Hansard

We should congratulate all the Health and Sport Committee’s members—and the clerks, of course—for all their hard work on the committee report. We are again looking at a bill that has the potential to help a lot of people to live healthier lives, with better guidance and better support.

Its three main provisions on NVPs—vaping—the duty of candour, and ill treatment and neglect could be beneficial in principle. However, we need to look at each one in depth and to distinguish what is beneficial and what could end up being undesirable and, perhaps, impractical.

I would like to point out a few of the issues where more evidence is required and where we need a better understanding of what the assumed policies aim to do. Some members have pointed out the move towards limiting sale and advertising of nicotine vapour products. Although the move towards restricting products that are harmful is welcome, a large amount of the evidence that was received—we have just heard some from Kevin Stewart—stated that they are less harmful than cigarettes. Of course, we also know that they are a good way of weaning people off smoking tobacco, and there is little doubt that smoking tobacco is worse for a person than vaping. However, there are concerns.

Nicotine is a poison—it was formerly used as an insecticide—and it is an addictive chemical. It affects people’s cardiovascular systems and can even lead to birth defects. That is all well documented. There are therefore concerns that there is some targeting of non-smokers. We hope, of course, that under-18s would be non-smokers. Therefore, I support the Government’s proposals in that respect. We know that there has been targeting even at football matches, at which e-cigarettes have been given away.

I fully appreciate and support the view of Kevin Stewart and others that we need vaping to wean people off the more harmful smoking of tobacco, but vaping is probably not harmless—although I am afraid that we do not have enough evidence. Therefore, there is a very fine line between what the bill seeks to promote as a better alternative to smoking for those who already smoke and the unintentional consequences that it could have in promoting NVPs as being attractive to people who do not smoke or—as some witnesses put it—in glamorising products, in particular to people under 18.

Members will be aware of my member’s bill that is going through Parliament, which aims to raise awareness of the damage that is caused to the respiratory systems of children by second-hand tobacco smoke. As we are not yet aware of the long-term impact on lungs from inhaling vapes, a wise health policy should prevent a larger-scale problem from occurring. Therefore, I support that approach. The measure to prohibit sales of NVPs to under-18s—under-18s only—is a reasonable step.

We know that there is a lack of robust research and evidence, so it is better to err on the side of safety in protecting young people. Stewart Maxwell’s evidence on that and on the length of time that it takes for cancers to appear from when people start to smoke cigarettes was good enough. We also have to consider the growing vaping market and the word-of-mouth reputation that vaping products obtain among under-18s. The measure is therefore sensible, and is—of course—supported by numerous organisations, including Cancer Research UK.

I also support the provisions that build on the Lib Dem-Labour coalition legislation on smoking bans. Stewart Maxwell was very much involved in that legislation at the beginning. At that time, the British Medical Association’s chairman said that that day would be remembered as

“the time Scotland took a bold and politically courageous step”.

The bill takes that further to protect areas around—of course—hospitals, health centres, general practices and other areas where health is promoted, and it will put Scotland closer to being the tobacco-free generation by 2034 that Malcolm Chisholm mentioned.

Another element of the bill is the duty of candour. Although I believe that that will provide better emotional support to patients, we must ensure that its use is balanced against its necessity. Let us look to the professional opinion of the BMA. I was informed that the measure could add administrative burdens, costs and responsibilities to health boards and general practices. The BMA pointed out that

“Any incident ... which occurs should be seen as an opportunity for improvement and learning”.

We know that doctors, nurses, consultants and every single medical and clinical member of staff want to help their patients and look to provide the best care to them. That is, after all, a basic element of the Hippocratic oath for new doctors as well as an element of the General Medical Council’s standards and ethics guidance. Although I welcome the bill’s raising of awareness of the duty of candour, we must seek further information on how it might affect the relationship between practitioners and patients.

Likewise, part 3 of the bill will introduce offences of wilful neglect and ill treatment by healthcare professionals and organisations. I reiterate that medical personnel do not seek to harm their patients, so I would tread very carefully on that point as it moves forward at the various stages of the bill. I ask the minister in her summing up to give specifications on that matter, given the current context in which practitioners work. We know that health boards and, as a consequence, doctors, nurses and accident and emergency departments are squeezed very tightly financially, and we recently saw health boards borrowing from the Scottish Government to break even. Departments are understaffed, staff are overworked and targets are pressing. I would be grateful if the minister would address my concerns that health professionals and care workers should not be unduly criminalised for any failings.

Our concerns are echoed by the BMA and its concerns focus on the concern that by imposing such sanctions we may still not be solving

“the serious failings in health care delivery in Scotland... and ... adding a criminal offence would not provide any additional protection for patients.”

I am pleased to see that we are advancing further in promoting patient care and health. If the bill is to achieve an optimal result, we need to look at its provisions a little more closely and build upon it more constructively for the future.