Chamber
Plenary, 31 Jan 2007
31 Jan 2007 · S2 · Plenary
Item of business
Health Board Elections (Scotland) Bill: Stage 1
I cannot agree with that.
There are arguments against the bill. The national health service is centrally planned. Elected members could inhibit centrally planned initiatives and entrench a postcode-lottery system. Turnout for the elections would almost certainly be low, which would mean that it would be easy for special-interest or single-interest groups to gain influence and further their agendas.
The majority of trusts cover a mixture of urban and rural areas, in which there are different conditions. Because urban areas contain denser populations, there is a real danger that rural communities' needs and requirements could be overlooked. Elections every four years could lead to short-term planning and reactive policies, which could damage the system's fluidity. Rolling budgets over the four-year term should therefore be considered. Furthermore, the cost of the elections—which has been estimated at between £1.2 million and £2.4 million—would remove valuable resources from the front line and patient treatment. I call on the Executive to re-examine the bill's key areas and to lodge appropriate amendments at stage 2.
I hope that the bill will raise the Executive's awareness, which is urban based, of the financial and operational challenges that are involved in serving a wide urban, rural and island mix of areas. It is essential that rural areas are not neglected, as they have been by recent Executive legislation and policies.
As members have said, it is important to rationalise trust boundaries to reflect accurately urban and rural demands and aspirations. It is also important that NHS budgets do not suffer, particularly at a time when they are very stretched. The financing of elections must reflect rural sparsity. We must not fall into the free personal care trap so that rural councils such as Argyll and Bute struggle to cope.
Refusing to remunerate board members would reduce the ability of elections to provide members from a wide range of backgrounds and with wide experiences. The costs involved in such an approach must be considered.
As I said, we broadly support the principle of local communities getting more involved and taking more action in the provision of public services. Our argument is that a system in which big government tells local people what to do and how to do it does not work. It is important that the new system does not disadvantage our rural areas, potential elected members on low incomes and already stretched health budgets. I look forward to re-examining the bill at stage 3 and hope that the Executive will take my suggestions on board.
There are arguments against the bill. The national health service is centrally planned. Elected members could inhibit centrally planned initiatives and entrench a postcode-lottery system. Turnout for the elections would almost certainly be low, which would mean that it would be easy for special-interest or single-interest groups to gain influence and further their agendas.
The majority of trusts cover a mixture of urban and rural areas, in which there are different conditions. Because urban areas contain denser populations, there is a real danger that rural communities' needs and requirements could be overlooked. Elections every four years could lead to short-term planning and reactive policies, which could damage the system's fluidity. Rolling budgets over the four-year term should therefore be considered. Furthermore, the cost of the elections—which has been estimated at between £1.2 million and £2.4 million—would remove valuable resources from the front line and patient treatment. I call on the Executive to re-examine the bill's key areas and to lodge appropriate amendments at stage 2.
I hope that the bill will raise the Executive's awareness, which is urban based, of the financial and operational challenges that are involved in serving a wide urban, rural and island mix of areas. It is essential that rural areas are not neglected, as they have been by recent Executive legislation and policies.
As members have said, it is important to rationalise trust boundaries to reflect accurately urban and rural demands and aspirations. It is also important that NHS budgets do not suffer, particularly at a time when they are very stretched. The financing of elections must reflect rural sparsity. We must not fall into the free personal care trap so that rural councils such as Argyll and Bute struggle to cope.
Refusing to remunerate board members would reduce the ability of elections to provide members from a wide range of backgrounds and with wide experiences. The costs involved in such an approach must be considered.
As I said, we broadly support the principle of local communities getting more involved and taking more action in the provision of public services. Our argument is that a system in which big government tells local people what to do and how to do it does not work. It is important that the new system does not disadvantage our rural areas, potential elected members on low incomes and already stretched health budgets. I look forward to re-examining the bill at stage 3 and hope that the Executive will take my suggestions on board.
In the same item of business
The Deputy Presiding Officer (Trish Godman):
Lab
The next item of business is a debate on motion S2M-5478, in the name of Bill Butler, that the Parliament agrees to the general principles of the Health Boar...
Bill Butler (Glasgow Anniesland) (Lab):
Lab
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 developm...
Mr David Davidson (North East Scotland) (Con):
Con
Bill Butler said that he would be prepared to accept various amendments at stage 2, but what would he do if health boards as we know them were abolished? The...
Bill Butler:
Lab
I believe that the CHPs are not inimical to the reasonable reform that I have suggested. In response to David Davidson's first question, I point out that no ...
Margo MacDonald (Lothians) (Ind):
Ind
The member has pointed out the need for democracy, openness and accountability. Might they not be provided by a better system of accountability and report ba...
Bill Butler:
Lab
The improvements that have taken place in public participation—I think that that is what the member alludes to—are to be welcomed. In fact, every witness who...
The Minister for Health and Community Care (Mr Andy Kerr):
Lab
It is perhaps no surprise to anyone in the chamber that the Executive is opposed to the bill. I will spend some time explaining the reasons for our position....
Brian Adam (Aberdeen North) (SNP):
SNP
Why does the minister think that it is perfectly acceptable for Edinburgh's man in Glasgow, for example, to be accountable to the public through the minister...
Mr Kerr:
Lab
Because it is the national health service. Week after week in this chamber I hear from members about postcode prescribing, about boards not doing what they s...
Bill Butler:
Lab
Does the minister agree that the estimated cost of £5 million, which is at the top end of the Executive's approximations, would be a drop in the ocean compar...
Mr Kerr:
Lab
Yes, it does. However, the Electoral Reform Society does not believe in Mr Butler's approach to the elections, which could be even more expensive than has be...
The Deputy Presiding Officer:
Lab
You should be finishing now, minister.
Mr Kerr:
Lab
The bill is emphatically not the answer to the concerns that have been expressed. Our opposition to the bill is long standing and principled and there are go...
Shona Robison (Dundee East) (SNP):
SNP
I pay tribute to the work of Bill Butler and his bill team in developing the bill.The Scottish National Party has supported the principle of direct elections...
Margo MacDonald:
Ind
I simply want us to get our statistics in order. Do we know what percentage of the public is satisfied that they are properly represented in the decisions th...
Shona Robison:
SNP
I am sure that there are a number of views about that and that many members of the public feel that they are not properly represented in the Parliament's dec...
Mike Rumbles (West Aberdeenshire and Kincardine) (LD):
LD
I am surprised by what the member has said, because it is my understanding that Bill Butler is not willing to discuss having a fair voting system and that we...
Shona Robison:
SNP
Mr Rumbles knows how the Parliament works. It is a question of trying to persuade people of the merits of one's arguments at stage 2. That is all one can do....
Mr Duncan McNeil (Greenock and Inverclyde) (Lab):
Lab
Will the member give way on that point?
Shona Robison:
SNP
I have taken two interventions and I need to make some progress. Interruption.
The Deputy Presiding Officer:
Lab
The member is not taking an intervention.
Shona Robison:
SNP
Surely the same arguments and concerns could be raised against involving the democratic process in the management of education or social work. Even so, I ass...
The Deputy Presiding Officer:
Lab
The member should be closing.
Shona Robison:
SNP
Surely that option is preferable to that which the minister is taking in fudging the issue by calling for pilots. Clearly, he is diametrically opposed to the...
Mrs Nanette Milne (North East Scotland) (Con):
Con
I came to the stage 1 consideration of the bill with a completely open mind. I fully understand Bill Butler's reasons for introducing it. Over the past year ...
Mike Rumbles:
LD
Will the member take an intervention?
Mrs Milne:
Con
No. There have been exceptions, including the fight to retain the option of giving birth in community hospitals in Aboyne and Fraserburgh in Aberdeenshire. I...
Mr Kerr:
Lab
Is the member aware that, in all the major configurations—including the one that Lewis Macdonald conducted in Lanarkshire—major concessions were made in favo...
Mrs Milne:
Con
I hear what the minister is saying, but I am dealing with a point on Aberdeenshire. The outcome in that case was successful, but only because of a committed ...
Mr Jamie Stone (Caithness, Sutherland and Easter Ross) (LD):
LD
Will Nanette Milne give way?