Meeting of the Parliament 01 December 2015
I accept the minister’s explanation but, having sat all day yesterday waiting to get the response, I would probably have been better just to ignore the information that came in. I am just making a general point on an issue that I feel quite strongly about.
Part 1 was generally accepted by witnesses, as the proposed controls and restrictions on the sale of nicotine vapour products such as e-cigarettes more or less mirror the current statutory restrictions on the sale of tobacco products. On balance, I think that that is sensible because, although it is accepted that NVPs do not have the same harmful effects on health as tobacco, the evidence base on long-term harm is still developing. Therefore, a proportionate and balanced approach to their availability for sale seems wise, although they undoubtedly have a place as a smoking cessation tool, alongside trained support.
The committee was concerned, however, that, due to the current cost and complexity of registering an NVP as a medicinal product, it is unlikely that many will be registered as such, which puts into question their use as smoking cessation aids. I hope that the industry will pursue that matter further with the Medicines and Healthcare Products Regulatory Agency.
It is prudent that retailers should have to register their intention to sell NVPs, although there might be some on-going disagreement about whether there should be separate registers for the two types of product, with one register that includes tobacco and NVP retailers, as the bill stipulates, or, indeed, one register that covers those who sell any age-restricted products, as tentatively suggested by the committee. The Government intends to provide a clear separation between NVPs and tobacco products on the website where the register is held. That is because, as I said, on current evidence, the former are considerably safer than tobacco. I think that that approach will be welcomed.
With regard to banning smoking in hospital grounds, it is right to introduce enforceable legislation because, although most if not all health boards already forbid smoking on their premises, and most people respect that, it is not a statutory requirement. As the bill progresses through Parliament, there is likely to be further debate on whether the enforceable ban on smoking should be a ban in an area that is defined by regulation as the same distance from hospital buildings for all hospital grounds, as proposed by the Government, or an area that is defined by each health board specifying its own legally enforceable perimeter, as suggested by the committee. There is also discussion to be had about possible exemptions, particularly for mental health patients.
As I said at the outset, the general principles in part 1 seem to be acceptable to most people who have engaged with the committee. Parts 2 and 3 are more controversial, with the Law Society of Scotland, the British Medical Association and the Royal College of Nursing among those who have expressed reservations. Those who are opposed to the duty of candour do not think that legislation is the way to create a culture of openness in the NHS and they emphasise that there are already requirements to be honest with patients about their treatment and any failings that occur. They feel that an apology for shortcomings is more meaningful if it is given spontaneously rather than as the result of a legally enforced duty.
Also, because harm in this context is not specifically defined, they feel that the duty is too broad and could encompass very minor events that it is not intended to cover.