Current Petitions
Hospital Closures (Public Consultation) (PE643)<br />Health Service Configuration (Consultation) (PE707)
Petition PE643 relates to public consultation on proposed hospital closures and PE707 relates to consultation on the configuration of health services.
Petition PE643 calls on the Scottish Parliament to take the necessary steps to improve public consultation on any proposals to close hospitals for which additional public funding has been provided through fundraising and other donations. Petition PE707 calls on the Scottish Parliament to urge the Scottish Executive to consider a new legal framework for consultation on the configuration of health services that would include advice on the proper use of guidelines and an independent process for the selection of expert advice, particularly where the provision of national services is affected, and to create a process for the establishment of integrated maternal and child health services.
On 4 February 2004, the committee considered PE643 and agreed to seek comments on the issues raised in the petition from the Minister for Health and Community Care. The committee expressed particular concerns regarding apparent flaws in consultations on proposed hospital closures by health boards across Scotland, as illustrated by the petitioner in relation to Greater Glasgow NHS Board.
The committee took the view that the consultation process employed by all health boards should be more meaningful than it has been and that all submissions to such consultations should be publicly available. The committee also asked whether the Executive plans to introduce guidelines on consultation procedures for health boards as part of the National Health Service Reform (Scotland) Bill. The committee expressed concerns regarding the configuration of maternity services and sought the Executive's views on the apparent lack of strategic planning as regards the location of maternity services in Scotland. At its meeting on 3 March 2004, the committee agreed that, given the similarities between the points raised in PE643 and PE707, we would ask the Executive to address the specific points raised in PE707 as part of the response to PE643. Specifically, the committee requested the Executive's comments on the petitioners' claim that, during the consultation process, Greater Glasgow NHS Board
"provided misinformation to the public and misquoted National Guidance documents, including EGAMS and BAPS".
The committee also agreed to seek the views of Greater Glasgow NHS Board. The committee has now received responses from the minister and from Greater Glasgow NHS Board and I would like to hear the committee's comments on those responses.
I did not comment on the previous two petitions because I will get a chance to do so when they come before the Health Committee.
On petition PE643, I have received a copy of the draft guidelines on consultation that, I believe, have been sent to all MSPs. I think that the consultation period ends at the end of April. As far as consultation is concerned, that is one of the most crucial documents that we have had to deal with in the five years of the Scottish Parliament. We must express our views on the document and urge the wider community to do likewise as the guidelines will set the pattern for the future.
Although petition PE643 says that it is about additional public funding through fundraising, the petitioner's presentation was nothing to do with that. It would therefore be helpful if we could set that issue to one side.
I welcome many of the assurances given by the minister. My colleague Pauline McNeill, who sends her apologies for not being here as she is convening another meeting, is of a similar view and would like the petitions to be sent to the Health Committee.
However, a number of issues remain unresolved, not the least of which is that, although the EGAMS report is quoted, no evidence has been provided of regional planning and it is not evident that the health board has taken on board a substantial body of opinion. That comes back to the issue of preset agendas. My colleague Pauline McNeill, who has been actively involved in the issue, and I suggest that we should send the petitions to the Health Committee because they fit into wider issues about maternity services that the Parliament needs to address.
At present, health boards throughout the country appear to take decisions in isolation from elected representatives. Although there is cross-party opposition to the closure of units, health boards ignore elected members' views and proceed. I can speak specifically only for Ayrshire, although I suspect that the same is true in other areas. The issue is almost a constitutional one. Health boards take such action despite unanimous cross-party opposition.
That point will be taken on board.
Although Dorothy-Grace Elder's petition relates to fundraising, it also mentions the fact that the Queen Mother's hospital and Yorkhill hospital have a good location. Without fundraising and money from the public, those hospitals would not have Ronald McDonald House and other facilities. Dorothy-Grace Elder argued that, because money from the public is involved, a separate consultation process should be carried out. I do not agree, but I wanted to mention part of the reason why Dorothy-Grace Elder lodged the petition. The public have gladly given millions of pounds, but that money will disappear if the health board swallows up the hospitals. However, I agree with members that we could not have a separate consultation process.
I agree with Jackie Baillie about the reply from the minister. The minister's reply is not unwelcome, but I do not see anything positive in it. He says that he will make his decision after 20 April when the health board has made its decision. I hope that we can persuade him to take action either before or after that. I agree also with Jackie Baillie that, although the minister mentions regional planning, the EGAMS report has not been taken on board. As I said to Jamie Stone and George Lyon, the health board seems to be working with the EGAMS report, but there are two reports, which are as good as each other. Both the reports mention that strategic planning and regional planning should take place. However, such planning has not been carried out at all, as can be seen from the number of petitions on hospital closures that we have received over the months.
I have several points about Professor Arbuthnott's reply. I submitted written evidence to the health board. He mentions the EGAMS report and he is good enough to mention that two versions of the report were produced. However, the health board did not tell anybody during the consultation process that there were two versions. He goes on to say that both versions have equal weight. The health board's working group said that the EGAMS report was everything, but that is not the public's perception. I question the validity of the documents that were produced on that issue.
Professor Arbuthnott admits that there was an error about the British Association of Paediatric Surgeons guidance in the consultation documentation, which we have been saying since that documentation was produced. However, that did not stop the health board producing documents based on the BAPS guidance—I think that 35,000 papers were sent out with what I call misinformation. Professor Arbuthnott has kindly mentioned that there was one error about the BAPS guidance. That might have been minor to the health board, but it certainly was not minor to the people who looked at those documents.
Professor Arbuthnott mentions that the advisers were part and parcel of the consultation process. One of those advisers, Dr Barker from Sheffield, did not come up to Glasgow to have a look and the advisers who came were in Glasgow for only half an hour. It is unacceptable that the person who had the most input into the health board's decision—Dr Barker—did not even visit the Queen Mother's hospital or the Yorkhill hospital.
I shall finish on this final point, because I know that there are other points that people want to raise. The reply mentions the fact that the consultation mentioned the safety of all maternity patients; it also mentioned services at the sick children's hospital. When I gave evidence to the board, Margaret Reid told me that the Queen Mother's hospital was a separate issue from the Yorkhill hospital and that I was not to refer to the Yorkhill hospital again in the same context. She said that the Royal hospital for sick children was a separate issue, yet Professor Arbuthnott's reply to us mentioned the fact that Yorkhill was looked at closely when the decision was taken regarding the Queen Mother's hospital. When I gave evidence to the working party, however, I was told in no uncertain terms not to raise Yorkhill because it had nothing at all to do with the issue—I was even told not even to call the hospital Yorkhill, but to call it the Royal hospital for sick children.
I find all those contradictory facts in Professor Arbuthnott's reply not puzzling or surprising but quite disgraceful. I certainly know for a fact that half of the stuff that he has sent back to us is still blatantly wrong. I shall obviously wait to see what the committee has to say regarding a recommendation to do with all the health services. I am glad that we have the replies back, but I am still not satisfied with them.
It is quite clear that all four petitions raise concerns. It was mooted earlier that we should send the petitions to the Health Committee, and I know that Sandra White has said that the issue should be referred back to the Executive. We have now reached a point at which we have gathered together a lot of information about concerns with regard to the reviews and consultations, and I think that it would be useful to pass that information on to the Health Committee and ask it to consider the issue in a wider context.
I agree. Professor Arbuthnott's response illustrates one of the big issues. It states:
"There is no evidence that the pre-consultation Working Group failed to take into account the views of current Yorkhill staff".
Such assertions are made, but there is no opportunity to examine the basis on which they are made.
Even in some of the consultations on secure units, people have had complaints about how they have been carried out, but the criteria and the scoring exercise have been reasonably transparent. The public has had no opportunity to weigh the various submissions that have been made against the conclusions of the health board in relation to maternity services. We have no opportunity to trawl through the evidence that has been submitted and to get the health board's rationale and its explanation why it favoured certain evidence and discounted other evidence. We need to be able to scrutinise that process independently but, at the moment, we do not have the facility to do so.
That is the big question that needs to be addressed in the review of consultation. We need to ask exactly what consultation is, and there is no point in having a consultation if all the facts and evidence are in the domain of only a select few.
That is a valid point. There are specific concerns about all the reviews and consultations as well as concerns about the generalities. Are members happy that we draw out all the main points, send the four petitions— PE718, PE689, PE643 and PE707—to the Health Committee and ask that committee to look at them specifically?
Members indicated agreement.
Meeting suspended.
On resuming—
Further Education (Management Practices) (PE574)<br />Further Education (Governance and Management) (PE583)
The next petitions are PE574, on the openness and accountability of further education college boards of management, and PE583, on the governance and management of further education colleges.
PE574 calls on the Scottish Parliament to consider commissioning an investigation into management practices at the Central College of Commerce in Glasgow and to overhaul the Further and Higher Education (Scotland) Act 1992, so that the openness and democratic accountability of college boards of management are guaranteed.
PE583 calls on the Scottish Parliament to inquire into the governance and management of Scotland's further education colleges and to consider reforming the legislative framework governing further education.
At its meeting on 10 December 2003, the committee considered a response from the Scottish Executive and agreed to invite both principal petitioners to comment. Mr McCracken's response appears to focus primarily on the management of the Central College of Commerce. However, members are reminded that the committee is unable to become involved in that specific case. Mr Eyre states:
"The Executive's proposals fail to address the main flaw in the present system of the governance of colleges: the requirement, under the 1992 Act, that a majority of members of college Boards should be representative of business interests. This business domination of college Boards was brought about at significant cost to the representation of other legitimate interests".
Do members have any comments on either or both of the petitions?
Although I do not want to stray into the specifics of petition PE574, I think that it is worth noting that the employment tribunal did not find in favour of the college. I therefore cast my comments of principle in light of that.
There is something in what has been said about the issues raised in response to petition PE583 to do with the principle that underlies the composition of boards of management in colleges. For that reason, I think that it may be worth pursuing the matter further by inviting the views of the Executive on the specific response that we have had to PE583 from the petitioner, suggesting that there should be a more interesting balance on college boards that would allow for trade union representation in particular.
I agree. The Further and Higher Education (Scotland) Act 1992 was introduced by a Tory Government. Petition PE574 raises issues about the merits of that legislation, which need to be examined. It concerns me greatly that employment tribunal cases are outstanding.
There are broad questions about how and in whose interests the boards of management of further education colleges are operating. It concerns me that financial decisions are being made that are affecting the type of education that is available to students, because courses that require resources are less likely to be offered. The comments by Joe Eyre in particular, the confidentiality arrangements at board level, the lack of representation and the ability to represent members and students effectively on boards give me great cause for concern. Those general issues need to be examined further. The Further and Higher Education (Scotland) Act 1992, the composition of further education college boards and who is in control of them and the lack of democratic accountability are all up in the air given the issues that are flagged up in the petitions. The whole system pertaining to further education colleges needs to be examined extensively.
I agree with Jackie Baillie's recommendation.
I agree with Jackie Baillie as well.
I am glad that the case mentioned in petition PE574 was upheld. Like others, I feel that the whole area needs to be looked at and overhauled. That should not be up to just one individual but, unfortunately, we find ourselves in that position. We should try to prevent the situation arising again. I agree with Jackie Baillie's recommendation that the petitions should go to the minister for his comments. I would not like the situation that we had in Glasgow in the Central College of Commerce to arise again, although I am sure that it is just waiting to happen in other colleges. It is wrong that a board should be unaccountable to the students and members of staff. I ask the minister to consider the petitions and the comments that we have made today and to reply to us.
Petition PE574 was specific and we have had a reply from the petitioner. Do we agree to close our consideration of that petition, but to take action on petition PE583 and ask the Executive for its views on the general principle about boards and management?
Members indicated agreement.
NHS Prescribed Drugs <br />(Effects on Children) <br />(PE631, PE638, PE639 and PE640)<br />Children with Learning Difficulties (Support and Information) (PE663)
The next five petitions are linked, in that they were all submitted by the same organisation. PE631 is on the lasting effects of prescribed neuroleptic and similar drugs. PE638 is on the prescription of vitamin supplements for nutritional imbalances. PE639 is on the storage and dispensing of national health service-prescribed drugs in schools. PE640 is on banning the prescription of neuroleptic and similar drugs to children. PE663 is on support and information services on learning difficulties.
Petition PE631 calls on the Scottish Parliament to urge the Scottish Executive to investigate the effect on the future employment, housing and insurance cover of individuals who were prescribed neuroleptic and similar drugs as children. PE638 calls on the Scottish Parliament to investigate whether certain vitamin supplements should be prescribed by the NHS to help children with a nutritional imbalance caused by an addiction to NHS-prescribed drugs. PE639 calls on the Scottish Parliament to investigate the storage and dispensing of NHS-prescribed drugs in schools. PE640 calls on the Scottish Parliament to take the necessary steps to ban the prescription of neuroleptic and similar drugs to children. PE663 calls on the Scottish Parliament to take the necessary steps to ensure that the need for support and information services for parents of children with learning difficulties and behavioural problems is recognised by the Scottish Executive.
The Executive provided a detailed response to each of the petitions, while pointing out a number of issues that impact on reserved matters. Members have had a chance to read the responses. What do you think?
I think that we should ask for the petitioner's view of the responses; he will probably be able to pick up on more issues than I could, although a couple of things in the Executive response concern me. In the second paragraph under the heading "PE361: Effects on Future Employment, Housing and Insurance Cover for Individuals", the response states:
"From a pharmacological point of view neuroleptic drugs are reversible inhibitors. They are excreted from the body over a period of weeks or months".
My understanding—and I do not think that I am wrong—is that there is limited research on the effect of such drugs on children. The physiology of children is very different from that of adults. I am concerned at the assertion that has been made in the absence—I think—of adequate research. I think that the matter needs to be examined further, and the Executive needs to take responsibility for ensuring that that happens.
Paragraph 4, under the heading "PE640: Ban on the Prescribing of Neuroleptic and Other Brain Altering Drugs in Children", states:
"Finally, in relation to a national data base of children prescribed neuroleptic and other drugs, the prescription data available centrally are not patient-specific and do not identify the condition for which the medicine has been prescribed … Data on items dispensed in hospitals or hospital-based clinics are not collated centrally."
That is an absence in the system. There is concern that there is a trend towards an increase in the prescription of such drugs. If the data on the number of children being prescribed those drugs are not being monitored by the Executive, then that is an absence. It is incumbent on the Executive to examine both the data and the consequences. We take responsibility for health policy and it is not acceptable simply to leave the control of trends in this area to individual general practitioners. It is the responsibility of the Parliament to look into the issues. I am happy for the petitioner to be asked his views first, but I would think that there would be merit in the Health Committee examining some of the issues at some stage.
Will we wait until we see what comments the petitioner makes on each point?
I agree that we should do that. Paragraph 4 of the page of the Executive's response concerning PE639 comments that the Health Department's chief scientist office, or CSO, has
"no current plans to commission research into ADHD but would be pleased to consider proposals for such research which would, of course, be subject to the usual peer and committee review."
I would like the Executive to be a little more proactive than that and put out a call for that research. Otherwise, the Executive is heavily reliant on the general public reading the detail of the various documents that are in front of us now to pick up on that scope for possible research. From other discussions that we have had on the matter, I think that there is a clear case to be made on the whole issue of supplements and alternative treatments, whether for children or for adults. There needs to be some more detailed research in that area.
I agree—that is a good question to ask the Executive—but that would have to wait until we get a response back from the petitioner. The petitions will come back before us once we have seen the response, and we can make that point at that stage. We will keep the petitions open, with the prospect of getting more information from the petitioner. Is everyone happy with that?
Members indicated agreement.
HMP Peterhead (PE667 and PE675)
The next two petitions are linked. PE667 calls for the Scottish Parliament to investigate the alleged discrimination against convicted sex offenders held at Peterhead; PE675 calls for the Scottish Parliament to investigate the suitability of Peterhead prison for the long-term imprisonment of convicted sex offenders.
At its meeting of 26 November 2003, the committee agreed to link the two petitions and to write to the Scottish Executive, requesting its comments on the issues raised in both petitions. The committee has received a response from the Scottish Prison Service, stating that work has begun on the installation of electric power in cells in HMP Peterhead, and that the work is due for completion in August 2004. However, there are no plans for in-cell sanitation.
On the STOP 2000 programme, the SPS states:
"In the current year, particular problems have been caused by a number of staffing difficulties"
but that
"This situation is being addressed by the Governor and a multi-disciplinary ‘Succession Planning' group, whose work has resulted in an increase in the target for STOP completions from 24 in 2003-04 to 50"
in 2004-05. Further correspondence has also been received from one of the petitioners questioning the apparent success of the STOP programme.
Do members have any comments on petitions PE667 and PE675?
As far as the delivery of rehabilitation programmes is concerned, we should perhaps refer these petitions to the Justice 1 Committee, which is examining the matter. However, I do not think that the committee will touch on in-cell sanitation. The SPS letter says that there are no plans to introduce such a measure; however, when I checked with HMP Peterhead as to whether at-risk prisoners were a factor in its decision, I discovered that centralised research and a risk assessment had concluded that there was no danger that the prisoners would do something when they got out of their cells. As a result, the SPS felt that it was not in-cell sanitation that prisoners needed, but access to sanitation. Can we refer that aspect of the petitions to another committee or will everything go en masse to the Justice 1 Committee? It is terrible that people do not have sanitation in their cells.
There is no reason why that aspect cannot be referred to the Justice 1 Committee.
I agree that the petition on the treatment of prisoners at Peterhead should go to the Justice 1 Committee. On Sandra White's point, I am surprised that the SPS's response does not refer to any risk to prisoners. Instead, it mentions that
"the safety of staff and security of the establishment"
will be placed at risk.
Members will recall that proposals to close Peterhead prison were subsequently reversed by the Executive. However, I thought that part of that decision included the requirement that cells had to be brought up to what might be called modern standards. As a result, I am also surprised that the SPS's response states that there are no plans to install in-cell sanitation. I do not know whether it is the Minister for Justice's responsibility, but the Executive should be required to clarify what happened at Peterhead prison after its rethink and decision to retain the facility. The SPS's response is out of line with my own recollections, although other members might remember differently.
Shall we write to the Executive and ask for clarification on that matter?
Members indicated agreement.
We should also write to those in charge at Peterhead prison and ask for their views. I am extremely concerned that, although the idea was to install in-cell sanitation, the SPS has subsequently evaluated the costs and decided not to go ahead with it. I understood that the policy was to end slopping out, even though it was probably not being implemented as quickly as some of us would have liked. In that light, I would be concerned if the SPS did not have any plans to end the practice.
That is a valid question. We could specifically ask the Executive, either directly or through the SPS, about its plans in this respect. After all, when the issue was debated at length in the previous parliamentary session, decisions were made and commitments were given. I imagine that we are entitled to ask what has happened to those decisions and the plans to implement them. Obviously, we will refer the petitions to the Justice 1 Committee for its consideration. We could ask a specific question about the future of slopping out at Peterhead, because I do not think that that would form part of any investigation that the Justice 1 Committee might carry out on the general issues raised in the petitions. Are members agreed?
Members indicated agreement.
Public Finance and Accountability (Scotland) Act 2000 (PE683)
We move on to petition PE683, on the annual audit of public expenditure. The petitioner is calling on the Scottish Parliament to modify the Public Finance and Accountability (Scotland) Act 2000 to ensure that the annual audit of the bodies and office holders mentioned in the act is expanded to include the examination of technical as well as financial matters.
The Committee agreed to seek the views of the Executive, which states that it is
"still not entirely clear what Mr Alexander means by ‘technical matters'".
The Executive also states that it is unclear whether the proposed examinations into
"legality, economy, efficiency and effectiveness"
in every audit of annual accounts should apply to every item within the accounts. The Executive states that, if that is the case, such an approach would
"add a significant burden and cost"
and that
"It is also unclear … how the Auditor General for Scotland would direct such examinations each year".
On the petitioner's call for a public consultation, the Executive states:
"At the moment, we do not think that there is a sufficient demand for a change in accounting procedures to justify a consultation".
We have circulated to members a letter dated 18 November 1999 from the then Minister for Finance, Jack McConnell, which the petitioner has submitted. The petitioner states that the minister intimated in his letter that there would be a
"move away from simply concentrating on financial regulatory audit"
and states that that, in essence, is what his petition is all about.
Do members have comments on the responses?
We should ask the petitioner what his response is. If I remember correctly, it was a wee bit difficult to pin him down on what criteria he wanted to be assessed. I have some sympathy with the petitioner because of my experience of private finance initiative projects; the current system does not audit or examine the quality of the building, the contract or how the contract operates after handover, which is what I would like to happen. We should ask the petitioner to respond to the Executive and be more specific about what criteria he wants to be made part of the audit process. If he is vague, it is easy for the Executive to say that the cost burden would be too high; if he is more specific we can perhaps examine the petition further.
Are members happy with that?
Members indicated agreement.
Historic Scotland (Remit) (PE703)
We dealt with petition PE689 earlier, so the last petition under current petitions is petition PE703, which concerns a review of Historic Scotland. The petitioners call for the Scottish Parliament to urge the Scottish Executive to amend, as part of its review of Historic Scotland, the organisation's remit to ensure that it is accountable for its decisions and responsive to communities' views.
At its meeting on 4 February 2004, the committee agreed to invite the views of Historic Scotland and the Minister for Tourism, Culture and Sport. In its response, the Executive states that it published its review of Historic Scotland on 12 February and that the report
"looks to the Agency to be more open its dealings with the public, partner organisations and others with an interest in the historic environment. The Chief Executive has established a Change Management Group within the Agency to take forward the recommendations made in the Review."
Do members have any opinions on the response? It might be worth chasing up timescales.
I was going to say the same. The results of the review have been announced and they will have to be put into effect, so it would be helpful to know over what period that will be done. I do not know what the life of the change management group is. The response says:
"The Chief Executive has established a Change Management Group within the Agency to take forward the recommendations".
It is presumably an ad-hoc group with that specific remit, so it would be helpful to know over what period it is expected to act and report.
We can ask those questions. Is everyone happy with that?
Members indicated agreement.