Public Petitions Committee

Meeting date: Tuesday, March 2, 2010

Official Report 466KB pdf

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Current Petitions

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Cancer Treatment (Cetuximab) (PE1108)

That would be appropriate. We do not want the Government to send out something that must be corrected or revised almost immediately.

What we have here is the result of a petitioner working with the committee, and the committee, in turn, working with the minister and the Scottish Government. A lot of progress has been made in respect of the terms of the petition, which should continue to be recognised.

We have before us a draft letter from the convener, which—if we send it—sets out a range of questions for the cabinet secretary on the draft chief executive letter guidance. The letter raises a number of important additional points on which we would like a bit more clarity and encapsulates many of the comments that have been made by the petitioner, Tina McGeever. On that basis, I think that we should send that letter to the cabinet secretary.

I raise a couple of points on which the convener’s draft letter touches, the first of which relates to exceptional prescribing requests. I know that that issue is largely covered in annexes C and D of the draft CEL, which is to be welcomed in broad terms. However, the convener’s draft letter makes points about the language that is used, which could lead to the guidance being less than binding on NHS boards. We would not wish that to happen, as it could lead—inadvertently, I am sure—to the postcode prescribing that we seek to avoid. In other words, it could risk regional variations. We must make the guidance as prescriptive as is necessary, so that boards are under an instruction to do what the guidance says; we must not just assume that that will happen.

The convener’s draft letter also refers to the lack of reference in the guidance to the appointment of local liaison officers, which is something that the committee suggested in paragraph 85 of its report, “Availability on the NHS of cancer treatment drugs”. I hope that the cabinet secretary will agree that that omission needs to be rectified.

All in all, many of the issues that were raised in the petition have been addressed thoroughly. I hope that, if we agree to send the convener’s draft letter, the cabinet secretary’s response will bridge any gaps that there may be in the guidance that has been worked out. We therefore find ourselves in a very positive place.

That would be helpful.

We want to pursue the matter. My letter will be framed in line with the structure of our inquiry and report. We will follow through on the areas in which we want to get consistency from the Government, to try to progress some of the issues on which the Government has been responsive. We will take forward those points. The clerk suggests that we may want to get a response from the Government before the CEL goes out; we will explore whether that is possible.

I thank members for their time and the petitioner for her patience.

Item 4 on our agenda is consideration of current petitions. I welcome back to the committee Tina McGeever, who is in the public gallery. Her petition PE1108, on behalf of Mike Gray, calls on the Scottish Parliament to urge the Scottish Government to consider the provision of cancer treatment drugs—in particular cetuximab—on the national health service to ensure equity across NHS boards in relation to the appropriateness, effectiveness and availability of such treatments. Tina has been pursuing the matter with incredible vigour and energy, and she has supported the committee in our process.

I seek members’ views on how we should continue to deal with the petition.

I absolutely agree with what Bill Butler has just said. I have had some contact from the pharmaceutical industry via its representative body, the Association of the British Pharmaceutical Industry. It says that things have moved on significantly but that one or two issues remain to be addressed, which we could add to the convener’s draft letter. The association states in an e-mail:

“Medicines that are accepted by SMC, or their equivalents, are expected to be available within NHSScotland”.

The question is asked:

“How do ADTCs appraise which medicines are deemed equivalent? There should at least be transparency around this decision and the equivalent medicines named, so that patients and clinicians are aware of which equivalent medicines should be used in place of an SMC accepted medicine.”

A related point is:

“Patient access to SMC accepted medicines that are not put on the NHS Board formulary needs to be quick and easy.”

To access those approved drugs, patients

“should not have to resort to individual treatment ... requests.”

That is perhaps another point to highlight.

Regarding patient and public involvement, the association states:

“NHS Boards should be required to do more than just make information available. There should be opportunity to input into ADTC processes.”

Finally, the association suggests that

“The SMC has a very good model for patient and public involvement.”

The Scottish Government could ask health boards to mirror that. I will pass on the e-mail to the clerks.

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Knife Crime (Mandatory Sentencing) (PE1171)

We dealt with the petition in our earlier discussion of knife crime in relation to PE1313, when we agreed formally to suspend consideration of both petitions.

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Permitted Development Rights (Port Authorities) (PE1202)

PE1202, from Joyce MacDonald, calls on the Parliament to urge the Government to remove the general permitted development rights of port authorities. We have considered the petition on a number of occasions. How do members wish to deal with it? We are still waiting for the household permitted development order to be laid before Parliament. I suggest that we suspend consideration of the petition until that happens. We can write to the Scottish Government to draw to its attention the letter that we have received from the petitioner about a recent incident in the fish-meal shed.

Members indicated agreement.

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Same-sex Marriage and Mixed-sex Civil Partnership (PE1239 and PE1269)

The last time that I checked, no information had come out about the outcome of the court case. It has been postponed again.

I agree that we should suspend the petitions. I am looking to the gallery for confirmation, but I gather that a House of Lords ruling is imminent as well. That might be something else to look at in connection with the petitions.

The next two petitions are grouped together. PE1239, from Nick Henderson, on behalf of the LGBT Network, calls on the Parliament to urge the Government to amend the Marriage (Scotland) Act 1977 to allow two persons of the same sex to register a civil marriage and a religious marriage if the relevant religious body consents. PE1269, from Stiofán McFadden, on behalf of the Equal Marriage Campaign, calls on the Parliament to urge the Government to amend legislation to allow same-sex marriage and mixed-sex civil partnership. We have considered both petitions previously. I draw members’ attention to a letter that has been submitted by Shirley-Anne Somerville, who has expressed support for the petitions at previous meetings.

Fergus Ewing, the Minister for Community Safety, said that the European Court of Human Rights case had been postponed until 25 February this year. Shirley-Anne Somerville is asking us to continue the petitions at least until we get the outcome of that case. Did we get that on 25 February, or is the court still deliberating?

So the case has been postponed—it is not just that the court is still deliberating.

I support suspension of the petitions until we have the outcome of the Schalk and Kopf v Austria case, which may not just influence the Scottish Government but require it to take action. It is incumbent on us to suspend consideration of the petitions until such time as we have a European Court of Human Rights ruling on the case, because it may have an impact not just in Scotland but throughout Europe on how Governments legislate on the issue of same-sex marriage.

There is a consensus that we should suspend the petitions. There is an administrative issue, given that the petitioner for PE1269 has not responded; PE1239 is the central petition because it raises the core issue. In the interest of controlling the number of petitions that we have, we could close PE1269 and suspend PE1239 until the outcome of the European case is known, at which time we can have further deliberations. Given the number of petitions, we really need to tidy up outstanding petitions to give the clerks some oxygen and help them to survive. If it is okay with members, we will suspend the core petition, which is PE1239, and close PE1269.

Members indicated agreement.

We could put some gentle words to Fergus Ewing on that matter.

Thank you for that. We hope that, even though one petitioner has not responded, the remaining petition addresses the concerns that he raised.

I could find no information that would indicate when a decision might be made.

In my opinion, we should await the outcome of the case, although I know that we do not know when we will get it. There does not seem to be a huge appetite in the Government to look at the issue, but it may change its mind, depending on the outcome of the case. I would rather keep the petitions open.

I agree with John Wilson and Anne McLaughlin, but perhaps we could ask the Government whether it is at least prepared to set up an advisory committee to meet immediately after the European decision has been made public.

We should not close the petitions but suspend them. Despite the fact that the Scottish Government has said on four separate occasions that it has no plans to change the law—the UK Government has the same position—there might be an impact when the Schalk and Kopf case is heard in Europe, so it would be wise for us not to close the petitions but to suspend them. That will give us and the Government a chance to react in due course when that case has been heard.

I do not know whether my colleague Robin Harper’s suggestion that the Government should have an advisory committee ready to go is practical, but we can ask the question.

I could modify my suggestion and propose that the Government keeps open the possibility of setting up an advisory committee if advantageous circumstances arise.

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School Buildings (Asbestos Management Plan) (PE1268)

I was going to make a similar point.

John Wilson makes a helpful suggestion; I am conscious that the issue will return if we are not vigilant, careful and rigorous.

I agree that we should close the petition, but in doing so we should confirm to the petitioner that, if she becomes aware of incidents that raise concerns, she will be able to petition the committee again to deal with those. I know that the issue has arisen not only in the petition and in Scotland. There is a UK-wide debate on the issue, and a thorough debate is taking place south of the border on the possible impact on those who are teaching, working or studying in school buildings that may be affected by asbestos.

PE1268, by Catherine Mitchell on behalf of St Gilbert’s primary school and all schools in the west of Scotland, is on asbestos management in schools. Given that we have had a fair discussion about it and have explored the options, I do not know that we have anything further to add. I recommend that we close the petition on the basis that we can take it no further. I invite comments from members.

I do not think that we can take the petition further. Colleagues might have a different point of view, but it seems to me that the detailed points that the petitioner made in their previous response have been addressed by Glasgow City Council. It states unequivocally that it would not approve works on any occupied site if it believed that there would be unacceptable risks as a consequence. On that basis, and given that the Health and Safety Executive has written to each local authority to draw attention to their statutory responsibility, there is not much more that we can do as a committee. We should close the petition.

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Changing Places Toilets (PE1270)

PE1270, by Linda Burke, on behalf of the Profound and Multiple Impairment Service and the Learning Disability Alliance Scotland, calls on the Parliament to urge the Government to request that local authorities use British standard 8300:2009 to ensure that at least one public toilet built to the changing places standard is provided in the centre of each town that has a population of more than 15,000, and in each new larger and publicly accessible building and complex.

We have had the opportunity to discuss the petition in the past, so any comments from members would be helpful.

I propose that we close the petition, but submit the petitioner’s final submission to the Scottish Government for consideration.

One of the reasons that I proposed that we close the petition is because the petitioner has asked us to close it.

The committee has taken the petition as far as it can. The petitioner’s objective was to raise awareness of the issue, and we have taken that task on board. We have raised the issue with a number of public bodies to try to take the debate forward, but there is a difficulty with regard to what the committee can do and what the petitioner has requested that we do. The petitioner has asked us to close the petition because they feel that, in many respects, awareness of the issue has been raised. The relevant authorities will, we hope, take the issue forward.

I suggest that we discuss the concerns that Rhona Brankin raised, which I think we all share. In closing the petition, we may want to draw it to the attention of the relevant minister with responsibility for planning in relation to any developments. It strikes me that we need to address the concern about clarity in policy guidance and in the implementation of that guidance at a local level, so that we are not left in the ridiculous situation, as Rhona Brankin mentioned, in which something that seems reasonable is not being provided.

It may be a UK Government issue too, in relation to equalities legislation or human rights.

I will let John Wilson in, but we will come back to that point, as it raises a legitimate issue.

I understand that.

We may want to write to the appropriate minister in Scotland with responsibility for the planning framework, and we can perhaps consider the UK position in relation to the broader disability issues.

Okay. We should put the issue in the manifestos of all the parties. We need to pursue information from appropriate ministers. I thank members for their comments.

Do members accept that recommendation?

Having looked at the petitioner’s request, I was quite surprised that there was no way of making it happen. It is an important issue that we must not take lightly. We perhaps need to reflect on why it cannot happen, and on the issues surrounding that.

I know that I have come to the petition only lately, but I wonder whether it is a matter for equality legislation. I am not sure whether the Equality and Human Rights Commission would have any comment on the situation. I do not want to keep pursuing the issue unnecessarily, but I wonder why there is nowhere for it to go.

This may be slightly controversial, but here goes. In closing the petition, we could write to the First Minister, because I can think of nowhere else to write, to say, “Here’s a good idea. It costs money, but it doesn’t cost a fortune.”

The official response has—correctly—been to say, “We cannot tell people what to do”. However, in a country the size of Scotland, there should be a mechanism—although the Government cannot tell local authorities what to do—for influencing people to understand that the idea is sensible and does not cost a fortune, and to ask them, “Hey guys, why aren’t you doing this in your area?”

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Education (Scotland) Act 1980 (Parental Choice) (PE1284)

I think that we should keep it open. The Government stated its intention to introduce regulations to set a maximum of 25 pupils in a class by, I think, August of this year. We should ask whether it is still on target to do that.

We wish to keep the petition open and we will explore the points that members have raised.

PE1284, by Graham Simpson, calls on the Parliament to urge the Government to note the successful outcome of a number of legal cases brought by parents against local authorities in relation to placing requests. The petition highlights the statutory right of parents under the Education (Scotland) Act 1980 to choose the school that they wish their children to attend. There has recently been public debate on the issue in one local authority area. Do members have any comments on how to deal with the petition?

It could be politically controversial, but I think that the question that Nanette Milne has suggested deals with a matter of fact—we are trying to explore what the fact of the matter is. In the same vein, we could ask the Government when it will introduce regulations to reduce the size of classes in primary 1 to primary 3 to a maximum of 18 pupils. Asking those two questions would be a reasonable way to begin exploring the petition.

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NHS Translation and Interpretation Services (PE1288)

Interpretation.

Yes, that is what we are really talking about. I think that interpretation rather than translation is the issue.

Yes, I have an interpreter beside me—Anne McLaughlin’s brain is slightly less addled than mine, principally because she was not at this morning’s meeting of the Justice Committee.

The issue is whether we can get the Government to get its mind around interpretation as a whole, across not just the NHS but the rest of the public service.

I agree with that last point. Surely there is a case for the provision of a comprehensive public translation and interpretation service that could be accessed not just by the NHS but by all branches of local government, including education and social services.

It was encouraging to see comments in our paperwork about British Sign Language. We should recognise that BSL is a language, just as much as Romanian and Spanish are.

We will take on board the comments of Nigel Don and Robin Harper. We wish to keep the petition open and to clarify some of the points that have been raised.

I hope that we will feel able to continue the petition. We have had the classic response from everyone that they are all doing the right things. We would expect that, and we do not necessarily have to disagree. However, alongside that are the petitioner’s comments, which are along the lines that things are not like that for some people. The petitioner’s response contains some quite harrowing experiences.

We should write to the Scottish Government to ask whether what it is doing is enough. It has been suggested to us in responses that some people in the NHS feel that they should not use the services in question because they cost too much. That reluctance is understandable but probably inappropriate.

We could also write to the Equality and Human Rights Commission to ask what its take is on the matter. There is a real case for saying that such services should be provided in principle. I would like us to dig a bit further and see whether the Government is willing to consider translation—I am sorry; that is not the right word.

We have considered PE1288, by Dr Godfrey Joseph, on behalf of Multi Ethnic Aberdeen Ltd, on previous occasions. It calls on the Scottish Parliament to urge the Government to ensure that NHS boards have the structure, funding and capability to provide speedy, accurate and appropriate translation and interpretation services for patients and their families, and that such services are consistent across NHS boards.

Do members have comments?

You have an interpreter beside you.

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Safe Guardian Law (PE1294)

Do we wish to continue the petition on those grounds?

Okay. Thank you.

Our second-last petition today is PE1294, by Allan Petrie, which calls on the Scottish Parliament to urge the Scottish Government to implement a safe guardian law to allow family members to care for children who might be at risk. Do we wish to continue the petition or have we taken it as far as we can?

Perhaps we could continue the petition to ask the Scottish Government one question. What is the Scottish Government’s response to the petitioner’s point that, in his experience, the current legislation is not applied at an early enough stage, and that he would like local authorities to take steps to act as soon as concern about a child’s welfare has been identified? At the very least, it would be interesting to get the Scottish Government’s response to the petitioner’s opinion and its view on whether that opinion is based on fact or is not backed up by evidence. We should ask that at least.

Yes. There is also the issue about the length of time involved.

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Low-dose Naltrexone (PE1296)

Our final petition this afternoon is PE1296. I thank the petitioner, who is in the public gallery and who has been very committed to the petition. The petition, which is on behalf of LDN Now, calls on the Parliament to urge the Government to make low-dose naltrexone readily available on the NHS to auto-immune disease sufferers, as well as to those who suffer from other conditions that are not classified as auto-immune, such as HIV/AIDS, cancer and infertility, thereby reducing the danger of sufferers having to incur higher costs by purchasing the drug through private medical providers. The petition also asks for guidance on LDN protocol to be provided to all general practitioners and for GPs to be required to collect clinical data on LDN .

We explored the petition at a previous meeting, and have received extensive submissions from the petitioners. I know that Robert Thomson has been keeping all committee members up to date on progress as well as seeking support from all layers of decision making in Scotland and the UK. How should we deal with the petition?

I accept that; we still need to ask some questions.

We should continue the petition. We are almost in a catch-22 situation because LDN is not licensed for the dosages that are being recommended, so official bodies are reluctant to take it on, but we should push a bit harder. For example, the Department of Health could make representations to the Medicines and Healthcare products Regulatory Agency and ask it to assess the safety and efficacy of LDN. We really need to pursue the issue a bit further. Clearly there is a body of opinion that thinks that the drug is very effective for many conditions in small dosages, but it cannot be used at the moment because it is not licensed for that.

We wish to continue the petition. That might have sounded like quite a brief summary to Robert Thomson, who has sat all the way through a long afternoon, but given our previous discussion of the petition, I can say that we want to see whether we can help, because we think that the petition contains points of significant value. We will raise those issues with the Scottish Government and the Department of Health.