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Consultant-led Maternity Services (PE689)
We have a change to our agenda this morning, because some of our petitioners are not quite ready. With members' agreement, we will skip to petition PE689, on consultant-led maternity services. Jamie Stone MSP has asked Parliament to ensure the availability of consultant-led maternity services throughout Scotland. The petitioner believes that the findings of a recent report from the expert group on acute maternity services will lead to the downgrading of consultant-led maternity services to midwife-managed community facilities in parts of the Highlands. Jamie Stone is present, along with another visitor.
The reason why I have lodged the petition is that it relates to the single biggest issue in the north of Scotland. Two years ago, NHS Highland considered downgrading the consultant-led maternity service for the north of Scotland to a midwife-led service. There was a huge campaign to ensure that the service was kept at the standard that we have enjoyed and two years ago, we thought that we had won the battle. However, to our dismay the EGAMS report has given NHS Highland the opportunity to revisit the issue.
I am sure that most people would be concerned about what you say about distances if maternity services were to be lost in the north of Scotland. What alternative provision would there be if a mother and child had to be transferred from Wick or Thurso in the far north, for example?
I do not think that there is an alternative. If the service was downgraded to a midwife-led service and there were urgent or potential difficulties with new-born children, people would have to go to Raigmore hospital, which is a huge distance, as you know. Even the ambulance service in Wick has said that it doubts that it could cope with the transport of people up and down to Raigmore. I cannot see an alternative. We must fight to save the service.
Alternative provision is quite a distance away. How many miles are we talking about if Raigmore hospital is the nearest consultant-led facility?
We are talking about in excess of 100 miles each way. The road is a coastal road and is treacherous for anybody who travels on it at any time. We are talking about it perhaps taking more than two hours to get a person to Raigmore, and the person's state of health will obviously increase the risks to them and increase panic. The road's logistics do not allow for safe transport.
I am acquainted with such arguments. I represent a remote community in which the distance to Raigmore can be around 150 miles. I understand that midwives are concerned about their responsibilities if they do not have a consultant at hand to deal with emergencies. If a new-born child requires resuscitation, they will not have the skills to provide it and they think that the proposals put too much responsibility on them. Do you have anything to say about that?
Everybody involved is concerned that the service is taking a step back. Whether people could cope is a worry and an unknown.
Therefore, the proposal to have midwife-led maternity services, at least in remote locations, is not in the best interests of patients. Is it financially driven?
We are talking about a risk that is definitely a step back. The proposals are not an improvement. My friends and family and all those who are involved are deeply concerned that the step is a step back and not an improvement. We are losing the service, and if it disappears we will probably never regain it.
I emphasise that the EGAMS report refers in passing to distance, but it does not really address the issue. I must go further and say that the minister, Malcolm Chisholm, has conceded in his answers that distance is an issue in this case. Dianne Laing is quite right; we take the view that we already enjoy the service. I do not think that money is the issue—if it is, it is up to NHS Highland to tell me, you and the Executive that it needs help. In fairness, the Executive is pretty good at recognising issues of remoteness and peripherality. If the argument was presented correctly, the Executive would be supportive.
I have several questions. Taken on their own, I am sympathetic to the arguments that have been put forward in favour of midwife-led units. Historically, with the medicalisation of childbirth, there has been an increased level of intervention and a higher risk of complications in operative surgery. I am clear about that. However, the issue is about access, choice and context.
I will try to pick my way through your comments. I very much agree that the problem is Scotland-wide, although it seems to surface in different parts of Scotland in different ways. During the Lesley Riddoch programme about the Queen Mum's hospital, I tried frantically to ring in to say, "What about Caithness general hospital?", but my call was not selected. It seems that health authorities in different parts of Scotland have seized on EGAMS and exclaimed, "Aha! The very tool that we have been seeking!" That is most unfortunate and I do not believe that it was the intention of ministers, who, I suspect, will have to consider the issue on a Scotland-wide basis.
You are absolutely right about the EGAMS report. Services should be located as near as possible to the woman's home and special attention should be paid to deprived areas. Do you know how many births there are in the area that we are discussing?
I should have brought that statistic with me.
The service is to be downgraded from level IIa to level Id, which is the community maternity unit. Table 1 of the EGAMS report says that the "Care need and delivery" category is the same for levels Id and Ib, which is
The issue comes back to the risk assessment, which will be kicked off on 15 December. We will all make our case on the paediatric front. I understand your argument, but for the cost of providing the paediatric care—oh yes, make no mistake about the fact that additional costs would be involved—Caithness would be able to offer the grade of service that one would expect.
The point that I was trying to make is that, although the unit currently has the advantage of being consultant led, it still does not have neonatal services. If the unit is downgraded to level Ib, it will not be consultant led and it will still not have neonatal services. My point is that the downgrading would be a retrograde step. Is that what the mothers in the area would say? They will not get improved services and some consultant-led services will be taken away from them while they will still be without neonatal services. That was the point that I was trying to make.
I accept that point—it is glaringly evident. It is interesting that the issue was not addressed some years ago.
Another point that I want to make is that, although people keep mentioning the EGAMS report, sections of it can be taken out to suit any particular area. We might quote the EGAMS report, but not everything in it rings true in certain circumstances. It would be handy to get further information on the number of births in the area.
That would be useful. I think that Carolyn Leckie has done some research on that and she thinks that there are about 600.
I would have said that the number was at about that level, but I wanted to give the accurate figure. There is a steady stream of births each week. It is a cheerful wee unit.
After Jackie Baillie and Linda Fabiani's questions, I will ask for recommendations on what we should do with the petition.
I will try to be brief. It strikes me that two issues are involved. One issue is the principle of what is happening under maternity reviews across Scotland; the other is the particular circumstances in the Highlands.
The problem is that the present level of paediatric cover is perceived as a risk and is stated as such in the EGAMS report. Therefore, it is time to revisit the issue. My own belief is that one could think laterally on the matter. In order to tackle the problem, there is no reason why we could not have a sort of roving consultant who would oversee perhaps Orkney, Shetland and Caithness on a circular basis.
Given that there is a nationwide shortage, simply raising the amount of money available will not produce additional consultant paediatricians. Where will you get them from?
We have to make the attempt and I am not convinced that we have done that. The NHS in the Highlands owes a great deal to people coming into Scotland from other countries. I believe that one of the ways to get people is to advertise abroad. Let us face it; it is a good career move for a trained paediatrician to come here.
Jamie Stone has already touched on the working time directive. However, the problem is nationwide, as Jackie Baillie said. It is also compounded by the Royal College of Physicians and its training regimes. Unless there is a big enough throughput per unit, the RCP will not pass the unit as a training establishment, so the consultants who might otherwise be tempted to go outwith the central belt are unable to do so.
I am aware that we are talking about the issue as if the downgrading has already happened. As I understand it, Jamie Stone has worries about what will happen as a result of the EGAMS report. What makes him think that what he fears will happen will happen in Wick? His petition asks to ensure the availability of consultant-led maternity services throughout Scotland. What should the committee do with the petition? What is his preferred option? Should it go to the Health Committee or to the minister with a view to its being debated in the Parliament? What were his feelings on that when he submitted the petition?
I will have to be careful about how I put this, but I have been told up-front in private meetings with NHS Highland that I am wasting my time because they are not going to do what the petition asks. I do not know whether I am covered by parliamentary privilege in the committee, but I have been told that point blank. My reply is that I will oppose the proposal tooth and nail. My fear is that it is a foregone conclusion.
Exactly, that is my point. Your petition makes a case more widely than for services in Caithness; it makes a case for services throughout Scotland.
That was deliberate.
There is an issue about how services throughout Scotland should be defined. What are the criteria that would enable us to say that maternity services in Scotland cover the country? It is a big issue. We should think carefully not only about what to do with petition PE689 but about how we can use the petition as the basis for further discussion.
We will hear from Carolyn Leckie, which will give members an opportunity to think about what to do with the petition. We need to think about our recommendations.
A couple of issues have not yet been drawn out in the discussion. One issue relates to access. I have heard various health board members and members of professional organisations talk about informed choice.
I think that that was a statement rather than a question. I seek recommendations about what we should do with the petition.
What Carolyn Leckie said highlights the complexity of the debate. I suggest that we refer the petition to the Health Committee. I know that members of that committee have taken a keen interest in the review of maternity services and the wider implications of the review.
I go along with Jackie Baillie. I was going to suggest that we refer the petition to the Minister for Health and Community Care, placing emphasis on the Highlands, about which the petition is particularly concerned. We should emphasise the fact that the EGAMS report mentions deprived areas and the extent to which the mothers and children need to be close to the hospital. I do not wish to put this matter to the vote, but if the committee wishes the petition to be passed to the Health Committee, then—
We can do both things, Sandra.
I would like the petition to be passed to the Minister for Health and Community Care. I think that we should point out to him the special circumstances that exist in the Highlands and highlight the emphasis that the EGAMS report puts on deprived areas and on the need to offer care as close as possible to the woman's locality. We should take particular account of the downgrading of Caithness general hospital. If it is downgraded from level IIa to level Ib or Ia, nothing else will be provided there. We need not mention that in our report, but I think that our letter to the minister should emphasise those things. It is not that I disbelieve Carolyn Leckie—I do not—but I would like to see the details of the grades in black and white: IIb and IIc, for example. I know that the issue is about the number of births in the area, but I would like to get that information from the minister.
The minister will have a very long letter to respond to at this rate. Aside from the specific problems that we need to address in relation to Jamie Stone's petition, I would invite the minister—if we are to write to him as well as refer the petition to the Health Committee—to consider the problem of the centralisation of neonatal maternity and paediatric services. The problem is evident right across Scotland and, as Carolyn Leckie said, it takes choice away from patients at every level.
There is an urgent need for the Parliament to debate the issue. I support the idea of passing the petition to the Health Committee and of writing to the minister. I agree with John Scott on the wider question of paediatric services. There is a bigger political context here. Do we accept the situation or do we take steps to do something about it? The problems around training could be addressed in other ways. I am not sure that the alternatives have been explored—for example, rotating the work of specialists in the units. It would not be acceptable for a junior registrar to spend their six months or year of training in a unit with only 600 deliveries a year. However, they would not need to spend all that time there—cover could be provided while training was provided elsewhere. I do not think that that possibility has been investigated enough.
We can write to both the Minister for Health and Community Care and to the Health Committee, but it would not be the committee's practice to do so simultaneously. We tend to write to a committee, asking it to take up the issues in question with the relevant minister, or we write directly to the minister, telling him or her that we want a response that can be passed on to the relevant committee. We apparently do not ask a committee to take up an issue at the same time as we write to the minister with our questions. We can do both, but not at the same time.
Can we clarify whether the Health Committee is doing something on the matter? Some discussion was reported in the press and it has been said that the Health Committee intends to take on board the wider-context issues that the petition raises. If the Health Committee is about to do something on the matter, it would seem a shame to delay submitting the petition to it while we engage in dialogue with the minister. However, if we have time, it would seem sensible to engage in dialogue with the minister first.
I imagine that the Health Committee will be aware of our discussions on the matter. I suggest that we write to the minister, asking him for a quick response. I would expect us to refer the petition to the Health Committee thereafter.
I agree with John Scott. I think that we should write to the Minister for Health and Community Care first. We should remember that the Health Committee has been considering the Primary Medical Services (Scotland) Bill. We should get a response from the minister first and then send the petition to the Health Committee if we need to.
How quick would a quick response be? It would be a shame to miss the boat.
We need to emphasise the urgency of the situation, although we do not know whether that will make the Executive write back more quickly.
In our submission to the Health Committee, we should point out that there is doubt about the review's conclusion that midwife-led care was neither less safe nor less effective than consultant-level care.
Yes, but we must decide which route we want to take. Should we write to the minister first and let him know that we want information because we intend to pass the petition to the Health Committee, or should we go straight to the Health Committee and ask it to take up issues with the minister?
Could we write to the minister and to the convener of the Health Committee, saying that we have done so with a view to passing the petition to the Health Committee?
That is a good idea, although we cannot pass the petition to the Health Committee until we receive a response from the minister. Are members happy with that approach?
Scottish Environment Protection Agency (Main Board) (PE680)
We return to petition PE680, because the petitioner is now available. The petition calls on the Parliament to urge the Executive to disband the board of the Scottish Environment Protection Agency and to allow the agency to reform its board without political interference. Members may wish to note that the original principal petitioner, Alan Clarke, recently passed away. I am sure that members join me in passing on the committee's condolences to Mr Clarke's family. Mr Jim Roberts has taken over the role of principal petitioner and he is present to give evidence to the committee in support of the petition. Welcome to the committee, Mr Roberts. You have three minutes in which to make your opening remarks, after which we will ask questions.
I will pass on the committee's condolences to Alan Clarke's family. I am sure that the comments will be much appreciated.
Mr Roberts, you have given a catalogue of specific details about what has gone on. Have you or the previous petitioner at any stage taken the matter to the Standards Commission for Scotland, which is responsible for investigating breaches of conduct by board members such as the board members of SEPA?
No, not to my knowledge.
Mr Roberts, you make some fairly serious accusations in your petition. You refer to the "indiscretion and cronyism" of SEPA's chairman in
Ken Collins.
What evidence do you have that he accepted honorary titles and awards? Who were they from? Who gave out the awards and titles?
The first one was awarded by the Institute of Waste Management at its Scottish centre Christmas lunch. The second one was presented by the Scottish Environmental Services Association to Mr John Ferguson, the project manager of the national waste strategy.
So the awards were given to individuals, not to SEPA as an organisation.
No. They were given to individual members of the SEPA hierarchy. I question whether that is right. Those are the organisations that SEPA, as our environmental watchdog, should be regulating. What kind of impression does that give to the people of Scotland?
I understand what you are saying, but there is a distinction between the individuals and the organisation.
No, but it is my understanding that an audit has recently been conducted on SEPA's performance.
Do you know who that was done by?
The audit is described in the "Policy and Financial Management Review of the Scottish Environment Protection Agency", which contains a list of 29 recommendations for action.
That is a normal part of the process. All quangos go through such an audit on either a three-year or five-year basis. That is standard practice.
Is that not excessive—29 items?
I have not read the report, but that sounds a lot. I do not know how strong the recommendations were or whether they have been acted on.
I cannot comment on that. I do not have the information relative to that to hand.
The statement is on the background information that we have been given. Paragraph 3 of the e-petition says:
It is probably something to do with the national waste strategy and the drive to minimise waste. I could not comment fully on that, though. If I did, I would be speaking out of turn.
That is the most serious aspect of the petition and I would want to see some evidence before accepting the allegation.
Mr Roberts, I understand that you did not submit the petition, but I have some questions on the detail of what the petition says. Reference is made to SEPA's failure to act on formaldehyde discharge levels that were recorded in Auchinleck Academy and Ochiltree Primary School. Can you give me some more detail on that issue? How do you know that those formaldehyde levels were recorded? What do you believe to be SEPA's normal practice in such a circumstance as opposed to what happened in that case?
On the formaldehyde issue, there was a period in May 2001 when no readings were taken from some of the monitors of the Egger plant. The reason given for that was flat batteries. I believe that self-regulation is carried out and that the results are forwarded to SEPA, which checks them. Some of the results that were taken showed that excessive levels of formaldehyde had been discharged from the plant. I have copies of those results and will make them available for your perusal, if you so wish.
I asked about the copies of statutory consultation responses being given to Mining (Scotland). Can you tell me what the normal practice is in relation to such documents? To whom are they normally circulated? Is it only Mining (Scotland) that receives privileged copies?
When our Killoch campaign was on the go, our action group visited East Ayrshire Council headquarters to examine the statutory consultee responses. That was the only document that we could find that had been copied back to the applicant. My understanding of the planning process is that statutory responses are available to anyone who wants to go and view them in the council's headquarters. I do not think that there is anything in the planning process that says that the documents should be copied to the applicant. I also have a copy of the document from SEPA that was copied to Mining (Scotland).
Is there anything in the planning guidelines to say that information should not be passed on to the applicant? You said that there was nothing to say that it should be passed on, but is there anything to say that it should not?
I am not sure; I honestly do not know. I think that information is available, but any statutory consultee who wants any document has to make a formal request to the relevant council. However, the document was copied straight from SEPA to the applicant.
Do you know whether the applicant applied for that information?
It was just sent straight to the applicant from SEPA.
So you know that there was no request for the information.
Not on that. I can show you the document.
The petition is about disbanding and reforming the board of SEPA. A code of practice is coming in for public appointments. What is your view on how SEPA will suddenly just reform its board?
In the membership of any board, professional qualifications, levels of competence and experience should be considered. We, as members of the public, have grave concerns about how SEPA is run.
The petition asks the Executive to "disband" the board and allow SEPA to reform it "without any political interference". How would that happen? What would be the process?
The first thing would be to grant SEPA more autonomy, allowing it more scope to run its affairs. Let it turn itself into a body in which the Scottish people can be confident.
But if SEPA is the board, and if you disband that board, who would make the decisions on who would be on the new board?
SEPA is a publicly funded body so, in the first place, guidance would have to come from the Scottish Executive. However, appointments must be based on criteria such as competence, professional qualifications and experience.
So you are asking the Executive to take steps to reform the board.
Yes—on behalf of the Scottish people.
That was the question that I was going to ask.
Do members have views on what we should do with the petition?
In the light of the allegations, we have to write to SEPA to ask it to justify itself. SEPA has to be given a right to reply. It would be helpful if Mr Roberts were to furnish us with any written evidence that he has to substantiate the allegations that Mike Watson alluded to and others have asked about.
I would like to see a copy of the policy and financial management review that Mr Roberts referred to, so that we can see its recommendations.
I would have thought that, if substantive allegations are made, they should be made to the Standards Commission for Scotland and not necessarily to this parliamentary committee. For the petitioners' benefit, I would say that complaining to the Standards Commission would be far more appropriate than complaining to us. However, I do not dissent from John Scott's recommendation.
That is fine, but it deals with an issue that is a wee bit separate from the bones of the petition, which is about reforming the board. By simply investigating specific complaints, we would not be addressing that point. I cannot remember when the new legislation comes in about public appointments, but I presume that it will apply only when there are vacancies on the board. We could ask for the Executive's view on whether it would consider completely reforming the board of any public agency. We cannot separate SEPA from all the rest—unless the allegations that we have heard are well founded. We should ask the Executive for a general opinion on public appointments following the new legislation.
I have no problem with the principle of that, but the allegations are specific and, as such, the Standards Commission should be the body to deal with them.
We have to separate both elements of the petition.
Yes.
Are members happy with John Scott's suggestion that we should write to ask SEPA for its views and with the suggestion that we ask the Scottish Executive about its general position on the formation of quangos?
What will we do on receipt of information from Mr Roberts?
That may make our action more specific to SEPA, but that depends on what we receive.
Shall we take up Jackie Baillie's suggestion of referring the petition to the Standards Commission once we have gathered all the information?
That is not up to us.
That is up to the petitioner.
That route is available to the petitioner, but it is entirely separate. The committee cannot approach the Standards Commission, which would consider the petitioner's concerns. Jackie Baillie's advice to the petitioner is accurate. The committee has heard concerns about SEPA's actions and has a petition that asks how SEPA or any non-departmental public body could be reformed, so we will seek information from the Executive.
That is a broader sweep than I thought that we would take. The petition is about SEPA; I do not think that concern is widespread that quangos are not being run efficiently or accountably.
We could narrow our focus to SEPA.
As far as I know, board members can be changed only when they come up for reappointment, unless they have done something illegal, in which case they could be removed. I do not want such a broad approach as was suggested to be taken. We should ask what the recommendations of the policy and financial management review were and write to ask SEPA what it has done to implement the recommendations.
You want us to write to SEPA about its actions in response to that review.
Yes. SEPA should be asked to respond to the points that have been made and to tell us what it has done to implement the recommendations in the review.
We can wait to receive that information before we deliberate the petition further.
I think so.
I am worried that that will not address the petition, which is about replacing the board.
My point is that we will not know whether that is justified until we see SEPA's response.
As the allegations are specific, I suggest that the petitioner should take a much quicker route. If members of any organisation have breached the code of conduct—allegations have been made about SEPA—the route that I suggested is the way to pursue the matter, rather than through the committee.
That is fine, but are we saying that, if the commission felt that big problems existed, it might consider doing something about the board?
We cannot suggest what we expect the commission to do.
Can we ensure that when we respond to Mr Roberts and the other petitioners we give full details of how to complain to the commission?
That would be useful. If Mr Roberts needs advice, we will provide it.
If the committee tells me the points that the petition raises on which it needs further information, I can furnish that information before you make your official response. Would that help?
Yes. We need more information on Mike Watson's point about the review, but we can ask SEPA for that information. However, there would be no harm in your giving your opinion of the review.
We would also like more information on the political interference that the petition mentions.
The committee's advice is that the petitioner should take concerns about the actions of any individual board member to the Standards Commission, which he should furnish with the information that underpins his concerns.
I thank Mr Roberts for attending.
Thank you.
Scottish Water (Business Charges) (PE686)
Our next petition is PE686, which is in the name of Mr Rob Willox, on behalf of Bo'ness means Business. The petitioners call on the Parliament to review urgently the charges that are levied by Scottish Water on Scottish businesses. Rob Willox is here to give evidence to the committee, and he is joined by Cathy Peattie, the local member of the Scottish Parliament. Mr Willox, you have three minutes; we will then ask questions.
Thank you for hearing this petition and for giving me the opportunity to speak in support of it. Bo'ness means Business believes that the current level of water charges is detrimental to the long-term future of Bo'ness town centre, and that it places an unfairly levied burden on businesses of all sizes, in particular on small town-centre retail outlets that face historical long-term decline in local shopping patterns.
Thank you very much.
I think all members present will have heard about the issue from people in the areas that they represent. I was interested in your mention of standing and volumetric charges. Last night, a retail unit representative told me that, even though the business that his company was involved in used hardly any water—the staff boil the kettle a few times a day; that is all—the charges are horrendous.
It is proposed that such companies be charged £300 a year.
Yes. Can you give me an example of the rise in cost that a business such as a retail unit has faced over the piece and what such businesses have to pay now?
I will not mention any names, but there is a user that uses water primarily for boiling a kettle to make a cup of tea and for flushing the toilet and so on whose standing charge is about £78 per quarter and whose volumetric charge is about £2.68.
What were the charges before?
The company's standing charge would have been about £5 or £6—or perhaps £10—a quarter.
The increase is huge.
Yes, the increase in the standing charge is huge.
I acknowledge all that the petitioner has said. It concurs with all that I have heard in my area of Ayrshire and from organisations such as the Federation of Small Businesses. I am aware that I am in danger of making a statement rather than asking a question.
We do not mind you making a statement.
I do.
I accept the evidence that Mr Willox has provided and I thank him for it; I will leave it at that.
You focused on scale, but another issue that I picked up was that the new charges appear to have come from nowhere. Was it the experience in Bo'ness that there was a lack of notice, so that you could not even begin to reflect the new charges in budget forecasts? If that is the case, what impact does that have on businesses that work on very tight profit margins?
Most of the small town-centre businesses in Bo'ness work on very tight margins and they depend on footfall and people coming through the door. To be landed—between one bill and the next—with charges that, in some cases, are 10 times higher than they were before has caused considerable concern to those businesses. That is primarily why a considerable number of those in our group came to us to ask whether we could do something about the situation.
You are confirming that there was no notice, bar the bill landing on their doorstep.
The new charges just seemed to be landed on those businesses. A number of businesses have written to Scottish Water and the water industry commissioner and, in many cases, they have got short shrift—to an extent, they have been told to like it or lump it.
Communication with traders is a real issue. Traders have found that they have received huge bills, without knowing where they came from. There did not seem to be much continuity—some traders received larger bills than the shop next door. We got Scottish Water to meet the traders in Bo'ness and it was found that people had different meter sizes. There was a lot of confusion.
I agree with Cathy Peattie. The system seems almost as regressive as the poll tax. Can you give me an idea of the differences in charges that are being imposed on businesses of varying sizes? What are big businesses being charged? What do you envisage as an alternative system of charging?
The business group has not put forward any proposals, but I can give you my personal view.
I am trying to get the view of small businesses such as hairdressers, who use a lot of water.
There was a hairdresser at the meeting who was being charged a horrendous amount. She complained and Scottish Water took on board her comments and was able to reduce her standing charge. The main problem in her case was that she had the wrong size of meter installed. The meters were installed in businesses in earlier years arbitrarily; there was no focus on the specific needs of the businesses. For 2003-04, it is proposed that there be a fixed charge depending on the mains sizes that small businesses in Bo'ness use, which range from 12mm to 20mm. Some small businesses had larger pipes, which is why their charges were higher. However, no check seems to have been made before the charges were applied to see whether the charges would be justified or in line with businesses' requirements.
Are you aware of any comparators with big businesses?
I am not quite sure that I know about that.
Are you talking about multinational businesses?
Yes.
The BP facility in the constituency is querying its £1 million charge. It is a completely different ball game.
I am trying to get a handle on what big businesses are paying in comparison with what they use and what smaller businesses are paying in comparison with what they use. I suspect that there is a bit of a disparity.
There is a great disparity between the standing charge and what they are using. The volumetric charge for 2003-04 is approximately double the charge that applies in England. However, I do not think that too many people would complain about that aspect. The cripplingly high fixed standing charge is the problem. A charge of £300 might not sound like a lot of money, but that means that, depending on its profit margin, a business has to do £1,500 to £2,000 of business just to pay its water bill. It is a considerable problem. Many businesses have said that, if nothing is done about the situation, they will have to close their doors.
The charges certainly seem to be ill thought out; they are being pushed through too quickly. I note what you said about meter sizes.
The petition was based primarily on Bo'ness town centre. Some of the voluntary organisations in Bo'ness have also had water charges and standing charges applied to them because they use the local community centre or whatever. That is equally horrendous. Some of those organisations have closed their doors and no longer operate from where they did before.
There is certainly no information about companies in Bo'ness—which are a bit bigger than rug makers—moving out because of water charges, although people are obviously concerned about the charges. Businesses are choosing to stay in an area that they are committed to working in.
Larger businesses can often do something about the charges. They can realign how they sell and market their products and change how they run their businesses. Small town shops are limited to people coming through the door and it is much harder for them to work around the charges than for a business on an industrial estate outside the town, which can take other action. The small town shops are limited; many of them are one-man or two-man businesses.
Or two-woman businesses.
Sorry, Cathy. I was using the term generally.
The point that you make that has most resonance is on the disproportionate effect of the charges on small businesses and their effect on business start-ups or sustainability. I am a member of the Enterprise and Culture Committee, which is beginning to look at that issue. We are looking into why Scotland has a lower business start-up rate than England and why the UK as a whole has a lower start-up rate than other European countries. We will want to bring the important issue that you raise into that debate.
Speaking personally—this is not the view of the business group—I think that that avenue could be looked into. If the standing charge were linked to volumetric usage, it could be set at a minimum level—there is no problem with that. We understand that a lot of work remains to be done to improve Scotland's water—
I accept that. I am asking whether your organisation recognises the fact that some of its members would pay more in that situation because they use more water.
Yes. If the system is seen to be fair across the board, I think that many of the businesses that use a lot of water—such as hairdressers—would be prepared to pay for the water that they use.
That would be like the situation south of the border, where water meters are used. There would be pay-as-you-go water charges for businesses.
Businesses already have water meters.
They all have water meters.
Ah, but the charges are not made on a pay-as-you-go basis: they are not based on what the businesses use. I suggest that the meters could be used to decide what businesses pay. I was looking for clarification on that.
To be honest, I cannot answer that question. The figures that I have provided are those that have been projected by Scottish Water for 2003-04. The figures for England and Wales are extracted from a report for the same period and list the water charges there. I presume that, prior to Scottish Water coming into existence, the charges would relate to the companies that covered the water supply in those areas before it—
So, your impression is that the gap has begun to widen since the consolidation of Scottish Water from three companies into one, which happened last year sometime.
That appears to be the case. That would be our opinion.
I will try not to be political. I understand that, before the English companies were privatised, all the debts belonging to the water companies were written off. The companies were, therefore, starting on an even keel. That is not the case for Scottish Water. As Rob Willox said, the equivalent costs for Scottish Water are being spread among the service users, which is why there is a considerable difference.
What do members want to do with the petition?
Does the petitioner agree that the thing that upsets his fellow petitioners most is the fact that it is unfair that small businesses have to carry the brunt of the charges? Does he agree that small businesses are carrying a disproportionate burden?
That is correct. The charges are disproportionate for small businesses, as the level of standing charge that is applied is considerable for them and is a serious problem.
Do members have any ideas about what we can do with the petition?
The petition refers to people who are involved in
As Cathy Peattie said, that has not been an issue in our area. Cathy probably knows more about that, as she is the MSP for the area. Domestic users will probably approach her rather than our organisation. I am not in a position to comment on the views of domestic users on water meters.
Domestic users in my constituency do not have such meters, although traders who live above their shops perhaps pay a small charge for the water that they use. However, when they boil a kettle or go to the loo in the shop, they pay three times the domestic charge, and I do not feel that that is particularly fair.
So, the petition basically refers to people who are involved in some sort of business activity.
Yes.
I think that we have given the petition a good airing. We should start to think about recommendations.
I seek some clarification, convener. Something at the back of my mind says that some sort of inquiry into the water industry is being conducted by one of the Parliament's committees, although perhaps it has finished. We could perhaps feed into that.
I think that the Finance Committee is responsible for that inquiry.
The petitioners have asked for the petition to be sent to the Environment and Rural Development Committee, but if another committee is looking into different elements of the water industry, it may be appropriate to consider asking that committee to address the issue.
If the Finance Committee is undertaking an inquiry into the water industry, I propose that we send the petition to that committee. However, if the Finance Committee is not investigating the water industry, my alternative proposal—which I leave for the convener to sort out—is that we write to both Scottish Water and the water industry commissioner for Scotland, raising two specific issues. The first issue is the scale of charges for small businesses and the disproportionate effect that the charges have on them; the second issue is the lack of notice.
I agree with that, but there are also significant issues in the petition that should lead to a fundamental review of water charging. I hope that the petition does not end here and that we refer it to the Environment and Rural Development Committee at some point.
The immediate reaction on the petition is, as Jackie Baillie has recommended, that we send it to the Finance Committee, if that is the appropriate committee. If not, we should write to Scottish Water and the water industry commissioner and ask for their views. The petition will then come back to this committee. Is that agreed?
Bone Marrow Register (PE687)
Our next petition is PE687, which is on donation of bone marrow and blood stem cells through a bone marrow register. The petition is from Geva Blackett, on behalf of Millie's campaign and the Anthony Nolan Trust. The petitioners call on the Parliament to urge the Executive to run a campaign to encourage donation of bone marrow and blood stem cells through a bone marrow register, and to recognise and support organisations that recruit bone marrow donors.
Many of you will have heard about Millie's campaign through the media. Twenty-year-old Millie Forbes from Aberdeenshire was originally diagnosed with acute myeloid leukaemia 18 months ago. After six months of intensive chemotherapy in Aberdeen royal infirmary, she appeared to have overcome the disease.
Would Dr McEwan like to make some introductory comments or just to take questions?
I could do either, but I would like to put some flesh on the bones of what could be done in Scotland in respect of bone marrow donors.
In the statement that you submitted to the committee, you say:
One of the trust's aims is for the UK to be represented fully on the register. It is interesting that over the past year we have recruited on to the register more than 2,500 additional donors from Scotland. That is the result of Millie's campaign and previous activity. This year, 17.5 per cent of the donors whom we have recruited have been from Scotland. One reason for that is the high-profile campaigns that have been undertaken in Scotland. Last year, we appointed a recruitment officer specifically to recruit in Scotland, which is paying dividends in recruitment of Scottish donors.
It is encouraging that the response from Scotland is being addressed. However, I take the point that a more extensive campaign than the Anthony Nolan Trust could organise might increase the number of people who come forward.
Your petition is quite modest in its demands. It is shocking that the Anthony Nolan Trust is wholly reliant on charitable donations and the voluntary donation of time by health professionals.
The UK has three registers: the Anthony Nolan Trust register, which was formed back in the mid-1970s; the National Blood Service register, which I think covers both England and Scotland; and a separate register in Wales. Both the NBS register and the Welsh register are tied in with the blood transfusion services in those countries.
Does the Anthony Nolan Trust fund the whole process, including harvesting?
In effect, the harvesting of marrow from our donors is charged to the national health service. That charge covers—for want of a better term—the variable cost of getting the donor to the hospital, hiring an operating theatre to extract the marrow and then getting the marrow to wherever it has to go. If, for the sake of argument, the donor needs time off work, the Anthony Nolan Trust will come in and settle any bills for lost income. We also allow donors to bring their relatives or friends to London to be with them when they are harvested. Obviously, we also insure the donor just in case any issue arises from the harvesting.
I have one other detailed question about recruitment of donors, which is an important issue. Because the NHS system is based on blood donors, who tend to be older women, I think that the Anthony Nolan Trust targets younger men and people from ethnic minorities to become donors. Will you expand on that in a bit more detail? What is necessary to improve the availability of donors? What should the role of the NHS be?
Both organisations have a role. There is no doubt that blood donors make good bone marrow donors—they like having needles stuck into them, they are used to the procedure and their outlook is perhaps a little more altruistic. Our focus on bone marrow donors allows us to focus on certain sectors of the population. Being a member of some groups of people is a hurdle to becoming a blood donor. For example, young males and people from ethnic minorities are perhaps not so integrated with the idea of being a blood donor. We feel that we can focus on those people. A patient from those groups is sometimes a spur to recruit donors, as can be seen from Millie's campaign and many other campaigns. If a person from within an ethnic minority needs a bone marrow transplant, people from their community often respond by registering.
The petition calls on the Scottish Parliament to urge the Executive to take certain actions. Has the trust approached the Executive, or is the petition the first point of contact?
The petition is our first point of contact, in this forum. We have started to find out whether there is any interest in the Scottish system but, in effect, the petition is the first move forward.
I want to get my mind round what is involved. You say that you want to compile a register—no doubt a register already exists, but you want to extend it. If a person goes on the register, do they give a bone marrow sample at that time? What is the procedure for people who go on the register?
To go on the register, a person gives a small blood sample and fills in a medical questionnaire to assess whether they would be acceptable as a bone marrow donor. For example, a person cannot be a bone marrow donor if he or she suffers from hepatitis or another disease that would affect any patient who was to receive their bone marrow. Once a blood sample has been taken, we tissue-type the person in our laboratories, which means that we work out to whom the bone marrow could be donated. The person's details then sit in our database, perhaps for 10 or 20 years.
I am sure that the campaign is gathering momentum, not least because of public awareness of Millie's campaign. However, a campaign would need to inform potential donors that donating bone marrow involves a short visit to the hospital or the doctor's surgery for a simple procedure, but not lengthy hospitalisation. I think that the general public are concerned that the procedure is lengthy and think that they would not have the time to become donors.
There is a balance to be struck between explaining to potential donors how easy it is to join the register by undergoing a very simple procedure to give a blood sample, and making it clear that if they are found to be a match, donating bone marrow is not the same as having a blood sample taken. We have to inform them, for example, about the risks of going under general anaesthetic—if they choose that procedure—or the possibility that they might have to take time off work.
What action do members think the committee should take?
I note that two and a half years ago, in response to a question that was asked in Parliament, the then Minister for Health and Community Care said that the Executive would liaise with colleagues in England and confirm the proposals for broadening the range of people who come forward as donors. We should ask the Executive what progress has been made since then. Given that the petition is before the committee today, it is obvious that whatever progress has been made is not sufficient. Obviously, the then minister's comments were made before Millie's campaign was up and running, but at the very least we should ask the Executive for an update.
The recommendation is that we ask the Executive to tell us what it is doing.
I agree that we should make that request to the Executive, but the petitioner has raised broader issues by asking for recognition and support to be given to organisations that recruit bone marrow donors. I think that that hides a question about funding that needs further exploration, probably by the Health Committee. We should also ask the Executive about its intentions in relation to funding of registering and the process of becoming a donor.
My proposal was intended to be a first step. When we have a response from the Executive, we can address issues such as the one that Carolyn Leckie raised.
When we ask the Executive the question that Mike Watson outlined, we should also enclose a copy of the petition and ask the Executive to comment on it. That would be a first step; we will be able to move forward after that.
I think that that would happen as a matter of course. Are members happy with the recommendation?
Public Finance and Accountability (Scotland) Act 2000 (PE683)
Petition PE683, in the name of Bill Alexander, calls on the Scottish Parliament to amend the Public Finance and Accountability (Scotland) Act 2000 to ensure that the annual audits that are required by the act are expanded to include examinations of technical matters. Mr Alexander has lodged three petitions that the committee will consider today, but he will give evidence only in relation to PE683.
For nearly six years, I have been involved in a fairly protracted debate with the Auditor General for Scotland, Mr Black, which began when he was controller of audit at the Accounts Commission, over my suggestion that the method of annual audit that is utilised by the Accounts Commission and Audit Scotland should change its emphasis from being what is virtually a purely financial audit to one that combines both financial and technical investigations from the outset.
You have had almost five minutes, Mr Alexander. Could you please draw some conclusions?
I am sorry. I suggest that Audit Scotland and the Auditor General for Scotland do not have the wide-ranging expertise that is required to carry out annual audits. The legislation should be changed to enable the introduction of annual consideration of technical matters.
It strikes me that an awful lot of extra auditing would be required to fulfil the level of audit that you propose. How do know how much the extra audit would cost? Is it possible to over-audit?
I accept that it is, but one can also under-audit. For example, in the area that I know most about, which is construction procurement, it is not standard practice to bring in outside expertise as a matter of course. The decision to do so is left up to the individual auditor. If someone has an accountancy background, they will not pick up on the things that go on in the construction industry.
I have some sympathy with your argument, but I am struggling to understand the issues. My background has given me experience of hospital building projects in which problems arose, whether or not they were built under a private finance initiative. I am thinking of variations in the specification having to be negotiated after projects were completed.
Yes.
It would help us to understand where we are going if you could give us some tangible examples of what could be done better.
If we look at the example of the Parliament's Holyrood project, when the Auditor General brought his team in to do the initial audit, a firm of surveyors was involved. No architects or engineers were asked to look at what had happened. Without wanting to prejudge the outcome of Lord Fraser's inquiry, I think that we will find that the process of appointing the professional team was flawed. The regular audit team that is charged with looking at these matters could have picked up on things an awful lot earlier, prior to Mr Black's initial involvement.
I seek clarification on that point. I am getting confused about what you are asking for. You are saying that an architect should be brought in, but I am not convinced that an architect would be the best person to look at the procurement process. I am confused about who you want to get in to do what. Where do the divisions lie?
It depends on the circumstances. I am talking primarily about construction, but another example would be an audit of the procurement of an expensive computer system, in which someone with a computer background would be needed to work in tandem with the accountants. Someone with that background could say, "The project might have come in within budget but it does not meet the specification for the following reasons."
That was a better example, because it was very succinct.
The position is very complicated, depending on what is being audited. It is necessary to have someone from the appropriate background who understands the process. For example, the problem in construction is getting a professional who is an expert in procurement; it would be necessary to bring in a construction lawyer.
Does the Auditor General not currently have powers, if he thinks that there is a problem, to investigate matters further and bring professionals in to help to facilitate his investigation?
Only if he thinks that there is a problem. Such further investigation does not happen regularly.
Are you saying that there are problems that, by definition, he does not know about because he is not an engineer or an architect?
Yes.
Do you have specific examples of that, other than what the Fraser inquiry has gleaned, from knowledge gained during your life's work in the construction industry?
I worked for Scottish Enterprise and when I looked at two significant construction projects I uncovered that no collateral warranties had been signed on the contract and that a firm of engineers had been paid to carry out a full design brief but had carried out only a partial design brief. The firm of engineers subcontracted the work to a firm of contractors, so effectively the taxpayer paid twice for the same service.
Is that a matter that the Standards Committee should investigate?
Possibly. The problem is wide ranging. I spent six years trying to see if I could get some change and the difficulty that I have found with Audit Scotland is that the organisation seems to be entrenched in the financial aspects. Audit Scotland does not seem to understand that although it looks at the books and can see whether they balance, it is also necessary to ensure that what is being provided meets the technical requirements. Only someone from a technical background can give that opinion.
You mentioned that you had been in correspondence with Audit Scotland for six years. When the Finance Committee dealt with the Public Finance and Accountability (Scotland) Act 2000, I do not remember it being suggested that we extend the legislation in the way that you now suggest. Do you know whether that suggestion was made? Did you investigate the means by which you could have played a part in the process and suggested that the act should have a broader scope?
No. I was not involved at a parliamentary level at that stage. I still hoped that I could persuade Audit Scotland to try out the suggestion on a couple of projects and see whether there was any merit in it.
Has Audit Scotland given you written replies as to why it is not prepared to take on board your suggestions?
Yes. There has been a lot of correspondence.
Why does Audit Scotland think that it is not necessary to do as you suggest?
It says that the auditors will have expertise to decide whether something is untoward and that the auditors have the power to call in experts if they need them.
Without wanting to rival Mr Rumsfeld in some of his syntax, it is a case of "You don't know what you don't know", and therefore you cannot ask the questions.
There are known knowns and unknown unknowns.
I did not want to go there.
I can talk only about the construction industry. There is a temptation for a firm that it is desperate for work not necessarily to be 100 per cent forthcoming about its resources and abilities in order to win a contract. When a firm goes down that road it can become involved in a deception and cross the line between making a good sales pitch and becoming fraudulent. That is the legality side of the matter.
You are hypothesising—you are not aware of any such examples.
We will wait to see what Lord Fraser's inquiry brings out. The point that I have made is that the architects' company that won the work had not carried out any design work before.
My point is that that was not necessarily illegal.
No, but I would be interested to read the representations that the company made when it was being selected. If it made a false representation, we have a problem.
For personal reasons, I want to stay away from any discussion of the Holyrood project.
I do not think that we need such full-blown audits. However, returning to Carolyn Leckie's point, I think that where there has been excessive expenditure on a construction project a good surveyor might be able to look at it and conclude, for example, that it has gone wrong because there have been too many variations. He can then find out whether the design changed because, for example, the client gave too many instructions or the architect did not do his job properly. At that stage, the surveyor could say to the auditor, "We need to see the architect for a couple of hours", to find out whether he has complied with the contract. The process would evolve.
You could do the same with spot-check monitoring.
But I think that such monitoring should be compulsory.
I have to say that I am concerned about the resource issue.
Well, how much money is wasted at the moment? We do not know.
We could get into a whole discussion here. I was just saying that introducing a system of spot checks might promote better practice.
You mentioned that the Auditor General had said that he was not able to carry out such investigations. However, our information suggests that the Public Finance and Accountability (Scotland) Act 2000, which you want to amend, already gives him such a power.
Yes. He can take that power when he wants to do so. However, as I understand it, it is compulsory to have what is called a cyclical audit of financial matters, but it is not compulsory to examine any other aspects.
But he can do that.
Yes, but—
So you are asking for those aspects to be made compulsory.
That is right.
I think that Mr Alexander is saying that the Auditor General has the power to carry out such audits, but does not use it. I have a lot of sympathy with the issues that he has raised. However, it is unfair to expect Mr Alexander or other committee members to come up with answers to questions such as the size of projects that should be routinely monitored. Personally, I feel that big PFI projects such as hospitals and so on should be monitored in that way. For example, did what happened to the generators at Edinburgh royal infirmary come about because of the procurement process? It strikes me that experts would be needed to examine the construction aspects and contractual relationships, which are not necessarily merely financial matters. We could explore the resource questions that Linda Fabiani has raised, and I would be sympathetic to an approach that prioritised the auditing of big public projects. As a result, I think that we should support the petition, which requires more detailed discussion and argument, and refer it to the appropriate committee for its consideration.
I am concerned about the automatic compulsory aspect of the audits as outlined in the petition. The resource implications for what would be minor audits would be absolutely horrendous.
Yes. I do not think that we can just pass the petition on at the moment, because there is an awful lot more to explore. Whoever we pass it on to would just ask the same questions. Perhaps we should write to the Executive for detailed comments on the petition and send Mr Alexander the Executive's reply for further comment. We could then reconsider the petition when those comments come back. In that way, we might start to hone the issues for consideration, should the petition be passed on to someone else.
I think we need a debate on the issues, because we do not know the answers.
I do not think that we can determine whether we should have a debate. The recommendation is that we seek information; we can then determine what we do with the petition.
I support Linda Fabiani's recommendation. It is important that we give the Executive the opportunity to reflect on the terms of the petition.
Are members happy with that recommendation?
Scottish Executive (Complaints and Correspondence) (PE681 and PE682)
We can take petitions PE682 and PE681 together. They are both in the name of Mr Alexander, but they cover different issues from those that are raised in PE683, which is why we did not discuss them in conjunction with that petition.
I want to highlight a couple of procedural issues. On both petitions, under the options for action, we are asked to consider that the Parliament has no remit in relation to the internal workings of the Executive. If that is the case, I wonder why the two petitions were not ruled inadmissible.
The Parliament has a remit in relation to Executive ministers. For example, the Standards Committee has considered the ministerial code of conduct. We do not have a remit in relation to the civil servants.
In that case, I do not really understand the statement in the recommended action. Is the clerk saying that we do not have a remit in relation to only part of the petition?
I hate to be awkward and prolong the meeting, but is it not the case that, through ministers, one can consider the whole issue, because they are ultimately responsible?
Possibly. We will consider the petitions and see whether we can determine that.
Fine.
Petition PE681 asks the Parliament to urge the Executive to establish a transparent and independent procedure for handling public complaints about its operations. Petition PE682 requests that the Parliament urge the Executive to establish a transparent correspondence-handling procedure that the public can access. Those are specific issues. Do members see why there is a limit to what we can ask in relation to them?
We should just pass copies of the petitions to the Executive, given that it is reviewing its procedures at the moment, and ask it to include consideration of the petitions in its deliberations.
Are members happy with that?
Education (Anti-Semitism and Gender Inequality) (PE669)
Petition PE669, in the name of Elaine Pomeransky, is on anti-Semitism and gender equality in Scottish schools. It asks the Parliament to investigate what practical steps are being taken to deal with anti-Semitism and to promote gender equality in Scottish schools. The petitioner believes that, despite the existence of anti-discrimination legislation, anti-Semitism is still being promoted, particularly in religious teachings. In the background material to the petition, she describes her experiences and claims that she has suffered discrimination from neighbours and public servants for being a single disabled woman. The information available on what is happening in this area appears to be general.
The best way forward is to write to the Executive and ask it for specific details about what it is doing in relation to both gender equality and dealing with anti-Semitism in schools. We should wait for a response to that.
Are members happy with that?
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Current Petitions