Hansard

At one time there were adverts to promote cigarettes showing Ronald Reagan giving them as Christmas gifts or Superman jumping out of a helicopter, but long gone are the days when cigarettes were so fashionable that around half of all adults in the United Kingdom were regular smokers. Decades on, attitudes have changed drastically, but cigarette smoking is still the world’s leading cause of preventable poor health and premature death.

In Scotland, tobacco use is associated with more than 13,000 deaths and around 56,000 hospital admissions every year. A key aim of the bill is to tackle that further by making it an offence to smoke within part of designated no-smoking areas around buildings in hospital grounds. Those caught smoking will be liable on summary conviction to pay a fine of up to £1,000. At present, all NHS hospital grounds are no-smoking areas. The bill would not change that; but it proposes to enable no-smoking areas around hospital buildings to be enforced by local authority officers.

Currently, people who refuse to comply with rules on no-smoking areas in hospital grounds can only be asked to leave the grounds and move on. We all know from our casework and the objections and complaints that have arisen that that has caused our constituents a great deal of concern. Indeed, the Greenock Telegraph has run a campaign about the abuse of the no-smoking rule at Inverclyde Royal hospital.

Thankfully, most witnesses agreed that smoking immediately outside hospital entrances, exits and windows should be an offence. However, the committee had concerns about the feasibility of the Government’s approach of setting the same distance of possibly 10m or 15m from every hospital building as the enforceable part of a larger no-smoking area. We recommended that the Government reviews that approach and instead allows each health board to propose its own legally enforceable perimeter, which would enable it to reflect the different grounds and types of hospital in each area.

Regrettably, the minister disagrees with the committee’s recommendation, because the Government considers that if NHS grounds all have different enforceable areas, that could lead to patients inadvertently committing an offence. However, I seek the minister’s view on whether the same issue could not arise under the Government’s proposed approach. If the enforceable perimeter is indeed set at 10m or 15m, for some hospitals that could extend the area for the offence to all the hospital grounds, whereas for others only a small part of the grounds might be covered. Indeed, the enforceable perimeter could be less than 10m or 15m if an exempted site such as a hospice is co-located within the hospital.

Another part of the bill introduces restrictions on the sale and advertising of nicotine and non-nicotine vapour products. None of us can have failed to notice the rapid increase in people using e-cigarettes, vaping pipes, hookah pens or whatever else they may be called—I have no experience of any of these things. We heard that currently 2.6 million people in the UK use NVPs. In our online survey we received many comments about the benefits of using NVPs to reduce or stop cigarette smoking. However, the research published to date appears to suggest that although NVPs can help with smoking cessation and are indeed much less harmful than tobacco cigarettes, they might not be completely harmless. We agree that more long-term research is needed.

We agree with the proposals in the bill to treat nicotine vaping products as an age-restricted product, which would include restricting their sale to over-18s.

One area of debate concerned the powers in the bill that enable ministers to introduce additional restrictions on advertising of NVPs, over and above those already in place at European Union and United Kingdom level. The Scottish Government has confirmed that it intends to use those powers to restrict advertising of NVPs to the point of sale only. Given that long-term evidence about the use of NVPs is still developing, we supported that precautionary approach. I also welcome the Scottish Government’s acknowledgement of our concern that a possible unintended consequence of implementing further restrictions on advertising in Scotland could be to provide a competitive advantage to existing NVP retailers. We welcome the Government’s intention to monitor the potential risk that NVPs might be made more attractive to children by using flavourings and point-of-sale advertising.

Part 2 of the bill focuses on the impact on people when mistakes arise in health and social care services. It proposes to give health, social care and social work organisations a duty of candour. It means that when a person experiences or could have experienced unintended or unexpected harm from their care, unrelated to their illness or condition, that organisation has a duty to tell them. Although many witnesses supported the duty of candour in the bill, we heard evidence that there was no need for the legislation, given that there are long-standing professional and ethical duties that require candour or disclosure of harm. While we recognise that those duties currently exist, the committee supported the inclusion of a duty of candour in the bill because it builds on existing good practice and, more importantly, because the duty will apply to organisations.

The duty of candour procedure will be set out in regulations that will be subject to the negative procedure. Those regulations will play a significant part in ensuring that the duty of candour procedure is implemented effectively. Therefore, we believe that the provision should be changed to be subject to affirmative procedure. In its response to the committee report, the Government disagrees. Given that, I invite the minister to consider further how the Parliament might be given greater opportunity to scrutinise fully these significant regulations when they are introduced.

The final part of the bill proposes to create new offences of ill treatment and wilful neglect. One offence would apply to adult health and social care workers and the other would apply to adult health and social care providers. We heard concerns that the creation of those offences would work against the openness, honesty and candour that part 2 of the bill seeks to create. The minister clarified for us that that concern should not arise as the triggers for engaging the duty of candour—that is, unintended or unexpected harm—are separate and distinct from those that will trigger the offence of wilful neglect or ill treatment; that is, deliberate acts with a high level of intent. That said, we recognise that training and education for all health and care staff will be key to the successful implementation of the procedures for the duty of candour and the new offences.

This is a large, diverse bill and I have been unable to do justice to all the committee’s recommendations in the time allowed. However, I place on record the committee’s thanks to all those who provided written and oral evidence. We look forward to scrutinising amendments at stage 2.