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There are powers to enforce in other parts of the system. The professional regulatory bodies can take action and the police can take action if there is a police concern. A number of different bodies other than the commissioner can ensure that enforcement occurs, should it be needed. The key point in relation to the commissioner is for the system to learn lessons. We have a responsibility there.

If we think of the big issues that have been raised with us—for example, by mesh-injured women, the valproate families and infected blood people—those people were asking for a long time for their story to be heard and for inquiries and explanations to be made. They did not necessarily want blame to be apportioned; in fact, the infected blood people were very keen simply to have an apology and an acknowledgement. Ensuring that the system learns, and that issues are picked up and dealt with, is really very powerful, because we can see so many examples of where that has not happened in the past.

Yes, convener—I have a brief one.

I thank the committee for inviting me to give evidence, and I pay tribute to the work of Baroness Cumberlege and her team and the patients, healthcare staff and professionals who have worked hard to contribute to development of the bill. I am certain that future generations will benefit from safer care because of their efforts.

It will be helpful to make some brief opening remarks to summarise the intention behind the bill.

Patients, their families and the wider public have told us that, too often, they do not feel listened to when they raise concerns about the safety of their care. The patient safety commissioner for Scotland will be an independent public advocate whose primary focus will be on ensuring that the patient voice is heard in the healthcare system, in order to make care safer for all. Patients told us that the commissioner must be independent of both Government and the national health service. That is why we are proposing that the commissioner be answerable to Parliament directly and, therefore, to the people of Scotland. The commissioner will be directly accessible to patients in order to hear about their experiences and about what could have been better. People sharing their stories will be the key to making the role work and to making healthcare safer for all of us.

The commissioner will focus their attention on the concerns that patients tell them matter most, and will listen to patients’ accounts of their experiences and combine those with data from other organisations to identify systemic safety issues and to recommend improvements.

The commissioner will not necessarily be the person who is best placed to investigate every concern that patients raise with them, and they are not intended to take on and resolve individual complaints. There are already well-established processes for those functions, which are delivered by other organisations, including health boards and the Scottish Public Services Ombudsman. The commissioner will hand over to them, where that is appropriate, but we propose that the commissioner has substantial information-gathering and investigative powers for situations in which they wish to look further into an issue that other organisations, such as Healthcare Improvement Scotland and the Scottish Public Services Ombudsman, are not better placed to take on.

I look forward to answering questions from the committee and to the discussion.

Yes. The commissioner will have power to require organisations to provide evidence. Those are robust powers.

If I may explain, it is a role that is really about encouraging a culture of openness and inquiry, and it is absolutely in the system’s best interests to adopt that culture. That is how we will give the best patient care.

If we do not learn when mistakes happen or when safety issues arise, mistakes will be repeated, which is not in the interests of patients or the system. Therefore, I think that there will be enough power, but I am open to suggestions, if you think that some powers need to be strengthened. I am listening and I am open to that, but it is very clear how the concept of this role has evolved, so I would like to think that there is a wish and a will in the system to learn those lessons to prevent further harm.

Our commissioner will have a slightly broader role. It is a new role and the commissioner will learn in the job. However, the point of the role is to listen to patients, hear what they are saying and ensure that the healthcare system is able to pick up and act on safety concerns that have been raised by patients because we know that that has not happened in the past or has not happened fast enough.

It should be perfectly possible for staff to raise concerns and for the patient safety commissioner to listen to those concerns. I expect the patient safety commissioner to be an ear in the system and listening to staff would be an important part of that.

We need to make clear that staff can raise their concerns. We are at stage 1 of the legislation and I am open to ideas about how we can make sure that that is clear. Essentially, however, the commissioner should be a listening ear. It would seem odd to me if they were not listening to staff.

We need to be careful that we do not duplicate existing powers. Regulators can take action against individual professionals, there are the police and there is the potential to take action in various ways, so we need to ensure that we are not duplicating effort. The fundamental role of the patient safety commissioner is to ensure that the voices of patients are heard and that that open learning culture is fostered so that the system learns and prevents further harm, rather than these things going on for far too long and harm continuing while those issues unfold.

Yes. There are people with that type of expertise who do a lot of independent consultancy work, so an individual role may not be needed. It may simply be that expertise is needed in one situation, and there might be capacity to think about using individuals with specific expertise as the role develops.

The commissioner’s role came from the Cumberlege report. It was not the Government that came up with it, and it was not the Parliament that suggested it, as has happened with many other commissioners. There were really solid reasons to bring forward the commissioner’s role.

There probably is a need to look at the commissioners as a whole strategically. There is always room to look at where the whole Government’s focus is and what resources are going where—that often happens around budget time—as opposed to the individual commissioner whom we are discussing.

It seems reasonable to me. We do not want the patient safety commissioner to be picking up noise from the system and dismissing it as something anecdotal rather than an evidence-based concern. Sometimes having the data is the only way of dispelling concerns about whether what you are picking up is genuine or just some incorrect signal.

There will have to be a robust capacity for data analysis, but I am not going to write the job descriptions for the various job roles in the team now. I should say, though, that there is a lot of data analysis expertise already in the system, and that will have to complement the work that is being done, but I get what was said last week about being able to crunch the data and develop fresh insights.

I hope so. There are pockets of brilliant practice all over Scotland in many areas. One of our challenges is making sure that that practice is the same all over Scotland and making sure that the same quality and safety focus happens everywhere. That would be a good outcome, but I do not see it as being a primary one, because, remember, this role is absolutely focused on the voice of the patient. Where the commissioner finds good practice, that might be one way of improving the situation if they found a safety concern in one part of the country.