Health and Community Care Committee, 27 Jun 2001

Meeting date: Wednesday, June 27, 2001

Official Report 128KB pdf

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Petitions

We move to agenda item 4, which is a report on petitions. Annexe A of the report shows that three petitions have been referred to the committee for information only. If committee members want the committee to respond in some way other than merely to note the petitions, they may say so now. The petition from the Kirkcaldy area abuse survivors project has been passed to the Social Justice Committee so that substantive work can be done on it. It might be best to let the Social Justice Committee get on with it, and if members want to contribute they can do so through that committee. Is it agreed that we will simply note the three petitions?

Members indicated agreement.

There is a petition on Stobhill. There seems to be an on-going situation about the siting there of the medium secure unit and the removal of acute medical and surgical services. Should not we return to that petition, given that it relates to an on-going concern?

I remind members of the position that we took previously, which is that despite having received several petitions about the acute services review and specific hospitals and trusts, it is not the best course of action for us to take on every petition. When we dealt early on in the session with the Stracathro and Stobhill petitions, we were careful to ensure that we looked at strategic issues, such as consultation and the involvement of staff. We did not second-guess the people on the ground with regard to acute services reviews.

There are a number of people round this table who will be particularly interested, not only in what is going on in Glasgow, but what is going on in Dundee, Perthshire, the Highlands and so on. If we get involved in every single acute services review or every decision to close a hospital or trust, what else in our work load will we get through? I am restating the position that we have taken all along. If the message went from the committee to petitioners that we will take on board every aspect of acute services reviews, we would not get any other work done.

I agree with that view in principle, but I wish to put it on the record that, like Mary Scanlon, I would like the petition to be a live petition. An indication should be given that we will keep a watching brief on the petition. We should bear it in mind that there are more than 40,000 signatures on the petition and that the acute services review that affects Stobhill and other hospitals in Glasgow is the largest such review in Scotland.

On Stracathro, we commissioned a report from one of our members and interviewed witnesses, which improved the consultation process. However, most members would agree that we should not fade into the woodwork entirely and that we should maintain a watching brief to see whether the process continues to be fairer than it was initially at Stobhill, because it was not fair to the public at first. I request that we regard the petition as a live petition, and that we hear more about it as the months go on.

First, we should distinguish petition PE354, which is on the acute services review, from the previous petition on the special unit. Petition PE354 has nothing to do with the decision that was taken—or rather not taken—yesterday by Greater Glasgow Health Board.

The Public Petitions Committee still views petition PE354 as a live petition, although it is satisfied with the consultative method that Greater Glasgow Health Board has set up. A reference group has been established to consider all the options in the north of Glasgow, involving local MSPs, MPs and staff who work in the NHS in that area. If the reference group is unhappy with the way in which the health board conducts that review, it can come back to the Public Petitions Committee, which would forward the matter to the Health and Community Care Committee if it thought that such action was justified at that stage.

I am satisfied with what the convener of the Public Petitions Committee has said.

The manner in which the Public Petitions Committee has dealt with the petition is helpful. When we considered the petition on the siting of the secure unit at Stobhill, we said to Greater Glasgow Health Board that the consultation that it had undertaken was insufficient. We also recommended to the minister that the consultation process should be strengthened. I welcome the fact that yesterday's decision was made in light of our recommendation that the Stobhill consultation should be revisited. I am happy with the action that John McAllion mentioned.

The petition has been sent to us for information and at this stage we should simply note it. The Public Petitions Committee will give us more information in due course.

We may wish to examine or obtain information about the acute services reviews that are happening throughout Scotland. Rather than examining individual issues, we could then consider the wider context.

I did not receive a copy of petition PE367, which is from Mr Drummond.

I did not receive a copy of it either.

We are lucky to have John McAllion with us. I would like to know why the petition has been referred to us for information purposes only; I am concerned about that. An increasing number of nationally important but small services fall under only one health board and are not funded appropriately. We may be required to investigate the principle of funding those services. However, I cannot tell why the petition was referred to us for information only, because we have not seen the papers.

I seek clarification on whether committee members have received papers on the petition.

I do not remember seeing any papers.

I do not recall receiving any, either.

Perhaps I should say why the petition was referred in this manner. A number of committees criticised the Public Petitions Committee for referring petitions to them too readily, so it was decided that the Public Petitions Committee should do the initial spadework. In this case, we wrote to the Executive and the relevant health boards to ask for their response to the petition. When those responses are received, we will consider how to dispose of the petition. If we are not satisfied with the response, we will pass the petition on to the Health and Community Care Committee.

We should probably deal with the petition in the same way as we dealt with the petition on the secure unit at Stobhill hospital. We will note that it is on-going and await the further information that the Public Petitions Committee has requested.

May I make a suggestion about future consideration of petitions? It is useful that John McAllion is a member of this committee, but other committees will not be told why they are being asked to note petitions. It would be helpful if we could receive an indication of the action taken by the Public Petitions Committee and an explanation of its recommendations.

On a more administrative note, even though a petition has already been circulated, it would be useful if it were circulated again with the meeting papers. We tend to misplace the odd paper now and then, given the amount of paperwork that comes to us.

Although John McAllion has heard our comments, could we communicate them formally to the Public Petitions Committee? I have been contacted by a number of organisations about small groups of people who suffer from particular diseases or conditions. Those organisations are concerned about current funding methods. Under the internal market, people could purchase treatment from a health board. However, the new system is much more cumbersome and funding has yet to be dealt with adequately. I have concerns—I put it no more strongly than that. Perhaps we could pass those points back to the Public Petitions Committee to consider and ask it to seek a response from the Executive on whether particular principles apply to the funding process.

When we raised that privately with Malcolm Chisholm, he said that, as a local constituency MSP, he, too, had written to complain about the service—to himself.

We have had a partial success in Lothian as the funding has now been found. However, we have all received similar letters; on this occasion they seem to have borne some fruit. We will write back to the Public Petitions Committee with Richard Simpson's point that, although we are concerned about the specific problems of sleep apnoea, petition PE367 opens wider areas of concern. We will return to the petition when we have had further information.

Let us move on to annexe B, which lists on-going petitions. Petition PE320 is on the implications for health policy in Scotland of the World Trade Organisation's liberalisation of trade in services. Perhaps John McAllion can update us on that, as he is the reporter on that petition.

I have not been officially appointed as the reporter.

Have you not?

No. However, I have been reading the papers that have been sent to me by the World Development Movement and the Health and Community Care Committee clerks.

The situation is complicated—as ever, there are two sides to the story. The concerns are not about the general agreement on tariffs and trade treaty that was negotiated with the WTO in 1994. The concerns that have arisen come from the on-going renegotiations. The supporters of the general agreement on tariffs and trade—the WTO, the UK Government, the American Government and the big multinationals across the world—are trying to allay everyone's fears by saying that there is nothing to worry about, because the GATT treaty defends the position of public services. However, opponents point out that that is not the case. The system is complicated. The GATT was created to remove trade barriers and to allow the expansion of trade and competition.

Given the recent general election and the indication from the Prime Minister that he is seeking greater involvement of the private sector in the provision of public services, it would be worth appointing a reporter to investigate the matter. I know that health is a devolved matter, but the move towards greater competition and private sector involvement could have implications for our health service.

I propose John McAllion as the reporter, as he seems to have such an interest in the topic.

If John McAllion is happy with that suggestion, do members agree to appoint him as the reporter?

Members indicated agreement.

Petition PE283 calls for the Scottish Parliament to initiate a public inquiry into the practice of organ retention at post mortem. We are still awaiting comments from the Executive on the petition, so we will have to postpone its consideration.

Can we have an update from John McAllion? I understand that petition PE283 was discussed at the Public Petitions Committee last week and that Lydia Reid gave evidence.

That was a different petition on the same topic. The Executive inquiry has not been published yet and we are waiting to see that before we decide on our next step.

Am I right in thinking that the other petition is also heading our way?

It will be. When petition PE370 was before the Public Petitions Committee last week, we were told that the Scottish Organisation Relating to the Retention of Organs was no longer calling for a public inquiry. However, the petitioners pointed out that, although the head of SORRO had switched her position, the majority of people involved still wanted a public inquiry. We are still lacking a lot of information. The Public Petitions Committee should do more work on the matter before we pass it on.

We will note the petition at this time. We will consider the petitions on haemophilia and hepatitis C later.

Petition PE145 is on vaccines and autism. The committee awaits the Executive's response on the measles, mumps and rubella vaccine. We hoped to have that before the recess, but it has not arrived yet. We were anticipating that we would have comments today on the cancer plan, on hepatitis C and on MMR, but we have not received them. We were told that we would have the comments before the summer recess, so they might arrive later in the week. That is how things stand, although it is unfortunate.

We set a deadline, did we not?

The deadline is Friday, so the Executive is technically allowed until then to respond.

The Executive is perfectly aware that this is the last meeting of the Health and Community Care Committee before the recess.

I have been informed by the committee clerk that we set an earlier deadline, but that the deadline was changed at the Executive's request. We will write to the Executive to say that, although we accept that the revised deadline was Friday, it would have been useful for us to have had some comments today so that we could deal with them before recess.

There is a wider issue about the manner in which the Executive deals with requests for information from this committee. I do not know whether other committees meet with the same treatment, but the Health and Community Care Committee is constantly kept waiting for responses until the last moment or beyond. Members will see that, later in the agenda, we are dealing with a response from the minister on haemophilia and hepatitis C. We were asked to push back our deadline in relation to that response as well. Members can decide later whether that response was worth waiting for, but I do not think that it was. It is difficult for us to do our job if the Executive constantly flouts our deadlines for the receipt of information.

It is especially problematic in relation to issues such as hepatitis C. The delay means that the patients groups and the interest groups that have worked hard on the matter might be kept waiting for another two or three months before they get a response. I think that the Executive's conduct is unacceptable.

The responses that we are waiting for are special cases, as we are about to enter the summer recess, but we will pursue the matter nevertheless.

We should send two letters. One should raise our concerns about the MMR response and the other, which should be more strongly worded, should deal with the general issue of the time it takes to get a response. That letter should point out that a protocol has to be developed to ensure that responses are received in good time, particularly when committees are facing deadlines such as the beginning of summer recess.

There is already a protocol that says that the Executive should respond within eight weeks. The clerk informs me that the Executive is not responding to us within that eight-week period. However, we would have to check how often the deadline is being missed before we sent a particularly strongly worded letter. The clerks and I will do that. My anecdotal view is that we are often kept waiting for information on important issues and that that has an impact on the clerks' ability to give us information in good time rather than on the day of a meeting.

Petition PE145 has significantly wider issues, given that the uptake in the MMR vaccination rate is down by 2 per cent. According to reports in the press this week, there is an increase in autism. Many parents are waiting for the advice that they will receive in the report. If it cannot be addressed in eight weeks, we should at least get an update and a date by which all the issues can be examined.

We need to be clear about whether the Executive has broken the protocol. If that has happened, a strongly worded letter is appropriate.

The Executive has broken the protocol.

Has it?

Yes. Our deadline was 8 June, and it had been put back to suit the Executive.

Given the general election, does the eight-week protocol still stand?

The general election was nothing to do with us.

That is what they all say.

We can absolve ourselves of all blame.

We will move on. Later in the meeting, we will consider petition PE123 from the warm homes campaign. We will also look at PE217 from the Glenorchy and Innishail community council.

We move on to petition PE247 from the Epilepsy Association of Scotland. On 12 December, the committee agreed to await the acute services review before looking at services for the 30,000 people in Scotland who have epilepsy. However, the petitioner has asked us to look at the petition again on its own merits rather than in terms of the implementation of the acute services review.

Does that relate to the Scottish health plan?

We have no further information on that.

We should have that information. We need to know whether we are talking about the Scottish health plan.

Do members want to reverse the decision that we took on 12 December? If we want further information or notes to be provided by the Scottish Parliament information centre, we should make a decision today.

The problems are similar to the geographical question that was discussed earlier in relation to Stobhill. If we look at a particular disease group, we will have to look at every disease group. Are there any general principles that the committee wishes to look at in respect of a petition of this sort?

The general principle is that a minimum standard of service should be available across Scotland to all epilepsy sufferers. That principle applies to any disease group. In the light of the new performance assessment framework that was reported to us in the budget debates, I suggest that we write to the Executive asking what minimum standards it intends to set for the provision of services to epilepsy sufferers. That would at least allow us to establish a starting point for future decisions about investigations of the kind that are raised by PE247.

That suggestion would tie in with some of the comments that we made in our budget report. We raised concerns that some services across Scotland vary in certain postcode areas. The example that we used was the availability of multiple sclerosis nurses—that example was symptomatic of the committee's wider concerns.

Are members happy with the suggestion that was made by Richard Simpson?

Members indicated agreement.

We await the decision from the National Institute for Clinical Excellence in relation to petition PE223. The Health Technology Board for Scotland will then look at the suggestions that are made by NICE and add to them. We await both those responses.

I apologise if I am taking up time, but our timetable showed that NICE's second lot of economic investigations would be completed in August. The HTBS would then take six to eight weeks to comment on those investigations. I suggest that we write to the Executive to ask for confirmation of that timetable. We owe it to MS sufferers to be certain that there has been no further slippage in what is an already significantly delayed timetable.

Could we write direct to NICE and ask it?

At this stage, all we need is the information on the timetable. It is probably best to get that from the Executive because the issue involves not only NICE, but the HTBS, as it will do work following the NICE judgment. Writing to the Executive would be the most effective course of action. Are we agreed?

Members indicated agreement.