Hansard

This afternoon sees the completion of the fifth piece of legislation to be scrutinised by the Health and Sport Committee in the last few months of this parliamentary session. I echo the thanks that have already been expressed to all those who have contributed to our understanding of the bill’s provisions and to those who have worked to make improvements to it as it has made its way through the parliamentary process. I feel particularly indebted to the committee clerks, who have shouldered a heavy workload recently, and to the witnesses who provided written and oral evidence as the committee scrutinised the bill in its early stages.

The Health (Tobacco, Nicotine etc and Care) (Scotland) Bill contains three important parts. As we know, part 1 progresses the Scottish Government’s anti-smoking strategy by introducing policies on tobacco, nicotine and smoking; part 2 introduces a duty of candour to encourage a culture of openness within the NHS and social care services; and part 3 brings in a new offence of wilful neglect and ill treatment, which is aimed at health and social care professionals and providers of care.

When I was preparing for this short debate, I found the briefings from Action on Smoking and Health Scotland and the Royal College of Nursing very useful. Those briefings neatly sum up the general response to the provisions of the bill as it comes to the end of its parliamentary scrutiny.

Part 1, which deals with the regulation of electronic cigarettes and introduces a statutory ban on smoking within a designated distance from hospital buildings, is widely accepted and welcomed. ASH Scotland focuses on nicotine vapour products as a means of reducing the use of tobacco, which is a goal of everyone involved in public health. There is a growing body of anecdotal evidence that e-cigarettes have assisted people who were previously very heavy smokers to quit smoking when all other attempts have failed. Any potential harm from the use of NVPs will have to be monitored over time, but there seems to be little doubt that they are very much safer than tobacco products.

There are, however, concerns about people who use NVPs alongside tobacco, and particularly about attempts to recruit non-smokers into using nicotine via NVPs. That is why the bill’s proposals on age restrictions, a ban on self-service sales through vending machines and requiring people who sell e-cigarettes to register and adopt age verification policies are seen as sensible and proportionate.

I think that the proposed restrictions on marketing—particularly promotions aimed at young people—will be useful in preventing vaping from becoming a gateway to smoking, which appears to be happening in some countries, although not yet in the UK.

The ban on smoking in designated parts of hospital grounds will give statutory backing to the current position held by most NHS boards, which have introduced smoke-free policies in hospital grounds. That ban is receiving a general welcome, although concerns have been expressed to me about patients in psychiatric hospitals who find it extremely difficult to give up smoking. However, I agree with the health boards’ assertion that physical health is as important for people with a mental health problem as it is for other members of society. In that context, I find ASH Scotland’s suggestion of testing the success of weaning such patients on to e-cigarettes to help them quit tobacco an interesting proposal. That approach could also be tested in the prison population, where heavy smoking is the norm.

I fully accept that NVPs are much safer than tobacco-based products but, as yet, there is no knowledge of any potentially harmful effects of vaping. Therefore, the evolving use of NVPs needs to be monitored over time, and I hope that, in a few years’ time, the Parliament might find time to look at the effectiveness of the legislation in relation to public health.

Although some concerns have been expressed about the need to introduce a duty of candour, I think that there is a general acceptance that such a measure is needed to drive cultural change within health and social care services. However, the RCN still has serious reservations about part 3 of the bill, which introduces an offence of ill treatment and wilful neglect. It feels that it might work against building the culture of transparency that we all want to see in our health and social care services if people feel that they could be under the threat of litigation, particularly when they are faced with the stresses of a shortage in workforce capacity.

The duty to provide or procure communication aids and other support for those who need such assistance is, of course, a very welcome addition to the bill, and I am more than happy to endorse it. As the minister said, communication is essential for human wellbeing, and the inability to communicate can be quite devastating for those who are affected. A friend of mine had a stroke, following which he could understand what people were saying, but could not articulate a response. He was like that until his dying day, and it was very obvious that it was the most frustrating thing that he ever had to cope with in his life. Therefore, I feel very strongly about the matter.

I will go into a little more detail about the reservations that have been expressed about parts 2 and 3 in my closing remarks. Overall, I find the bill’s provisions acceptable, and the Scottish Conservatives will support it at decision time.