Public Petitions Committee

Meeting date: Tuesday, April 17, 2012

Official Report 473KB pdf

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New Petitions

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Public Sector Staff (Talents) (PE1423)

Good afternoon, ladies and gentlemen, and welcome to today’s meeting of the Public Petitions Committee. I ask you all to switch off mobile phones or other electronic devices, because they interfere with our sound system.

There are four new petitions for consideration. The first is PE1423, in the name of Gordon Hall, on behalf of the Unreasonable Learners, on harassing—sorry—harnessing the talent of public sector staff. That was perhaps a Freudian slip. Members have a note on the petition from the clerks, which is paper 1, a briefing by the Scottish Parliament information centre and a copy of the petition.

I welcome the witnesses: Dr Tony Miller, from the school of engineering at Robert Gordon University; Mike McCarron, from the Transform Drug Policy Foundation Scotland; and Andy Lippok, the director of Resolis Associates Ltd. I invite Tony Miller to make a short presentation. You should take around five minutes, after which we will move to questions.

The Unreasonable Learners are a group of people from various backgrounds who are academics and consultants from all sectors of the economy. What unites us is that we think that the way forward for Scotland is through the energy and creativity of the ordinary person and that for that to happen we must address the current management philosophy that delivers public services. There are therefore two ideas: first, releasing the energy and creativity that is out there but is imprisoned at the moment; and, secondly, requiring a new level of thinking about management to do that.

We see Scotland as a country that suffers from certain chronic conditions that despite our best will and intentions remain stubbornly challenging. They include low levels of literacy in schools, the problem of drug abuse, the high numbers of the prison population, the lack of start-up companies in the private sector and the lack of innovative thinking in the public sector. The focus of our petition, however, is the amount of ineffective spending and misdirected effort in the public sector.

The Christie commission considered the delivery of public services and, in general, its proposals meet with our approval. Sadly, our view is that that laudable initiative will not deliver the expected improvements, because there are unseen obstacles. Those are the unacknowledged assumptions that currently underpin our management thinking and which lead to management that is based on targets and to a culture of compliance. Those common assumptions, which perhaps we should call theories, will continue to frustrate our best efforts until we start identifying, discussing and challenging them.

As evidence that that is the case, our members reported on change initiatives that they had experienced. Although they were as usual backed by good intentions, they were implemented through a management system using ideas that—ironically—frustrated the effectiveness of the good intentions. So, the policy was good, but the management thinking to implement it frustrated achieving the outcomes that should have come from the good policy.

Also, we found that even when changes were successful, which often occurs when outside consultants and new thinking come into an organisation—sometimes impressive gains are shown—over time the old assumptions reasserted themselves and the good work was undone. Again, we have evidence of that, and we can discuss it later.

The petition is our attempt to start a process of revealing those underlying assumptions—those management theories—that, unbeknown to those holding them, serve to create inefficiency and waste in the delivery of public services.

If we are successful with the petition and everything goes to plan, our idea is that, focused on this one particular issue of waste in the public sector, we hope to move the conversation from methods to theories. If that is successful, we can progress to the other chronic conditions that I mentioned, which are in the grip of similar ineffective theories.

Thank you for your interesting presentation, Dr Miller.

I have not previously come across some of those concepts but, if I understand them correctly, you are talking about a completely different mindset in the public sector—a move away from command and control—to utilise the best talents, particularly of front-line staff. Is that a fair summary of what you are attempting to do with the petition?

Yes. People tend to think that management theories are additive—that they can keep adding more in—but they are not. Some management theories are in conflict. Someone might say that they want to put more effort into front-line staff, but still hold to the idea that they should have targets—compliance is the culture of the day, if you like. They cannot have both. People do not realise that they are trying their best to implement a system that acts as a barrier to the very things that we want, which is people working together more, and creativity.

What sort of feedback have you had on your ideas from local authority leaders, the Convention of Scottish Local Authorities and the trade unions? Have you had any in-depth discussions with those key stakeholders?

I am afraid that I cannot answer that. Gordon Hall, who submitted the petition, is the person who goes round and talks to all those people.

In Aberdeen, where I come from, there was an attempt by the major agencies to get together regularly at the highest level—heads of police, heads of the councils, heads of fire and rescue and so on—for joint working. However, that collapsed. It did not sustain itself. You might ask why that was, because everyone is for interagency working. Something must have been acting as a barrier. I would say that because those meetings did not look at the underlying assumptions and theories of management, they did not see what was pulling them apart. That goes on throughout Scotland. Interagency working is a bit patchy because of that factor.

There are good examples. I have worked with John Seddon of Vanguard, who I believe has also been a witness in a committee. You just need to read the books that he has written, where there are lots of examples, not only in the public sector but in the private sector. Let us not think that the private sector is immune to this—it is anything but. There are lots of examples in Scotland, such as Dundee City Council and Lothian and Borders Police. I have done intervention work at the General Register Office for Scotland and the Mental Health Tribunal for Scotland, in small areas, and they are transformational. People would not recognise the results.

Did we do anything to the people? No, we did not. We did absolutely nothing to the people. We did not take them on away days or training; we just got them to look at the work. What we did was transform the thinking of the senior executives. In the case of the General Register Office for Scotland, we took the deputy registrar general through a normative experience of the work of producing certificates—death certificates and so on—for customers. We brought him to tears, because he had never seen how the work was experienced by the customers. The transformation of his thinking was key to making the changes happen and allowing the people not to be set targets, but to go and investigate the situation, get the evidence and redesign their work.

I know that John Seddon has examples of his experiences with chief executives of organisations—Stockport Council is one in the public sector and Aviva is one in the financial services sector—and we have done lots of work with housing associations that has delivered transformational results.

Those sound like excellent examples, but is the key not how those changes can be made permanent? Is there a danger that, as Dr Miller said, a consultant might make changes in the short term but, in the longer term, people go back to the bad old habits?

We do not teach the Vanguard method in such a way as to ingratiate ourselves in order to ensure that there is continuation of work. At a practical level, it is about teaching the people who do the work to know what to do to ensure that the changes can be continued. However, as Tony Miller said, if someone else comes into the organisation—I understand that the management of GROS has changed—and the old way of thinking is still there, all of the work that has been done could be undone. That is a risk.

The concept that you mention is interesting. I think that everyone in this room has some experience of the way of working that you have been talking about, in offices, in social work departments and in the private sector.

Dr Miller, you talked about releasing people’s ideas, which are currently imprisoned. I would like to know how you intend to do that. Would there be more rules and parameters, or would it be a case of bringing consultants into certain firms to show them a more modern way of working? Would the Government have a say in that, or would it be down to individual firms that wanted to modernise their workforce? I cannot get my head around the concept that you are talking about, so I would be quite pleased if you could expand on how what you have in mind would come to fruition.

This is one of the problems. People want to be told about methods; they want to be told what to do. Unfortunately, we cannot tell them that. We can encourage people to discuss, analyse and challenge their thinking. Every situation is different and every organisation is different. If we get politicians and the Government to start thinking about the way in which they go about setting policy—not the methods, but the theories that underpin that—the context within which people in the public sector work will change so that they do not have targets that become the customer instead of the real customer, or overbearing pressure to comply with all the rules and regulations, which distorts people’s behaviour, as can be seen in the case of Alison Hume and the Galston mine incident.

14:15

A good example of what we are talking about is the announcement today by the Angiolini commission on women offenders of a range of proposals that suggest substantive changes. It is not about bringing in external people; it is more a case of being clearer and more transparent to all those who are interested in such changes, as the Unreasonable Learners and others are, about what theories will underpin the changes that are proposed over time, and of providing better and more available information on an on-going basis about how the process is progressing. That picks up the issue of whether change gradually gets stifled and filters away. In Scotland, good reports have often been produced on particular subject areas, but 10 years later people say that nothing has changed. The same thing happened with women offenders 10 years ago, if you remember.

I have a small follow-up. Mr Lippok gave some practical examples of situations in which I can see more innovative thinking working, but Dr Miller seemed to give the impression that it was for everyone to adopt a different level of thinking, so I do not quite know where the petition is coming from or where it is going. That is why we are taking evidence. I can certainly understand Mr Lippok’s idea that, if we had more innovative thinking we could perhaps move forward, but where does the idea of everyone adopting a different type of thinking fit in with Mr Lippok’s practical examples?

It is less about everyone suddenly changing their set of theories and more about making explicit the theories that we have at the moment. It is interesting that the Christie commission report is all about methods, except for one bullet point, which I will come back to.

We are encouraged to think about what we must do. We must change that approach to one that involves thinking about what the real underlying issues are. Unless we start to do that, we will be stuck. Mike McCarron can say something about that from the point of view of drugs.

The organisation that I represent was formed by relatives of drug users, whose view was that, in some ways, it was the blanket prohibition on drugs that made for a lot of the difficulties that families experienced. I know that this is an extremely difficult issue for Governments, not only because drug policy is reserved to the United Kingdom, but because it is very much given direction by the United Nations conventions, which have been going for about 40 years. Therefore, there is a tendency to say that we no longer need to think about the issue or about the underlying assumptions.

The fact that we are dealing with a difficult global situation is not a reason for Scotland not to question or to think about the underlying assumptions. Immediately, the Unreasonable Learners would say that the command and control that the UN conventions are a good example of seem to go completely against the sorts of theories that work, so there is a question mark there.

On Saturday, the important summit of the Americas was held, at which 33 heads of Government in South America and North America met and discussed the drug problem. President Obama said that it was legitimate to have a public debate about whether we have got it right with blanket prohibition. President Santos, who is the president of Columbia, which was the seat of some of the most traumatic and violent aspects of the drug trade, has called for an international task force that is built on expertise and evidence to look again at the underlying assumptions and at what other alternatives might be.

Drugs are not an issue on which Scotland can go it alone, but that is not a reason for Scotland not to think about and to question the approaches that are taken. That is happening in the community, and it should be more widespread.

I should say that I have met Gordon Hall and that my dad had some involvement with the Unreasonable Learners when he was based in Aberdeen.

As someone who has been on a council, I am interested in your notion of targets being prohibitive. The mindset out there is that the expenditure of public money and its effectiveness must be scrutinised. How would that operate in an area in which targets were not used, for example to assess the effectiveness of such expenditure?

I can give you what I think might be a solution, but it would be a particular method for dealing with a particular problem.

There are ways of doing this—you do not need to set a target all the time. Indeed, when you put a target in place, you shift the aim of the whole enterprise; the target becomes the customer rather than the customers themselves. As a result, we need new theories that allow us to get away from targets but which still allow Government to know precisely what is going on. One method might be the simple reporting of measures.

The evidence on the target of treating everyone in accident and emergency within four hours will show that people got treated three hours and 59 minutes after they arrived. The GROS had a target of issuing 99 per cent of all certificates within seven days, but when were the certificates issued? Day seven. Targets distort services, and not having them does not mean that you cannot measure things. People try to cheat not because they are bad but—guess what?—because the system encourages them to do so. That comes from Government. Our plea is that if Government does one thing it should change the system of measurement, stop setting targets and get people to focus on the right thing for their customers. Customers—in other words, the people who want the service—will very quickly tell you what they want and how and when they want it, and that should become the measure. Once you start focusing on that, you can get people to think, “This is what I’m measuring” and, if customers tell them that something is not working, they can improve service delivery.

As all the evidence that I have submitted shows, and as John Seddon and Vanguard have made clear, if we change thinking around targets and start thinking about what motivates people, service will improve dramatically, costs will plummet and morale will rocket. People think that other people are naturally lazy—that is Skinnerian behaviourism—and that the only way to motivate them is by either punishing or rewarding them. Whatever happened to intrinsic motivation? All the thinking from parenting and schooling right through to the workplace is simply wrong. In response to your question, therefore, you can replace targets with measures.

That feeds neatly into my second question. This is all about changing Government thinking, but will you not need to change wider societal thinking as well? If the Government of the day—not just this but any Government—were to turn round and say, “We’re going to stop measuring waiting times in hospital,” the Opposition of the day and the press would stand up and say, “That’s because you’re failing on waiting times and you don’t want us to know about it,” and everyone would get involved in a debate about the reasons for stopping measurement of waiting times. It would be fine for Government to make this change, but surely if other people do not change their thinking it will not make that much difference at the end of the day.

Any difference would be good. The Unreasonable Learners is just an unfunded bunch of volunteers who are trying to cover many different sectors and, in our document, we divide Scottish society into sectors and set out initiatives for each. This is the top sector, if you like, and this is our initiative in that respect.

Mark McDonald is right. We cannot just have the Government saying, “We are not going to do this,” because that is command and control again. You can only do that when you have started to engage the people who are delivering the service, who are talking to their customers about what they are looking for from the service, and are beginning to build up from there a view about the correct service to meet the most need in the best possible way. They then need to start building back from that.

So Mark McDonald is right that we are talking about a culture change. The theme of people being deemed to be lazy when they are in the benefits system is another difficult question. It is a reserved matter at the moment but with more powers coming to Scotland, it might become an issue, so we should be questioning it. The idea that people who are on benefits are scroungers or lazy does not fit with the theory that people have a lot of intrinsic motivation if it is liberated. It is important to think completely differently about welfare. For example, Professor Standing’s idea about a citizen’s income was aired in the Parliament a few months ago. Would that be a better way of starting to engage with people for transformative change?

These are very big issues requiring big thinking by lots of people, and that needs to be set in train. Setting that thinking in train is the most important thing for culture change.

Your presentation so far has been fascinating. It is a pity that we do not have a psychology of work committee that we could refer the petition to.

I was also taken by the recent debate about targets that has gone on in Lothian NHS Board. As you know, a target was set but there was a suggestion that there was a lot of manipulation of that target. Your point about targets is very well made.

The trade unions might have a view on another point. From the discussion that we had, it appears to me that there is an awful lot of wasted talent in the public sector, particularly at entry level. I remember reading one management theorist who said that we should look across the globe at entry-level staff and ask how it is that so many of them are earning the basic minimum wage but, in their spare time, they are scout leaders, authors, painters and so on. That is a fascinating insight into the psychology of work, but perhaps I am straying slightly from the petition.

As members know, I have been involved with Gordon Hall for a considerable length of time, since he came to one of my surgeries and told me the idea. I suggest that the name “Unreasonable Learners” does not actually engage people who do not understand what you are talking about. Perhaps a name change could be brought about.

We are getting a lot of negative feedback on that.

The concept is fascinating. The example that grabbed me initially was in Grampian police, when a police constable was given full charge of a case from arrest right up to court. That dramatically reduced the time between arrest and the accused appearing in court.

The other example was the physiotherapists in Tayside who brought down the waiting time for physiotherapy from the targeted 18 weeks to something like four days by eliminating re-referrals and other wastage in the system. That was absolutely fascinating and it is what we need at a time when resources are scarce, and the Government is beginning to think about outcomes and preventative spending and so on. I am very much behind the concept, which is one of the reasons why I think that the petition is a great idea.

I can, however, see barriers of empire, if you like, from management, and people who are scrutinising targets. I can see that there will be resistance to some of the ideas that you are proposing. You are right that a groundswell has to build up to change thinking. If we take the petition forward and send it to the Government, and I know that the Government is beginning to think along these lines, have you any suggestions about how we can start to turn the tanker around? The process will obviously be long and slow. Have you any positive suggestions about where we can start the process to build up a change in thinking? We are all victims of current thinking.

My thought is that if the Government writes a report on the subject showing that a lot of the waste in the public sector happens because of the way we are thinking, which has not been identified and made explicit, and if that report shows that there is a set of new ideas that have not been tried yet on the grand scale, but have been very successful on the small scale, it would start a discussion in the Parliament and in Government and send good signals to the public sector that a new age might be coming in which people will feel fulfilled in their work in the public sector. That is the idea.

14:30

Have you had discussions with civil servants about the things that you suggest?

Absolutely. The response is patchy. We get enthusiasm from people in the Government, but they are single people within a bigger organisation. I know that there are people at the top of the civil service who are keen on systems thinking and so on. The whole idea is to make the theories open for discussion—that is the way forward.

Prisons and early years provision are two key, flagship Government policy areas in which we could try to make available information about the theories, the processes, the aspirations and the evidence of change over time.

Because of the inherent capabilities of our workforce, we should look for more experimentation. Many of the changes that you mentioned were made by people in their professional areas through experimentation; they used their imagination, tried different things and reported back. The changes that we propose will require a lot of experimentation. Let us have good experimentation, and let us not be frightened of experimenting.

Sometimes, we need to look abroad. On the diminution of the prison population over time and better provision for women offenders, perhaps we need to look at examples such as the decriminalisation of drugs that is happening in 25 or 30 other countries around the world. We know that drugs are a part of prisoners’ experience.

It is that kind of culture that we are looking for.

That is interesting. An area that I would add, given my background, is health. We have had a target-driven health service for quite a long time—although that is perhaps not so much the case now compared with the position under previous Governments—and health is a major part of Government spending.

Does Mr Lippok have anything to add?

From direct experience, I am aware at first hand of the impact of Vanguard’s work and interventions in organisations—clearly, Vanguard is not the only company that does this work. The impact is small scale in certain cases, but it can be organisation-wide, and there are plenty of examples of that.

The approach is about allowing people to experiment with doing things differently, but it is about setting the scene that says, “You have to change the thinking.” It is not just about applying tools. Lean tools are pervasive, but they are just tools and they do not change the underlying thinking.

As the others said, the Government should try it in one or two areas. If it tried to do it everywhere at the same time, it would be an impossible task—it would be like trying to eat the elephant. It is also important to share good practice. I think that there is insufficient sharing of good examples not just in the Government but in the Parliament. It is important to ask how people can learn from one another.

Good afternoon. I welcome this discussion. I worked on the fringes of local authorities for more than 20 years, and some of the language that is being used today has been around for that length of time. We have talked about best practice, which local authorities are supposed to have been promoting. We have also talked about community planning partnerships serving the communities that they represent and working to a customer-focused agenda, and the issue of outcomes versus outputs has been mentioned. There are a number of issues that we need to revisit.

The difficulty that I have—Mark McDonald highlighted the situation—is that, every four or five years, we get a change in the political leadership of the Government or local authorities. How do we address the different attitudes of the elected members? It is predicted that we are likely to see major changes in local authorities throughout Scotland on 3 May, and the individuals who come in to take up elected office will have different attitudes and perceptions of how services should be delivered. How do we address that change, which can take place every four or five years? If you believe that the democratic process is in control of how services are delivered, how do services deliver based on what you are presenting to us today?

I am happy for new ideas to come in and refresh things, but I would like the underlying assumptions to be made clear and reported on so that other people can say, “Well, you’re using that behaviourist theory, but we know that there’s another theory that acts against that.” As long as the thinking is discussed, that is fine—the more variety, the better.

That is a real issue. With the local government elections coming up now, we are looking forward to four years of stability, which may be an opportunity to get some developments in place. The developments that work will be the ones in which the customers and the front-line deliverers agree on how best to do the job. If we can get that embedded, it would be a brave new chief executive who came in four years later with a different idea about that and changed it. We would hope to have a culture in which they would have to give the reasons for thinking differently and provide their evidence for that. There would also be a strong customer voice in certain services saying, “No, we won’t accept that.”

You refer to the customer voice and what the customer wants, but the difficulty is that not every customer can get what can be delivered by the public sector and we must try to match expectations against what can be delivered, particularly at this resource-tight time. How do we deliver what the customer wants? That is easy in the private sector, where the provider makes a product or delivers a service that the customer pays for. In the public sector, how do we measure customer satisfaction with what is being delivered by a local authority or by Government? How do we know what the customer perceives should be delivered?

There is some interesting work going on about how we engage citizens in solving problems to do with local government responsibility. Last month, I heard a speaker from Austria talk about wisdom councils. There is good evidence about how councils can broach that problem and do things better. You will never please 100 per cent of the people all the time; it is about getting a broad sense that the best that can be done in a situation has been done, and there are an increasing number of good examples of that happening.

There are good examples even in Scotland, which we have already cited. In Dundee City Council, social services, adult care and health were formerly competing with each other but can now deliver within 10 days a physiotherapy service that it used to take 300 days to deliver. Do not tell me that that does not save money, which can be redirected. Every customer—every citizen—gets satisfaction because they get what they want. It is about designing a system that allows variety to be absorbed. The problem with a lot of councils is that they try to standardise the system—they say that everybody is the same and that is all that they will get. It is about the people who know about a service designing the work, absorbing variety and delivering it. In my experience, that is also always cheaper.

That brings me back to the best practice argument. Mr Lippok just highlighted that local authorities tend to repeat what they perceive as best practice from other authorities. Their perception of the delivery of best practice might differ from someone else’s perception.

Mr Lippok mentioned experimentation. In the culture of local authorities and the Government, it is difficult to experiment in service delivery, because that can be dangerous—it can succeed or fail. As has been pointed out, when it fails, the media and the public clamour against what was delivered, because it has failed. How do we get over to the media and the public the message that, if we are to change the fundamental management philosophies in local government and in the delivery of public services, we must accept some failure in how we manage the delivery of services?

I remember hearing a number of years ago that the Scottish Public Services Ombudsman had looked at how, in relation to health services, the first thing that individuals wanted to do was to go to litigation to blame somebody; they did not see that something went wrong and that it was too complex to allocate blame to one individual. The ombudsman realised that individuals wanted first and foremost an apology for something that had gone wrong. An apology was not seen as an admission that somebody was blamed; it just involved saying that something went wrong. The ombudsman wanted to know first and foremost whether the situation would happen again.

You can get trust from the public. The media are part of that—it is about carefully encouraging a change in the language that is used. Something should be seen not as a failure but as an experiment. All experiments deliver learning—something is learned from them. People do not like it when nothing is learned.

I am afraid that we are a bit short of time. I will bring in Anne McTaggart for a quick question.

My point will be brief. I welcome the witnesses and thank them for their extremely energising presentation. I come from a community development background, so that was music to my ears. You are exactly right—what is being done must change. Because of the lack of resources, delivery must change from the top down.

That is why we are here.

Yes—absolutely. I have studied some of the Pacific Institute materials, which are about different thinking. Your concept is music to my ears and it could be tested in short pilot versions.

Once you talk the language of theories, you are talking the language of experimentation and testing theories, and then you are on a learning track.

I am sorry that we are running short of time. I ask the witnesses to stay for just a few minutes, because the next step for the committee is to look at where we go with the petition. I thank the witnesses for their contribution to a fascinating 45 minutes.

We should certainly continue the petition and ask the Scottish Government for its views on it. As I indicated in asking a question, it would be useful to get the views of COSLA, of trade unions that represent the public sector across the board—such as my union, Unison—and of perhaps a selection of city, rural and very rural authorities from the 32 local authorities.

Nanette Milne gave an example of a health board. We should also write to a selection of health boards about the petition.

Yes.

I would like to see information about the examples that Mr Lippok cited. Will he provide to the committee the examples of cutting timescales and saving money, such as the example of the physiotherapists? That would be interesting.

Yes. I can obtain case studies, if necessary. Alternatively, I could direct you to the individuals concerned in the various organisations and councils who could give direct evidence. I can convey a rational picture of the issue, but you need to hear the normative experience of such people, who will be even more passionate about the issue than I am.

14:45

I suggest that we write, too, to the Society of Local Authority Chief Executives and Senior Managers because, as one or two of my colleagues have said, we need to change attitudes from the top down as well as from the bottom up. We should also write to the Improvement Service, which I understand was established to try to bring best practice to local authorities throughout Scotland, to ask for its views on what the petition proposes.

I agree with everything that has been said so far. I wonder whether, given the expertise of the witnesses, they could help the clerks with what we should ask the various organisations to which we will write. It might be useful to progress matters to have a meeting at some stage with people in the health or education directorates.

It would be worth getting responses from the organisations that have been highlighted. However, it strikes me that this might be an interesting topic for a future round-table meeting, which may be a more productive and informative way in which to pursue the issue.

That is a good point. I thank our three witnesses for their fascinating evidence. We will certainly wish to pursue the petition.

14:46 Meeting suspended.

14:48 On resuming—

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Remote and Rural Areas Transport Provision (Access to Care) (Older People) (PE1424)

Our second new petition is PE1424, in the name of Joyce Harkness, on behalf of the road to health team, on improving transport provision for older people in remote and rural areas. We have a note from the clerk on the petition, which is paper 2, a SPICe briefing and a copy of the petition.

I welcome our witnesses, who are Peter Ross and Keith Jakeman from the Dumfries and Galloway third sector forum. I invite Peter Ross to make a short presentation of around five minutes, after which I will ask a couple of questions, then give way to my colleagues.

Thank you very much, convener, for having us here. It is really interesting for us.

We are the point men for nine volunteers from Dumfries and Galloway. We are here courtesy of the regional third sector forum, which applied to be part of the community partnership project 3. The process started three years ago. The call went out through our associated membership and nine volunteers came together. We did not know one another at all, as we came from across the region, with 110 miles from one volunteer to the next.

The subject was debated in the regional third sector forum and among us. We settled on considering health and transport, particularly patient transport. That was the start, but it grew into considering wellbeing as well. That is roughly what we did.

We were ably co-ordinated by the regional third sector forum and the intermediary organisation the Bridge Dumfries & Galloway, and we met continually. Doing that was not without its difficulties, because we are over 100 miles apart from one another and we are all “older people”. The bulk of the budget was spent on making round trips of over 100 miles in order to meet.

As I am sure the committee knows, Dumfries and Galloway is a very rural area with a small population of 149,000 spread over 2,500 square miles. It is 150 miles from the town that is furthest east to the village that is furthest west. It has one main centre, which is Dumfries.

The region is interesting in that, to my knowledge, it has no real comparators. For example, the Highlands and Islands region has over 50 per cent of its population in one centre, as far as I am aware, which is Inverness. We have only 30 per cent of our population in one centre and the rest are scattered throughout the region.

Another point is that Dumfries and Galloway is the future of Scotland in the sense that 30 per cent of our current population is over 60 and 44 per cent is over 50, and those percentages are set to grow. We have already exceeded the forecasts for 2015.

In considering transport and health, our organisation sent out over 1,000 surveys to older people and we had 324 returns, which provided us with basic information with which to produce a report. Some of the figures were interesting. For example, 70 per cent of our respondents had to find their own way to health appointments, which I find amazing. I live roughly 100 miles from Dumfries. If I become ill or, which is more likely, my partner becomes ill, we will have a lot of travelling to do. Can we afford it in the future? Never mind me, can we all afford it?

Another finding was that many people travel more than 100 miles for a hospital appointment. Some appointments for villagers from Drummore, which is 120 miles from Dumfries, are at 9 o’clock in the morning. There is no doubt that the situation is unco-ordinated, difficult and complicated.

Our main finding was that the system is unco-ordinated. There is provision from the Scottish Ambulance Service—we contributed to its survey—patient transport, volunteer transport, St John’s Ambulance, the health board, councils and the transport partnerships. Our finding was that the transport provision is unco-ordinated and wasteful of both human and natural resources.

We discovered through our research the Audit Scotland report “Transport for Health and Social Care”, which broadly echoed our views. The report talks about an unco-ordinated approach and it states:

“The Scottish Government and partners should ... work together to clarify responsibilities for planning and delivering transport for health and social care”.

Our findings and Audit Scotland’s report chime with each other.

We were surprised, because we started off with stories about, for example, poor Jimmy from Sanquhar being taken by patient transport to Dumfries hospital, which is only 50 miles away, via Stranraer, which added 120 miles to his journey. An individual in Whithorn goes to Belfast for his treatment. That is the nearest place. At one time, he could not go to Belfast. He was told that he would get patient transport and that a volunteer driver would take him to Aberdeen for treatment, but he would have to go up and down in one day. When he delved a bit deeper, he found out that the reason for that was that there was no budget to allow the volunteer driver to stay there overnight. Quite a lot of case stories are coming out in responses.

We have done all that work and spoken to MSPs, and we have, I hope, cross-party support for a motion to be debated later this month or next month. We have contributed to the Scottish Ambulance Service’s work on improving access to patient transport and to the rural transport solutions project that our local partnership has run, and we are having conversations with the south-west of Scotland transport partnership, which is the transport partnership for Dumfries and Galloway. We have expanded our work slightly to look at wellbeing for a rural area, as it is all tied in.

We hope that, if the petition goes forward, it will keep up our impetus and confidence and allow us to try to break down some of the silos that exist between all of the partners. I think that the people who spoke to the previous petition talked about the same thing. There is no doubt that every individual is trying to do their best, and there is no criticism of individuals, but things simply do not work. There is an incredible waste of money.

Thank you very much for your comments, which covered points that I was going to raise.

You talked about a lack of co-ordination. I presume that the lack of co-ordination causes a lot of extra stress and strain for elderly patients in Dumfries and Galloway, which is obviously not very helpful for their health recovery.

We asked about that, and we have a little pie chart that tells us about stress. Of approximately 350 people, 29 reported that travel to and from their medical appointment was stressful or very stressful. That was across the whole region. We had answers from every postcode area.

My final question is about the flip side. Do you have any examples of really good practice that the committee should be aware of, which could be echoed across Scotland?

Yes. We are aware that there seems to be a good system that works in Banff and Buchan, I think. In our area, Wigtownshire Community Transport took part in the rural transport solutions project in the European northern periphery programme. That has worked for community transport. Wigtownshire Community Transport provides day centre care transport and activity and resource centre transport as well as some school transport. As I said, we have had conversations with SWESTRANS people, and we would like to see that approach rolled out, but there is an issue. There are 24 community transport associations in Dumfries and Galloway, and they do not all agree.

You mentioned community transport. I have hosted a round-table discussion wearing my other hat as convener of the cross-party group on older people, age and ageing—I do not know whether the gentlemen on the panel were involved in that. MSPs from every party were at the discussion, and issues that have been mentioned to do with not only community transport but health were thrown up at it. People cannot get to local doctors, never mind hospitals. I am therefore aware of your difficulties, although I do not live in your area, as you may know.

I think that Audit Scotland reported on a transport action plan checklist. National health service boards were asked to identify local needs and improve access, but only eight of the 14 boards completed transport action plans. I am really concerned about that. Did you have any input into those plans? Have you had any feedback from the boards? I think that the checklist was first mooted in 2009, but only eight of the 14 boards completed plans.

15:00

No, we did not have any input. When the Audit Scotland report, “Transport for Health and Social Care”, was mentioned at our meeting, one of our volunteers, who is on the CHP, said that it was on the agenda at the CHP, so he would get the minutes from its meeting. It is quite funny in some respects, because when he sent us the minutes, they revealed that the report was only for noting at the CHP meeting. To be blunt, we said, “That is that.” When we downloaded the report and read it, it was an eye-opener. We are not aware of anything happening in our locality in response to the report. Something may well be going on, but we have not heard about it.

Thank you very much. That is an issue that I would like to follow up on.

I have found what you have said very interesting. I am glad that you mentioned the previous petitioners, because I had just said to Anne McTaggart that your comments were relevant to the previous petition.

In my area, patients who have out-patient appointments at the eye department are allowed transport home, because they have had atropine put into their eyes, but they are not allowed transport to the hospital. That seems a bit bizarre. What are they meant to do? They get to the hospital in their own car but must leave it there when they get driven home in hospital transport. There is a lack of co-ordination. It sounds like there is a serious lack of co-ordination between the Government and health boards or within health boards. There needs to be some joined-up thinking across Scotland. I hope that you agree, but I would like to hear your comments.

Absolutely. We heard of one lady who was wandering around outside Dumfries and Galloway royal infirmary in her nightdress at 11 o’clock waiting for a taxi. We also know of a very old person, who is quite fragile, who phoned up NHS 24 and was told to go to hospital. As she lives 26 miles away, she asked whether she would go in an ambulance. The NHS 24 operative said, “No. Find your own way to hospital.” She paid £70 for a taxi there and back.

There is a serious lack of co-ordination. We have had private conversations with some community transport people who say that it is about individuals. They say, “I get on with this person, but I do not get on with that person. This person is good and that person is not.”

There is also a lack of clarity about the criteria for transport. No one knows what goes on or what the criteria are. That reflects our own findings. We sent a slightly modified questionnaire to all our general practices—I think that there are 27 or 37—and we got three back.

They were all of the same opinion. Their responses were identical, although they had not collaborated.

It is bad enough for people who need transport for hospital appointments or whatever, but someone who is blind or has dementia needs carers and there is no provision for carers. There might be provision for them to get to hospital, but certainly not to get back.

There are no more questions for the petitioners, but I ask them to stay while the committee considers how to deal with the petition.

I would be interested in getting some more evidence on the Audit Scotland report about transport in the NHS, given that only eight out of fourteen boards have responded to its recommendations.

The short-life working group on healthcare transport is due to arrive at its conclusions in April or May. I would like to see its report. We should keep the petition open and find out what is happening with the publication of that report. I would also like the committee to write to the health boards that have not responded to Audit Scotland’s report to establish why they have not done so.

Mr Ross mentioned the successful dial-a-bus service in Banff and Buchan. We could perhaps write to it to get its views on what we have heard, because I am sure that we will get the same story.

We can try to establish best practice. That is a good idea.

To follow on from Nanette Milne’s points, I suggest that we write to a range of community transport initiatives in Scotland to find out how they are being used and what issues they face. As we heard in the presentation from the petitioners, in many cases, people are not aware that community transport is available and, in other cases, community transport is not being applied where it should be. That is for various reasons, including decisions by health boards or other decision makers. We should write to a couple of initiatives, particularly in Dumfries and Galloway, to ask what the issues are. One issue that was raised was about an overnight accommodation allowance to allow volunteer drivers to assist patients who are travelling further afield.

That is a fair point. Some of those issues will be picked up in the Scottish Government’s report.

I agree with what has been said. We should continue the petition and wait for the report to come out at the end of April or in May.

I thank members for their comments. We agree that we will continue the petition, taking into account the points that Sandra White, John Wilson and Nanette Milne have raised. I thank the witnesses for coming and for making an excellent contribution.

15:06 Meeting suspended.

15:07 On resuming—

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Ferry Fares (PE1421)

The third new petition is PE1421, in the name of Gail Robertson, on behalf of the Outer Hebrides Transport Group, on fair ferry fares. Members have a note by the clerk, which is paper 3, a briefing from SPICe and the petition.

I give apologies for Rhoda Grant, my colleague from the Highlands and Islands, who has taken a great interest in the issue but who unfortunately cannot be here because of a family illness. She has circulated comments on the petition to members. The content of her note will be posted on the website. If members agree, I will highlight a couple of her points although, because of the time, I will not read out all of the note. She states:

“The Petition is regarding the withdrawal of RET from commercial vehicles in the Western Isles. Fares are increasing at an alarming rate—capped at a 50% rise per annum. These changes are being made without consultation and without any economic impact assessment. These rises cannot be absorbed by business and will be passed onto islanders—every family will face increased costs for essentials due to these rises.”

Her conclusion states:

“I would ask the Committee to consider asking the Scottish Government to step back from these rises until the full impact can be assessed. I believe that this policy will cost the public purse dearly as we seek ways to mitigate the impact of these rises. Indeed it will cost more than the expected savings of these huge ... rises.”

That is from Rhoda Grant, the Labour MSP for the Highlands and Islands. I ask members to note her comments.

Do members wish to make any general comments?

I am not greatly familiar with the issue. However, regarding Rhoda Grant’s request, I do not think that it would be appropriate for us as a committee to call on the Government to step back from something. We should write to the Government and ask for its response to the petition.

I cannot think of an example since I joined the committee in which we have expressly said to the Government that it needs to do something differently. We should facilitate the transfer of information and, if need be, call for further evidence. In the first instance, we should ask for the Government’s response to the petition, rather than issue some form of instructions.

I cannot put words in Rhoda Grant’s mouth, but I am sure that she would appreciate that the committee is asking the Scottish Government to consider the terms of the petition. As Mark McDonald said, that would be the normal next step.

As members know, because of my Highlands and Islands brief I have a particular interest in the RET issue, and I spoke in the debate in Parliament. I was in Stornoway last week and I know that there is still great heat around the issue, not only among commercial hauliers but in the whole community.

In fairness, the RET generally went down extremely well when it was first introduced. The issue was the withdrawal and the extra cost for hauliers, which is of course an added cost to every person in the community. The heat in the community is reflected in comments in the Stornoway Gazette and the West Highland Free Press, and on the radio and on television. The next step would be to ask the Scottish Government to comment on the petition.

I agree with that, as it is only fair. We have all had e-mails from people in the islands highlighting their serious concerns about what has been going on, and I endorse what has been suggested. When the petition comes back to the committee, I hope that Rhoda Grant may be able to come along in person to continue the discussion.

As Nanette Milne said, we have all received e-mails regarding the issue.

I am not that familiar with all the areas, although I have visited them. In reading the submissions, it struck me that there are commercial vehicles, which I presume are small enough to get around the islands, and there are also large lorries—15m or 5m—that are transporting stuff. It has been suggested that that last group is not happy with what has happened. Do we have evidence that haulage firms have contributed to communities? They may not have passed on any benefits to local communities, which raises alarm bells for me.

How many hauliers transport to and from the islands? It seems that the RET is fair enough, and it has been spread throughout the islands, particularly for passengers, coaches and small commercial vehicles. I would be interested to know how many haulage companies operate in the islands, and whether they have passed on any benefits from the RET to their customers.

On Sandra White’s first point, the Scottish Government announced on 7 February that the exemption will include lorries of up to 6m in length. I just wanted to put on record the Government’s position in that regard.

In discussions that I have had via e-mail with commercial hauliers, there is a huge strength of feeling: they feel that they have passed on savings in the past, although the Scottish Government has taken a different view in the debate. I personally disagree with the hauliers in that regard, but the commercial organisations—in particular the Outer Hebrides Transport Group—are very strong on that issue. I am sure that we can get further evidence if members wish to do so.

We move to Angus MacDonald, who has a personal interest in the Western Isles.

As I originally hail from Stornoway, I should flag up a non-pecuniary interest. I have had dealings with a number of Stornoway hauliers in a previous life, so I am certainly aware of the issue. I should also flag up that one of my family members transports shellfish from the island, although that qualifies for substantial subsidy.

The comment that

“every family will face increased costs for essentials due to these rises”

is debatable. I was up in Stornoway last week, and I am aware of the feeling among some members of the community that the hauliers did not pass on the benefits of the RET. That issue also divides members in the Parliament, some of whom have a similar feeling.

The issue clearly requires further investigation and debate, and I agree that the committee should write to the Scottish Government for its views on the petition. It is clearly a hot issue up in Stornoway. There have been some compromises, but we will have to wait and see how the petition progresses.

15:15

Thank you for that contribution. As no other members wish to speak, do members agree to write to the Scottish Government for its views on this petition?

Members indicated agreement.

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Land Reform (Scotland) Act 2003 (PE1422)

The fourth and final new petition is PE1422, in the name of Wendy Barr, on the inequality of the Land Reform (Scotland) Act 2003. Members have the note by the clerk, which is paper 4, the SPICe briefing and the petition. I invite the committee to consider the petition and suggest next steps for it.

I found the petition interesting; it is coming from the other side. We always hear about the right to roam—the right to be able to go through land—but we never hear the other side, from people who have perhaps had negative experiences of that. If it is okay with everyone else, I would like the committee to continue the petition and write to the Scottish Government and Scottish Natural Heritage, as suggested in paragraph 17 of the clerk’s note.

No other members wish to contribute. Do members agree to the steps suggested by Sandra White?

Members indicated agreement.