Breastfeeding etc (Scotland) Bill: Stage 1
The next item of business is a debate on motion S2M-1640, in the name of Elaine Smith, on the general principles of the Breastfeeding etc (Scotland) Bill.
I refer to my registered interests that relate to the bill, which include assistance from Mike Dailly of the Govan Law Centre and funding from Unison.
I welcome the visitors who are in the public gallery, particularly the mums and babies who have come along. I thank everyone who has helped the bill to get to this stage, including the Health Committee, which recommended that the bill proceed to stage 2, its officials and the secondary committees that have been involved.
I am pleased that my first speech in the new Parliament building is on my own piece of legislation. I add to the many positive comments that have been made about the building by commending its accessibility. The bill promotes accessibility for families in all public places in Scotland. The idea for the bill arose after my members' business debate on breastfeeding in May 2001. It seemed to me that such an important health issue should not merely be mentioned once a year during breastfeeding awareness week, but deserved practical action by the Parliament. During that debate, I related the experiences of a mother who was put off a bus in Edinburgh for breastfeeding. In response, Malcolm Chisholm said:
"Ministers wrote to Lothian Regional Transport … but under current laws we do not have powers to enforce anything on a bus company in that regard."—[Official Report, 17 May 2001; c 902.]
Three years later, the Parliament has the opportunity to change that situation.
If we enact the bill, in future no mum will have to suffer the stress and indignity of being harassed, segregated or ejected from a public place merely for wishing to give their child the best start in life.
The principal aims of the bill are to ensure that breast and bottle feeding mothers are given equal and unimpeded access to public services and spaces where children are entitled to be, and to encourage and make provision for the promotion of breastfeeding.
I have been asked many times whether women actually experience such ill treatment. The simple answer is yes, they do. In evidence to the Health Committee, Rosemary Dodds of the National Childbirth Trust said:
"I deal with a slow but steady stream of concerned women who have been asked to leave premises."—[Official Report, Health Committee, 11 May 2004; c 853.]
Indeed, Kate Maclean MSP recalls being frogmarched out of the powder room of an Edinburgh department store for breastfeeding while, at the same time, a staff member ran off to get water for a customer's dog. Some of the many incidents that have been brought to my attention include a mother who was chastised over the tannoy in a Clydebank shopping mall, a women being slow handclapped out of a Glasgow cafe and two women being asked to leave general practitioner and dental waiting rooms in Dumbarton and Ayrshire respectively.
Of even greater importance than those examples is the impact that they have on women's choices for feeding their babies. Figures released by the Department of Health last May showed that more than two thirds—67 per cent—of women believed that the general public find breastfeeding in public to be unacceptable. That clearly indicates that the 16 per cent of people who objected to the idea of women breastfeeding babies discreetly—which was the word that was used in the question—in public have a significantly disproportionate influence on women's perceptions. If we allow the barriers that make breastfeeding a largely hidden practice to remain unchallenged, future generations will be denied any positive reinforcement of breastfeeding as normal, everyday, maternal nurturing behaviour.
Scotland has one of the lowest breastfeeding rates in Europe and one of the highest rates of ill health. Coatbridge has one of the lowest breastfeeding rates in Scotland and—perhaps not coincidentally—has some of the highest rates of ill health in Scotland. It also has significant levels of deprivation. The correlation between areas of higher deprivation and poverty and low rates of breastfeeding is clear. Jenny Warren, the national breastfeeding adviser, makes the following observation:
"The mothers who have most to gain in terms of their own and their babies' health, namely the young, poor and least educated, are least likely to breastfeed … They are more likely to be dependant on public transport and lack the confidence to breastfeed in public."
Given the importance of breastfeeding for the future health of our nation, it is vital that the Scottish Executive continues actively to promote breastfeeding. Section 4 of the Breastfeeding etc (Scotland) Bill will help with that.
Other members will no doubt expand on the many proven health benefits of breastfeeding. Suffice it for me to say that the wealth of scientific research into the benefits of breastfeeding suggests that there would be massive societal recompense in increasing the levels of breastfeeding. Indeed, research indicates that improvements in the levels of breastfeeding could save the national health service in Scotland an estimated £3.82 million a year through associated reduction in gastro-intestinal infections alone. That does not begin to take into account the savings associated with all the other health benefits to mother and child.
While the legislation would undoubtedly help to achieve those goals, it has been suggested that there might be alternative means, such as changing the civil law. However, that would put the onus on mothers to engage in civil action and would force them to endure the associated cost and stress involved. Another suggestion is to take the licensing route. However, the bill is not simply to do with improving access to restaurants, cafe and leisure facilities; it is primarily about ensuring that all breastfeeding mothers are given equal access to public services and are able to visit local authority offices, use public transport, attend doctors' appointments and so on. No one should be excluded from public areas because of the way in which they feed their baby and, as many of those areas are not subject to licensing laws, a change in that regard would have limited impact.
It is not envisaged that this legislation will result in many prosecutions. It is intended to act as a deterrent. Indeed, in evidence to the Health Committee, Deputy Chief Constable David Mellor, who was representing the Association of Chief Police Officers in Scotland, said:
"My view is that it would be good law in that it would be symbolic, it would reinforce the aims of the bill and it would exist as a threat. Sometimes people need a threat so that they change their attitudes and behaviour. In support of the bill, I say simply … that I anticipate that prosecutions would be few in number."—[Official Report, Health Committee, 11 May 2004; c 866.]
I hope that that gives comfort to anyone who might be putting their concern about fines before the need to protect vulnerable women and children.
In any case, the fines in the bill are based on the fines in current disability discrimination legislation and go up to a maximum of £2,500. The Scottish Human Rights Centre believes that
"this approach is a reasonable one to take"
and that it is likely to be
"considered, under ECHR, as a ‘proportionate' measure".
The Conservatives' spokesperson Nanette Milne said recently:
"Owners of cafes, shops and restaurants should be free to decide for themselves whether to allow breastfeeding or not on their premises."
Surely she cannot be condoning the expulsion of breastfeeding babies and their mothers. The example of the mother from Dumbarton who was told to stop breastfeeding in her general practitioner's waiting room while sitting under a sign that said "Breastfeeding mothers welcome here" shows that voluntary means have only limited success. In evidence to the Health Committee, Ellen Kelly from the City of Edinburgh Council said:
"After more than 25 years in local government, I can say that people do not do things unless they are compelled to do so, particularly in the field of equality. No advance in equality has been achieved without accompanying legislation".—[Official Report, Health Committee, 1 June 2004; c 928.]
The issue is not party political but has support across the political spectrum. Winston Churchill said:
"There is no finer investment for any community than putting milk into babies."
If we strengthen legislation, that will help us to meet our legal obligations under the United Nations Convention on the Rights of the Child and various other human rights obligations and it will allow us to respond proactively to the World Health Organisation's call for Governments to adopt imaginative national policies and strategies to support breastfeeding.
A change in the law will not immediately effect the big shift in attitude that we need in Scotland, given our non-breastfeeding-friendly culture, but in time it will do just that. The Minister for Health and Community Care seems to agree. Malcolm Chisholm said in his evidence:
"the bill will certainly help to change cultural attitudes."—[Official Report, Health Committee, 1 June 2004; c 904.]
In the meantime, by legislating we will send a strong message that Scotland supports breastfeeding and will not tolerate the exclusion, segregation and harassment of mothers and babies that are legally permitted at present.
The legislation's primary aim is to protect and promote breastfeeding, but it protects all infant feeding of milk in public places. It is child centred and it is based on the protection of a child's right to eat while accessing vital public services. Health professionals throughout the country do commendable work and should be proud of their success in improving uptake and duration rates, but by the new year we are supposed to meet the challenge of 50 per cent of mums to be breastfeeding at six weeks, and as we stand now the figure is less than 40 per cent. The extent of the challenge in turning the tide towards breastfeeding in Scotland means that those health professionals undoubtedly need the Parliament's political support.
A mum, Shelley Joffre, highlighted the need for legislation when she said:
"The simple fact is, if you can't do it in public, then you face weeks of living under house arrest."
Breastfeeding should not have to be carried out in private as if it is something shameful. It should be supported, protected and celebrated in our society. The bill protects the right of hungry babies to eat—it is as simple as that. Today, the Parliament has the chance to take a practical step towards providing that protection and I urge all members to support the motion in my name.
I move,
That the Parliament agrees to the general principles of the Breastfeeding etc. (Scotland) Bill.
I am pleased to respond for the Executive today, as I did as deputy minister all those years ago in Elaine Smith's previous debate on the subject. This is a welcome opportunity to discuss a subject that the Executive has supported, promoted and resourced since the establishment of the Scottish Parliament in 1999. I pay tribute to my predecessor Susan Deacon for all that she did in that regard. Perhaps we will hear from her in a moment.
We all want our children to be healthy and to grow up to be healthy adults, so we should do all that we can to ensure that children are well nourished from the minute that they are born. The bill will make it an offence to prevent or stop a child under the age of two years, who is permitted to be in a public or licensed premises, being fed milk in that place. It also seeks to impose on Scottish ministers a specific duty to support and encourage the breastfeeding of children by their mothers.
Elaine Smith's preparatory work in introducing the bill and the Health Committee's stage 1 deliberations have enabled us to explore some of the wider issues that affect a child's right, and a woman's ability and desire, to breastfeed. Although the bill centres on the child's right to be fed any form of milk in its formative years, it is fair to say that one of the bill's aims is to create a socially tolerant and safe environment in which a woman can breastfeed where and when it is most appropriate for her child, regardless of whether she is at home or in her local cafe. For that reason, I thank Elaine Smith for introducing the bill.
The reasons why the current Executive has supported breastfeeding throughout its time in power should be obvious, given that the health benefits of breastfeeding for both mother and baby are well accepted. The antibodies in breast milk protect against a wide range of infections and stimulate a baby's immature immune system. Moreover, breastfeeding is known to provide the best nutrition for a baby, with advantages over formula feeding. As breastfed babies grow up, they have less chance of developing respiratory tract problems, gastroenteritis, ear infections, asthma, eczema, diabetes and obesity. Mothers who breastfeed are less likely to develop ovarian or breast cancer.
The Executive wants a Scotland in which all mothers who can and want to breastfeed do so and are given the information, support and encouragement that they need. To achieve that, we have implemented a wide programme of work that is delivered in four key ways. First, the national breastfeeding adviser, Jenny Warren, encourages, supports and audits national health service boards in developing breastfeeding strategies. Secondly, the Scottish breastfeeding group works across professional interests to share information on and to raise the profile of breastfeeding. It also takes forward pieces of work on breastfeeding. Thirdly, the breastfeeding website gives parents and practitioners news, statistics and information about good practice and research. Fourthly, the work of NHS Health Scotland includes the development of promotional materials and resources for parents, training materials for health professionals and support for evidence-based policy making through networking and research.
The good news in Scotland is that those strategies are producing positive results. Across NHS Scotland, most NHS boards are now implementing breastfeeding strategies. Of our maternity units, 11 have qualified for the United Nations International Children's Emergency Fund—UNICEF—UK baby-friendly initiative. The remainder are at various stages of working towards that award and 10 have received a certificate of commitment to acknowledge their progress in doing so. To put that in context, it means that 38 per cent of our maternity units are fully compliant with the baby-friendly initiative. As a result, 48 per cent of Scottish babies will be born in a unit that provides the highest level of available support for breastfeeding. By comparison, the equivalent figure for England is only 10 per cent and for Northern Ireland and Wales only 34 per cent. We should all be proud of that and encouraged by it.
Progress is also being made within our communities. For example, Anniesland, Bearsden and Milngavie local health care co-operative received Scotland's first UNICEF community award, which others are also working towards. Across the country, there are 150 breastfeeding support groups and a number of peer support initiatives and training strategies to ensure that health staff provide evidence-based and consistent advice and support to mothers.
Although there has been a steady upward trend in both the initiation and duration of breastfeeding in Scotland, the rates remain lower than we would like. In 1994, a national target was set with the aim that, by 2005, 50 per cent of mothers would still be breastfeeding their babies at six weeks of life. Our most recent data, for 2003, show a rate of 36.5 per cent, so we have some way to go to reach that target. I have asked officials in the Executive to develop a breastfeeding action plan to identify key areas for action for the next five years and to provide guidance on how the NHS can work with a range of key bodies and stakeholders to support delivery.
It is fair to say that, so far, work to promote breastfeeding has been largely concentrated within the health sector, but we appreciate that we need to involve other partners in early-years services if we are to give every child the best start in life. That is why breastfeeding will be a key, joint outcome measure in the Executive's integrated early-years strategy.
The stage 1 consideration of the bill flagged up concerns that the Health Committee was able to explore in depth. I myself had raised concerns on behalf of the Executive about the bill's enforceability. However, the Executive is content with the Health Committee's conclusions on enforcement and for the bill to proceed.
While the Health Committee accepted that there are likely to be few prosecutions under the bill once enacted, it also concluded that the legislation may have a deterrent effect. The act will set out clearly the circumstances in which it will be an offence to prevent or stop a child being fed milk and it may empower women to make key decisions about their feeding choices. The Health Committee accepted that legislation can assist a shift in attitude and behaviour and that the bill could thus support the uptake and duration of breastfeeding. Although there may not be universal acceptance of the bill, consultation has proven that there is an extremely high level of support for it both in organisations and among the public across Scotland, with many people greatly saddened that such a bill is needed in the first place.
The committee concluded that, although much of the evidence is anecdotal, adverse reaction to breastfeeding in public, or fear of such reaction, may impact negatively on the take-up and duration rates of breastfeeding. Regardless of the excellent promotional work by NHS Health Scotland and health boards across Scotland, there are still those who feel embarrassed or offended by breastfeeding. Those views are based, of course, on ignorance and prejudice and must be challenged. What many people do not appreciate is the physiological impact that asking a mother to stop breastfeeding can have and the distress that that can cause. The debate and discussion around Elaine Smith's bill have done much to address that.
The bill could also mean that more women will choose to breastfeed in public. That itself would bolster the image of breastfeeding as a normal, natural and socially acceptable life event, which we hope would encourage even more mothers in the future. We do not want mothers to be put off breastfeeding by feeling that it could constrain them in where they can take their baby. Breastfeeding is, after all, the ultimate convenience food.
The bill places Scottish ministers under a specific duty to support and encourage the breastfeeding of children by their mothers. However, I should point out that the National Health Service Reform (Scotland) Act 2004 has already introduced a general duty on Scottish ministers, health boards, special health boards and the Common Services Agency to promote health improvement. The relevant provision will come into force on 1 January 2005.
As I have indicated, I am content with the conclusions that the Health Committee reached on the bill and for the bill to proceed, but very much in the context of our overall policy and strategies to promote the best possible start in life for the children of Scotland. [Applause.]
I remind members of the public that it is not appropriate to applaud.
I congratulate Elaine Smith and all who helped her to bring the bill to the Parliament. I know from personal experience the great deal of hard work that goes into a member's bill. Only members with great personal commitment will embark on the process in the first place. I also pay tribute to the fine speech that Elaine Smith made.
Anybody who has read the bill and monitored its progress through stage 1 will be aware that the bill's main thrust is to encourage a cultural change in Scotland with regard to views on breastfeeding. We in the Scottish National Party support that principle. The health benefits of breastfeeding are well known and I will discuss some of them later.
On a personal note, I feel that it is right to stress that I am not generally inclined to legislate in areas in which cultural change is needed. However, I believe that legislation is necessary in some cases and this is one such case. We must create a culture in which breastfeeding in public is accepted and, more important, regarded as the norm.
Elaine Smith referred earlier to Deputy Chief Constable David Mellor's evidence. However, given that he is the deputy chief constable of Fife, it would be remiss of me not to quote him. He said in evidence to the Health Committee:
"It is perfectly legitimate to create a criminal offence as part of a strategy to change attitudes. However, I sense that the creation of a criminal offence in this bill seems to be principally a symbolic act, although I accept that the existence on the statute book of an offence that means that people can threaten to use the criminal law is a convincing way of changing attitudes and behaviours."—[Official Report, Health Committee, 11 May 2004; c 866.]
It is my view that in doing that the bill will have a positive impact on breastfeeding rates in Scotland and there will be a subsequent improvement in the health of our children. However, such an improvement will not be possible if the bill exists in isolation. There must be greater a focus on narrowing the inequalities in breastfeeding rates that exist throughout Scotland. The bill must be supported through increased education and awareness campaigns that highlight the benefit of breastfeeding to both mother and child.
I am hopeful that the bill will be part of a multifaceted approach. Will the member join me in congratulating Rosehall High in Coatbridge, which is bringing in mothers from the community to work on educating first year pupils about, and highlighting the importance of, breastfeeding?
I thank the member for that intervention. I have absolutely no hesitation in welcoming the initiative in Coatbridge and I hope that it will be followed in schools throughout Scotland.
I have no doubt that members are aware of the health benefits of breastfeeding to both children and mothers, but it never hurts to remind ourselves of some of the facts. Research has shown that breastfeeding can play a large role in reducing the number of childhood illnesses and in improving health in later life. A move to help our children get the best start in life must be welcomed. The World Health Organisation recommends, where possible, exclusive breastfeeding for infants up to the age of six months. Although Scotland might boast increasing levels of breastfeeding over the past 10 years, there is certainly no room for complacency.
An equally important point is that statistics show that rates in poorer areas are worse than those in affluent ones, which Elaine Smith touched on. In Shettleston in Glasgow, a mere 21 per cent of mothers breastfeed six months after their child is born. It is in tackling that inequality that the benefits of the bill can be seen most clearly, by creating a culture that encourages breastfeeding among all social classes. There is evidence to suggest that prior exposure to breastfeeding or a positive role model in breastfeeding increases the likelihood of a new mother choosing to breastfeed her child. That evidence is true no matter which area or social class it is applied to.
Ending the negative attitudes towards breastfeeding and helping to create a culture across all sections of society where breastfeeding is the norm would be the bill's most important achievement. However, just as the bill respects the right to breastfeed, we need to ensure that those mothers who cannot breastfeed for whatever reason are not made to feel inadequate. Childbirth is a traumatic enough experience without new mothers feeling pressured into breastfeeding in the first place.
At present, funding for breastfeeding promotion and support is spread across various departments. Investment in the promotion of breastfeeding will save money in the longer term. Research has shown that there could be savings in the national health service of £3.5 million if breastfeeding rates increase—a fact that the Executive must take into account when deciding on funding in this area.
In conclusion, I am happy to support the general principles of the bill. I believe that it can play a vital role in making breastfeeding more acceptable in our society, but legislation alone cannot achieve that. The bill can achieve its aims only if it is supported by a coherent national breastfeeding strategy and education campaign. I welcome Malcolm Chisholm's remarks about a breastfeeding action plan, given that some health board areas do not have a strategy for breastfeeding. The action plan is long overdue and it will enhance the bill once it is enacted.
I acknowledge Elaine Smith's commitment to this topic and the work that she has done, although that does not mean to say that we agree with everything in the bill.
I look at the subject from a slightly different angle; as I go through I will explain where I am coming from. The bill appears to be an attempt at socially engineering an attitudinal change in order to increase the practice of breastfeeding in Scotland. It promotes an ideal without providing the specifics of what antenatal professionals could or should do to encourage mothers to breastfeed and does not state that education authorities should get across during school years the message that breastfeeding is best. It makes no mention of midwives, health visitors or general practitioners encouraging mothers to extend the period for which they breastfeed. Surely, if children, who are the next generation of parents, are not given the basic information on the benefits of breastfeeding, they will not be encouraged to take it up when they become parents and I ask why that was not included in the bill.
As Malcolm Chisholm has outlined, there is a lot of work going on in the Executive, and I have cited an example from a school in my constituency. The bill is part of a multifaceted approach; it is one way in which we hope that we can effect a change in cultural attitudes, which will help to increase breastfeeding rates.
The bill's only specific mention of the promotion of breastfeeding is in section 4, which states that ministers
"shall make arrangements … for the purpose of supporting and encouraging the breastfeeding of children by their mothers."
However, that is qualified by the get-out-of-jail phrase,
"to such extent as they consider necessary to meet all reasonable requirements".
When I wrote that comment, I was not aware of Malcolm Chisholm's words, so he will be encouraged when I get to another part of the speech, which shows that he and I are coming from a similar position. Under current legislation, ministers already have a duty to take measures to improve health, so that role is already covered.
The Conservatives support the promotion of breastfeeding as best for baby and mother. Indeed, I was lucky that my five children were able to have the benefits of being breastfed by their mother, which she managed to do in all sorts of places around the world. Evidence exists that mothers who are able to breastfeed are less likely to develop certain types of cancer and postmenopausal hip fractures and that the baby is less likely to suffer from infections, allergies and childhood obesity, which can lead to early diabetes. That is of huge benefit in cost savings to the NHS, and children being healthier means less loss to the economy through parents taking time off work to look after ill children, which is not to mention the basic improvement in individual quality of life that the children will have over time.
We recognise the existence of a national breastfeeding adviser, a post that was set up by the Conservative Government in 1996 to work with health boards to provide tailor-made local solutions to develop and implement breastfeeding strategies. Thirteen of our 15 boards have a strategy, one has a policy and the other has a policy and guidelines. Evidence from various audit processes raised concerns about the target setting, the patchiness in peer support, the availability of funding, the implementation of the World Health Organisation's international code of marketing of breast-milk substitutes and the sale of subsidised formula milk on NHS premises. In 1990, the Conservative Government signed the Innocenti declaration—the joint WHO-UNICEF piece of work that Malcolm Chisholm mentioned—which pledged to reinforce a breastfeeding culture within the health system, workplace and community.
Although breastfeeding rates are increasing, that is due to initiatives on the ground, not regulation. In 1994, the Scottish Office set a target of 50 per cent of mothers breastfeeding for at least six weeks. In 1990, 30 per cent of mothers did; in 1995, that rose to 36 per cent, as the minister mentioned; and in 2000, it was 40 per cent.
Will David Davidson acknowledge the fact that, despite the excellent work of the national breastfeeding adviser—a post set up, as he rightly says, under a previous Conservative Administration—and all the excellent work that is being done in the health service and on the promotion of breastfeeding in a range of other settings, progress towards the target that the Conservative Government set has been much slower than any of us would want? If he is setting his face against the bill, perhaps he would like to tell us how we will accelerate progress towards the target that the Conservative Administration set.
On the progress over the past seven years, Susan Deacon must ask the ministers who preceded her in having control of the system and did not carry on working towards the target that was set. In fact, I am encouraged by what the minister said today and if he is playing catch up, I will help him if I can. I cannot breastfeed, unfortunately, but I can influence people.
None of what was achieved in the period up to 2000 was the result of introducing what I see as a legal cosh that is aimed at business owners and employers. The measure has nothing to do with promotion. It is not for business owners and employers to suggest to young mothers that they should breastfeed.
In Elaine Smith's pre-legislative consultation, evidence was received that 92 per cent of the public think that it is acceptable to breastfeed discreetly in public. The Health Committee heard evidence that many women do not wish to breastfeed in public but would rather have access to quiet and clean facilities—not toilet areas—but Elaine Smith told the committee that she did not wish to add that burden to businesses.
Will the member be explicit about whether he defends the right of a cafe, restaurant or shop owner to ask a woman to leave because she is breastfeeding her baby?
I will answer that point when I come on to it in my speech.
There is no evidence that legislation such as the bill helps to encourage breastfeeding. In places where similar legislation is in place, such as many states of America, the breastfeeding rate has not improved and no cases have been identified as being brought under the breastfeeding laws.
The evidence to the Health Committee from the Association of Chief Police Officers in Scotland was that even if the bill became law, it would not be a priority for action and could lead to a negative attitude to breastfeeding. Procurators fiscal are already hard-pressed by current crime rates and would be unlikely to undertake prosecutions—the Scottish Consumer Council shares that view.
My answer to Carolyn Leckie is that the current law protects all citizens—including mothers and other adults who are taking care of children—from assault or being threatened. Police evidence suggests that forces would take action under common law as appropriate if an assault occurred or a threat was made. I also point out that no action has yet been taken under section 29 of the Sex Discrimination Act 1975.
In this modern society, we need to support better public information and education, not the use of negative legislation that is unlikely to be enforced and which does not promote breastfeeding to those who are not attracted to it or are simply unable to contribute.
The Parliament has a duty to pass sensible and practical legislation—not nanny-state measures that are seen to be politically correct. In the Health Committee, I said that I could not support the introduction of the proposed criminal offence. I believe that Elaine Smith genuinely seeks to promote breastfeeding—a laudable aim that all Conservatives share—but I give notice that we shall not support her bill in its current form. The inclusion of foodstuffs other than breast milk, albeit for technical reasons, has clouded the issue and invoked a negative response from health professionals.
The bill is unnecessary. It would overlap with existing legislation and would be unlikely to be applied. It would not be the best way to promote breastfeeding as the norm and it would not help more babies to be breastfed.
First, I add my congratulations to Elaine Smith on introducing this small but important bill. She is using the Scottish Parliament's processes as they were designed to be used. I cannot imagine the introduction of such a bill in pre-devolution Scotland.
I make it clear that no whip is being applied to the Liberal Democrats in the vote on the bill. It is a member's bill and it is appropriate that members can vote on it outwith normal party-political discipline—members all know how keen I am on that.
The bill would make it an offence to prevent or stop a child who is under two from being fed milk in a public place. It is essential to stress that in Scots law, a child who is under two is already allowed to be fed milk in a public place. That is not what the bill is about. As members have heard, the police confirmed in evidence to the Health Committee that people who feed milk to children in public have the same right as anyone else has not to be assaulted or threatened.
The bill proposes to tackle the offence that is caused by people who insist on treating this natural and normal activity as though it were offensive. We should encourage and support the breastfeeding of children by their mothers. All members of the Health Committee, barring David Davidson, felt that the evidence that we received showed clearly that legislation to promote breastfeeding was necessary and important.
David Davidson could not answer the question that Carolyn Leckie asked him in her intervention. He cannot seriously defend the actions of a cafe owner who demands that a breastfeeding mother should leave the premises.
If Mr Rumbles had been paying attention, he would know that I did answer the question. Current law exists that can be used in such cases if an application is made to the police. Therefore, an extra piece of legislation is not required to cover such incidents. Of course I do not agree with such behaviour.
Explaining David Davidson's position to the general public is difficult—I hardly understand it myself. It is unfortunate that the committee's report could not be unanimous, but there you are.
The passing of legislation to promote attitudinal change has a strong track record. How many people are prosecuted each year for not wearing car seat belts? We all know that we should wear car seat belts for our own safety, but passing a law requiring everyone to wear seat belts and creating a criminal offence with penalties for not doing so was felt to be necessary. That legislation has been very successful in changing people's attitudes and leading to greater road safety.
The situation that we are discussing is similar. I hope that we do not have to charge anyone under the legislation, but it is necessary to have the backing of the criminal law if we want to get the message across that insulting mothers by preventing them from breastfeeding their children in a public place is simply unacceptable.
I am sorry that we cannot all see the need for the legislation, and it is unfortunate, to say the least, that the Conservative party, for which David Davidson is speaking, seems to be stuck once again with attitudes that are more akin to those of the 19th century than those of the 21st century. That, of course, is a matter for the Conservative party, but I wish that it would at least recognise the offence that is given to many parents and that there is a need to take every opportunity to tackle the issue.
In conclusion, I sincerely congratulate Elaine Smith on introducing the bill and I urge colleagues from all parties—even Conservative members when they arrive for the vote this evening—to take a leap into the 21st century and support the bill.
I congratulate Elaine Smith and her supporters on their hard work to get this member's bill to this point and am pleased to rise in support of the bill, which has secured support in the Health Committee. The responses to the consultation were sound and helped the Health Committee to explore many of the issues in depth. There is no doubt in my mind that the bill is long overdue. I have also been delighted to learn this afternoon from the Minister for Health and Community Care, Malcolm Chisholm, that there will be Scottish Executive support for the bill.
The bill will give a mother a right to feed her baby in a public place and it provides Scotland with the chance to lead the way in the United Kingdom. From the many conversations that I have had with Elaine Smith, I know that there is widespread interest in the proposed legislation. Other members have spoken convincingly about the very real benefits of breastfeeding for the health of mothers and babies. I congratulate everyone who is working hard to promote such benefits in respect of such an important health issue.
I know that Elaine Smith has travelled far and wide to speak at conferences on the issue and has given many radio interviews on it. For the benefit of anyone who is in any doubt that mothers and babies are currently denied the right in question, I would like to give one illustration of the sort of thing that happens.
I stress that the bill has two critically important features, one of which relates to the rights of mothers and babies or carers, while the other relates to promotion by the Government. I will deal with the claim that there should be a right and will take up a point that David Davidson made. He said that the bill is really about changing attitudes. To me, the bill, in the form in which it was presented to the Health Committee, clearly stated that it will be about rights.
I will illustrate the need for a right to be established by sharing the details of a case that underlines how vital the bill is. The most recent mother to contact the Parliament told how she was informed by the proprietor of a Stirlingshire restaurant that such "practices" were "better done in private". I think that referring to "practices" is very offensive. The mother was compelled to leave the restaurant. In her e-mail, she said that the restaurant is commended by VisitScotland and that it is promoted as having no age restriction on child access. That begs the question whether we want tourists also to experience this unfortunate aspect of our culture. She tells us that her story appeared in the Stirling Observer earlier in the summer. The restaurant in question is the Conservatory at Ballachallan, near Callander, and it received a tourism award. The mother is a doctor, who clearly knows the value of breastfeeding as she has breastfed all three of her children.
As Mike Rumbles said, and as the mother said in her correspondence to the Parliament, that attitude belongs in the 19th century. It does not reflect the type of Scottish hospitality that we need and want to promote to visitors. I agree whole-heartedly with that doctor. She continued in her e-mail:
"Any mother or midwife will tell you that you need to be really committed to breast feed your baby for more than the first few days post partum, it is generally painful and uncomfortable and many women find feeding in public a stressful experience."
That is a sentiment that anyone who has breastfed their babies in public would agree with—I know that I experienced that feeling. She continued:
"To be confronted as I was by the proprietor was not only embarrassing to me and the other customers it is also unacceptable at every level."
She concluded:
"It has the potential to destroy a woman's confidence breastfeeding."
That is just one example, but it was replicated many times in the written evidence that came to the Health Committee. This is the point at which I diverge from the view of David Davidson. He said that the evidence that the Health Committee had received said that many mothers did not want to feed in public. In fact, the great majority of the written evidence indicated that many mothers wanted to have the right to feed in public. The witnesses who came along to the committee very much supported that view in their oral evidence.
I believe that there is a need for the Parliament to legislate to require the Scottish Executive to promote breastfeeding, because there might not always be an Executive in power that is so thoroughly committed to this aspect of our life. Safeguards need always to be built in to ensure that, irrespective of whether individuals change, the policy is rooted in our legislation. I ask all members to give this vital bill a fair wind and to help turn what is evidently a sorely needed change into legislation.
I congratulate Elaine Smith on bringing the bill before Parliament and on the work that she and others have undertaken for the bill to reach this point. As this is a stage 1 debate, we are being invited to support the general principles of the bill. Like the Liberals, the SNP has no whip on the matter—it is a free vote. I place on record my support for the general principles of the bill. I view the issue of breastfeeding not simply as one of promoting good health. It is also a matter of equality and choice. It is about the right of individuals to feed the children for whom they are responsible as they see best, without fear of being discriminated against, shamed or otherwise pressured into following a particular route.
We should recognise that, even in an ideal world, breastfeeding is neither possible nor desirable in some cases—in the unfortunate case where a mother has died, in the presence of certain medical conditions, where mothers do not wish to breastfeed for personal reasons, or where mothers have drug addictions. While we promote breastfeeding, we should ensure that those who cannot or do not wish to breastfeed are not subjected to the same culture of disapproval to which some mothers who choose to breastfeed are subjected at the moment.
Although it is generally understood that breastfeeding has many advantages, and although there has been some advance in the situation in recent years, the number of women choosing to breastfeed—and, significantly, those who choose to do so during the crucial first six months, as identified by the World Health Organisation—remains disappointingly low. The greatest barrier that many mothers face is social and cultural. There is wide variation across Scotland in the number of mothers who breastfeed at six to eight weeks. The figure is as low as 26 per cent in Lanarkshire but as high as 48 per cent in the Borders and Lothians.
There are some in this chamber who will argue that we cannot effect cultural change by legislation and that the state has no role in such matters. Although they are correct to say that legislative change alone cannot change cultural attitudes, they are wrong in assuming that it has no role whatever. We need to promote a more positive attitude to breastfeeding, we need to encourage and support women who wish to breastfeed and we must challenge the culture of disdain that unfortunately exists in certain sections of our community, promoting instead a positive acceptance of breastfeeding. We must also continue to develop breastfeeding strategies, as advocated by the WHO.
We must do all of those things, but we must do more. Positive promotion of breastfeeding is all very well, but there is a political role too. We need to send out the right signals from this Parliament. I believe that, in this instance, legislation can be used to promote social change and that that social change is desirable. By supporting the bill today, the Parliament will be sending out the right message. That is why I have great pleasure in supporting Elaine Smith's bill this afternoon, and I hope that the Parliament does so too.
I am happy to speak in support of Elaine Smith's bill. What I have to say will sound quite similar to what other members have said, because there is a lot of agreement and support, and I am glad about that. Before I begin, however, I want to pick up on something that David Davidson said about the use of existing laws to protect a woman who might be harassed by a proprietor while she is breastfeeding in a cafe. David Davidson may want to correct me, but it sounded to me as if she would almost have to be physically assaulted before she could invoke that law. That is not what we are talking about. We are talking about people being disapproved of in a way that makes them feel uncomfortable when they are carrying out a natural act and I do not think that existing laws necessarily cover that.
Breastfeeding is a human rights issue. I am not talking specifically about the rights of the mother to breastfeed, although I support those. I am talking about the right of a child to be fed where it needs feeding and its right to be fed on human milk. The benefits of breastfeeding are well known. Other members have run through the short-term benefits for the baby, which include less gastroenteritis and fewer respiratory infections and allergies. There are longer-term effects for the baby as it grows older, with less asthma, fewer ear infections and less diabetes and obesity. There are also benefits for the mother, with a more rapid return of the body to its pre-pregnancy state, greater ease in regaining one's figure and, in the long term, a lower instance of some cancers.
As I said, the benefits of breastfeeding are well known. Equally well known is Scotland's poor rate of breastfeeding. Despite the initiatives to promote breastfeeding that were mentioned by the minister and which I fully support, I feel that out there on the ground, rather than at strategic decision-making level, we have a tendency not to be as strong as we might be in promoting breastfeeding, because we do not want to make mothers who choose to feed their babies artificially feel guilty. Of course, we should not do that, but I believe that we still hold back a bit on actively promoting breastfeeding. Given our poor rates, particularly in some parts of the country, that is a pity.
It is true that, in our society, mothers must have the choice as to how to feed their infants, but let us make that a real choice and not a decision that is influenced unduly by the prejudices of those few people—the 16 per cent that Elaine Smith mentioned—who seem to find a natural act odd. Helen Eadie mentioned that an unfortunate experience, such as those that we have heard that certain people have suffered while breastfeeding, can destroy a woman's confidence in breastfeeding. The fear of that happening could cause a woman never to start breastfeeding and the bill will remove that fear. For that reason alone, it is an excellent thing.
If breastfeeding is to be normalised—it is awful that we actually have to do that, but it is the reality—the bill will help to do it and our children will benefit. There is no doubt that we need to change attitudes in order to promote breastfeeding. The bill by itself will not do that, but it will prevent some of the obvious and unacceptable manifestations of negative attitudes to breastfeeding. It will send a powerful message about the rights of mothers and children in Scotland. The mothers in Scotland who are least likely to breastfeed are those for whom, paradoxically, breastfeeding is most important. Children of young disadvantaged mums are more likely to suffer from many of the common childhood infections that were mentioned at the beginning of the debate and that breastfeeding is known to reduce, but their mothers are most likely to be deterred from breastfeeding by negative attitudes. As well as a human rights issue, this is an issue of health inequality.
There are many things that must be done to support breastfeeding, including support from midwives and health visitors in the early stages. As other members have mentioned, breastfeeding is not always easy. Breastfeeding may be a natural act, but in many cases it is not one that can just happen without support to get it established. Other issues, such as maternity benefits and employment law, are outwith the scope of the Parliament, but the bill deals with an issue that is within our power. The bill is something that we can do to make it easier and more pleasant for Scottish mothers to breastfeed their children.
I believe that the bill will help to improve our attitudes to and, eventually, our rates of breastfeeding in Scotland. I urge the Parliament to support it.
I thank Elaine Smith for bringing the bill before the Parliament and I will speak in favour of its general principles. Through this debate and the discussions that have taken place in the Health Committee and elsewhere, Elaine Smith has already achieved a great deal in sending a positive message to Scotland about our support for breastfeeding.
It is interesting to note that, as far as I am aware, during the consultation process and the parliamentary discussion of the bill no one has questioned the clear benefits of breastfeeding. It is widely accepted that breast is best and that, for the health of both the mother and the child, we should do more to encourage breastfeeding. The disagreements start over the issue of breastfeeding in public, which is why I believe the bill is needed. There is no doubt that some people have a strongly held view that breastfeeding in public, however discreet—I believe that it is nearly always discreet—is unacceptable. Even more worrying is the fact that a considerable number of people are not hostile to but awkward, uncomfortable or uneasy about breastfeeding. That is a debilitating attitude, because its effect is to discourage young mothers from breastfeeding their children.
The embarrassment factor—the fact that breastfeeding in public is still unacceptable to some and is not that commonplace—stops mothers even considering breastfeeding their children. The bill is necessary because it tries to change that negative attitude. The legislation confirms that breastfeeding is an everyday activity that we should accept as normal, rather than eccentric, and it gives support and protection to those who are occasionally made to feel small, despite the fact that they want to do the best for their child.
I will say a few words from a personal perspective. I will not pretend that my experience is typical, but I hope that it illuminates some of the difficulties that we face in promoting and encouraging breastfeeding as the healthiest option for young children. Some members will know that I have three young children. In fact, my wife, Claire, is currently expecting and is due in five weeks. I am thinking of applying to the First Minister for support under the fresh talent initiative.
I like to think that I have always been aware of the benefits of breastfeeding, but I remember vividly how awkward and uncomfortable I was when I first encountered it in practice. That happened only three or four years before my first child was born. I was visiting a friend, Sallyanne, just after the birth of her child, and I remember feeling that I could not enter her front room, because her husband, Brian, told me that she was breastfeeding. Sallyanne told me not to be stupid, but I had to work hard to get over my embarrassment.
As members might expect, I am a little more comfortable with breastfeeding after having three breastfed children of my own. I do not want members to think that I have undergone some sort of aversion therapy. The point that I am trying to make is that, despite my rational understanding of and support for breastfeeding, there are strong cultural and societal attitudes that influence our behaviour and to which we often conform despite ourselves.
We do not need legislation to tackle male embarrassment or social awkwardness. If we needed bills to deal with every tic in the Scottish male psyche, we might have to meet constantly for months on end. However, some negative attitudes to breastfeeding spill over into something far more damaging: prejudice, hostility, discrimination and even segregation. I believe that the bill will address those problems.
Of course, when I became a dad and Claire was breastfeeding our babies, the boot was on the other foot. I do not know how many times she—like so many other mums—had to put up with dirty looks and tuts of disapproval when she found herself stuck in the wrong place at the wrong time with a hungry baby who did not understand what some, laughingly, call manners, or so-called polite behaviour. I remember at least two occasions when I was with her or met her and noticed that she had become a little quiet or subdued. When I asked what the matter was, she said that she had just been given a row by a total stranger. On both occasions she had been asked to sit in the toilet while feeding.
Claire did not let those incidents—unpleasant though they might have been—change the way that she chose to feed her baby, but we are kidding ourselves if we think that such attitudes are not a significant factor in putting off nearly half of all mothers from ever breastfeeding. The bill offers those mothers some protection. This is not about prosecuting individuals who feel strongly that breastfeeding in public is unacceptable, but it is about supporting those who want to do what is best for their child. It is about trying to establish in every young mother's mind the idea that, far from breaking a social taboo, they are doing what is right and, furthermore, what is normal.
Sadly, it is the case that the children who would most benefit from the best start in life and from the protection and help that we can offer are those who are most likely to miss out on the advantages of breastfeeding—a point made by Eleanor Scott a few minutes ago. Children born to families in areas of social deprivation are far more likely to be bottle fed than breastfed. Young mothers with little status, income or education are disadvantaged yet again by having the poorest access to safe public areas to breastfeed and not having the self-confidence to challenge public intolerance.
The evidence presented to the Health Committee was overwhelmingly in support of the bill. The submission from the Scottish NHS Confederation included a comment from a health worker, who said:
"It's acceptable to give a human baby animals' milk in a plastic bottle and yet what it ultimately should be having, human milk from a breast, needs a bill through parliament. What a strange country we live in!"
This Parliament, perhaps more than many other institutions, should recognise and understand the need to help our young people at the earliest stage in life to give them the best chances in life. I know that the Executive is committed to doing just that through many different programmes from nursery education and fresh fruit in schools to early intervention and books for babies. We are tackling child poverty and allowing all children the opportunity to develop to their full potential. Encouraging more women to breastfeed would be one of the strongest public health measures that we could introduce and it would improve the quality of life for millions of future Scots. It would improve our terrible dental health record and help to reduce obesity. It would reduce the risk of some cancers and it would tackle a whole list of chronic and acute diseases. What is more, breastfeeding is environmentally friendly and sustainable, it is accessible to nearly all and it is free. The bill marks a major step in the right direction: let us take it.
I congratulate Elaine Smith on getting this far and on achieving the support of the Executive. I look forward to the bill becoming law.
I start by addressing some of the remarks made by David Davidson. I have to say that to refer to health promotion and the benefits of breastfeeding, and to claim to be an advocate of breastfeeding and to support the achievement of a higher uptake of breastfeeding, but then to suggest that the bill will not assist in achieving those aims displays a degree of ignorance. He fails to take account of the effect that disapproval—even if it is only a dirty look—has on the physiological process of breastfeeding. The let-down reflex sometimes does not happen if a woman feels sufficiently uncomfortable or embarrassed. David Davidson really ought to reconsider. Perhaps for the first time I am genuinely trying to dissuade him from his view.
David Davidson ignored the main reason why women might be reluctant to feed in public when he referred to women being unable to contribute—whatever that meant. He ignores the fact that women might be reluctant to feed in public because those very attitudes exist in the first place. He uses the fact that some women who presented evidence to the Health Committee said that they would prefer to feed in private, but ignores the fact that that only reflects the prejudices that exist in society because we have done nothing to tackle them. Perhaps he might reconsider his position.
During the progress of the bill through the Health Committee, I was surprised that there was no attempt to use legislation to provide facilities for people—I mean decent facilities, not toilets and back rooms. It seems that we are coming at the issue from a different angle. We cannot encourage change just by legislating; we must start with the bottom of society, by which I mean young people from the knee—indeed, from the breast.
With due respect, the member's point is another massive red herring.
The member said that the Tories appointed the national breastfeeding adviser. However, under the Tories, breastfeeding nurses who specialised in supporting women in maternity hospitals went out the door when staffing levels were reduced, so we are witnessing a wee bit of hypocrisy.
As Elaine Smith said, the bill represents just one approach. The Tories have not explained how their opposition to the bill will help to achieve the outcomes that they talk about. No one disagrees with the Tories when they say that they would like there to be more resources—which I take it the Tories would fund through direct taxation—to promote breastfeeding, employ more midwives and health visitors and give midwives more time to help the poorest and most vulnerable women to start breastfeeding. I am glad that David Davidson expressed support for such measures and I will remember that he did so when we are demanding more midwives, health visitors and resources to promote breastfeeding.
Just as David Davidson raised concerns, I have some concerns that the bill will not go far enough. I whole-heartedly support the bill, but other measures should be taken, too. Ken Macintosh's anecdote reminded me of my first militant breastfeed, which took place within 36 hours of the birth of my daughter. I had to confront the attitudes of my father-in-law—now my ex-father-in-law, thankfully. I was not in a restaurant, a cafe or another public place; I was in my bed, in the maternity hospital. I had to confront my father-in-law's discomfort, embarrassment and tut-tutting at that stage, which demonstrates that there is a disproportionate need for a shift in attitudes among men. Dare I say that David Davidson might be one of those men?
I hope that Elaine Smith will consider supporting an amendment that I intend to lodge about the age limit in the bill. I breastfed both my daughters, who are now teenagers, thankfully—I can see the light at the end of the tunnel. I breastfed my first daughter until she was two years and two months old. I am sure that all members support the principles of baby-led feeding. We are trying to get the message across that breastfeeding cannot be artificially halted; it is a dynamic process between mother and child and no one has the right to interfere with it. I am concerned that the bill will set an arbitrary time limit, especially when we consider a conscious child at two years, who knows the words "breast" and "milk" and can make vocal demands. I am concerned that the bill will create a situation in which the day before a child's second birthday, nobody would be able to interfere with her right to request a breastfeed, but a day later, people could interfere.
An age limit was included because it was thought that there should be a legal definition of the word "child". I am sure that we can consider that at stage 2. We decided on a limit of two years—rather than one, three or four years—because WHO advice is to breastfeed for
"up to two years and beyond".
Of course, although it would not be illegal to prevent a child over two from being breastfed in public, the status quo would prevail. Once a cultural shift has taken place, I think that we will find that all breastfeeding is much more accepted in society.
I hope that we will be able to find a form of words in an amendment that achieves a wee bit of a compromise. That would be helpful.
As members are talking about changing attitudes through legislation, we should consider our own back yard. Yesterday we debated the Fraser inquiry report. I do not think that Enric Miralles had breastfeeding mothers in mind when he conceived his vision. We do not have a crèche for MSPs or staff and, to my knowledge, we do not have facilities to enable women who return to work to express or store milk on the premises. We have to look closer to home.
Unfortunately, that situation reflects the situation in many workplaces. We do not have sufficient maternity leave. Mothers do not have the right to time off to express milk or to the facilities to store expressed breast milk, and they do not have the right to leave work to go and feed their child when they have returned to work. All those things have to be tackled if we are to increase the rate of breastfeeding.
Even in maternity hospitals, midwives who return to work find it difficult to express and store milk and to get the time off to ensure that their child continues to be breastfed while they are supporting new mothers and helping them to establish breastfeeding. There is also an issue with staffing levels in maternity hospitals. In my experience, I often had to leave a distraught woman who was having difficulty establishing breastfeeding because I had to deal with an emergency somewhere else because there was no one else to deal with it. Midwives should not be forced to make those choices when they are attempting to deliver equal care. Women should not be left bereft and distraught without the support that could be available if the appropriate resources were devoted.
I make those comments to the Executive. There is lots to be done, specifically for the poorest and most vulnerable women, only 22 per cent of whom are breastfeeding at six weeks. We need to tackle the nutritional health of those children.
To finish, I refer back to David Davidson's remarks about not doing anything about the promotion of formula milk. I absolutely agree with him and cannot believe that he shares my condemnation of companies such as Nestlé that promote the use of milk that leads to the death of children in the developing world and which put profits ahead of children's health. I am glad that David Davidson agrees that that is inappropriate and I look forward to hearing the Tories' proposals for tackling corporations such as Nestlé and preventing them from stalking the poorest children in our world.
I congratulate Elaine Smith again. We will support the bill, and I look forward to stage 2 when I hope that we can address some of our concerns. I am glad that she has brought this issue before the Parliament.
Like everyone else in the chamber—apart from David Davidson, possibly—I welcome this member's bill, and I commend Elaine Smith for her hard work. I also commend the organisations and individuals who have supported her and helped her to get it to this stage.
Of course, the bill will not by itself change Scotland's record on breastfeeding, but it will give strong support to breastfeeding mothers. Like other equalities legislation, it will send a strong signal to our society that babies have a right to be fed when and where they are hungry. I welcome what Malcolm Chisholm said about the Executive's support for breastfeeding mothers. I will not rehearse the health, emotional and psychological benefits that breastfeeding brings to mothers and children, because I realise that everyone in the chamber is aware of them.
Our country's reluctance to accept breastfeeding is not a new phenomenon; it has been growing for the past 60 years or so, so we have two or three generations of entrenched attitudes to overcome. When John Farquhar Munro was in the chamber earlier, I was going to suggest to him that the timescale paralleled the decline in Gaelic and I wondered whether there was any link. However, he is not here to be teased so what is the point?
Perversely enough, the establishment of the welfare state began the shift away from breastfeeding, with the availability of orange juice, which was good, cod liver oil, which was good, and national dried milk, which was not so good. I was lucky, because my mother breastfed me, and she was supported by my auntie, who was a midwife. In our family, babies were breastfed.
By the time that I had my four children in the mid-1960s to early 1970s, breastfeeding was almost a thing of the past. My children were born in rural hospitals, not urban hospitals, and each time I was one of only a couple of mothers in the ward who were breastfeeding their babies. There was tremendous pressure then to bottle feed. Unless mothers really insisted that they would get up in the middle of the night, the nurses would very kindly bottle feed their babies for them, believing that mothers would prefer to have a good night's sleep. When women left hospital, they went away laden with packets of Cow & Gate and SMA and every kind of baby food. Mothers were given the impression that those were the best things to use.
I will tell members a story at which I hope they will not faint. When I went to my general practitioner for my post-natal check-up after my first child was born, I asked how I would know if my baby was getting enough milk. He said, "Oh, just get a red hot needle and enlarge the teat." I said, "Pardon?" and he said, "Are you breastfeeding?" It was assumed that everybody bottle fed. I felt like some kind of weird person, because all the other women I knew would remark about it and say things like, "I thought it was only people with really large boobs who could breastfeed." I thought, "Well, no, I'm not too bad."
I was interested in recent surveys on attitudes to breastfeeding, which show that attitudes have not changed in 40 years. I did my own surveys back then, and asked mothers why they preferred bottle feeding. The answers then were similar to those now. First, it is perceived to be difficult to breastfeed. Sometimes it is difficult to establish it, but once someone is breastfeeding it is much easier than faffing about sterilising bottles and so on. There is the business about not knowing how much a baby has had, but it can be seen if the baby is thriving, although support from district nurses and health visitors is required.
Another issue, which Ken Macintosh touched on, is the attitude of partners and husbands. Unless women have the support of their male partner, they are unlikely to breastfeed. Sometimes, husbands thought that breastfeeding was dirty and they did not fancy what might happen, which made women uncomfortable with their own bodies. They talked about wanting their figure back and it not being very nice. There was an embarrassment factor. I do not blame women for that, because they are victims of our society. They do not have the attitude towards their bodies that allows them to breastfeed comfortably.
That attitude was illustrated in a recent poster campaign advertising the enlargement of the European Union. The poster showed a mother breastfeeding her baby, but for Britain the nipple had to be airbrushed out. That shows that our society is at once prudish and sex-mad. We have to examine our attitudes. I do not blame mothers, because they are responding to society's attitudes, which have resulted in women being asked to leave buses, restaurants and shops. I have seen a nursing mother who was trying to feed her child on a train from Inverness to Edinburgh in tears, because she was being stared at disapprovingly by other passengers.
The bill will give babies rights—the right to be fed without harassment wherever they are. That means not in toilets or shitty, smelly nappy-changing rooms, as my daughter describes them, but where they and their mothers feel comfortable. Nursing mothers do not want to flaunt themselves or make exhibitions of themselves, but they do not want to be treated as freaks. They are doing the most natural thing in the world.
My daughter has just had her third baby and I am proud to say that she is breastfeeding him, as she did her other two babies. When I told her about the bill she was ecstatic, until she discovered that it would not apply in London, where she lives. She wants to know, "Why can't we have it here, too?" In Scotland we are leading the way. I hope that, in time, the bill will change attitudes and help to give breastfeeding mothers the support that they need. Breastfeeding is a natural function that should be celebrated and supported for the health of our children and the health of our mothers.
I am delighted to speak in support of the bill. I commend Elaine Smith for the work that she has done in getting the bill before the Parliament today.
There has been criticism of the bill on a variety of fronts, from accusations of a nanny state—which is perhaps an unusually apt expression in this instance—to claims that it will interfere with business, to assertions that the issue is somehow too trivial for parliamentary action. I refute all those criticisms. It is entirely appropriate for Parliament to take action on the matter. We are not the first Parliament to legislate on this important issue. The considerable health benefits of breastfeeding to mother and child are well proven and significant. We should tackle anything that acts as a barrier to mothers choosing to breastfeed their babies. A baby has a right to be fed when it is hungry; therefore, it is important to establish the right of babies to be fed in public places where children are permitted to be, otherwise breastfeeding mothers will, in effect, be forced to stay at home.
Embarrassment and the apparent unacceptability of breastfeeding in public have been found to be key factors that influence choices in infant feeding and whether mothers breastfeed. According to UNICEF, nine out of 10 women who breastfeed give up breastfeeding before they want to do so. For a quarter of those women, the reason is that they are returning to work, and I presume that they feel that breastfeeding in or near the workplace is difficult or impossible. The introduction of legislation to ensure that babies can enjoy the best possible start in life without their mothers being housebound or banished to the less than savoury environs of the public toilet may seem like overkill, but sadly it has proved to be necessary. I cannot decide whether it is appalling or stupid that many mothers are put off the natural, healthy option because of the reaction of people such as shop and restaurant owners and managers to the perceived public disapproval of breastfeeding. I am saddened that mothers occasionally encounter public disapproval.
The bill will raise awareness of the importance of breastfeeding and encourage mothers to make the natural, healthy choice when it is possible for them to do so. Breastfeeding is not possible for every mother and, for a variety of reasons, some will choose not to breastfeed, but that should be for good and sufficient reasons, not because of actual or perceived public prejudice and ignorance. Breastfeeding can be done discreetly and need embarrass no one—I sincerely hope that there will be a great deal more of it about soon.
It is unusual for two Liberal Democrats to speak after each other.
There has not been a huge turnout of members for the debate, not because the bill lacks importance, but because it has a large measure of support from across the political spectrum, apart from the Conservatives. I do not understand why the members of the Conservative party have been largely absent from the debate, given that they oppose the bill. It is one thing for members who are content with the proposed legislation not to attend the debate, but it surprises me that the seats of the party that opposes the bill are largely empty.
The bill is not about so-called political correctness, nor is it about the nanny state, as Nora Radcliffe pointed out. It will not give mothers the right to breastfeed their children in public places, because they already have that right. However, the bill will make it a criminal offence to prevent a mother from feeding milk to her child in a public place. It will create a criminal offence to harass a mother in that way, which must be right.
We all want more children to be fed naturally. Everyone agrees that breast is best for the health of both mothers and babies. We must send a clear message to society that people's attitudes to the subject must change.
People who prevent mothers from feeding breast milk to their children in a public place must not be able to do so. We need this legislation, just as we needed legislation to get people to wear seat belts in their cars, as I mentioned earlier. Educational campaigns were not enough in themselves to change people's attitudes and they are not enough now. That is why we need this bill, which I urge members of all parties to support.
I call Nanette Milne to close for the Conservatives. At this point, we are quite a bit ahead of the clock.
I am sorry to disappoint you, Presiding Officer, but I think that my speech might not last the full length of time that is allotted to me.
We are all agreed that breastfeeding is good for babies and good for mothers. The health benefits of it are not in dispute and it should be encouraged whenever possible. I would welcome a return to a culture in which breastfeeding is the accepted norm and I applaud Elaine Smith for what she is trying to do and for the hard work that she has put in in bringing her bill to this stage 1 debate. However, I remain to be persuaded that legislating to force proprietors to allow breastfeeding on their premises under threat of prosecution for a criminal offence is the way in which to win hearts and minds or to increase the number of mothers who breastfeed their infants. As David Davidson said, the civil law can cope with the worst examples that we have heard today. I have to say that I do not share Bruce McFee's conviction that legislation will be effective in changing social attitudes.
In present-day society, many mothers find it more convenient to bottle feed for a number of reasons, such as wanting to share the burden of feeding, to get back to work, to have more time for themselves or to find out how much milk the baby is taking. It is also true that some mothers are put off by the fear of embarrassment if they breastfeed in public. However, many women have no desire to breastfeed or bottle feed in public and would rather have that enjoyable and intimate contact with their babies at home or in private when not at home. I would like more business proprietors to provide comfortable facilities for private breastfeeding on their premises.
Does Nanette Milne agree that providing private facilities forces women to be segregated from the rest of society? They might not be able to sit and have a coffee with their friends, for example. If they go to their GP's practice, why should they have to be segregated? I tried to let Nanette Milne in when I was speaking, but she did not want to intervene. I ask the question again. When she says that shops and restaurants should be free to decide whether mothers should be allowed to breastfeed on their premises, is she condoning the expulsion of breastfeeding mums and babies?
I am not condoning arrogant attitudes to breastfeeding mums; I am saying that a number of mums do not want to breastfeed in public and I would like there to be private facilities for those mums who do not want to breastfeed or bottle feed in public.
Much has been done in recent years to promote breastfeeding in Scotland and I was pleased to hear the minister's comments about the strategy to make further progress in that regard. In Scotland, rates of breastfeeding have increased by 8 per cent since 1995, which is more than double the rate of the increase across the United Kingdom. Even in areas of deprivation, the rate has increased by 7 per cent. We are moving in the right direction.
Public attitudes are changing. In recent surveys, a large majority of people said that they found discreet breastfeeding in public to be perfectly acceptable. That positive change in social attitudes to feeding infants in public is welcome and has come about without Government intervention.
An increasing number of establishments welcome breastfeeding and I firmly believe that encouragement without coercion would lead to that becoming the norm. In countries where there is already legislation on breastfeeding, it is hard to find any evidence of the effect of that legislation on rates of or attitudes towards breastfeeding and there seem to be few examples of such a law being enforced. As we have heard, it is unlikely that the police and procurators fiscal will be willing to undertake prosecutions under the bill given that they have such a large amount of serious criminal work to deal with. Furthermore, there is a concern, as voiced by ACPOS, that the use of criminal legislation could lead to a negative attitude towards breastfeeding.
This afternoon, Elaine Smith, Helen Eadie and others recounted some appalling examples of bigotry and maltreatment of nursing mothers who wish to breastfeed in public. I do not condone what happened in those examples. I listened to the BBC this morning and a number of the e-mails that had been sent in made it clear that many people in the country deplore those bigoted attitudes. The desired cultural change is already under way. Of course, we have not heard about any good examples today, but I suppose that that is the nature of a debate such as this.
I point out to Carolyn Leckie that the formula milk that is provided to third-world countries as state aid has saved the lives of many babies whose mothers are starving and unable to provide the milk that their babies need. Formula milk is not all bad when it is sent to the third world.
I gently take exception to Eleanor Scott's statement that a child has a right to be fed human milk. I am not sure whether she meant to say that, but the statement is upsetting to those mothers, such as adoptive mums, who are physically not capable of breastfeeding their children. I hope that she accepts that that is a fair comment.
To conclude, I speak for my party when I say that we fully support the promotion of breastfeeding in Scotland. We have no bias against breastfeeding in public and we welcome the change in public attitude. However, we do not see the necessity for a criminal law to move that change forward. Moreover, we do not think that such a law would be effective, because it would result in few, if any, prosecutions. I commend the work that Elaine Smith has done on the bill, but we remain of the opinion that we should encourage and assist the continuing evolutionary change in public attitudes to take its course. Therefore—I am sorry—we cannot support the general principles of the bill.
Ken Macintosh said that no one is questioning the fact that it is best for children to be breastfed where that is possible. I agree. The question today is: by what route should we meet the targets?
To reflect what Elaine Smith said about compulsion, it is a fact that, in the field of equality, more than in any other field, we do not achieve anything unless we legislate for it. The equal pay legislation is a case in point. I think that we have had that legislation for 40 years but, even so, women are still paid a lot less than men in percentage terms. It is disingenuous to pretend that we do not need to do anything.
I point out to Nanette Milne that we are not talking about creating a branch of the police force—the breast police—who will run about so that folk can report any violation. Deputy Chief Constable Mellor said:
"I sense that the creation of a criminal offence in this bill seems to be principally a symbolic act."—[Official Report, Health Committee, 11 May 2004; c 866.]
He accepts that the existence of an offence on the statute book means that people start to change their culture. That is what the bill is all about. The bill that Elaine Smith is promoting will never change attitudes if it does not have some teeth.
I mentioned equality legislation, but that is reserved to Westminster, so we cannot do anything about it here; Elaine Smith has not been able to go down the anti-discrimination route. It is a credit to her and Mike Dailly of the Govan Law Centre that they have come up with something as sensible as the bill that we are today considering at stage 1.
Section 1 of the bill does not affect Scottish licensing law; it does not say that any breastfeeding mother or anyone who wants to feed a baby with a bottle of milk can breenge into any premises and have the right to do so there. It does not
"prevent a business from excluding breastfeeding on its premises where the lawful custom or practice is to exclude children generally."
The bill is about places where children and babies already go and are entitled to go. It is about the right of a child to be fed in that way.
It is interesting to read the World Health Organisation's international recommendations, which influence the targets that are set in this country. Not all the initiatives are possible, as Tricia Marwick said, but we can work towards achieving some of the targets that are reproduced in the policy memorandum to the bill. The Executive has started to go some way towards achieving those targets, but there is still a long way to go. A bit more uniformity is required in the funding for the promotion of breastfeeding, but I think that all members are willing to work towards achieving that end.
I see that time is running out, so I will move on.
Feel free to develop your arguments, if you wish.
You do not say that very often, Presiding Officer. Okay, I will have a rant.
As Carolyn Leckie mentioned when she picked up on the issue that David Davidson raised about the powdered milk that was promoted in NHS premises in this country, it is ridiculous that powdered milk is still promoted in non-developed countries. It is all very well for Nanette Milne to say what she did, but we all know that some companies actively tell mothers in non-developed countries that breast milk is bad and that powdered milk is good. That is all about the companies promoting their products and their profits. Given that we are considering today whether the Parliament should legislate to provide rights in this country, I hope that all members will agree that we should take an interest in promoting fairness in that respect in undeveloped countries as well. It is a strange anomaly that powdered milk, which must be mixed with water, is actively promoted in countries in which one cannot be sure that the water supply is safe for drinking, let alone for mixing with powdered milk for babies.
On that point, does the member agree that it is amazing that companies make so much profit from ensuring that the artificial milk is as like a mother's milk as possible, yet the world's poorest and most oppressed people are women, who are the producers of the real thing?
I agree that that is absolutely ridiculous. Of course the World Trade Organisation's rules are ridiculous and bizarre. We are talking about ensuring equality and fairness for people in this country, but we should extend that by pushing our Governments to promote equality and fairness all over the world. Dealing with mothers and babies is surely a good place to start.
I call on Susan Deacon to wind up the debate. I am happy to allow her the same latitude as I have given to other speakers.
It is not often that I am given latitude by the Presiding Officer, but I am happy to take it on this occasion.
I am pleased to close the debate and I thank Elaine Smith for giving me the opportunity to do so. I pay tribute to her for her work, commitment and sheer tenacity in promoting the bill. Frankly, she has been a real champion in the Parliament of breastfeeding. As Ken Macintosh said, the discussion surrounding the bill has already done a huge amount to raise awareness and to change culture and attitudes. That is a significant achievement in itself.
I thank members of the Health Committee for their assiduous consideration of the bill and for their thorough stage 1 report. I am delighted that the committee agreed to support the general principles of the bill. On behalf of all members in the chamber, I record our appreciation to all those—far too many to mention—who have given of their time and energy in their input to the initial consultation and in their evidence to the committee. I thank them for the information, evidence and anecdotes that they shared with us. That wealth of knowledge and experience has greatly aided our understanding both of the issues involved and of the real experiences of women across Scotland.
Finally, I thank all members who have contributed to today's thoughtful debate. We have heard some well-informed and heartfelt speeches. I am sure that we all thank Maureen Macmillan, Carolyn Leckie and Ken Macintosh for sharing with us some personal, honest and humorous anecdotes, which brought to life some of the issues that are involved in the debate.
We said from the outset in this Parliament that we wanted to give all Scotland's children the best possible start in life. That commitment has been a thread that has run through many Executive policies and much of the Parliament's legislation. I was pleased to hear Malcolm Chisholm speak so fully and passionately about the issue and I very much welcome the extent of the Executive's commitment to promote breastfeeding and the fact that it is happy to see the bill progress.
The importance of ensuring that babies get the right nurture and nutrition from the first days and weeks of their lives must not be underestimated. Common sense as well as a huge body of evidence tells us that the health and other life outcomes of our young are shaped from a very early stage. The bill addresses only one aspect of what is a big subject—the health and well-being of our young—but that aspect is vital.
The health benefits of breastfeeding for babies and mothers have long been established, as many members have said. There is also a long-established consensus within the public policy community and across the political spectrum that efforts should be made to promote breastfeeding and to encourage more women to breastfeed and to do so for longer. The question then arises as to how to make that happen.
As members have said, a great deal of progress has been made towards achieving the target that the Conservative Government set back in the 1990s of 50 per cent of mothers breastfeeding for six weeks or more by 2005. Malcolm Chisholm set out for us some of the excellent work that has been done in our maternity units—for example, through the UNICEF baby-friendly initiative. Other members referred to the work of health visitors and midwives in the community and to voluntary organisations working in the community. However, something still stands in the way of change.
I take this opportunity to endorse strongly the comments made by Tricia Marwick, Bruce McFee and Nora Radcliffe that a mother should, of course, always be respected for her choice of feeding method. That is a personal decision and no one should be made to feel guilty because they choose not to breastfeed or, in some cases, because they are unable to breastfeed. The fact remains that, despite all the support and information, many more women would like to breastfeed than do and many who breastfeed would like to do so for longer.
The Health Committee's report and the evidence that was heard throughout the committee's discussion of the bill have proven beyond any doubt that culture and attitudes lie at the heart of the question. Scotland has a culture that remains stubbornly unfriendly to breastfeeding. As Elaine Smith said, survey evidence shows that the majority of people are relaxed about seeing breastfeeding in public and are supportive of it, but women do not feel that they are. Ken Macintosh was honest in his account of what many individuals—men and women—grapple with, which is our rational perspective on these matters versus how we feel as products of our society's deep-rooted cultural issues.
The feeling that breastfeeding is not publicly acceptable has been reinforced by the actions of some who have actively prevented women from breastfeeding their babies in public places. When the bill was first proposed, it was suggested that such incidents were isolated and that they were not a real issue for women. However, I would urge anyone who might still hold that view to read the evidence and the testimonies shared with the Health Committee and to listen to the sort of account that Helen Eadie shared with us earlier.
It is a fact that women across Scotland have been asked to get off buses, leave cafes, go into toilets in shops and, yes, even leave waiting rooms in doctors' and dentists' surgeries simply because they wanted to breastfeed their child. How can any of us claim, with any credibility, that we are working towards a national breastfeeding target, that we support breastfeeding or that we want to create a breastfeeding-friendly culture in Scotland while standing by saying that such practices are acceptable?
Given the support in the debate for Elaine Smith's bill, I suspect that this is probably the point at which I should turn to those few members who have called into question the effectiveness of the measure. Let me deal with some of the points that David Davidson raised. He said that there was no evidence that such legislation was effective. I think that he is being selective in his reading. In the United States, for example, evidence has shown that four out of the five states that have achieved the highest increase in breastfeeding since 1992 had either introduced legislation that made it an offence to prevent a woman from breastfeeding in a public place or explicitly stated the rights of women to breastfeed in public. In Maine, after such a law had been in place for a year, there was a 20 per cent increase in breastfeeding. As others have said, evidence was heard throughout the Health Committee's consideration of the matter that a vast number of experts and professionals in the field truly believe that the bill will result in a change in practice and an increase in the rate of breastfeeding in Scotland.
David Davidson, in his continued bid to cast around for reasons to oppose the bill because of his ideological dogma in this terrain, said that the bill was not about education and that it did not say enough about health professionals and the like. I have not heard any member today or anyone who has engaged in the discussion of the bill in committee and elsewhere say anything other than that the bill needs to be part of a package of measures to encourage, promote and support breastfeeding in Scotland.
Excellent work has been done in the health service, in maternity units and in communities and I believe that we are progressing in the direction in which we all want to go. It is incumbent on those who think that the bill will not be effective to say what measures they would propose to bring about the change that we all want to see.
The Conservatives support the role of breastfeeding, as we did when we were in government. We recognise its importance and believe that people should be encouraged and supported to breastfeed and to do so for longer. Our argument is not about the fact that the minister has taken up the initiative that we started when we were in government. As I said earlier, I welcome his comments on that.
However, responsibility for the issue has been in the hands of the Labour Westminster Government and the Executive for the past seven years. The Conservatives cannot take the blame for the fact that we have not reached where we would like to be. However, I find it refreshing that the minister is carrying on the work that we started. We started off well; we got the rate up to 40 per cent without legislation.
I am suggesting that we get our professionals out there doing their job. The minister has to support that, because resources come from him. We need more people on the ground to deal with the matter. Vast sums of money have gone into the health service. Members should not point the finger at me.
I am genuinely disappointed by David Davidson's approach, as shown in that intervention. If ever there was an issue over which we could come together, work together and try to find common cause and a way forward, surely to goodness it is a public health issue such as this.
I am not interested in apportioning blame to anybody, whether a Tory Government of the past, a Labour Government since then or a Labour-Liberal Democrat coalition Executive since then. I really do not care. What matters is how we achieve the target and ensure that Scotland genuinely becomes a much more breastfeeding-friendly place. All the information, evidence and anecdotes tell us that we are not yet there and that we will not get there unless we do something that will bring about a step change. The bill gives us an opportunity to do that.
I will be absolutely honest. Elaine Smith first discussed the proposal with me years ago when I was Minister for Health and Community Care. I was enthusiastic about the principle behind it, but I was terribly cautious about whether statutory change was the way forward. In matters of public health and lifestyle, it is right to tread carefully when considering whether to use the legislative powers of the Parliament and criminal law to bring about changes to behaviour. However, I believe absolutely that, just as in similar circumstances attitudes have shifted in the debate on smoking in public places, the consensus on breastfeeding has shifted not least because of the debate surrounding Elaine Smith's bill. The process of investigation that the committee has taken forward has brought out a latent pool of support for the measure and, critically, that will make a real difference. Those combined considerations should be enough to make every one of us support the measure irrespective of our party-political associations.
I think we still have a lot of time. Will I take another intervention from David Davidson?
No.
My colleagues are rather less enthusiastic than I am about taking a further intervention from him.
I will end my comments on the Conservatives by saying something about the critical issue of whether we should condone people asking a woman to leave a place because she is breastfeeding. Nanette Milne has said on record that cafe and restaurant owners, for example, should be allowed to decide whether to allow breastfeeding. I disagree with her view. It is not akin to allowing the owner of a pub to bar a disorderly drunk or allowing a shop to ask an abusive customer to leave. Breastfeeding is not some kind of offensive behaviour and it should not be treated as such; it is literally the most natural thing in the world. It is the right of babies to be fed when and where they need to be and in a way and place that their mothers choose as appropriate.
I note in passing, as Maureen Macmillan did, the hypocrisy that exists in our society in that respect. We live in a society that is happy to see the female body in all its splendour displayed in all sorts of forms, media and places, so surely we can cope with the sight of an infant tucked discreetly under its mum's jumper having a feed. That is what we want to promote and encourage through the bill, because we need to embed precisely that image in our culture as not only acceptable, but positive. As society becomes more comfortable with that image, women will become more comfortable and confident about breastfeeding their babies.
The debate is not esoteric, ideological or PC; it is about the real factors that influence women in their feeding choices. If a woman feels that she cannot breastfeed her baby in a park, shop, cafe or public library, she will either stay behind closed doors in her home, with all the implications that that has for her and the baby's physical and mental well-being, or she will simply give up. The evidence shows us that that is precisely what is happening now in Scotland.
Too many women have sat in smelly, cramped toilets feeding their babies, too many women—those who can—have turned car parks into feeding areas and too many women have not breastfed or have stopped breastfeeding, not because they wanted to, but because they felt that those around them would not like them to. The bill and the legal protection that it will provide to the rights of a baby to be fed by breast or bottle when and where it needs to be are necessary and right. I urge members from all parties to vote for Elaine Smith's motion to support the bill's general principles and to allow it to pass to its second stage. In so doing, we will make a real difference to the future of our society and the well-being of our children.