Official Report 286KB pdf
Before we take evidence on the first petition, I will make a brief statement. The volume of petitions that the Public Petitions Committee receives is always much greater than the number of people from whom we can hear oral evidence. It is of concern that people who have submitted petitions misunderstand the time constraints on the committee and its capacity to deal with petitions, even those for which individuals cannot provide oral evidence.
It might be helpful to make the petition forms clearer. We should ask people whether they would be willing to give oral evidence if they were invited to do so. At the moment, there is a box for those who would be willing to give oral evidence and one for those who are not. It looks like people are being given a choice and, once they request it, they may go away with the impression that they are able to give evidence.
There is an additional point about perceptions. I understand people's concern about not being given three minutes to speak—indeed, if I were a petitioner, I would feel the same as they do. However, giving three minutes to petitioners such as Gordon McPherson and Jane McPherson and others is only part of the process. Sometimes the process can be much lengthier. If every petitioner had the same time to give oral evidence, we would not have enough time to deal with every petition effectively. We will constantly review the process, but what Rhoda Grant said is helpful. I hope that we will come back to committee members on that.
Deep Vein Thrombosis (PE1056)
I am sorry about the delay before consideration of our first new petition. Our petitioners have been very patient.
Thank you very much.
Do you want to add anything, Jane?
No, not at all.
I appreciate your giving of your time today. The matter is a personal one and you have been brave in coming to committee. Your commitment to the issue is clear and I am pleased that you have pursued it with such vigour. We move on to questions from the committee on issues that you raise in the petition.
Good afternoon, folks. In PE1056, you make explicit your request for different procedures to be used in the diagnosis of DVT. You also talk about the national screening—or, at least, the local screening—of newborn children. Which of those suggestions is it more important for us to support?
It is important that all aspects of the petition are supported. On the first item, there should be commonality among all health boards throughout Scotland. Katie was in the care of Lothian NHS Board first and then the former Argyll and Clyde NHS Board. The boards had two totally different ways of assessing DVT. If both boards had used the same method, Katie would have been here today. That has been shown to be the case.
It is important that screening is offered. We cannot possibly say that every child should be screened—we need also to consider the ethical aspects and so forth—but parents should be given the offer of DVT testing for their newborn child. If we were ever to have grandchildren, we know that our son would definitely say that they would be tested.
Is the procedure for DVT testing complicated?
It depends on the procedure that is used, which depends on the hospital to which someone goes. When I was tested for suspected DVT, I was given a simple blood test. When it came back as positive, I was automatically given anti-coagulant injections. If I had gone to a hospital 4 or 5 miles in the opposite direction, I might have had a dye injected into my veins, or had my blood pressure checked—the test depends on the hospital to which someone goes. That is one of the big points that we are trying to put across.
You just had a simple blood test.
Yes.
You said that, when your son was screened, the discovery was made that he had the factor V Leiden gene. Does that affect his insurance? Does he have to declare that for travel insurance purposes?
No. That request has never been made. Testing for the factor V Leiden gene is not like testing for HIV. Having the factor V Leiden gene will not necessarily kill someone; they simply have a defective gene. Testing lets someone know what to do if they develop symptoms of a DVT nature. If they are going on a long-haul flight, they will know to take aspirin before they go and to do their exercises, and if they are going on a long car journey, they will know to make stops. It does not affect the quality or quantity of someone's life.
Are travel insurance companies more reluctant to insure your son? What if he plans to take a long-haul flight, which might increase his susceptibility to DVT?
He has never been on a long-haul flight, so I cannot answer the question. I think that the longest flight that he has made was probably four or five hours long, which is probably more of an average flight time.
Insurance companies may jump on this and say, "Here's another way of excluding certain things." It is down to their ethics whether they do that, but it is not as if my son has cancer and is at risk when he flies. As long as he is aware that he has a factor V Leiden gene, and he drinks lots of fluid—I have told him before that that means water rather than cider—there is no problem.
And did he listen?
Of course not.
Sons with that name are all the same. They never listen.
Mine has the same name.
It must be something about that name.
That is why we are here.
Do you have any update on that? Have they done anything at all?
We are in constant contact with NHS Quality Improvement Scotland and members of the Scottish Executive. We had a meeting in February with NHS 24, NHS Direct, NHS QIS and the Executive, and we were told that a report would be issued in March. We received it in August. We have also been told that in October a letter to all health board chiefs will be issued by Scotland's chief medical officer, countersigned by the chair of NHS QIS. I will believe it when I see it. We feel that we have to keep the pressure on because, if we do not, the issue will just keep slipping. It has to be dealt with now.
Do you have any indication of the number of people in any given year who are affected by DVT, including those who have died and for whom it has been the cause of death, and those who have been treated? Is that information held centrally?
I can refer only to the information from the chief medical officer of England, Wales and Northern Ireland, who issued a report in March or April stating that 30,000 deaths per annum can be attributed to venous thromboembolism. As Scotland represents 10 per cent of the UK population, I can only assume that there are 3,000 per annum in Scotland. However, the General Register Office for Scotland states that only five deaths in the past 10 years have been attributed to pulmonary embolisms. It is all down to how the death certificate is signed. We have been told by many consultants that they only knew that it was a pulmonary embolism that killed the person after the post mortem. Sometimes the cause of death is put down as heart attack, sometimes as a stroke, and sometimes as cancer. Sometimes it is only when the post mortem is carried out that it can be stated categorically that it was a pulmonary embolism. The other thing that the chief medical officer of England, Wales and Northern Ireland stated is that 10 per cent of all deaths in hospital can be attributed to venous thromboembolism.
I think also that approximately one person in 20 is at risk of developing deep vein thrombosis. That is another figure that came from England.
However, with regard to deaths, we can only give the figure that I mentioned.
The figures are difficult to come by. We have had great difficulty in getting accurate figures for the number of death certificates that mention deep vein thrombosis. Katie's death certificate stated that she died from a pulmonary embolism as a direct result of a deep vein thrombosis. Her post mortem showed that the clots had been present in her leg for approximately 10 days, which was about the length of time since she had first gone to the hospital with symptoms.
The numbers that you have mentioned are truly horrific, so it is perhaps not surprising that the Government is reluctant to gather those figures centrally. You need to insist on that as part of your campaign because we need that kind of information.
The health boards say that there might be 130 to 138 deaths per annum, but they cannot narrow that down to say that a definitive number of deaths are caused by DVT or pulmonary embolisms. It all comes down to how the death certificate is signed.
If there are no further questions from committee members, we will move on to consider how to deal with the petition. Do members have any strong views on how we should progress the petition?
We should ask the charity that has a keen interest in the condition—Lifeblood: The Thrombosis Charity—for its views.
We are working closely with Lifeblood.
We contacted Lifeblood just after Katie's death. For our work on the issue in Scotland, Lifeblood has been feeding us with the information that it has on the situation down south. However, as I said when I first started having meetings with politicians, the issue should be dealt with not by a charity but by the national health service. Why should a charity do the work of the national health service? Yes, Lifeblood is knowledgeable—its medical director, Dr Beverley Hunt, is very knowledgeable—but why should a charity carry out work that should be done by the Government?
My suggestion was not that we should get the charity involved in doing something but that we should ask it for professional advice, which I am sure it would be willing to impart.
I know that it would be very willing indeed because I meet Beverley Hunt each month down in London.
From the petition and oral evidence that we have considered this afternoon, it strikes me that senior decisions could be made that could have a powerful impact both on the research on DVT and, more important, on the support structures for such conditions.
I see no good reason why the health boards should not get together to identify best practice and to issue best-practice guidelines. We should ask the Scottish Government's health department to pursue the matter.
I agree.
When we write to the Government and NHS QIS, can we check what guidance will be issued to health boards in October? We need to know exactly what information they will put out, because if their guidance will tell each health board to react in the same way—
They said that they would issue a report to all the health boards. I had sight of the first part of that report in August. They have tried to reinvent the wheel, but all that they have done is ask all the questions that we asked last November. They have gone round and asked all the health boards the same questions and have got the same answers that we got. I do not think that the report will be that much help to you.
It would be interesting to know exactly what guidance will be provided, so that we have a full picture when we decide what action to take.
My only point on that is that there will be a strong need for the insurance companies to become aware of all the aspects of deep vein thrombosis before they can make a justifiable decision about how they will deal with the condition. It is an issue of education. They may just fly off the handle and say, "We're not going to insure anyone who tests positive for the factor V Leiden gene."
I am not saying that we should not explore that route; it is just that I am always nervous about encouraging insurers to take views on such matters. The Association of British Insurers is probably the best United Kingdom body to write to.
If we are to propose an action that would lead to people getting cover, we must find out what the insurers think and ensure that the education process takes place before we recommend a course of action.
I want to clarify what you are saying about the report. Are you saying that the health boards cannot agree on what is best practice? You said that the same questions have been asked and the same answers have been received. What is the next sentence after that? Have the health boards still not come to an agreement?
We had a meeting, at which we were assured that we would have a report on our desks. It took a further three months of harrying to get part of the report sent to us. The report should have a beginning, a middle and a conclusion. All that we got was a copy of the beginning, which we provided. As far as the middle and the conclusion are concerned, there is nothing there—there was nothing there in August. September has gone by and we are now in October. It took from February or March until August for me to get the first 44 pages of a 67-page report. All of a sudden, 23 pages will be produced in a much shorter length of time.
As a family, we feel that we have done as much as we can to get to this stage. It is time for action. People have been palming us off, giving us copies of this and bits of that. We feel that we cannot do any more. We need help to continue our campaign. Action is required. Something needs to be done because the present situation cannot be left to continue.
That is a positive note on which to end today's consideration of the petition. Committee members must take on board that message. As Robin Harper suggested, we need to get clarification from the Scottish intercollegiate guidelines network about what the guidelines say. Once we get information back, the clerks will be in correspondence with you because there might be areas in which we want to do further probing. We must try to get clarity from a range of organisations.
Thank you for listening to us.
Independent Midwifery Services (PE1052)
PE1052, which was brought by Jayne Heron, calls on the Scottish Parliament to urge the Scottish Government to promote the services of independent midwives and to ensure that such services continue to be available to pregnant women in Scotland. Before it was lodged, the petition was hosted on the e-petition system, where it attracted 364 signatures between 1 March and 12 April.
I have experienced two births: one courtesy of Greater Glasgow NHS Board and one under the care of an independent midwife. To be frank, the two experiences cannot be compared. In my national health service birth, it was clear that the hospital and its staff were at the centre of the system and that pregnant women must fit in around that. However, with the independent midwife, my needs were of the utmost importance and continuity of care meant that my midwife and I could build enormous trust. That trust makes all the difference, not only to the progress of the birth but to its aftermath.
I am a bit confused about what you are asking the committee to do. I understand that independent midwives are private practitioners. Are you asking for them to come under the auspices of the NHS, so that they would be NHS employees rather than private practitioners? Are you talking about a shake-up of the midwifery service that the NHS delivers, or are you asking the NHS to fund private practitioners?
At issue is the proposed Government legislation that would provide that independent midwives must have professional indemnity insurance. Independent midwives want it, but no companies in the UK or abroad provide it, partly because of the small numbers of independent midwives and the potential for high pay-outs. However, there has not been a substantial pay-out against an independent midwife since 1994, which is not bad going. Women should be able to choose whom they want to care for them. Independent midwives work privately. We are not asking for jobs in the NHS—I could get a job in the NHS if I chose to do so. We need to find a solution to our insurance problems, so that women have the right to choose their carers at any time. Perhaps the NHS could subcontract our services, so that women would not have to fund their own care.
I am still having difficulty getting to the bottom of your reasoning. The public sector does not pay for insurance for the private sector. That is a strange request.
I am not asking it to pay for our insurance, but to extend insurance. If I was contracted to care for Jayne Heron in her pregnancy, I would automatically be covered by CNORIS—the clinical negligence and other risks indemnity scheme—in Scotland. We have checked that with the administrators of CNORIS. We are acting on the recommendation of the Chief Nursing Officer for Scotland and are happy to follow his advice, but health boards have not replied to us and time is running out.
I have the same concerns as Rhoda Grant. As I understand it, until 1994 all independent midwives were covered by the Royal College of Midwives indemnity scheme. The Royal College of Midwives, which I presume represents you, will no longer allow independent contractors such as you to be covered by its indemnity scheme. Is not your problem therefore more with the Royal College of Midwives? It seems to me that you are trying to get round the problem that your trade body, the RCM, is not prepared to offer an indemnity scheme.
It is not a problem with the RCM. In 2002, a vote of the whole membership of the RCM was taken. It decided not to insure independent midwives because there were only 47 of them at that time. The RCM's 33,000 members felt that a £5 increase in their subscriptions to cover the increased insurance premiums was not fair on them. It was an open and democratic decision. Our problem is not with the Royal College of Midwives, which is our union. We want insurance and have made every effort to get insurance. However, it is not so much insurance that is the problem. The issue is not to do with the RCM.
The petition is about continuity of care. I cannot get continuity of care on the NHS: the only way I can is by contracting an independent midwife.
Let me see whether I have got this right. You do not want to be treated by the NHS—you want to have an independent midwife because you can afford to pay for it—
No—I cannot afford to pay for it. I have had to remortgage.
Okay. For you to get an independent midwife, midwives must have insurance indemnity, which they do not have at the moment, so you expect the NHS to pick up that insurance indemnity to allow you to have an independent midwife for whom you can pay but for whom others cannot pay. Is that fair?
We are saying that we want the NHS to subcontract midwives in order to provide that kind of care. That already happens in the United Kingdom: the Albany midwifery practice is a well established model that has been going for 10 years and the NHS contracts its midwives to provide a service for it. The issue is not about private care or pampering people who want unrealistic services: the women need not have chosen not to be cared for by the NHS, but might well have needs that mean that it is very important that they have continuity of care. I have had clients who have had histories of abuse and could not face seeing half a dozen different people in the NHS. The issue is not about BUPA by another name; rather, it is about women having access to the care that they want.
If you were contracted to the NHS, as you wish to be, and the NHS said to you, "Cassy, we need you to look after a woman in Kirkcaldy and we are subcontracting you to do so," would you do that? What are you looking for? Do you want the woman to contact you, as an independent contractor, and for you then to be able to go to the NHS to get it to subcontract you to look after that woman? I am genuinely confused about what you are asking us to do.
Maybe we are not explaining ourselves clearly. We are saying that we could subcontract to the NHS to care for any woman who specifically wants, for example, continuity of care or a home birth, or who has a history that means that she would benefit from having such continuity of care. It would be up to the NHS to send us to whatever women it chose. We are not looking for the NHS to pay for individual women in the way that you suggest. We would be contracted to care for, say, 60 women a year who want home births. They could be any women.
But if the NHS is doing that—
The NHS is not doing that.
Bear with me for a minute. There are midwives in the NHS who are paid by the NHS to carry out home births and deliveries in the hospital. If you want the NHS to be able to use your services for any woman, why do you not just join the NHS?
I could do that, but—
If a woman books a home birth or a hospital birth, she does not know who will be caring for her on the night she gives birth. It could be a complete stranger—someone she has never met. A woman in the most vulnerable position she will ever be in must suddenly form a huge relationship with a stranger who walks into the room.
I fully understand what you are saying. However, given that Cassy McNamara wants the NHS to use the independent midwives as contractors, I am trying to establish whether, in that situation, the NHS would ask the midwife to provide the care, or whether people such as Jane Heron could go to an independent midwife to ask for care, upon which the NHS would, because Jane wants it, contract Cassy to look after her. How would that help other women who need the same level of care but who simply cannot afford it?
Because the NHS pays for the care now, any woman has access to it. The issue is not about who pays for care that is subcontracted.
When women have their 12-week booking-in appointment, they should be asked whether they would like to sign up for the present system or whether they would like continuity of care. Women who want continuity of care could be provided with a list of midwives in the area who might do that. That is the approach that I envisage.
Any woman could do that.
Yes—any woman could do it.
But there are only six independent midwives in Scotland.
Any midwife could work that way. If we start subcontracting midwives who want to work that way—
So you want all midwives to be subcontracted.
No. Any midwife who wanted to work that way could do so and any woman who wanted continuity of care would have the choice of having the care subcontracted through the NHS.
So you suggest that all midwives who are in the NHS at present could become independent contractors and the NHS could subcontract the care, to get over the problem that you cannot get indemnity insurance.
No. No specific studies have been done on the issue, but we are aware of a few midwives who wanted to work in that way and who left the NHS and midwifery because they could not. The Independent Midwives Association has statistics on that.
I will abuse my role as convener a little. Members are raising critical points. It strikes me that two different issues are involved. One is the issue that Jayne Heron has raised about the nature of the care and the responsiveness and attractiveness of the current options that are available to expectant mothers. The other issue is the structure of the relationship and insurance indemnity. The two issues are linked, but in our discussion, we need to unravel the responsibilities and roles in the NHS, and the problem in relation to insurance cover. Some of the crossover is not consistent, which makes it difficult for members to feel comfortable with the petition. That is what we are trying to explore. One or two other members have questions—we will get through those and explore the issues, but I do not know whether we will come to a satisfactory conclusion for anyone round the table. That is the concern that I have heard from members.
The witnesses have clarified some of the points that I was going to raise. If there is general agreement that the independent midwifery service is a good service, why not argue that it should be provided under the NHS, working with the RCM, rather than contract out services, which the witnesses say should happen? The concern of some members is that you say that we should contract out midwifery services to the independents. However, if the model of care for expectant mothers that you describe is a good one, perhaps we should have the RCM and the NHS work together to consider whether we could replicate it in the NHS.
I absolutely agree. In fact, that is exactly what has happened in the past few years. The RCM supports continuity of care and that model of care working—there is no doubt about that. The NHS says that it would like to provide the service, but that it is unable to do so for several reasons. As the convener said, there is a mix of two issues. We want to provide continuity of care and some women want it. If legislation is introduced in 18 months that means that I will not be able to practise or maintain my registration as a midwife if I do not have insurance—which I cannot get anywhere—that will mean that, as a professional, I will be left with the option of an NHS job or no job. No other profession is put in that situation.
Cassy McNamara said that some health boards have responded and have said that they would be willing to offer this level of care if they could. What reasons have you been given for their not providing it?
The health boards said that it is down to numbers because one-to-one care needs a lot of time commitment and involvement. They also expressed concern about whether enough of their midwives would want to work in that way and whether enough women would have access to that model of care, but they had not asked the midwives. The Independent Midwives Association has asked midwives: 78 per cent of midwives, out of a poll of 1,200, said that they would like to work that way if they were given the opportunity. However, at present there is no opportunity in the NHS for them to do that, except at the Albany practice in London.
If the NHS decided to offer this service and contracted independent midwives, how would that fit in with people's working conditions, holidays and the European working time directive? It is all very well for a woman to say that she wants the same midwife from the start of her pregnancy all the way through until several months after the birth, but people take holidays and get sick. Also, babies do not come to order and labours can go on for quite long periods. I can see why the NHS would be reluctant to say to one person that they had to be there all the time. It may not be safe for the same midwife to be in charge of the labour all the way through if it was a very long labour, because they could be absolutely exhausted.
That is exactly how I work now, and it involves a huge amount of time. I spend nine months of the year on call for 24 hours a day for my clients. The Albany practice has been going for 10 years and has six independent midwives. They work three months on—on call for 24 hours a day—and one month off, and they cover for each other. Each midwife has a caseload of 30 women a year for whom they are the primary midwife and 30 women for whom they are the secondary midwife.
And the midwives at the Albany practice get 12 weeks' holiday a year.
With the best will in the world, someone cannot be guaranteed the same midwife all the way through. If it is their month off—
If Jayne Heron and I were working with the same client who was one of my primary clients and her baby was due in May but I was off in May, Jayne would not be off in May. At the Albany practice, in 94.6 per cent of cases the woman has her primary midwife present at the birth; in the other cases, the woman's secondary midwife is present. That applies for both hospital and home births.
Let us return to the main question. You are saying that you would like that service to be offered on the NHS.
Yes.
I am getting rather confused. What do you find unacceptable about the midwifery services that are provided in the NHS?
Where do I start? The biggest issue for me is continuity of care. Throughout a woman's pregnancy, she has a number of antenatal appointments. After she has given birth, she receives postnatal visits from a midwife, as well. For me, having a woman see a different midwife at every appointment, however many midwives are on duty during the birth and different midwives for postnatal appointments—all of whom are strangers to her—is an unacceptable way to handle birth. Giving birth involves the woman placing a huge level of trust in her care givers. She and they will make decisions about the birth together as the pregnancy unfolds and she has to trust that they are well informed as to what is happening and what level or course of action to take at the time.
I worked for the NHS for 10 years before working independently. Without doubt, there are wonderful midwives in the NHS. By and large, the NHS can do a great job and many people are grateful to the service and happy with it as it is. However, every area of the NHS has its problems. The petition is not about solving all the NHS's problems; it is about giving people another option.
I am not particularly surprised that you do not get a favourable response from the NHS for what you propose. Did you both train under the NHS?
I am not a midwife.
I did. All midwives must train with the NHS.
Now you want to take that expertise into the private sector and offer the service in various communities at a cost to the individual.
That is what I do now.
That, to me, is not a medical service, it is a business. Because you want to go into that sort of business, you expect the NHS to indemnify you against any problems that may arise. That is quite unreasonable.
No. I think that there is a general impression that that is what we are asking the NHS to do, but I am not asking that I should be able to keep working the way that I do and the NHS should foot the bill for my insurance. That is not why we are here. We have been told that a way round the lack of indemnity insurance would be to subcontract. There are women who want the services of an independent midwife, women who need those services and women who cannot have them for many reasons. Subcontracting would be cheaper than the cost to the NHS of a hospital birth—even with the way that I charge now, I am about £1,300 cheaper than basic care and a hospital birth. We are not asking the NHS to fund some plush service but to provide a service for women who might really need it.
It has been a fairly torrid discussion. Well done to the witnesses for taking on some pretty rigorous questions from the committee members. You have raised many big issues that might require more examination. People need to be persuaded. I have the sense that, when you leave the committee you will say, "Ooph! That was a toughie this afternoon."
It seems to me that the problem has arisen partly because the UK Government, which is responsible for the registration of midwives, wants to bring in legislation that will insist that midwives have professional indemnity insurance. I understand that the view of Ivan Lewis, who is a Parliamentary Under-Secretary of State at the Department of Health, is that the Government at Westminster does not want to put independent midwives in an impossible situation. If that is the case, we should write to the UK Department of Health, which is responsible for the registration of midwives, to ask what suggestions it has for overcoming the situation that has been created by its legislative proposal.
I have in my bag a letter containing the Department of Health's suggestion, which was that independent midwives should be subcontracted. All independent midwives have had the same letter, from the Department of Health in England and from the chief nurse in Scotland. That is what we have been told.
The convener asked for strong views. I have the strong view that midwifery in Scotland and the UK should be getting more support rather than less support. It is clear that we face the possibility of a diminution of services, so something needs to be done.
I can understand where Tricia Marwick is coming from, but I do not think that anyone would suggest that a private practitioner should not be insured. I can also understand where the petitioners are coming from. There must be some comeback if something goes wrong when someone is in the hands of a private practitioner. If something goes wrong at a birth, the consequences can be serious for the rest of the child's life and for the mother. I am not sure that we should argue that indemnity insurance should not be allowed.
Members of the Independent Midwives Association have tried all the major insurance companies and the reason that we have been given for not being offered insurance is that our numbers are small and that any claims against us could result in high payouts over a long period of time. I agree that we do not want to have no insurance. The fact that we are allowed to work without having formal insurance does not mean that we cannot be sued. Quite frankly, I would rather not lose my house but, as things stand, those are the conditions under which I work. I want insurance.
I am conscious that we are running short of time. We have a number of other petitions to consider and we need to take a five-minute break. We must obtain information from a range of agencies because the issue is fraught with complications and it gives rise to strong personal views. I get the sense that the committee has strong views about preserving the ethics of the NHS as regards public provision. Understandably, that is one of the discussions in which the petitioners have been caught up.
Meeting suspended.
On resuming—
Physiotherapy Graduates (Employment) (PE1044)
Welcome back. Our next new petition is PE1044, which was lodged by Kate Mackintosh on behalf of the student members of the Chartered Society of Physiotherapy in Scotland. The petition calls on the Scottish Parliament to investigate the merits of extending the employment assistance that is given under the one-year job guarantee for newly qualified nurses and midwives to include newly qualified physiotherapists, with particular reference to the benefits for patient care. Before being formally lodged, the petition was hosted on the e-petition system, where it gathered 1,748 signatures between 14 December 2006 and 9 February 2007.
I listened to that lobby, and I was enormously impressed with the students who came to lobby us.
Like Robin Harper and the convener, I remember the lobbying before the election. I declare an interest in that I was lobbied by my nephew, who comes into the category that we are discussing.
When we write to the Scottish Government, we should ask about access to physiotherapy. I understand that there is a long waiting list but many problems can be sorted out if patients are seen early, and some of the health problems that come from not getting the right physiotherapy do not arise. If people who are off work with back problems have quick access to physiotherapy, that might have a knock-on effect on them getting back to work quickly. There would also be less of a drain on public services as a result of people claiming benefits when they are off sick.
A number of suggestions have been made. There is also an issue of looking at the expertise and asking whether special pilot projects or initiatives could be introduced in the period that would involve a range of different providers, such as the health service and social workers, to target intervention work or to reduce waiting times for physiotherapy or support.
We will be in contact subsequently with those who submitted the petition. I thank you for your time. If you have anyone to sort out, you can leave now. Could you come and see me after my knee operation?
Charter for Grandchildren (PE1051)
The next petition is PE1051, by Jimmy Deuchars, on behalf of Grandparents Apart Self-help Group Scotland. The petition calls on the Parliament to urge the Executive to make the charter for grandchildren legally binding to ensure that the rights of children are recognised by all public agencies and families and are enforced by law. Before being formally lodged, the petition was hosted on the e-petition system; between 27 February and 14 April it gathered 277 signatures. A further 95 signatures have been provided in hard copy.
I declare yet another interest, in that I am a grandma.
I do not believe that.
I know, but I was a child bride, which helped in the first place.
I agree. Grandparents play a huge role in the lives of their grandchildren. I know of a lot of cases in which grandparents have taken over the care of grandchildren. In some cases, grandparents are not consulted and are left battling in the dark. I would agree with anything that would help grandparents get support. I know that Children 1st has groups of grandparents and supports family groups. It would be worth consulting it on the issue, as well as asking the Scottish Government for its thoughts.
I believe that the petitioner is present in the public gallery. We will ask the Government for its position on the issues raised and on the legal framework. The petitioner has heard from members of the committee that there is general sympathy with the petition. We have to consider the legal interpretation and which rights are paramount. I hope that we will get a response; once we do, we will continue the process for the petition.
Supermarket Developments (PE1058)
I welcome to the committee Sandra White MSP who has expressed interest in the next petition. I know that Bashir Ahmad has to leave now; he has to deal with another commitment unexpectedly. He kindly sought permission to leave, which I have kindly granted. Thank you for your contribution, Bashir.
Thank you.
The next petition is PE1058, by Samer Bagaeen. I genuinely apologise if I have pronounced that wrong; I have had a lifetime of people mispronouncing McAveety, so that is my wee bit of revenge. The petition calls on the Scottish Parliament to consider and debate the traffic, environmental and sustainability impact on existing communities in designated town centres of large 24-hour supermarket developments. Before being formally lodged, the petition was hosted on the e-petition system between 8 March and 11 May, where it gathered 594 signatures.
Thank you for allowing me to come and speak in support of the petition, convener. You said that the petition was hosted on the e-petition system between March and May. The reason for that is that Tesco changed the application, so objectors had only that short time to start objecting and picking up names for the petition. The situation has been on-going for a number of years. The petition relates to an area in Partick with which you might be familiar, convener. Given certain aspects of planning legislation, the petition should be taken forward, although that is up to the committee. Scottish planning policy 8 relates to how an application affects communities, shopping and the environment and SPP 17 relates to the traffic implications of a development.
Do any other members have comments or observations?
Convener, I seek a point of clarification. Sandra White mentioned that there are a number of large retail outlets nearby, but she did not say whether any of those open all day. Do any of those outlets have 24-hour opening?
The store in Crow Road—just up from Dumbarton Road, where Crow Road leads into Anniesland—has 24-hour opening. The local residents have complained about being wakened at 4 and 5 in the morning. The store is not open for shopping 24 hours a day, but people are woken up at 4 and 5 in the morning because deliveries take place 24 hours a day. That store is just up the road from the proposed development. Also, the Asda store just over the river is open 24 hours a day.
A traffic impact assessment needs to be done. Clearly, there are issues with allowing such shopping developments to go ahead in a built-up residential area. I am sure that residents in many towns and cities throughout Scotland have similar complaints about the traffic impact, in particular of heavy goods traffic. As Sanda White indicated, if the level of white goods that will be sold in the outlet requires heavy goods vehicles to move through a built-up area 24 hours a day, that will have an impact on the amenity of the area for local residents.
I will try to refrain from referring to any development to which I have objected in the past. Instead, I will stay with the general concern about the huge power of supermarkets to change the entire shape and social fabric of our cities and towns. It is long past the time when the Parliament should have given the issue its serious attention. The Government needs to produce a planning framework that allows the survival of what is left of our town centres and the social fabric that they represent.
In normal circumstances, I would say that we should leave the matter to the local authority, given the strictness of the planning guidelines and the fact that this is a local authority issue.
That makes sense. It is a good idea.
Two issues are involved: out-of-town supermarkets that open 24 hours a day and supermarkets in built-up areas that also open 24 hours a day. The decision that is the subject of PE1058 has broader implications. I am not sure whether either the current planning guidelines or the provisions in the Planning etc (Scotland) Act 2006 make a distinction between out-of-town supermarkets and those that are located in built-up areas.
As has been mentioned, it would be helpful to get the present position—although that is dependent on the democratic structures of the planning committee and the process that is being engaged by the local authority for the application—as some of the issues that are being raised are critical. As a broader submission, we should also seek views on whether there could be a conflict of interests because local authorities have a dual role in the process and on whether a neighbouring authority could use its professional judgment to oversee the effectiveness of the process.
Legal System (Fee Arrangements) (PE1063)
The next petition is PE1063, from Robert Thomson, which calls on the Scottish Parliament to investigate the apparent conflict of interests that exists between solicitors or advocates and clients in the present system of speculative fee arrangements—commonly known as no win, no fee arrangements—and to urge the Scottish Executive to overhaul the existing speculative fee arrangement framework and procedures to make solicitors and advocates more accountable to their clients. Before being formally lodged, the petition was hosted on the e-petition system between 11 December 2006 and 8 June 2007, where it gathered 15 signatures.
I have some sympathy with the petitioner, but I cannot see how we can do anything to give him comfort. If no win, no fee arrangements were not available, the people who use the service would not be able to take the cases that they want to pursue through the legal process. If someone does not pay a fee to a solicitor, the case proceeds on the basis that the solicitor will try to recoup a fee somewhere in the process. If that person were to say that the solicitor could not take a certain action, they would be preventing the solicitor from recouping their fee.
I accept Rhoda Grant's position and I agree with her. I am interested in whether there is sufficient guidance for people who decide to enter into a no win, no fee arrangement. Citizens Advice Scotland does some work in the area. If we were to ask for other views on the position, I would like us to explore whether it is made clear to people what they are entering into with a no win, no fee arrangement.
Perhaps we could write to the Law Society of Scotland, asking what guidance solicitors give when they operate on a no win, no fee basis and whether it is made clear to the person on whose behalf they are operating that, at the end of the day, the solicitor must find a course of action that will enable them to be paid a fee.
That is a helpful suggestion. We should also write to the Scottish Consumer Council, asking for its views on the appropriateness of the available information about the service and the enforcement and commitment issues. We can write to those two organisations. Do members have any other suggestions of organisations to which we could write?
We should also write to Citizens Advice Scotland.
That is not a bad idea. Writing to the three organisations that have been mentioned would be a reasonable starting point.
We should also write to the Faculty of Advocates, as it is mentioned in our briefing and operates under a different system.
Fair enough. I thank members for those suggestions. We will process the petition in the way that has been outlined.
Scottish Prison Population (Catholics) (PE1073)
The next petition for consideration is PE1073, from Tom Minogue, which calls on the Scottish Parliament to investigate and establish the reasons for the apparently disproportionate number of Catholics in Scottish prisons. Before the petition was formally lodged, it was hosted on the e-petition system between 28 November 2006 and 15 June 2007, where it gathered 131 signatures. Do members have views on how the petition should be taken forward?
The figures that the petitioner cites seem anomalous, but they should inspire a piece of sophisticated social research. It does not strike me that the anomaly has anything to do with religious persecution. If the figures that have been cited are accurate, a sophisticated piece of social research should be commissioned.
As someone of that persuasion I am nervous about dealing with the petition, on the basis that I might find myself in jail. There is concern about the fact that the number of Catholics in prison is disproportionate. Some would argue that there are powerful sociological, class and economic reasons for that, but the discussion on the e-petitions system indicates that some people are still strongly of the view that the figures should be investigated. It is obvious that there is not much information on the issue, so we should explore it further. How do members think we can get to the bottom of the matter, so that we can reassure people that the judicial process is fair and not discriminatory, as we would be concerned if there were evidence of discrimination? We should send out a strong message that we are tracking the phenomenon and that we will deal with it appropriately, where possible.
I suggest that we widen the discussion. The petition suggests that the number of Catholics in prison is out of kilter with the percentage of Catholics in the population, but the figures that are before us show clearly that the same is true of other ethnic groups. If we are to make approaches to anyone, we need to seek responses that address the wider issues that relate to those categories of prisoners and to investigate why the differences that have been identified exist. The Muslim population of Scotland is 0.8 per cent of the total, but Muslims make up 1.7 per cent of the prison population. Clearly, the number of Muslims in prison is out of kilter with the percentage of Muslims in the general population. Instead of confining the discussion to one religious group, we should widen it out and ask whether any research into the issue has been done, what its findings were and what impact the phenomenon has on society in general.
I am happy with what has been suggested.
When I proposed that there should be sophisticated research, I meant that it should be wide ranging—as John Wilson has suggested—and that there should be statistical analysis of the entire prison population to establish the commonalities that exist. Something else may be behind apparent commonalities that have been identified.
As for how best to respond to the issues that have been raised in the petition and in the committee's discussion, one option is to write to ask the justice department what information it has. Some statistical research or academic work could be useful. I am wondering off the top of my head who would be best to call for that. We may well see a gap or an anomaly. Could we ask the Government whether, in its research models or its commissioning of research to influence policy frameworks and development, it has considered religious affiliation in examining where the numbers in the prison population are coming from? Much work is done on the social class and the economics of the prison population. Is religious affiliation considered in relation to the prison population and sentencing policy? Are like-for-like comparisons made between ethnic groups and religious groups in relation to sentencing policy?
Road User Charging (PE1074)
The next petition is by Nancy Gardner and calls on the Scottish Parliament to urge the Executive to reject road user charging or national road pricing on Scotland's roads. Do members have views on that?
I am not aware that the Scottish Government has any plans to introduce road pricing on Scotland's roads. I suggest that we note the petition and close it.
Are members happy with that recommendation?
That was quick—sorry, did Robin Harper want to speak?
I want just a tiny word. I put it on the record that I am reluctant to let the petition go.
I assure the member that I do not want the Government to be involved in any difficult political situations in the near future but, if it pops up with that idea, I am sure that the member will have a view. What Robin Harper said is in the Official Report now—it was a bit green of him to miss the opportunity.
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