Meeting of the Parliament (Hybrid)

Meeting date: Tuesday, December 14, 2021

Official Report 1009KB pdf

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Topical Question Time

The next item of business is topical question time. I remind members of the Covid-related measures that are in place, and that face coverings should be worn when moving around the chamber and around the Holyrood campus. I will give Mr Balfour a moment until the chamber quietens down. I will give colleagues a moment to move places.

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Interlinked Fire Alarms (Funding)

To ask the Scottish Government whether it will provide an update on what flexibility will be afforded for the installation of interlinked fire alarms in light of recent reports about the available funding for low-income households. (S6T-00356)

Flexibility is built into the existing legislation through a provision that sets out that the work should be done

“within such period as is reasonable in all the circumstances”.

That allows flexibility for home owners who cannot install alarms by 1 February 2022.

Home owners are generally responsible for paying for works to protect their properties. However, in recognition that some people might not be able to meet the cost of fitting the necessary alarms, we provided additional funding of £500,000 to Care and Repair Scotland to help older and disabled people. That was in addition to the £1 million of funding to the Scottish Fire and Rescue Service for its home fire safety visit programme to install alarms for owner-occupiers who are assessed as being at highest risk from fire. Furthermore, our £15 million in loan funding for social landlords enables them to fit compliant alarms to the new standard by next year.

Will the cabinet secretary define a “reasonable” period? What is the cut-off date when the law will be enforced? That will give people certainty about when the work needs to be done by, rather than a vague timescale that is reasonable.

Legislation often refers to a reasonable period, which is not defined as a number of weeks or months; it means a reasonable period for someone to get a fire alarm system installed. We understand that there have been issues with supply of systems, so we are prepared to give people a reasonable period that will give them a bit of breathing space if they are finding it difficult to get their hands on devices or to get devices fitted. As I set out in my initial answer, support is available for people who require assistance.

I will press the cabinet secretary. If alarms are not fitted by the appropriate time, there will be home insurance issues. What conversations has she had with home insurers about whether policies will be valid? When will it be decided that the reasonable period has ended? The Government must fix a date at some point—or is it unwilling to make the decision?

We have not in any way said that the issue should be taken into account by insurance companies. Insurance policies are a matter between insurance companies and the people who hold policies, but we have never specified that the issue should be included.

As I said in my original answer, the legislation provides flexibility for the work to be completed within a reasonable period, taking into account individual circumstances. I think that that is a reasonable position. It is a matter of getting the message across to people that we want them to install the devices because they improve fire safety within their homes. Of course, that originated from the Grenfell tragedy. It is important that we all give the message to home owners that installation is an important thing that they should do as quickly as possible.

I absolutely accept the necessity of people being safe. However, given the current pressures of omicron—which are understandably very distracting for people—as well as the rising cost of energy, I welcome flexibility on the deadline. I hope that the cabinet secretary will take into account the other pressures that are on households just now, quite apart from their obtaining devices and having them installed.

Christine Grahame has made a reasonable point. People are understandably concerned about having the necessary alarms fitted by the deadline of 1 February, and I understand the current challenges with living costs and Covid, which the member pointed out. I emphasise that the legislation provides flexibility.

Careful consideration is needed to balance the risks that are associated with further delays to implementation of the legislation, which I am not keen on. At the end of the day, it is about improving fire safety. One death from a fire in Scotland’s homes is one too many. It is important that we give the message that people should prioritise making the investment—and, of course, that support is available for people who will struggle with that.

The cabinet secretary has alluded to this, but colleagues in local government have told me that deliveries of orders of interlinked alarms are being delayed, in part due to the global semiconductor shortage, but also because of the disruption to trade due to the pandemic. In short, there are not enough alarms to go around.

What flexibility is there? We have spoken about a reasonable period, but people are worried about breaking the law after 1 February. What more consideration has the cabinet secretary given to a fixed delay to the coming into effect of the legislation?

I am aware that some manufacturers are facing supply issues, particularly with imported components. Some manufacturers have stock availability, and specialist retailers are also able to meet demand, subject to logistical challenges. My officials are in discussion with manufacturers to establish when supply issues are likely to be resolved more generally. That is why—as I said in my previous two answers—we are giving a degree of flexibility. It is important that people get the devices installed as quickly as they can, because it improves their safety and that of others in their homes.

We recognise, however, that, because of the challenges, people need a bit of flexibility, which is why we are giving a reasonable timeframe for people to comply with the law.

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NHS Lothian (Paediatric Audiology Services)

To ask the Scottish Government what action it will take in response to the British Academy of Audiology report on NHS Lothian’s paediatric audiology services, which was requested by NHS Lothian following a review by the Scottish Public Services Ombudsman. (S6T-00362)

Last week I made clear my views about the unacceptable failures that were highlighted by the British Academy of Audiology’s report on the provision of paediatric audiology in NHS Lothian. Our priority is to restore and rebuild confidence, and to ensure that support is provided to those who have been affected by the situation in Lothian and that the situation is not repeated for any other family.

In response to the on-going issues, NHS Lothian has been escalated to stage 3 of the national health service board performance escalation framework for paediatric audiology performance and service delivery.

I met the board’s leadership team again yesterday, and we will work in partnership with the board to develop a formal recovery plan. We agree with the BAA’s recommendation to share the report more widely for greater learning in Scotland and across the United Kingdom. Our response to the findings and to the concerns that have been raised must assure families across Scotland that their children are getting the best possible audiology care.

For all those reasons, I will write to health boards to seek assurance on the quality of care.

Six children could, and should, have received cochlear implantation surgery, but were missed in assessment and missed out on life-changing surgery. That was set out by NHS Lothian in a briefing that I attended on Friday. Why did concerns have to be taken all the way to the Scottish Public Services Ombudsman before the failure of service was identified, and what can the cabinet secretary do to ensure that health boards take concerns seriously, and assess whether there are underlying systemic issues that need to be addressed, so that such problems, which are years in the making, are identified promptly?

Fiona Hyslop is absolutely right to ask her question with such strength of feeling. If I have the phrasing right, she asks why it took a complaint to the SPSO to surface the issues. It should not have taken that complaint to surface the issues, which is the fundamental issue that the BAA has highlighted in its report. In its report, the BAA brought a number of failures to the attention of the health board. One of the most disturbing failures related to how dismissive, in some instances, people in the department were of complaints and parents’ concerns about their children.

On what will be done next, there will be a formal recovery plan that will look at the issue that Fiona Hyslop has raised and at all the issues that have been raised by various reviews, including the BAA review.

One of the concerns about how the service had been operating was that it was not a regulated statutory service and that all training was in-house, which entrenched inadequate observational assessments of young children. What can be done to ensure that that is not happening elsewhere in the health service, and will the cabinet secretary action the National Deaf Children’s Society’s call in that regard, as well as its other recommendations? Finally, and most important, what support and assurances have been given to the children and families who have been affected, and how can trust in the service be restored?

There were three questions there, which I will try to answer quickly.

Later this week, I will meet the BAA and the National Deaf Children’s Society, which is an organisation that I have known for many years. I have seen its recommendations and will consider them with an absolutely open mind.

In terms of assurance, I have already asked NHS Lothian whether certain red flags were missed in the paediatric audiology department, and for assurance that, if similar issues and complaints are being flagged in other departments, they are surfaced. I have informally asked all health boards—I will also formally ask them—to ensure that the same issues are not present in their paediatric audiology departments.

Fiona Hyslop made a good point about regulation. At the moment, I am having discussions with the United Kingdom Government about reform of professional healthcare regulation. Even before the BAA report, I was in favour of looking at regulation for audiologists; the report has strengthened that feeing.

The shocking review reveals the completely inadequate level of care that is given to youngsters with hearing difficulties in NHS Lothian. The families deserve an explanation of how the scandal happened. Sadly, the critical failings have a lifelong and significant impact on the young people and their families. I am pleased that NHS Lothian has accepted all the recommendations from the BAA report, but I am concerned that the problem could happen elsewhere.

As has been mentioned, the National Deaf Children’s Society is calling for an independent review of children’s audiology services across Scotland, which is more than the cabinet secretary has stated today he will do. There is a real danger that many more deaf children will not get good-quality care unless the review is carried out across all our services in Scotland. When will such a review take place?

Sue Webber has raised a number of important points. In my answer to Fiona Hyslop, I omitted to say that NHS Lothian issued letters last week to the affected families, and that measures are in place to identify any young child whose case might require further clinical review. A helpline is also available, and I have asked that NHS Lothian keep close to the affected families.

In terms of the broader point, I will meet the National Deaf Children’s Society later this week.

I say to Ms Webber that I would like health boards to look at their own paediatric audiology departments and to thoroughly examine and explore whether any of the issues that were raised by the BAA report are present there. If I find any suggestion that any of the issues are more widespread, of course an independent review might be the appropriate thing to do, but I would not rush into that before I let the health boards do the work that they will do, which will be done at pace.

Ms Webber is absolutely right to raise the concern that the issue could be more widespread than being only in NHS Lothian. That is what I am exploring and examining. I will be happy to give all members who have expressed an interest in the issue an update when the review is complete.

I associate myself with Fiona Hyslop’s remarks and their tenor. I, too, attended the briefing on Friday, and I welcome the points that the cabinet secretary has made. However, the issue clearly goes beyond technical clarification of the test. There are clearly fundamental problems with the culture in the unit, as was identified in section 4 of the report. What will be done to tackle that culture?

On the red flags, do we need to go further than merely asking the question? Should other areas of practice that are not subject to statutory regulation be examined more fully?

Finally, children have experienced life-altering consequences from the failure. Will the Government consider putting together a compensation process so that the affected families do not have to go to court to get the on-going financial support that their children will need for the rest of their lives?

I thank Daniel Johnson for those questions and the manner in which he asked them.

On the culture, there are two things to mention. The first is the human resources processes that NHS Lothian is taking forward. I will not comment on them; Daniel Johnson would not expect me to do so. The other is that he is right to say that the BAA, in its recommendations, recommends changes in culture and practice. NHS Lothian has shown no hesitation in accepting those. I will stress the point that he made about culture when I next meet NHS Lothian, which I do regularly.

On regulation, I do not disagree with Daniel Johnson. As I said to Fiona Hyslop, I am in on-going discussions about which healthcare service specialists who are not regulated should be regulated, and how regulation can be made more streamlined. If Daniel Johnson has particular concerns about a particular specialism, he can, of course, furnish me with the details. I am happy to have such conversations.

I will consider what Daniel Johnson said about compensation. There are processes whereby individuals can seek compensation from NHS health boards if they feel that there has been negligence. He is right that we would not want that to be a lengthy process, if there is fault. Clearly, that would be a matter between the health board and the families, but I will take on board what Daniel Johnson said and give it some further consideration.