Section 9—Free oral health assessments and dental examinations
I welcome the minister and her officials to this afternoon's session. We expect to reach amendment 11 today. We hope to deal with this item in about an hour—that is the plan.
Convener, you will have to guide me as this is my first experience of stage 2. Do I move both my amendments together?
Speak to both amendments, and move amendment 23.
Amendments 23 and 24 would remove free dental and eye checks from the provisions of the bill. My colleagues and I consider that to provide free eye and dental checks for everyone by 2007 would not be the best use of public resources—free checks are already available for people who need them. The difficulty lies in persuading those who are eligible for free checks to come forward for them and, in the case of dentistry, in finding sufficient national health service dentists to carry them out. Moreover, once the checks are done, there are in many parts of the country not enough dentists working in the NHS to carry out treatment that may be required. It is neither sensible nor ethical to make a diagnosis and then not to carry out the treatment.
It comes as no surprise to find that the Conservatives are moving to amend completely the bill that will give free eye and dental checks to all. The Scottish Parliament's approach to legislation is evidence-based. Every witness who gave evidence to the committee—evidence to which Nanette Milne listened—accepted that free eye and dental checks would improve the state of the nation's health; some argued that it would improve it dramatically. Every single piece of evidence suggested that that will be the case. I do not like the ideological approach to the bill that the Conservative party, which Nanette Milne represents, is taking. Her group does not approve of the measures, but it could not find anybody who could give the committee evidence to back up its claims.
I hope that that automated blind's movement is not a sign of the curtain coming down, Mike.
The Executive and, I hope, the committee cannot support amendments 23 and 24. The introduction of universal free eye and oral health examinations is, as has been said, an important part of the Executive's commitment to improving public health through comprehensive and preventive care. At stage 1, the Health Committee and Parliament accepted the principle of free eye and dental checks for all. The free checks are preventive health-improvement measures—our purpose in introducing them is to assist in early detection of oral cancers, diabetes and conditions such as age-related macular degeneration, detaching retinas and certain cancers and tumours.
I ask Nanette Milne to wind up and to say whether she will press, or seek leave to withdraw, amendment 23.
I have little to add to what I said earlier. My concern is that, despite their eligibility for free eye and dental checks, many of the most vulnerable people do not come forward for them. I would prefer to see the Executive target what is a scarce resource on those people; they need to be brought into the system so that their oral and eye health is checked. It is not good to pass a law when it is pretty well known that the provisions that it contains cannot be carried out. I will press amendment 23.
The question is, that amendment 23 be agreed to. Are we agreed?
No.
There will be a division.
For
The result of the division is: For 1, Against 8, Abstentions 0.
Amendment 23 disagreed to.
Section 9 agreed to.
Section 10—Free eye examinations and sight tests
Amendment 24 moved—[Mrs Nanette Milne].
The question is, that amendment 24 be agreed to. Are we agreed?
No.
There will be a division.
For
The result of the division is: For 1, Against 8, Abstentions 0.
Amendment 24 disagreed to.
Section 10 agreed to.
After section 10
Amendment 25, in the name of Nanette Milne, is in a group of its own.
The argument for amendment 25 follows logically from what I said about amendment 23. Given that the aim of amendment 25 is straightforward, it can be dealt with quickly. It would provide that the Executive place a duty on health boards to ensure that people who are eligible at the present time for free eye and dental checks are targeted more effectively. The people to whom I refer are the most vulnerable people in our society, yet their health is most at risk because they escape the net and therefore fail to have the checks carried out. Even if free checks become available to everyone, those people will still need to be targeted.
Again, the Conservatives have missed the point of the bill and of the debate on targeting and universal benefits, which is that we have to ensure that the very people to whom Nanette Milne referred obtain the health benefits that are available to them. Obviously, all experience shows that some people do not take up benefits even though they are eligible for them; those people are either not sure whether they are eligible or find the process too complicated. The point is that, if benefits are provided universally, everyone will be clear that the benefits are freely available to them.
Unlike the previous two amendments that Nanette Milne lodged, I have some sympathy for the principles of amendment 25. That said, I am unable to support it. Its prescriptive nature would mean that an unreasonable duty would be placed on health boards. For example, in terms of the categories of people who would be entitled to receive free sight tests and dental examinations, health boards would in future always be required to refer back to 1 April 2006. The requirement to do so could become excessively burdensome 10 or 20 years down the line.
Given the minister's reassurance that the people to whom I refer will be covered, I am prepared to seek to withdraw the amendment.
Amendment 25, by agreement, withdrawn.
Amendment 26, in the name of Kate Maclean, is in a group on its own.
I have some sympathy with the principle behind what Nanette Milne outlined in amendment 25, in as much as the existence of free provision will not necessarily mean that people will take up the opportunities for sight tests or dental checks. I have lodged amendment 26 because I consider the bill to be a good legislative vehicle for measures on eye examinations and dental inspections for school pupils because it already contains provisions on sight tests and dental checks. Provisions on dental care exist in the National Health Service (Scotland) Act 1978, and proposed new subsection (2A) that amendment 26 would insert into section 39 of the 1978 act would introduce ophthalmic care as well.
I am anxious that children should have more frequent eye checks, so I agree with Kate Maclean. It is sad that, although we used to have school eye and hearing examinations, as well as a general health check, those do not now seem to be standard throughout Scotland. Nothing would hinder a child more than inability to see or hear properly, so there should be even more frequent checks throughout primary school because many children get missed. I am not sure whether we can change that through the bill, as I am not sure whether that was the intention, but I agree with Kate Maclean that there should be more frequent tests throughout primary school.
I support amendment 26. It is a practical measure that makes a great deal of sense. Had such tests not been available to me routinely, the fact that I required spectacles might not have become obvious to me until later in my life. It is important to set out such a routine to ensure that such checks are carried out on people who might not be aware that their sight is failing, or of other problems associated with their physical well-being. I welcome the amendment as a chance to include that in the bill.
In our e-mail today, we received a briefing from the Royal National Institute for the Blind Scotland supporting Kate Maclean's amendment 26. I urge the minister to consider the issue, because the RNIB Scotland supports the amendment strongly. My experience of the need for glasses being picked up at an early age was similar to Brian Monteith's. It is important.
I thank Kate Maclean for raising an issue that is clearly important to the Health Committee and which is important to me, as somebody who worked in education for many years. I, too, came across youngsters in secondary schools whose problems had not been picked up. There is concern.
RNIB Scotland has campaigned on the issue for some time, and I have been involved in meetings on the matter with previous health ministers. Nothing has happened, and this is the first—and probably only—legislative vehicle through which we will be able to deal with the matter for some time. Amendment 26 is based on a strong recommendation of the committee. Also, evidence from the College of Optometrists suggests that the Hall 4 guidance would lead to a decreased service.
In view of what is stated in the committee's stage 1 report, I ask whether other members of the committee are content for amendment 26 to be withdrawn.
I agree that something should be done before stage 3, so that the matter is finally decided upon.
Amendment 26, by agreement, withdrawn.
Section 11 agreed to.
Section 12—Arrangements for provision of general dental services
Amendment 2, in the name of the deputy minister, is grouped on its own.
Amendment 2 is a technical amendment. Section 12 is concerned with the expansion of the categories of persons with whom health boards can enter into arrangements to provide general dental services. The amendment will extend the list to include bodies corporate, which are generally referred to in practice as dental corporations.
Amendment 2 agreed to.
Amendment 3, in the name of the deputy minister, is grouped with amendments 12 to 14.
Amendments 3 and 12 to 14 are technical amendments. Taken together, they will create a single definition of
Amendment 3 agreed to.
Section 12, as amended, agreed to.
Section 13 agreed to.
Section 14—Provision of certain dental services under NHS contracts
Amendment 4, in the name of the deputy minister, is grouped with amendment 5.
Amendments 4 and 5 amend section 17AA of the 1978 act, and are consequential on part 3 of the bill, which, through new section 17V of the 1978 act, makes provision as to how contractual arrangements between pharmaceutical care services, contractors and health boards or other health service bodies are to be treated. Existing section 17AA makes provision for certain services to be treated as NHS contracts for certain purposes.
Amendment 4 agreed to.
Amendment 5 moved—[Rhona Brankin]—and agreed to.
Section 14, as amended, agreed to.
Section 15—Lists of persons undertaking to provide or approved to assist in the provision of general dental services
Amendment 6, in the name of the deputy minister, is grouped with amendments 7, 9 and 10.
These are minor amendments that amend sections 25(2A)(a) and 26(2A)(a) as they are inserted into the 1978 act by sections 15 and 17 of the bill respectively. The amendments will allow for regulations to provide for subdivisions in either part of the lists of persons who provide or are approved to assist in the provision of general dental and general ophthalmic services. The Executive's policy is that all principal and non-principal dentists and optometrists who provide or assist in the provision of general dental services or general ophthalmic services should be listed in each health board area. The reason for providing for further subdivisions of each part of the list is to provide for practitioners who may provide a more limited or specialist type of dental service.
Amendment 6 agreed to.
Amendment 7 moved—[Rhona Brankin]—and agreed to.
Amendment 27, in the name of Nanette Milne, is grouped with amendment 28.
The amendments are intended to ensure that those who are already providing dental or ophthalmic services are subject to the same disclosure checks, in the same timeframe, as those who are being added to the registered list. In my view, if disclosure checks are necessary for new practitioners before they can be listed, they are necessary for all registered practitioners. That should be made clear on the face of the bill.
As I recall, the issue with which the amendment deals was raised at stage 1.
I appreciate what Nanette Milne is trying to achieve with amendment 27. I support in principle the suggestion that both those applying to join a list and those who are already on one should be subject to the same requirements for disclosure of appropriate information. New subsections (2A)(e) and (c) of section 25 of the 1978 act allow for regulations that will apply equally to those who are currently on a list and those who are applying to join one.
With the reassurance that the bill addresses the principles behind my concerns, I will ask to withdraw amendment 27.
The point arose from the committee's stage 1 report. Are members content for the amendment to be withdrawn?
Amendment 27, by agreement, withdrawn.
Amendment 8, in the name of the deputy minister, is grouped with amendment 11.
Amendments 8 and 11 make it clear that regulations may require providers of general dental or ophthalmic services to be included in a health board's list. The bill will insert new sections 25(2B) and 26(2B) in the 1978 act, which will make explicit provision that regulations may provide that people may not assist in the provision of general dental or ophthalmic services unless they are on the second part of the list. No similar explicit provision is made that regulations may provide that people may not provide services unless they are on the first part of the list.
Amendment 8 agreed to.
Section 15, as amended, agreed to.
Section 16 agreed to.
Section 17—Lists of persons undertaking to provide or approved to assist in the provision of general ophthalmic services
Amendments 9 and 10 moved—[Rhona Brankin]—and agreed to.
Will Nanette Milne move amendment 28, which was debated with amendment 27?
As amendment 27 was withdrawn, I will not move amendment 28.
Amendment 28 not moved.
Amendment 11 moved—[Rhona Brankin]—and agreed to.
Section 17, as amended, agreed to.
That ends today's consideration of the bill at stage 2. Before everyone rushes off, I inform members that the target for next week's meeting is to complete consideration of part 3, which is on pharmaceutical care services, and of part 4, which is on discipline. The deadline for lodging amendments is noon on Thursday 19 May.
I was not aware that provision existed for committee amendments. I thought that amendments were the responsibility of individual members.
That is the case, but our stage 1 report contained several recommendations and we need to find a way to show that an amendment derives directly from those recommendations and is not an individual member's proposal.
I am not entirely happy with the proposal. If you are saying that you and other members wish to lodge amendments that derive from our report, that is fair enough. However, you should not tie other members into supporting amendments without their agreement.
We would do nothing without members' agreement. That is par for the course. If committee members are content to continue in the present way, we will do that. However, I ask members who lodge amendments that derive directly from the stage 1 report to say that they are doing that. That information is needed because—with the best will in the world—committee members might have forgotten that they unanimously agreed a position previously. We want to make clear where amendments derive from.
Meeting closed at 16:16.