Meeting of the Parliament (Hybrid) 09 March 2022
My thoughts are with all those whose care has fallen short of the high standards that we hold for our public services. Fighting to have your voice heard can be exhausting, so I also thank those who have tirelessly campaigned to bring injustices or failure to light, especially Milly’s family, and I thank Anas Sarwar for securing the debate.
Our public services are invaluable and we should all be able to rely on them, particularly during a global pandemic. Unfortunately, sometimes those services fall short of the standards that have been set for them. When that happens, it is right and proper that there is honesty and transparency about what has gone wrong and how those failings can be addressed. However, as the motion and the Government amendment note, individuals and their families are too often left seeking answers or justice.
We must not underestimate the pain and hurt caused to individuals who know that something is not right with either their or their loved ones’ care, but who are ignored or dismissed when they try to raise concerns. Too often, I know that people feel shut out of the process when investigations are taking place. It is important that any investigations and their findings are communicated on an on-going basis to patients and their families. It is essential that whenever public bodies have failed in their duty of care towards members of the public, they are held accountable.
Transparency and candour are fundamental to ensuring that people can trust the services that are available to help them. The public has a right to know when there have been failings, as well as what action will be taken to prevent such failures in future. Without that, relationships can be damaged. Understandably, that can lead to fear, hurt and anger on behalf of those who have been failed and their families. As we recover from one of the greatest challenges that our NHS has ever faced, we must prioritise rebuilding and repairing the relationships between patients and health services, which have been severely tested by the strain that Covid has placed on them.
As the Cumberlege report notes, the system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. The report found that people from all over the UK who have been affected have been dismissed, overlooked and ignored for far too long, and that the issue was not one of a single or a few rogue medical practitioners or differences in regional practice, but that it was system wide.
There is no intention to blame individual members of staff, the vast majority of whom work extremely hard to deliver excellent care for the people of Scotland. However, there is clearly a culture where patients are not always listened to when things go wrong. A “clinician knows best” approach fails to take into account that patients are often the first to know when something is not right with their own bodies or the care that they are receiving. That is why the creation of an independent patient safety commissioner will be so important and will ensure, when patients do have concerns and complaints, that they are listened to and that those complaints are considered alongside other similar concerns and complaints so that patterns can be detected at an early stage. The commissioner will be able to advocate for patients in a system that is not always willing to take their concerns seriously, or capable of doing so.
Services should be held accountable when failings are discovered but, when genuine mistakes have been made, we need to support staff to come forward, and to establish an opportunity for learning, training and development. Creating a hostile culture that discourages people from coming forward will not serve patients or staff well. The Sturrock review laid bare the cultural problems that exist within our NHS and the terrible toll that they have taken on staff, who are afraid to speak out about issues. We need to foster a culture in which people feel comfortable and safe in coming forward when mistakes have been made.
I close by expressing my thanks to all those working in the NHS and wider public services, many of whom have been dealing with extremely difficult conditions since the beginning of the pandemic. Improved transparency and accountability will serve patients and staff better, and we owe it to all who are affected to make sure that that happens.
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