Official Report 314KB pdf
Criminal Memoirs (Publication for Profit) (PE504)
There are quite a number of current petitions. I hope that we will get through as many of them as we can in the time that we have; we have an important evidence-taking session on two of them later in the afternoon.
The petition has been bounced around between the UK Government and this committee. It might be worth asking the Cabinet Secretary for Justice to appear before the committee to probe him a little about what is going on between the two Governments.
The petition has been around for a long period. Such a request is not unreasonable. Does that have committee members' broad consent? If so, we can move the petition on, as we need to do. There needs to be some conclusion to the matter. There is a role for the cabinet secretary and the Scottish Government, but there are also UK legislation issues. Let us see if we can cut through some of that. Are we happy to support Nanette Milne's suggestion?
Okay—that will be our course of action.
Institutional Child Abuse <br />(PE535 and PE888)
The next two petitions are on the broad topic of institutional child abuse. PE535, by Mr Chris Daly, calls on the Parliament to urge the Scottish Executive to make an inquiry into past institutional child abuse, particularly in respect of children who were in the care of the state and under the supervision of religious orders, to make an unreserved apology for said state bodies, and to urge the religious orders to apologise unconditionally. The petition was lodged quite a while ago; in fact, it is the second-oldest petition in the system.
We should close consideration of them. The petitions have been successful in bringing a grave issue into the public arena and ensuring that things have happened. There has been great movement, and people have taken seriously the concerns that have been expressed, as they should have done. What has happened shows that submitting petitions to the committee works.
Do members agree that we should follow the course of action that Rhoda Grant suggests?
Vulnerable Adults (Medication) (PE867)
PE867, by W Hunter Watson, calls on the Parliament to provide adequate safeguards against vulnerable adults being given, by surreptitious means, unwanted, unnecessary and potentially harmful medication. We have the relevant papers in front of us. Do members have any comments on how we should deal with the petition?
The matter has been dealt with. Two distinct issues are involved. There are people who have the capacity to give consent to receiving medication and people who do not have that capacity. The Adults with Incapacity (Scotland) Act 2000 was an innovative piece of legislation in Scotland, and the code of practice under that act was recently revised to take account of covert medication. There will be issues for the Scottish Commission for the Regulation of Care if it appears that an offence has been committed by giving medication surreptitiously—against someone's will or without their knowledge—to people who have the capacity to consent to receiving medication.
I think that members received other information on the use of medication.
I happen to know the petitioner, as he was a neighbour of my mother years ago. He has put a huge amount of work into following up his real concerns.
Perhaps the revised code of conduct that was laid before the Parliament in December 2007 meets the petitioner's concerns.
To put it bluntly, the petitioner is still unhappy, even given the care commission's structure and the code of conduct. We need to be accurate about where he stands on those issues, and to try to arrive at a view today if we can, regardless of whether or not that view will benefit the petitioner.
I do not know whether what the petitioner seeks to achieve will ever be achieved. Whatever guidance is in place, some people will always slip through the net. It is an extremely difficult situation.
That is true. The safeguards that have been put in place should be sufficient. The important issue is how to legislate for people who ignore those safeguards or try to get round them—how to deal with people who are not following the guidelines. It seems that the petitioner is concerned about how the care commission acts when cases are reported to it—whether it investigates and takes the necessary action.
I get the impression from the contributions so far that people think that, on balance, there is a framework in place—we would hope—to address some of the concerns that the petitioner raises. There is a reference to the care commission and the code of conduct in respect of legal protection for individuals. Given that information, we should think about closing the petition, as there are more appropriate safeguards than there were before the petition was submitted that can, we hope, address the concerns. Was that what you were suggesting, Angela?
Yes, absolutely. I appreciate that the petitioner has an individual case, and I have had experience of constituents who have been unhappy with investigations by bodies such as the care commission. If the petitioner remains unhappy on the issue of human rights, he will perhaps have to pursue legal recourse on that basis. I am not sure what the committee can add that will be useful at a practical level.
I am inclined to agree with that. It is almost a case-by-case issue. I have little doubt that there are cases that cause problems.
On that basis, do members agree to close the petition and to indicate that we believe that there are now frameworks in place that can address some of the concerns that the petitioner has raised?
Victim Notification Scheme (PE899)<br />Stewart Committee Report (PE1106)
The next item concerns two petitions that are linked together: PE899 and PE1106. The first is by Hazel Reid, calling on the Parliament to urge the Scottish Government to review the operation of the victim notification scheme to ensure that victims of serious violent and sexual crimes are given the right to receive information about the release from prison of an offender who has committed a crime against them. PE1106, by Jamie Webster, calls on the Parliament to urge the Government to review those aspects of the Stewart committee report, "Keeping Offenders out of Court: Further Alternatives to Prosecution" that relate to the rights of victims of crime to obtain information on the handling of a case.
Can we close PE899, given that the review has taken place? We need to see how it beds in and whether it has the desired outcome, so we could leave the petition open and wait and see, but that has not been our policy. Usually if there has been a review and a new policy has been introduced, we close the petition. After all, if anyone experiences any difficulty in future, they can always come back to us.
I am happy to accept that recommendation in relation to PE899. However, as there are still some issues outstanding with regard to PE1106, we should keep it open at least until the Crown Office and Procurator Fiscal Service updates us on the review of the policy on warnings. In too many cases, people think that an offender has been released too early or is involved in other matters that might cause problems for family members.
Disabled Parking (PE908)<br />Local Authorities' Traffic Orders (Procedure) (Scotland) Regulations (PE909)
Disabled Parking Bays (Improper Use) (PE1007)
PE908, PE909 and PE1007 all relate to provision for disabled parking bays, including, for example, the use of dropped kerbs, to prevent their misuse by those who do not have disabilities and ways of ensuring that only registered disabled users can access them. Again, these petitions have been in the system for a while. I should say that a proposal for a member's bill on this issue by a colleague from my own political group has gained cross-party support, but I do not know what stage it has reached.
It would be interesting to know where things stand with the proposed member's bill.
So we will keep the petitions open to find out what stage the proposed bill has reached.
Have the Government and the Convention of Scottish Local Authorities met to discuss the matter? I cannot remember whether our papers make that clear.
The Government met COSLA, but I do not know whether anything emerged as a result.
We should certainly find out.
I am sure that tons of good things will come out of the new, historic concordat. As you can see, I am on-message. I am getting the language and everything.
I was surprised by COSLA's view that, apart from a few hot spots, this was not a problem.
Are you saying that that is not your experience?
Certainly not as an MSP and not in my 10 years as a local government councillor. This is a recurring problem, and I am interested to find out what is happening to Jackie Baillie's member's bill. We should also get in contact with the Government on the issue.
So we will seek an update on the result of the Government's discussions with COSLA and on any courses of action that the transport directorate—and, indeed, the directorate responsible for equalities—might be planning to take.
Why have the petitions been grouped together? Surely they are different. Petition PE909 is about dropping kerbs; it is nothing to do with disabled parking bays.
You are right to say that although petitions PE908 and PE1007 are broadly similar, petition PE909 is about dropped kerbs, which comes under the remit of local authorities. However, it raises concerns that can be dealt with alongside the other two petitions.
As the three petitions deal with broadly the same topic, we grouped them together for the committee's convenience. However, they are stand-alone petitions.
So we are dealing with all three in one go.
The committee will invite the Scottish Government to respond to the issues highlighted in each petition, but in future the petitions will be considered together for the committee's convenience.
So there will be three different ways of dealing with the three different petitions.
Essentially, there is a symmetry between items in the petitions. We will make inquiries about the issues and ask whoever we raise the issues with to respond to the specific concerns that each of the petitioners has raised. I understand that you are saying that you do not want to lose sight of one particular element, because it is not the same as the parking-bay issue. As we know from our time in local government, dropped kerbs are a big issue in many communities, particularly communities with a growing elderly population or with individuals with disabilities. Are you worried about that issue getting lost?
Yes.
I assure you that we will pursue the issue with great vigour and vigilance.
I am getting old, too, you know.
I am a long way away from that, but you can declare an interest.
Skin Cancer (PE931)
PE931, by Helen Irons, on behalf of Skin Care Campaign Scotland, calls on the Scottish Parliament to urge the Scottish Executive to review its policy on tackling the growing skin cancer epidemic in Scotland. Do members have any suggestions on how we should deal with the petition?
How is Ken Macintosh's member's bill on sunbeds coming along? That is an issue that causes a lot of concern.
There is an issue about access to sunbeds increasing the incidence of melanoma.
I am on the Health and Sport Committee, and I know that sunbeds will be dealt with in the Public Health etc (Scotland) Bill. The Government has been working with Ken Macintosh and is considering lodging amendments at stage 2 to incorporate some kind of process for dealing with sunbeds. I am not clear about what that will be, but I know that there is a commitment.
So the issue is moving forward.
Yes.
The petition raises specific issues other than the sunbed issue.
Is the Health and Sport Committee aware of the petition? It might be worth drawing the petition to the attention of the committee and Ken Macintosh.
We can do that. It would be useful to make the committee and the member who is pioneering a member's bill on the subject aware of the petition. There is an issue for the health department and the Cabinet Secretary for Health and Wellbeing about progress on diagnosis. There has been substantial progress over the past four or five years on tackling cancer in Scotland. The investment in the area has been higher than before and new treatment centres have been developed. Those developments were much needed. It would be useful to hear from the Government about waiting-time targets and so on.
Elderly People (Residential Care) (PE1023)
PE1023, by Dr H I McNamara, on behalf of Highland Senior Citizens Network, calls on the Scottish Parliament to urge the Executive to ensure that a greater proportion of residential care places for the elderly are provided for and staffed by the statutory sector, particularly in rural areas.
The petition merits a lot of support, as it suggests that places in such establishments should be allocated on a fairer and more regulated basis. I see nothing wrong with that.
There is also an issue about access to residential care in remote rural communities when care is provided by the private sector, which the petitioner underlines. Economies of scale cannot be made when the population is small, so care provision often comes under threat. We should maybe pursue with the Government issues to do with accessibility and standards of care. Not so long ago, people on Mull had to move to the mainland for residential care. Couples who had been married for 50 years were parted and made to live in different parts of the country. There is a fundamental need in rural areas for local government or the Government to step in and provide care when other sectors cannot continue to provide it, given the population level.
The review of free personal care, which the Cabinet Secretary for Health and Wellbeing announced early in the new Administration, presents an opportunity. It might be useful to draw the petition into that. I was briefly involved with the elderly care and community care sectors when I was a minister, so I am aware that in rural Scotland it is not easy to find private sector providers who will fill the gaps that are left when local authorities pull out. There is much pressure on councils in relation to how they look after and support older people. It would be useful to seek the Government's views on the issues that are raised in the petition.
Elderly People (Provision of Care) (PE1032)
PE1032, which is similar in theme to PE1023, was brought by Elizabeth McIntosh on behalf of Renfrewshire Seniors Forum. The petition addresses in particular care provision for the housebound elderly and calls for seniors forums to be fully consulted in relation to the provision of care for the elderly.
Employment Opportunities for Disabled People (Public Procurement) (PE1036)<br />Employment Opportunities for Disabled People (Home Working) (PE1069)
We link petitions as much as we can do. If members are unhappy about that, they can say so. PE1036 was brought by John Moist on behalf of the Remploy consortium of trade unions and calls on the Scottish Parliament to urge the Scottish Government, in partnership with Remploy and other sheltered workshop employers, to promote employment opportunities for disabled people by reserving local authority and/or Government contracts for supported businesses, as permitted by article 19 of the European Union directive on public procurement.
On PE1069, the issue is how to get the message to business that people with disabilities want employment at home. We all know that able-bodied people work from home, but people with disabilities also want such opportunities. Is it worth approaching the Federation of Small Businesses Scotland or the Scottish Chambers of Commerce, which have a handle on business and might disseminate information among their members?
That is a reasonable suggestion.
We could approach Scottish Enterprise, too.
Okay. The Cabinet Secretary for Finance and Sustainable Growth gave evidence to the Parliament's Equal Opportunities Committee. It would be helpful to get a summary of the key points on how the Government is encouraging access to employment for people with disabilities and ensuring that people who perhaps struggle to get out of the house but can still work have opportunities for employment at home.
It might be worth while contacting the National Group on Homeworking to find out about some of the issues that arise from home working. In a previous existence, I dealt with concerns that arose because of the way in which employers treated individuals who worked from home. We need to safeguard those individuals' rights. Three or four years ago, several high-profile cases arose in which people who were working from home were regarded by employers as low-cost employment. Those people were not guaranteed their right to the national minimum wage and other conditions. It would be useful to contact the National Group on Homeworking to find out whether it has concerns over the proposals. The group produces useful information for people who undertake home working to ensure that they are guaranteed their rights. If we move down the road that is suggested, there is a danger that rights may be eroded by certain unscrupulous employers.
An issue arises with supported employment, too. The situation in Aberdeen, where the former Blindcraft organisation could be under threat, has been all over the press, although I know that that is not mentioned in the petitions. A lot of work is being done to ensure that the organisation does not close. A suggestion has been made—I have approached the Government about it—that it might be better if some supported employment organisations were brought under an umbrella organisation, to allow them to cut administrative costs by having central procurement and administration personnel. That would allow the organisations to work as individual units, but more efficiently than they can at present, given that they have to look after all aspects of the business. I have been trying to explore the idea and I wonder whether it would be worth while for the committee to emphasise it.
I am happy to take on those points.
I want to raise a concern about Nanette Milne's suggestion. Some organisations such as Remploy and the Blindcraft organisations—particularly Blindcraft in Glasgow—have taken and continue to take different approaches to how they recruit people. An issue might arise if we tried to get those organisations to work together to cut administrative costs, as they have different philosophies and outlooks in relation to whom they work with and why they work with those groups. Remploy is a UK-wide organisation, whereas the Blindcraft organisations are usually local authority based. Blindcraft in Glasgow does a lot of good work—not just with people who have a visual impairment, which is what the name suggests, but with individuals with various disabilities. It takes a different approach to its work from that taken by similar organisations. I would be concerned if we suggested that those organisations should be brought together under one umbrella, because there are different philosophies and outlooks and different approaches to how the organisations treat individuals with disabilities.
I was not necessarily suggesting that we should do that; I was purely wondering whether the idea was worth exploring to see what response we would get.
We will handle the idea with care.
I will try to be helpful. Nanette Milne seemed to moving towards the idea of having a system in which companies that offer supported employment are assisted in bidding for Government contracts. I understand John Wilson's point—indeed, many of the companies employ folk in their administrative back-up services who need assistance, too. Perhaps we need an advisory group that helps those companies to bid for Government contracts.
That is helpful. Do members accept those comments and recommendations?
Physiotherapy Graduates (Employment) (PE1044)
PE1044, by Kate Mackintosh, on behalf of the student members of the Chartered Society of Physiotherapy in Scotland, calls on the Parliament to investigate the merits of extending the one-year job guarantee employment assistance for newly qualified nurses and midwives to include newly qualified physiotherapists in Scotland, with particular reference to the benefits for patient care. The petition has been in the system for a while—the issue emerged in early 2007. I understand that a working group was set up to try to address some of the issues raised just before the elections last year. Do members have any strong views on how to deal with the petition?
Given that the Chartered Society of Physiotherapy in Scotland is a member of the national solutions group for physiotherapy, perhaps we could close the petition. The petitioner is now in a position to work towards a solution.
I do not disagree with that, but it is important that workforce planning for physiotherapy is done properly and that there is investment in the area. I have been having physiotherapy for a back problem, and I would hate to think that people with physiotherapy skills were unemployed and unable to treat people who experienced the sort of agonies that I have been experiencing for the past little while. The issue is important, but I am not sure that the committee can take it further at this point.
Thanks for those comments. Do we agree to close the petition on the ground that the issues of concern raised in it can best be addressed through the national solutions group for physiotherapy?
Land Reform (Scotland) Act 2003 (PE1061)
PE1061, by Mr and Mrs Mark J Lochhead and Mr and Mrs Henry McQueen Rankin, calls on the Parliament to urge the Scottish Executive to ensure that measures that are taken by communities to tackle antisocial behaviour in urban residential areas are not restricted by the duty of a local authority to uphold access rights under the Land Reform (Scotland) Act 2003. I invite comments from members.
The recent clarification by the Minister for Environment that
It seems to me that the minister and COSLA have slightly different interpretations of events.
Never—that is the first crack in the armour.
Perhaps we should get clarification. I totally agree with Angela Constance about what the position should be, but perhaps the guidance should be clearer. I do not know how we can achieve clearer guidance, apart from by writing to the minister about it.
Do members wish to close the petition but draw to the petitioners' attention the statement by the minister that duties under the 2003 act should not be an inhibitor? A neighbouring local authority to East Renfrewshire Council has chosen to take a different course of action. I am happy to close the petition on that basis.
Do we not need to draw to the attention of East Renfrewshire Council the letter that we have had from the minister?
We could do that. We could refer the council to the minister's statement. We are talking about a local decision, but the council will need to consider what it does in the light of the statement. I would not want to interfere with the right of local government to make decisions locally.
When we took evidence, it seemed that East Renfrewshire Council was saying that its hands were tied on the issue and that it could not allow the gates that had been put up to remain in place.
Yes.
It would be helpful if the committee were to get in touch with East Renfrewshire Council.
I am happy to do that, but I will take the clerk's advice on whether we can also close the petition now, or whether we have to wait to do so.
You have to wait.
Okay. I understand the procedural issue that concerns Claire Baker, and I thank her for raising it.
Ambulance Services (PE1099)
PE1099, by John Grant, on behalf of the community councils of highland Perthshire, calls on the Scottish Parliament to urge the Scottish Government to monitor the provision of ambulance services such as those in the highland Perthshire area. Given our previous discussion on the subject and that no concerns were raised in the responses from the organisations that were involved in the decisions to restructure the ambulance provision in the highland Perthshire area, how should we deal with the petition?
We should close it.
The recommendation is that we close PE1099 on the ground that no further concerns have been raised. Are we agreed?
Motorcycle Facilities (PE1100)
PE1100, by Bob Reid, on behalf of the Scottish Auto Cycle Union and North Lanarkshire Scramble and Quad Bike Club, calls on the Scottish Parliament to urge the Scottish Government to review planning and environmental regulations to allow for the provision of safe local and national off-road motorcycle facilities, including a centre of excellence in North Lanarkshire, as a way of tackling antisocial behaviour.
We have sent reminders to the Scottish Government, but to no avail.
After my comments today, there may be a mad scramble to respond. I look forward to that. We still await a response from the Government, so I suggest that we write again. We want to be fair to the petitioner, particularly given that the petition has been in the system for a while. Is that okay?
I assume that the Government has a copy of the report that is in our papers.
Yes.
Psoriasis and Psoriatic Arthritis (PE1109)
PE1109, by Janice Johnson, on behalf of Psoriasis Scotland-PSALV, calls on the Scottish Parliament to urge the Scottish Government urgently to develop clinical guidelines on the diagnosis and treatment of psoriasis and psoriatic arthritis; to develop national standards of care for people who suffer from those conditions; and to define them as chronic conditions that should be included in the list of conditions that are exempt from prescription charges.
In her response of 31 March, Mrs Johnson makes a number of valid points, including points about the need for clinics and nurses. If we are to write to the Government on the matter, will we automatically include a copy of the letter? If not, we should.
We will forward a copy to the Government.
Mrs Johnson makes important points, which the Government should consider.
We will contact SIGN and the Government's health department on what procedures and guidelines are in place. We will review progress once we receive the responses.
Foreign Teachers (Recruitment) (PE1110)
PE1110, by Kevin O'Connor, calls on the Scottish Parliament to urge the Scottish Government to review the policies, guidance and procedures that apply to the recruitment of foreign teachers and the right of recourse to investigate claims of discrimination.
Yes. I think that I am a member.
Okay. Does any member who does not have a personal interest in the regulatory framework for teachers want to comment on the petition? I have a view, but I would prefer to hear the views of other members.
I understand that a person has to be registered with the GTC to carry out teaching activities in Scotland. The GTC has in place screening and checks. That should provide enough security. We should close the petition.
Are members happy to accept that recommendation?
I am conscious of the time. We scheduled the next session with the health boards for 3.30 pm. Staff from NHS Tayside are with us. They win the gold star for getting to committee before their NHS Greater Glasgow and Clyde colleagues—perhaps they are having trouble parking their motors. We will take a 10-minute break.
Meeting suspended.
On resuming—
Parking Charges (Hospitals) <br />(PE1086 and PE1091)
I thank everybody for their patience, as we are resuming a few minutes later than intended. The next petitions are PE1086, which calls on the Scottish Executive to issue new guidance to health boards to remove excessive charges for car parking, preferably for those staff who work shifts and for whom public transport alternatives are limited; and PE1091, by Mary Murray, which calls on the Scottish Parliament to urge the Scottish Government to review the levying by NHS boards of car parking charges at NHS hospitals, such as that proposed by NHS Greater Glasgow and Clyde at Stobhill hospital.
I will say something briefly. From the guidance that we were given, I did not expect that we would have the facility to make opening statements.
I am a nice guy.
As ever, convener.
There is a slightly different history in Tayside. There are two chargeable parking areas there—at Perth royal infirmary and Ninewells hospital. Chargeable parking has been the subject of a private finance initiative contract, which was set for 30 years in 1998, so it still has another 20 years to run with respect to the Ninewells site.
I open up the discussion to questions or comments from members of the committee.
I presume that the staff in your hospitals arrive in shifts. Many staff may arrive at 1 o'clock in the morning and another lot may arrive at 3 o'clock or 4 o'clock or whenever. Have you developed travel plans for them that encourage car sharing? I presume that such plans would nicely free up spaces.
That is one of the initiatives in the Ninewells travel plan. We have become a joint subscriber with Dundee City Council and the University of Dundee to the web-based liftshare.com car-sharing initiative. This week, we are analysing the results of a travel plan staff survey. We carried out such a survey four years ago and another one last month to find out whether there has been a shift in how people travel. The early indications are that fewer single-occupancy cars are coming on site and that car sharing has increased, which seems to be helping us.
Are you encouraging that in any specific ways?
We publicise the scheme in NHS Tayside staff newsletters. We focus on the Ninewells site, but taking part in the lift share scheme is open to anybody in NHS Tayside.
We operate a lift share system in greater Glasgow and Clyde, too. It has been operational since earlier this year, and it operates in a similar way to the one in Tayside. On uptake, several hundred people have logged on to the site. I am not sure how successful things have been with shared journeys, but we do operate the lift share system. We have also considered other incentives, such as a bike loan scheme, reduced-rate ZoneCards and other travel cards. We are working closely with Strathclyde partnership for transport to consider other benefits that we could make more affordable and accessible to staff who need to access our sites at various times of the day.
Do you have figures showing the percentage of staff who now travel by car and what improvement there has been over time?
We are working on that. We have been working closely with the Energy Saving Trust, and a company called JMP has recently audited all our acute sites. We are forming and rationalising our travel plans now, and we will consider the detailed audit document—which arrived only this week—as we decide how to take forward its recommendations. The document goes into particular detail on localised journeys and how staff go to and from work.
We will be happy to go over that information with the committee once we have had the opportunity to analyse it and ascertain what improvement has been possible.
Have car parks always been oversubscribed, and is that why charges were introduced? Are there other reasons for introducing charges?
The history of the situation in Tayside goes back some time. The decision to charge for car parking was not based on income generation—there was no income generation for the health trust, as it used to be. We estimated that if car parking was not charged for, there would inevitably be a cost to the NHS in running the car parks efficiently and effectively. In Tayside, we reckoned it would come to about £0.5 million a year. It was decided in Tayside in 1998 to offset the cost to the NHS of administering car parking and to make the money available for patient care. That was the basis of the decision at the time.
As I hinted earlier, the best ratio of available spaces at any of our urban sites in greater Glasgow and Clyde where we introduced the policy was 1:1. That covered staff parking alone. The worst ratios were 5:1 and 6:1. We were oversubscribed before we started to make arrangements for fairer access for patients, visitors and relatives.
I want to be quite clear about that. Are you saying that at every site where car parking charges have been introduced there were difficulties in getting parked because too many people were using the car park?
Yes—at each site that has been covered in the roll-out thus far. As I said, our entry point into the exercise was that patients, visitors and relatives were not getting fair access to parking and we needed to change the balance. Immediately on changing the balance, even the site that had the greatest number of spaces was substantially oversubscribed.
There is much shift working at hospitals, and public transport is not always available at the end of a night shift or the start of an early shift. The health service's workforce is predominantly female. What risk assessments have been performed and what steps have boards taken to ensure that staff are safe when they make their way to and from work?
We were fortunate in getting European funding for our integrated travel plan a couple of years ago. On the Ninewells hospital site there is comprehensive public transport infrastructure—it is like a bus station. We work closely with Dundee City Council to match the timing of buses to our shift patterns. That is where we have concentrated our efforts, but there is always room for improvement.
I understand that you take steps on site, but the bus will probably not take everyone to their front door—or anywhere close to it—and people might have to take a bus to the town centre to catch a connection, which are disincentives for people who have to travel alone late at night. Have you considered such issues?
The bus interchange at Ninewells, which is outside the front door, is completely undercover. It is all glazed, so it is virtually internal. We have fitted it with intensive closed-circuit television coverage, to try to give confidence to staff—
Sorry, but that is not what I meant. I understand that you have taken steps on site, but given that the buses that come to Ninewells do not deliver everybody to their door, people probably have to travel into the city centre to catch a transfer that takes them home. Have you given thought to people's safety while they are hanging round the town centre bus station late at night?
We work closely with the Tayside and central Scotland transport partnership and we are in close discussions with bus operators at bus strategy meetings to try to get operators to make changes. It is clear from responses to our travel survey from people who travel from outwith Dundee that buses from Blairgowrie or Forfar tend to go to the city centre before they go to Ninewells. We suggested to the bus operators that buses should go to the hospital before going to the city centre. We are fairly confident that the operators are looking favourably at changing schedules to save staff from having to pick up connections.
I prefix my questions by saying that I am vehemently opposed to hospital car parking charges, which I believe are a tax on the sick and on those who work with and visit them. Such charges go against the founding principle of the NHS, which is that services should be free at the point of delivery. That view is based on my experience of car parking charges at St John's hospital in my constituency. I cannot comment on experiences in Tayside and Glasgow, of course, but I would be interested to know what thought was given to ways of controlling access to car parks other than by the imposition of fees.
We have tuned the levels of charge to reflect different levels of salary and, indeed, the fact that some people work part time. One of the issues that has been raised and will be considered as part of the review is whether the differentials are at the right levels to ensure that those who are the highest earners pay sufficiently more for their space than others do. In the implementation of the policy, we have sought to recognise those differences in income and have set the charges accordingly.
Very similar arguments were advanced in Tayside. In 1998, the Ninewells decision was governed by the opportunity to obtain, through a PFI contract, significant capital investment that had not been available to the health board. The PFI contract was not about just car parking charges, but about building an infrastructure for car parking, which included a multistorey car park.
I do not know the Glasgow hospitals at all; I know the Grampian ones best and the Tayside ones reasonably well. The system in Grampian is not dissimilar to that in Tayside—the first half hour of parking in Grampian is free, then £1.50 is charged for up to about five hours, after which the price goes up. I visited Ninewells two or three weeks ago and was relieved to find a parking space close to where I wanted to be. When I was there, I was struck by the turnover. When I parked my car, I saw three or four cars leave that bit of the car park, and when I returned to collect my car, the same thing happened. I accept what has been said about turnover, which was obvious from my short visit.
In Glasgow we have worked closely with our clinical colleagues and out-patient departments to identify those categories of patients who would qualify for concessionary parking, which is free. Whether they qualify depends on the nature of their care and is detailed in the Executive guidance. We have also worked closely with the company that manages our car parks and we link that with the clinical service to issue a permit either for a single journey or a group of journeys, so that a range of patients—whether oncology, renal or other patients—receive free parking. That arrangement is extended to cover visitors of patients who are in intensive care units, cardiac care units, or who are receiving longer-term care. We also have arrangements in place to cover people who are in receipt of low-income benefits. We manage that through CP Plus, ensuring that the arrangement is made available to users of our sites as they come and go. That has worked successfully and, as it stands at the moment, that has been a particular success of our operational policy.
Is it seen to be hassle free by the people on the receiving end?
Yes, it is absolutely hassle free. To be fair to us, we put a lot of effort and time into making it a success—it did not happen by accident. Prior to the implementation of the policy, we spoke to our clinical colleagues and we identified the key groups of people who would be affected so that we could have in place the mechanism and the policy at the front end to help us on our way. That particular aspect of the policy has been successful.
Regarding your point about turnover, we have sought to be sensitive to that in the way in which we have structured the pricing charges. For the first two hours we charge a flat rate of £1. You were struck by the rapidity of turnover—for a lot of the high-volume attendances, not least the out-patient clinics, two hours will cover a significant majority of attendances.
In Tayside, we have similar arrangements for patients who need free permits. We work closely with our clinical colleagues, clinical team managers and senior charge nurses. The patient population that benefits from the permits is mainly oncology and radiotherapy patients, renal patients and such like. Those departments almost get a regular supply of permits—they know what patients are coming in. Other clinical groups can ask for permits as and when they are required; equally, they can recommend and request free-parking permits for relatives of patients who, for particular reasons, have long stays or need particular care. It works very well—although I did wonder how it could work without being abused, because as soon as a system is put in place, someone is on to it and trying to work a fast one.
Have you carried out any customer satisfaction surveys?
We use them a great deal. A patient partnership group, consisting of members of the public, regularly comes to Ninewells to carry out surveys and speak to relatives and visitors on a range of subjects. We usually encroach on the group and ask them to include a few questions on car parking. There has been a vast improvement in the response from patients and, especially, visitors, since we introduced the changes approximately a year ago.
Paul Martin has also raised this issue and he has attended the committee a number of times for that reason. I invite him to ask a question.
I wish to take Tom Divers back to his earlier remarks to the effect that the inspiration for the introduction of car parking charges was due to the number of complaints received from both patients and visitors. Can he provide us with the number of complaints in respect of Stobhill? I would not like to think that he introduced the charges as a result of anecdotal evidence, but that the decision was evidence based.
I do not have the numbers with me today but I am happy to get them. Many of the complaints from people who have had difficulty parking are handled by the clinical staff who see patients at a clinic or patients' visitors. I have received a small number of approaches and letters. I am happy to get further evidence.
That is an important point. For any professional organisation to implement a policy it would need to be evidence based; it cannot be anecdotal. It has always been expected of me that I would return to your office with evidence of complaints that I receive. You cannot provide anecdotal evidence alone to the committee—that is not sufficient. We need evidence of how many complaints have been received and of other difficulties. My experience of Stobhill hospital, both as a local resident and as a user, is that until the construction of the ambulatory care and diagnostic facility there were never any car parking difficulties. Prior to the ACAD project, I received no complaints about parking at Stobhill and never wrote to Greater Glasgow and Clyde NHS Board about the issue. I am not aware of other elected members having received such complaints.
The concentration of major capital projects around Stobhill has been greater than that at any of the other sites in greater Glasgow. Ideally, we would not have planned for four significant developments to be under way at the same time. We examined whether there was an opportunity for us to stagger the developments, without having a detrimental effect on the service improvements that we were keen to make, but that was not possible—not least because the prioritisation at United Kingdom level of the new Marie Curie hospice by one of the major funding partners, Marie Curie Cancer Care, was dependent on funding being accessed at a particular time. I know that Paul Martin is in touch with that development. The combination on one site, at the same time, of four major projects was always going to be substantially disruptive.
With the convener's indulgence, I will ask two further questions concerning the local community. You referred to a public meeting on the south side of Glasgow. I understand that that meeting took place at the behest of the local community and was not initiated by the health board—representatives of the health board were asked to attend the meeting. I am not sure whether you were trying to make that clear.
I would hate it to be thought that we were dumping the problem on anyone. The policy is a really important aspect of the provision of high-quality patient care and is designed to provide patients and their relatives with better and fairer access to the hospital. In my opening comments, I sought to acknowledge that in the original consultation that we undertook prior to the policy's introduction we may have underestimated the importance of engaging with community interests. It is not the case that there were no such interests—we received comments from a number of them—but the situation that has unfolded since implementation has given me pause for thought about how we can conduct such interactions better in the future.
The health board said that it has introduced these charges partly because of the green transport policy. However, how does reducing the charge to a maximum of £3 help to implement that? Given that that is what a return bus journey to the south side of Glasgow costs, surely the volume of traffic to Stobhill hospital—I have been using that as an example, but I am sure that the same can be said of the Southern general and other hospitals—will remain the same. Such a reduction is simply a token gesture. After all, if the aim is to implement the green transport policy, the charge might as well be reduced to zero.
The green transport policy is simply one part of what has driven the development of this strategy. As Paul Martin, who has closely followed our regular briefing sessions on the implementation of various service strategies in greater Glasgow, will know, we have been required to submit a campus plan for all the sites in the city of Glasgow that are covered by our acute services plan. That also involves meeting the requirements of the green transport policy. However, that is but one aspect of what has caused us to take this route.
But do you accept that the volume of car traffic going to and from the hospitals will remain the same? Making the parking charge the same as the cost of a return bus journey will simply not prohibit people from taking their cars to the hospital.
I am not in a position either to accept or to disagree with your point. As we made clear earlier to Mr Harper, we are still weighing up evidence from a series of measures.
As the witnesses from both NHS Greater Glasgow and Clyde and NHS Tayside have made clear, the health boards came up with the idea of car parking charges after considering alternatives, such as introducing parking restrictions at car parks. However, as Angela Constance has pointed out, the move does not sit well with the principle of the health service being free at the point of delivery. Why was it felt that there was no option other than to introduce such charges? Indeed, according to certain statements, NHS Greater Glasgow and Clyde initially considered charging £7 a day for parking. In that light, is the £3 maximum, as set out in the revised guidance, delivering dividends for NHS Greater Glasgow and Clyde? I realise that I have asked a couple of questions, but I hope that they can be dealt with.
In Tayside, the issue is straightforward. The decision to charge for car parking and to do so through a private finance initiative was taken to mobilise significant and rapid capital investment on the Ninewells site and to free up capital for schemes for direct patient care. That was absolutely the reason for mobilising the contract.
As I said, the £7 charge was, in essence, a deterrent. We did not want to charge anyone £7 a day for car parking, but we wanted to ensure that staff who did not have a permit did not bring their cars on site. As I said, the fact that the interim maximum charge has been set at £3, whereas we had £7 in our policy, has not impacted materially on the financial model that we developed, because we had no expectation that we would collect large numbers of £7 charges and no desire to do so.
We imposed a £10 surcharge in Tayside—we have now removed it because of the new guidance—because of the evidence that surcharging stops people parking. We were determined to put our patients and their relatives first and foremost. The evidence from our patients and their relatives is that that was enormously successful.
I will follow that up, as it leads me straight to the issue about the permits that have been issued to staff. I take on board Mr Marr's point that it is vital that patients and relatives who visit hospitals have parking spaces, but it is also vital that some staff who work in hospitals have access to parking, where necessary. Although there has been movement on pay scales in the NHS, it still has some of the lowest-paid workers in the country and charges are being levied on their low wages. I am concerned about the proportional impact on those individuals of the permits that are being issued. Do health boards take into account the type of workers when permits are issued? Is an economic impact assessment made when NHS boards levy charges from staff who work in hospitals, to ensure that the lowest-paid workers are not adversely affected?
I take on board that comment, but we have not yet considered that issue in NHS Tayside. We apply a flat-rate charge of £1.60 for parking for the day. We have 1,400 staff permits and the monthly charge is £25. We have not differentiated between low-paid workers and higher-paid staff. However, I would not rule that out; it merits some examination.
Earlier on, we discussed how we apply our permit charges. We have permit charges that start at £5 per month and go up to £25 or £40 a month, depending on an individual's earning capacity. For people who earn up to £10,000, the maximum charge for a permit is £5 per month. In addition, we acknowledge that many of the low-income staff on our sites do not have a business need to travel between sites and so that group of staff are less likely to need a permit to fulfil the requirements of their post. That is part of the allocation criteria and, so far, the logic that we have applied has appeared to be reasonable and fair.
I have another question for Greater Glasgow and Clyde NHS Board on travel between sites. I recently spoke to someone who travels between sites, although not between hospitals that currently have car parking charges in place. They said that travel from the Western infirmary to the dental hospital could be charged at a taxi rate. I know that this is outwith the issue of parking fees, but it goes back to Robin Harper's point about greener transport. Has the board considered getting people who are working off site to take public transport between sites rather than clock up car mileage? That might have an impact on who would require car parking spaces at various sites.
In certain parts of the board area we operate shuttle buses between various sites. Those buses are managed to a rigorous, tight time schedule and run frequently. There are good connections between the majority of our acute sites. Staff can access those services and thereby avoid the unnecessary use of cars or taxis. We also have in place a shuttle bus that connects certain sites with Glasgow Central station. That is another mechanism to reduce the need for car journeys. We are focused on that. We are looking at improving the car-share scheme and rolling out a pool-car system across certain sites to reduce the need for taxi travel and encourage shared journeys between sites.
We have piloted a pool-car scheme at Ninewells, which has been a great success and which we plan to expand. People do not have to come to work by car; they can use public transport, but there is a car available if they need to travel between sites. We have even put in two pool bicycles, but we are still waiting for the first one to go.
I have another question on the Ninewells PFI car park. The figure of £0.5 million was mentioned. Would that be the cost per annum to the health board?
Yes. Because of the nature of the contract—which I was not involved in—we reckon that the penalty for buying out the PFI scheme would be a one-off payment of somewhere in the region of £10 million.
Is that because the scheme still has 20 years to run?
Yes.
I see that £3 per day is the cost for a full day's parking at hospitals in Glasgow. What is the minimum?
The minimum charge is £1 for the first two hours. Then the charge rises on an incremental scale to a maximum of £3 for more than four hours, up to 24 hours.
Just so that we are clear, is it correct to say that Greater Glasgow and Clyde NHS Board charges by the hour, in effect?
The first two hours cost £1; between two and three hours costs £1.50; between three and four hours costs £2.50; and more than four hours costs £3.
That is because the rates are capped at the moment; it is not the rate that you initially wanted to introduce. If a patient attends a clinic that runs late, the patient will be penalised for the clinic, not them, running late. Is any account taken of the late running of clinics when a patient has waited longer than the designated time or has been directed to another clinic while they visited the hospital?
Yes. That could happen daily. The car park service is managed by our facilities staff, who are closely linked to our management company, which is called CP Plus. We recognise any detrimental effect on the patient or visitor in the event of a clinic overrunning or the appointment schedule running late and we ensure that no punitive measure is taken as a consequence of it. We manage that through our internal communication system.
Are patients notified that penalty charges can be claimed back or they can be exempted from them, whichever is the case?
Yes. Patients are notified at the point of service, generally by our clinical colleagues. If a clinic is running late, we tend to be informed by other colleagues and we pass the information on to CP Plus. If there was a slippage of communication for some reason, we would look favourably on any patient on whom a penalty was applied and ensure that we withdrew it.
The only element of our charging regime that was changed as a consequence of the CEL was the maximum daily charge, which was reduced from £7 to £3. The other elements of the pricing structure remain, including the fact that the charges do not apply beyond 9 o'clock at night. We have now altered the weekend position.
I have been quite patient today and I have allowed lots of questions to be answered, but I have a wee list myself. Is there any acute hospital site at which Greater Glasgow and Clyde NHS Board does not charge?
We apply charges to all the sites in Glasgow. That saw us through phases 1 and 2. We are now considering phase 3.
That is the city of Glasgow, at this stage.
The guidance that you have from the Government says:
The assessments that we have carried out on each of the sites thus far show that each has a level of car parking pressure that is not replicated in a number of the other non-acute hospitals. Between 45,000 and more than 80,000 patients come to their accident and emergency units each year and, between them, they have more than 1 million out-patient attendances. They are heavily used sites. As we work through the programme, the guidance requires us to carry out a structured appraisal on every site for which we believe that that is necessary. We will follow the guidance in the later stages of the process.
You and the other witnesses represent greater Glasgow and Tayside, so my worry is that citizens in our two poorest cities will be going to hospitals where there is charging. That is the reality of the evidence that we have heard, although I understand the history and why we have arrived where we are, due to a combination of assumed free access and the impact of the PFI programme.
NHS Greater Glasgow and Clyde is running a monthly trading account and we are looking at expenditure versus income. As of the year end, our surplus was just short of £90,000. That—
I am sorry to interrupt; I will rephrase my question. If you were to provide parking free of charge, how much would it cost as a percentage of your overall budget? The figure must be pretty low.
It is. It is £1.3 million against £1.8 billion.
Okay. I am not very good at counting, but I think that that is not a big figure in percentage terms.
It is 0.1 per cent.
But—
I am sorry to talk over you, Tom, but charging is an issue. Our case load as elected members tells us that.
It is an issue, but there is also what else we can do for direct patient care with £1.3 million.
I concede that point, but only as a debating point. You, as the health boards, and we, as elected members, are getting grief and all for £1.3 million. Surely the good will that free parking brings is part of the glue that binds people to the health service. As Gerry Marr said, the debate is an emotional and philosophical one. You have had to come before a parliamentary committee to defend a spend of only £1.3 million. We are interrogating you because our constituents are—rightly—interrogating us on charging as a percentage share of overall budgets. Given what constituents have told me and other members, what patients are telling you, and what staff have said in the submissions that we have received from trade unions, is charging really worth while?
Contrary to public perception, guys such as Gerry Marr and me do not set out to create upset and unhappiness. That is not what brought us into these roles.
Thank God for that.
You are right about the merit of the point as a debating point—£1.3 million is a significant sum. Our view is that it should be used to deliver direct patient care. I say that notwithstanding the fact that, as you said, I and Gerry Marr have responsibility for some of the poorer parts of Scotland. Our policies are designed so that we do not penalise those who are on income support or incapacity benefit. We try to make our policies as sensitive as possible to the issues. However, £1.3 million buys a lot of direct patient care.
I endorse what Tom Divers said. We have implemented car parking charges on the two sites in Tayside that require intensive traffic management—which is an issue that must not be underestimated. Other sites in rural parts of the region or city-centre psychiatric hospital, learning disability or elderly units do not require the same level of traffic management. We have restricted charging to car parks where traffic management is required. The question is: do we provide such traffic management on the NHS or by levying a charge? As I have said, we determined that we should do it by way of a charge, and that decision has released funds for, for example, somewhere between 70 and 80 hip replacements a year.
Okay, but surely £1.3 million is not an overwhelmingly significant figure given overall NHS expenditure on bureaucratic elements such as administration. What would you say if you were engaging with Government ministers on the subject? In Wales, the Administration has chosen to go down the path of not having charging at hospitals. Would you welcome the Scottish Government making that commitment if there was no impact on your overall budgets?
We would be placed in severe difficulties because of the nature of the PFI contract.
But you could seek discussions with Government on how to address that over a long period of time. For example, it could be managed through the grant allocation. Have you raised that with ministers?
We have not raised that as yet.
Should you?
This is the first time that the issue has been raised with us. I need to reflect on it, although I do not discount the suggestion. You make a valid point, convener. We need to consider it.
When I was a student, I worked at Stobhill during the summer holidays. My mother was a cleaner and my father was a porter at the hospital, so I have an emotional interest in the debate. One of my duties was to work as the gateman, which was a fantastic overnight shift, given the slice of life that one encounters in Paul Martin's constituency. We had a boom system. My duty was to ensure that no one whom we did not know got in or out. I know that you will say that that was 25 or 30 years ago, but the important point is that good behaviour was expected of residents and visitors when they entered hospital grounds.
Car park charging is an essential component of intensive traffic management. We know what the volume of traffic is. When I left Ninewells hospital to come here this afternoon, I drove past cars that were queueing to park. This morning I was at PRI, where I drove past cars that were queueing to park. I have no doubt that if we did not have car parking charges, the car parks would be full before the first patient arrived for a 9 o'clock out-patient appointment. I see car parking charges as part of a traffic management system.
We are having a notional debate about car parking. Is the important issue not managing access to the space, which need not include an element of charging? The point is for your structures and for the staff who are employed at the hospital to have the capacity to manage access. I am thinking aloud. The period to which I referred may have been a golden age, but management by staff prevented excessive misuse of car parks.
We are keen to learn from the Welsh experience. We are intrigued by how the Welsh have managed to address the issue. I know that many car parking schemes in Wales were private finance initiative schemes, so I would be interested to find out from those in the Welsh Assembly how the measures that have been introduced were managed fiscally, which must have been a significant challenge. We do not have that information.
It was important for me to put to you the questions that I have asked, as those are the questions that the public ask us all the time. People see accessing hospitals as different from accessing multiplexes and other public spaces. They have a powerful sense that when they are trying to visit people who are unwell, they should not be harassed by guys in yellow coats.
I do not think so. I hope that our exchange has been of value to the committee. We acknowledge entirely that car parking charges are a difficult, sensitive issue. I hope that both of us have indicated that we will keep the arrangements under review. I have promised to follow up on one or two specific issues that Mr Harper and Mr Martin raised. I am sure that the committee will look forward with interest to the series of reports that NHS Scotland will make early in the summer.
Are you obliged to respond to the Cabinet Secretary for Health and Wellbeing by 30 June?
That is the point to which I was alluding.
I reinforce Tom Divers's comments. We are grateful to have had the opportunity to rehearse the debate in public during this afternoon's exchange. We will take members' comments on board.
Thank you for your time this afternoon. I hope that your car parking charges have not expired.
Not on the train, convener.
Your office is right in the city centre.
It is important that we continue with these petitions. In my experience—I say this with no disrespect to the gentlemen before us today—getting transparency on the income and expenditure associated with car parking charges at hospitals has been rather fraught and difficult. Collectively, we would be doing a good service to our constituents if we were to give the issue some scrutiny. All NHS boards have to reply to the minister by the end of June, so it would be good to get a flavour of that and to find out how the minister responds.
Could we find out from Wales how the matter is managed there? It must have the same problems with the size of car parks, the number of people trying to park and people using the free parking at hospitals as cheap parking for the day while they go off elsewhere, because there are usually good bus services. We cannot take those issues lightly, and it would be good to find out how people in Wales have overcome, or are working to overcome, such problems.
The discussion will be in the Official Report, but we need to ensure that the Government gets the complete record of what has been said this afternoon, so it can consider that as part of the review.
We must pursue with vigour the issues that Mr Divers assured us he would follow up on, in respect of the complaints received. I am concerned about how he will present his response to us. I do not have any difficulty with his providing a copy of the complaints and redacting the names and addresses of the individuals. I would like committee members to see quality evidence that large volumes of complaints about car parking were received. I am not saying that I do not believe Mr Divers, but he must provide the evidence.
Paul Martin is right—we need to get some indication of the level of complaints that brought about the introduction of car parking charges in greater Glasgow. We also need information on the level of usage of the car parks, because we need to get that in proportion to the level of complaints. It is easy enough to say that a number of complaints were received, so car parking charges were introduced.
Those suggestions are helpful.
Hospital car parks are being misused. As one of the witnesses made clear, if there are no charges, the car parks will simply fill up before the first patient turns up. The fact is that the management of the car parks is not working properly; if it were, we would not have this problem.
Have I missed anything in my summary? I hope that the evidence session has been useful. This is one of those issues that tend to bop around without anyone getting a chance to examine how we reached this point.
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