Official Report 269KB pdf
The first petition is on behalf of the Dundee Royal Neurosurgical Unit Fund, and calls for the Scottish Parliament to conduct a debate on the subject of the proposed closure of the neurosurgical unit at Ninewells Hospital, Dundee.
I would like to raise a general point, which covers the three petitions in front of us, and any other petitions that come before us. You might recall that I suggested at a previous meeting that we raise with the Public Petitions Committee the manner in which it is forwarding petitions not only to our committee, but to any committee. The Public Petitions Committee simply passing petitions on without indicating why does no service to this committee, the Parliament or indeed to the petitioners.
I do not know whether Hugh has had a chance to read the Official Report of the most recent Public Petitions Committee meeting of 18 January, but those points were raised by members of that committee, against a backdrop of that committee's increasing work load. As more people become aware of the existence of that committee, more petitions will be submitted, which, as Hugh indicated, will increase the work load of the subject committees. There is some indication that some members were aware that passing petitions on without giving them extra consideration might create a logjam elsewhere in the system.
I would like the point that I raised to be passed formally, on behalf of this committee, to the Public Petitions Committee—which must consider my point—and to others, such as the Presiding Officer or the conveners committee. We need to address this matter in a far more structured way.
I do not want to open the issue up to too much discussion. Are members generally happy with what Hugh has said?
I support Hugh.
I will write to the convener of the Public Petitions Committee and copy the letter to the conveners committee. There has been some discussion in that committee about the issue, but it is right that we should continue to revisit the matter.
John McAllion has lodged a motion on this subject. That does not negate what you suggest, convener, but I imagine that he would be interested, as he has lodged such a motion.
I had not noticed that he had lodged a motion on it.
It would be appropriate to involve him. The petition does not contain thousands of signatures, so the best course of action would be to refer it to John McAllion or to the other members from Tayside.
John McAllion might want to submit the petition to the Public Petitions Committee.
I have looked into the background to this matter, and I would support John McAllion were he to raise the issue as members' business. I read the acute services review, which did not recommend the closure of the neurosurgical unit at Ninewells. I also found out that a short-life working group, chaired by Sir David Carter, is reviewing neurosurgical services in Scotland. It is due to visit Ninewells hospital on 24 February. However, a concern has been raised that the short-life working committee includes neurosurgeons from Aberdeen, Edinburgh and Glasgow, but none from Dundee.
I shall try to follow the best avenue for encouraging a members' business debate on Ninewells. I am not sure whether we can bring about that debate but, having considered the matter, this committee would be pleased to have a debate in the chamber on it. That would be preferable to taking up the committee's time in considering the issue.
By sheer bad luck we do not have a Tayside member on the committee, who would be more qualified to comment than we are. Is it possible not to confine the issue to members' business? Could we have a debate on neurosurgical facilities in Scotland, which the Tayside members might dominate in view of the circumstances? Such a debate might last for one and a half hours or so—instead of half an hour—and end in a vote. Would it be possible to leave that option open? Could we suggest that the issue be raised either as members' business or as a debate on neurosurgical services?
If the matter is raised in members' business—and John McAllion has already lodged a motion—we will be able to deal with it more quickly. If we have to wait until the end of February for a short-life working group to conclude its business—which business is then in the Executive's hands for consideration—there will be some delay.
The report is due in April.
As Mary Scanlon says, the report is not due until April. If we want to debate the issue soon—and considerable concern has been expressed by the petitioners—pursuing a members' business debate is the best course of action.
Lord Steel has made the further ruling that members' business should concern local, constituency issues. That condition would be satisfied by John McAllion's motion. I do not think that there is a case for widening the issue. After all, this petition is about Ninewells and it comes from Ninewells.
We also have no control over what is accepted for debate in the chamber. That decision rests with the business managers.
As it would be the first time that we have referred a petition to the Parliament, rather than dealt with it ourselves in the committee, I would have to investigate what options are open to us and whether we should write to the Presiding Officer or to the Parliamentary Bureau. Members' business is probably the best place for discussion of the issue.
A wider debate could result from that, as happened in the case of domestic violence.
Are members happy with that?
Yes.
The next petition comes from the west of Scotland group of the UK Haemophilia Society. It calls for the Scottish Parliament to hold an independent inquiry into hepatitis C and other infections that affect haemophiliacs.
A motion that has been signed by approximately 60 members—not far short of half the Parliament—has been lodged. Clearly, there is a mood in Parliament to do something about this problem.
I would be quite happy with that.
I support that idea. What is the deadline for the Executive's report?
We do not know.
I would not recommend that we take action before we have seen that report.
No—that is the point. The people who are concerned about the matter had a meeting with Susan Deacon, who set up the internal inquiry. However, some of the petitioners—not only those who signed this petition, but those who have petitioned the Parliament and members of this committee individually over the past few months—are unhappy with that and would have preferred an independent inquiry.
I suggest that we invite representatives of the Haemophilia Society to that meeting, to ensure that they are also satisfied.
Yes. That is understood.
Cannot we ask the Executive when it will be ready to report on that, so that the inquiry is not open-ended?
We can provide that information to members before next week's meeting.
The way in which this matter has been handled is reminiscent of what happened at Stracathro, with doctors finding out what is happening from the newspapers rather than from the health board.
There is an element of that.
The briefing paper states:
I would like to check something with you. We get the impression from the Public Petitions Committee that there is a sense of urgency about this issue. That committee asked the health board to defer its decision. Because it did not, that committee has asked the chair of the health board to appear before it to explain why the decision was not held back, despite that being requested by a parliamentary committee. According to the Official Report of the Public Petitions Committee's meeting of 18 January,
That would be appreciated. The issue about the irreversibility of the process is important. Considerable amounts of money would be spent on producing a planning application. We must ask whether it would be better to go back to the drawing board and consider whether the proposal should go ahead. We do not want a planning application being considered at the same time as the Parliament considers issues such as whether local people have been treated fairly and whether the appraisal process was carried out properly. John McAllion, the convener of the Public Petitions Committee and I—as the local member—asked the Parliament to develop a view and issue a recommendation, on the understanding that local health boards have to make their own decisions.
The committee should be aware that Susan Deacon is on record as saying that this is entirely a local matter, to be dealt with by the health board.
I also have an interest in this issue, as I have an interest in the east end of Glasgow. The local public is massively opposed to this unit. Over the months, there has been a total lack of consultation. Our briefing paper states that the health board claims that it has consulted the public and held public meetings. It has, but only towards the end of last year and in January, when the heat had been on it for many months from a local public outraged by the lack of consultation. Last week, the health board once again brushed aside the views of the public and local members, who were not given a fair hearing. By going ahead with the decision, the board is saying that it is in charge. At the same meeting, it voted to close the Auchinlea day hospital psychiatric unit in Easterhouse. The east end of Glasgow is short of mental health units, but the unit that is proposed for Stobhill is not for local people. The expenditure at the special unit would also be huge—£100,000 per patient.
Before I attempt to get the committee's view on what we should do with this petition, do members want to raise any issues that have not been picked up already?
Before I make a general comment, I want to ask a specific question that might help. Paul Martin indicated that the vast majority of people involved in the campaign are not opposed to a secure unit being sited in Glasgow, only to its being on this site. Has any indication been given of where else a secure unit might be sited?
We support having a secure unit but I do not want to suggest, before a proper appraisal is carried out, where it should be sited.
That answer helps me to formulate my general comments. The committee should not become involved in local issues. If we say that we are opposed to a specific proposal we might, in a few months' time, find that another community petitions us and says the same things about the siting of a secure unit. That is a local decision in which the committee's involvement is not appropriate. However, Paul has given the matter a wider perspective within which we have a legitimate remit. Yet again, concerns have been articulated by a local community about a health board's failure to carry out proper consultation. The Health and Community Care Committee should ask the health board to carry out proper local consultation. We should then make no further specific comment. We should also consider telling the Scottish Executive that we are concerned about the increasing evidence of failures by health boards to carry out proper consultation on a range of issues and suggest that it undertake a review of how health boards operate and their democratic accountability.
Hugh more or less summed up what I was going to say. Without clear national guidelines on consultation we are likely to get more and more petitions. Merely publishing notice in a local newspaper that there will be a unit is not consultation. We should ask for clear guidelines—we will then be in a position to judge whether health boards follow them. With Stracathro and Stobhill, a pattern seems to be emerging.
I have attended a number of meetings at which the willingness of clinical and managerial health professionals to consult more fully has been evident. Some health boards are better than others, but people want to consult, given the right guidance and assistance.
Guidelines are needed as some health boards still have the old habit of secrecy. They know that they should be consulting, but I am not sure that they know how to.
The problem is that hitherto consultation has been seen as consisting of issuing a report on a decision that has been made—only at that point is there discussion with the community that is affected by the decision. There should be wider, earlier and more open consultation, at the option appraisal stage.
It is not acceptable for the Minister for Health and Community Care to dismiss this as a local issue—almost any issue can be dismissed that way. It is one of the first of a controversial type of unit. There is massive local opposition to it, including from Paul Martin, his father Michael Martin MP and all parties. Glasgow health board should be questioned by the committee or, as Richard Simpson suggested, at the very least asked to account in writing for its decision and particularly for its timing. The health board called a number of public meetings, which Paul and I and others attended, but they were all held after the decision had been made.
What does the committee want to do? The first option is to take no action, but I would not want to do that. The second, as suggested by Hugh and others, is to take up the wider issue of consultation and to write to the health board asking questions about the consultation undertaken. We could then comment to the Executive on any concerns on how health boards operate and their democratic accountability that are raised by that reply, by the Stracathro inquiry and by other information that has come to us from around the country. We could also comment on the need for a clear set of guidelines with, possibly, training and back-up from the managerial executive. Another option would be to appoint a reporter who would find out what we need to know and, at the next suitable meeting, report back on the question of consultation and on the point that Paul made about appraisal of sites.
Do we have an answer to the question I asked, about what we would do in the light of a firm decision by the Minister for Health and Community Care that siting of the unit is a local issue and, ultimately, a planning issue?
My understanding is that we can write to the health board and to the minister to express the committee's point of view. You are right: in the end it is a local decision, which will be taken by the health board. The minister's input will come after the fact. However, the committee is in a position to state its point of view. We might be in a stronger position if we have, at least, taken some kind of evidential approach, which might involve a reporter investigating some of the concerns that have been raised in committee. We can take action based on their report.
I would like clarification on a point, which might influence what action we take. Will this unit, despite being housed in Glasgow, deal with cases from anywhere in Scotland, in the way that the state hospital at Carstairs caters for people from all over the country, if they fit the right criteria? Will it be simply a unit for people who were formerly resident in Glasgow or who have a Glasgow connection? That could influence whether there is a national dimension, or whether it is a Glasgow problem.
Can you pick up on that in your comments, Paul?
Paul might be able to answer that better than I can; however, I am aware of proposals for similar establishments in a number of areas as part of the review of service delivery. Other health board areas will face similar problems in future.
I would welcome the appointment of a reporter, with the caveat that the committee considers calling witnesses at a later stage. It is, however, for the committee to decide whether it wants to follow that course.
We are running short of time.
I fully support the appointment of a reporter. There are clear issues that need to be considered. Perhaps we could move on—Dr Richard Simpson might consider being the reporter for Stobhill.
Are you happy with that suggestion, Richard? What do other members think?
There should be two reporters, as a lot of work will be involved.
That is a recipe for getting nothing done.
Having two reporters would make it more difficult to co-ordinate diary dates and so on.
We should leave reporting in the hands of one person. There is a sense of urgency in this matter.
There is also a huge amount of work to be done.
The reporter will be able to talk to any other members of the committee. All committee members will be able to give their input in advance and say what they think ought to be done. Any suggestions should include contact names, and so on. Richard Simpson probably has better contacts in the Glasgow health area than me, but I have some names that I would make known. Everybody will be able to contribute to the reporter's report, but it would be better if one person produce it. I suggest that we should have that report back on 9 February. Is that acceptable?
I have a question about the time scale that you have announced. I appreciate the need for urgency, but Dr Simpson will be seeking evidence from several witnesses and 9 February might be an unreasonable deadline.
We can expect an interim report by 9 February. We might have to extend the time scale, but an interim report will be an adequate response to the urgency with which the Public Petitions Committee is treating this matter.
Can you clarify that the issue is not exclusively about Glasgow?
Dorothy-Grace, I ask that you refer any other points on this issue to Richard Simpson. We must move on.
In my report I will not try to adjudicate on where the unit should be placed. I will examine only the processes by which the decision on siting the unit has been reached.
Thank you.