Public Petitions Committee

Meeting date: Thursday, June 29, 2017

Official Report 558KB pdf

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New Petitions

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Prescribed Drug Dependence and Withdrawal (PE1651)

Agenda item 2 is consideration of new petitions. The first petition on which we will take evidence is PE1651, by Marion Brown on behalf of Recovery and Renewal, on prescribed drug dependence and withdrawal.

I welcome Marion Brown to the meeting and ask her to make an opening statement of up to five minutes.

First, I give apologies from Beverley Thorpe. She had hoped to be here, but her mother is very ill.

I am here today to represent many people in Scotland who are not well enough to be here in person. Some courageous individuals have provided clear evidence to the committee on the terrible suffering that is being endured as a consequence of taking antidepressants and/or benzodiazepines, as prescribed by their trusted doctors. We have previously raised our concerns directly with the doctors, with national health service representatives locally and nationally, with MSPs and with the Cabinet Secretary for Health and Sport. We actively contributed to the British Medical Association board of science’s 2014 United Kingdom research and are taking part in the BMA’s on-going work on prescribed drugs associated with dependence and withdrawal.

Our focus now is on raising political, press and public awareness of the issues in Scotland, complementing the activities of the all-party parliamentary group for prescribed drug dependence at Westminster. The Scottish Parliament information centre summary links to the current official medical guidance and policy, and it also outlines the recent BMA recommendations.

We have found major discrepancies between what the official medical guidance would have us all believe and the very different actual experiences of patients. The SPICe briefing states:

“despite the licensing procedures and guidance ... it is ultimately the decision of clinicians to decide whether or not a drug should be used in the treatment of their patient”.

That is a comment that seems to come back time and again in response to any questions.

Clinical trials of medicines are usually carried out over relatively short periods. Patients may be prescribed these medicines over very long periods, perhaps in combination with other medicines. We have found that individual reported patient experience is frequently ignored, put down and disbelieved by clinicians. The clear medical guidance is that benzos should be prescribed for a very short time only, but that is not happening. There is substantial evidence for prescribed benzo dependence and withdrawal issues going back decades. In contrast, medical guidance for antidepressants is that they should be taken for at least six months, and then they are commonly prescribed indefinitely.

There are now many people who have been on antidepressants and/or benzos for twenty years or a lot longer. Long-term harm is now clearly apparent. Safe tapering after different periods of prescribed treatment is fraught with difficulties for patients. The very few—mostly online—support groups that exist have for years been informally gathering evidence on a trial-and-error, ad hoc, patient-report and patient self-help basis. That genuine experiential patient learning and sharing has been largely dismissed, disregarded and even denigrated by the medical profession.

Now that there is a great deal of patient communication via online social media, as well as extensive internet availability of research and medical information, patients often come to know much more about their own conditions than their doctors possibly can. When patients try to discuss what they have learned, doctors patronise them and say that they should not believe anything that they find on Facebook or the internet. Those patients find themselves perceived by their doctors as troublesome and difficult heart-sink patients, and acquire psychiatric diagnoses such as personality disorders and medically unexplained somatic, functional or conversion disorders.

I refer to the diagram in my written submission, which summarises the pattern of the patient journey that we have now observed across numerous accounts by patients of what has happened to them. The fact that patient medical records are confidential to doctors turns out to have unexpected consequences for patients. Self-reported serious drug-effect symptoms have been noted in medical records but have not been acknowledged by doctors as drug effects, and instead further medicines have been prescribed for the reported symptoms.

Complaints procedures tend to be perceived as threatening to doctors. The medical defence organisations encourage doctors to do what any other doctor would do and to comply with current medical guidelines. If patients complain, it results in professionally defensive responses, so adverse drug effects continue to be unrecognised for what they are and are not reported to the regulator. There is no provision for systemic patient feedback and constructive learning.

To sum up, patients are suffering very serious harm from taking these medicines as prescribed. Dependence and withdrawal problems are causing untold damage; doctor-patient relationships are being destroyed; and all parties are suffering. The consequences are utterly desperate.

Long-overdue recognition of these issues will open the door to honest communication and genuine collaboration, leading to the establishment of appropriate national, regional and local support services and facilities for those who need them and, most important, urgent prescribing guideline reviews and updating of doctor education. The principles of the duty of candour surely apply here. Given the focus of Scotland’s “Realising Realistic Medicine” on “listening” to patients, “shared decision-making” and “collaboration”, I hope that we can show by example what that means in real practice. This is raw genuine feedback from the public and patients.

I will end my statement by citing “Black Box Thinking: The Surprising Truth About Success” by Matthew Syed, who says:

“The anatomy of progress is adapting systems in the light of feedback.”

Thank you.

10:00  

Thank you for your statement. I also thank all those who have provided submissions; we have received a significant number in which people have talked about their own experiences, and they will help the committee’s consideration of the petition.

Your petition refers to the BMA’s recent recommendations, one of which is the introduction of

“a national, 24 hour helpline”.

Could you, as a starting point, clarify whether you would want the Scottish Government to establish a Scottish helpline or to contribute towards a UK-wide helpline?

We envisage a UK-wide approach with the Scottish Government collaborating with all the other UK partners. The whole of the UK could be covered by a helpline and a website containing lots of information; indeed, the website in particular would be incredibly useful for doctors, not just patients. It would be immensely helpful if there were reliable information to which doctors could refer. A UK-wide measure would also be fairly cost effective, as it would cover all the regions.

Has the UK Government taken action in response to the BMA’s recommendation?

I understand that BMA representatives met Westminster Government representatives on 22 June, but I have heard no reports of what happened there. The BMA has certainly approached the Westminster Government about the issue.

That is a matter that we can inquire about.

I want to find out more detail about the helpline. What role would it perform? Would it be a source of medical advice, act as a counselling service or signpost people to various sources of support?

Discussions are on-going, but it would have to be a combination of those roles. Sometimes people are incredibly distressed, so they need help; the Samaritans, for example, have been overwhelmed with this problem, but it does not have the expertise to help people. In any case, there is nowhere to signpost people to at the moment.

Do you foresee the need for specialist training to carry out that role?

Yes, there would certainly have to be specialist training, but it could be centralised. Although there is nothing in Scotland, helplines have been running in England for quite a long time now—about 20 years—although some of them have closed down due to lack of funding. Barry Haslam, who has sent in one of the submissions to the committee, helped to set up a helpline in Oldham, and that set-up has been replicated in other places in the north-west of England.

Is the service widely used?

Yes. There is one in Bristol, too. The service is overwhelmed—people cannot get through to it.

There is huge need for a properly resourced service that has information that doctors will believe. At the moment, even if people tell their doctor that they have phoned a helpline and have been advised to take a particular action, the doctor will say that they do not know anything about that and that that is not what it says in the guidelines.

There needs to be more crossover and co-operation between the two.

Yes, absolutely. It needs to be something that the medical profession—

Can feed into.

Yes, and which it can collaborate with and believe in, too. I hope that patients are getting good advice from somewhere. Quite often, people get good tapering advice, usually from one of the online resources, but when they go back to the doctor and tell them what they have been advised, the doctor says, “My guidelines don’t say that—I suggest you do this.”

So there is a disconnect.

Yes.

Another of the BMA’s recommendations calls on

“Each of the UK governments, relevant health departments and local authorities”

to

“establish, adequately resourced specialist support services for prescribed drug dependence.”

Can you expand on what “adequately resourced specialist ... services”, in addition to the helplines and websites that you mentioned earlier, might look like?

We are still in the early stages of figuring out exactly what they would be. The BMA has been talking to the charities that have been running support helplines and so on, and there is a lot of expertise there to work with. Early in the process, collaboration would mean everyone speaking to everybody else and trying to work out what is needed.

At the moment, people are being left in the long grass and are really suffering. You just have read their accounts; there is just nothing—no support—for them. They are just left, and nobody believes what is wrong with them.

Thank you.

Good morning, Marion. I am well aware of the good work that you do with Recovery and Renewal in my home town of Helensburgh. It is a great benefit to the area.

The BMA’s recommendations also call on professional bodies to offer

“guidance on tapering and withdrawal management”.

Are you aware of any work that is being done to develop such guidance?

Again, it is at an early stage. Because the problem has not been recognised by the medical profession, nobody has done the research. Nobody has really done anything about it—except hope that it will all go away. However, some research is being done now, and more will follow.

One thing that I would like to say is that there is a lot of expertise in the self-help groups, the Facebook groups and the internet groups. The patient self-help groups have developed a huge amount of expertise, and they will be able to share what they have learned, as long as they are willing to. They have been helping real people go through real processes, and there has been a lot of coming and going and a lot of people supporting each other.

There is a lot of expertise out there, if it is recognised. If everyone were able to talk to each other and collaborate, that work could be developed.

Do you find that that is helping you in your work in the Recovery and Renewal centre?

We do not have a centre.

I am sorry—I mean the work that Recovery and Renewal does.

We have found it really difficult. People are struggling desperately with the medication; the doctors are not helping them and their advice is often unhelpful. It is really hard. When Recovery and Renewal started up in 2013, we approached local doctors, told them what we would be doing and asked whether they would be interested in coming to speak to the group or whatever. We heard nothing. We have kept writing to various people, and we keep getting nothing. The response has been nothing—a blank. Everywhere we go in the medical profession, we get a blank response.

We have been trying to help people and signposting them to the charities and the Facebook groups. There is a website called “Surviving Antidepressants” and another one called “BenzoBuddies”. They have been going for years and have built up a huge amount of knowledge and experience, but they are not funded. Basically, they are self-help groups.

You have said in your evidence that many people appear to have been taking for many years prescribed medication that was intended for only short-term use. From the many submissions that we have received from patients, it would appear that they consider the practice to have harmed their health. What can the Scottish Government do to better monitor prescribing practice and raise awareness of the issues?

The first thing to do is to raise awareness of the issues. As far as prescribing practice goes, once the issues are recognised and taken into account, that will begin to help things change through the process of feedback that I referred to. However, the issue of prescribing practice is really for the Scottish Government and is not really for us to help with. I can speak only about the public perception of what is happening.

The suggested overuse of prescribed drugs perhaps leads to a change in people’s personality, which can result in a lack of good decision making. In the current system of prescription, patients can stockpile prescription drugs. Is that, coupled with the impaired decision-making process, exacerbating the problem?

Are we going on to issues of misuse?

No—I am thinking more about the way that the drugs are prescribed and the possible lack of control by the medical profession, which could be allowing that poor decision-making process to exacerbate a health problem with antidepressants.

I am not sure that I can give an opinion on that.

That is okay.

Convener, I just want to put it on the record that I am here on behalf of and at the request of Joanna Dennison, a constituent of mine who had hoped to be here but who was unable to come. I believe that members all have her personal testimony.

As I have said, we are very appreciative of the personal submissions that people have made. They have given us an idea of some of the important issues that Marion Brown has flagged up.

Marion, you mentioned an all-party parliamentary group at Westminster. Have you explored the possibility of a cross-party group involving members of the Scottish Parliament to highlight the issues?

Jackie Baillie raised something like that back in, I think, 2013, soon after we started our group. We have been involved with Jackie Baillie right the way through, and she knew about that possibility. She came to one of our meetings and contacted a cross-party group on something similar, such as mental health issues.

There is a range of groups. We would have to look at them, because specific questions on prescribed drug dependence might be a subset of the issues that an existing group deals with. You have distinguished between the misuse of drugs and dependency on prescribed drugs, which is a slightly different issue.

We asked Jackie Baillie to explore that, and a letter came back saying that the group did not think that that was necessary.

The petition might generate an interest in the issue, and that could then be looked at.

We appreciate your evidence and the substantial written evidence that we have received on the issue. There is a dilemma here. First, there is the appropriateness of prescribing particular drugs at all, and then there is the issue of prescribing drugs for longer periods than they are intended to be used for. Are there some drugs that ought not to be prescribed at all or whose use should be discouraged?

There is also the issue of the extent to which the medical profession is alive to people’s concerns when they feel that they have become dependent. We will all have been in circumstances where we have raised questions and had the response that it is a clinical decision, which is difficult to argue with.

The petitioner has raised a number of important points, and we now need to decide how we want to take forward the petition. What are members’ views on that?

As you have alluded to, convener, the issue is not the prescribing of the drugs per se but the length of time that those drugs are prescribed for. In cases where drugs are supposed to be used for only a short period, what is in place for the medical profession to change that service? The only thing that I can think of doing is to write to the Government to ask for its view on the petition.

That would certainly be a good starting point, because the Government would then take advice from the chief medical officer. We could ask patients organisations other than Marion Brown’s that deal with mental health issues whether they are seeing people with the same concerns. For example, the Samaritans, which Marion Brown mentioned, or the Scottish Association for Mental Health might have evidence on the scale of the problem that they face.

10:15  

It is clear that the BMA is aware of a problem. There is no denying that this is a huge issue; it is just a question of how we take the issue forward. Certainly, we should write to the Scottish Government as a first step.

If the BMA is aware of an underlying problem in the profession, I would like to understand why that problem exists. I do not know whether we need to go any further than writing to the Government at this point.

I suggest that we write to the Scottish Government, which will get information from the chief medical officer. It might also be worth exploring with SAMH, the Samaritans and other such organisations whether they are aware of the issue. We had a petition in tragic circumstances where a young woman was prescribed drugs on her first surgery visit and then sadly died. We are very aware of individual tragic circumstances and another petition on the issue. We might want to tease out the issue of the appropriateness of prescribing drugs in the first place, and there is also the issue of managing dependence at a later stage.

We should perhaps bring the issue to the attention of the UK all-party parliamentary group for prescribed drug dependence, which Marion Brown mentioned. We might as well benefit from the larger area that it covers.

We want as much collaboration as possible.

Have you been in touch with that group?

It might be worth contacting it to ask what it has done on the issue.

Yes—just to gather evidence.

We have been involved with that group. We know it and we have been working with it.

We can perhaps also ask the BMA for an update on where it has got to with its recommendations on a helpline.

That has been a reasonable first stab at what is an important petition. Again, I thank Marion Brown for attending. The petition will come back on to the agenda after the summer recess and once we have received responses from the Scottish Government and other organisations.

I suspend the meeting to allow a changeover of witnesses.

10:17 Meeting suspended.  

10:19 On resuming—  

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Active Travel Infrastructure Strategy (PE1653)

The next new petition that we will take evidence on is PE1653, on active travel infrastructure, by Michaela Jackson on behalf of Gorebridge Community Development Trust. This morning, we are joined by Michaela Jackson, who is accompanied by Dave du Feu and David French, who are both members of Spokes, which is a cycling campaigning group in Lothian. I welcome you all to the meeting and invite Michaela to make an opening statement of up to five minutes, following which we will move to questions from the committee. I also welcome Christine Grahame MSP, who has an interest in the petition.

Thank you very much for having us this morning. I am joined by Dave du Feu, who will talk about policy issues, and David French, who will help me to present and will talk about the issues with option B for the Sheriffhall roundabout.

I started the petition when it became clear that the option that had been chosen for the Sheriffhall roundabout was the worst option with regards to accessibility for pedestrians and cyclists. The issues extend to broader transport policy because the chosen option is at odds with two key Scottish Government policy objectives. The first is CAPS—the cycling action plan for Scotland—which was initiated in 2010 with a vision that 10 per cent of all journeys in Scotland would be taken by bicycle. A recent review has indicated that there has only been a 0.2 per cent increase in cycling journeys. At that rate, it would take more than 300 years to reach the 10 per cent cycling goal. It is clear that, at present, transport policy does not integrate cycling or active travel enough: cycling and active travel have to be central to policy, rather than add-ons at the end.

The second Scottish policy objective that option B is at odds with is climate change. Scotland has really ambitious CO₂ emissions reduction targets, but when I read through the environmental analysis report for the Sheriffhall roundabout, I was surprised to see that climate change was not really considered with regard to how the construction was to be implemented. The key considerations were the actual environment and journey saving times.

We need to look at how what we build impacts users. If we build for traffic and cars, we will get more traffic and cars; if we build for people and places, we will get more people and better places. I ask that active travel be not an add-on, but absolutely integral to any new transport infrastructure, especially in relation to trunk roads in key commuting areas.

I will spend two minutes outlining policy issues.

As Michaela said, the Government’s preferred option B for Sheriffhall is the worst option for cycling and walking. It will make it impossible to include a direct pedestrian/cycle bridge and it has numerous slip-road crossings. The Government’s option B announcement did not even mention cycling.

In its report “Strategic Cross-Boundary Cycle Development”, the regional transport authority SEStran—the south east of Scotland transport partnership—identified the importance of having a bridge at Sheriffhall if there is to be high-quality cycling provision. Sustrans, the Scottish Government’s main partner on cycling infrastructure, stated in a letter to the designers that the option was so poor that it would not comment on the details and instead urged a rethink of the options. Even the Scottish Government, in a letter to Spokes, damned option B with faint praise, saying merely that it is better than the existing arrangements.

In 2004, Scottish ministers allocated £800,000 to Midlothian Council for a cycle bridge at Sheriffhall. Sadly, the cash was subsequently reallocated because, at that time, the roundabout rebuild appeared to be moving up the agenda.

More generally, the Scottish Government has a trunk roads cycling initiative policy, which might particularly interest Mr Whittle and Mr Corry, having been introduced by Lord James Douglas-Hamilton in 1996. It is still current, and it commits the Government to

“give special consideration to cyclists in trunk road improvements,”

“ensure no hazards to cyclists are built in,”

and

“ensure that opportunities for cyclists are exploited.”

However, that policy is clearly breached by choice of option B.

Finally, option B reflects a general issue in respect of treatment of walking and cycling in infrastructure projects, of which I have countless examples: major decisions are taken and only then do designers try to fit in active travel, although good options may by then be impossible. Instead, cycling and walking should be essential criteria from the outset and holistic solutions should be developed. I now pass over to David French.

I will talk briefly about Sheriffhall itself, which is an important road intersection. However, for pedestrians and cyclists it is, equally, an important barrier between Midlothian and Edinburgh. Crossing the current roundabout is not a fun experience, whether you take the pavement and cross the carriageways or cycle round the roundabout. The building of a new roundabout is a great opportunity to fix that and to make active travel between Midlothian and Edinburgh at Sheriffhall an appealing option. However, the proposed design option B does not manage to do that.

As Dave du Feu said, improving safety at Sheriffhall for non-motorised users is not a particularly high bar to clear, but I am not convinced that the proposed design even manages that. The assessment report asserts that safety for non-motorised users will be improved by grade separation, but crossing the slip roads will still be dangerous, especially if the crossings are not signalised. The nearby Straiton junction is already grade separated, but it was recently listed by Sustrans as one of the worst accident spots in the country. We really need segregated routes across the Sheriffhall junction.

Thank you very much. We are obviously interested in the specifics, but we also want to look at the more general issues, so thank you for flagging up some of those. Rona Mackay has a question.

Good morning. Your petition calls for active travel considerations to be incorporated into all new major infrastructure projects. We know that there is disagreement over the extent to which that is already being achieved. Therefore, how we measure the provision and quality of active travel infrastructure is important. Do you have any suggestions for how the provision and quality of such infrastructure can be objectively measured? Are you aware of a widely acknowledged standard or guidance that can be drawn on for that purpose to make comparisons?

I do not know; I am not an expert. However, personally I feel that if I can take my children along a path, it is a safe path for active travel. I do not define myself as a cyclist—I am just trying to get from A to B and to get some exercise into my day—but alone I will take greater risks and travel on busy roads that I would not dream of taking my children on. For me, the benchmark is whether you would take an eight-year old child on the road. I do not know what work Spokes has done.

I do not know the details, but I know that when the Scottish Government—or Transport Scotland—consulted on the options for a Sheriffhall roundabout, Sustrans did a very detailed analysis of the options based on various criteria. We can provide that letter from Sustrans, if that would be helpful.

Did you get an explanation for why option B was chosen over the others?

I have just looked at the assessment report. Different criteria are put into a model called STAG—Scottish transport appraisal guidance. However, the problem with the model is that it extrapolates data from 2014 to 2024, when the roundabout will come into use, and it looks at the impact that that will have on journey times, safety and the local environment. However, I feel that we cannot use models that extrapolate from 2014; we need to look at where we want to be in 2024. We cannot just assume that traffic will increase by 40 per cent. Transport is already the highest contributor to greenhouse gas emissions in Scotland, so we have to look at how to hold that back and how to decrease the level of traffic. We cannot just tinker around the edges of the current system; we need to look at creating a different system that actively supports different methods of getting from A to B. We cannot build that sort of hard measure into our society when we are looking for long-term change.

10:30  

Would there be merit in looking to some of the European infrastructures that have been operating for some time, and looking for best practice there?

Undoubtedly, it would. It is not a difficult problem to solve, because lots of other countries have solved it. In Copenhagen, 50 per cent of the people on the streets are on bicycles.

It is also about the level of priority that is given to walking and cycling in decisions. There are the obvious reasons—Michaela Jackson has mentioned climate change and public health, which are obviously important—but we must also remember the Government’s policy and its clear objective for 10 per cent of journeys to be made by bike by 2020. That will now be incredibly difficult to meet, if not impossible, but we at least want to work towards it.

The Government has no policy to increase journeys by car, yet we have decisions being made in which the convenience and time savings of car travel are given much greater priority than walking and cycling are. In the Scottish Government’s overall transport policy, which is in the national transport strategy, there is a very clear statement of its vision for the future of transport, which is of

“a culture in which fewer short journeys are made by car,”

yet here we are taking decisions that are increasing car journeys and making walking and cycling more difficult.

Okay. Thank you.

Good morning. The Scottish Government has published “A Long-term Vision for Active Travel in Scotland 2030”, which includes this aspiration:

“Main roads into town centres all have either segregated cycling provision or high quality direct, safe and pleasant alternatives. Pedestrian and cycle paths are in place. Rural and suburban minor roads have low speed limits, linking nearby communities and services so opening up new travel opportunities and choices.”

Have you had a chance to review that strategy? Do you have any thoughts on the Scottish Government’s vision? I am thinking about whether the policy is integrated and whether it will lead to the desired stated outcomes.

I have looked over it briefly, and it sounds wonderful; I agree with everything in the vision. I just feel that it is a little bit like CAPS, in that the Government has these amazing visions and we have incredible targets that we hope to meet with regard to climate change, but we are not putting in place the policies to achieve those visions. It is a bit disjointed: there is no cohesion and everything is in silos. We have good visions on individual things, but we do not consider how to implement them and join them up with transport, education and health. That is the problem. The document is great, but there is not enough practical detail on exactly how the vision will be achieved.

The first point that Brian Whittle quoted was about segregated provision on main roads. We believe that that is critical for the future. On interauthority cycle routes—Sheriffhall is a good example, as the route runs from Midlothian to Edinburgh—it is really important to have segregated provision; I believe that I am right in saying that the Conservative manifesto for the Scottish Parliament election included segregated routes in every city in Scotland.

The problem with segregated routes between local authority areas is that—quite understandably—each local authority wants to invest its cycling funding in its area of greatest population, so there is less money for routes between authorities. Some years ago, the regional transport partnerships used to have capital funding, but that was removed by the Government when it first came to power, and as a result there is now a lot less money available for interauthority cycle routes. When SEStran had capital funding, it allocated £4 million for routes between Edinburgh and Midlothian, East Lothian and so on. That was all lost when the capital funding was scrapped.

One project that survived was the A90 cycle route, which goes from Edinburgh to the Forth road bridge and Fife. That was completed about two years ago and has been incredibly successful. I do not have the figures with me, but I am sure that the City of Edinburgh Council could supply them. There has been a major increase in commuting into the city via that route.

As far as Sheriffhall in particular is concerned, SEStran has pointed out that the existing biggest flows of cycling between Edinburgh and the surrounding areas are between Edinburgh and Midlothian, so it is a particularly important corridor.

With regard to Sheriffhall, I know that Midlothian Council is planning on a bit of a cycle highway between the Sheriffhall roundabout and the Tesco Hardengreen roundabout—I do not know whether you know the area—and then between Hardengreen and Eskbank. It is quite a wide road and the council is really keen to segregate it properly. I feel that having provision properly implemented in Sheriffhall could kick-start other really exciting developments to support commuting into Edinburgh. Journeys within Midlothian are really challenging. The Midlothian transport report stated that it is very difficult to get from west to east in Midlothian by public transport so improvements at Sheriffhall would support connecting Midlothian as well.

The committee is aware that some local authorities have adopted active travel action plans. Are you aware of whether that is widespread and do you consider that the Scottish Government should promote those initiatives?

I believe that in the cycling action plan for Scotland there is a very strong request to all local authorities to adopt such plans—I do not know whether it is actually a requirement. Some money and resources—via Cycling Scotland—have been put into assisting local authorities with drawing up plans, so I believe that the process is under way. I am not quite sure what stage it has reached; I am sure that Cycling Scotland could advise on that.

I deal with the Midlothian active travel transport officer quite closely and Midlothian has tiny pockets of money. A lot of them are for soft measures such as cycling days to try to get people out and get their bikes fixed. In fact, the transport officer has said that the focus in Midlothian is on commuting to work by bike. He tries to go along with people to show them the best routes to get to their work and so on. There is a small amount of money, but it is so small that the whole thing basically relies on one person’s single vision and a lot of soft measures.

Some hard measures are about to be implemented; I think that there are, for example, plans along certain parts of the railway. That was a key missed opportunity to implement really good active travel infrastructure. The small pockets of money come every now and again but instead of connecting roads, they just pave an existing path. The problem is that people do not know about the paths. There is a path at Mayfield, by the Shell garage, that is impossible to see. I know that it is there only because the transport officer told me about it.

Some years ago, as the committee will know, there were regional councils rather than the present set-up, so because the councils were much bigger, it was possible to set up expertise within each council on walking and cycling. Lothian Regional Council, for example, had a fantastic cycle team.

When the regional councils were split up, Edinburgh was fine because it is still a fairly large local authority, but Midlothian, West Lothian, and East Lothian all basically lost nearly all their expertise. This is an area in which regional transport authorities could help considerably. I know that SEStran is trying to work on that in order to build up regional expertise and to provide assistance to all the smaller local authorities that just do not have the resources for it. That does not help with the capital funding, but it provides the expertise, which is the other side of the coin.

To follow on from that—you have answered half my question—what involvement has Sustrans had in option B and the other options?

Are you asking about Sustrans as opposed to SEStran? I was talking about SEStran in relation to providing expertise for small local authorities.

Right, okay.

Sustrans has paid a great deal of attention to Sheriffhall roundabout specifically. It did a very detailed assessment of the original options and, as I said in my opening statement, it has said that the option that the Government has chosen as its preferred option is so poor that Sustrans is unwilling to comment on the details and feels that the Government should rethink which option it is going for.

Has Sustrans told the Government that it is unwilling to comment?

Yes. Sustrans has written a letter—it is publicly available—to AECOM, the consultants that the Government has taken on for the design.

That is great.

A key part of your petition is about how the consultation process feeds into the development of infrastructure projects. Do you have any suggestions about how the Scottish Government could achieve a higher standard of public consultation on active travel infrastructure?

The consultation was not the issue; there was a consultation. David French was involved and he said that he was listened to and heard. Sustrans and Spokes have had input—they have been heard and listened to by the Scottish Government. Despite that, priority is given to the STAG model, which sets out what measures will create what amount of journey time saving. If we were to increase cycling by 10 per cent, for example, the model would not look at how that would decrease congestion, what the impacts on the local economy would be or what the CO₂ emissions savings would be.

There is nothing wrong with the STAG model, but it must be a lot broader and take into consideration different criteria. It is very narrow. I have a masters degree and I studied environmental assessment methods. There is nowhere near enough of that in the model.

Do you know whether figures about or surveys of active travellers regularly feed into the development of infrastructure projects in Scotland? Do you have any suggestions on how the Scottish Government could source that data? Dave French mentioned sharing details from Sustrans.

I would look to Sustrans to answer that.

Local authorities collect some data, but I am not sure how consistent that is between authorities. Edinburgh has a lot of automatic traffic counters that count cyclists as well as motor traffic, but I do not know the position in local authorities in general.

In academic literature, a plethora of research states something along the lines that the more roads we create, the more traffic there is. There is a direct correlation between the length of a road and the amount of cars that will use that road. There is also clear evidence that providing active travel infrastructure, such as segregated cycle paths, leads to an increase in cycling. Furthermore, there is a lot of literature on the economic benefits of creating active travel infrastructure. People may argue that transport budgets are tight, but the payback is quick.

To follow up on the question of how big decisions are taken, there seems to be a general feeling among designers and decision makers that the big decisions on a project can be taken and walking and cycling can be fitted in afterwards. As I said in my introduction, the big decision often rules out the best option.

By far the best example that I can give you of that is the Edinburgh tramline system. As you will know, a great number of related injuries—250—have been seen at Edinburgh hospitals, and the tramlines have possibly been implicated in a recent death.

A lot of the problems are to do with the tramline layout. We made such points 10 or 12 years ago when the layout was being discussed. We even brought over an expert from the Netherlands, who did a report that showed how the tramline layout could be made much more amenable to walking and cycling. Unfortunately, all that was turned down. As a result, it is much more difficult to implement safe interaction between walking and cycling and the trams. The tramline layout cannot be changed—that would be far too expensive and disruptive.

The consultant who came over said, “What you’re doing is implementing a tram then trying to fit everything around it. If we were doing this in the Netherlands, we wouldn’t be implementing a tram; we would be looking at trams, buses, walking and cycling and how the whole thing fits in for maximum safety and maximum convenience for the whole of society.”

Thank you—that is a helpful example.

We are tight for time, but I promised Christine Grahame that she would get an opportunity to ask questions. I ask her to be alive to the time pressures.

10:45  

You loved saying that, convener, as I do in the chamber.

I know the Sheriffhall roundabout like the back of my hand, because I use it regularly on the A7 or the A6106, and I have never seen a cyclist trying to navigate it. As the petitioners and I know, the lights change immediately and, as soon as the lights for the bypass change, the next lane whizzes off. I do not think that I have ever seen a pedestrian trying to navigate the roundabout. I believe that cyclists call it the blender, and I am not surprised.

I am practical about such issues. We have all these models and things such as that, but I am looking at a picture of option B, and, to be frank, the only thing that is proposed is to lift up the bypass; the original roundabout, which as we know has lights that switch rapidly, will be left as it is. That is no use whatsoever to cyclists and pedestrians. The irony is that, as you and I know, although there is a cycle path on the A7 to the north of the roundabout, there is no way of reaching it.

I have asked the minister a couple of times about the issue. I asked whether he would make provision for cyclists, and this is what I got back:

“Suitable provision for all users, including cyclists, is an important part of the proposed improvements to Sheriffhall Roundabout and this will be developed in further detail”.—[Written Answers, 15 May 2017; S5W-09136.]

I have heard nothing since. My concern is that we will get something planted on that will not work for cyclists.

You talked about graded lanes. Given that something is in train, are you saying that you also require—as you probably do—lights that change for cyclists and pedestrians and which hold the local traffic as well as traffic on the slip roads that go to the bypass east and west, because of the way in which the current light system operates? What is your solution? You are the cyclist, so you know better than anybody else.

Ideally, what everyone wants and what Midlothian was promised is a cycle bridge. Unfortunately, with option B, the bypass goes over the roundabout, so there cannot be a bridge over the bypass.

The situation is difficult. Because the current option is so poor, we are hammering something on to the outside, whereas it should be integrated in the design. I presume that that would be an improvement to the current situation. I would not cycle on the Straiton roundabout either, because it is a nightmare. If we create a system that is still a barrier but has a sort of minor improvement, we will not get people on bikes. We do not need to get cyclists on bikes; we need to get people on bikes who want to have the opportunity. We need to get the lady who works in radiology at Little France on her bike because she feels that the journey will be safe and she will not have to sit in traffic. Brave cyclists such as my husband will do it, but it is the normal people who need support and should be given as much support as possible, which I presume would mean lights. Ideally, the measure would not be tacked on at the end. We want a proper crossing.

If we were to tear up option B, we would still have to deal with the enormous amount of bypass traffic and separate local traffic from it and the traffic that feeds on to the bypass. What would you do instead of having a flyover for the bypass?

Option C.

Yes, option C. In the consultation, I criticised that option for some minor things, but it would be a huge improvement on what is there now and on options A and B, because people could cycle from Dalkeith to Edinburgh without crossing the A720 or the A7.

I consider myself to be a fairly confident and brave cyclist, but I have found cycling round Sheriffhall terrifying. The last time I went there, I took the pavement, and it took me three minutes to go round the roundabout, as I had to stop and wait for a gap in the traffic, which is not always obvious, because drivers do not always indicate when they are coming off the slip roads, and they go terrifyingly fast.

They also switch lanes.

I am a brave and confident cyclist, and I am terrified. We should build infrastructure that people are happy to take an eight-year-old across, that an 80-year-old will be happy cycling across and that people in wheelchairs can go across. We do not have that.

As a final point—I thank the convener, who has been tolerant—will you say what option C was?

Option C involved moving the roundabout half a mile west, using the old roads—the current A7 and A6106—and putting cycle lanes on them, and then building a bridge over the A720 to the east of the new roundabout. It would have been great.

This is a live issue and the minister will be questioned on it, but we need to consider what to do with the petition. I thank the witnesses for the evidence that they have given, which has been useful.

Do members have comments or suggestions for further action? I think that we want to take the petition forward. We have discussed the issue of planning and not bolting things on afterwards, when they become difficult.

I would be interested to hear feedback from the Government on the plan and the reasons why it has gone with option B.

We will contact the Scottish Government.

Can we press it for an answer to Christine Grahame’s question, which she has not had much feedback on?

Yes—the answer just mentioned a general principle and said, “We will make sure they are catered for.” There was no practical detail.

In consultation with the clerks, we can see whether it would be worth while to get the minister in, as opposed to simply dealing with the matter through correspondence.

Are there any other suggestions? Sustrans has been mentioned.

We should write to Sustrans, and we should also get more information on option C, which has been emphasised.

The conclusion section of the clerk’s note for the committee recommends writing to various bodies to seek their views on the petition. May I suggest that you add to that and seek their views on the petition in respect of transport projects in general and specifically the Sheriffhall roundabout? There are two issues—

I appreciate that, but I would need to take advice on whether, as the Public Petitions Committee, we can focus on individual projects. We might be able to ask the minister about the project in that context, but we can check that out. I am sure that the clerks will be happy to advise us.

Given the nature of the petition, we should also contact Scottish Environment LINK, which is the umbrella body for a number of non-governmental organisations, and perhaps WWF, which I know has strong views on the current situation.

We can highlight a number of issues, and we will get back to the petitioner on the direct question about whether we can seek views on the specific as well as the general. Thank you very much for your attendance. I suspend the meeting to allow the witnesses to leave the table.

10:52 Meeting suspended.  

10:54 On resuming—