Chronic Pain Services (PE1460)
Under agenda item 4, we consider PE1460, on the improvement of services and resources to tackle chronic pain. The committee will take evidence from the Minister for Public Health and from Healthcare Improvement Scotland. I welcome the minister and the HIS witnesses: Robbie Pearson, the director of scrutiny and assurance; Lesley Holdsworth, the programme lead; and Dr Steve Gilbert, the national clinical lead for chronic pain. I also welcome to the evidence session Jackie Baillie MSP.
We will go immediately into questions. Any of the witnesses may answer any of the questions.
This whole issue has not been handled very well. Can the minister or HIS give an early indication of how HIS will start to capture relevant data and ensure that a clean reporting mechanism is in place going forward?
Robbie Pearson (Healthcare Improvement Scotland)
Healthcare Improvement Scotland certainly has lessons to learn on transparency, and that point was very much acknowledged in the letter to the committee from the chief executive, Mr Glennie. Indeed, it was very much accepted in the 30 April meeting with the cabinet secretary.
Data is a fundamental part of understanding the patient’s journey—how they access care, how they are managed within primary care and how they are subsequently moved into other more specialist services. As we take this forward over the next six to 12 months, capturing data in a robust, transparent and understandable way will be a key issue for us, which goes beyond waiting times into understanding the whole patient experience. Dr Holdsworth will pick up on that point.
Lesley Holdsworth (Healthcare Improvement Scotland)
I have recently taken over as programme lead for this work. We have been working very closely on exactly that issue with our steering group, our partners and so on and, by the end of this year, we will have some really robust data that will give a better reflection of patient experience, which is obviously very important, as well as an outcome perspective. We are working with a number of partners on that and we will have a report available.
So we have an assurance that there will be no more comments about data being sparse and of poor quality, about it having been construed as misleading or about the documentation not being public facing, and instead will have openness, transparency and robustness.
I assure you of that.
I declare a particular interest in this issue. As some of the panel will be aware, I am one of the co-conveners of the cross-party group on chronic pain, along with Jackie Baillie and my colleague Jackson Carlaw.
This is about the amount of data that is collected and recorded and how that data is presented. A number of the individuals who have made submissions and who are very interested in the delivery of chronic pain services are concerned that the data that is being collected or pulled together is not sufficient to record what is actually happening in the various health boards.
Through the work of the cross-party group, we know that individuals have raised a number of issues. They have spoken about things happening in one health board area but not in others. There seems to be a discrepancy around what is happening and how people are being dealt with, either at a primary level or by consultants. Does the minister or anyone else on the panel wish to comment on that?
The Minister for Public Health (Michael Matheson)
There is no doubt that there has been patchiness in how services have been delivered across different health boards. Different health boards have been moving at different rates on this issue.
HIS has taken on board the points that were made about the process that it went through to collate the data and publish its report. There is a need for that to be done much more transparently and for the data that is being used to be much more robust, as Robbie Pearson and his colleagues have recognised. They will seek to address that and do it more effectively, and I am confident that they will. The data provides an important resource for us to evaluate the progress that boards are making on the issue.
Achieving a more consistent approach does not mean exactly the same thing happening uniformly in every board area. There will be different responses, depending on a board’s situation. Therefore, we have asked all our boards to have in place a service improvement group, which will be responsible for producing the service improvement plan, and that plan will be submitted to the Scottish Government by the end of this month.
The work will then be taken forward and built into local delivery plans. In 2014, part of the plan will clearly set out the progress that each territorial board plans to make in the coming year on improving services around chronic pain. That will allow us to consider the proposed planning and services in local board areas and ensure that those are built into the local delivery plans.
The local delivery plans are very clear. They show what the boards say, what they intend to do and how they intend to go about it, so we will see that for chronic pain services. That approach of using the local delivery plans, along with addressing how the data is captured and the service improvement groups, will allow us to measure the data more effectively and to achieve a greater degree of consistency in how boards are dealing with the whole issue.
I wish to echo that point. The service improvement groups are fundamental in embedding the improvements on the ground. Over the past six months, there has been a positive uptake from NHS boards. Data will become increasingly important in capturing the patient’s journey so that we understand the progress that has been made against the original report five or six years ago.
One of the issues that some of the individuals involved have raised is the financial reporting by health boards of the budgets that are available for the service. Should the committee be aware of any issues with how boards are identifying and reporting on budgetary constraints in the delivery of chronic pain services throughout Scotland?
On the budgetary aspect, chronic pain services would be viewed as a core part of an NHS board’s service delivery. They should be funded within the board’s overall budget for whatever services they need to provide.
We have provided boards with some pump-prime funding to help them to establish some of the arrangements that are needed to improve services at a local level. Some of that will help to support the work that boards are taking forward around the service improvement groups. The specific delivery of chronic pain services is funded through the boards’ overall budgets, but we are providing them with some additional pump-prime funding to assist them in taking forward some of the early work.
I have a question on the social care model. In the debate in the chamber on 29 May, the Cabinet Secretary for Health and Wellbeing stated that the Scottish Government is “very committed” to the principle that services for sufferers of chronic pain should be delivered through not just a medical health model but a social model. How does the Scottish Government intend to achieve a social model of care for sufferers of chronic pain?
A key part of delivering the social model is taking a much more holistic approach to the needs of people with chronic pain. That does not just involve looking at the medical aspect, which is what has traditionally been done under the medical model. Rather than just looking at what treatment people require and what types of clinical intervention might be appropriate, the social model involves looking at the impact that the condition can have on other aspects of people’s lives, such as their daily activities, their lifestyle, their home environment and their employment. That is a much wider and more holistic approach.
The chronic pain service model that we are taking forward in Scotland involves a tiered approach. Services can be delivered at a local level and supported through voluntary groups, and there is a range of different services to help to support individuals and give them advice and information. More clinical interventions are made at the primary or secondary level as and when they are necessary. I see the chronic pain service model as a key part of that holistic approach to supporting people.
Another aspect is that a number of our boards have established chronic pain programmes and others have pain management multidisciplinary teams. In the past, a patient who presented with chronic pain could see only a doctor to try to get that addressed, but that approach does not necessarily fit in with delivery of the social model. The multidisciplinary approach is important. Occupational therapists, physiotherapists and others can help to support people in addressing effectively some of the other consequences of chronic pain.
We try to deal with things at different levels, and alongside that there is a multidisciplinary approach involving different professionals, all of whom have a contribution to make to delivering the intended outcomes under the social model.
Thank you, minister.
Patient participation is an important part of this. What steps is the Scottish Government taking to ensure that there is a greater level of patient participation in the continuing development of services?
I mentioned the service improvement groups. All 14 of our territorial boards will have such groups in place, and they will have patient participation on those groups. Alongside that, we have the national chronic pain steering group, which is looking to increase the level of patient participation in its programme and involve a greater number of patients. Therefore, there is patient involvement both at a local level through the service improvement groups and at the national level through the national steering group.
How does that relate to the HIS work? Perhaps Dr Holdsworth could say something about the work that HIS is doing, or is it all part of the same thing?
HIS is leading on the national group. With the creation of the service improvement groups, we need to look at how we can ensure that they feed in more effectively to the national steering group. I understand that, at its meeting in May, it discussed how it can ensure that the leads for the service improvement groups at a local level can feed in more effectively to the national steering group and how they can also increase patient participation in the process. That will help to ensure that the link from the national to the local level is much more consistent.
I ask Robbie Pearson and his colleagues whether they want to add to that.
To reiterate the point, Healthcare Improvement Scotland has a legal responsibility to ensure that we comply with the duty of user focus. Given the concerns raised by the petition about the level of public involvement in the chronic pain steering group, perhaps Dr Holdsworth can elaborate a little on the thinking behind the relationship between the chronic pain steering group at national level and the work that is under way at local level through the service improvement groups.
I reiterate what the minister has said. We are currently working on putting in place strong public participation in the service improvement groups, which will collectively have a much stronger and more robust link with the national steering group. At our meeting of the national steering group in May, membership was discussed as an agenda item, so we recognise the need to have much stronger and reinforced patient participation. Work is in hand to take that forward.
The next question is from Angus MacDonald.
Convener, my question on patient consultation has been covered.
We move on to Jim Eadie.
Good morning, panel. We have already heard evidence this morning about the importance of capturing data in a robust and transparent way. Mr Pearson has illustrated the need to do that so that we can understand better the patient’s journey. The minister has said that it is important to evaluate the progress that NHS boards are making. That will no doubt be of increasing importance as we seek to roll out the delivery of the local plans that you mentioned. In Healthcare Improvement Scotland’s “Update Report on Scottish Pain Management Services”, a range of factors are mentioned in the data spreadsheet that were presumably part of the audit but are not covered in the “Detailed findings” section of the update report. Can you explain why that was the case?
As I said at the start, on reflection it would have been preferable to have all the data not only on the website but accessible within the report. That is a point of learning for us in Healthcare Improvement Scotland. In producing the document, a balance had to be struck in providing something that is accessible to the public, but we perhaps pitched the balance in the wrong way in not making the data readily available. The need to ensure that the facts and findings are available is a point of learning for us. We have taken that point from the petition and from other feedback.
Dr Holdsworth might want to elaborate on that.
I reiterate what our chief executive said at the cross-party group about this not being our finest hour, but we have taken those issues on board. Do you have a specific question in relation to that?
The question that I posed was about the reason why information on issues such as referral to spinal cord stimulation and waiting list initiatives was not included. Was that because you had insufficient data, or was it because you had sufficient data but chose not to include the information?
Dr Steve Gilbert (Healthcare Improvement Scotland)
The number of people being referred for spinal cord stimulation or residential pain management programmes was very small. Some boards did not refer any patients and some referred one or two, so we felt that we could not draw a conclusion from that. However, it was useful for us to look at how many people were referred and to discuss with boards why some boards sent a lot more patients, so we looked at the variation there.
In the tertiary part of the service model, which deals with intensive pain management options such as residential programmes or spinal cord stimulation, we are organising for the centres that perform such procedures to draw up their own referral and treatment guidelines. We want the outcome measures to be more tied down so that there is collaboration between the centres that carry out those more interventional procedures.
I think that you are saying that there was a lack of information available rather than—
There was only a little bit—
Excuse me, sorry. Are you saying that there was a lack of information available rather than a deliberate exclusion of information from the report?
Yes, we felt that it was not something that we could report on.
I have an additional question for the minister, on the development of an intensive pain management service. The Government has made a commitment to that, which has been widely welcomed, drawing on the experience of patients who have had to access the service south of the border. Where are we with that?
NHS National Services Scotland is presently in the final stages of drafting the consultation order, and has also established a specialist group that is helping to inform us in that process, and we hope to publish the consultation next week.
I have already been outed by my colleague as one of the co-conveners of the cross-party group on chronic pain. There are two or three things that I want to ask about, and I shall try to be concise. You have entered into a bit of mea culpa and contrition over the report, but when we are talking about the importance of patient participation, who actually decides who the patient representatives will be? I would have expected them to be a bit more vocal. I would not necessarily want to characterise them as friends of the establishment, but who is responsible for ensuring that the patient representatives are thoroughly independent and are asking the questions that might have led to all this information being available publicly sooner? How do we ensure, going forward, that we have the right patient representatives and ones who will genuinely ensure the independent voice of the patients?
To pick up on your point about patient involvement, we need to learn lessons from this experience, particularly by ensuring that there is an active voice for the service improvement groups and that that voice plays into the national steering group. It is particularly important that that voice is heard as we design local or national services. Dr Holdsworth might want to pick up on your point about the actual involvement.
We are working closely with the major patient representative bodies—the Pain Association Scotland, Pain Concern and the Health and Social Care Alliance Scotland—and we are also looking to build on the service improvement groups and to get more local representation. We are trying to cast a wide net to get those groups who are active advocates for patients as well as pain sufferers themselves at local level.
I will be full of anticipation to see who the patient representatives are.
As a general consequence of the report, there was an underappreciation of where we had progressed to on chronic pain services delivery, and I listened to what you had to say about that, minister. You were with us recently to discuss health boards’ lack of application of the strategy on insulin pumps, and you put a robust requirement on health boards to update you on a regular basis on the progress that they were making towards the plan, which in many respects they had failed on. How would you compare the reporting process that you are requiring in relation to the provision of chronic pain services to that which you put in place for achieving the insulin pump targets?
The requirement for reporting on chronic pain is more robust now than it has been in the past. For example, the service improvement groups for each of our boards have to submit their plans for us to consider. We will have that completed by the end of this month, and we will then look at how to build those plans into their local development plans for 2014. The Scottish Government receives a draft copy of the local development plans for each of our boards, so that we can compare them against what was set out by the service improvement groups and look at how they intend to deliver those plans in the coming year. We have a robust mechanism that allows us to establish a clear pattern of how boards are taking work forward, and also to see which boards are making more progress than others. We must then ensure that, at national level, the steering group continues to monitor progress at local level through the service improvement groups. A combination of factors, including the local development plan, the plans that have to be submitted by the service improvement groups and the national steering group, give us a robust architecture for monitoring how we take this forward and for addressing any issues that might come up in due course.
Finally, in the debate in the chamber, the cabinet secretary announced the consultation to which you have referred. I believe that there are three principal options on which you seek to consult. One is the original intention of the petition, which is a pain management centre equivalent to that at Bath. A second option is some sort of mobile resource, and a third is improved services within local environments.
Obviously, in terms of the investment that would be required, the easiest of the three options to quantify is the first, because an equivalent exists and one can understand what it would cost to set up a centre. Is it the Government’s intention that a parallel level of investment would follow each of those three options? Have you quantified what you think the level of investment in chronic pain management would be as a result of whatever option is considered best after the consultation? Could it be a mix of those, or is that wishful thinking, given the level of resource that you have available?
You appear to be ahead of me, because I have not seen the consultation document yet.
I thought that the cabinet secretary announced those options.
The situation will broadly be in that frame.
During the debate, some members thought that we were considering consulting on whether we should have a residential service in Scotland or not. That is not the case. We have given a commitment that there will be a residential service of some form in Scotland. We now need to consult on the model for delivering that service in Scotland and we will launch a consultation next week. During the consultation period, we will see what the views are; if views come back around a particular option and if that option is, for example, for a single site which has an in-bed facility and can also provide an out-patient facility, we will consider the resource implications of that for us and how we will fund that particular service.
I do not want to get into a situation where I say, “We’ve decided that we’re going to go with option X, because that’s what the budget is.” Let us see the outcome of the consultation and from that point assess what the options are in terms of cost.
We have to be mindful that we need to try to provide a service in Scotland that can meet the needs of patients across the country. During the debate, the cabinet secretary referred to the fact that we need to think about how, if we have a single-site option in Scotland, we can ensure that we also provide the necessary support and advice in other parts of the country, such as Grampian, the Highlands or the islands, where that option might not be successful for those patients. We have to find a service option that allows us to provide a special service that may be residential, but also provide support and assistance in remote areas in which people may not be able to access that service as readily.
Given that we come now to the third and final co-convener of the cross-party group on chronic pain, most of the subject has been covered. The consultation on the specialist centre is very welcome. Currently, we think it acceptable to send people from all parts of Scotland to Bath, so what is proposed would be a vast improvement, whether we have a one-site centre or whether other mechanisms of delivery are explored.
I acknowledge, too, the acceptance of the lack of clarity and transparency in the report. That allows us to move on and to welcome the very helpful momentum injected by the minister and the cabinet secretary.
That said, may I pursue a little bit the question of what will be done with the data? If I understood correctly, we can expect that at the end of December. I am assuming that it will be in published form. Will that include not just a measurement of patient experience and outcomes—important though those are—but the numbers in whole-time equivalents of clinicians, nurses, physiotherapists, psychologists and occupational therapists? When a multidisciplinary team was described, a box was simply ticked to say that there was one. However, clearly there is a difference between a fifth of a consultant and a whole consultant. Transparency on those figures would be particularly welcome.
Equally, the minister mentioned that there would be transparency on waiting times. I take it that that applies to the first and second appointment as well.
On those points, the data is important. It is also important that we can demonstrate the mix of services on the ground and the range of staff involved. We will certainly pick up the point about waiting times and the journey in respect of the AHP advanced practice musculoskeletal project.
That was very helpful.
My final question goes back to Jackson Carlaw’s point, which I do not think you addressed, of who currently decides the patient representatives on the national steering group.
Secondly, I hear a lot of discussion about involving people in the service groups. Admirable as that might be, it does not replace direct representation on the national steering group. Are there plans to increase the number of patient representatives on the national steering group?
Answering the second question first, I have to say yes. Indeed, that is fundamental to our statutory responsibilities and user focus duty. We have not necessarily always got that right in the past, but we are learning from what we have done and will ensure that representation on the group is broadened.
With respect, I did not get an answer to my first question, which was a repeat of Jackson Carlaw’s. On the basis of my persistence, I seek leave to ask it again.
Obviously, decisions have been made in Healthcare Improvement Scotland about who should be involved. We and Scottish Government colleagues will learn from that and need to ensure that there is broader representation on the group.
So it was this huge organisation—Healthcare Improvement Scotland—that made the decision. Was there no one person who decided the national steering group’s make-up?
That was before my time in Healthcare Improvement Scotland, but I am happy to come back to the committee on the process of making those decisions and the engagement with individuals.
That would be helpful. I always like it when members say that they have a final question and then ask another three.
We have had a very helpful evidence session. I am happy to say that things have moved on and hope that with the assurances of openness, transparency and robustness that we have received we do not have the cabinet secretary or, indeed, the minister turning up at meetings and not knowing what the situation is. We will no doubt keep an eye on what happens.
The committee now has several options; indeed, members might wish to suggest options of their own. We can close the petition under rule 15.7 on the basis that the chamber debate on chronic pain took place on 29 May, that the cabinet secretary—and, indeed, the minister today—has committed to establishing an intensive pain management service in Scotland and that the Government has set out its aims for implementing the Scottish service model over the two years for which funding has been provided. Secondly—and this might be the more sensible option—we could defer further consideration until November, when we could seek an update from the Government on its short-term commitments such as the delivery of the intensive pain management service.
On the basis that I have ordered a cooked breakfast from time to time and the waitress has forgotten to bring it, I am in favour of deferring further consideration of the petition until November, when we can see the outcome of the consultation and what we are going to receive.
I have to say, Jackson, that it does not show.
It might just be because he is Jackson Carlaw that his breakfast is not getting delivered—but that is another story.
I agree with Mr Carlaw that we should defer consideration until November, not just to ensure that the consultation period is over and the cabinet secretary and the minister have deliberated and made decisions on the matter but to allow us to hear again from Healthcare Improvement Scotland about its reporting mechanisms and structures and how it has improved on what was seen as a disaster when it previously tried to report on what was happening out there.
Is that the committee’s verdict?
Members indicated agreement.
I thank the minister; his Government officials, Mark O’Donnell, Rachael Dunk and Gillian Gunn; and, from Healthcare Improvement Scotland, Robbie Pearson, Lesley Holdsworth and Dr Steve Gilbert. I suspend the meeting to allow the witnesses to leave.
Free Methanol (Ban) (PE1376)
Agenda item 5 is consideration of current petitions. The first is PE1376, which was lodged in November 2010 by James McDonald, calling on the Government to take the necessary action to bring about a ban on the use of free methanol released by aspartame. As members will see from the briefing paper, the European Food Safety Authority is re-evaluating its analysis of aspartame, but that will not be ready until November 2013. It is recommended that we continue the petition to await the results of the Food Standards Agency’s research and EFSA’s work. Is that agreed?
Members indicated agreement.
Flood Insurance (PE1441)
PE1441, by David Crichton, is on flood insurance problems. As members will recall, the issue was the subject of a debate in the chamber in May 2013. There are several recommendations on the petition, one of which is to write to the Minister for Environment and Climate Change to seek an update on the negotiations between the Department for Environment, Food and Rural Affairs and the United Kingdom insurance industry, which were supposed to have crystallised at the end of June. However, that has now been pushed back a month, although the statement of principles is due to expire at the end of July.
The briefing paper suggests that we write to the Minister for Environment and Climate Change to ask what action he is taking to ensure that the Scottish Environment Protection Agency develops a new commercial licence as quickly as possible so that we can secure the appropriate insurance. It also suggests that we write to SEPA to ask it what steps it is taking.
I agree with the suggestion that we write to the minister and to SEPA, but I suggest that we also write to DEFRA to remind it of our particular interest in the matter and seek assurances that it will reach an early conclusion so that people who might be affected by floods are safeguarded in future insurance policies.
I am very concerned that the issue has not yet been resolved through negotiations between DEFRA and the UK insurance industry, so I think that it would be sensible to write to the Minister for Environment and Climate Change to seek an update on the negotiations. I agree, too, that we should send a letter to SEPA to ensure that a new commercial licence is developed as soon as possible and to seek its views on that issue.
The suggestion was forcibly put in the evidence that we took and in the debate that there would be no extension beyond the end of June. We should welcome the fact there has been an extension to the end of July, but it would be sensible to say in our letter that, having established the principle of extending by a month in anticipation of an agreement, we would very much welcome the minister and the industry reassuring people that there will be pro tem extensions until an agreement is arrived at. As there has been an extension for a month, I do not see that any great principle is at stake in offering people such reassurance.
That is a very good point.
Do members agree that we will write to the minister in the terms that I expounded, and to SEPA and DEFRA?
Members indicated agreement.
Miscarriage (Causes) (PE1443)
PE1443, which was lodged by Maureen Sharkey on behalf of Scottish Care and Information on Miscarriage, calls on the Parliament to urge the Government to offer all women who have suffered miscarriage investigations following one loss and to review NHS Scotland’s policy.
There is a comprehensive response from the Royal College of General Practitioners Scotland in members’ documents. What action does the committee wish to take on the petition now that we have that information? We could seek further information, refer the petition to the Health and Sport Committee, or close it on the basis that the Scottish Government has stated its clear support for the current Royal College of Obstetricians and Gynaecologists guidelines. Do members have views?
I suggest that we close the petition, as the Scottish Government has expressed its view, which it says is based on the evidence that it has received, and there has been support for the current practice and position from all the parties from which we have sought to obtain evidence.
It is hard to argue with the clinical advice on that, but I was concerned about what the petitioner said about the service that is available. In particular, the Royal College of General Practitioners Scotland said:
“GPs should be prepared to offer counselling to women”.
I think that the petitioner suggested that that was not widely available. I wonder whether it is worth taking up that point, as there is obviously an issue from the petitioner’s point of view, some of which may well relate to that side of things.
I agree with Malcolm Chisholm. The sporadic nature of counselling should be tightened up. Most parents do not know that it is available to them. I thought that the petition was great, but I am not sure where we should go from here.
Shall we write to the Royal College of General Practitioners Scotland and state that we wish to see counselling meaningfully incorporated by GPs for patients who are in this situation? I have sympathy with the view that, having done that, we close the petition. Do members agree with that proposal?
Members indicated agreement.
Congenital Heart Disease Patients (Care) (PE1446)
PE1446, which was lodged in October 2012, is on congenital heart disease patients and how we track adults who suffer from that condition. We are asked to consider what action we wish to take based on the evidence that we have received and subsequent correspondence.
We can close the petition, on the basis that the Scottish Government has stated that the first task of the Scottish congenital cardiac network is to look at the standards that are appropriate for the Scottish service and that funding for the Scottish adult congenital cardiac service has increased by 60 per cent in recent years; we can defer consideration of the petition until the beginning of 2014 and seek an update from the SCCN; or we can refer the petition to the Health and Sport Committee for consideration as part of its remit.
I have taken an interest in this petition and have asked some questions in Parliament about it. Although I support deferring it, the petitioner has raised a particular point that we should raise with the minister. In her paper, the petitioner notes that the Scottish Government’s response said:
“The adult congenital population includes a large cohort of patients with minor lesions, who do not need to be urgently followed up.”
However, the petitioner goes on to quote a 2006 recommendation that
“All adults with congenital heart disease whatever the level of complexity are seen by an ‘expert’ from a specialist centre at least once and receive a written care plan.”
One of the concerns is the number of adults who, as it were, get lost and are not identified by health services as having a problem. I probably should take that up with the minister, but in general I support deferring consideration.
It is good that we have the Scottish congenital cardiac network, but the answer tends to be that the network will deal with this issue and that issue. We need to keep a watching brief on that.
Given the issues that we raised with the panel on PE1460, the question is to what extent there is patient involvement with the network.
As well as deferring the petition to see what happens and writing to the Government, it is important that we allow the petitioner the opportunity to examine and comment on the national standards that the SCCN will draw up. It would be useful if the petitioner was somehow involved in the discussions—
That marries with Malcolm Chisholm’s suggestion.
It ties up with Malcolm Chisholm’s suggestion about how patients interact with the review. I would particularly draw the SCCN’s attention to the petitioner and her work on this issue.
Does the committee agree to write to the minister and defer consideration until the beginning of 2014?
Members indicated agreement.
Organ Transplantation (Cancer Risk) (PE1448)
PE1448, by Grant Thomson, calls on the Parliament to urge the Government to raise awareness of the links between organ transplantation and cancer. We could write to the Government to ask what more can be done to make sure that all clinicians are aware of the potential risks in this area and that knowledge is up to date—which seems immensely sensible—in order to ensure that there is consistency across all NHS boards and that the quality of information that is given to transplant recipients does not vary. Alternatively, we could refer the petition to the Health and Sport Committee, or, on the basis that the three Scottish transplant units and the Newcastle unit have implemented the Scottish transplant group’s recommendations, we could close the petition. What is the committee’s view?
The first option—to write to the Scottish Government to ask what more can be done to make sure that all clinicians are aware of the potential risks and that knowledge is up to date—is my preference.
I totally agree. It is important that we continue the petition, to ensure that the information is disseminated. We must ask the Scottish Government about that before we can consider closing the petition.
Is that agreed?
Members indicated agreement.
Hyperemesis Specialist Nurses (PE1454)
PE1454, by Natalie Robb, calls on the Parliament to urge the Scottish Government to consider placing hyperemesis specialist nurses in hospitals, for consideration of serious vomiting in early stages of pregnancy. The recommended options are to refer the petition under rule 15.6.2 to the Health and Sport Committee; to write to Dr MacLean, from whom we have had information in a letter, to support the proposal to form a Scottish hyperemesis network and ask that interested parties, such as the petitioner, are included in taking that forward; or to take any other action that the committee considers to be appropriate.
I consider that the setting up of a network, involving the petitioners and those who are affected or interested, might be the way forward. Are we agreed?
Members indicated agreement.
I will take PE1458 at the end, because I think that we will have more commentary on that.
Evictions Due to Underoccupancy Deductions (PE1468)
Petition PE1468 was lodged on behalf of Govan Law Centre and calls on the Parliament to amend section 16 of the Housing (Scotland) Act 2001. We have been asked to consider—[Interruption.]
I remind members of the public in the gallery—[Interruption.]
Excuse me. I remind members of the public who are in the gallery that they must be silent and not demonstrate either vocally or by pictorial means when proceedings are under way, but should behave in an orderly manner. If they fail to do so, I will suspend the meeting, they will be asked to leave, and we will continue with our business. The dignity of this Parliament will be protected.
As I was saying, PE1468 is on behalf of Govan Law Centre and the committee is invited to consider what action it wishes to take. We could refer the petition to the Welfare Reform Committee under rule 15.6.2 for further consideration as part of that committee’s remit, or we could take other action that the committee considers to be appropriate.
I support the petition; it would be good if it were to go to the Welfare Reform Committee because it has been addressing the subject of the petition, which is clearly a key issue for that committee. That would be the best procedure and action to take.
I suggest that we close the petition on the basis that the cabinet secretary has made it clear that the Government does not intend to act on the petition, which is also the view of the Convention of Scottish Local Authorities and the various other organisations that have responded to it. I am thinking particularly of the legal point about hypothecating the issue in terms of law.
I support Malcolm Chisholm’s proposal that we send the petition to the Welfare Reform Committee, along with the evidence that we have gathered to date. We have managed to get some further evidence and responses, and the Welfare Reform Committee is dealing with the range of welfare reforms that are currently being implemented by the UK Government and which impact very harshly on many residents in Scotland and elsewhere.
I support the view that has been expressed by Malcolm Chisholm and John Wilson. Members of the committee will know about my support for the petition and for protecting people from eviction that might result from the bedroom tax. I do not believe that the Scottish Government has issued any guidance that would help local government to deal with the problem, so if the committee is minded to send the petition to the Welfare Reform Committee, that would be helpful. The Welfare Reform Committee might be minded to invite the petitioner along. There were certainly some questions that the committee wanted to ask him, but he was not present.
If we send the petition to the Welfare Reform Committee, that will be a matter for that committee. Are there any other views?
I entirely agree with Jackie Baillie. It is important that we refer the petition to the Welfare Reform Committee.
We all have constituents who are paying the price of this UK Government initiative. However, there are a number of salient points in the Scottish Government’s response that should be noted. In particular, it states:
“The rationale for the measure is not of Scotland’s making”,
“The measure runs roughshod over devolved policy making, taking no account of Scotland’s housing and homelessness policies”
“The Scottish allocation of the DWP Discretionary Housing Payment (DHP) fund is entirely insufficient.”
It is worth making those points at this stage, prior to the petition going to the Welfare Reform Committee.
Are you in favour of that action?
I fully endorse and support the comments of colleagues who wish to refer the petition to the Welfare Reform Committee. It is very important that we do not dismiss the issue and that it is properly considered.
So are we agreed, by a majority, that the petition will be sent to the Welfare Reform Committee?
Members indicated agreement.
Wind Turbine Applications (Neighbour Notification Distances) (PE1469)
We come to PE1469, by Aileen Jackson, calling for a change in planning regulations to enable an increase in the current neighbour notification distance of 20m in relation to wind turbine planning applications. I know from experience that that distance has created difficulties in cross-council-boundary applications.
Our options are: to look for further information; to refer the petition, under rule 15.6.2, to the Local Government and Regeneration Committee for consideration as part of its work on the third national planning framework and the Scottish planning policy; and to close the petition under rule 15.7, on the basis that the Scottish Government has
“no plans ... for a further review of neighbour notification or other publicity requirements for planning applications.”
I would like to advocate none of those, and to suggest that we defer consideration of the petition until the autumn. I note that the response from the Scottish Government states:
“While some amendments to the general publicity requirements are about to be laid in Parliament as part of consolidated planning regulations, we have no plans at present for a further review of neighbour notification or other publicity requirements for planning applications. We will, however, consider further the issues raised by the petition and the Committee’s discussion and update the Committee in the autumn.”
We have a commitment from the Government to come back to us to say how it intends to take forward these issues. I would like to remind the Government of that commitment and to defer further consideration of the petition until we receive a report about what the Government intends to do.
That is sensible. Do members agree to that suggestion?
Members indicated agreement.
Judiciary (Register of Interests) (PE1458)
PE1458 is on a register of interests for members of the judiciary. Recommendations for action that the committee might wish to take are included in the papers. One is to invite Moi Ali, the Judicial Complaints Reviewer, to give evidence to the committee at a future meeting. We could also take any other action that we consider appropriate.
Before I make any personal comment, I seek the views of members of the committee.
Previously, the committee decided that there was no further purpose in pursuing the Lord President. I pointed out that the Government-appointed JCR had particularly strong views on the matter and said that, although the Lord President wants to talk only about the constitutional principle, that principle needs to be seen in the light of potential constitutional changes. The view was that we should seek to close off the petition with the Lord President. However, I certainly recommend that we get Moi Ali in here to hear her views.
I agree. I thought that we had reached something of an impasse. When I saw the support for the proposal from the Judicial Complaints Reviewer—an appointment that was established under the Judiciary and Courts (Scotland) Act 2008—I felt that, given that the weight of evidence so far from the establishment has been of one colour, it would be interesting to hear why the Judicial Complaints Reviewer takes a different view.
I have not been involved in the petition, so I would really like to ask a question. I have read Lord Gill’s view of judicial independence in relation to attending the committee and answering questions. Are his and others’ objections to the register based on the same principle of judicial independence, or are they not really to do with that at all? I do not know whether anyone can answer that, but it seems to me that the petition raises interesting general questions about the line between judicial independence and accountability and political oversight. In part, that relates to an issue about judicial independence that I raised in last week’s debate in Parliament on the Victims and Witnesses (Scotland) Bill. I am curious about the issue.
The view that was taken was that there are other mechanisms and checks and balances, such as recusal, that secure the independence of the judiciary without exposing judges to what would be seen as a breach of the Scotland Act 1998 in performing their role.
So the issue is about a register that would affect judicial independence, rather than just about the Lord President appearing here to answer questions. Is that what you are saying?
That is the difficulty and the reason why we are struggling. We are looking for openness and transparency, but the Lord President has chosen not to attend to explain why there should not be a register of interests for judges, as there is for members of Parliament, members of the Scottish Police Authority and so on. That is his view.
Lord Gill’s response, which took us to something of an impasse from our point of view, was, “It’s not happening down south, and neither I nor anybody else has any intention of doing it, so get your tanks off my vested-interest lawn.” We were unable to find a way to break through that, but the information that we have received from the Judicial Complaints Reviewer potentially offers us an interesting extension of the discussion. However, I do not think that the issue that the petitioner raised has ever been properly and fully addressed, beyond the Lord President saying that he does not think that a register is necessary and, surprisingly, neither does anybody else who is currently employed in the profession.
I agree with Jackson Carlaw. Given the interesting comments in the response from the Judicial Complaints Reviewer, it would serve a purpose to invite her to give evidence to the committee. I hope that, once we have heard that evidence, Lord Gill might reconsider his position in relation to section 23(7) of the Scotland Act 1998. Basically, my interpretation is that Parliament and its committees cannot call judges or sheriffs to give evidence on and to be accountable for judicial decisions that they have made, but the petitioner’s main point is that we should hear from Lord Gill in his role as the Lord President, which involves overseeing the judiciary.
I hope that Lord Gill might reconsider his position in the light of the fact that we are to take further evidence. I hope that that evidence will draw out other issues that are relevant to our deliberations. I support Jackson Carlaw’s suggestion to take evidence from the Judicial Complaints Reviewer.
Okay. We will invite Moi Ali to give evidence.
I recently attended the Justice Committee to talk about changes to the Scottish Court Service; it is somewhat paradoxical that the Lord President was happy to go along to that committee to explain—or not to explain, as the case may be—the rationale behind those changes.
Do members have any other comments?
I just want to reinforce Mr Carlaw’s and Mr Wilson’s points. Notwithstanding the points that the Lord President made in his letter to the convener that judges cannot be compelled under the Scotland Act 1998 to appear before committees of the Parliament, I note the statement in that letter that
“a register of interests for the judiciary is both unnecessary and unworkable.”
It would have been beneficial if the committee had been able to hear oral evidence from the Lord President about why he thinks that that is the case. Like John Wilson, I hope that the Lord President will reconsider that. However, I certainly endorse the view that we should hear further evidence from other expert witnesses.
I draw the committee’s attention to the petitioner’s letter, in which he asks the committee to approach a Green Party member of the New Zealand Parliament, Dr Kennedy Graham, who is currently putting his Register of Pecuniary Interests of Judges Bill through that Parliament. We could approach Dr Graham to ask for his views.
We can e-mail Dr Graham, but we will need to ask him very specific questions. I do not think that there is any harm in that but, as the clerk has just pointed out to me and as the correspondence makes clear, the suggestion is that the New Zealand Government is intending to move in the direction of recusal. Should I formulate some questions and just zap them around everyone?
That would be fine, convener.
I do not think that we should rule out a future evidence session involving experts from furth of Scotland. When the Health and Sport Committee considered minimum unit pricing of alcohol, it benefited greatly from evidence from Canadian experts—notwithstanding the time difference between the two countries.
I thought that you were going to suggest that we go out there to speak to them.
We have covered the position and, as agreed in agenda item 1, we move into private session for the final two agenda items.
12:12 Meeting continued in private until 12:33.