Official Report 222KB pdf
Members will recall that, periodically, we consider new petitions that have been received and consider the progress that has been made in dealing with petitions that we have previously received. In passing, I say that the Health and Community Care Committee gets its fair share of petitions and has a good record of dealing with them effectively—I am not saying that only for the benefit of the Public Petitions Committee's convener, who is also a member of this committee.
I have not read as many background papers as John McAllion and Richard Simpson have so I would like someone to explain to me the ways in which the WTO's liberalisation of trade impacts on health policy in Scotland. I seem to have missed that.
John, would you like to do that? I could have a stab at it, but I think that you are much more of an expert.
The issue is causing a great deal of concern both inside and outside the Parliament. The WTO is seeking to come to a new agreement on trade and services. The majority of the members of the WTO have private health systems or part-private and part-public health systems and want to open up public services, in particular health and education, to competition. The UK is a member of the WTO and will be able to contribute to that debate but, if the member states decide to open up our core public services to competition, the private sector will be able to compete to provide such services. To an extent, that already happens—we heard this morning that four of the new hospitals will be built using a public-private partnership agreement under which the private sector will run the hospitals and the ancillary services. The new generation of walk-in-walk-out hospitals will be open to the same process as well.
The examples that you mentioned suggest that the issue is to do with buildings rather than with clinical services.
The liberalisation that is proposed by the WTO would include clinical services.
If the regulations that are proposed by the WTO are accepted in their current form, countries would not be able to run a state national health service without allowing private companies to compete for services. To take the example of an ambulatory care and diagnostic unit, we have already opened up to competition the construction of the building and the running of the maintenance and cleaning services, although the national plan shows that we are trying to pull back from having competition in relation to the latter service. However, under the proposals, the clinical service of the ACAD would also have to be opened up to competition.
The members of the committee can fill in the end of that sentence appropriately; I think that we would all agree with you, Richard.
What is the House of Commons Health Committee doing in relation to the matter? Obviously, the WTO's proposals will have an impact on the rest of Britain. It might be useful to find out what is being done in England, Wales and Northern Ireland. That would ensure that, before we decided what to do, we were all examining the issue from the same point of view.
Anyone would agree that there should be an inquiry into the issue, but who should conduct it? We no longer have any bodies to spare, so we might not be able to assign a reporter to the inquiry. I agree with those who favour having a debate in the chamber first.
One of the problems with that is that the debate would not be as well-informed as one that took place after an inquiry. It is important that we get in contact with the Executive and with the UK Government to find out what their positions are. We should also contact the World Development Movement to put together the arguments for and against the WTO's proposals so that we can take an objective view.
I do not have problems with people coming to Scotland for operations, for example, but I understand my colleagues' points of view. However, as trade and industry policy is a reserved power—it is part of the remit of the Department of Trade and Industry—we would be better off examining what is being done in Westminster. There is no point in our having a debate about something that is not going to happen anyway. We need some guidance on that before progressing.
First, we need a steer about what is happening in Westminster, not only what the Government's input into the negotiations will be but what the House of Commons Health Committee is doing. Once we have that information, we could return to the matter. Bearing in mind what I have said about the Westminster dimension, I agree with my colleagues that, although the matter is a trade issue, it has clear implications for Scotland's health service, which is not a reserved matter.
I would be happy to work on the report.
I was going to say that if I had not received an indication from a member, there would have been a timing implication and an issue about work load. However, as John McAllion has indicated that he is prepared to take on board that work, the question is whether it would be useful for us and, more widely, for our colleagues both in the Parliament and elsewhere in Scotland, for the committee to do some work on that issue, bearing in mind what is going on at Westminster. Once we have received information about the Westminster dimension, we will return to the issue.
I also need to know what the time scale will be for the liberalisation policy.
Do members agree that we should confirm that information with Westminster first?
The second new petition is from the Scottish Organisation Relating to the Retention of Organs and calls for the Scottish Parliament to initiate a public inquiry into the practice of organ retention at post mortem without the appropriate parental consent.
I am quite happy with John McAllion's approach. The report has been published—I think that the final part of it is out now. The report is in two parts: an initial rapid report by Sheila McLean and a more considered report of the implications of organ retention. Timing is important and, ultimately, we will need to comment on the report. The balanced decision that we must make is whether we comment as part of the Executive's consultation that will arise from the report or whether we do so once the Executive publishes its view.
I understand that guidance was issued in January, in the form of a code of practice, and that recommendations about consent, removal and retention will be announced in the autumn. I would like the issue to be put back on the agenda in September or October, so that we can ask whether those recommendations address the issues that have been raised in Geraldine MacDonald's petition. Although that is a wee bit of time away, should not we wait for those recommendations?
We can follow the John McAllion line by seeking further information on the situation. When we have obtained that information, we will be able to decide when and if we want to return to the petition. As Richard Simpson said, there may well be an opportunity for the committee to comment during the consultation exercise.
As the code of practice might have addressed SORRO's concerns, would it be appropriate to ask the organisation for its response to the code?
We could ask whether the organisation wishes to make further comments at this stage.
Could I ask the more knowledgeable member on my right—Richard Simpson—whether the two points raised by the petitioner have been addressed by the Millan committee in its huge report?
I think that, to an extent, the report covers the second point raised by the petitioner. However, I am able to say that only anecdotally, as I have read the report only once.
I believe that the second point raised by the petitioner is already covered by the Data Protection Act 1998. The petitioner can force access—
Does not that act cover computer records only?
No. It covers documents as well.
Do members agree to take on board the issues raised in the petition and to consider access to records when we do further work on the new mental health legislation?
Petition PE214 is about the Scottish cardiac transplant unit. Did members receive today the new letter from the Executive, which provides an update of the situation?
It is almost exactly a year since the unit at Glasgow royal infirmary closed. We should consider writing to the minister to ask on which exact date—or even in which month—the unit will reopen.
Has not the unit reopened already?
I do not think so.
I support Dorothy-Grace Elder's proposal. It appears that the minister intends to make a full statement about the work of the unit in the near future.
The text of the minister's announcement, which was issued on 30 March, says that the unit
There were delays last year.
I accept that, but you cannot hand-knit consultants and staff for the unit.
When the unit closed, there was no declaration that it would remain closed for as long as a year. Since patients have had to go to Newcastle, which handles only a handful of operations, the operation rate has dropped drastically.
Reading between the lines, I think that, had the unit reopened as a single-handed, one-consultant unit, it could have reopened earlier. However, the Executive is proposing a massive increase in the unit's funding and a fourfold increase in staffing, and those staff have yet to be put in place.
I agree. I was involved in the issue when the unit closed, and the timing of exactly when to reopen the unit must be a clinical decision. It would not be possible to put in place four senior consultants tomorrow and expect them to work as a team immediately. That must be planned clinically, rather than being planned by a minister. I am sure that the team at the unit will let the minister know as soon as the unit is ready. The four consultants will not just sit there if it is possible for them to do heart transplants, because they have skills to maintain and will be keen to start work.
I read the Executive's letter of 23 March, which, to be honest, I thought was a bit vague. However, this morning, we have been circulated with a copy of the minister's statement, dated 30 March. When I made my earlier comments, I was unaware of that statement, and I am sorry about those comments. We have been given a full outline of what is happening and I hope that the petitioner will be happy with that information.
That is excellent.
On parties raising issues for debate, this is the second time that the committee has been involved in taking evidence and a debate has been called in the Parliament before we have completed the process. It makes a mockery of the committee system for that continually to happen. We will be involved in a debate tomorrow when we have not even heard from the minister. She may well make comments tomorrow that would otherwise have been made to the committee on 23 May. The matter must be raised at the conveners group. It is not helpful at all.
On the point of principle, each party decides which subject it wants to debate. That has always been the case and the Executive does likewise. The committee's on-going inquiry has been wide ranging and has looked back over a number of years. This week's debate is on the specific subject on which we will hear information from SPICe later. The Health and Community Care Committee's inquiry has been broad; the subject for debate this week is specific, so I do not think that Margaret Jamieson's comments are relevant.
I have not seen the motion yet, so I am not sure what it is about.
It is about compensation.
I have a lot of difficulty with this. We have been working hard and had an excellent session with the Scottish National Blood Transfusion Service and the Haemophilia Society. We asked them to send further information and asked the minister for her response. It is sad—very disappointing—that we are being bounced into taking lines.
That is a bit rich, given what the Tories did over Sutherland—bringing forward a debate in the middle of an inquiry. Whether Mary Scanlon feels ready to discuss her view on compensation is a matter for her. I know that the people out there with hepatitis C are ready for a debate in the Parliament, and they want it as soon as possible. That is clear. They come first. Quite frankly, Mary Scanlon should practise what she preaches.
We have a committee system. I feel strongly about my party politics too, but the people of Scotland expect us to put their health before our party politics. I am sorry, but I think that Shona Robison has to learn the lesson that when we come to the committee, we work together.
I know that a number of members want to have their say, but I am intent on bringing the matter to a close. I am quite proud of the fact that, to a large extent, members of the committee—both past and present—have left their party politics and dogma at the door. They have considered the issues, taken the evidence and, in some cases, voted against their party line as a result of the work that we have done in committee. That has value, which I do not like to see abused.
Or we might not.
Or we might not. I feel frustrated that all parties have, at some point, chosen to have debates in a manner that frustrates the committee process. The correct place to discuss that is, first, among the conveners of all parties and then at the Procedures Committee and the Parliamentary Bureau. We must try to find a way to work together. It is not useful for the meeting to descend into a squabble. We are talking about a petition on which we have so far all done incredibly good work.
Convener, it is your job to stop the discussion if you feel that that is appropriate.
That is what I am saying; I am stopping the discussion. I will raise the matter at the conveners group and will ask the Procedures Committee, the Parliamentary Bureau and the Scottish Parliamentary Corporate Body—if that would be useful—to consider it. That is my recommendation.
Will there be an appeal against the judgment?
We will come to that. That is the substantive point.
It is important in relation to our considerations.
As of yesterday, I understand from very good sources that there will not be an appeal against the judgment.
It would be helpful to know.
That is my understanding.
Has time run out for the appeal?
No; it has been decided that there will not be an appeal.
So it has been announced that there will not be an appeal.
I do not know whether it has been announced. It has been announced at ministerial level that the decision for England will not be appealed. We must make a decision in that context.
That is today.
No, she will not. The report has been delayed. I am sorry about that.
It has been delayed. That shows that I am just reading my notes without thinking. Dorothy-Grace will report in the near future.
Petition PE223, from Mr and Mrs McQuire, calls on the Scottish Parliament to ensure that multiple sclerosis sufferers in Lothian are not denied the opportunity to be prescribed beta interferon. We agreed that we would await the National Institute for Clinical Excellence report and the Health Technology Board for Scotland report. Are members happy to maintain that position?
I would just like to note that NICE has put the report back until about October or November. The last I heard, it was November, but it has certainly been delayed.
I think that it is September. The HTBS will then have another six or eight weeks after that. So, for us, it will be October or November.
I certainly thought that it was October or November, but that might be the date for the HTBS. I do not see that there is any benefit to the committee in making a statement on beta interferon in advance of the NICE and HTBS statements.
Do we have a reason for such a long delay?
Yes. You can question how valid it is, but the reason is that the original report that was about to be published was not thought to have enough appropriate health economic data or modelling—our adviser might agree with such criticism in another context. NICE therefore put out to tender a research project to look at the health economic modelling. The results will not come in until August, and it will therefore be September by the time that NICE can report. There will then be eight weeks beyond that for the HTBS to look at the report. You can argue about the validity of that reason, but that is why there are all those delays.
Does anybody know how far on the HTBS was before—
The HTBS, quite correctly, has made a decision to work with NICE. If NICE is undertaking an investigation, the HTBS will not replicate it in Scotland. That would be a waste of resources. However, the HTBS will comment on the NICE report. Without wishing to anticipate the report, there is much more MS in Scotland than there is in England. There are therefore arguments for saying that we need to look at the situation separately and make our own decisions. However, we should do so on the back of the UK evidence. The delay is, understandably, very unacceptable to MS sufferers and their families, who are dismayed by the delay.
Dismay is the word. I feel dismayed, too. I have to declare an interest as honorary president of Glasgow and North East MS Society. As you know, some MS cases degenerate so rapidly that six months is crucial. Sometimes it can take only two or three months.
The other thing to remember is that the cost of beta interferon is exorbitant in the UK. We have failed to negotiate adequate prices, but that is another matter. Prices here are much higher than they are in the rest of the world, and people are now buying it over the internet at two thirds of the price that we pay for it as a country. That is another issue.
We shall await those reports. In responding to those reports, the committee will probably want to comment on the petition.
The only other point is that there is an annexe to this agenda item on petitions. There is information from Mr Grant about psychiatric care in the NHS in Aberdeen, which I think might be useful to members, who should bear it in mind when we return to the Millan commission on mental health.
Meeting continued in private until 12:38.
Previous
Subordinate Legislation