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I bring members’ attention to my entry in the register of members’ interests as a former councillor in East Ayrshire Council.

The committee has received the report that says that the majority of people are in favour of the regulations as set out, but several local authorities raised questions and issues, so I will explore them with the minister.

One of the issues that East Lothian Council brought to the attention of the committee is the requirement to “make safe” versus “repair”. Given that the ultimate responsibility for headstones lies with the lair holder, can we explore that a little? Local authorities say that they have a backlog with regard to bringing headstones up to the required level, as set out in the instruments.

I have one other wee question—you touched on it earlier—about many of the workers within the sector being part time; also, a lot of them are women. I would like to explore a little how we will make sure that the workforce will have their lot improved, as far as we can possibly do that.

If we are not proceeding with the national care service at this stage, how can we protect that workforce as much as possible in the meantime, given the precariousness that we are now seeing, with the added pressure of that national insurance change?

Good morning, minister. I want to explore some issues around the fair work agenda. We have already touched on some of that, but I would like to go into a bit more detail.

Stakeholders have advised that a definition for ethical commissioning should be discussed and agreed, emphasising that that is critical in delivering the fair work agenda.

We have heard from you this morning about the sectoral bargaining issues that you have been discussing with your UK counterpart, which was quite helpful. It might be good to get a bit more information about that.

We have also heard about the pressures that will be put on the system by the estimated £21 million in additional costs for the third sector because of the national insurance changes. We know that there are good examples of collaborative commissioning and procuring arrangements, such as the Granite Care Consortium and the Fife care at home collaborative. How do you intend to further facilitate and accelerate more ethical commissioning models and improved procurement practices, bearing in mind that those new pressures will perhaps put some spanners in the works?

I have a final question, which is about 16-year-olds. Someone spoke earlier about whether 16-year-olds have the capacity to make a decision on assisted dying. However, we allow them to make decisions about healthcare in general. Can you explore that idea? Perhaps Dr Provan could start.

That is quite helpful. The questions that I am trying to get at are in relation to assisted dying being an adjunct to palliative care. They are two separate systems, but if the bill became law, there might be an integrated pathway where the two systems would have to interact with each other—it is about considering how they could mutually benefit the patient.

In the interests of time, I will move on and let Dr Mills and perhaps Rami Okasha answer as well.

I remind members of my entry in the register of members’ interests: I am a member of the Humanist Society Scotland.

We have already touched on the issue of capacity, but I would like to explore it a wee bit further. Some submissions to the committee set out concerns about the ability of doctors and specialties outwith psychiatry to undertake capacity assessments as part of the assisted dying process. Conversely, last week, we heard from the mental health witnesses that they did not share those concerns, and they argued instead that undertaking capacity assessments was a core part of medical practice. However, they did share a concern that the bill turns an incapacity test into a capacity test, which is different to what they do as part of their work. They were also looking for the reference to mental illness to be removed altogether, and they suggested that more senior doctors be involved in the capacity assessments, as we touched on previously.

Do the witnesses have any concerns about the approach to assessing capacity as set out in the bill, and could you explore a wee bit more what specialist training needs to be undertaken?

Colin Poolman, you are looking at Dr Provan, so we will start with him.

I will explore that a bit further. If an individual determines that they are not going to proceed with treatment—they are taking a decision that will absolutely result in their death—what is the difference between having a stand-alone consultant or GP assess their capacity to make that decision versus requiring a specialist service to assess someone’s capacity to make a decision around assisted dying?

I will cover the theme of assisted dying as an adjunct to palliative care. We have heard quite clearly that we have to look at assisted dying and palliative care as two separate things, and I think that that is absolutely right. We have had written submissions and oral evidence saying that palliative care can be complemented by assisted dying as an alternative. People have stressed that there is a therapeutic value to having a choice of an assisted death and how that can remove an element of suffering not addressed by palliative care, even if it is ultimately not exercised.

Conversely, we have also heard that the two are not compatible and that assisted dying would divert resources away from palliative care and erode its quality and availability.

I would like to explore that a little bit. Do witnesses recognise the potential therapeutic value that accessing assisted dying can have for individuals approaching the end of their life, especially those individuals for whom the best palliative care would perhaps not be enough to relieve their suffering?

I will start with Amy Dalrymple and work across from left to right.

I am actually going to ask you whether you can lengthen your answer a little bit for me. I want to explore the therapeutic effect that access to assisted dying has reportedly had for some people who may not eventually exercise their right to it but who report that unpacking those really difficult conversations with palliative care specialists—availing themselves of that opportunity to explore all the options—allows them to live as best they can for the remaining time, even though they do not exercise that right at the end.

Does anyone else have any thoughts on that?