Hansard

First, I wish to draw attention to my entry in the register of members' interests relating to the financial support given to me by Unison to aid the development of the Health Board Elections (Scotland) Bill that is before the Parliament today.

I wish to record my thanks to the 160 individuals and organisations who took part in the consultation on the bill proposal, and the various organisations that took part in the ad hoc bill steering group, such as Voluntary Health Scotland, the National Childbirth Trust, the Scottish Trades Union Congress, the Royal National Institute of the Blind Scotland, Capability Scotland and Help the Aged Scotland. Their contributions have been invaluable. There has also been support from the printed media, most notably from the Evening Times and The Herald, for which I am duly grateful.

I welcome the Health Committee's stage 1 report and the diligence of all its members in their detailed interrogation of the bill at stage 1. I am pleased that the committee recommends that Parliament should agree to the general principles of the bill and allow it to go forward to stage 2. However, I am very aware that the committee expressed several continuing concerns in three specific areas, and voiced its belief that changes should be considered in those areas if the bill is to proceed to stage 2. If I may, I will address those concerns and make an initial response to them.

To quote the committee report, the first issue is:

"The absence of any remuneration, loss of earnings or expenses for elected members discriminates against people with low earnings and favours candidates who are retired and well off."

When I appeared before the committee on 14 November, I acknowledged in response to a question from my colleague Helen Eadie that the lack of remuneration or compensation for loss of earnings was a gap, and that I would seek to bridge that gap at stage 2. That is still my intention. My suggestion will probably centre on introducing loss of earnings compensation capped at just over £7,000 per annum, which is the average for appointing members to health boards. Given that members will serve an average of three days per calendar month, that would mean that people who earn up to £80,000 per annum could put themselves forward to serve. I hope that such a proposition would be at least a starting point for debate in the Health Committee at stage 2, and I thank the committee for pointing out that omission.

The second area in which I agree with the committee that more discussion is needed concerns the bill's proposal to have 14 constituencies mirroring the existing 14 area NHS board boundaries. I was struck by the apprehensions that were voiced by several colleagues on the committee, particularly Kate Maclean and Roseanna Cunningham, that such constituencies would not accurately reflect the diverse geographical areas that many national health service boards encompass. I am open to the suggestion on page 15 of the Health Committee's report that

"it would be fairer to sub-divide those board areas into a number of more representative electoral ‘wards'. These smaller areas could for example reflect local authority boundaries or the rural:urban characteristics of particular board areas."

I am only too happy to discuss with the committee at stage 2 how such an amended geography could be effected. I have no problem with that notion in principle. My legal adviser, Mike Dailly of the Govan law centre, has been turning his mind to that very matter, among others, in anticipation of stage 2.

The third area of concern that was raised by the committee—the percentage of board members to be directly elected—might prove to be more challenging. I agree with the committee that there is a debate to be had on that, but I remain of the view that 50 per cent plus one, or a simple majority, would produce a reasonable blend of appointed members with their experience of the NHS and a directly elected element that would inject a welcome degree of direct accountability to the workings of the board. However, if the bill proceeds to stage 2, I stand ready and willing to enter into the debate on the matter in a spirit of collegiality.

I believe that there is strong support across Scottish society for the introduction of direct public elections to Scotland's NHS boards. I also believe that the case for greater democracy, accountability and transparency in the decision-making process for local health services is compelling. I continue to believe that the best way to achieve greater accountability and transparency is through the introduction of direct public elections.

The Health Board Elections (Scotland) Bill would significantly increase public involvement in local NHS services. It would involve people in the planning and delivery of health care services in their communities. The bill's main aim of introducing more democracy into the operation of health boards does not mean—I emphasise this—that I believe that all board decisions are necessarily wrong and detrimental to local health services. That would be absurd.