Chamber
Plenary, 09 Dec 1999
09 Dec 1999 · S1 · Plenary
Item of business
Adults with Incapacity (Scotland) Bill: Stage 1
As Roseanna Cunningham said, we made a commitment in our manifesto for the Scottish Parliament to support an incapable adults bill, with the proviso that the bill should not include legislation on advance statements. That was done for a simple reason: we did not wish the focus of the bill to be distorted by the inclusion of what, obviously, is a controversial issue. I was delighted in June when the First Minister stated that the bill would not include legal provisions for advance statements.
However, there are still concerns that the bill could lead to what some call back-door euthanasia, particularly because nutrition and hydration are defined in the bill as medical treatments. The concerns have not been lessened this week by claims in the press that food and drink have been withdrawn from elderly people in national health service care who were not terminally ill. In spite of the minister's concession today, which I welcome, that area will attract amendments at stage 2. My colleague Trish Marwick will expand on the issue later.
When the committee took evidence, concerns were expressed, particularly by the British Medical Association and the Scottish Neurosurgical Consultants Forum, that measures to help long- term incapacitated adults could inadvertently affect the emergency care of those with acute organic mental incapacity, for example, those admitted to hospital after bad road traffic accidents with severe head injuries. Decisions to treat in such cases often have to be taken at night and at
weekends, and often before relatives, proxies or guardians can be contacted. It is important to ensure that the measures in the bill for securing consent to treatment do not present an obstacle in emergencies. I hope that amendments at stage 2 will enable clarification of the necessity to treat in emergencies.
Section 48 is about authority for research. I welcome the minister's concession. As it currently stands, it would be illegal to conduct research for the benefit of other, and potential, sufferers rather than for the benefit of the adult with incapacity. I was impressed by the submission of Alzheimer Scotland. It pointed out that a great deal of non- therapeutic research is currently being carried out and that the cessation of such research could have serious consequences for future prevention and treatment.
For example, Alzheimer Scotland claims that, as it stands, the bill would outlaw the taking of blood samples, which could aid genetic research, and it would preclude all proper clinical trials of drug or other treatments. It also points out that many people with early dementia state that they would wish to give their consent to research being carried out at a later stage, even though they know that it is unlikely to be of direct benefit to them.
The Law Society of Scotland recognises those concerns and suggests that amendments could be made, as long as they involve minimal risk or discomfort to the patient and ensure that non- therapeutic research is subject to strict regulation.
In the short time allocated, I have highlighted a few of the health issues arising from the bill. The bill is not a political issue. I know that it has the support, in principle, of most—if not all—members of this Parliament.
I ask not only the minister but members to ensure that at stage 2 amendments are lodged to clarify and enhance the bill, and to give rights, status and protection to Scotland's 100,000 people with mental incapacity. The bill will also make life a great deal easier for their carers, as it should enable them to manage their loved one's finances and make welfare decisions on their behalf when they can no longer do so for themselves.
However, there are still concerns that the bill could lead to what some call back-door euthanasia, particularly because nutrition and hydration are defined in the bill as medical treatments. The concerns have not been lessened this week by claims in the press that food and drink have been withdrawn from elderly people in national health service care who were not terminally ill. In spite of the minister's concession today, which I welcome, that area will attract amendments at stage 2. My colleague Trish Marwick will expand on the issue later.
When the committee took evidence, concerns were expressed, particularly by the British Medical Association and the Scottish Neurosurgical Consultants Forum, that measures to help long- term incapacitated adults could inadvertently affect the emergency care of those with acute organic mental incapacity, for example, those admitted to hospital after bad road traffic accidents with severe head injuries. Decisions to treat in such cases often have to be taken at night and at
weekends, and often before relatives, proxies or guardians can be contacted. It is important to ensure that the measures in the bill for securing consent to treatment do not present an obstacle in emergencies. I hope that amendments at stage 2 will enable clarification of the necessity to treat in emergencies.
Section 48 is about authority for research. I welcome the minister's concession. As it currently stands, it would be illegal to conduct research for the benefit of other, and potential, sufferers rather than for the benefit of the adult with incapacity. I was impressed by the submission of Alzheimer Scotland. It pointed out that a great deal of non- therapeutic research is currently being carried out and that the cessation of such research could have serious consequences for future prevention and treatment.
For example, Alzheimer Scotland claims that, as it stands, the bill would outlaw the taking of blood samples, which could aid genetic research, and it would preclude all proper clinical trials of drug or other treatments. It also points out that many people with early dementia state that they would wish to give their consent to research being carried out at a later stage, even though they know that it is unlikely to be of direct benefit to them.
The Law Society of Scotland recognises those concerns and suggests that amendments could be made, as long as they involve minimal risk or discomfort to the patient and ensure that non- therapeutic research is subject to strict regulation.
In the short time allocated, I have highlighted a few of the health issues arising from the bill. The bill is not a political issue. I know that it has the support, in principle, of most—if not all—members of this Parliament.
I ask not only the minister but members to ensure that at stage 2 amendments are lodged to clarify and enhance the bill, and to give rights, status and protection to Scotland's 100,000 people with mental incapacity. The bill will also make life a great deal easier for their carers, as it should enable them to manage their loved one's finances and make welfare decisions on their behalf when they can no longer do so for themselves.
In the same item of business
The Deputy Presiding Officer (Mr George Reid):
SNP
We move to the next item of business, a debate on motion S1M-213, in the name of Mr Jim Wallace, which seeks the Parliament's agreement to the general princi...
The Deputy First Minister and Minister for Justice (Mr Jim Wallace):
LD
I am pleased to move this motion to approve the general principles of the Adults with Incapacity (Scotland) Bill. The bill is a major piece of law reform. It...
Mrs Margaret Ewing (Moray) (SNP):
SNP
Part of the problem that I have with the bill is the inclusion of people in discussions of how to decide to give power of attorney, for example. What does th...
Mr Wallace:
LD
Individual cases—it is important to stress that cases are considered individually—will differ according to the individual's incapacity and the particular cir...
Malcolm Chisholm (Edinburgh North and Leith) (Lab):
Lab
I welcome the change to section 44 and the deletion of the reference to nutrition and hydration by artificial means as a medical treatment. However, as that ...
Mr Wallace:
LD
Malcolm Chisholm is talking about situations in which there is a conflict of opinion between the doctor and the guardian on a proposed course of action. We h...
Roseanna Cunningham (Perth) (SNP):
SNP
It is only right that, as convener of the Justice and Home Affairs Committee, I take a few minutes in the chamber to comment on the committee's experience of...
The Deputy Presiding Officer:
SNP
Please close.
Roseanna Cunningham:
SNP
A great deal of concern has also been expressed about the definition of "medical treatment" in the bill. In large part, that is linked to the definition of "...
The Deputy Presiding Officer:
SNP
Will you close now, please?
Roseanna Cunningham:
SNP
The clock shows that I have 50 seconds left, Presiding Officer.
The Deputy Presiding Officer:
SNP
You are two minutes over.
Roseanna Cunningham:
SNP
We should recognise that many organisations feel that, whether it intends to or not, the bill will introduce euthanasia by the back door. Much of the evidenc...
Ben Wallace (North-East Scotland) (Con):
Con
I speak as the reporting member of the Health and Community Care Committee and as the deputy health spokesman for the Conservative party. When I welcome the ...
Mr Jim Wallace:
LD
I am happy to give the member that assurance.
Ben Wallace:
Con
Although we all agree with its aims, the proposed legislation throws up the ethical question of euthanasia. Despite the minister's assurances, there are part...
The Deputy Presiding Officer:
SNP
I call Nora Radcliffe.
Nora Radcliffe (Gordon) (LD):
LD
I did not expect to be called.
The Deputy Presiding Officer:
SNP
You are on the list to speak for the Liberal Democrats. Do you want to speak? If not, I can open the general debate.
Nora Radcliffe:
LD
I have not prepared a speech, but I will make some remarks, wearing my equal opportunities hat. I welcome, in particular, the bill's emphasis on the rights o...
The Deputy Presiding Officer:
SNP
Contrary to expectation, we can probably fit in two general speeches before lunch. I call Richard Simpson, to be followed by Kay Ullrich.
Dr Richard Simpson (Ochil) (Lab):
Lab
The bill is to be welcomed—that is clear—but there are some problems with it. I am not sure whether the bill will last as long as the Curators Act 1585, whic...
Kay Ullrich (West of Scotland) (SNP):
SNP
As Roseanna Cunningham said, we made a commitment in our manifesto for the Scottish Parliament to support an incapable adults bill, with the proviso that the...
The Presiding Officer (Sir David Steel):
NPA
I am sorry, but the chair is in some slight confusion. The debate will be resumed this afternoon.I advise members who have indicated a wish to speak that I h...