Public Petitions Committee,

Meeting date: Wednesday, May 3, 2006

Official Report 303KB pdf

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Current Petitions

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Adults with Learning Difficulties<br />(Provision of Services) (PE743)<br />“The same as you? A review of services for people with learning disabilities” (Implementation) (PE822)

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“The same as you? A review of services for people with learning disabilities” (Findings) (PE881)

The first current petitions are PE743, PE822 and PE881, which are on the Scottish Executive's "The same as you?" policy. At its meeting on 21 September 2005, the committee agreed to seek the views of the Deputy Minister for Health and Community Care on PE881 and to link it with PE822 and PE743. The committee also agreed to invite Executive officials to update the committee on the implementation of "The same as you? A review of services for people with learning disabilities" once comments had been received from the petitioners on previous responses.

Peter Stapleton, Bette Francis, Jenny Pickthall and Jean MacLellan from the Scottish Executive Health Department are here to provide an update on the implementation of "The same as you?" and to answer members' questions. Would you like to introduce the subject or do you want to go straight to questions?

The four of us will make a presentation to provide the update.

We are more than happy to hear that.

Thank you for the opportunity to provide an update on the progress that is being made to implement "The same as you?" I will introduce the team briefly. I head the adult support and protection unit, which takes the lead on the work; Bette Francis is my deputy; Jenny Pickthall is the policy officer on learning disability; and Peter Stapleton works in the carers branch. We thought that collectively we would cover the territory more effectively.

In previous communication, we have advised the committee on the key themes of partnership in practice, our plans to meet Enable, the NHS Quality Improvement Scotland programme of work and our plans for an updated hospital closures report. We propose to update the committee briefly on those strands of work. We will also take the opportunity to highlight our action plan for the next two years of work at national level.

The committee may be aware that an early focus of the national implementation group was local area co-ordination, hospital closures and employment. More recently, it has produced reports on day services, work with children and advocacy. Those reports were published only last week and copies are available in the Scottish Parliament information centre. The minister will send all those reports to Jackie Baillie in her capacity as chair of the cross-party group for learning disability.

The Scottish Executive is addressing, in a number of ways, the issues that the petitions raise. For example, we sponsored the Scottish conference on older carers last November and we funded Enable to develop a toolkit to identify the needs of older carers and work with them to plan for the future of their adult children. Peter Stapleton will update the committee on the response to the care 21 report "The Future of Unpaid Care in Scotland".

For children, the changing childhoods programme aims to ensure the planning of children's services. It will take the needs of children with learning disabilities and autism properly into account from the earliest years through to the transition to adult services. Bette Francis, who will speak next, will update the committee on the progress of the hospital closure programme.

We are now past the halfway point of our 10-year programme. The action plan for the next two years will be set out in the national overview of the 2004 to 2007 partnership in practice agreements. It will include a number of issues that will be addressed through seminars, through possible guidance, and through following up on the on-going evaluation of local area co-ordination research. We recognise that what we need to do now is address the balance between mainstream service responsibilities and the development of appropriate specialist services, taking account of wider policy development since "The same as you?" was published in 2000. Jenny Pickthall will describe some current initiatives and will say what we hope to achieve in the next two years.

Monitoring the effectiveness of the policy is critical. Multi-agency inspections of learning disability services will provide part of that information, and our implementation team is working closely with other policy areas on the development of social work and joint improvement performance indicators.

I will focus initially on the hospital closure programme. The closure of long-stay hospitals was one of the specific recommendations with a target date in "The same as you?" Early in our hospital reprovision work, we realised that not all boards would meet the target. At the last return of figures from the remaining six health boards, 194 people were still in long-stay hospitals. The Minister for Health and Community Care wrote to national health service boards last year and issued an updated report on hospital closures. At that point, there were 312 long-stay patients, so there has been a shift, although a lot of work remains to be done.

The minister asked officials to visit each of the six boards, and last year we did so. We now review quarterly the progress towards identified targets. There have been delays for a number of reasons that are discussed in the NHS Quality Improvement Scotland overview report that was published recently, which makes a number of further recommendations about service reprovision. We will discuss that at our national implementation group next week. Until we have had that discussion, I cannot say what programme of action we will agree to.

While we were visiting the boards, our NHS and local authority colleagues raised a number of concerns over the definition of "assessment and treatment" and over who should be in assessment and treatment beds. We have responded to those concerns. We will hold a seminar in June to bring people together to consider who should be using NHS beds because of learning disability, how appropriate resources should be provided in the community and what obstacles remain.

We are also following up on last year's consultation on vulnerable adults and the Adult Support and Protection (Scotland) Bill. We asked about additional legislation specifically for people with learning disabilities who have challenging behaviour; we also asked about people who had been detained under mental health legislation. I am convening a group that will specifically consider both existing legislation and how people with learning disabilities can be better supported by mainstream legislation—those were the key issues that came out of the consultation.

Events will be held on health improvement. In June, we are holding a seminar that will focus on the care in general hospitals of people with learning disabilities. The seminar will bring chief executives of NHS boards together with directors of nursing, to consider current plans for improving services for people who have to access general hospital care. The seminar will also consider the role of carers.

As for people who have more profound and multiple disabilities, although the just published day services report, which has been the result of collaborative work with service users, carers and service providers, does not make many recommendations, its main aim is to raise awareness of the views and interests of all those groups in continuing to develop and improve day services. Of course, that is of great interest to many people, including family carers for those who have profound and multiple disabilities.

As members might be aware, we also fund the profound and multiple impairment service to support people with profound and multiple impairment through developing and maintaining the national information service for parents and professionals referred to in "The same as you?" As our national implementation group is keen in all its future work to focus on the needs of people with the greatest level of disability, it will seek representation from PAMIS in deciding how we target our efforts and meet the needs of all those with learning disabilities.

I will provide a brief overview of continuing national work. The national implementation group has set up a task group to consider how the implementation of the recommendations of "The same as you?" have been or will be affected by changes in supporting people funding. The task group's work will inform the on-going evaluation of supporting people funding, particularly with regard to the effect on learning disability services. The group aims to take its findings back to the implementation group and relevant ministers.

Implementation of "The same as you?" has informed development in other policy areas. For example, in further education, the guidance document "Partnership Matters: A Guide to Local Authorities, NHS Boards and Voluntary Organisations on Supporting Students with Additional Needs in Further Education", which was published in January 2005, outlines all the agencies' roles and responsibilities in supporting people with additional needs in further education. It was widely disseminated, and there is already evidence of formal and informal partnerships between colleges and local authorities around the country.

Moreover, the recent consultation on "Finding Practical Solutions to Complex Needs" found out more about young people's experiences in accessing further education and arrangements for attending specialist provision in England. The Executive is considering options for changing the current arrangements and hopes to consult on the way forward in the near future.

On employment, the employability framework will take forward the recommendations made in "Working for a change?" with regard to the employment of people with learning disabilities. The Executive has commissioned the Scottish Union for Supported Employment to develop a blueprint for supported employment and how it relates to the employability framework. The plan will outline quality standards; assess training needs across supported employment organisations; act as a resource for local partnerships; and help to provide more people with learning disabilities the opportunity to take up employment.

I will say a few words about carers policy and the Executive's response to the care 21 report "The Future of Unpaid Care in Scotland", which Rhona Brankin mentioned last year in her letter to the committee on these petitions.

The care 21 report captured views and experiences of unpaid carers and professionals and used economic modelling to predict future pressures. Although its 22 recommendations for action over the next 10 years are directed mainly at the Executive, some are also addressed to the UK Government, the NHS and local authorities.

On 24 April, Lewis Macdonald responded to the report by setting out the Executive's priority actions, including the development of more personalised, preventive respite care—which, as the research underpinning the document discovered, is a key priority for carers. In recognition of the health implications of caring on some carers, the Executive will engage with the NHS and general practitioners in identifying carers and prioritising their needs. It will also develop a consistent framework for carer training, to help carers, particularly new ones, to develop the necessary knowledge and skills to manage their caring roles. Finally, the Executive will prepare an evidence base to allow it to consider in next year's spending review the resources required to meet some of the report's recommendations.

Implementation of the response is now under way, and task groups for early actions on young carers and respite will be convened over the next few weeks.

That concludes our presentation. We are happy to clarify any points and take any questions.

Thank you for taking the time to give us that very comprehensive update. I will now open up the discussion to members' questions. We will go first to Jackie Baillie, who is champing at the bit.

I was going to out myself as the convener of the cross-party group for learning disability, but that was done for me before I could. I am not sure whether I am required to declare my interest formally. If so, consider it done, convener.

What the Scottish Executive has done is tremendous and has been welcomed by people who are learning disabled and by people who represent learning disability organisations. We think that the policy framework is absolutely sound, partly because we involved people with a learning disability in shaping it, so that everyone feels a huge degree of ownership of it and wants it to succeed. Please accept my comments in that context. We feel that we own the policy and know what needs to be done. The reality—not just the perception—in some areas of Scotland where local agencies understand and support this work is that the transformation has been extraordinary, but in other areas, it is as if "The same as you?" had not happened. We want it to happen in every area of Scotland. I do not doubt the work that is being done or the intentions, but the reality is different.

Let me explore with you how we turn the right policy—what you said about working for a change and implementation of "The same as you?"—into reality everywhere in Scotland. I will focus my comments on monitoring. I would like to hear more about multi-agency inspections. You referred to an implementation team.

That is us.

There may be a resource issue. I am interested by the fact that, given that some time ago the cross-party group was shouting about performance indicators, five years in we are only discussing those, if I understand you correctly. What monitoring do you do? How do we ensure that partnership in practice agreements are not variable? We know that at the moment they are, because we have seen some of them. Some are excellent, but some could do with extra work. How do you know that your money is being spent? I can report to you that, irrespective of the supporting people programme, some local authorities are reducing the services that they provide to people with a learning disability, as is the case across the board. That is not anecdote but fact. We want to help you. You can blame us for the situation, but we think that you need a very robust monitoring framework.

I am sure that I speak on behalf of the team when I say that we are gratified by the fact that Jackie Baillie views the policy so positively. Like her, we consider ownership by users of the service to be critical. If we do not have the people who use services alongside us, our policy as a whole will be empty. We recognise what she says about the variation across Scotland in the success of the policy to date. She will acknowledge that, with 32 recommendations, we must prioritise. We have done so in the way that I have described in the reports that we have undertaken to date. We have sent those more detailed reports to all local authorities and health boards, in the expectation that they will be used as blueprints for implementing policy at a local level. We see that as critical.

In my introductory statement, I spoke about balancing the need for mainstream service with that for specialist service. Increasingly, we recognise that it is not sufficient for us to keep producing reports that are owned by many people but which are essentially written at the centre. We want to get alongside people in local authorities and work with them on what they are doing for people with a learning disability in their mainstream policies. That is why we talked about the employability framework and so on. Jackie Baillie knows that as well as I do.

We carry out monitoring directly through our partnership in practice agreements. Monitoring is conducted on a three-year cycle, because we are mindful of that fact that if we monitor more regularly, people will tell us that we should let them get on with the business and not constantly review what they are doing. The aim is to strike a balance and not to become overly bureaucratic in our expectations of monitoring returns. We have a statistical return that is largely quantitative, rather than qualitative, but we are looking forward positively to what the Social Work Inspection Agency is doing on monitoring and joint inspections.

As Jackie Baillie rightly said, we are five years into the policy. As she will know, the social work services inspectorate was recently made into an agency, so some change has taken place. The Social Work Inspection Agency now has a programme of joint inspection in relation to learning disability. For obvious reasons, some work has been done in the Borders, but the agency is also in the throes of conducting an inspection in Ayrshire.

To summarise, I recognise the points that Jackie Baillie made. I have explained how we currently carry out monitoring, but the national implementation group also provides another barometer of what is happening locally. For example, the users organisation People First keeps us informed. If issues of particular concern are raised at the national implementation group, we make direct contact with local authorities and health boards to clarify the position. However, I am interested to hear what more members think we could do and what mechanisms we might use.

I do not wish to prolong the meeting, but I would be happy to respond to that just now. However, perhaps the convener would like me to respond later.

If we have time, I will let Jackie Baillie offer her suggestions at the end.

I join my colleagues in welcoming the presentation that we have heard this morning. I associate myself with the positive remarks that Jackie Baillie made about the national implementation group's work, which I believe is important. I believe that the policy direction is absolutely right.

This question is probably for Jenny Pickthall, given that she talked about supporting people funding and the establishment of a national task group. Will she say a little bit more about supporting people funding, which is an issue in the area of Fife that I represent? In February, the committee considered a petition on that issue from Stella Macdonald on behalf of the Citizen's Rights Action Group in Fife. Indeed, I am meeting the minister on that topic this afternoon.

When will a review of the supporting people formula take place? Will such a review take place? Does the current formula take account of the age profile and levels of multiple deprivation in council areas such as Fife? I ask her to bear in mind the background, which is that Fife Council has taken great pride in the provision that it has made in supporting people with special needs across the county. However, I know that funding is an issue not just in Fife. The issue was raised at the big blether conference in Perth and it has also been raised by people from Grampian.

If Helen Eadie does not mind, I think that her question would be better answered by Bette Francis, who has done some direct work on costings.

The formula for supporting people is not managed by the implementation team, but we work with colleagues in the Executive who take forward the supporting people agenda. Although we have representation on the task group and we are examining costings, I am afraid that I cannot answer questions specifically on the supporting people formula. Obviously, I can ask colleagues from the supporting people team to answer those.

The purpose of the task group is to look at the fear that a loss of service would result from the changes in the supporting people allocations. As part of that work, we are looking at expenditure by local authority social work services on supporting people and expenditure by NHS boards to see what shifts and trends have emerged since supporting people was introduced. We will use that information to inform ministers on whether additional funding is needed in future spending reviews.

On monitoring, which Jackie Baillie mentioned, I think that the reason why we have had such good feedback is that people are comfortable. However, there have been concerns and perhaps even some criticisms. The two main issues on which people gave feedback were that there was no real monitoring of services and that local authority provision can be a postcode lottery.

Jean MacLellan mentioned that monitoring has been carried out every three years. If the most recent monitoring was carried out in 2005, that means that the next one will not take place for another two years. I appreciate the point that people do not want constant interference but, given the concerns that we have heard in feedback from petitioners, is it sufficient to monitor services only every three years?

If that was all that we did, it would not be sufficient, but we do other things as well, such as our work on the national implementation group and the statistical return, which is quantitative rather than qualitative. We take part in a number of activities on our priorities. It would be difficult to ask local authorities and health boards to do monitoring more often than every three years.

Our national implementation group includes representatives from health boards, local authorities and user groups. As well as those strands, there is the joint inspection programme and the work that NHS QIS has been doing with us, so we engage in various elements of monitoring.

As I said to Jackie Baillie, I would be happy to work with the cross-party group on how to tackle those areas in which there is a perception that service has been reduced. We have not received sufficient evidence to indicate that that is the case.

I am sure that Jackie Baillie and the cross-party group will bring forward any evidence that comes to light. A number of individuals have come to me about lack of service provision, so perhaps I will pass that information on to the group.

My next question is about people's perception that they are not getting an adequate service—"perception" might be the wrong word because, for the people who come to me and say that the service that they get in their area is not as good as the one that is provided to people who live in another area, that is a real situation, not a perception. Is there a system of checks and balances? Do you go back to the local authority if you get representation from people in an area to the effect that standards are not being met?

In all our policy areas, we do such work routinely when we get representations from members of the public or from voluntary organisations. If we receive correspondence of that nature, we respond to it. If we had sufficient concerns, we would go out to talk to people. Bette Francis mentioned hospital closures. We knew from the quantitative data that the targets were not going to be met but, in addition, a number of people said that they were not satisfied with the degree of progress in particular areas. As a result of that, the minister asked us to go out on a series of visits. That led to the quarterly returns, which Bette Francis described. We will do further visits to those six areas so that when an issue comes to the fore, we will assess it and address it as appropriate and with the minister's approval.

That is comforting. You said that you do not have a great deal to do with the supporting people fund.

A different team in the Executive deals with that.

It is handled by employment and education staff. We know that there are cutbacks in the supporting people fund, which is a reserved area of policy. How much input does your team have to the relevant team in the Executive? Can it make an input into Westminster about the moneys that have been allocated? There is a dearth of services and people are extremely worried that they will no longer receive services when the supporting people fund is reduced or stopped.

At the moment, there is one member of that team who is on the group that Bette Francis described, which is examining the different pots of money that are available. She informs us about what the intentions are in relation to supporting people as she becomes aware of what the impact may be for people with a learning disability. Above that level, my division head is in discussion with the division head who heads up the supporting people team on the issue so that we will know at an early stage what the impact will be in each of the coming years.

Thank you for the quality of your presentation, which must have taken a long time to put together. Your commitment to the issue is welcome and I am totally behind it. I suspect that you might have just answered my question, but I will try to spell it out in words of one syllable. I am concerned about the long-term affordability of the more complex care packages for the 194 people who, according to you, are still in hospital. From experience in my constituency, I presume that the cases that have not yet been resolved are the more complex ones. Can you assure me that the funding that will be required to resolve those cases will be put in place? I would be happy to take your assurance. I would also like to know about the long-term position.

Before the witnesses answer that, I will come in, because I was going to ask a similar question. We are down to smaller numbers, as John Scott says. In my constituency, there is a hospital that is closing and has only a handful of service users. If a dispute arises between the advocacy team in the hospital and the service user and their family about the package that the social services department in the area has devised, how can the issue be resolved? It is difficult to use one individual case to highlight a wider problem but, if it can happen in one case, it could happen in others that the social services department is forced to provide an inappropriate care setting because that is more cost efficient. How would you make a policy intervention on such a decision?

We tend not to get involved in individual cases, as you appreciate. Local authorities largely make their own decisions about the use of resources and social services departments tend to lead in decision making about individual cases.

On the 194 patients in long-stay hospitals about whom we know, generally speaking, John Scott's perception that it is those with the most complex needs who remain in hospital is accurate. However, that is not the case in all instances, because different hospital closure programmes operated in different ways; some closure programmes began with those with the most complex needs and then moved to those with less complex needs. That has varied over time and in different parts of Scotland.

The work that Bette Francis described involves acknowledging the point that John Scott makes. We need to get a better handle on the specific needs of the 194 long-stay patients en bloc rather than one by one, which would not be appropriate. Some of those people might require particular services if their behaviours are challenging, whereas others might require to be assessed and treated and then go back into the community for a while and then, possibly, have another period of hospitalisation. We are just beginning to scope that in the depth that would be required to give a concrete answer.

That is the best that I can do on that question for now. We are on to it and are examining it closely. We acknowledge that some of the 194 have high-cost care packages. However, we do not know whether those high-cost care packages are objectively necessary.

I agree with the convener, because there is a similar set of circumstances in my area. It is difficult to site a generality on a specific instance, but the convener has said something similar. More and more of the responsibility for providing the care package is being transferred from health authorities to local authorities through their social services departments. With the best will in the world, health authorities apparently have more money than local authorities, which seem to be short of money throughout Scotland. Is that a long-term problem? You are not intervening at the moment, but do you not have concerns about the long term?

We do not regard it to be a long-term problem, as we have gone from several thousand people being in long-stay hospitals down to 194. We are concentrating on that number through the NHS QIS work that Bette Francis described, which lists the hospitals that currently have people in them and when their closure dates are. We followed that work up with visits to get the lie of the land in each hospital; we now have quarterly returns and will visit again. Through that process, we will better understand the detail in respect of that group of fewer than 200 people. We will continue to focus on that until we resolve the issues for what is a relatively small number of people in comparison to the several thousand people who were in long-stay hospitals five years ago.

Before we discuss recommendations on what to do with the petition, I think that Jackie Baillie wants to ask another question.

I do not have another question, but I am happy to start the recommendations, to try to be helpful to you, as I always am. I am conscious that helpful bits of work are going on, including work that the Scottish Consortium for Learning Disability is doing on the impact of "The same as you?" alongside people who have a learning disability. That is helpful and interesting work, although I do not know when the report will be produced. I recommend that we keep all three petitions open. The officials gave an explicit invitation to the cross-party group for learning disability to comment on the monitoring framework and implementation. As the officials may regret making that explicit offer, I will take it up before they can withdraw it.

I do not think that we will regret that—it is partnership working.

I am conscious of the primacy of the parliamentary committee, convener, but would it be possible for the cross-party group to do that work and then report back to the Public Petitions Committee? Perhaps then, if we are successful, which I am sure we will be, we can close the three petitions. Until then, can we keep them on the table?

We have written to cross-party groups before to ask for their perspective on issues. Your suggestion is not inappropriate. It would be welcome to hear from the cross-party group as part of our consideration of the petitions. I hope that we will keep the petitions open so that we can continue our dialogue on the issues that they raise.

I support Jackie Baillie's proposal, but I have one question for the witnesses. In the Scottish Parliament and the Public Petitions Committee, we are always careful not to suck up power from local authorities and we try not to criticise them, because we acknowledge their decision making and authority. However, I would like to get a feel from the witnesses about the extent to which the funding for local authorities on the issue should be hypothecated. Do you have a sense that local authorities throughout Scotland are not using the funding as it was intended when the Scottish Executive handed it out through the supporting people initiative?

As I am a civil servant, it would not be appropriate for me to comment on that.

Okay.

We should take up Jackie Baillie's recommendation, but I recommend that we should also send a copy of the Official Report of the meeting to the petitioners and invite them to comment on what we have heard this morning, so that we can get as wide a perspective as possible. Do members agree to the recommendations?

Members indicated agreement.

I thank Jean MacLellan, Jenny Pickthall, Bette Francis and Peter Stapleton for taking the time to give us that comprehensive update, which the committee appreciated greatly.

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Environmental Protection Act 1990 (PE884)

Our next current petition is PE884, by Sandra Clarkson, on behalf of Prestwick marine neighbourhood watch. The petition calls on the Scottish Parliament to urge the Scottish Executive to amend the Environmental Protection Act 1990 to ensure that local authorities keep beaches free of litter and refuse throughout the year.

At its meeting on 21 September 2005, the committee agreed to seek the views of the Scottish Executive, SEPA, the Marine Conservation Society, COSLA and South Ayrshire Council. Those responses have been received. As is our practice now, we will advise the petitioner of the responses and ask them to comment. Are members happy with that?

Members indicated agreement.

I welcome the positive response from the Minister for Environment and Rural Development. I look forward to hearing the petitioner's views.

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Neurological Services (Post-polio Syndrome) (PE873)

The next petition is PE873, by Helene MacLean, on behalf of the Scottish Post Polio Network. The petition calls on the Scottish Parliament to urge the Scottish Executive to join the international community in recognising post-polio syndrome and to conduct a much-needed national review of neurological services to take account of the needs of PPS and all other long-term neurological conditions, with a view to establishing multidisciplinary centres of excellence to assess, treat and research such conditions, which affect the lives of many thousands of individuals in Scotland.

At its meeting on 9 November 2005, the committee agreed to seek further comments from NHS QIS and NHS Greater Glasgow. Those responses have been received and circulated. A further response from the petitioner has also been circulated.

Margo MacDonald has joined us to talk about the petition.

I thank the committee for the opportunity to appear before it again. Although the petitioner will not be participating in the meeting, she is present, so we can act quickly if anybody wants us to set up a multidisciplinary clinic in the foyer.

The prevalence of the condition has been recognised and Greater Glasgow NHS Board has said that it is keen to undertake a study. I suggest that we go right away to stage 2 of what the petition proposes—a study not of prevalence but of models of service delivery. The Kerr report was anxious to promote the idea of a multidisciplinary, one-stop facility, with specialist nurses who direct patients to various people. Sufferers of long-term neurological conditions—such as post-polio syndrome—say that they feel like shuttlecocks being battered about from one consultant to another.

I suggest that we move to what is almost stage 2 and recommend that Greater Glasgow NHS Board considers models of service delivery. As far as I can see, the only question that is left to be answered is who will pay. I do not imagine that the study will cost a huge amount of money, because studies elsewhere in the world can be used as source material. If it will not cost a huge amount, who will pay for it should be tied up pretty quickly.

I suggest that we take up Margo MacDonald's proposal and write to ask the Minister for Health and Community Care about the prevalence study and the modelling. It would also be appropriate to write to determine the chief medical officer's perspective. Do members have suggestions?

That is fine.

Those people might be pleased to hear from you, because if the study considers models of service delivery, it could be a prototype for all the stuff to which the Kerr report referred.

The petition has been a success. I draw members' attention to the additional information on updating the statistics on people who have PPS. Could we forward that information? We have been asked to update a website, but that is not in the committee's power. However, I presume that we could send a copy of the information to the chief medical officer and NHS Health Scotland.

We will provide all the available information.

I have just checked my notes and found that I forgot to suggest writing to the chief scientist office.

I should have mentioned that; I always mix up the medical man and the scientist, although they look different.

It is worth asking for all opinions.

The scientist would take the lead and the medical man would say okay. If the scientist works out matters, that will be fed into the implementation of care through the medical officer.

If we write to all the people who have been suggested, we should receive information that allows us to see whether we are making the progress that we hope to make.

The other big thing is time—the proposal has been kicking around for quite a long time. The two issues are time and money.

I thank Margo MacDonald for her input. After we receive the responses, we will address the matter in due course. We hope that you will have another opportunity to see how we are making progress.

Would you like me to mark you out of 10?

Not at the moment.

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School Buses (Safety Measures) (PE892)

Our next petition is PE892, by Ronnie Beaty. It calls on the Scottish Parliament to urge the Scottish Executive to amend the Education (Scotland) Act 1980 to set down minimum safety standards for school bus provision, including the provision of certain safety signs; to make regulations under the Road Traffic Regulation Act 1984 requiring the use of certain safety signs and lights on school buses; to make failure to comply with such signs an offence; and to seek the necessary powers to require bus operators to remove such safety signs from school buses when they are not in school use.

At its meeting on 26 October 2005, the committee agreed to seek the views of the Scottish Accident Prevention Council, the Scottish Parent Teacher Council, the Educational Institute of Scotland, Transform Scotland, the Confederation of Passenger Transport and COSLA. Responses have been received and circulated. The committee has received correspondence from John Swinney MSP and Jim Wallace MSP, which has also been circulated. We are joined by Stewart Stevenson, who wants to comment on the petition.

Thank you for your courtesy in allowing me to be present. I know that Mr Beaty and his family are here, although Mr Beaty appears to have popped out for a moment.

In considering whether there was a problem, I was particularly struck by the response from the Scottish Accident Prevention Council, which states:

"there were 431 children killed or seriously injured in road accidents and approximately two thirds of these were pedestrians. 20% of all child road casualties happen on the school journey and the peak time for these accidents is between 3 and 4pm on weekdays."

It is clear from the statistics provided that Mr Beaty's petition relates to an area in which there is definitely a problem.

The minister acknowledges in his comprehensive reply that existing regulations do not create requirements but are merely enabling. COSLA highlights the fact that there are no legislative requirements; the Scottish Accident Prevention Council suggests that there should be requirements; and the EIS supports the petition.

It appears from where I am sitting—members might take a different view—that there is considerable support for what Mr Beaty is trying to do among people with an interest in education and children's safety, and that some, although not all, of his objectives can be delivered by the Parliament. I hope that the committee will look favourably on the responses that have come in and find a way for the Parliament to take the petition forward.

I welcome Stewart Stevenson to the meeting; I also welcome his comments. We should consider referring the petition to the Education Committee. I was particularly struck by the comment from the Scottish Accident Prevention Council that

"there should be a more consistent national approach to school transport and attendants on school buses",

which the committee might wish to address—that might be the best way forward.

I am aware of the minister's response that this is a local authority issue. I have to say that that is an entirely reasonable position for him to take. I hope that local authorities will take note of that, because ultimately the buck stops with them. It seems to me that the minister has done all that he reasonably can do.

There is outstanding support for the petition among the responses, most of which Stewart Stevenson mentioned. The Scottish Parent Teacher Council quite rightly pointed out that, unfortunately,

"action only appears … to be taken when children have been seriously injured or killed."

We have to pay heed to the various submissions that have been made. I agree that it would be best for the petition to go to the Education Committee so that it can see how powerful the petition and the responses to it are.

I do not dissent from anything that has been said. Standards vary among local authorities for no apparent reason. I am pleased that the minister has drawn to local authorities' attention the recommendations from the Scottish Consumer Council's recent study. However, as we saw with our previous petition, implementation is always an issue. We should send the petition to the Education Committee and ask it specifically to consider how regulations are being implemented and whether they need to be changed.

I echo everything that has been said. All the responses are positive—even the one from the Minister for Education and Young People. I disagree with him in only one regard. He says that the recommendations should be commended to local authorities, but I think that they should be mandatory. The issue is an important one throughout Scotland, not only in certain regions. I agree that we should send the petition to the Education Committee, drawing special attention to the paragraph that John Scott mentioned.

Has the petitioner seen the responses that we have received?

If that has not happened, we will make all the responses available to the petitioner. If he wants to provide any additional information, we will give that to the Education Committee as well.

I welcome the remarks of the committee members. Might members be prepared to suggest to the Education Committee that, if it identifies any actions that could be taken by another Parliament, it should express a desire that that happen, so that that can add weight to deliberations that might take place elsewhere?

If we were to tell a committee of this Parliament to tell another Parliament what it should do, we would be getting into dangerous territory.

If I may be helpful, convener, I would just point out that the Education Committee will be able to read the entirety of our discussion in the Official Report. Therefore, the point has already been made.

That is a good way around it. Do we agree to follow the action that has been suggested?

Members indicated agreement.

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Mental Health (Care and Treatment) (Scotland) Act 2003 (PE889)

Our next petition is PE889, by James A Mackie. It calls on the Scottish Parliament to examine the workings of the Mental Health (Care and Treatment) (Scotland) Act 2003 and, in particular, the making available of legal representation and legal aid to patients detained in psychiatric wards or released to the community who are under the influence of prescribed antipsychotic or brain-altering drugs.

At its meeting on 26 October 2005, the committee agreed to seek the views of the Law Society and the Scottish Association for Mental Health. Responses have been received and circulated to members.

Should we invite the petitioner to submit his views?

Do we agree to do that?

Members indicated agreement.

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A96 Improvements (Elgin Bypass) (PE558)

Our next petition is PE558, by Pauline Taylor. It calls on the Scottish Parliament to urge the Scottish Executive to include as a matter of urgency a bypass for Elgin in the programme for improvements to the A96.

At its meeting on 20 April 2005, the committee agreed to ask the Executive to keep it updated on any developments in respect of the strategic transport projects review, particularly with regards the proposed Elgin bypass.

An update has been provided by the Scottish Executive, which states:

"While the Elgin bypass is not included in the current investment programme, we are working closely with the Highlands and Islands Transport Partnership and the North East Scotland Transport Partnership in a multi-modal corridor study to identify the future transport needs of the A96 corridor."

It appears that no further action is required on the petition. However, I just point out that we received the petition in 2002. Were the petitioner a man, he would have grown a very long beard by now. I note that the letter is from the Enterprise, Transport and Lifelong Learning Department. The minister concerned needs to bear in mind the fact that people might ask why it takes such a long time for certain issues to be resolved.

That point is worth making.

The coalition is obviously failing.

Do we agree to take no further action on the petition?

Members indicated agreement.

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Vulnerable Adults (Medication) (PE867)

The next petition, PE867, is from W Hunter Watson. It calls on the Scottish Parliament to provide adequate safeguards against vulnerable adults being given, by surreptitious means, unwanted, unnecessary and potentially harmful medication.

At its meeting on 7 December 2005, the committee agreed to seek further comments from the Executive and Enable Scotland. Responses have now been received and circulated to members. The Committee has also received a further submission from the petitioner, which has also been circulated.

We are aware that a revised code has been prepared but has not yet been published. Some of the concerns that the petition deals with have been expressed to the Executive as part of its consultation on the code. We should keep the petition open until the code is published, at which time we will be able to see whether the Executive has taken on board the comments that have been made.

Do we agree with that suggestion?

Members indicated agreement.

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Medical Negligence (PE866)

Our final petition is PE866, from James Kelly. It calls on the Scottish Parliament to consider and debate the need for an independent body to be set up to investigate claims of medical negligence.

At its meeting on 22 February 2006, the committee considered responses from the British Medical Association Scotland, Citizen's Advice Scotland, the General Medical Council, the Law Society of Scotland, the Royal College of Physicians of Edinburgh, the Royal College of Physicians and Surgeons of Glasgow, the Royal College of Surgeons of Edinburgh and the Minister for Health and Community Care. The committee agreed to invite the views of both the petitioner and the minister on the responses. Now that those have been received, do members have a view on how we should address the situation?

I have the greatest sympathy with the petitioner and acknowledge his perception of how he was treated by NHS Ayrshire and Arran. However, on the basis of the minister's response, I have to say that we must agree with the minister. I do not think that we need any more bodies looking into these matters. There are adequate avenues by which appeals can be made. That has to be our position. Therefore, we must, regrettably, close the petition. There is nothing more that we can do.

Do members agree?

Members indicated agreement.