Health and Sport Committee

Meeting date: Tuesday, October 31, 2017

Official Report 539KB pdf

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Subordinate Legislation

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Functions of Health Boards (Scotland) Amendment Order 2017 (SSI 2017/304)

Item 2 is consideration of a negative Scottish statutory instrument. The committee will take evidence from the Minister for Public Health and Sport on the Functions of Health Boards (Scotland) Amendment Order 2017. Jeremy Balfour MSP has lodged a motion to annul the order that we will formally consider later.

I welcome to the committee Aileen Campbell, the Minister for Public Health and Sport, and from the Scottish Government, Mary Stewart, team leader in the health protection division, and Lindsay Anderson, solicitor. I invite the minister to make a short opening statement.

Thank you for the opportunity to discuss with the committee Mr Balfour’s motion to annul the Functions of Health Boards (Scotland) Amendment Order 2017. As you have pointed out, I am joined by Mary Stewart, who is team leader in the health protection division, and Lindsay Anderson, who is a solicitor from the legal directorate.

The order is required to empower national health service boards to provide free abortion services in Scotland to women who normally live in Northern Ireland. In developing the order, we have consulted a wide range of stakeholders, including third sector organisations and NHS experts. In Northern Ireland, abortion is permitted in only very limited circumstances, and therefore hundreds of women travel to Scotland and England each year to access services. That creates an inequality, but it is significantly addressed if those women do not have to pay for treatment. It is important that, alongside similar provision that is being made by the UK Government, Scotland enables the women who travel here from Northern Ireland to receive clinically safe NHS treatment without being charged.

I recognise that abortion can be an emotive subject and that there is a range of views on it in Scotland, including in this committee room. However, similarly to the UK Government, we believe that abortion should be available as part of a standard healthcare service for all women. Women in Northern Ireland who need abortion services face considerable challenges in accessing them, so it is right that Scotland plays its part in providing clinically safe and legal care for women who have made the decision to access those services.

In light of those remarks, I hope that Mr Balfour will consider withdrawing his motion.

Thank you, minister. I welcome Jeremy Balfour to the committee and I invite him to ask any questions that he might have.

Thank you for having me here, convener. I agree with the minister’s closing remark that abortion is an emotive subject on which people have different views. The questions that I have are not about the issue of abortion itself but about some of the issues behind it.

My first question for the minister is about the cost of what is proposed. We are all very aware, particularly given the committee’s earlier discussion, that our NHS in Scotland has cost pressures and that there are already pressures on hospitals, doctors and so on. What will the cost to Scotland be of what is proposed. How much will it cost and how many people might come from Northern Ireland to Scotland to use the service, particularly if we offer it as a free service, compared to the number who go to England, as some people do at the moment?

Secondly, does the proposed provision set a precedent for treatment? For example, if we in Scotland find a cancer drug that might help three or four-year-old children but that drug is not funded in Northern Ireland, are we going to say that, because people in Northern Ireland do not have it, we can fund it? I wonder whether we are creating a precedent here with regard to other jurisdictions.

My final question is about parliamentary jurisdiction. Whatever our view on the subject of abortion, the Northern Ireland Assembly has taken a view on it. I wonder whether we are interfering in another jurisdiction and why the order relates just to Northern Ireland. There are other countries in Europe with a view on abortion that is similar to that of Northern Ireland. Why are we limiting provision simply to Northern Ireland? Why are we not seeking to expand it to central European countries as well?

Those are the questions that I have for the minister.

Thank you. I invite the minister to respond.

I am not sure whether Mr Balfour has had a chance to look at the business and regulatory impact assessment, but it sets out that the cost of the policy will depend on the number of women who choose to travel to Scotland and that we have estimated that that cost will be between £17,000 and £98,000. However, it is also important to recognise that the Scottish Government will receive consequentials because of the new spend that is required to fund the equivalent policy that the UK Government announced for England. Those consequentials will be used to fund the service in Scotland.

We are confident that Scottish abortion services will have the capacity to be able to treat women from Northern Ireland without that having a detrimental impact on the service to women in Scotland. However, that will require continual monitoring, which is what we will endeavour to do.

With regard to interfering with the devolved Northern Ireland Assembly, abortion remains a devolved matter for Northern Ireland. However, if a woman from Northern Ireland chooses to travel to Scotland for an abortion, we want to provide her with the same service and care that women in Scotland receive without being charged—that is the difference. Women from Northern Ireland should therefore be given the same care and support as women in Scotland.

The Republic of Ireland is a separate country in its own right. What we are proposing is about tackling inequalities in the UK context. The UK Government announced that it will seek to ensure that women from Northern Ireland going to England for an abortion receive the same care and support that women in England receive, and we want to do the same in Scotland for women who come here from Northern Ireland for an abortion. There is therefore a distinct difference between women from Northern Ireland and those from the Republic of Ireland who come to England and Wales or Scotland for an abortion. What we are doing is in line with what the UK Government is doing.

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Does Jeremy Balfour want to come back on any of that?

No.

Do any members wish to ask any questions?

For clarity, minister, do you have an estimate of how much the Barnett consequentials are likely to be on this matter?

I do not think that we have that information at present, but we continue to work with the UK Government on that. We have set out the anticipated costs in the Scottish context, and any funding that we get from the UK will be used to fund the service in Scotland. We will continue to work with colleagues in the UK Government on that, because we want to provide care and support to women travelling to Scotland from Northern Ireland to have this very difficult procedure.

Does anyone else want to comment?

Members: No.

Do you wish to make any final comments, minister?

No.

We move to formal consideration of motion S5M-08451, in the name of Jeremy Balfour MSP, which asks the Health and Sport Committee to recommend that the Functions of Health Boards (Scotland) Amendment Order 2017 (SSI 2017/304) be annulled. If Jeremy Balfour wishes to proceed with the motion, he will speak to it and move it. There will then be an opportunity for members to debate the motion and for the minister to respond. Following that debate, Mr Balfour will be asked whether he wishes to press or withdraw his motion. Under standing orders, the debate cannot last longer than 90 minutes. I do not think that it will last that long.

I ask Jeremy Balfour to speak to and move the motion.

In the light of the minister’s answers to my questions, I withdraw the motion.

Thank you.

As agreed, therefore, we now go into private session.

11:31 Meeting continued in private until 12:26.