Public Bodies (Joint Working) (Scotland) Act 2014 (Consequential Modifications) Order 2016 [Draft]
The second item on the agenda is an instrument that is subject to affirmative procedure. We will hear, as usual, evidence on the instrument from the Minister for Public Health and her officials. Once we have asked our questions we will move to the formal debate on the motion.
The instrument that we are considering is the draft Public Bodies (Joint Working) (Scotland) Act 2014 (Consequential Modifications) Order 2016. I welcome the Minister for Public Health, Maureen Watt. The minister is accompanied by Brian Nisbet, who is a senior policy officer in the health and social care integration directorate; Clare McKinlay, who is a solicitor from the Scottish Government; and James Laing, who is a policy officer at Disclosure Scotland. I invite the minister to make a brief opening statement.
I would like to say a few words about the draft order, which has been produced as a consequence of the establishment of integration joint boards under the Public Bodies (Joint Working) (Scotland) Act 2014. The purpose of the order is to amend the Protection of Vulnerable Groups (Scotland) Act 2007 and the Protection of Vulnerable Groups (Scotland) Act 2007 (Prescribed Services) (Protected Adults) Regulations 2010.
The amendments are technical and are necessary to ensure that the PVG scheme continues to apply to its full extent once integrated health and social care arrangements are in place. The amendments make it clear that staff who deliver to vulnerable people health and care services that are provided or secured under the integration arrangements remain within the scope of the PVG legislation.
The practical impact on health boards and councils will be minimal because staff who provide such services for those organisations are already doing regulated work and so are able to join the PVG scheme. The amendments should not to lead to more staff having to join the PVG scheme. The changes will ensure that the integration arrangements do not have the unintended effect of removing the possibility of health boards and councils carrying out PVG scheme checks in appropriate cases.
Committee members will wish to note that the order does not introduce new policy, but is needed simply as a result of wider legislative changes that provide for integration of health and social care. I am happy to take questions.
If there are no questions for the minister we will move to the formal debate on the affirmative Scottish statutory instrument on which we have just heard evidence. I remind the committee and others that, during the formal debate, members should not put questions to the minister and officials may not speak. I invite the minister to move motion S4M-15463.
Motion moved,
That the Health and Sport Committee recommends that the Public Bodies (Joint Working) (Scotland) Act 2014 (Consequential Modifications) Order 2016 [draft] be approved.—[Maureen Watt.]
Motion agreed to.
09:35 Meeting suspended.Pharmacy (Premises Standards, Information Obligations, etc) Order 2016 [Draft]
Item 4 on our agenda is another affirmative instrument. The instrument that we are now considering is the draft Pharmacy (Premises Standards, Information Obligations, etc) Order 2016. Again, we welcome the Minister for Public Health, who has been joined by Alpana Mair, who is deputy chief pharmaceutical officer in the healthcare quality and strategy directorate.
I invite the minister to make a brief statement.
Thank you, convener. The statement on this instrument is slightly longer than the previous one.
The Scottish Government and the health departments in the three other nations are committed to legislative change in healthcare regulation to enhance public protection. That is why changes are being made to the General Pharmaceutical Council’s legislation through the order, which is made under the Health Act 1999. The change is to ensure optimal design to provide safety for users of pharmacy services, while facilitating and reducing the barriers to responsible development of practice, innovation and a systematic approach to quality in pharmacy.
The General Pharmaceutical Council was established in 2010 with the approval of both the Scottish and United Kingdom Parliaments. The order will make seven key amendments to the legislation governing the GPhC’s processes. The first is to remove the requirement for the GPhC standards for registered pharmacy premises to be set in rules. Those will now be set in a more proportionate and flexible way, without requiring the use of rules that must be formalised in legislation. As a consequence of moving the premises standards out of the rules, they will no longer be included in a statutory instrument that is subject to Privy Council approval and laid before both the UK and Scottish Parliaments. Standards for individual registrants are not subject to such procedures. However, the order does include an explicit and important requirement for the GPhC to consult Scottish ministers, as well as English and Welsh ministers, on changes to pharmacy premises standards.
Secondly, the proposals will enable the GPhC to apply the standards to associated premises that are integral to provision of pharmaceutical services as well as to registered premises. That reflects the fact that, in some respects, the traditional model of pharmacy premises being entirely self-contained operations at which all aspects of the retail pharmacy business are carried on is outdated. For some businesses, integral parts of their business operations, such as electronic data storage, may be elsewhere.
The third amendment sets out the registration sanctions that the GPhC may use where pharmacy owners breach the standards. The General Pharmaceutical Council already has powers to issue improvement notices where a pharmacy owner breaches the standards for pharmacy premises. The order will mean that breaches of premises standards will be dealt with as a disciplinary matter by the GPhC’s fitness-to-practise committee.
Fourthly, the order will introduce the use of interim suspension orders by the GPhC when that is in the public interest, prior to a disqualification decision or a removal decision taking effect after a full hearing of a fitness-to-practise case. Those changes reflect the move to align better the disciplinary provisions for pharmacy owners in respect of breaches of pharmacy premises standards with those for individual registrants.
As well as the changes to premises standards, the order makes some adjustments to the GPhC’s powers to set rules around information-gathering obligations. Should the GPhC exercise its amended powers to make rules on information obligations, those changes will be subject to further parliamentary scrutiny. The order provides for a new criminal offence to support enforcement of the rules on information obligations. That provides a backstop should a pharmacy business fail to comply with an improvement notice from the GPhC. The Crown Office and Procurator Fiscal Service has been consulted and has indicated that it is content with that.
Fifthly, the order makes changes to the GPhC’s powers to gather information from pharmacy owners so that the regulator will be able to allocate resources proportionately by assessing the risk in a pharmacy. The order also clarifies when the GPhC can require pharmacy owners to provide such information through its rules, and the type of information that is covered.
The sixth amendment clarifies what information the GPhC may publish in reports of pharmacy premises inspections and makes it clear that if a report includes personal data it is assumed, for the purposes of data protection requirements, that such information can be published.
Finally, the order will make a correction to terminology used in the General Pharmaceutical Council’s procedure on the notification of the death of a pharmacist or pharmacy technician in Scotland. The legislation is changed to refer to a district registrar, rather than the Registrar General, as is currently the case.
The Scottish Government considers that the best way to improve consistency, create greater efficiency and simplify professional healthcare regulation would be to introduce a single UK bill covering all professional groups, which would build on the work of the Law Commissions. I understand that the Department of Health has now confirmed that there will not be such a bill in the near future. Instead, the department has proposed a consultation leading to a policy paper on future regulatory policy. The Scottish Government is disappointed at the lack of a bill, but is currently working with the Department of Health to understand the nature and extent of the new proposals.
The order will make important changes to allow for optimal design to provide safety for users of pharmacy services, while facilitating and reducing the barriers to the responsible development of practice, innovation and a systematic approach to quality in pharmacy.
I am happy to take any questions that members have on the draft order.
I seek some clarification on pharmacy premises standards. We have stand-alone pharmacies, pharmacies that are joined to doctors’ surgeries, pharmacies within stores such as Boots and so on. Would the instrument allow a pharmacy to be established in a grocery shop or a wee corner shop? There are a lot of areas where there is no pharmacy near certain parts of the population. Would the order change that situation or am I going down the wrong path?
I will ask Alpana Mair to answer that question.
The standards apply to registered pharmacy premises. In order for a pharmacy to be established it would still have to go through the normal procedures—the order does not amend those or change the control-of-entry requirements that currently exist.
Will a pharmacy apply to be established within a locality under the same regulations as before?
Yes.
Thank you.
I apologise if I missed this point, but does the order bring Scotland more into line with the rest of the UK and Northern Ireland?
09:45
As I said in my opening remarks, we would like to see a more level playing field. That will not come in the near future, but we are working closely to ensure that standards are more aligned.
I just wondered what the situation is south of the border.
Draft pharmacy standards are in place across the four countries. The legislation will make the standards, which will apply across the four countries, enforceable.
It was mentioned that there would be a consultation on any future proposals in this area. Who would carry out the consultation, how would Scottish pharmacy play into it and who will evaluate its results?
There are two aspects to that. Are you referring to the pharmacy standards that are in place?
Yes.
The General Pharmaceutical Council—the GPhC—recently conducted a consultation, which was undertaken by an independent body. Community Pharmacy Scotland and other pharmacy contractors in Scotland would have been able to contribute to that. The GPhC has considered those comments, and it has revised and amended how it undertakes the inspections.
According to the committee’s notes, there were concerns about how any set of patient standards would be acted on or enforced. Would further consultation be wise at this stage?
As I said, the consultation has taken place recently. The response to it was positively in favour of how the GPhC was progressing the changes that it had made.
There were concerns and a lack of clarity about how any breaches in the standards would be dealt with.
Concerns can be fed back to the GPhC. When the GPhC formerly sets its standards, the process is open to people feeding back to it.
Any concerns would not be brought as breaches of premises standards; rather, they would be dealt with as a disciplinary matter under fitness-to-practise standards.
We have exhausted questions, so we move on to agenda item 5, which is the formal debate on the affirmative SSI on which we have just taken evidence. As is usual at this point, I remind members that they cannot put questions to the minister and officials may not speak in the debate.
Motion moved,
That the Health and Sport Committee recommends that the Pharmacy (Premises Standards, Information Obligations etc.) Order 2016 [draft] be approved.—[Maureen Watt.]
Motion agreed to.
We suspend to allow a changeover of witnesses.
09:48 Meeting suspended.National Health Service (Scotland) Act 1978 (Independent Clinic) Amendment Order 2016 [Draft]
Healthcare Improvement Scotland (Fees) Regulations 2016 (SSI 2016/26)
Protection of Vulnerable Groups (Scotland) Act 2007 (Prescribed Purposes for Consideration of Suitability) Regulations 2016 (SSI 2016/27)
Public Services Reform (Scotland) Act 2010 (Commencement No 7) Order 2016 (SSI 2016/22)
Agenda item 6 is an evidence-taking session on four Scottish statutory instruments that, taken together, provide for the regulation of independent healthcare clinics. I welcome—again—Maureen Watt, Minister for Public Health. The minister is joined from the Scottish Government by Dr Sara Davies, public health consultant, and Ailsa Garland, solicitor. Minister, do you want to make any opening remarks?
Yes, please, convener.
Thank you for providing me with the opportunity to explain the rationale behind the National Health Service (Scotland) Act 1978 (Independent Clinic) Amendment Order 2016, which, along with a commencement order laid at the same time as that SSI, expands the regulation by Healthcare Improvement Scotland of independent healthcare provision to include clinics in or from which services are provided by doctors, dentists, nurses, midwives and dental care professionals.
The Scottish Government commissioned an expert group, which included a range of service providers, members of the public and industry regulators, to develop the strategy on which the policy is based. The outcome of the expert group’s work, which the Cabinet Secretary for Health, Wellbeing and Sport accepted in July last year, has been developed, with stakeholder engagement, in the policy to extend the regulation of independent healthcare to specific clinics in order to continue our programme of improving public safety and standards of care wherever services are accessed.
The policy has been welcomed by many regulatory bodies, including the British Association of Cosmetic Nurses and the General Medical Council, which will be issuing new guidance in spring for doctors who carry out cosmetic procedures. Significantly, many of the service providers have indicated their support for the policy. Although I recognise that service providers incur costs for the purposes of registration and inspection of premises, I consider that to be a necessary burden to ensure the safety of both users and providers in the industry.
The affirmative order that is before the committee—the National Health Service (Scotland) Act 1978 (Independent Clinic) Amendment Order 2016—amends the definition of an independent clinic in the National Health Service (Scotland) Act 1978 by including the additional health professions of registered nurses, registered midwives and dental care professionals. The rationale for the addition of those three groups is that, due to the changing nature of the independent healthcare market, those professionals can now offer services that include the provision of cosmetic procedures. The proposed change in the definition is supported by the chief medical officer, the chief nursing officer and the chief dental officer, as well as external stakeholders.
The order also adds specific exemptions to the definition of an independent clinic. That reflects the policy intention that the purpose of regulation is not to regulate services that are ancillary to the purpose of an organisation, which is why health clinics in schools, colleges and universities or occupational health services that are provided solely for employees by the employer are exempted. The purpose is also not to regulate services that are inspected by NHS Scotland—jointly NHS, independent general practitioner and primary dental services—and not to put a disproportionate regulatory burden on first-aid clinics, for example at sporting events, or talking therapy clinics.
The related order, the Public Services Reform (Scotland) Act 2010 (Commencement No 7) Order 2016, commences provisions in the 1978 act so that regulation of independent clinics will go live on 1 April 2016, with a delay, until 1 April 2017, in the introduction of the offence of not registering a clinic. That year’s grace will allow clinics that are new to the area of regulation to work with HIS to understand the requirements of registration and ensure that their systems, policies and care are in place for the process and the following years’ inspections and reports.
The Healthcare Improvement Scotland (Fees) Regulations 2016 set the maximum fees that can be charged by HIS on matters such as applications for registration of independent healthcare services. That is a ceiling and, as required by the enabling powers, has been consulted on together with the fees that HIS plans to charge for the year 2016-17. The regulations set maximum fees in relation to independent hospitals as well as clinics and revoke and replace existing fees regulations from 2011. I am aware that the fee structure has generated some interest but, as HIS is providing the service on a cost recovery basis, it is intended to be self-funding.
The Protection of Vulnerable Groups (Scotland) Act 2007 (Prescribed Purposes for Consideration of Suitability) Regulations 2016 will allow HIS to check the suitability of a provider or manager of an independent healthcare service that is registered with it.
In summary, the Scottish Government considers that the best way to improve patient safety in the independent healthcare clinic setting is to introduce regulation of clinics through the legislation described. I am happy to answer any questions that committee members have.
Thanks, minister. The first question is from Fiona McLeod.
The instruments are very much about phase 1 of a three-phase approach towards the regulation of the industry. Can you give us any idea of a timetable for the different phases?
Also, one of the issues that arose from the round-table discussion that we had last week was that, over the three phases, we will end up with a situation in which some clinics have to register or some people will be regulated. How will the different ways of looking at that over the three phases all come together?
Phase 1 commenced in 2014 and we are obviously at the end of that stage now. Phase 2 will commence in April 2016, on the completion of phase 1, and we expect that to last until the end of this year. Phase 3 will start thereafter and will probably take another year, I think.
Yes. For phase 2, there have been preliminary discussions through the expert group, but the proper work for phase 2 will need to be scoped and provided to the minister with recommendations.
On Fiona McLeod’s question about whether some providers and clinics will be regulated, at the moment the aim is that the clinics will be regulated, because healthcare professionals are regulated under other circumstances. For phase 2, the idea is to find a way of making sure that the non-surgical cosmetic procedures that are carried out by other healthcare practitioners such as beauticians or hairdressers, which are a limited stock of non-surgical cosmetic procedures such as dermal fillers, are also captured. Whether that will be through work with the environmental health officers who license skin piercing and tattoo parlours has to be scoped and options have to be provided.
Phase 3 will be for people such as the very few healthcare scientists who provide laser services. Again, whether they are clinics and would be regulated as in phase 1 has to be scoped out.
It helps to get that explanation. Thank you.
So to an extent, the distinction between phase 1 and phase 2 is that, in phase 1, the responsibility for inspection and regulation will be that of Healthcare Improvement Scotland and, in phase 2, that will be somebody else’s responsibility. Is that partly what the distinction is based on?
We would need to see exactly what the outcome will be after consultation. Local authorities may well have a bigger role in the second phase than they do in the first phase.
Is what is proposed fundamentally what was proposed a long time ago in the Regulation of Care (Scotland) Act 2001 in relation to the inspection of independent clinics by the care commission—as it was being set up then—but with that now the role of Healthcare Improvement Scotland?
Yes. I was not around then, obviously, but I do not think that that was taken forward to regulation. It was then superseded by the Christie commission and the change to public services. Sara Davies can give a better explanation.
Not at all. As the minister said, there was the work from 2002. Then there was the Scottish Medical and Scientific Advisory Committee—SMASAC—report, after which the CMO had a specialist advisory group looking at cosmetic surgery in 2005-06. That recommended moving forward with the regulation of independent clinics, but then there was a change, as the minister said, with the move to Healthcare Improvement Scotland.
The Scottish Government then had a consultation on what should be done. The block has always been that doctors’ and dentists’ clinics had to be regulated, because it was right to do so at that time. What we have now brought forward is a result of all the consultation and the need to cover a wider group of healthcare professionals.
10:00
Some concerns were raised in evidence. The British Association of Aesthetic Plastic Surgeons was concerned about
“some situations where non health care practitioners are working within independent clinics and providing cosmetic interventions.”
I do not know how that will work and whether that will be part of phase 2.
The British Dental Association was concerned that
“the definition of ‘independent clinic’”
was based
“on the healthcare professional providing the service”
rather than
“on a specific procedure”.
The BDA gave the example of
“beauticians working in beauty salons who carry out teeth whitening ... without any regulation or formal training”.
Would those two situations be captured by phase 2? How would they be dealt with?
I will answer the first question. If a beautician is working in an independent clinic providing certain services, it may well be that there is a nurse there. If the beautician is doing certain types of non-surgical cosmetic procedures, they will need a prescriber. If a clinic is providing certain prescribed medicines such as botulinum toxin in all its varieties, there will need to be a prescriber, so that clinic will be regulated. The person who is delegated to give the treatment will have to be under the supervision of one of those professionals.
On the example from the British Dental Association, as I think was heard in evidence, at a certain percentage of the chemicals, teeth whitening has to be done by a dentist. One of the other aspects of the work may well be that there is greater awareness of who should be doing what.
I want to ask about that very subject, because I was quite shocked on hearing the evidence about teeth whitening. When I was driving one day, I noticed an advert at a tan shop saying, “Get your teeth whitened here.” That shocked me. What would happen regarding those premises? They would have to take that out, surely.
The legislation is clear that teeth whitening is a role for dentists. That has possibly always escaped people’s awareness. Teeth whitening has to be done by a dentist, at a certain percentage of the chemicals. At other percentages, it can be done by different groups of people. I believe that, in some situations, people used to be able to buy kits in certain shops to do it at home. The level of teeth whitening that is done by dentists must only be done by dentists. I am not answering your question, but the answer is that, if teeth whitening that should be done by dentists is being done by people who are not dentists, that should be reported.
There are adverts on the television inviting people to send away for such kits.
Anyway, I will leave that to one side and I will come on to my main question. Regarding fees, I am all for regulation and picking up people who are outside the system. We must ensure that, for instance, people’s teeth do not fall out after they have been somewhere that is not regulated to get their teeth whitened. However, I am concerned about the level of the fees. In some instances, they can be nearly £2,000. There are independent midwives, and I see that there was strong resistance to having a flat registration fee. Why is that approach being proposed?
I was shocked to find that those who apply but do not meet the criteria and are refused do not get their fee back—HIS keeps the fee. I was given the assurance that HIS would work with the person concerned to ensure that they met the criteria, but there are still such cases. Independent nurses and midwives and other people who may be working and making a living outside the health service—I say that with the greatest respect—could be faced with a fee of nearly £2,000 in order to set up. Will that encourage people? Why do we not have a sliding scale? Why do we not say that, if people do not meet the criteria, they get a proportion of the fee back? I would certainly not like to hand over £2,000 only to be told that I do not meet the criteria and I will not get my £2,000 back.
I take your point but, as I said in my opening statement, HIS is working on full cost recovery, and the same work must be done regardless of the person making the application. That was discussed by the HIS board, and it was judged that a flat fee would be the fairest approach for the first year.
We need to put it in context. There are probably only about three independent midwives in Scotland. All providers, including midwives, will have a full calendar year to register and discuss the process with HIS.
As you heard from HIS at your previous meeting and as we have heard from HIS previously in relation to people putting in applications, the registration process is quite discursive. It is not a case of people providing the money and it not being returned. A lot of consultation goes on. HIS provides as much as it can by way of templates for the type of policies that people are meant to have. There is quite a long process to work through before there is a definite handing over of a cheque that cannot be returned.
If someone applies, can they sit down with HIS, prior to handing over their money, and talk through what they want to do? That might allow them to conclude that they will not meet the criteria, so they can do something else.
Yes.
I take the point. The evidence that we have received confirms that there are few independent midwives, but they are there and they are doing a job, and they will be affected by the measures. There is quite a difference between Optical Express, for example, and an independent midwife, but they will have to pay the same flat fee.
The other point that has been raised with us is about what aspects of independent midwives’ work would be inspected. They do not operate on the high street; they operate in people’s homes. As well as the challenge of the fees that would be levied upon them, there is a question of how to effect the objectives of the measures.
As I think we heard from HIS previously, the idea of the regulation is to review current practices in a range of areas. That is about clinical governance as well as business matters.
For a midwife, for instance, HIS would want to check her record keeping, the decontamination of objects and how she manages her complaints system, in the same way as it would do for independent nurses with a small clinic providing services in a range of places. That is about the governance, the clinical governance and the financial viability of the service. That is the sort of thing that HIS would want to consider in the place that the midwife decrees is her office. There would be a report on the work that she does in people’s homes. HIS would therefore not inspect individual homes where she provides her services, but it would want to ensure that her service is a viable entity and meets the standards that are required for it.
But she is already complying with standards and is, I presume, paying a registration fee as a nurse or midwife. She is regulated by all of that, which assures some of the quality issues. Nurses and midwives will have to pay a fee of thousands of pounds to be registered, but how will that mean that someone who purchases additional services will get a better quality or safer outcome when those nurses and midwives are already regulated?
There is a big difference between operating in a hospital, a dentist’s premises or an independent hospital and working in a person’s home. As Sara Davies said, there are issues around decontamination and ensuring that the equipment that is used is clean and up to standard. At the end of the day, it is about the protection of consumers. In this case, people are not working in a regulated environment, and it is important that standards are high.
At last week’s committee meeting, there were questions about how dentists are currently inspected and there was a request that any inspections that are carried out on private dentists be carried out by dentists. People asked why dentists, who are contracted to deliver services as part of the national health service, have a different inspection regime from other parts of the health service, and there was a suggestion that we now have an opportunity to ensure that dentistry as a whole is regulated and inspected by HIS. Why do dentists stand separate from other practitioners?
At your evidence-taking session before the recess—
Right enough, the meeting was two weeks ago. The recess flew by.
I think that people were surprised to hear that private dentists are not regulated at all, even though people who go to private dentists can pay a lot of money to do so. Consumers will be pleased that private dentists who operate completely outwith the NHS system will now be regulated.
Yes, but that regulation will be different. There was an opportunity to ensure that all dentists were regulated in the same way.
They will be regulated according to the same sort of inspection as independent hospitals. It is not quite the same approach as is taken with the NHS facilities, where public money is involved.
So you agree with the principle that dentists should inspect themselves. The suggestion is that the inspection of a dental practice in the NHS should stand separately from the new regime, and that qualified dentists should carry out those inspections. Dentists are happy with that situation, of course. The only plea that they made to the committee was that, if we are going to inspect the private dentists, it should be dentists who carry out that inspection.
As you probably heard during your evidence gathering, health boards inspect the dental practices that are under the NHS. The work that HIS is doing with the GDC and other dental groups is designed to ensure that the inspections of purely private dentists that HIS will now start doing meet what HIS wants to do with regard to independent healthcare regulation but also tie into what the health boards are getting from other NHS dental inspections.
The plastic surgeon at your last meeting said that HIS will need experts to conduct examinations of different types of clinics. Getting independent dentists to inspect other dental practices is what happens at the moment in relation to the NHS.
It is like saying that only doctors can inspect doctors and only nurses can inspect nurses, is it not?
Absolutely.
HIS is not staffed in that way. The inspectors that HIS uses have a speciality in inspecting—you mentioned book keeping and record keeping. I think that there is an inconsistency here that has been highlighted by the new measures. There is a big argument that HIS is not independent enough from health boards. We have health boards inspecting dentists and dentists carrying out inspections. That does not seem a reassuring model for managing risk and the hierarchy of hazards.
10:15
We would expect the inspection procedures to be drawn up with healthcare professionals in the mix, whether they are doctors or dentists. Those professionals might not necessarily carry out the inspection, but would at least have had an input into the inspection procedures.
They would be inspected against standards. We must have more dentists than we did 10 years ago if they are running about carrying out inspections.
You have an uncanny knack of answering the question that I was going to ask, convener.
I was quite surprised to see the independent midwives included, because I understand that they are already pretty heavily regulated by the Nursery and Midwifery Council. What can HIS do that is better than the current regulators? It seems odd that independent midwives are included.
The reason that the independent midwives are included is to cover the two areas: the midwifery practice and where a midwife takes additional training and is involved in cosmetic procedures. The expert group advised that there are some midwives who also carry out cosmetic procedures—outwith their midwifery practice. We wanted to make sure that there were no gaps in covering the healthcare professionals who were providing such services.
Independent midwives are well regulated in relation to midwifery services. Whether the clinic or organisation, in the sense of the total services that they provide, is looked at is not clear, because they are regulated for part of the services that they provide, but not the totality.
That is helpful. I had not picked up the point about the cosmetic side.
HIS seems to be involved in many areas of health inspection these days. Are you confident that HIS will be able to get the appropriate people to carry out the work?
HIS has been provided with extra resources to deal with the extra work.
If there are no other questions I will pick up on Richard Lyle’s earlier question about professionals offering services online or on television and so on in Scotland, whose businesses are registered outwith Scotland or have no fixed premises or just a PO box. Will such companies be required to register?
Where services are provided from a base in England they will be regulated by the Care Quality Commission. Where services are provided in Scotland, where at all possible they will be dealt with under the regulation.
Where a business has only a PO box or website it is quite difficult. HIS is already looking into how it can track down the business to ensure that there is some type of regulation.
That could become a loophole for teeth whitening.
It is more a question of how practical it is for HIS to regulate such services. HIS will say to people with websites that if they provide services to Scotland they must be regulated.
That will be the basic requirement. Whether they will and how we make them will be the challenge.
Exactly. However, HIS will be saying that services to people in Scotland must be registered through HIS.
If there are no further questions we will move to the formal debate on the affirmative SSI on which we have just taken evidence. Again, I remind the committee that members should not put questions to the minister during the formal debate and that her officials may not speak in the debate. I invite the minister to move motion S4M-15452.
Motion moved,
That the Health and Sport Committee recommends that the National Health Service (Scotland) Act 1978 (Independent Clinic) Amendment Order 2016 [draft] be approved.—[Maureen Watt.]
Richard Lyle wishes to contribute to the debate.
I agree to the order, which will tighten up the situation. As I said earlier, I was quite concerned two weeks ago when we were told that tooth whitening could be done anywhere, and I saw it on a notice outside a shop.
The only concern that I have is the cost, if someone applies and does not get their fee back. However, I have sought assurance on that, and we have been given the assurance that people will be allowed to sit down and discuss the matter with HIS to ensure that they are not paying fees, only for HIS to come back a couple of weeks later and say, “Sorry, you do not meet the criteria.”
No other member wishes to speak and the minister has nothing to add in summing up. The question is, that motion S4M-15452 be agreed to.
Motion agreed to.
10:20 Meeting suspended.
Under agenda item 8, which is more subordinate legislation, we have two negative instruments before us, both of which were discussed as part of the evidence that we took on regulating independent clinics.
The first instrument is the Healthcare Improvement Scotland (Fees) Regulations 2016. There has been no motion to annul and the Delegated Powers and Law Reform Committee has not made any comments on the instrument.
As members have no comments, do we agree to make no recommendations on the instrument?
Members indicated agreement.
The second instrument is the Protection of Vulnerable Groups (Scotland) Act 2007 (Prescribed Purposes for Consideration of Suitability) Regulations 2016. There has been no motion to annul and the Delegated Powers and Law Reform Committee has not made any comments on the instrument.
As members have no comments, do we agree to make no recommendations on the instrument?
Members indicated agreement.
Thank you. I will suspend the meeting until our next witnesses arrive.
10:25 Meeting suspended.