Official Report 125KB pdf
Hospital Services outwith Cities (PE407)
The next item is an update on the situation regarding the significant number of on-going petitions.
Post-mortem Organ Removal (PE406)
Petition PE406, from Margaret Doig, calls for the Scottish Parliament to redress the omissions concerning the law and code of practice governing post-mortem removal and retention of organs and disposal of body parts when the deceased has no relatives, as and when recommendations for changes in the law and codes of practice in relation to those matters are implemented.
Allergy Clinics (PE276)
Petition PE276, from Elizabeth Girling on behalf of the Lothian Allergy Support Group, calls for the Scottish Parliament to establish specialist clinics for the diagnosis and treatment of allergies in national health service hospitals. The Public Petitions Committee has referred the petition to us with the recommendation that it be for information only at this stage. Is that agreed?
Cancer Rates (East Lothian) (PE349)
Petition PE349, from Mr Thomas Stevenson, calls on the Scottish Executive to carry out an urgent investigation into reasons why cancer rates are higher in East Lothian than elsewhere in the Lothian Health area. The Public Petitions Committee has obviously done some work on the petition and has referred it to us.
Organic Waste Disposal (PE327)
Petition PE327, on behalf of the Blairingone and Saline Action Group, seeks redress from environmental pollution and noxious odours caused by the current practice of spreading sewage sludge and non-agriculturally derived waste on land in Scotland. The Transport and the Environment Committee forwarded the petition to us for comments. No comments have been received since it was circulated to members, so I suggest that we take no further action at this time.
I suggest that we nevertheless express concern about this matter, because we do not even know the form—whether cake sewage or loose sewage—in which the sewage is going on to the land. The matter is extremely concerning. When the petition was originally lodged, blood was also being spread on the fields.
The substantive part of the petition is being taken forward by the Transport and the Environment Committee, so the issue is being followed through.
I appreciate that.
All members of the committee had an e-mail circulated to them prior to this meeting asking for their comments on the petition. At this stage it is probably best for us simply to note the petition and the continuing work that is being done by a fellow committee of the Parliament. Is that agreed?
Myalgic Encephalomyelitis (PE398)
Petition PE398, from Helen McDade, calls for the Scottish Parliament to urge the Scottish Executive to carry out a strategic needs review assessment on ME and chronic fatigue syndrome and to take a range of other steps in relation to the treatment of and research into those conditions. The Public Petitions Committee has referred the petition to the Health and Community Care Committee and asks whether we intend to, and whether we could, conduct an inquiry into the issue. The Public Petitions Committee has also requested comments from the Executive on issues that the petition raises and has asked for updates on the ME working group—which is based in England—on which the Executive has observer status. As far as we are aware, the Public Petitions Committee is still waiting for a response. I ask Mr McAllion, who is the convener of the Public Petitions Committee, whether that is correct.
Yes, it is. The petition was one that most impressed the Public Petitions Committee by the way in which it was presented and by the evidence that supported it. The committee's view was that the petition should be pursued. We are awaiting the chief medical officer's report on the situation in England and Wales, which will obviously have an influence on the Scottish Executive. However, the report is not binding on the Executive, which could take a different course of action.
That is duly noted. I think that we have probably all been lobbied at one time or another about the issue. I have been lobbied by local ME sufferers. There is a great deal of sympathy for what John McAllion has said.
The deputy convener of the cross-party group on ME, Alex Fergusson, spoke to me about the petition. He, too, made John McAllion's point about the psychiatrists pulling out of the CMO's group. He said that 25 per cent of those who are worst affected by the condition do not support the CMO's group, in which there seems to be little faith. He has asked me whether we can take a fresh look at ME in Scotland and take a lead by supporting the establishment of a group to carry out further research. In fact, we are being asked to support the actions set out in the petition.
Given that we seem to be in a period of flux with regard to what the CMO's working group is doing in England, probably the first thing we should do is establish exactly what is happening and what time scales that group is working to. When we have that information, we can return to the issue and decide whether we want to investigate the matter as a committee.
Petition PE370 is from Lydia Reid on behalf Scottish Parents for a Public Enquiry into Organ Retention. I hope that our earlier decision on the issue stands. We shall return to the matter. Is that agreed?
Petition PE374 is from Dr Steve Gilbert and calls on the Scottish Parliament to act urgently to redress the underfunding of chronic pain management services, to debate the matter in Parliament and to urge the Minister for Health and Community Care and health boards to move chronic pain up the health agenda.
The problem was that the Executive misunderstood the brief on the petition. That is why we had to refer it back. It included such things as palliative care. The petition is not to do with palliative care. Chronic pain is something that affects up to 500,000 Scots in the community, most of whom do not have life-threatening problems but are suffering from back pain or arthritis, which cause terribly severe pain. The Executive still does not seem to have grasped that point.
I support what Dorothy-Grace Elder says. The Executive misunderstood the nature of the petition and its response includes services that are not relevant to the petitioner's concerns.
Is it your understanding that some of the facilities and services that are listed in the Executive response would fall into that category again?
Yes. That is why we have two separate cross-party groups in the Parliament, one on palliative care, the other on chronic pain. I declare an interest: I am convener of the cross-party group on chronic pain. I think that the Executive has made a simple mistake. I do not think that it has deliberately skewed its response, but I think that we should continue to push for the right response.
Do members agree to write again to the Executive to ask for further clarification on chronic pain management other than palliative care?
Where are the references to palliative care in the health department's response?
I certainly saw one letter that referred specifically to palliative care—
One. There is one reference in relation to Argyll and Clyde Health Board. There are no references to palliative care in relation to Ayrshire and Arran, Borders, Dumfries and Galloway, Fife, Forth Valley, Grampian, Greater Glasgow, Highland, Lanarkshire, Lothian, Orkney or Shetland. I have difficulty following what Dorothy-Grace Elder and John McAllion are pursuing here.
Let us be clear. Given the point that Margaret Jamieson has made, are you saying what you are saying because you know that some of these services involve palliative care, or are you making that comment on the basis of the one service that is mentioned as being palliative care?
Palliative care is mentioned right at the beginning, albeit in relation specifically to Argyll and Clyde. However, the fact that it is mentioned at all—in view of an earlier response from the Executive—shows that we are still talking at cross purposes, to some extent.
Maybe I am misreading this response. My understanding of what it says about Argyll and Clyde is that a formal chronic pain management service is provided. However, under the heading
Glasgow does provide a service, as does Edinburgh, but those services are overladen with patients from other areas. Look at the number of blanks that are in the response: "Forth Valley … none … none", et cetera, et cetera. I refer members to the section on Greater Glasgow. It states:
Dorothy-Grace Elder needs to go back and look at what petition PE374 talks about. It does not talk about who delivers the pain management; it says that it should be moved up the health agenda. We have a baseline report that says, "This is what we supply currently in each of the health board areas. This is what they are going to do for the future." The Executive is taking the issue forward. It meets the terms of the petition. The petition does not ask us to do what Dorothy-Grace Elder is indicating.
I agree with Margaret Jamieson. Traditionally, anaesthetists have been the clinicians who have provided chronic pain management. In some of the trusts, pain nurses are also available, which is the way in which we want to see things going. I thought that the petition was looking for services to be provided. We now seem to have evidence that those services are provided in most areas, and I do not understand why there is a problem with that.
I support what Dorothy-Grace Elder is saying. I know from personal experience in Dundee that there are serious problems. Somebody who was associated with the pain clinic there killed himself. These services are underfunded throughout Scotland.
Although this seems a fairly comprehensive list of services, which appear to cover the whole of Scotland, the response does not show us the strain on any of them; nor does it give us further information about whether they are coping with the demand in any given place. To be fair, I do not think that that was the question the Executive was asked.
Could we not do both? That would satisfy the issue about what the petition relates to and show that the committee is concerned that there is a lack of information in an associated area. We could ask for that information and I suggest that we do so and continue with business.
I support asking the Executive to consider the inconsistencies of approach throughout Scotland and whether it could recommend some sort of protocol or guideline to address those inconsistencies. The petition is about underfunding but we would be concerned about the inequalities of access to chronic pain services. We could ask for a commitment to a consistent level of services across Scotland.
We also need the Executive to give us waiting times. At the moment, at Ninewells hospital in Dundee, it takes six months to see a chronic pain consultant; in Glasgow it takes about four months. We are getting fudgy information. For example, the Executive's response on improvements in Lanarkshire in the past year states:
Shona Robison pointed out the sensible way forward. We have asked questions about the petition and the Public Petitions Committee has drawn it to our attention. The Executive's response probably does answer the petition. However, having been shown the range of services, we can ask for further information on some of the points that colleagues have raised. A key point is whether supply and demand are matching one another or whether there are identifiable pockets where demand is not being met by the services that appear to be available throughout the country. The committee has general concerns and wants the issue of chronic pain to be flagged up to ensure that the Executive is aware that concerns have been raised with the committee. Are we agreed?
I do not think that we have the information to answer the petition. The petition asks for Parliament to redress the underfunding of chronic pain services. We do not have the information to say that that is what is being done.
We do not have the authority either.
We are seeking information to answer the petition and I do not see why we cannot ask for further information.
There are hardly any improvements listed—
Dorothy-Grace, please address your comments through the chair.
I keep returning to the original wording of the petition. John McAllion is raising another issue about underfunding, which is subjective to each and every one of us.
It is in the petition.
It might well be, but we need to go back to find out what the Public Petitions Committee asked and whether it drew attention to the underfunding aspect of the petition. If attention was not drawn to that, you would not receive a response. The response from the health department provides answers about the situation in each health board area. Did the Public Petitions Committee ask the health department specifically about waiting times and waiting lists?
I ask John McAllion to clarify whether the question of underfunding was raised with the Executive.
That question was raised in petition PE374. The Public Petitions Committee's view was that the Health and Community Care Committee should address the petition, as it was not for the Public Petitions Committee to do that. Petition PE374 asked the Public Petitions Committee to address underfunding of chronic pain services in Scotland. I suggest that we do not yet have the information to respond to the petition.
There are two ways of looking at the matter. Either we decide that we do not have the information to make a decision, or we decide to continue with the petition by asking for further information.
Scottish Ambulance Service (PE381)
We move to petition PE381, which was lodged by Thomas Campbell on behalf of the Transport and General Workers Union and Unison. The petition calls for the Scottish Parliament to examine the Scottish Ambulance Service's proposals to close five of its eight operations rooms. The Public Petitions Committee considered responses from the Scottish Ambulance Service and from the minister and it agreed to refer petition PE381 to the Health and Community Care Committee for our consideration. Members have a copy of the responses.
Toward the end of this year, the Scottish Ambulance Service will make another report to the Audit Committee. That report will advise on the service's business plan, in particular in relation to priority despatch.
Do members agree to consider petition PE381 at a future meeting and to note that the Audit Committee is keeping an eye on the petition's progress?
Trade Liberalisation (PE320)
We move on to petition PE320, which was lodged by John Watson on behalf of the World Development Movement Scotland. The petition calls for the Health and Community Care Committee to examine the implications for health policy in Scotland of the World Trade Organisation's liberalisation of trade in services. John McAllion was appointed as our reporter on the matter. His report will be considered under item 5. We will therefore return to that report later in the meeting.
Organ Retention (PE283)
We move on to petition PE283, which was lodged by the Scottish Organisation Relating to the Retention of Organs. Do members agree that the decision that we took earlier on petition PE406—to allow members time—stands for petition PE283?
Fuel Poverty (PE123)
We move on to petition PE123, which was lodged by the Warm Homes Campaign, on fuel poverty. Members will recall that we agreed on 23 September that the clerks would merge the reports of committee reporters Dorothy-Grace Elder and Malcolm Chisholm. The suggested date for us to reconsider that merged report is 5 December. Do members agree to do that?
Epilepsy Services (PE247)
We move on to petition PE247, which was lodged by the Epilepsy Association of Scotland. The petition calls on the Scottish Parliament to ensure co-ordinated health and social services to benefit the 30,000 people in Scotland who suffer from epilepsy. In December 2000, we agreed to await the acute services review. On 27 June, we further agreed to write to the Executive asking, in the light of its performance assessment framework, what minimum standards it intended to set for provision of services for epilepsy sufferers. Members have copies of the two Executive responses. Do members have comments to make?
In Trevor Lodge's letter dated 30 October, the first paragraph on the second page mentions that
Would it be reasonable to send the Executive's response to the EAS to make it aware of what has been offered and seek its response? I would hope that the organisation would see the response as a positive step and that it might want to offer further input on the back of it. Generally speaking, I think that the committee welcomes the Executive's response.
In the course of setting up a group in the Highlands, I have been quite shocked that people who have been diagnosed as suffering from epilepsy have been told simply to go home and get on with it. As a result, I strongly support the petition. Although—as the letter says—between 70 and 80 per cent of sufferers have their condition and their medication under control, a large percentage of people who have the condition still feel very isolated. I had not appreciated that fact until recently.
We will send the Executive's letter to the petitioner and await a response. We will decide then whether we should simply draw a line under the matter. Do members agree?
Multiple Sclerosis (PE223)
We move on to petition PE223, from Mr and Mrs McQuire, which 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 on 27 June to await the report from the National Institute for Clinical Excellence and to seek information from the Executive on the timetable for publication of the report. We further agreed on 19 September to continue to wait for the NICE report. NICE's final appraisal determination on beta interferon was published on 2 November; I hope that colleagues have had a chance to read the document.
Since we discussed the petition previously, there have been new developments. For example, the announcement of beta interferon trials is significant. However, I feel that we are operating almost in parallel universes. I am not quite sure how the appraisal and the forthcoming trials relate to each other. Although it seemed as though the beta interferon trials would supersede the results of the appraisal, the focus now seems to have returned to the appraisal. We need to get in touch with the Scottish Executive urgently for an update on the trials as they relate to Scotland. When Malcolm Chisholm was Deputy Minister for Health and Community Care, he confirmed that the trials would be extended to Scotland; as a result, we need to find out the time scale for introduction of the trials. That impacts on MS sufferers in Lothian, who will, I presume, receive the same access to those trials as everybody else, if the trials are deemed appropriate.
I am not clear about one point. I understand that when NICE issues the final guidance, the HTBS will assess it before making recommendations to the Scottish Executive. That means that we could be well into next year before the position in Scotland becomes clear.
That is quite likely. We should ask the HTBS this evening about the timetable for that decision.
Sleep Apnoea Services (PE367)
Our last petition is petition PE367, from Mr Eric Drummond, which calls on the Scottish Parliament to ensure that adequate and equal services for diagnosis and treatment of people who suffer from sleep apnoea are available throughout Scotland. The committee agreed on 27 June to note the petition and to pass its concerns about the present system of funding small disease groups to the Public Petitions Committee. The petition was further noted on 19 September, together with correspondence that was forwarded by the Public Petitions Committee. The Public Petitions Committee considered the results of Lothian Health Board's review of its sleep services at its meeting on 23 October and is seeking the views of the petitioner before considering the petition again.
The petitioner comes from Lothian. That said, we have received responses from elsewhere in Scotland. Although we felt that Lothian Health Board's petition was very positive, perhaps the live issue as far as petition PE367 is concerned is the two-year waiting time for accessing the service. The petitioner has the chance to make that point to the Public Petitions Committee. We will then consider what to do about the petition.
The Official Report says that you received a response from the Executive. We do not have a copy of that letter.
As far as I know, the letter is for information only. We are still waiting to hear from the petitioner and, when we do so, we will make our final recommendations. That said, if the Health and Community Care Committee wants to see all the responses, we will send them to you.
I have just been informed by the clerk that we noted the Executive response on 19 September. We will continue to note the petition until we hear the final recommendations of the Public Petitions Committee. We will then decide what to do with it. Perhaps it would be helpful if Mr McAllion could send me a copy of that response.
Meeting adjourned until 10:19 and continued in private until 10:56.
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