Hansard

Agreement to amendment 56 would mean that, as part of their duties in respect of transplantation and donation, the Scottish ministers should have a campaign of awareness raising and information at least once every calendar year. Amendment 57 would set a duty on the Scottish ministers to promote regular opportunities for persons to make, or to review, their decision to donate or not to donate, and to consider how such opportunities can be provided when a person is receiving healthcare services. Under the Human Tissue (Scotland) Act 2006, Scottish ministers have a duty to promote information and awareness about donation for transplantation. Proposed new section 1(d) of the 2006 act—as set out in section 2 of the bill—will add to that by requiring Scottish ministers to promote information and awareness about how authorisation for transplantation may be given, including deemed authorisation. Awareness raising that is carried out in accordance with the duty will make it clear to people what their choices are, and what the implications of the new system will be. One of the strengths of the Human Tissue (Scotland) Act 2006 has been the duty on Scottish ministers to promote awareness and information about donation. As a result of the importance that has been placed on that by successive Administrations, and of the evidence-based approach to awareness raising, efforts to fulfil the duty have resulted in high public awareness of donation, which is demonstrated by year-on-year increases in people recording their decisions on the organ donation register. The duty is fulfilled in a range of ways—from specific initiatives being targeted at various groups of the population, to high-profile media campaigns. Awareness raising is on-going and includes promotion at public sporting or entertainment events, and information being provided in general practitioner surgeries, pharmacies and other public places, which is similar to what David Stewart calls for in amendment 57. In addition, information is given through various media activities, including on social media, that happen regularly throughout the year. We will build on that as we raise awareness about the opt-out system. As well as broad awareness raising, it is crucial that we undertake work to reach specific groups. We are committed to working with different groups including disability and faith groups, and to research, develop and test clear and accessible information, which will be available in a range of languages. I know that the committee has made a number of helpful suggestions in that regard. We are also committed to learning from Wales about its engagement strategy—in particular, regarding reaching minority groups. Officials are also in regular dialogue with English counterparts about developments there. We will continue to work with Kidney Research UK, which will provide updated training for peer educators in order to raise awareness of donation among south Asian communities. Specific work will target young people—I think that that point was made by Jeremy Balfour. We will update the secondary schools education pack; as we did previously, we will work with Education Scotland to do that. We are also looking to identify ways to inform young people of the law shortly before they reach their 16th birthday, and to continue to keep them informed on an on-going basis. The bill’s financial memorandum takes that into account. Our intention, which is backed up by the new duty in section 2, is that regular awareness raising about the opt-out system will be a priority, so opportunities will continue to be taken to promote information and understanding of the opt-out system and the choices under it. That will be supported by monitoring of changes in public attitudes—which was mentioned by Emma Harper—and awareness, as part of the planned evaluation of the opt-out system, which means that we can be responsive, if there is a need to adopt that approach. I support the principles of amendment 56 to have an awareness and information campaign at least once every calendar year, so I am happy to recommend that it be agreed to. However, given the crossover between the provisions in the bill and the amendment, I think that it would be preferable to refine the text at stage 3. I will be happy to work with Lewis Macdonald before stage 3 in order to achieve that. I thank David Stewart for lodging amendment 57. I hope that I have been able to provide reassurance about our continuing commitment to use every opportunity to raise awareness—in particular, about the new system. I consider that the duties in the bill and on-going practice already meet the intentions of the amendment, so I ask him not to move amendment 57. In light of the fact that I hope to have discussions with the convener in relation to amendment 56, I will also be happy to meet David Stewart, to ensure that any refinement of the text takes into account his points and anything that is missed by the committee not passing amendment 57. Amendment 4 would require Scottish ministers to send information at least once in every two-year period to persons who are registered on the electoral roll. In light of the intended awareness raising and the general approach that I have outlined, although I appreciate the aim of the amendment, I consider it to be too limiting. Even if the law allowed access to the electoral register for that purpose—I understand that it does not—the information would not reach people who had decided not to include their details on the electoral roll, as has been mentioned. In addition, the proposal in amendment 4 would have a high cost—estimated, at current rates, at about £2.5 million every two years—and would have the effect of reducing the ability of the Scottish ministers to raise awareness in other ways. The awareness-raising work that we undertake is based on evidence of what works best. I do not want inadvertently to limit us by being required to use specific awareness-raising methods that might not be the most effective ones. I reassure Mr Balfour that, as well as the awareness-raising methods that I outlined, there will be a direct mailing to all households within a 12-month period, which will mean that even those who are not on the electoral roll will have access to the information. That is accounted for in the financial memorandum. On that basis, I ask Jeremy Balfour to consider seeking to withdraw amendment 4. Amendments 7 and 8 are direct alternatives that would increase to two or three years the time that a person need ordinarily be resident in Scotland before deemed authorisation for transplantation would apply. I appreciate that Mr Balfour is concerned that people who are newly resident in Scotland might be subject to deemed authorisation when they are not aware of the system. When developing the bill, a key consideration was the need for the protection of certain groups of people who might not be aware of or understand “deemed authorisation”. The “ordinarily resident” requirement is part of those protections, and the required duration of 12 months is in line with the legislation in Wales and England, as Mr Balfour said. Establishment of what length of time spent living in Scotland is sufficient before deemed authorisation will apply requires that a balance be struck. Mr Balfour’s amendments 7 and 8 seek to lengthen the period to either two or three years. The proposal in the Transplantation (Authorisation of Removal of Organs etc) (Scotland) Bill, which was introduced by Anne McTaggart in the previous parliamentary session, was six months. The Health and Sport Committee at that time considered that to be an insufficient period and recommended that it be increased to 12 months. I appreciate and accept that there are differing views on what is appropriate, but I am not persuaded that the duration should be increased from 12 months. A 12-month residency requirement has been in place in Wales since 2015 and we are not aware that difficulties have arisen from the approach there. Additionally, the bill contains safeguards that aim to ensure that donation does not proceed when that would be against the potential donor’s wishes. The safeguards include awareness-raising duties to ensure that there is public awareness of the implications of the new system, and of the duty to inquire, which applies in all cases and seeks to ensure that the views of the potential donor will establish whether donation is authorised. I hope that the information on awareness raising that I have already outlined provides assurance on that point. For people who are newly resident, we are looking at what has been undertaken in Wales, which uses various channels for awareness raising, including new GP registrations, universities, estate agents and major employers. Such activity would supplement the broader on-going awareness-raising campaign. I hope that that provides reassurance that the system will include sufficient safeguards alongside the awareness-raising work and that, therefore, the requirement for residency of a duration of 12 months should be retained. On that basis, I ask Mr Balfour not to move amendments 7 and 8. If they are moved, I urge members to resist them. Finally, amendment 63 would prevent the opt-out system from being implemented before a two-year awareness-raising period has passed, which would begin from royal assent. We have always been clear that there needs to be a high-profile public information campaign over at least 12 months before commencement of the system, so I was pleased that the committee welcomed that commitment in its stage 1 report. The approach was also proposed in the Scottish Government’s consultation, and attracted significant support. I understand that there is in the Welsh legislation a similar requirement to what is proposed in amendment 63. However, there has been more exposure of the opt-out system since then. There have been many conversations in Scotland over the past few years about the introduction of opt-out, including in this Parliament. Most recently, an awareness-raising campaign, which will run for 12 months, was embarked on in England. I reassure members that, although we have committed to an awareness-raising campaign of at least 12 months before the introduction of the opt-out, that is not limiting. I am grateful to Lewis Macdonald for taking the time to discuss his amendment 63 with me, and I am happy to give the assurance that, in addition to the 12-month campaign, we intend to provide information about the move to the new system in a variety of ways, which will start as soon as the bill receives royal assent. As I said, I am pleased that the committee welcomes the Government commitment to having a high-profile awareness-raising campaign. I am satisfied that the awareness-raising duties in the bill, along with the commitments that the Scottish Government has made, including to raise awareness over a period of at least 12 months, support the bill’s aims and will ensure that people are aware of the new system and their choices within it. Although I agree that awareness raising is needed, I hope that members will agree with me that the balance is right, given the additional assurances that I have given today, so I ask Lewis Macdonald not to move amendment 63. If he moves it, I ask that members reject it. 10:30