Chamber and committees

Okay. We have six commissioners and an ombudsman. With the potential for future commissioners, does the Scottish Government need to look at how we can ensure that a more strategic approach is taken to resourcing and establishing additional commissioners? Is work being done now to look at that?

Does the way that we measure and gather data need to be flexible because of the technology and because some products are not yet licensed for emissions reduction in dairy cattle? Am I right to say that everything has to be flexible and must be allowed to evolve as the science, technology and support enable emissions reduction by farmers?

I know that we are conscious of time, so I can stop there.

I know that I am not a regular attendee of the committee—I am here as a substitute—but I would like to comment. In the notification, it says that the SI is to

“adjust the level of European seabass that may be caught within British fishing limits”.

I am aware that only one licence has been issued for catching sea bass in Scotland, so, when the notification talks about adjusting, does that mean both up and down?

I want to pick up on Jim Fairlie’s questions and ask about emissions in other countries. In debates in the chamber, we have talked about how much water it takes to produce a litre of almond milk. It takes about 101 gallons of water to make a cup of almond milk, which is not even made in this country. In comparison, we grow grass really well in this country, and that can support our diet.

At the Health, Social Care and Sport Committee, Alice Stanton, an expert witness, talked about the misinformation that consuming red meat causes cancer, as there is now evidence that that information is not quite accurate.

How can we support food production and emissions reduction? How do we compare with other countries on those issues?

I will be really quick because a lot of information has been covered already.

I am thinking about data management and collection. Jackie McCreery said that two thirds of dairy farms have done a carbon audit. However, I am thinking about measuring other emissions reduction. There are biostimulants, such as those produced by Tricet, such as Pro-Fortis and Pro-Soil. There are also other products for emissions reduction, such as yeast-based products for ruminants like Biocell. Then there are other products such as Slurrycell, which helps to reduce nitrogen emissions in slurry.

Do we measure that kind of stuff? Do we know what farmers are using Slurrycell or Biocell? Do we know who is using biostimulants, which are not organic but are regenerative and will help to reduce nitrogen?

I will direct that question to Andrew Moir first and then Jackie McCreery.

I asked the previous witnesses about the commissioner not focusing only on safety, because care and compassion are at the heart of how we support a patient’s journey—whatever care they are in receipt of—and determine whether harm has occurred. Do you have any comments on whether we should focus only on safety aspects or whether we should consider the whole patient journey in relation to care and compassion?

I know the work that Dr Gordon Baird and the Galloway community hospital action group have done to get the petition to the Parliament, and I know that local people feel powerless. I know that Professor Sir Lewis Ritchie is interested in how Australia’s National Rural Health Commissioner works—Australia is also a big rural country. I also know that a centre of excellence for remote and rural medicine is being created, but it does not have an advocacy role. That is what Professor Sir Lewis Ritchie said when he gave evidence.

The proposed agency is not about picking up individual casework. That is not what Dr Gordon Baird was after when he asked for an agency to be created. It is about advocating for and giving a voice to people who feel powerless and who do not know that, for example, they should be offered a choice of care that might be closer to home. That is one of the challenges.

NHS Dumfries and Galloway committed to addressing cancer care pathways and then Covid came along. Therefore, when the board comes in front of us, we will need to ask specific questions about where it is with altering cancer care pathways and what steps it has taken. This is not about addressing all the challenges overnight. I know that there are real challenges—everybody does; I was a healthcare clinician as well.

I am keen to ensure that, whatever pathway we take, Dr Gordon Baird is permitted or invited to give evidence about the challenges for remote and rural healthcare and advocacy for patients.

I am well aware of this petition; I was at the Citizen Participation and Public Petitions Committee meeting at which it was presented by the petitioners, and I know that other members in the room were there, too. I know the history behind it, and I am keen that we do not lose sight of rural health and social care needs and that we hear people’s voices.

The example that I have before me is the experience of people in Stranraer. A key issue that the petitioner has been trying to raise for 20 years now relates to the fact that NHS Dumfries and Galloway is part of the south-east cancer network and that, as a result, patients in the south-west of Scotland—which isnae in the east of Scotland—end up having cancer treatment in Edinburgh instead of at the closest cancer centre for radiotherapy, which would be in Glasgow. It means that, instead of just going up the road to Glasgow, people who are undergoing radiotherapy or other cancer treatment have to travel a distance that is pretty hefty for them.

My understanding is that, for 20 years now, Dr Gordon Baird, who is a retired GP and former chief medical officer at the Galloway community hospital, has been trying to look at ways in which we can hear the voices of people who live in remote and rural parts of Scotland, particularly Dumfries and Galloway—although, as we can see from the other petitions, the issue goes wider than that to, for example, Caithness. The question is how we support what is best for patients; it is not about telling them, “You’ll get your treatment where we tell you,” but about giving them the best opportunity to get the best care where they choose and reducing the issue of travel.

Currently, the people in question are means tested for their travel, whereas those in other parts of Scotland are not and get their care without having to cough up from their own finances. That is a health inequality issue, too—means testing people for their care should not be happening.

There are other issues regarding maternity services. I know that a review of the midwifery-led service in Galloway is happening right now because no baby has been delivered in Stranraer for four years. That is similar to the issue at Dr Gray’s hospital, which has been raised in the chamber of Parliament on a number of occasions.

My concern is that, for 20 years, little progress has been made to hear the voices of the people who live in remote and rural areas, whether that is in the area that NHS Dumfries and Galloway covers or more widely. If we in the committee do not keep the petition open and hear from witnesses, I am concerned that we might lose sight of what the real issues are for people in remote and rural areas.

I know that the Cabinet Secretary for Health and Sport said that he did not want to

“clutter a landscape”

that

“already has a fair bit of bureaucracy around it”—[Official Report, Health and Sport Committee, 17 January 2023; c 14.]

through the organisations, agencies and institutions that we already have. I am aware that the establishment of an agency is not the route that the cabinet secretary wants to take. I suppose that the big issue is how we ensure that rural voices are heard. We have raised the issue in debates and through questions in the chamber, but how do we get rural voices heard if we do not continue to pursue evidence taking?

I know that the petition calls for the establishment of an agency. I need to understand whether we need the petitioner to submit a new petition that addresses the specific issues with remote and rural healthcare rather than calling for an agency.