Hansard

I accept the core of what Mr Findlay says about the importance of women having faith in the specialist service. Undoubtedly, one of the harms that has been done is the harm to trust—I accept that. However, the alliance has canvassed and reached large numbers of women, many of whom have written to me. Women want the service, notwithstanding the fact that there are questions that need to be answered. However, I do not think that it would serve them well to pause the service; rather, we should try to address all those questions while we continue to develop that work. I think that it is entirely possible to do both, hand in hand.

The close working partnership between the specialist service and the specialist centres in England will allow for benchmarking and peer review, and I hope that it will help to restore trust and confidence in our services. As such, we are happy to accept Jackson Carlaw’s amendment to the motion.

In respect of other specialist centres, my senior officials recently met patient groups and we are considering whether additional centres or services would be helpful for those affected by sodium valproate and Primodus, in line with the other review recommendations.

As members know, we have established a £1 million fund for women with mesh complications. The fund opened to applications on 1 July and runs through to next year. To date, 276 applications have been received.

The Cumberlege review makes an important recommendation on data. Members will be aware that patients expressed concerns about that area to the Public Petitions Committee. The MHRA has been working on a sodium valproate-specific registry, the aims of which include monitoring the use of valproate in women and girls across the UK, compliance with the current regulatory position and identifying and monitoring any children born to women taking that drug.

We have set up a device identifier programme unique to Scotland to develop a system for collecting data on implanted devices. Our aim is that the information that we collect, particularly when combined with similar information collected elsewhere in the UK, will allow for better quality assurance, comparison and peer review. We have agreed to work with NHS Digital on a UK-wide database of procedures that it is establishing. We will join the pilot, which has an initial focus on pelvic floor procedures, including those using mesh and related procedures. In the longer term, NHS Digital ultimately intends to capture information on procedures concerning all surgical devices and implants from NHS and private providers. Those are all important drivers of change and continuous improvement, and a key aim of the programme is to support NHS Scotland’s commitment to continuously improve patient safety.

I now turn to what I think is a key recommendation of Baroness Cumberlege’s report: the appointment of an independent patient safety commissioner. It is clear to me from not just her findings but my discussions with mesh-injured women, families and professionals that there is still work to be done to ensure that people are listened to and heard, and that their experiences are acknowledged and valued. They should not be experiencing additional distress when what they need is further care and support.

NHS Scotland carries the mantra “safe, effective and person-centred”; I believe in that absolutely, but I also know that there is more for us to do to deliver on it. People must be at the centre of the decisions that are made about their care. We fully expect clinicians to facilitate shared decision making, listen to their patients’ concerns and explain the risks and benefits of treatment options to allow them to make informed decisions. That is central to the principles of realistic medicine and should be fully embedded in the new specialist service for mesh complications. Indeed, when I met Baroness Cumberlege yesterday, she spoke at length about that. It is vital, and it is why we agree with Alison Johnstone’s amendment to the motion.

It is vital that patients have confidence that, every time that they access any part of the healthcare system, they will receive not only the information that they need to make an informed decision but the best available treatment without fear of harm. By creating a culture of openness and learning, everyone should feel able to share what has gone well but also what has gone wrong and what could have gone better. That will help us all to learn and to continually improve our services, our experiences and the outcomes that we seek. The challenge is to make that a reality and ensure that learning and improvement happen even when things go wrong.

Whether through boards or through the Scottish Public Services Ombudsman, there are established routes for patient feedback and complaints, but those routes are largely reactive, and it is clear that not everyone gets the outcome that they are looking for and not everyone feels that they have been properly listened to or that change will come from their feedback. As a result, relationships between patients and health and care providers break down, with patients losing faith in the service. That needs to be addressed, and establishing the patient safety commissioner role for Scotland is now a programme for government commitment.

The role will initially focus on improvements to patient safety around the use of medicines and medical devices, as set out in the review. The role must be proactive and enhance what we already have in place, with the emphasis on listening to and learning from people’s experiences and driving implementation to continually improve patient safety.

To get that right and make it work for patients, we must listen to them, so we will shortly begin a consultation to understand what patients want from the new role and then act to implement that as soon as possible. I am anxious that we do not delay in that area.

I hope that what I have set out makes it out abundantly clear that we take the findings of Baroness Cumberlege’s report seriously. Although there is a great deal of alignment between our thinking and our actions to date, her report gives us the opportunity, and arguably the impetus, to go further.

As we draw together our implementation steps, I am pleased that Baroness Cumberlege has accepted both my invitation to offer me advice on our delivery plan and my offer to support her as she seeks to ensure that the Governments of all four nations implement her recommendations.

As we move forward with that and put in place the detail and, in particular, the consultation on the patient safety commissioner, I will be happy to keep all members advised of our progress.

I move,

That the Parliament welcomes the recommendations made by Baroness Cumberlege in her report on the independent medicines and medical devices safety review; acknowledges the Scottish Government’s apology to women and families affected by Primodos, sodium valproate and transvaginal mesh; welcomes the Scottish Government’s commitment to establish a Patient Safety Commissioner, and notes the actions taken by the Scottish Government to offer improved services for women who have suffered complications as a result of transvaginal mesh.