Breastfeeding etc (Scotland) Bill
The next item of business is a debate on motion S2M-1968, in the name of Elaine Smith, that the Breastfeeding etc (Scotland) Bill be passed. I call Susan Deacon to speak to and to move the motion.
The Breastfeeding etc (Scotland) Bill, if approved by Parliament today, will be a landmark piece of legislation for Scotland. I am delighted to open the debate, and I thank Elaine Smith for giving me the opportunity to do so.
A great many individuals and organisations have contributed to shaping the bill, and I know that Elaine Smith has a very long list of people whom she wants to thank in her closing remarks. I am sure that they all join me, as will colleagues in the chamber, in thanking Elaine for her supreme efforts in introducing the bill and for championing breastfeeding in Parliament. [Applause.]
Even before it has reached the statute book, the bill has raised awareness and changed attitudes. It has spawned debate and discussion, given us insight and understanding, and enabled us to get behind some deep-rooted and sensitive cultural issues in our society. It is worth remembering that, when Elaine Smith first mooted the proposal, many people thought that it was at best unnecessary and at worst daft. The usual suspects described it as political correctness gone mad, and even the more measured commentators said that it was just not a real issue. However, as letters appeared in the newspapers and submissions came in during the consultation process, it quickly became apparent that it is a real issue and that the oft-quoted cases of a woman being thrown off a Lothian bus for breastfeeding and of a woman being asked to leave the cafe in a well-known department store and to feed in the baby-changing room instead were not isolated incidents. It became clear that such experiences were real and had been shared by many women throughout Scotland.
It is testament to the efficacy of the workings of Parliament that through consideration of a bill proposal from a back-bench MSP, we were able to bring to the surface those experiences and give a voice to the women who had them. Not only that but, critically, through the personal stories and testimonies that emerged, we were able to identify a strong link between the feeding choices that are made by individual women and the attitudes, or perceived attitudes, of those around them. It is easy for politicians to sign up to targets and principles, but the key is always to find the complex mix of policy, action, investment and—yes—sometimes legislation that will actually make a difference.
No one in this chamber would dispute the health benefits of breastfeeding to mother and baby. No one would suggest that the Executive or Parliament should do anything other than promote breastfeeding, and I think that everyone across the political spectrum signs up for the national breastfeeding target. Indeed, David Davidson has never missed an opportunity to remind us that it was, in fact, a Conservative Government that set that target. However, setting targets is one thing; achieving them is another. As the bill has been discussed through the parliamentary process, it has become increasingly clear that, if the rates of breastfeeding in Scotland are to continue to increase, we need to do something more and something different.
Education and awareness are vital; so, too, is the tremendous work that is done by midwives and health visitors in our maternity units and in the community. All that work has had, and is having, an impact. We must continue to build on that and I welcome the Executive's commitment to do so. However, all the evidence that was presented to us during the passage of the bill suggests that those efforts will not, in and of themselves, get us there. We need to go a step further in tackling culture and attitudes if Scotland is truly to become more breastfeeding friendly. The bill gives us a tremendous opportunity to do that.
Let me say for the avoidance of doubt that the bill is not about telling anyone what to do, least of all telling a woman how to feed her baby. That is a deeply personal choice and every woman should be respected for, and supported in, the decision that she makes, whether it be to feed from the breast or from the bottle. What the bill will do is provide legal protection for a baby to be fed where and when it needs to be fed, by breast or by bottle.
The detail of the bill has been subject to rigorous parliamentary and external scrutiny and the principles of the bill were overwhelmingly supported by Parliament at stage 1. Today, we need to take the next step and translate those provisions into the law of the land. In doing so, we will send out an important signal that, in a modern Scotland, we cannot allow breastfeeding to be treated as unacceptable or offensive behaviour. A woman should not be moved on from, or chucked out of, a public place for doing that most natural and necessary of things: feeding her baby. A woman should not have to go into a toilet or to sit in her car—if, indeed, she has one—simply to feed her baby. As one mother put it, a woman should not feel that she is under house arrest because she feels that she is unable to feed her baby outside the privacy of her own home.
It is a fact—as we have heard during the bill's passage—that too many women in Scotland have not breastfed or have stopped breastfeeding earlier than they would have liked, not because they did not want to breastfeed, but because they felt that those around them would not like them to breastfeed. Part of the reason why is that our culture and our law tolerate the practice of excluding women from public places simply because they want to feed their babies. We must tackle that situation and we must all learn to feel more at ease with the sight of a baby at its mother's breast. Change will be gradual; it will not happen overnight. However, the bill will help us to bring about the much needed step-change in the culture and attitudes that I truly believe stand in the way not just of our achieving targets, but of our bringing about a genuine and positive societal shift in respect of breastfeeding in Scotland.
If we pass the bill, we will lead the way in the United Kingdom. However, we will not be in wholly uncharted terrain. Similar measures have been adopted in other countries and they have made a difference. I am in no doubt that we can also achieve such change in Scotland, partly through the range of measures and work that are already under way in the Executive, the health service, our schools and elsewhere but—crucially—we can also do so through the significant step forward of changing the law of our land through the bill. I believe that the bill is not only one of the most innovative measures that have been brought forward in Parliament, but one of the most practical and significant ones. The bill underscores our sincerity in wanting to give all our children the best possible start in life and in working tirelessly to improve the health of Scotland. The bill is an opportunity that we should grasp with both hands and take forward at decision time today.
I will end on a personal note. I genuinely appreciate Elaine Smith's giving me the opportunity to contribute to a debate that, as she knows, has a particular resonance for me. Not a lot of people know this, but about six years ago I sat in front of a Labour Party Scottish Parliament selection panel. One of the standard questions, as many colleagues here will recall, was, "If you had the chance to take a member's bill through the Scottish Parliament, what would it be?" At that time, I was a fairly new, bursting mum. Based on my experiences at that time, I waxed lyrical to the panel about how I would like to introduce a bill that would help to make breastfeeding more acceptable in Scotland, and about how important it was for us to change our culture and attitudes to make Scotland a more breastfeeding-friendly place. I got the knock-back from that particular selection panel and will never know whether my choice of bill had anything to do with that. However, I do know this: while I merely aspired to doing something, Elaine Smith has done it. For that, she has my heartfelt admiration and thanks, both as a politician and as a mum.
This is, potentially, a landmark occasion for Parliament. To agree to the bill is the right thing to do. It will make a difference, so I am pleased and proud to move the motion in Elaine Smith's name.
I move,
That the Parliament agrees that the Breastfeeding etc. (Scotland) Bill be passed.
I congratulate Susan Deacon on her opening speech on behalf of Elaine Smith. We owe thanks to Susan for that and to Elaine for bringing the bill before us.
I am grateful for the opportunity to convey the Executive's support for the bill. Although I was appointed to the health remit only recently, members may rest assured that I and my Cabinet colleagues have been following the progress of the bill throughout its time in Parliament.
I have been impressed by the level of support for and interest in the bill among members from across the political spectrum, which is good to see, although Conservative members demur from that. It is a great shame that they have been unable to support a measure that has the potential to have an important and valuable impact on the health and development of our youngest citizens. The rest of the Parliament should be proud of the support that it has offered Elaine Smith in developing such unique legislation. I offer my thanks to Elaine and members of the Health Committee for the scrutiny and hard work that they have undertaken to progress the bill thus far.
The bill has stimulated discussion about breastfeeding throughout the country and has proven to be much more than simply a piece of legislation. In my view, it has been a valuable vehicle for raising the profile of breastfeeding, particularly among groups in our society who might not normally engage in discussion of such topics. The importance of that should not be underestimated; after all, communication is the key to change.
Effective communication is already working. Over the past 10 years, many more of us have learned about the benefits of breastfeeding. We know that breastfeeding is good for our children's health and is also good for mothers' health. I point especially to the evidence from the Dundee infant feeding study, led by Professor Stewart Forsyth and his colleagues, which found that breastfeeding can reduce health inequalities during childhood and might also alter the relationship between childhood socioeconomic disadvantage and poor adult health. All sorts of different aspects bring benefits for society at large. Therefore, we must do all that we can to improve breastfeeding rates in Scotland. That is why breastfeeding is a key part of the Executive's public health agenda and why we support Elaine Smith's bill.
The bill has not been introduced to curb the activities of licence holders or owners of public premises; it has been introduced to encourage, support and protect our citizens' rights to take part in vital health-promoting behaviour. The future act will create an environment throughout Scotland in which mothers feel free to participate in one of the most natural acts there is without fear of judgment and/or recrimination. It will mean that they can breastfeed where and when is most appropriate for them and their child—and, in future, without being in a smoky atmosphere. That is as it should be, because breast milk is the ultimate convenience food, to which the Executive and Elaine Smith lend their support.
The debate is not only about health, as we have heard from many members; just as important are the emotional and social bonds that are created between mother and child in the early years of infancy. Changes in attitude might not happen overnight, and the bill might not change the views of the most ardent critics, but it represents a major stepping-stone to achieving the behavioural and cultural shift that is needed in our country. It is only disappointing that the bill is required at all.
Last week, I was fortunate to be invited to speak at the United Nations Children's Fund—UNICEF—UK baby-friendly initiative annual conference. It was a fantastic occasion, attended by 800 people from all over the UK who are involved in breastfeeding and breastfeeding promotion, including professionals, mothers, support workers and volunteers. When I spoke about Elaine Smith's bill, the enthusiasm for the steps that we are taking in our Parliament was tangible. I was bolstered and reassured by the delegates' comments about why the bill will be such important legislation.
We also celebrated the UNICEF UK baby-friendly initiative, which is an accreditation programme. Hospitals and, more recently, community settings, such as local health care co-operatives, are encouraged to work to the high standards set by the initiative, with the aim of providing the highest level of infant feeding advice and support to new mothers. It was the first such conference in Scotland and I was happy to be given the chance to inform the conference of our excellent track record in the promotion and support of breastfeeding in Scotland.
Currently, 86 per cent of our maternity units participate in the scheme, which results in 48 per cent of our babies being born in hospitals that operate to the highest standards of care and support. That is a truly impressive record when we compare it with the average of 16 per cent in the rest of the UK.
That does not mean that the other 52 per cent of babies and mothers do not receive a high level of support in other hospital and community settings—14 of our 15 NHS boards are implementing dedicated breastfeeding strategies with the assistance and guidance of our national breastfeeding adviser, Jenny Warren.
Those facts are impressive in their own right and are due in no small part to the highly trained, committed and dedicated midwives, health visitors and infant feeding advisers throughout our country. I commend all those people for their efforts.
I spoke to the conference about the many examples of innovation and exciting practice in NHS boards in Scotland. Lanarkshire NHS Board is reinforcing the value of breastfeeding by displaying the slogan "You can't get fitter than a breastfed nipper" on 32 of its vehicles. Tayside NHS Board has produced a video and training package entitled, "Is she getting enough?", which highlights the influence of partners, friends, extended family and health professionals on the decision whether to breastfeed. I visited stalls at the conference and I was impressed to see that Scottish material was being snapped up by delegates from the rest of the United Kingdom, because Scotland is regarded as the benchmark in the UK for the promotion of breastfeeding. Indeed, Greater Glasgow NHS Board hopes to win the first global UNICEF award for a paediatric unit. I also spoke about our national approach, through the work of the national breastfeeding adviser, the Scottish breastfeeding group and NHS Health Scotland.
Delegates were encouraged to hear about the work that I described, but delegates from the rest of the UK were most impressed by my references to the Breastfeeding etc (Scotland) Bill. I am aware that not just Scotland, but the rest of the UK, is watching the progress of the bill. By introducing the bill, Elaine Smith has put Scotland on the map in relation to infant feeding. We have a real opportunity to show the rest of the world the way by supporting and passing the bill.
The figures for the uptake and duration of breastfeeding might not be as we want them to be, but we are working to drive them up. I commend Elaine Smith for her hard work and urge all members to support the motion.
I call Fiona Hyslop to open for the Scottish National Party.
I pay tribute to Elaine Smith for introducing the bill and, more important, for presenting the bill and arguing the case in a way that has persuaded people who might have been reluctant to support the bill at the start of the process. That is a tribute, because any member can progress a bill on proposals that have people's initial support, but the test is to persuade people during the process. During the debate on the stage 3 amendments, I talked about the compromises that many people have made to make the process work.
I should declare an active interest as a current breastfeeding mum of a five-month-old baby—don't wrinkle your nose, Presiding Officer. That is the point; we must address attitudes. As a breastfeeding mother, I know that my child is at less risk of gastrointestinal infections, respiratory infections, urinary tract infections, ear infections, allergic diseases, eczema, asthma, wheezing and insulin-dependent diabetes. I also know that I am at less risk of breast cancer, ovarian cancer, hip fractures and bone-density problems. I say to anyone who reports the debate that if they think that the issue is frivolous and should not be addressed by the Parliament, they should consider those statements. This is a serious issue.
The solutions for public health are not necessarily easy. We have to consider whether to pass laws that lay us open to accusations of a nanny-state approach. We must also consider whether law can lead public opinion. Elaine Smith has demonstrated that the progress of legislation can lead and persuade public opinion, which is an important point.
I want to talk about life-changing experiences. Not only did I have a baby earlier this year, but I passed a significant birthday. A few weeks after the birth of my baby and after my birthday—[Interruption.] It was my 21st birthday. A few weeks after that, I was mightily surprised to be asked to take part in a health promotion exercise for breastfeeding awareness. I was to star in a calendar. Before members start anything, I explain that I am talking about an alternative calendar, which will be launched at Livingston Football Club on 2 December. It shows ordinary women from West Lothian—including me—breastfeeding their children in ordinary situations. The best picture was taken at the club and shows rows and rows of people, including mothers and babies, all of whom are dressed in Livingston colours. The calendar shows that breastfeeding is natural and I commend it to members and the minister as a Christmas present. I took part in the promotion and was pleased to do so.
We should be relaxed about the issue—that is the whole point; we should not be uptight. That is where Carolyn Leckie misses the point—by getting so uptight. Breastfeeding is normal and natural.
What can we do to make a difference? How can we change perceptions? I have said before that I would prefer it if the legislation had been on the basis of antidiscrimination. The Queensland example is a good example of that, but we are not in that situation. I commend the committee for looking into the issue of criminal legislation and addressing it very seriously.
We have to address workplace situations. I would say to the Deputy Presiding Officer that continued breastfeeding in this place would be enhanced if, rather than the visitors' crèche, we had a workplace nursery. That might allow staff and MSPs to continue breastfeeding for longer than they would otherwise.
I refer the minister to section 4 on the promotion and support of breastfeeding. The UNICEF report was in July. One of the most serious issues that we will have to address—and I hope that the minister will do so—is the minister's powers under section 4. The 70 per cent of women who do not breastfeed after six weeks take that decision in the first few hours. Women are not being allowed to stay in hospital, with the support of midwives, in the early days after the birth of their child. They are not getting the medical provision that they need to continue breastfeeding. I appeal to the minister to examine the rates at which women are discharged from hospitals, because continued support by breastfeeding-supporting midwives would make a crucial difference.
Elaine Smith has done a marvellous job. She has persuaded people and that is the important thing. I hope that, in the days and years to come, we will have health ministers reporting that Scotland is leading the way rather than falling behind. Radical and considered measures are required and Elaine Smith should be congratulated on her proposals.
I, too, congratulate Elaine Smith on her dogged determination over several years—indeed, into her second session of Parliament—in pursuing her right as a back bencher to introduce a member's bill. I congratulate her on how she has gone about it. She has done so in a dignified manner, which does credit to the subject at heart.
We totally support the promotion of breastfeeding. There is no argument about that; no one in this chamber would be against it. However, I want to hear a bit more from the Executive about how it will support pre-birth mothers in gaining confidence, so that breastfeeding becomes an enjoyable habit, because the health benefits for the child and mother are undoubted.
When Fiona Hyslop declared some of her personal details, she named a number of things that she could avoid in life. One that she did not mention is rheumatoid arthritis. My wife will kill me for saying this but, despite feeding five babies by breast, she has developed rheumatoid arthritis. She may be the exception to the rule.
Mike Rumbles made an important point about the right to feed in law. There is also a right in the common law in Scotland not to be abused, manhandled and so on. The evidence that the committee heard from the police was that they did not think that many criminal charges would be brought if the new legislation goes through. I was speaking to a former policewoman today who had breastfed her child. She said that common-law remedies exist. If the police were invited to deal with an incident, they could do so under current law. If all else failed, they could use the well-rounded breach of the peace legislation. That has been done.
I recall from the evidence that was given to the committee that the Association of Chief Police Officers in Scotland said that it would not want to use breach of the peace legislation. The witnesses did not think that that was a realistic option.
The witnesses might have said that but, as I said, I talked to someone who was on the beat until very recently. They told me that the police were using the existing law. There is confusion on the subject.
As the minister rightly said, the key question is what we are going to do to increase the rates and duration of breastfeeding. Although I am pleased to hear that he wishes to promote both those things, his target of six months is adventurous, albeit that it is realistic. I wish him every success in trying to reach it.
The figures, which I also gave in the first debate on the subject, show that, following the targets that the Conservatives put in place, which have been supported by Government since that time, we reached 40 per cent in 2000. Unfortunately, since that time, the level has dropped to 36.5 per cent. The reasons for the drop in uptake must be examined carefully.
I agree with the comments that members have made about stigma. We need to ensure that legislation is practical, useful and delivers. The bill is supposed to be about encouraging more women to breastfeed for longer. It is about uptake and duration, not about the creation of a criminal offence that is unlikely ever to be invoked. In fact, where such regulations exist, including in many of the American states, almost no charges have been pressed and no increase in breastfeeding rates has resulted. Although I fully support the ideas behind Elaine Smith's bid to improve breastfeeding rates, I cannot support the introduction of a criminal offence that, in all probability, will never be used.
On behalf of the Liberal Democrat group, I congratulate Elaine Smith on her achievement. It is quite something for a back bencher to change Scots law—subject to the vote this evening, of course.
David Davidson's speech on behalf of the Conservatives was disappointing. Once again, the Conservative party is missing the point on the change from an offence in civil law to one in criminal law. At the moment, the onus is on the individual to fight a civil action through the court. Who would do that? Nobody. The practical objective of changing the offence from a civil offence to a criminal offence is to change attitudes.
Although I speak on behalf of the Liberal Democrats, I warn Elaine Smith that the vote is not a whipped vote. I have recommended that the Liberal Democrat group supports the motion, but that is all I can do—who knows, it might have been counterproductive of me to have done so.
The bill is an inclusive bill; it is not just about making a new criminal offence of preventing a woman from breastfeeding a child, but about making it a criminal offence to prevent a person from feeding milk to a child under two years of age in a public place. The bill is not an exclusive but an inclusive piece of legislation. [Interruption] I am glad to hear that one of the babies in the public gallery is supporting me. I hope that the Minister for Parliamentary Business has noticed my comment about the inclusivity of the bill, particularly in view of what I said yesterday.
The bill is not about making a change in the law to give new rights to breastfeed in public. As other members have said, that right is allowed under Scots law at the moment; we are talking about changing attitudes. Everyone must realise that we cannot have people being removed from a public place simply because they are feeding a youngster.
As I said, the bill moves the onus from civil to criminal law, which is a point that, unfortunately, the Conservatives have missed. The bill sends a clear message to everyone that, if they prevent a person from feeding milk to a youngster in a public place, their offence in so doing is so bad that it needs to be a criminal offence.
Once again, I congratulate Elaine Smith on introducing the bill. I am sure that all my Liberal Democrats colleagues will vote for it at decision time.
I congratulate Elaine Smith on the bill. My experience over many years has taught me the difficulty of persuading people to breastfeed. Although rates have been going up, too many people fail. One of the most important parts of the bill is section 4, on the promotion and support of breastfeeding—
I am sorry, Dr Turner, but I will have to stop you. Although two microphones are turned on in front of you, I understand that some members are having difficulty in picking you up.
I am sorry, what is the problem?
Could you position yourself closer to one of the microphones, Dr Turner?
Can you hear me now?
I can. Please start again.
I congratulate Elaine Smith. The bill is wonderful and makes a great statement. All my working life, I have found it extremely difficult to persuade people to breastfeed. Fiona Hyslop, who has been close to the subject recently, raised the most important points, which relate to section 4. I hope that that section, on the promotion and support of breastfeeding, will result in a great deal of effort being put into those activities in the antenatal and postnatal periods, in particular in hospital, in the special 48 hours after the birth, which is when some people find it difficult to breastfeed. Support requires time and staff, which are expensive. We need to put in a lot of effort in the few hours after birth. Nowadays, people are more frequently discharged early from hospital and go home to all their responsibilities—perhaps they have other children. When the child is a first one, people need home support, which takes time and people, and that requires money. I hope that section 4 will have an effect.
When people go home after giving birth, they often find that they have many well-intentioned relatives and friends who all want a wee share of the baby. They often persuade the mum that it would be much better if she bottle fed, because that would give them a bigger share of the child. A young mother in that situation who is not very assertive needs a lot of home support with breastfeeding.
At first, I had difficulty with the bill's introduction of a criminal offence, but I have been persuaded about that. The culture in Scotland means that people do not talk about such matters and do not like to allow breastfeeding in public. Few people would ever make it difficult for a woman to breastfeed in public because, most of the time, we are not aware that people are breastfeeding, as it is done surreptitiously. It is odd that the Health Committee heard so much evidence about people having a bad time breastfeeding in public.
One good feature of the bill is that it raises awareness of the issue. In conversations, people have been telling me about their experiences 30, 20 and 10 years ago. It is about time that people in this country accepted breastfeeding as something physiological that is good for everybody. We all accept the benefits, which have been highlighted. Breastfeeding is good for the baby's and the mother's health and it should be promoted.
I thank Elaine Smith for all her hard work. I took on board her evidence and the other evidence that the committee took. I fully support her and I wish the bill well. I hope that ministers read section 4 and provide support for the promotion of breastfeeding at the crucial time, which is just before and just after the baby is born. Too many people give up too easily.
I, too, thank Elaine Smith for introducing the bill and for the dedication that she has shown during the process. I also thank the Health Committee clerks for their hard work and support as we worked through the bill.
In scrutinising the bill, the committee sought to address several issues. The principal ones were whether evidence exists that mothers are likely to encounter adverse reactions to breastfeeding their child; whether such reactions are likely to inhibit the take-up and duration of breastfeeding; and whether introducing a criminal offence of deliberately preventing a person from breastfeeding would increase the take-up and duration of breastfeeding. It was difficult for the committee to access definitive research that details how common it is for women to be asked to leave a public place when breastfeeding. However, witnesses from the National Childbirth Trust and the Breastfeeding Network said that, in the course of their work, they were regularly in contact with women who have encountered such problems. While that evidence is clearly anecdotal, the committee accepted that there is evidence to support the view that mothers often experience adverse reactions to breastfeeding in public. There was also a clear consensus among witnesses that such reactions—or, at least, the fear of provoking them—inhibited mothers from breastfeeding in public. Therefore, the committee accepted that such attitudes could have a negative impact on breastfeeding rates.
We have heard a lot today about the fact that the bill seeks to make it a criminal offence to prevent or stop a child being fed milk. The issues surrounding that criminalisation were more complex. Some witnesses were strongly of the view that criminalisation would make more women confident and assured about feeding in public, but others were not so sure. The committee heard from the Association of Chief Police Officers in Scotland that, rather than make the prevention of breastfeeding a criminal offence, it might be preferable to include a statutory provision on breastfeeding in the licences and charters of public establishments. However, we heard evidence from Elaine Smith and from Mike Dailly of the Govan Law Centre that that would mean that some public places would be missed out.
It can certainly be argued that the principal reason for the bill is not punitive and that the possibility of legal action should simply act as a deterrent. Elaine Smith is keen that the bill should not lead to a large number of prosecutions and intends the purpose to be to change attitudes and to make women feel more comfortable about breastfeeding in public. David Davidson commented that, in other places in the world where it is an offence to prevent breastfeeding, the law has not been invoked, but it is not a good argument to say that, because the law would never be used, the prevention of breastfeeding should not be made a criminal offence. The fact is that we seek to make it a criminal offence as a deterrent to those who seek to prevent or stop women breastfeeding in public places. There was little doubt in the committee that legislation can have a positive impact on changing attitudes and behaviour.
On the duty on Scottish ministers to support and encourage breastfeeding, Malcolm Chisholm, when he was Minister for Health and Community Care, told the committee that the Executive's general commitment to promote health improvement in the National Health Service Reform (Scotland) Bill might render it unnecessary to include a specific duty on the promotion of breastfeeding. However, the committee fully supported the measures in the bill to promote the take-up and duration of breastfeeding and did not accept that the continuing discussions on the issue should hinder the bill's progress.
The bill is not about making it illegal to breastfeed babies over a certain age; it is about ensuring that breastfeeding and bottle-feeding mothers and babies are given equal and unimpeded access to public services and spaces. It will also have a key role to play in changing attitudes and ensuring that mothers no longer feel inhibited about breastfeeding in public. Therefore, I am happy to give it my full support today and to recommend that the Parliament pass the bill.
Members need not be nervous, because I will not be using any provocative language.
I reiterate that I feel positive about the bill. It is a tremendous achievement and the Scottish Socialist Party will support it despite our amendments not being agreed to. It was important to press the arguments in those amendments, because it is clear that prejudice and stigma continue to exist and need to be addressed.
Elaine Smith knows that, as she has argued in the past, the bill is not a panacea that will ensure the promotion of breastfeeding; nor is it the only way to increase breastfeeding rates and the length of time for which babies are breastfed. I will concentrate some remarks on those issues.
Contrary to allegations made earlier, the last thing that the SSP needs this week is publicity. I have an extremely long record—since 1986—of promoting and supporting breastfeeding. In 1986, when my first daughter was born, I lived in Castlemilk in Glasgow, which is just the sort of community where breastfeeding rates are extremely low—even lower than they are now. I was 21 and just as bolshie as I am now, but perhaps in a different way. It took a lot of determination for a young, working-class woman in Castlemilk to breastfeed, surrounded as I was by bottle-feeding friends, families that all bottle fed and society's attitudes towards breastfeeding.
I am immensely proud of doing that. It was the start of my promotion of and support for breastfeeding. I challenged my relatives, my friends and my community. In 1986 I established the first ever breastfeeding support group in Castlemilk with the help of the National Childbirth Trust and my local health visitor, who was excellent. It shames me that I cannot remember her name, but she is out there somewhere and she was very helpful. That started a long period of promoting breastfeeding and challenging stigma and it was mainly that experience that influenced my decision in 1992 to become a midwife. I was particularly interested in promoting choice for women in childbirth and an increase in support and resources for breastfeeding women.
Unfortunately, problems remain. I had many positive experiences as a midwife in the health service but I also had many negative experiences. I had to challenge the attitudes of fellow professionals and the medical establishment and I had to work in an under-resourced environment in which people are forced to make impossible choices, such as the choice between staying with a distraught early-breastfeeding mother who needs support and going to attend to an emergency. No midwife should have to make such choices, and that is my continuing challenge to the Executive. All those things need to be tackled if there is to be a real difference in the incidence and continuance of breastfeeding. Baby-friendly initiatives need to be backed up with resources and staff. Otherwise, they are just bits of paper.
I finish by again congratulating Elaine Smith. I want to make sure that no one makes the mistake of thinking that we do not support the bill—we absolutely do, but it is also normal and natural to breastfeed beyond the age of two.
I too congratulate Elaine Smith on her determination and application in steering the bill through Parliament. Turning a member's bill into statute is not an easy matter and even with the support that she has been given both inside and outside the Parliament most of the burden must have fallen on her shoulders. I congratulate her on the commitment and effort that she has shown.
There have been many obstacles in the way of the bill, not least the negative and hostile attitudes that the proposal to encourage breastfeeding—or even just to normalise it—has provoked. It never ceases to amaze me, even in these relatively liberal and liberated times, how much work we have to do to overcome the dark forces of reaction, ignorance, antipathy and inertia—or the Tories, as we more affectionately call them. It is clear from the way in which David Davidson and his colleagues are voting this afternoon that we still have some way to go.
Of course, there are some behaviours that we cannot change. When I spoke during the stage 1 debate on the bill, I said that my interest was more than academic because my wife, Claire, was heavily pregnant. The good news is that she gave birth two weeks ago to a baby girl, Annie. As we speak, Claire is either breastfeeding, between feeds or, if she is incredibly lucky, catching up on some sleep while the baby rests. I was tempted to move an amendment at stage 2 to make it illegal for babies to feed between midnight and 6 o'clock in the morning. I have no doubt that that would do wonders for exhausted new mums and dads, but I recognise that babies are only doing what comes naturally. The same cannot be said of the prejudice, hostility and discrimination that are too often shown to breastfeeding mothers; those are entirely social attitudes and learned behaviours.
Before I get too sanctimonious, I should admit that I still have a distance to travel in challenging my own attitudes. The speeches at stage 1 were excellent—they were more personal than we are used to but all the more illuminating for that. As usual, a passionate contribution came from Carolyn Leckie, who spoke of her first militant breastfeed against her father-in-law from her hospital bed. Unfortunately, my first reaction was to feel sorry for her father-in-law but perhaps, as I said, I have some way to travel.
The bill creates new criminal sanctions, but it is not its intention or my wish to criminalise otherwise law-abiding members of society. The aim is to change behaviour and to challenge negative attitudes. More than anything, the bill is about normalising and accepting absolutely natural behaviour.
I will conclude with another personal experience that is up to date. Last week, my wife, Claire, was in our local library with the kids at a storytelling event for children. Members can imagine that, after having four children, Claire is comfortable with breastfeeding. She asked the librarian, who is a lovely woman, whether it was all right to feed the new baby. The librarian said that she was fine with the idea, but that others might object, so she asked whether Claire would mind using the back room. The only things that should be put in the back room are old-fashioned and outdated attitudes. The bill will help to make that happen and I commend it to the Parliament.
I add my voice to those that have supported Elaine Smith and commended her for her work. When I had a word with her in the canteen queue the other day, she said that the culmination of three years' work had been reached. She has done an amazing amount of work on the bill, which will be a tremendous piece of legislation. I am happy to support it and to congratulate her on it.
In earlier debates, we heard upsetting stories of problems that mothers who feed their children in public places have faced in the recent past. I hope that the bill consigns such incidents to the past.
The health effects of breastfeeding are well-known and have been widely aired and discussed in the debate and at earlier stages. We all want the Scottish rate of 36 per cent breastfeeding at six weeks to increase. In some areas, the figure is better. The highest rate in Scotland is in Orkney, where it is nearly 70 per cent. That can be partly attributed to the excellent support that mothers there receive. The same team of midwives and general practitioners looks after mothers antenatally as looks after mothers and children in hospital and postnatally. That is quality care that is different from that which is received in a large specialist unit. As the figures show, breastfeeding can have a lasting effect on all children's health by conferring on children positive benefits. Specialist units cannot always match such figures.
I hope that the bill will help us to improve Scotland's breastfeeding rates and that the national health service will be properly resourced to support mothers. That should include help for peer support groups at which breastfeeding mothers support one another. As others have said, professional time to help is limited and peer support can be extremely useful.
Attitudes do not change overnight, but by stopping negative attitudes from impacting directly on mothers and babies, I hope that we can start to move to the point at which a mother has a genuine choice about how to feed her child, rather than a choice that is constrained by fear, embarrassment or the fear of being publicly embarrassed. If the Parliament agrees to pass the bill, today will be one of the days when I go off in the train and think that we all did a really good thing. I am happy to be part of that and to add my support and that of my colleagues for the bill. I thank Elaine Smith.
It is clear that I can add no expert knowledge on the subject, but I am happy to support Elaine Smith's bill and to congratulate her on her success in taking it through the Parliament. My similar efforts resulted only in the addition of one section to somebody else's bill, so she has done much better than I did.
It is important to recognise that legislation can help to change attitudes only if it is part of a package—the bill is intended to be part of a package. If the bill is agreed to and it results in an increase in the number of Scottish mothers who breastfeed and in no prosecutions, it will have succeeded. That is the objective. It is a question of changing attitudes, which is difficult, as we all know. Prejudices exist and an anti-woman prejudice remains in our society.
Recently I came across an amusing example of that prejudice. I thought that I would try to help the cause, so I inquired of two august Scottish establishments why they had no women members. When I asked whether their rules prohibited women members, I was told that the rules said nothing of the sort. However, the rules said that all members had to be proposed, seconded and voted on by members. No woman had ever been proposed. Prejudice can be relatively subtle, but it is still strongly present. It is important that we send out the message that it is good for women to feed their babies and that we should accept and recognise that as a natural process. Feeding babies in public is a perfectly normal part of human behaviour.
In addition to the bill, there must be education in schools and education of old fogies such as me so that we accept that feeding of babies in public is normal. There is a long history of anti-feminism, of which opposition to breastfeeding is part. The bill is very welcome, but we must all help to address this problem. The Executive must put effort into teaching people to have more sensible, sensitive attitudes to such issues, so that in due course, long after I am dead, women can be remotely equal with men. Unfortunately, there is still a long way to go before that is achieved.
I, too, congratulate Elaine Smith on the way in which she has piloted the bill through the parliamentary process and has kept members regularly informed about the detail as the bill has gone through its consultation and committee stages. I admire the member's tenacity in reintroducing the bill so soon after it fell at the end of the previous parliamentary session.
I am sorry that Conservative members cannot support the bill, but we believe that to make a potential criminal out of a proprietor who does not wish to allow breastfeeding to take place in public on his or her premises is a draconian measure and that what is needed to change attitudes is persuasion, not the threat of prosecution. We know from the police that there are likely to be very few prosecutions under the bill. Because the evidence shows that there will be enforcement difficulties, we think that it will not be particularly effective. Those are the reasons why we opposed the bill at stage 1 and the reasons why we will vote against it today.
However, we have no disagreement about the merits of breastfeeding. It is undoubtedly good for babies and for the long-term health of mothers. Every encouragement should be given to mums to start and to persevere with breastfeeding. As the minister said, national campaigns to promote breastfeeding, coupled with local support strategies, have resulted in a significant rise in breastfeeding rates during the past 10 years. An audit of health board strategies has concluded that significant progress has been made in developing and implementing those strategies and policies.
Campaigns to promote breastfeeding should continue and should be coupled with personal support and encouragement for mums to breastfeed in the early months of their children's lives. However, I cannot see that legislation of the kind that is proposed will do anything to win over the bigoted people who tut-tut and criticise mums who breastfeed in public. Thankfully, those people are increasingly in the minority. Gradually but steadily, we are seeing a change in culture away from their Victorian attitudes, and breastfeeding is again becoming accepted as normal and unremarkable, wherever it takes place.
Many mums do not want to feed their babies either breast milk or bottled milk in public, but neither do they want to be relegated to a toilet or baby changing room to do that. Proprietors should be actively encouraged to provide comfortable facilities for those mums who wish to feed their babies on the premises but out of the public eye. I fully support Fiona Hyslop's suggestion that there should be breastfeeding facilities in the crèche in this building, which would set a good example to other establishments.
There are breastfeeding facilities in this building. I encourage Conservative members to inspect them as part of their research. The point that I was making is that a workplace nursery is much more conducive than a visitors crèche to continuing breastfeeding.
I take the member's point and am sorry for misunderstanding it.
I will be surprised if the bill makes a significant difference to the number of mums who decide to breastfeed, because the reasons why women decide not to breastfeed are many and varied. They are much more complex than the fear of being embarrassed by narrow-minded onlookers.
Public attitudes are changing. A recent survey showed that the majority of people find discreet breastfeeding in public perfectly acceptable. That positive change has come about without Government intervention. I am convinced that, with encouragement, more and more establishments will welcome breastfeeding mums, until it becomes unthinkable for them not to do so.
I reiterate what I said in the stage 1 debate. My colleagues and I fully support the promotion and encouragement of breastfeeding throughout Scotland, have absolutely no bias against breastfeeding or bottle feeding in public and welcome the positive and on-going change in public attitudes. However, we do not see the need for a criminal law to move the position on, and we do not think that the bill will influence most mothers' decisions on how to feed their babies.
Will the member give way?
I am sorry, but I am closing.
We fully understand why Elaine Smith has brought the bill to the Parliament, and we applaud her intentions and hard work. However, we remain of the opinion that the on-going evolutionary change in public attitudes will be more effective in the long run than the threat of prosecution. We will therefore be maintaining our opposition to the bill.
Like every speaker so far, I pay tribute to Elaine Smith and the work that she has done on the bill over a number of years. I sympathise with her over the brickbats that she had to endure when she launched the bill. Similar comments were directed at me 18 months ago when I launched the idea of banning smoking in public places in Scotland. She had a worse time over a longer period, as Susan Deacon ably outlined in her opening remarks. It is difficult for a back bencher to introduce a bill. To get all the way to stage 3 and have the bill passed—which I hope it will be tonight—is an amazing achievement.
I also congratulate all the groups and individuals who helped Elaine Smith along the way by supporting both the bill and Elaine in her endeavours. I also put on the record my support for and recognition of the NCT and, in particular, its volunteer breastfeeding counsellors, who do an amazing job for many women throughout the country. My daughter and wife received the benefits of their work a number of years ago.
As we have heard, Scotland has a national target that, by 2005, more than 50 per cent of women will be breastfeeding at six weeks. It is good that we have that target. I wish that the target was higher and covered a longer period, but we are where we are. It is important that we stride ever forward on that target. Data from the child health surveillance programme show that in 2003 only 36.5 per cent of mothers in Scotland were breastfeeding at six to eight weeks. However, the figures are not the same throughout the country. As others have said, 70 per cent of mothers in Orkney breastfeed, whereas in other areas, the rate is much lower. The lowest rates of breastfeeding are in Lanarkshire NHS Board area, with a figure of 26 per cent, and Ayrshire and Arran NHS Board area, with a figure of just over 27 per cent. There are higher rates in the Borders NHS Board and Lothian NHS Board areas, where the rate is 48 per cent.
Breastfeeding is a health equality issue, and it is important that we do not lose sight of that fact. There are enormous benefits for babies that have been outlined by many members, but they are worth repeating. Breastfed babies have better neurological development, fewer respiratory and gastrointestinal infections, less allergic disease such as eczema and asthma and lower rates of diabetes and childhood obesity. Perhaps it can be seen as an example of joined-up thinking if we think of the bill as part of an anti-obesity strategy in its widest sense. Such a strategy is not just about exercise for older children and what they eat; it is about caring for their health from the day they are born and ensuring that they grow up as healthy young people.
There are also benefits for mothers. We have heard about less breast cancer, a lower risk of ovarian cancer and fewer hip fractures and bone density problems. Bone-density problems are on the increase in Scotland. They are often overlooked and we should pay them particular attention, because as our population gets older we will have to deal with the difficulties that they bring. It is important to use breastfeeding as part of a strategy to defeat bone density problems.
In July 2004 UNICEF revealed that new mothers in Scotland are more likely to receive effective breastfeeding help in maternity units than are mothers in maternity units elsewhere in the UK. We should be proud of that, but we must ask why Scotland has a lower breastfeeding rate than most of Europe. The answer is clear and relates to society's attitude once a woman leaves the maternity unit and moves back home and into wider society.
The NCT has said that there is public hostility and has put on record many instances of negative comments and even aggression towards breastfeeding mothers in public places. Public hostility to mothers is likely to affect young and disadvantaged women, who are the least likely to start or to continue breastfeeding. That exacerbates the health inequalities that already exist in Scotland. It is critical that the bill changes public attitudes.
When my daughter was being fed as a young baby, we did not experience abuse or aggression and we were never thrown out of anywhere or asked to go into a toilet. However, when we sat in public places, whether a park or restaurant, the problem was the sideways glances and the strange looks that we got from other members of the public, who obviously felt that it was not acceptable to breastfeed in a public place, even though we were being extremely discreet—I was amazed that anyone even noticed that my daughter was being breastfed. We have to effect an attitude change.
On the criminality issue, I hope that we never see anyone charged with an offence under the bill because I want the outcome to be attitudinal change in our society, not a list of criminal offences for people who own certain licensed premises.
There will be a free vote on the bill for members of the SNP group, as there will be for Liberal Democrats members. I encourage all SNP members to accept the recommendation of the Health Committee and to vote to support the bill at 5 o'clock.
I quote the policy memorandum, as it sums up my view of what the bill is all about. On page 5 it states:
"The message promoted is ‘Don't think of it as a woman's right to breastfeed. Think of it as a baby's right to eat'."
That is the critical message that we have to get across.
The debate has been good, informed and emotional and key points have been made. The bill is another plank in our public health strategy; it will contribute to the well-being of babies and their mothers. It is about giving children the best possible start in life and protecting mothers in that process.
Government has a role to play and I fully accept the responsibilities and duties that the bill would place on us. We are happy to meet the duties. We should acknowledge that we are doing a good job at the moment. Although members quite rightly want us to do better, key campaigners throughout the UK rate the Executive highly in their perception and understanding of the work that we are doing. Nevertheless, I absolutely accept our responsibility and we can, should and will better support mothers whether they choose to breastfeed or bottle feed. We need to acknowledge the difficult issues that mothers face and ensure that we provide as much support as we can.
It is also about empowerment. As Stewart Maxwell said, it is about empowering the baby to receive the best possible feed and empowering women to not feel uncomfortable about what is a natural process. The debate that we are having in society about this will help constructively to change attitudes towards breastfeeding.
Our breastfeeding strategy will focus on breastfeeding in the early stages. It will cover antenatal education and support and ensure that parental education supports breastfeeding and that information contained in our policies and strategies gets across to all mothers, particularly those in less well-off areas.
We recognise the role that breastfeeding can play in the health inequalities debate. I have mentioned NHS Tayside's video, which has been circulated to all health boards in Scotland. It is about the prenatal decisions that a mother will take, and it aims to help family and friends buy into supporting the mother. We support that.
Fiona Hyslop mentioned her event on 2 December. I am not sure what my diary looks like for that day, but I would be happy to receive an invitation, if that is possible. She mentioned the need for us to be supportive of mothers at all stages, particularly the prenatal stage.
The decision about when mothers should leave hospital is largely made at the local level, with different policies in different places. There is an increasing demand for mothers to leave hospital to get back to their home environment as quickly as possible. Our strategies reflect that, ensuring that community midwives and health visitors, as well as the army of volunteers involved with breastfeeding, many of whom I have met, are there to support mothers at what can be a difficult and challenging time.
I realise that we need flexibility but, in my recent experience, many young women have problems with the latching-on process. That might not be possible until the milk comes in, which might happen several days after a mother has been discharged, if she has been discharged within a few hours. There is an issue about early discharge, which Jean Turner also raised.
I genuinely believe that our strategies address and understand that situation, and the work that we do in the community—involving a number of the organisations that we support and various voluntary organisations—supports that. We offer mothers 24-hour helplines to help them deal with that sort of problem. I accept the point that Fiona Hyslop makes. My officials and I will review the debate in its entirety to ensure that the good ideas that have come from all round the chamber will be reflected in our breastfeeding strategy, on which we will report to the Parliament.
I reiterate my admiration and support for Elaine Smith, who introduced the bill. We have heard some very good contributions from across the chamber. This is another health improvement measure that the Executive and the Parliament are supporting, which will give young people the best possible start in life. On the bigger issue of changing attitudes, what we have done today and throughout the bill process is attempt to present society with what is a very normal situation. Hopefully, attitudes will change, and more mothers will feel confident about their right to breastfeed.
I have registered interests in relation to the Breastfeeding etc (Scotland) Bill.
I thank everyone who has contributed to this afternoon's debate, It has been very positive, which I am pleased about. I thank the visitors who have attended this final stage of consideration of the bill, including my son, Vann, who played an important role in inspiring this bill. He and I experienced at first hand some of the negative attitudes to breastfeeding that exist in Scotland. As has been the case with previous breastfeeding debates, many parents and children have joined us—most of them are watching from committee room 1.
I find it difficult to believe that we have now reached the final stage of the Breastfeeding etc (Scotland) Bill, the fate of which will be sealed at decision time. I have been working on the bill for the past three years, but certainly not alone, and I take this opportunity to thank everyone who has helped get the bill to this stage. When I first had the idea, I sought legal help for drafting a proposal from Mike Dailly of the Govan Law Centre, and he kindly agreed to assist. My thanks go to Mike for his hard work and commitment in turning my idea into a workable piece of legislation. I set up a steering group to advise me and to inform the process, and I invited a wide range of organisations to participate in it. In eliciting that support, I merely scratched the surface of the total number of people who work in the sector. That was enough, however, for me to witness the vast amounts of enthusiasm, dedication and commitment that Andy Kerr has spoken about. Those people deserve our support, and I hope that, if it is passed, the bill will go some way towards providing that. Unfortunately, time does not allow me to name all the individual members of the steering group. Suffice to say their help has been invaluable throughout the process.
Thanks are due to Unison for funding a piece of research and to Kay Sillars for producing it. I thank Boots and the Royal College of Nursing for sponsoring a reception tonight. I also thank the committees that considered the bill—particularly the Health Committee—and their clerks. The Health Committee's scrutiny of the legislation and its robust stage 1 report evidenced an excellent understanding of the issues.
In his previous brief as Minister for Health and Community Care, Malcolm Chisholm scrutinised my proposal and my thanks go to him and the Scottish Executive for their support. I also thank my MSP colleagues and Jenny Warren, the national breastfeeding adviser.
My staff also deserve recognition. In the early days, Margaret McGregor, John Rowan and Frances Wright gave me important assistance and my current staff, Lesley Dobbin and Catherine Murphy, have provided invaluable help on the bill. Last, but far from least, my thanks go to Susan Deacon MSP and her researcher Ann Henderson. As Susan Deacon has pointed out, I first approached her with the idea when she was Minister for Health and Community Care, and in that role, although naturally wary of how the legislation might work, she supported the principle. Over the years since that first conversation, Susan has been a source of help and advice, culminating in her agreeing to close for me in the stage 1 debate and to open in this debate. I am extremely grateful to her for that.
As the final hurdle approaches, I must address a few issues. On the whole, the bill has attracted positive support, but a minority has tried to undermine it by saying that it is a politically correct and trivial issue. In fact, this small, but important bill is a good example of how the members' bills system can work under devolution and how it can allow members to take forward important constituency-led issues to effect legislative change for the benefit of Scotland as a whole, and to lead the way in the UK.
It was the discovery that Coatbridge had one of the lowest rates of breastfeeding in Scotland that provided me with the impetus to pursue the bill, so it arose directly from my constituency work. If the bill helps to encourage more women to breastfeed, it will have a significant effect on the future health of children and women in Coatbridge and Chryston and right across Scotland. I was also motivated by the Executive's response that it had no powers to do anything about the incident of the woman who was put off the bus. Perhaps it will have those powers shortly.
The most controversial part of the bill seems to be that it provides legal protection only for children up to the age of two. It is regrettable that an age had to be included at all, but because it is criminal legislation, it must be clear and unambiguous and it must define what "child" means. We heard all the arguments during the discussion of amendments so I will only reiterate the point that the status quo prevails for children beyond the age of two, and it is not illegal to feed one's child.
The bill is important in underpinning the sterling work of health professionals in the NHS and in providing encouragement to the Scottish Executive to focus on the way in which breastfeeding is promoted and supported by the Executive. Further, given the low breastfeeding rates in more deprived communities, the bill could also be regarded as another tool to help tackle the social exclusion and poor health that is linked to poverty and deprivation. Indeed, last week when Professor Stewart Forsyth was referring to follow-up data from the Dundee infant feeding study, he commented on breastfed babies from poorer backgrounds by saying:
"babies who were from poorer communities actually do better in terms of health outcomes than many of the children from the more affluent areas who were bottle-fed."
I have never promoted the bill as a panacea. It is part of a wide-ranging approach that encompasses many different health departments, voluntary sector initiatives and Scottish Executive policies and programmes. If the bill is supported this evening, it will show that Scottish parliamentarians are prepared to play their part in helping to underpin the work being done elsewhere and send a clear message that breastfeeding is normal, nurturing and maternal behaviour and it ought to be supported.
I asked Susan Deacon to open the debate so that I could have the final word. If passed, the bill is not an end, but the beginning of the Parliament pursuing practical ways to support and encourage breastfeeding. Although I am having the final word in this debate, I assure Parliament, the minister and all those with an interest in breastfeeding that I will have much more to say on the subject during the rest of this parliamentary term and I am sure that many of my colleagues will too.
I am pleased to acknowledge the Executive's commitment to breastfeeding and its current plan to produce a Scottish strategy. However, it falls upon us all to ensure scrutiny of the Executive; given the interest in the bill, I am sure that we will rise to that challenge during the coming months and years.
The leader in The Herald in August 2002 was about the bill and it carried the headline
"Natural act is overdue official respectability".
The article concluded:
"Signalling to society that breastfeeding is an acceptable part of modern life is a message that is long overdue in its delivery."
Colleagues, at decision time, let us deliver that message.