Health and Sport Committee

Meeting date: Wednesday, March 17, 2010

Official Report 502KB pdf

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Subordinate Legislation

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National Health Service (General Dental Services) (Scotland) Amendment Regulations 2010 (SSI 2010/33)

I welcome the opportunity to address the committee on the issue of continuous dental registration. One of the commitments in “An Action Plan for Improving Oral Health and Modernising NHS Dental Services in Scotland”, which the previous Administration published in 2005, was to make dental registration a continuing and not a time-limited system. The regulations that we are discussing today represent the final step in achieving that commitment.

The key principle that underlies this aspect of the dental action plan and our policy approach is that there should be no automatic ending of registration after any given period of time. The continuous, lifelong relationship that that encourages is entirely consistent with arrangements elsewhere in primary care, such as general medical services and, in pharmaceutical services, the development of the chronic medication service.

The development of a longer-term, more stable relationship between a dentist and patient fits with the need to plan care on a long-term basis and to monitor oral health over time. The better known the patient’s history, the more likely the patient is to be treated appropriately, whether that is related to the development of periodontal disease, the replacement of restorations or the monitoring of pathological changes to the mucosa. Encouraging that relationship for all, instead of only for those who, historically, have been regarded as regular attenders, should bring significant health benefits as part of an overall strategy to improve attendance.

However, we recognise that registration itself is not the whole story; it is just one of the markers that indicate how available patient access to practitioners is. For instance, we are interested in not only the percentage of children registered but what happens to those children when they go to the dentist. We have therefore introduced a new health improvement, efficiency, access and treatment—HEAT—target, which measures the numbers who are getting preventive treatment. Similarly, with adults, we are looking at participation as a further indicator of the care that adults are accessing.

We also recognise that patients have a responsibility to attend their dentist when required. To that end, we are working with health rights information Scotland on an update to our leaflet, “Registering with a dentist for NHS treatment”, on what a patient should expect from his or her dentist and what a dentist should expect from his or her patient. I am pleased that the British Dental Association Scotland is working with us on that update.

In parallel, we are working on the development of an oral health assessment, which should address the BDA Scotland’s concerns about the further development of a preventive approach to dentistry.

Through the childsmile programme, we are already developing a comprehensive approach to preventive dentistry for children. We have delivered early the HEAT target that 80 per cent of three to five-year-old children should be registered with a dentist by 2010-11.

The strategy set out in the dental action plan, plus this Government’s work since taking office, has resulted in positive improvements in oral health, an increased dental workforce and better access for patients, but, of course, there is more to be done. By completing the dental action plan commitment to introducing continuous dental registration we will make a significant contribution to further deliver patient care with a consequent improvement in oral health. I will therefore oppose the motion that Mary Scanlon lodged.

We could do that. Is there any reason why we could not?

We will certainly see what can be done.

We view it as a shared responsibility to improve oral health. The patient information leaflets that we are working on with the BDA send out a clear message that patients, too, have a responsibility to attend.

The difference is that there will be no automatic deregistration. At the moment, a person who has not attended after a certain period is automatically deregistered. In future, although the dentist will retain the right to deregister patients, as do general medical practitioners if they give a certain amount of notice, that will no longer happen automatically. That is important, because those patients who are least likely to attend on a regular basis tend to come from the most deprived communities. We therefore need to do work beyond the patient leaflet and we will encourage health boards to do some specific work in the most deprived communities to get the message across that the best way to maintain good oral health is through regular attendance at the dentist’s.

I understand the need for a per patient fee, but if a dentist was able to provide regular check-ups and so on to, say, 400 patients—I do not know what sort of number of patients dentists deal with—but could get a small fee for another 400 irregular attenders, who could never be made full attenders because of a lack of capacity in the practice, the dentist would almost have an interest in having that additional list to attract some extra money. Do you understand what I am driving at?

Under the Scottish dental access initiative, we give grants to dentists to set up or to extend practices. Typically, one of the conditions is that each dentist would need to get 1,500 extra patients, which we think is a manageable number.

We have arranged to give dentists prior notification of when people are due to lapse and be moved to 20 per cent of the capitation fee. The dentist will then be able to decide whether to make an effort to get the patient to return, in which case the fee would go back up to 100 per cent. In a way, that will help dentists to manage their practice lists.

The practice would get 100 per cent of the capitation fee if those patients came back.

We have agreed with the BDA’s Scottish dental practice committee to joint monitoring of the arrangements from 1 April, so we will be able to pick up on any problems such as the issue that Rhoda Grant has raised. At the moment, dentists will know what capacity they have within their premises. As I said, the patients for whom dentists receive 20 per cent of the capitation fee will not all arrive requiring emergency treatment at the same time. Like the previous Administration, we feel that it is important that the relationship between the dentist and the patient can be built up over time. At the moment, that relationship ceases because of an arbitrary timeframe, so the dentist has no opportunity to develop the relationship to persuade those people to attend on a regular basis. We believe that that approach is wrong-headed. It is also out of step with the way in which other primary care services are delivered.

That has not really answered my question, but I think that I will take up the matter in writing.

I think that the question has been answered, but I accept that Rhoda Grant may take a different view.

We have fully aired the matter, and I want to move on.

Agenda item 2 is a debate on motion S3M-5939 to annul the regulations. I invite Mary Scanlon to speak to and move the motion.

Thank you, convener.

The regulations, which will introduce continuous registration for all dental patients, were brought to my attention by high street dentists; if they had not done so, I think that I would simply have nodded them through. I then sought advice from the British Dental Association Scotland.

The Government’s Executive note that accompanies the regulations states under the heading “Consultation”:

“The British Dental Association Scotland and the Scottish Dental Practice Committee have been consulted on this issue.”

What was conveniently missed from that statement is that almost 90 per cent of dentists who responded to the survey are fundamentally opposed to the regulations. It would have been not only honest, but helpful if the minister had notified the Health and Sport Committee and the Subordinate Legislation Committee of the response to the consultation.

For the sake of clarity, let me refer to some comments from dental professionals. The BDA was publicly critical of the decision, and reiterated concerns that it had previously expressed that continuous registration encourages patients to neglect their oral health, sends the wrong signal about the value of preventive care,

“devalues the relationship between clinician and patient”,

and could lead to an increase in undetected cases of oral cancer.

The BDA’s Scottish dental practice committee, which is the body elected to represent high street dentists throughout Scotland, has consistently warned of the issues that continuous registration raises. It has stated that continuous registration

“does not encourage a pattern of regular attendance”.

It also objects on the basis of capacity issues, patient expectations and perceptions, the possible detriment to existing registered patients, and the disruption to practices that will be caused by non-regular attending patients who require emergency care. It has pointed out that the change is a politically expedient way of artificially improving the statistics for the number of people in Scotland who are able to access NHS dentistry.

The National Institute for Health and Clinical Excellence recommends a maximum interval for dental check-ups of 12 months for children and 24 months for adults. Given that longer intervals between dental check-ups increase the likelihood of a patient requiring more complex treatment, I think it erroneous to compare the NICE recommendations to a patient’s attendance at a general medical practice. There are no recommendations stating that an adult must visit a GP every 24 months.

That is what the BDA says. I will share with the committee a Highland dentist’s views, which were published in the professional magazine, Dentistry Scotland. He says:

“The Minister for Public Health will continue to stand up in the Scottish Parliament and report on the record breaking dental registrations figures—she has ensured she will be spared the embarrassment of having to report on the thousands of lapsed registrations that would have occurred each month”—

he quotes a figure of 26,000 for one month alone—

“due to patients failing to attend their dentist at least once in ... 3 years.

Simply saying that patients will not be de-registered does not mean an improvement to access in NHS dental service—neither does it improve dental health or encourage a higher standard of oral hygiene.”

This dentist goes on to state:

“From a public health perspective this is a retrograde step—with life threatening conditions such as oral cancer on the rise, early detection is essential. If the patient can’t be bothered to respond to ‘recall’ letters when requested, nor attend even once within the existing 3 year period—why should we be obliged to care for them at all let alone provide them with all the benefits of registration for 19 pence a month?”

In that respect, though, I note that the minister said that the figure is 60p a month.

“Life time registration has nothing to do with building a long term continuing relationship with our patients—and everything to do with political manipulation of the registration figures for propaganda purposes.”

I repeat that those are not my words, but those of a dentist.

Finally, the dentist states:

“A number of my colleagues also stressed the necessity to review their emergency cover arrangements as they felt that patients would not distinguish between emergency, urgent and routine treatment—others stated that they would move out of the NHS or reduce the NHS element”

of dental services.

Continuous registration is more likely to close the list to new patients and therefore likely to increase waiting lists in areas where they exist. That, in turn, means less, not more capacity, because the dentists constantly have to keep space open for those who might at any time turn up for emergency treatment.

Finally, we come to the cost of these regulations, which has been set at £2.4 million. That money could be used effectively to increase access to between 20 and 40 new dentists, depending on whether they are salaried or are in general dental practice.

In my constituency, we had huge deregistration that happened in a matter of a month or two after the registration period had lapsed. No leniency or flexibility of any sort was shown, and that created huge anger. My office is knee deep in files full of my constituents’ anger at the way in which we have not looked after the nation’s dental health. I do not think that any politician around the table will ever do enough to improve the nation’s dental health. Poor dental health does not just impact on a person’s teeth; I am told by my dentist that it can impact on heart disease and a range of other aspects of a person’s bodily health.

For me, we are taking a step in the right direction today. I hear what Mary Scanlon is saying and what the concerns are. I am concerned to hear that 80 or 90 per cent of the dental profession does not agree with the regulations. Nevertheless, many of my constituents have been driven to blazing anger at the fact that no Government will ever do enough on the issue of dental health. As parliamentarians, we have a huge responsibility to fight constantly for improved dental health. Although £2.4 million is a lot of money, it is not enough—we need to spend more. We have salaried dentists in Fife and we have new dental clinics, thanks to Lewis Macdonald when he was a minister. He listened to the campaign in Fife and it was great to get £4.5 million, but it is simply not enough. Therefore, I will vote for the motion, not because it is enough, but because we need to do more.

On a point of clarification, dentists will be able to deregister patients, but they will have to give three months’ notice. Dentists will retain the right to do that, as doctors are able to, but the difference is that it will not happen automatically as it currently does. The relationship of a dentist with their patients will be similar to that of a doctor.

For further clarification, I presume that the conditions under which dentists would deregister patients would not include simply non-attendance.

No—a doctor or a dentist can deregister patients for a variety of reasons, as long as they give three months’ notice.

Just for clarification, there is not a loophole by which a dentist could deregister a patient with three months’ notice just for non-attendance.

We could bat that back and forward for a full morning, but we have a busy schedule and have probably had enough.

Good morning and welcome to the ninth meeting this year of the Health and Sport Committee. I remind everyone, including people in the public gallery, to switch off all mobile phones and other electronic equipment. Apologies have been received from Dr Richard Simpson and I am pleased to welcome Frank McAveety, who is substituting for him.

Item 1 is an oral evidence session on the National Health Service (General Dental Services) (Scotland) Amendment Regulations 2010 (SSI 2010/33), which amends the existing National Health Service (General Dental Services) (Scotland) Regulations 1996, so as to remove provisions that allow a continuing care arrangement or capitation arrangement to lapse. Members have a copy of the regulations with their papers for the meeting. The Subordinate Legislation Committee did not have any comments to make on the instrument.

The Minister for Public Health and Sport, Shona Robison MSP, is present. She is accompanied by Margie Taylor, chief dental officer; Eric Gray, branch head, dental, ophthalmic and fraud policy branch; and Lynne Morrison, senior policy officer, dental, ophthalmic and fraud policy branch, of the Scottish Government primary and community care directorate.

A motion that the committee recommends that nothing further be done under the regulations has been lodged by Mary Scanlon MSP and will be debated following the evidence session. As members are aware, once that debate has begun, the minister’s officials will not be able to participate. I invite the minister to outline the regulations briefly.

What we could do is divide the numbers into areas of deprivation by postcode, using the Scottish index of multiple deprivation. We should be able to get that information and give it to you.

The capitation fee for keeping patients on the books will reduce to 20 per cent of the full fee. That equates to about 2p per patient per day. We believe that that is a worthwhile investment to keep the relationship between the dentist and the patient. It is difficult to work out whether it will save money, because if a patient becomes a regular patient, which is what we want to happen, the fee would go back up to 100 per cent. We will have to monitor that over time and ascertain the impact either way. We certainly encourage people to become regular attenders, which brings a reinstatement of 100 per cent of the fee.

Are the regulations intended to remove responsibility for the oral health of the population to dentists, so as to encourage them to recall patients?

You are right about deprivation. A practice in my constituency that covered a number of areas decided six or seven years ago to deregister patients. There were no other dentists in those areas for some of my constituents to go to. A massive number of people in the Dunfermline East constituency were affected and I have been monitoring the matter closely. I was pleased that the then minister gave Fife £4.5 million to help us improve the situation, and seven or eight new dental surgeries were established as a consequence, with 30 salaried dentists from Poland. I shall continue to watch the situation very carefully.

I have a list with me of investments in Fife, which I can pass to Helen Eadie if she would find that helpful. It covers what has already been invested, certainly under our Government, as well as some planned investments under the primary medical capital fund. Dentistry has received the vast bulk of that, and there are planned future investments in Fife.

I would welcome that. I agree that we need to work harder and harder in this area. We cannot let up on the issue, which is critical for our nation’s health.

It would be handy to have had that as a parliamentary question and a written answer, but there we are.

I have a supplementary question following one of your answers to Helen Eadie, minister. I might have picked you up wrongly, but my understanding of what you said is that people who attend their dentists regularly for check-ups and so on will attract 100 per cent of the fee that is allocated to them, whereas people who remain on the dental lists but who do not attend regularly will attract 20 per cent of the fee.

Does that not almost create a reverse incentive for dentists? Every dentist who treats their patients regularly will operate at capacity. If they are being paid for having lapsed patients, is there not in effect an incentive for them not to noise up the lapsed patients too much, because they get a fee for them without any impact on their work? That allows them to go ahead at full capacity, pulling in those patients who attract the larger fee while maintaining a large base of folk who attract at least some fee for nothing.



10:15

Dentists manage capacity within their surgeries all the time. They will know that the patients for whom they receive 20 per cent of the capitation fee will not all turn up at the dental surgery at the same time on a Monday morning to demand treatment after having received none for three years. It does not work like that. The dentists would try to build in requirements to ensure that those patients come back in dribs and drabs.

Until now, if a patient on the list lapsed, the dentist’s capitation fee for that patient automatically stopped. Under the new set-up, we will move to a situation in which the dentist will still get 80 per cent of the fee. Is that what we are saying?

But the dentist will get the other 80 per cent if the patient then comes back. Therefore, dentists will be paid 20 per cent of the capitation fee irrespective of whether the patient comes back.

We will pay them 2p per patient per day to keep those patients on their books so that there are relationships between dentists and patients. It is the same in primary care. A person might not go to their general practitioner for five years, but they are still able to see them because they are a patient at that practice. Unfortunately, there has been a different relationship in dentistry, but we believe that, once they are registered, people should have a similar ability—they should have a right to see their dentist, although they might not have been within the timeframe that was set. We believe that 20 per cent of the capitation fee is worth paying in order to maintain the relationship between the patient and the dentist.

Have the sums been done? What is the estimated cost for the dentists in my constituency, for example, or throughout Fife or Scotland? Have there been cost breakdowns? Can you provide information on that in writing to us after the meeting?

There is some support from Helen Eadie, minister, which is good. Will you respond, please.

I will start with the issue of consultation, which is important. We first began discussions on the issue with the BDA and the SDPC on 19 November 2008, so we have been discussing the matter for a long time. Following those discussions, we wrote to them on 3 March 2009, proposing continuous registration. The SDPC voted on the proposal for continuous registration and accepted it, albeit by a narrow majority. We felt that that was the agreement of the profession, so we then got on with drafting the regulations. It was only after that that the survey to which Mary Scanlon referred was carried out, in which 90 per cent of respondents were opposed to the regulations. I point out that only 48 per cent of those who were surveyed responded at all, so we must be slightly cautious about that figure. When I speak to dentists, the first thing that I am asked about is decontamination and related issues rather than continuous registration.

When the proposal was first mooted, back in 2005, the BDA and the SDPC agreed with the dental action plan, in which continuous registration was explicit, and they raised no objection whatever. It is fair to say that the profession did not express major concerns about continuous registration either back in 2005, under the previous Administration, or when this Government began negotiations in 2008. It did so only on the back of the survey.





At the end of the day, Governments must make decisions about policy. The regulations meet the commitment that was given in the dental action plan of 2005. Helen Eadie described better than I can the impact of deregistration on individual patients. Patients require their oral health to be looked after, regardless of whether they have attended within the artificial timeframe that was set under the previous policy. It is right and proper that we ask general dental practitioners to play their part in doing that. We have emergency centres, but we should also expect GDPs to play their part in looking after the oral health of such patients, many of whom are among the most deprived.

Mary Scanlon says that the use of registration figures is politically expedient. In my opening remarks, I said that we will publish participation rates that ISD will formulate; those figures will show access to dentists. The registration figures will show those registered, whereas the participation figures will show the level of attendance at dentists, so people will be able to see the level of activity.

I agree with Helen Eadie that we need to expand access to dentistry. There has been a 10.7 per cent increase in the number of dentists. Dental surgeries and new dental centres have opened the length and breadth of Scotland. There is still work to be done, but access is improving.

The cost of £2.4 million must be set in context. In 2008-09, we spent £355 million on dentistry, so there is significant investment in the area. The element that we are discussing, which equates to 2p per patient per day, is a price worth paying to keep the link between the patient and their practitioner.

I hope that I have addressed most of Mary Scanlon’s points.

For the record, I make clear that I meant to say that I would vote for the regulations and against the motion to annul.

I was going to say that anyway, Mary. I am sorry, Helen—I am getting you muddled up with Mary this morning. I am just as muddled as you are.

First, I must correct Ian McKee on a point that he made. If he reads my remarks in the Official Report, he will find that at least 50 per cent of what I said was concerned with oral health and patient registration—it was not 100 per cent about the producer. Dentists, like doctors, are more than capable of speaking out on behalf of their patients and of talking about oral health, hygiene and public health in Scotland. As parliamentarians, we should respect that. Ian McKee is concerned to ensure that patients are seen more quickly; he gave an example from Wester Hailes. If the £2.4 million were used to employ up to 40 new dentists, there would undoubtedly be an increase in access.

My second point is directed to Helen Eadie. There seems to be an assumption that continuous registration guarantees better oral health, but it does not do that one bit. As dentists and the BDA say, it guarantees that people will see dentistry as an emergency service and not take the best preventive care, as we would hope.

The minister referred to the consultation. I was careful to say that 90 per cent of dentists who responded to the survey were fundamentally opposed to the regulations; the minister and I are in agreement on that point.

With regard to the impact on patients, the point is that a general dental practitioner or a salaried dentist will not be able to deregister patients in future. I appreciate what Helen Eadie has said about that. However, a dentist might have 2,000 patients on their list, and another 1,000 who have not attended for more than three years but who can come back at any time during their lifetime for emergency and potentially complex treatment. The dentists therefore have to keep capacity on their lists for all that emergency care that will result from continuous registration. They have told me that they will have to close their lists, because those people could turn up at any time.

The £2.4 million may be a drop in the ocean in comparison with the overall cost of dentistry in Scotland but, in these difficult financial times, that money could increase access by funding the employment of between 20 to 40 dentists.

But if there is a breakdown in the professional relationship—

No.

That is a critical point that the dentists have raised: patients cannot be deregistered due to non-attendance. That point is at the heart of the SSI.

I have got more muddled as the discussion has gone on. You are telling me that dentists can still deregister people for non-attendance but that there is now a requirement for three months’ notice, so deregistration is not automatic.

Yes.

Is that clear to everyone around the table?

Members indicated agreement.

I think that Mary Scanlon is content now that that has been clarified.

Yes.

The question is, that motion S3M-5939, in the name of Mary Scanlon, on the National Health Service (General Dental Services) (Scotland) Amendment Regulations 2010, be agreed to. Are we agreed?

Members: No.

In future, will the Government publish the number of people—children and adults—registered with a dentist, divided into high and low capitation fees?

That would be helpful. As you know, one of the problems that the committee and the Parliament face is getting the appropriate data. Sometimes the data are not held centrally. It will be important to monitor that information in future years, so I would appreciate it if we could get it.

How much does the Government expect to save by this move? Am I right in saying that the capitation fee is lower as time goes by—after three years?

I am not sure that I follow the question.

At the moment the Government has a responsibility to encourage the population to maintain good dental health. Is it your intention to remove that responsibility from central Government to dentists so as to encourage them to recall patients?

That is correct. After three years the dentist will be notified of people who will be moving to the 20 per cent capitation fee. Those are people who, currently, would be deregistered. We have agreed with the dental profession that the 20 per cent fee will be paid, basically for the dentist to keep those patients on their books so that they can get treatment when they return. Effort is required on the part of all of us to encourage those patients to return.

No, because as soon as such a patient turns up for treatment, the dentist can get 100 per cent of the capitation fee instead of 20 per cent. Therefore, dentists have a financial incentive to get those patients to come back for regular treatment.

I do not think that you understand what I am driving at. My worry is that dentists will be almost encouraged to have many lapsed patients on their books, for whom they will get a small fee. If a dental practice does not have the capacity to increase the number of patients who might be regarded as full payers, will the practice not have an incentive just to keep those patients on the books so that they can collect that small fee?

There will be an incentive to increase capacity, given that there is provision to give dentists grants to expand. From a purely business point of view, dentists will now have a reservoir of patients whom they could bring in if capacity was increased, so they might decide not only to see those patients for whom they receive the full capitation payment but to create more capacity to accommodate those for whom they receive the 20 per cent payment.

No, the dentist will get 20 per cent of the capitation fee.

Sure.

Mary, are you still quoting or are you speaking your own words?

The comments on the cost of the regulations are my words, not those of the Highland dentist. In fact, when I talked about continuous registration being more likely to close the list, those were my words as well.

I will repeat what I have just said because the point is important. The £2.4 million cost of the regulations could be used to increase access to between 20 and 40 new dentists, depending on whether they are salaried or GDP; reduce waiting lists in areas where they exist; and take tens of thousands of people off dental waiting lists.

Each health board in Scotland has an emergency dental service. I know that, because I used such a service while I was on a waiting list for an NHS dentist in Highland. People who have not visited a dentist for more than three years have the same access to emergency dental care as all other patients in Scotland, no matter whether they are registered and attend regularly, are on continuous registration or are on a waiting list.

The fact is that the regulations improve neither access to dental care nor, as the BDA has pointed out, oral hygiene. As a result, I move,

That the Health and Sport Committee recommends that nothing further be done under the National Health Service (General Dental Services) (Scotland) Amendment Regulations 2010 (SSI 2010/33).

I should have reminded members that we have a maximum of 90 minutes for the debate. Of course, we might not use all that time.

This is a classic producer versus consumer issue and, not for the first time, I have listened to Mary Scanlon concentrate 100 per cent on the people who provide the service, rather than on those who use it. I want to take an entirely different angle to the matter.

For many years, I worked as a GP in an area of multiple deprivation where dental health was absolutely appalling. The people in the area had—and, indeed, still have—to overcome many income, housing, education and other problems and very often dental care was put further down the list of priorities than perhaps you or I might think it should have been.



10:30

In a middle-class area, of course people will go to their dentists, keep their dental appointments and keep their registrations up to date, but that is not necessarily the case in areas such as that in which I worked. Time and again, I and our health visitors and nurses persuaded someone to go for dental care only to find that their registration had lapsed and they were unable to make an appointment with their dentist—the list was closed and they could not be seen. Yes, people can get emergency dental care if they can work the system, but in many parts of Scotland it is very difficult to access emergency dental care. Someone can ring their dentist and get no reply at all. In Edinburgh, the Western general hospital provides an emergency service, but only at certain times and people have to get there. In any case, what we are talking about is not emergencies, but the prevention of emergencies.

If people who have registered are kept on their dentists’ lists, whether or not it is three years since they have seen the dentist, then when health visitors, GPs and others are able to persuade them to go for dental treatment, it will be available. If they are deregistered, it will not be available. Therefore, I disagree with Mary Scanlon’s proposition.

The minister wants to come back in; I will then let Mary Scanlon back in if she wishes.

There are a variety of reasons why someone might be deregistered.

They can deregister patients for any reason. There is no bar on dentists deregistering someone, whether it is because that person has a bad debt, or for another reason; it does not matter. There is no explicit list of reasons that states that a dentist can deregister someone for this or that reason.

A dentist will retain the right to deregister someone for whatever reason they so wish. The difference is that it will not happen automatically after a fixed period of time; the dentist would have to actively make that decision themselves.

Do you wish to press the motion?

There will be a division.

For

Scanlon, Mary (Highlands and Islands) (Con)

Against

Eadie, Helen (Dunfermline East) (Lab)

Finnie, Ross (West of Scotland) (LD)

Grahame, Christine (South of Scotland) (SNP)

Grant, Rhoda (Highlands and Islands) (Lab)

Matheson, Michael (Falkirk West) (SNP)

McAveety, Mr Frank (Glasgow Shettleston) (Lab)

McKee, Ian (Lothians) (SNP)

The result of the division is: For 1, Against 7, Abstentions 0.

Motion disagreed to.

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Pharmacy Order 2010 (Commencement No 1) Order of Council 2010 (SI 2010/299)

Are members content not to make any recommendation on the order?

Members indicated agreement.

Item 3 is consideration of two negative statutory instruments. Members have copies of both instruments with their papers. The Subordinate Legislation Committee had no comments to make on either of them.

The first instrument is an order that brings into force amendments to schedule 6 to the Health Act 2006, which will enable the Appointments Commission to exercise the Privy Council’s functions to appoint members of the General Pharmaceutical Council. Do members have any comments on the order?

Members: No.

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General Pharmaceutical Council (Constitution) Order 2010 (SI 2010/300)

The second negative statutory instrument is an order that makes provision with regard to the constitution of the General Pharmaceutical Council, such that it will consist of seven registrant members who are pharmacists or pharmacy technicians and seven lay members. It also makes provision on other issues such as the limits on the period for which members may serve on the council.

Do members have any comments on the order?

Members: No.

Are members content not to make any recommendation on the order?

Members indicated agreement.

10:45 Meeting suspended.

10:46 On resuming—