Chamber and committees

:At the risk of badgering the member from the other side of the table, I am a little concerned about whether individuals may choose to take a course simply to be allowed to go into aesthetics rather than to actually do the work for which they trained. Dental nursing is an example of where people might do a course simply to be able to practise, rather than to do dental nursing specifically, at a time when we are desperate for dental nurses. Would the member agree with that?

:I will make general comments on this group of amendments. If we are talking about permitted premises under HIS standards, we are saying that a basic standard needs to be applied to anything that has a medical context. I think that it would surprise many people that, in a medical setting, you cannot use a normal fridge; you have to use a medical-grade fridge to store medicines, toxins and lots of other things, and you need to have documentation on the temperatures of the fridge. You need to ensure that there is a clear chain of documentation that notes when the medication was taken out of the fridge, when it was used and when it was binned. I am pretty sure that fizz and filler parties, which we have spoken about in the committee, would not follow that advice.

We are also talking about cleaning surfaces. When you go to see a GP or a dentist, you simply would not accept sitting on equipment that cannot be cleaned or is not clean. We should guard against anything that would water down HIS standards for injections and what I would suggest are medical interventions.

On the physical presence of a prescriber, we need to make clear exactly what we are talking about. I have two issues with that. For many years, I worked in orthopaedics, and I often operated alone in a theatre. However, the surgical list was never in my name; it was in the consultant’s name. Despite how senior I was, the consultant was in charge of the list. Other consultants and other people who were around could come in if something went wrong. That would be the case for a simple surgical procedure such as a carpal tunnel operation, which you would expect someone to be able to do at a junior level. It is not as straightforward as simply letting someone crack on with it.

I would like to discuss this with the minister at stage 3, but I am very concerned about the idea of giving blank prescriptions. For medical devices or prescription medications, you need to be given a prescription that is cashed before the medication is used. Someone could be writing a blank prescription for botulinum toxin, which is the most deadly toxin there is, and have no idea how it is being used, who it is being used on, the appropriateness of its use or the documentation on informed consent.

I have a real worry. As a GP, I trust allied healthcare professionals, and I trust advanced nurse practitioners, who have been doing their job for 20-odd years. I would not give them a blank prescription for antibiotics. If they thought that their patient needed something, they would discuss that with me or they would independently prescribe for their patient. I would not give them a blank prescription for cancer meds.

:My concern, minister, is that amendment 35, in your name, potentially allows future ministers not to consult anyone, as required, before making changes. Although some minor technical changes would probably not need a consultation, the concern is that consultation might be needed for any bigger change. The most important thing is that there is further discussion, but can any reassurances be given on that topic?

:The Presiding Officer has clearly stated that we cannot vote on my amendment 105 due to the financial constraints that it might cause. However, it is important to debate it, and I would love to hear what the minister has to say about it.

The provisions of the amendment were not intended to be financially burdensome or to make available a huge amount of money, but rather to enable current providers to move into regulation with guidance. If the wording is wrong, because the amendment refers to “financial assistance”, perhaps it would be better if I took that out and talked about the advice, support and written guidance that would be available. The idea was that the details would not be in the bill; they would be developed subsequent to the passing of the bill. That would give ministers flexibility to provide what they felt was appropriate.

However, it is important that existing providers get help, guidance and support to move to, for example, HIS standards and to deal with other important patient safety aspects. That is the point behind the amendment. I shall not move amendment 105, as instructed, but it is important to discuss it.

:I have been approached by a provider that has applied to HIS to get registered but has not heard anything back for a long time. What happens in the event that HIS is given a huge amount of work to do and ends up with a backlog? It would not be fair on businesses to have to stop while HIS works through such a backlog.

:Would the minister consider changing “clinical trial” in amendment 6 to “regulated clinical trial”?

:I feel that removing osteopaths from the bill is important, so I move amendment 64.

:I will not move the amendment, while noting the importance of having further discussions on the issue with the minister.

Amendment 78 not moved.

Amendment 79 moved—[Sandesh Gulhane].

:I tend to agree with Stuart McMillan that we do not do post-legislative scrutiny particularly well. The point of my amendment 108, therefore, is very similar to his, in that it would look at the impact of the legislation on businesses. Again, much as Stuart McMillan has chosen five years, I chose one year as an arbitrary figure, so I would be happy to negotiate that in order that we can agree to an amendment that means that we would actually get some post-legislative scrutiny.

:Amendment 94 is an important amendment that addresses a subject that we need to have further discussions about, but, given what has been said, I will not move it.

Amendment 94 not moved.

Amendment 95 not moved.

Amendment 96 moved—[Fulton MacGregor].