continued use of mesh in abdominal wall and groin hernia repairs. The report stressed the importance of shared decision making and informed consent and also emphasised the importance of choice and the availability of alternative treatments for those who want them. We have discussed the findings with professional bodies, including the relevant royal colleges and the British hernia society, and we will continue to work with them on this important issue. The chief medical officer has also asked medical directors to consider the development of local clinical groups and broader clinical networks for the management of complex cases. Furthermore, there is also work on going with regard to establishing registries encouraging better data collection, which will provide important surveillance and outcome information in the future. It is therefore clear that the Government is listening and is acting on the concerns expressed. It is important, however, that the action that we take is proportionate, and indeed there seems to be a broad consensus on that point when Parliament debated this issue in January. The Government is thus of the opinion that further review is not warranted, so I am unable to support this amendment, however, happy to discuss further, perhaps leading up to stage 3. I am unable to support this amendment just now, which risks undermining the independence of the commissioner by Parliament legislating for a particular strand of work. The commissioner should be able to make their own priorities based on the concerns that patients raised with them. I feel that it is important that the commissioner is forward-facing using their time to gather information and horizon scan for potential patient safety issues. I urge members at this point not to vote for amendment 23. As indicated, I would not be planning on pushing this amendment to the vote today. However, I fear that this is not an issue that is going to go away as the injury suffered by those affected is significant. The minister is, of course, the decision maker in this matter. I look forward to engaging with her further on the issue, but I would strongly urge her to meet with campaigners and, indeed, to give further consideration to those matters. I call amendment 6, in the name of the minister, group with amendments as shown in the groupings. Minister, to move amendment 6 and speak to all amendments in the group. Amendments 6 to 9 in my name are intended to ensure that the commissioner can require relevant information from all relevant health bodies, not only those who directly provide healthcare services to patients. I am not able to support amendment 24. The regulation of medicines and medical devices is a reserved matter, and it is complex. I agree that it would be desirable to bring manufacturers and suppliers of medicines and medical devices into information-gathering provisions. I have asked my officials to look into this further with a view to lodging an amendment at stage 3 and to keep Paul Sweeney informed of progress. I therefore ask Paul Sweeney not to move amendment 24 at this time. I support Carole Mocken's amendment 25. Transparency and information sharing are crucial to the success of the commissioner's role, and I do not think that amendment 24 would pose an unreasonable burden on the commissioner or on health boards and the common services agency or NHS national services Scotland. Amendment 10 is a technical amendment that clarifies that an offence is committed recklessly or knowingly by a person. This amendment brings the offence into line with offences in data protection legislation, recognising that information may contain sensitive personal data relating to healthcare treatment, which must be treated with utmost confidentiality. I cannot support amendments 26 and 27. As my predecessor Marie Todd said in her evidence to committee, professional regulators such as the General Medical Council are not like the patient safety commissioner, taking action against individuals rather than promoting learning and improvement. I do not want to create a situation with this bill that may impede the willingness of healthcare professionals to be frank and open with the commissioner. It is this spirit of openness and co-operation that I feel will drive improvement, and I do not want to risk that. I therefore move amendment 6, and I urge members not to vote for amendments 24, 26 and 27. Thank you minister. Paul Sweeney will speak to amendment 24 and other amendments in the group. Thank you, convener. I move amendment 24 in my name. This amendment would ensure that private companies supplying medicines and medical devices are captured in the category of persons who would be required to provide information under section 12 of the bill to inform investigations undertaken by the commissioner. There is a lack of clarity as to whether the proposed powers of the commissioner to require organisations to provide information will apply to private companies with section 12 of the bill referring only to persons or healthcare providers. That proposed amendment therefore insert a definition that for the purposes of this section healthcare provider also includes companies in the private sector who provide medicines and medical devices. I think that that is a reasonable definition, and I also would say that we are supporting the government's amendments on technical image in this section, so I would be eager if the minister would at least consider revising her position on this particular amendment, because I think that it is entirely reasonable to clear up that definition. Thank you, Mr Sweeney. Carol Mawkins will speak to amendment 25 and the other amendments in this group. Thank you, convener. I bring forward amendment 25 because I am firmly of the view that patient safety and staff safety go hand in hand. I thank the minister for her comments in support of this amendment. We must take all steps at our disposal to optimise co-operation between this legislation and the health and care staffing legislation passed in 2019, but yet to be implemented. We all know from recent evidence and media coverage that our healthcare workforce is feeling overworked and under resourced. There are challenges across the board in recruitment and retention, putting additional pressure on the existing workforce. We know therefore in turn that if high staff standards are not being met for our staff, then it is challenging for such standards to be achieved for patients. As I said earlier, my contribution both go hand in hand. Therefore, I am of the view that we ought to amend the health and care staffing legislation to incorporate a necessary information sharing function that will allow the patient safety commissioner when appointed to be fully briefed on the progress of such staff's safe staffing legislation and to be cognisant of the impacts that the implementation of the legislation or lack thereof is having on patients. Ensuring that this information sharing takes place annually will reaffirm both Parliament and the Government's commitment to ensuring that both pieces of legislation work well in the interests of patient and staff. Indeed, by incorporating that amendment, the position of patient safety commissioner would have further credibility and the commissioner would be in a stronger position to carry out their duties supported by strong information sharing and transparent cooperation. I thank the minister for agreeing to that amendment when the bill is to be introduced. A patient safety commissioner for Scotland is important but the implementation of legislation to ensure safe staffing is also important. We can see that both those pieces of legislation can work well together. As to my amendment 26, I think that this seeks to act on some of the recommendations set out at stage 1 of the report. That is why I intend to push the amendment. The Scottish Public Services of Brisbane and the General Medical Council offered suggestions for broadening the list of individuals that the commissioner would be expected to partake in the sharing of information with health and safety executives and professional regulators being highlighted. I certainly found those suggestions to be reasonable and would encourage the minister to think again to broaden the scope through the inclusion of those that I have listed in my amendment. The SPSO did state that the current list is fairly narrow and it is not our intention to broaden it significantly beyond a manageable level but I do believe that acceptance of this amendment would be positive for both the bill and the future co-operation for working. Thank you, Ms Morgan. Sandish Gohaniw will speak to amendment 27 and other amendments in the group. Thank you. I'll briefly speak on amendment 27 convener with thanks to the General Medical Council for its input. Amendment 27, in the name of Tess White, permits a disclosure of information to professional healthcare regulatory bodies in section 15 on the confidentiality of information to further enhance patient safety because there may be circumstances where such information points towards a potential risk but is only through further investigation and or correlation with other information held by the regulator that the scale of the risk becomes apparent. I note that Carol Mocken has taken a similar approach in amendment 26 to amendment 27 adding the health and safety executive to the list. I would suggest that our approach using the term professional healthcare regulatory bodies is a phrase that includes all regulators overseen by the professional standards authority and the health and safety executive is regulated by them. So I would suggest that our amendment covers health and safety executive. Thank you, Sandish Gohaniw. Pass to the minister to wind up, please. In moving my own amendments here, I want to ensure that commissioner can access the data needed to do the job. Where I am opposing amendments, it is so that we can try to protect the same spirit of openness and frankness and not risk the improvements that we all strive for. The question is that amendment 6 be agreed to. Are we all agreed? I call amendment 7, in the name of the minister, already debated with amendment 6. The question is that amendment 7 be agreed to. Are we all agreed? I call amendment 8, in the name of the minister, already debated with amendment 6. The question is that amendment 8 be agreed to. Are we all agreed? I call amendment 9, in the name of the minister, already debated with amendment 6. The question is that amendment 9 be agreed to. Are we all agreed? I call amendment 24, in the name of Paul Sweeney, already debated with amendment 6. Paul Sweeney, to move or not move. The question is that amendment 24 be agreed to. Are we all agreed? The committee is not agreed. Therefore, we will have a division. All those voting in favour, please indicate now. All those against, please indicate now. All those who wish to abstain, please indicate now. The clerks will now finalise the vote. The result of the vote on amendment 24 is votes for 2, votes against 6 and abstentions 2. Amendment 24 is therefore not agreed to. The question is that section 12 be agreed to. Are we all agreed? I call amendment 25, in the name of Carol Mocken, already debated with amendment 6. Carol Mocken, to move or not move. The question is that amendment 25 be agreed to. Are we all agreed? The question is that sections 13 and 14 be agreed to. Are we all agreed? I call amendment 10, in the name of the minister, already debated with amendment 6. The question is that amendment 10 be agreed to. Are we all agreed? I call amendment 26, in the name of Carol Mocken, already debated with amendment 6. Carol Mocken, to move or not move. The question is that amendment 26 be agreed to. Are we all agreed? The committee is not agreed. There will be a division. All those in favour, please indicate now. All those against. The clerks will now finalise the vote. The question is that amendment 26 be agreed to. The vote for is for. The vote against is six. There were no abstentions. And amendment 26 is therefore not agreed to. I call amendment 27, in the name of Tess White, already debated with amendment 6. The question is that amendment 27 be agreed to. Are we all agreed? The committee is not agreed. There will be a division. All those voting in favour, please indicate now. All those against. The clerks will now finalise the vote. The question is that amendment 27 be agreed to. In the name of Tess White, votes for, number 4, and votes against 6. Therefore, amendment 27 is not agreed to. The question is that section 15 be agreed to. Are we all agreed? I call amendment 28, in the name of Carol Mocken, already debated with amendment 1. Carol Mocken, to move or not move. Not moved. Does any committee member have an objection to that? No. The question is that amendment 29 be agreed to. Apologies. I'm skipping over a page. I call amendment 29, in the name of Jackie Baillie. How could I possibly forget you? Already debated with amendment 14. Jackie Baillie, to move or not move. Moved. Thank you. The question is that amendment 29 be agreed to. Are we all agreed? The committee is not agreed and there will be a division. All those voting in favour, please indicate now. All those against. The clerks will now finalise the vote. Number of votes for the amendments, for number of votes against, is 6. And amendment 29 is therefore not agreed to. I call amendment 30, in the name of Jackie Baillie. Already debated with amendment 14. Jackie Baillie, to move or not move. Moved. The question is that amendment 30 be agreed to. Are we all agreed? The committee is not agreed and therefore there will be a division. All those in favour, please indicate now. All those against. The clerks have now finalised the vote. The votes in the division on amendment 30, number of votes for, is 4. Number of votes against, is 6. And amendment 30 is therefore not agreed to. I call on amendment 31, in the name of Jackie Baillie. Already debated with amendment 14. Jackie Baillie, to move or not move. Moved. The question is that amendment 31 be agreed to. Are we all agreed? Moved. The committee is not agreed and therefore there will be a division. All those in favour, please indicate now. All those against. The clerks have now finalised the vote. Thank you. The votes on amendment 31, number of votes for, is 4. Number of votes against, is 6. Amendment 31 is therefore not agreed to. The question is that sections 16 and 17 be agreed to. Are we all agreed? I call on amendment 32, in the name of Tess White. Already debated with amendment 12. Sandra Gouhani, to move or not move. Move. The question is that amendment 32 be agreed to. Are we all agreed? The committee is not agreed, but therefore move to a division. All those in favour, please indicate now. All those against. The clerks have now finalised the vote. The result of the vote on amendment 32, is votes for, 4. Votes against, 6. And amendment 32 is therefore not agreed to. The question is that sections 18 to 20 be agreed. Are we all agreed? The question is that is scheduled to be agreed to. Are we all agreed? I call on amendment 33, in the name of Paul Sweeney, in a group in its own. Paul, we need to move and speak to amendment 33. Thank you, convener. I move amendment number 33, in my name. This proposed amendment applies to the definition of healthcare in section 21 of the bill and would look to include social care services as part of that definition on the face of the bill. We know that the social care system is facing a crisis in relation to workforce and rising costs. And as a result, capacity is stretched with social care workers stressing the difficulty of providing the level of care that they would like to under these circumstances. This amendment would not seek to widen the commissioner's remit to include social care as a whole. Instead, it would merely enable the commissioner to consider the interface with social care as part of their investigation only when these services intersect with the defined elements of healthcare within the commissioner's remit in relation to healthcare services provided in connection with illness and forensic medical examinations. And this amendment stands in line with the recommendations of this committee's stage 1 report. And I would encourage the minister to support. Thank you, Mr Sweeney. Minister. Thank you. I'm not able to support this amendment. In its stage 1 report, the committee called on the Government to confirm that the commissioner will be able to address matters arising at the intersection of health and social care. I am very happy to confirm this on the official record here today. The commissioner's role is about safety in healthcare. There is nothing in the bill that would prevent the commissioner dealing with healthcare provided in a social care context or any other context. I hope that Paul Sweeney will accept this confirmation and not press this amendment, which rather than clarifying matters may create some doubt about whether the reference to healthcare includes healthcare provided in contexts other than social care. I therefore ask Paul Sweeney not to press amendment 33. Thank you, minister. Paul Sweeney, to wind up and press or withdraw amendment 33. Thank you, convener. I welcome the minister's comments to clarify that point. And I think that it is a welcome clarification in terms of the intention of the amendment and stands in line with the recommendations of the committee in that respect. So, with that assurance, I would be content not to move the amendment today. Thank you, Mr Sweeney. Does any member object to that amendment being withdrawn? No. Thank you. I call on amendment 34 in the name of Jackie Baillie, already debated with amendment 14. Jackie Baillie to move or not move. Thank you, convener. And whilst I'm disappointed at the outcome of my other amendments, God loves a try. So, I will move for one last time and indicate to the committee that I will be bringing all of these amendments back at stage 3. Thank you, Ms Baillie. The question is that amendment 34 be agreed to. Are we all agreed? The committee is not agreed. There shall be a division. All those voting in favour, please indicate now. All those against. The clerks will now finalise the vote. The result of the vote on amendment 34 is number of votes for four, number of votes against six. And amendment 34 is therefore not agreed. The question is that sections 20 to 26 be agreed. Are we all agreed? The question is that the long title be agreed to. Are we all agreed? And that ends stage 2 consideration of the bill. Section 21, my apologies. The question is that section 21 is also agreed. Are we agreed? That ends consideration of stage 2 of the bill. At our next meeting next week, we will continue scrutiny of front-line NHS boards with sessions with NHS 24 and the Scottish Ambulance Service, and that concludes the public part of our meeting today.