Official Report 153KB pdf
Heavy Metal Poisoning (PE474)
After all that excitement, we move on to item 3, which is our quarterly look at the petitions that have been forwarded to us by the Public Petitions Committee. We have three new petitions to consider, as well as several on-going petitions.
I will explain the thinking behind the Public Petitions Committee's decision to refer petition PE474 to the Health and Community Care Committee. When the Public Petitions Committee received the petition, it approached the Executive for a response. That response is included in the papers that have been circulated. It is clear that the Executive takes a quite different view from that of the petitioner about the threat that heavy metals present.
In the absence of evidence, it might be worth asking the Medical Research Council, which appears to be the expert body, to produce an objective, impartial review of current research.
As no other members have comments, let us write to the Medical Research Council to ask for its views on the subject. Given the committee's work load, my view is that we should simply note the petition. Let us write to the MRC in the interim and we will return to PE474.
Audiology Services (Modernisation) (PE502)
Petition PE502 is in the name of Fiona Stewart. It calls on the Scottish Parliament to urge the Scottish Executive to show firm commitment to providing digital hearing aids and to modernising audiology services in Scotland. I invite John McAllion to provide some background. After considering the petition, the Public Petitions Committee agreed to pass it to us for information only at this stage. Why was that?
We usually seek the Executive's views before considering whether we should formally refer a petition to another committee. We are waiting for the Executive's response. The clerk to the Public Petitions Committee tells me that we have already received 13 responses from the Executive for the Public Petitions Committee's next meeting. I think that the relevant response will be among those. The petition will be formally referred after that.
Several members, not all of whom are members of the Health and Community Care Committee, have raised the issue of digital hearing aids and audiology services on behalf of constituents. We have all been lobbied about services for people with hearing difficulties. I have lodged parliamentary questions on the issue this week. We might want to return to the subject. Perhaps we could simply note the petition, unless anyone else has a point.
I wonder where we are with the review of audiology services, on which the Executive has not reported yet.
I presume that that will come out of its response.
Perhaps we should return to the petition after we have received the review. We will be able to assess whether the recommendations are adequate.
The reason for our procedure is that we are aware that the subject committees have heavy work loads. We do some of the initial spadework, so that when a subject committee receives a petition from the Public Petitions Committee, it has the Executive's position and the petitioner's position. That makes things easier.
There is usually a note to explain that the Public Petitions Committee is waiting for an Executive response. I was just informed that I was not expected to take any action. I was slightly concerned by that, because I did not think that the issue was one on which the committee would want to take no action. We will simply note the petition at this stage and return to it once the Executive has responded to the Public Petitions Committee.
MMR Vaccination (PE515)
The next new petition is PE515, in the name of Dorothy Wright. The petition calls on the Scottish Parliament to take the necessary steps to make individual measles, mumps and rubella vaccines available without delay.
Members indicated agreement.
Triple Assessment Breast Examinations (PE491)
Let us move on to consider on-going petitions. Petition PE491, in the name of Elaine McNeil, calls on the Scottish Parliament to take the necessary steps to introduce legislation to make triple assessment procedures obligatory for all women who present themselves for a breast examination within the relevant examination clinics across the national health service in Scotland.
Perhaps I have the wrong papers, but I am not sure that I have a copy of the letter from the Executive. The letter may deal with the point that I wanted to raise. I was involved with the petition at the early stages. Leaving aside the question whether triple assessment should be compulsory, I am interested to know what guidance the Scottish Executive gives to health boards on this issue. I also want to get some idea of what the practice of the various health boards is. Is that information provided in the Executive's letter?
The letter mentions that the assurance and accreditation of services is done through the Clinical Standards Board for Scotland, but I do not think that it covers much beyond that.
Would it be appropriate for the committee to approach the Clinical Standards Board to get its view on the practice in the various health boards? Aside from the argument about whether triple assessment should be compulsory, there is a basic question about what happens at the moment. As far as I can tell, the practice seems to be patchy.
Let us ask both the Executive and the Clinical Standards Board about that. The Executive's position could probably be summed up as being that, as not all women require all the different phases in the triple assessment, some of which are invasive, triple assessment is not used unless it is felt that it is necessary. The decision on whether a triple assessment is required is a clinical decision based on the needs of the individual patient.
However, in the case of the petitioner, it was judged that it was not necessary for her to have a triple assessment. She was misdiagnosed. It then turned out that, had she had the triple assessment, that misdiagnosis would probably not have happened. There is an issue about what guidance is being given to health boards and how that is being interpreted.
The other point that the Executive made is that any move towards triple assessment would have a knock-on impact because staff would need to be taken on board. That is the Executive's response in a nutshell.
Fife NHS Board (Right for Fife Business Plan) (PE498 and PE499)
Petitions PE498 and PE499 come from the Fife Health Service Action Group and the Dunfermline Press and West of Fife Advertiser. The petitions deal with consultation on acute services reviews and other major changes in health service provision. As previously agreed, those matters shall go on to the agenda of our next meeting.
Greater Glasgow NHS Board (Consultation) (PE453)
Petition PE453, in the name of Father Stephen Dunn, similarly calls on the Scottish Parliament to carry out a full review of the process of consultation with local communities, especially regarding the siting of the proposed secure unit in the Greater Glasgow NHS Board area. The committee considered the issue quite early on in its life. It is on the agenda for when we are considering general consultation issues on 18 September, so we will come back to the petition at that point. Is that agreed?
Members indicated agreement.
Fuel Poverty (PE123)
Petition PE123 is from the warm homes campaign and calls on the Scottish Parliament to identify, discuss and seek to implement measures that would eradicate fuel poverty as a matter of urgency. We have had two committee reporters working on the issue and we have passed our report to the Social Justice Committee to assist in its consideration of the Executive's draft fuel poverty statement. If there are no comments from the committee, I suggest that we take no further action on the petition at this time. Is that agreed?
Members indicated agreement.
Could the Public Petitions Committee be informed of that decision?
Yes. I put it on record that I believe that the Public Petitions Committee should always be informed of our decisions on petitions. Just for clarification—and it should probably not go on public record—does the Public Petitions Committee prefer to know on an on-going basis what the committee is doing with petitions or does it just require to know what our final decision is?
It is just the final decision, and it is only a matter of courtesy. The Public Petitions Committee does not have a right to know.
You know me—I always try to be courteous.
Epilepsy Service Provision (PE247)
Petition PE247 is from Epilepsy Action Scotland and calls on the Scottish Parliament to ensure that there are co-ordinated health and social services that will benefit the 30,000 people in Scotland who have epilepsy.
There seems to be a slight confusion. I understood that there was to be some sort of formal managed clinical network, which would bring together health and social services. That would give people who live in the Highlands, for example, access to the expertise that exists in Dundee, Aberdeen and elsewhere. Could we have clarification on whether there is to be a formal managed clinical network for epilepsy?
If my memory serves me correctly, I think that the Executive response suggested that the setting up of managed clinical networks was in the hands of individual groups of clinicians in any given area and that the Executive was in no way directing them to do that. If people were interested in doing it, they could get on and do it. That is not good enough. The information that was presented to us suggested that there is a patchy network of services across Scotland. We should not just replicate that patchy network of services by allowing managed clinical networks to spring up periodically where individual clinicians feel that they want to set up a network.
I agree. The response of Epilepsy Action Scotland to the Executive's letter makes the point very clearly that the managed clinical networks are voluntary and health boards are not required to put them in place. In England, there is a national framework where the health authorities must provide services for people with epilepsy. That is what EAS wants to happen in Scotland. I think the committee should take up that cause and chase it up with the Executive.
We definitely need national standards. We discovered that only two health boards were following the guidelines on epilepsy from the Scottish intercollegiate guidelines network. That shows just how patchy the current attitude is.
I was going to make the same point. An excellent guideline is available from SIGN. We should be concerned that only some health trusts adhere to the letter of SIGN guidelines. Members will recall my comment, at the committee's meeting in Inverness in April, on the reply to our question whether people could get a diagnosis within four weeks of their first seizure. As I said at that meeting, we were told that there was "not a hope" of that. What is the point of SIGN guidelines being issued if many trusts choose to ignore them?
I will come to other members in a moment—nearly all members have indicated that they wish to comment on this matter. Mary Scanlon touched on the subject of waiting. The figures from the Executive show that the wait from the first diagnosis of possible epilepsy until referral to a specialist in various health board areas ranges from 28 days in Lothian—which, as a Lothian MSP, I am happy about—to 120 days in Orkney, which I am pretty disgusted about. The intermediate figures tend to edge towards the high end of that range. The second-lowest waiting time is in the Western Isles, where there is a wait of 56 days. That is unacceptable, particularly when we think about each individual's underlying worries.
Colleagues have made some important, salient points, which we should raise with the Executive. I hope that we will receive a better response, which addresses those points instead of avoiding them.
I agree that we should write to the minister specifically about managed clinical networks. We should ask specific questions and if we do not get specific answers, we should consider taking evidence from the Minister for Health and Community Care.
That is what we will do. If anyone has any specific questions, please e-mail them to the clerks. If not, I will liaise with the clerks about what we will ask. At some point, if we do not feel that we have received satisfactory answers from the Executive to our questions about managed clinical networks, we may pull together the written and oral evidence that we have received and present that together with a report.
Organ Retention (PE283, PE370 and PE406)
The next petition is PE283, from the Scottish Organisation Relating to the Retention of Organs—SORRO. It calls on the Scottish Parliament to initiate a public inquiry into the practice of organ retention at post mortem without the appropriate parental consent. That has been an issue for some time and the Executive has published Professor McLean's report on it. Unless someone else can tell me this information now, I think that we should try to find out from the Executive when it intends to introduce legislation to implement the McLean report. I suggest that we then return to the three petitions on the issue.
Members indicated agreement.
We have also received further information from Justice for the Innocents, formerly Scottish Parents for a Public Inquiry into Organ Retention, on PE370. Lydia Reid, the main petitioner, has contacted us and I am sure that many members will have heard from her previously. Having asked for clarification, we will return to the matter at a later date. Aside from PE283 and PE370, we will clarify the point about post mortems in relation to PE406.
Chronic Pain Management (PE374)
Let us turn again to PE374, from Dr Steve Gilbert, which calls on the Scottish Parliament to act urgently to redress the underfunding of chronic pain management services. The committee will consider responses to its questionnaire and possible further action on 25 September. Is that agreed?
Members indicated agreement.
Did you miss PE320, convener?
I think that PE320 was the second petition relating to organ retention. We have agreed—
It is the petition from the World Development Movement, about the general agreement on trade in services—GATS.
That is still to come.
Is it?
There are too many bits of paper in front of me. We have not got there yet—you are getting ahead of yourself.
I see now that it is the next petition in my pile of papers.
Scottish Parliament Health Policy (PE320)
The next petition, PE320, is from John Watson on behalf of the World Development Movement, on the World Trade Organisation's liberalisation of trade and services. I recommend that the petition be continued until the publication of the Department of Trade and Industry consultation document, which should clarify whether requests to open up the UK NHS have been made under the general agreement on trade in services. Is that agreed?
Members indicated agreement.
Myalgic Encephalomyelitis (PE398)
PE398, in the name of Helen McDade, calls on the Scottish Parliament to urge the Scottish Executive to carry out a strategic needs review assessment of myalgic encephalomyelitis and chronic fatigue syndrome, and to take a range of other steps regarding the treatment of and research into those conditions. John McAllion was appointed to monitor the position of the Executive and to report back to the committee on that. In May the committee considered the Executive's reply to the petition. It was agreed that John McAllion should contact the Executive to seek further clarification on a number of points. A reply was received on 26 August. Members are invited to note the response and to consider whether the committee should take any further action in relation to the petition.
The short life action group has met several times and hopes to produce a report by the end of the month. I know that patient representatives on the group are concerned about the drift of the report's conclusions and that they are seeking a meeting with the Deputy Minister for Health and Community Care, Frank McAveety, so that they can influence those conclusions. I will report back to the committee as soon as information is available.
So we should delay our comments until we have received the report of the short life action group. Is that agreed?
Members indicated agreement.
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