Chamber
Plenary, 23 Nov 2006
23 Nov 2006 · S2 · Plenary
Item of business
Adult Support and Protection (Scotland) Bill: Stage 1
When I first started to read the bill, I realised that there was a need for people to be able to enter patients' homes to assess them but, as I read through the bill, I began to wonder how on earth its provisions could be implemented with due care and attention, such that such action represented the least restrictive option.
The legislation that I used as a general practitioner will probably be knocked out by the bill. The Law Society of Scotland highlighted in evidence and has subsequently reiterated that the bill will mean that it will no longer be possible to use section 47 of the National Assistance Act 1948 to remove adults who are not mentally disordered or incapable, but who through self-neglect are living
"in circumstances of serious squalor and risk to health."
The Law Society has made it clear that if the bill is enacted, people in that position will not be covered.
Although the definitions must be examined, I am happy to give the bill my support at stage 1 because the minister has suggested that he will tackle that issue and a few others, including the powers of local authority officials. The fact that council officials will have the ability to question the autonomy of a person who has capacity is extremely worrying, especially given that, as I read the bill, that could take place anywhere—in a nursing home, for example, or even in the ward of a hospital. There will be no restriction on the premises that a local authority official may enter if there is any suggestion that someone with capacity is endangered at any time of their life.
Although I welcome the provision, people will have to be properly trained. Such training should be available not only to local authority officials, but to GPs, because it might be appropriate for a person's GP to accompany the local authority official on such an occasion. Quite often, the GP will be well known to the person. If the right people enter a person's house to assess them, it might well not prove necessary to go through all the court procedures that give rise to the doubts that I have about overriding a person's autonomy. If someone does not want to be removed, it is quite a serious matter to create a power to allow them to be removed. I believe that people's human rights are under threat—we have been told that human rights will not be violated, but I am not sure about that.
People will need to understand the legislation and realise that the bill fills a gap. Given that they will need to be sure that they know which piece of legislation they are acting under, they will need advice before they move.
In the past, I would have thought that it was rarely necessary to enter someone's home without their consent, but I can see that in the future, with so much work being done in the community and so many people under strain because they do not have the support that they need, even carers who care very much for people may in some circumstances put themselves and the person for whom they are caring at risk. They therefore need support.
We need to know where people are going to be removed to, and it needs to be up front that it is of a high standard, equal to their current accommodation. As we already have difficulty finding accommodation for people who need respite, who are homeless or who need to be removed for other reasons, I do not know where such accommodation will be found.
It is great that professionals will be working together but, like the General Medical Council, I am wary about confidentiality of health records. That has been mentioned by other members. From the point of view of a patient's rights, we have to be careful about giving out information. Their wish not to have information passed on could be overridden. On the whole, professionals try to be careful about that.
The legislation that I used as a general practitioner will probably be knocked out by the bill. The Law Society of Scotland highlighted in evidence and has subsequently reiterated that the bill will mean that it will no longer be possible to use section 47 of the National Assistance Act 1948 to remove adults who are not mentally disordered or incapable, but who through self-neglect are living
"in circumstances of serious squalor and risk to health."
The Law Society has made it clear that if the bill is enacted, people in that position will not be covered.
Although the definitions must be examined, I am happy to give the bill my support at stage 1 because the minister has suggested that he will tackle that issue and a few others, including the powers of local authority officials. The fact that council officials will have the ability to question the autonomy of a person who has capacity is extremely worrying, especially given that, as I read the bill, that could take place anywhere—in a nursing home, for example, or even in the ward of a hospital. There will be no restriction on the premises that a local authority official may enter if there is any suggestion that someone with capacity is endangered at any time of their life.
Although I welcome the provision, people will have to be properly trained. Such training should be available not only to local authority officials, but to GPs, because it might be appropriate for a person's GP to accompany the local authority official on such an occasion. Quite often, the GP will be well known to the person. If the right people enter a person's house to assess them, it might well not prove necessary to go through all the court procedures that give rise to the doubts that I have about overriding a person's autonomy. If someone does not want to be removed, it is quite a serious matter to create a power to allow them to be removed. I believe that people's human rights are under threat—we have been told that human rights will not be violated, but I am not sure about that.
People will need to understand the legislation and realise that the bill fills a gap. Given that they will need to be sure that they know which piece of legislation they are acting under, they will need advice before they move.
In the past, I would have thought that it was rarely necessary to enter someone's home without their consent, but I can see that in the future, with so much work being done in the community and so many people under strain because they do not have the support that they need, even carers who care very much for people may in some circumstances put themselves and the person for whom they are caring at risk. They therefore need support.
We need to know where people are going to be removed to, and it needs to be up front that it is of a high standard, equal to their current accommodation. As we already have difficulty finding accommodation for people who need respite, who are homeless or who need to be removed for other reasons, I do not know where such accommodation will be found.
It is great that professionals will be working together but, like the General Medical Council, I am wary about confidentiality of health records. That has been mentioned by other members. From the point of view of a patient's rights, we have to be careful about giving out information. Their wish not to have information passed on could be overridden. On the whole, professionals try to be careful about that.
In the same item of business
The Deputy Presiding Officer (Trish Godman):
Lab
The next item of business is a debate on motion S2M-5042, in the name of Andy Kerr, that the Parliament agrees to the general principles of the Adult Support...
The Deputy Minister for Health and Community Care (Lewis Macdonald):
Lab
We introduced the Adult Support and Protection (Scotland) Bill principally to provide support and protection for those people in our communities who are vuln...
Christine Grahame (South of Scotland) (SNP):
SNP
Has the minister discussed the civil shrieval procedures that would have to take place? I see no mention of them. Will they be like interim interdicts? How w...
Lewis Macdonald:
Lab
We have taken appropriate advice on the procedures, to which I will be happy to return in the course of the afternoon to give Christine Grahame more detail o...
Shona Robison (Dundee East) (SNP):
SNP
The bill has had what I would describe as a difficult birth. Perhaps that is because, as I understand it, its origins lay with the Bichard proposals, from wh...
Mrs Nanette Milne (North East Scotland) (Con):
Con
This may be a somewhat repetitive debate.As we know, the general purpose of the bill is to provide an overall framework of support and protection for adults ...
Euan Robson (Roxburgh and Berwickshire) (LD):
LD
I am particularly pleased to take part in the debate. Legislation in this important area is clearly necessary.The reforms in part 1 of the bill are, frankly,...
The Deputy Presiding Officer:
Lab
It may be helpful if I indicate that at this stage in the debate I am not applying the normal time limits.
Euan Robson:
LD
Thank you. In that case, I will be slightly more expansive than I would otherwise have been.It is clear that statutory adult protection committees will be va...
Roseanna Cunningham (Perth) (SNP):
SNP
It is often said that the committee system is the heart and soul of what happens in the Scottish Parliament, combining as it does the functions of select and...
Janis Hughes (Glasgow Rutherglen) (Lab):
Lab
In my time on the Health Committee, we have scrutinised a raft of legislation on many subjects, and the bill is definitely up there with those that have enge...
Christine Grahame (South of Scotland) (SNP):
SNP
As some members might know, I come to the bill against the background of the Miss X case, in which a lady with learning difficulties suffered horrific abuse ...
Section 9, entitled “Examination of records etc”, says in subsection (1):
"A council officer may require any person holding health, financial or other records relating to an individual whom the officer knows or believes to be an ad...
Lewis Macdonald:
Lab
I seek clarification from Christine Grahame as to which places she thinks should not be included in the bill, because I think that the intention is evident.
Christine Grahame:
SNP
Such situations occur when people have capacity and against their will, but the bill would allow a council officer to go to their bank and look at their bank...
Euan Robson:
LD
The point is that if we put such committees on a statutory footing, there will be no doubt that they should exist. Although the Borders committee was born of...
Christine Grahame:
SNP
I cannot agree. The process is happening in many places in Scotland. The chief social work inspector could make plain through her guidance that that is what ...
Christine May (Central Fife) (Lab):
Lab
I think that I may be the only non-member of the Health Committee to participate in the debate so far.
Roseanna Cunningham:
SNP
No. Christine Grahame is not on the committee.
Christine May:
Lab
I beg Christine Grahame's pardon.It may come as a surprise to members, although I hope that it does not, to learn that we are all getting older. We hope that...
Dr Jean Turner (Strathkelvin and Bearsden) (Ind):
Ind
When I first started to read the bill, I realised that there was a need for people to be able to enter patients' homes to assess them but, as I read through ...
Christine May:
Lab
Does Dr Turner agree that some of the dreadful cases in the past have arisen because of reluctance to share such information?
Dr Turner:
Ind
Christine May is correct. People need training in how they should use and share information. I believe that people should share information. I also believe t...
Helen Eadie (Dunfermline East) (Lab):
Lab
I am in no doubt why the people of Scotland need the Adult Support and Protection (Scotland) Bill. It is clear to me, having sat through the Health Committee...
Christine May:
Lab
Yes I am.
Helen Eadie:
Lab
I am so sorry—I meant Christine Grahame, not Christine May.The response to those questions by Adrian Ward of the Law Society of Scotland was compelling. He s...
Shona Robison:
SNP
In which cases would the member think it appropriate to override the views of an adult with capacity who did not want an intervention?
Helen Eadie:
Lab
I will return to that point later in my speech. The point was covered by a Mr Graham, a physician who gave evidence to the committee on the bill.Mr Ward cont...
Robin Harper (Lothians) (Green):
Green
During the previous session of Parliament, in 2002 to 2003, I tried to have hate crime legislation extended to all the groups that are identified under Europ...
Euan Robson:
LD
It should be clear to the minister from the debate that parts 2 to 4 of the bill will not cause him a great deal of difficulty. The interest will focus on pa...