Hansard

I will begin by clarifying a question that I want to ask the minister, just so that she is clear from the outset, as I would very much like an answer in her closing remarks today. It concerns the duty of candour, which she mentioned. My question touches on a situation that has been brought to my attention, especially in the past six months, about care workers being disciplined at the Scottish Social Services Council. There are several such cases, and the number seems to be increasing. That is because, as the minister knows, more and more care workers are employed every day, because we have an ageing population. Currently, care workers who are disciplined by the SSSC are not entitled to any legal aid whatsoever and they often appear at tribunals completely unrepresented, as many of them are not members of trade unions. They also have to pay their own travel expenses to the hearings. When I asked a parliamentary question on the matter, the Scottish Government said that it does not keep records of the number of disciplinary hearings. There is an overlap with the duty of candour and how it will impact on people’s working rights and conditions, and I want to ask the minister whether, when the duty of candour and the provisions around wilful neglect come in, care workers will be entitled to legal aid when they are being disciplined by the SSSC. What is the overlap?

I welcome the bill and its wide-ranging provisions, and the steps that it takes to improve public health across a range of areas. Like the minister and the committee convener, I will start by addressing the issue of e-cigarettes. There has been an explosion in the use of e-cigarettes and nicotine vapour products in the last couple of years, and they have become a familiar sight in everyday life. I am sure that we all have family members and friends who have converted from cigarettes to e-cigarettes. Their popularity is undeniable and it can only be positive that people are looking for a less harmful way to smoke, or for a way to stop smoking.

The sudden and huge rise in their use demands this Parliament’s attention, so that we can ensure that there is a legal and regulatory framework by which they can be sold and used that is in line with our approach to tobacco. The Government’s proposals in the bill are sensible and measured, and they reflect the on-going development of the evidence base on NVPs. On that basis, we are happy to support them. I note the broad support that the proposals have gained from the respondents to the Health and Sport Committee, which Duncan McNeil mentioned. However, I agree with the Health and Sport Committee that we must continue to be alive to the opportunities that e-cigarettes present as a smoking cessation tool and I welcome the commitment of the Government and NHS Health Scotland to progressing that.

In a recent health debate, the minister told the Parliament that smoking has been reduced in Scotland by 3 per cent in the past year. I would be interested to know from her research and evidence what role e-cigarettes played in encouraging that fall. It would be in Parliament’s interest to know whether the fall is due to market forces and the availability of e-cigarettes or is due to public health campaigns, if she has that information.

We know that there is a range of views about the safety of e-cigarettes and their effectiveness as a way to reduce harmful smoking. ASH Scotland has said that vaping is less harmful than smoking but that it is not harmless. Cancer Research UK confirms that, although e-cigarettes can help people to cut down or quit smoking, the reality is that the full health effects are still unknown. However, I am also interested in the views of Public Health England, which cites emerging evidence that e-cigarette users have some of the highest successful quit rates. That takes us to the whole debate around making e-cigarettes available on prescription. I certainly believe that e-cigarettes represent a real opportunity to help move towards the smoke-free Scotland that this Parliament aspires to and which the minister recently spoke about.

The target of reducing smoking to below 5 per cent of the population by 2034 is ambitious. Like everyone else, I share that ambition, but we will not deliver it unless we take real action to deliver cultural change. While we gauge the evidence on the effectiveness of e-cigarettes in that pursuit, I welcome the cautious steps that the Scottish Government has taken to tighten up the legislation around their sale.

Perhaps the delayed but continuing work on the Scottish Government’s refreshed cancer strategy, which is to be published next year—we do not know whether that will be before or after the election—will include a strong public health agenda that will reflect on how we can use e-cigarettes to further reduce harmful levels of smoking.

I also welcome the move to enforce the NHS’s policy of no smoking outside hospitals. That is, I hope, another step towards changing smoking culture in Scotland.

On the care side of the bill, we generally support the aim of having a more transparent system that gives greater protection to patients. There is considerable support for the Government’s approach of introducing a duty of candour and an offence of wilful neglect. I hope that that will allow healthcare workers and organisations to build on existing good practice and offer a uniform standard that gives patients and staff certainty. However, there is obvious concern among the professional bodies that represent health workers, such as the Royal College of Nursing, and we must engage with them through the bill’s progress to reflect those worries and assuage them where possible.

For that reason, I am pleased that the Government has committed to involving health and social care staff in drawing up the procedures. As those procedures could have a significant impact on the working conditions and rights of nurses and care workers, I am slightly nervous that they are all being left to regulations rather than put in the bill, but it is the right approach to involve health and social care staff in drawing them up. It is important that we use the staff’s expertise to shape how we improve standards. I echo the committee convener’s call for the regulations to go through the Parliament by affirmative procedure rather than the negative procedure for the reason that, as I outlined, they could affect the working conditions and rights of nursing staff and care workers.

I put on record our thanks to healthcare workers, who do some of the most difficult, physically and emotionally demanding jobs in our communities, allowing our elderly and vulnerable people to remain in their home or supporting them in a care environment. The vast majority of carers work to high standards. However, as in every walk of life or profession, there will always be people who fall below that level, and then care is compromised. It is right that we have a system of redress for people who suffer or are inconvenienced as a consequence of that, but we must also recognise that if we are to set higher standards for our care workers, we have a duty to support them properly through better pay and conditions and improved training and support.

Scottish Labour has already committed to paying a living wage to Scotland’s care workers. We must also investigate how we can better train and support them, as we have continually rising expectations of their services and put trust in them to look after our vulnerable and elderly populations. In general, we must raise the esteem in which the job of carer is held. For too long, our social care system has been treated like a second tier of our health system. If we are to move towards a regulatory system that echoes the high standards in our NHS, we must acknowledge the duty to help care workers in their professional development and pay them a fair wage for the hard job that they do.