Meeting of the Parliament 03 March 2016
I am delighted to open the debate on the Health (Tobacco, Nicotine etc and Care) (Scotland) Bill. I thank the Finance Committee, the Delegated Powers and Law Reform Committee and particularly the Health and Sport Committee for their consideration and scrutiny of the bill as it progressed through the parliamentary process.
The bill is wide ranging. If passed, it will contribute to helping people live longer, healthier lives, to tackling significant inequalities in Scottish society and to improving the delivery of health and social care services.
Cross-party support for preventing the harm that tobacco use causes has seen Scotland remain a world leader on tobacco control. The Government has been clear that it will continue to encourage everyone, and particularly children and young people, to choose not to smoke. By so doing, we hope to create a tobacco-free generation of Scots by 2034. Creating the offences of smoking and of knowingly permitting smoking within a perimeter around buildings on national health service hospital grounds is an important step towards continuing to denormalise smoking behaviour and achieving our ambitious target.
As I have said before, the bill is not about stigmatising smokers. Preventing ill health is a major challenge for our health services now and in the future. Tobacco remains the biggest cause of preventable disease and death in Scotland, and I am proud that the NHS has shown, and will continue to show, leadership in supporting and promoting healthy behaviours, particularly through tackling smoking.
For the first time in Scotland, the bill introduces controls that are specific to e-cigarettes, or nicotine vapour products—NVPs—as they are termed in the bill. There has been much debate among experts about the potential risk, and the potential benefits, of those new products. Such interesting and lively debate has also been evident during the Parliament’s consideration of the bill, but I am pleased that we have not allowed the debate to become sensational.
The Scottish Government has worked closely with experts and stakeholders and listened to their views to achieve the right balance in regulating NVPs. I am pleased that we can all agree that non-medicinal NVPs should not be available to children under the age of 18 and that over-18s should be prevented from purchasing such products on their behalf. Agreement has also been widespread on the benefits that are associated with placing further age controls on the sale and purchase of tobacco products.
The requirement for persons who intend to sell NVPs to be on the register of tobacco and NVP retailers was the focus of much of the debate on part 1 of the bill. That was because of concerns that the requirement to have a single register would send the message that NVPs are just as harmful as tobacco products are.
However, it has been agreed that a single register is required to reduce the burden on retailers and enforcement officers. As I indicated in my response to the Health and Sport Committee, that issue is about how the register is presented. I have already committed to providing a separation between the products on the website where the register is held. That does not require a change to the legislation and will be managed during implementation.
There is nothing in the bill that demonises NVPs or NVP users, and I have been clear that any public health gains should not be hindered by unnecessary regulation. However, it has been agreed that there is no place for marketing of the products to children, young people or non-smokers. The detail of such a prohibition will be set out in regulations.
The bill places a duty of candour on health and social care organisations. Increasingly, it is recognised that openness and transparency are essential elements of health and social care systems. The duty of candour will apply to organisations that provide healthcare, social care and social work services. It will help to promote an open learning culture and accountability for safer systems. It will be a driver for staff engagement in improvement work and will engender greater trust among patients and service users.
The bill requires an organisation that becomes aware that there has been an adverse event resulting in harm to follow the duty of candour procedure. The procedure, which will be set out in regulations, will require organisations to take action to meet, apologise to and support the affected person. It will detail the requirements for recording and monitoring incidents and the provision of training and support to staff who carry out the procedure. The bill also requires all organisations to report publicly on the number and nature of the events that have been disclosed to people and to confirm that the obligations of the organisational duty of candour have been met.
It is worth remembering that legislation forms only one part of the duty of candour. We will work with stakeholders to produce guidance and national training resources to assist organisations in the implementation of the duty. Many organisations already have procedures in place for handling complaints or responding to adverse or significant events. Therefore, the additional administrative demands of the duty should be minimal for most.
Care, compassion and dignity are central to the vast majority of the health and social care that is delivered every day throughout Scotland. The bill’s provisions on ill treatment or wilful neglect strengthen corporate accountability in health and social care and allow the criminal justice system to hold individuals and organisations to account when they are responsible for serious and deliberate neglect or ill treatment in providing care.
Those offences are not about catching people who are doing the best they can in a busy environment; they are about dealing with situations where someone intentionally sets out to neglect or ill treat a person who is in their care. When neglect or abuse has taken place, it is important that there is access to justice for victims of such neglect or abuse. The bill will help to achieve that.
The provision of communication equipment and the associated support that is required to use that equipment are key requirements of children and adults who have lost their voice or who have difficulty speaking. The bill places an explicit duty on Scottish ministers to provide or secure the provision of communication equipment and associated support. In addition, under the existing powers of the National Health Service (Scotland) Act 1978, Scottish ministers will issue directions to health boards in the near future to support the discharge of that duty. Those directions will be developed in consultation with a group of stakeholders and will contain the correct level of detail to address the operational issues that we know are a concern. The group will meet next week to start the development process.
Loss of voice has a huge impact on the affected individuals, and the bill will ensure that those who are in need have access to the appropriate equipment. Importantly, they will also have access to the support that they require to enable them to lead as independent a life as possible and to participate in society.
I move,
That the Parliament agrees that the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill be passed.
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